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1.
J Ethn Subst Abuse ; 22(3): 589-605, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-34469277

RESUMEN

Tribal Nations experience substance misuse at high rates often attributed to historical and contemporary traumas. In response, several Tribal Nations are addressing these issues through efforts to promote recovery and prevention to substance misuse. Study objectives were to partner with a Tribal Nation to develop a study to explore factors that contribute to the wellbeing of families to children with prenatal substance exposure and disseminate findings that can be translated back into the community. We applied Community-based participatory research (CBPR), strengths-based, and community-driven approaches during this two-year study development phase. We experienced challenges and identified solutions to partnering with one Tribal Nation on an epidemiological mixed-methods study centered on families with children that have prenatal substance exposure. Key inputs were becoming familiarizing with the community setting, structural supports for CBPR research, incorporating Indigenous CBPR principles, and developing a Community Advisory Team. We successfully collaborated with the Confederated Salish Kootenai Tribes Early Childhood Services program to develop a robust study design and a dissemination plan to ensure translation of study findings to the community. The robust study design consisted of common themes specific to a highly stigmatized study population, substance-abusing pregnant women, to protect participant confidentiality. Research alignment with community goals, allotting meaningful time to develop a research partnership, and incorporating culturally sensitive and community-relevant measures contributed to the successful development of an effective and rigorous study to better serve the Tribal Nation on addressing substance misuse.

2.
Org Biomol Chem ; 16(22): 4159-4169, 2018 06 06.
Artículo en Inglés | MEDLINE | ID: mdl-29786725

RESUMEN

We report a modular five step synthetic route to the febrifugines that employs 2-(chloromethyl)allyl-trimethylsilane as a conjunctive reagent for the coupling of the piperidine and quinazolinone groups. We also demonstrate the application of a recent Rh-catalyzed quinazolinone synthesis for the facile generation of febrifugine analogs.

3.
J Pharmacol Exp Ther ; 361(1): 68-86, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28138040

RESUMEN

The ability of the N-methyl-d-aspartate receptor antagonist ketamine to alleviate symptoms in patients suffering from treatment-resistant depression (TRD) is well documented. In this paper, we directly compare in vivo biologic responses in rodents elicited by a recently discovered metabotropic glutamate (mGlu) 2/3 receptor antagonist 2-amino-3-[(3,4-difluorophenyl)sulfanylmethyl]-4-hydroxy-bicyclo[3.1.0]hexane-2,6-dicarboxylic acid (LY3020371) with those produced by ketamine. Both LY3020371 and ketamine increased the number of spontaneously active dopamine cells in the ventral tegmental area of anesthetized rats, increased O2 in the anterior cingulate cortex, promoted wakefulness, enhanced the efflux of biogenic amines in the prefrontal cortex, and produced antidepressant-related behavioral effects in rodent models. The ability of LY3020371 to produce antidepressant-like effects in the forced-swim assay in rats was associated with cerebrospinal fluid (CSF) drug levels that matched concentrations required for functional antagonist activity in native rat brain tissue preparations. Metabolomic pathway analyses from analytes recovered from rat CSF and hippocampus demonstrated that both LY3020371 and ketamine activated common pathways involving GRIA2 and ADORA1. A diester analog of LY3020371 [bis(((isopropoxycarbonyl)oxy)-methyl) (1S,2R,3S,4S,5R,6R)-2-amino-3-(((3,4-difluorophenyl)thio)methyl)-4-hydroxy-bicyclo[3.1.0]hexane-2,6-dicarboxylate (LY3027788)] was an effective oral prodrug; when given orally, it recapitulated effects of intravenous doses of LY3020371 in the forced-swim and wake-promotion assays, and augmented the antidepressant-like effects of fluoxetine or citalopram without altering plasma or brain levels of these compounds. The broad overlap of biologic responses produced by LY3020371 and ketamine supports the hypothesis that mGlu2/3 receptor blockade might be a novel therapeutic approach for the treatment of TRD patients. LY3020371 and LY3027788 represent molecules that are ready for clinical tests of this hypothesis.


Asunto(s)
Antidepresivos/uso terapéutico , Antagonistas de Aminoácidos Excitadores/uso terapéutico , Ketamina/uso terapéutico , Receptores de Glutamato Metabotrópico/antagonistas & inhibidores , Receptores de N-Metil-D-Aspartato/antagonistas & inhibidores , Animales , Antidepresivos/farmacología , Depresión/tratamiento farmacológico , Depresión/metabolismo , Depresión/psicología , Antagonistas de Aminoácidos Excitadores/farmacología , Hipocampo/efectos de los fármacos , Hipocampo/metabolismo , Ketamina/farmacología , Masculino , Ratas , Ratas Sprague-Dawley , Ratas Wistar , Receptores de Glutamato Metabotrópico/metabolismo , Receptores de Glutamato Metabotrópico/fisiología , Receptores de N-Metil-D-Aspartato/metabolismo , Resultado del Tratamiento
4.
Eur Child Adolesc Psychiatry ; 26(2): 231-240, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27341841

RESUMEN

Diagnostic criteria for eating disorders (ED) remain largely based on clinical presentations, but do not capture the full range of behaviours in the population. We aimed to derive an empirically based ED behaviour classification using behavioural and body mass index (BMI) indicators at three time-points in adolescence, and to validate classes investigating prospective associations with adverse outcomes. Adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC) provided data on ED at age 14 (n = 6615), 16 (n = 5888), and 18 years (n = 5100), and had weight and height measured. Psychological and behavioural outcomes were assessed at 15.5/16 and 17.5/18 years. We fit gender- and age-stratified latent class models, and employed logistic regression to investigate associations between classes and later outcomes. One asymptomatic and two symptomatic (largely representing higher and lower frequency ED behaviours) classes were observed at each time-point, although their relative prevalence varied by age and gender. The majority of girls in symptomatic classes remained symptomatic at subsequent assessments. Girls in symptomatic classes had higher odds of subsequent anxiety and depressive disorders, binge drinking, drug use, and deliberate self-harm. Data analyses were underpowered amongst boys. The presence of two symptomatic classes (characterised by different ED behaviour frequency) and their prospective association with adverse outcomes suggest a need to refine diagnostic thresholds based on empirical data. Despite some instability of classes, particularly in mid-adolescence, evidence that half of girls in symptomatic classes remained symptomatic suggests persistence of ED behaviours in adolescence, and highlights a need for early identification to reduce chronicity.


Asunto(s)
Conducta del Adolescente/psicología , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Adolescente , Trastornos de Ansiedad/psicología , Índice de Masa Corporal , Peso Corporal , Niño , Trastornos de Alimentación y de la Ingestión de Alimentos/clasificación , Femenino , Humanos , Modelos Logísticos , Estudios Longitudinales , Masculino , Padres , Estudios Prospectivos , Conducta Autodestructiva/psicología , Trastornos Relacionados con Sustancias/psicología
5.
Epidemiol Rev ; 38(1): 62-9, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26769723

RESUMEN

Despite the magnitude and consistency of risk estimates in the peer-reviewed literature linking firearm availability and suicide, inferring causality has been questioned on the theoretical basis that existing studies may have failed to account for the possibility that members of households with firearms differ from members of households without firearms in important ways related to suicide risk. The current bias analysis directly addresses this concern by describing the salient characteristics that such an unmeasured confounder would need to possess in order to yield the associations between firearm availability and suicide observed in the literature when, in fact, the causal effect is null. Four US studies, published between 1992 and 2003, met our eligibility criteria. We find that any such unmeasured confounder would need to possess an untenable combination of characteristics, such as being not only 1) as potent a suicide risk factor as the psychiatric disorders most tightly linked to suicide (e.g., major depressive and substance use disorders) but also 2) an order of magnitude more imbalanced across households with versus without firearms than is any known risk factor. No such confounder has been found or even suggested. The current study strongly suggests that unmeasured confounding alone is unlikely to explain the association between firearms and suicide.


Asunto(s)
Armas de Fuego/estadística & datos numéricos , Suicidio/estadística & datos numéricos , Sesgo , Humanos , Factores de Riesgo , Suicidio/psicología
6.
Ann Surg ; 261(3): 605-10, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24670845

RESUMEN

OBJECTIVE: This study evaluated the hypothesis that protein concentration and mitochondrial content in gastrocnemius biopsies from patients with peripheral arterial disease (PAD) predict mortality rates. BACKGROUND: PAD patients experience advancing myopathy characterized by mitochondrial dysfunction, myofiber degradation, and fibrosis in their ischemic legs, along with increased mortality rates. METHODS: Samples from the gastrocnemius of PAD patients were used for all analyses. Protein concentration was normalized to muscle wet weight, and citrate synthase activity (standard measure of mitochondrial content in cells) was normalized to muscle wet weight and protein concentration. Protein and citrate synthase data were grouped into tertiles and 5-year, all-cause mortality for each tertile was determined with Kaplan-Meier curves and compared by the modified Peto-Peto test. A Cox-regression model for each variable controlled for the effects of clinical characteristics. RESULTS: Of the 187 study participants, 46 died during a mean follow-up of 23.0 months. Five-year mortality rate was highest for patients in the lowest tertile of protein concentration. Mortality was lowest for patients in the middle tertile of citrate synthase activity when normalized to either muscle wet weight or protein concentration. The mortality hazard ratios (HRs) from the Cox analysis were statistically significant for protein concentration normalized to muscle wet weight (lowest vs middle tertile; HR = 2.93; P = 0.008) and citrate synthase normalized to protein concentration (lowest vs middle tertile; HR = 4.68; P = 0.003; and lowest vs highest tertile; HR = 2.36; P = 0.027). CONCLUSIONS: Survival analysis of a contemporaneous population of PAD patients identifies protein and mitochondrial content of their gastrocnemius as predictors of mortality rate.


Asunto(s)
Mitocondrias/metabolismo , Proteínas Musculares/metabolismo , Músculo Esquelético/metabolismo , Enfermedades Musculares/metabolismo , Enfermedad Arterial Periférica/metabolismo , Enfermedad Arterial Periférica/mortalidad , Adolescente , Adulto , Biopsia , Niño , Femenino , Humanos , Iowa , Pierna/irrigación sanguínea , Masculino , Persona de Mediana Edad , Enfermedades Musculares/mortalidad , Nebraska , Valor Predictivo de las Pruebas , Tasa de Supervivencia
7.
Psychol Med ; 44(9): 1937-45, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24168779

RESUMEN

BACKGROUND: We examine prospectively the influence of two separate but potentially inter-related factors in the etiology of post-traumatic stress disorder (PTSD): childhood maltreatment as conferring a susceptibility to the PTSD response to adult trauma and juvenile disorders as precursors of adult PTSD. METHOD: The Dunedin Multidisciplinary Health and Development Study (DMHDS) is a birth cohort (n = 1037) from the general population of New Zealand's South Island, with multiple assessments up to age 38 years. DSM-IV PTSD was assessed among participants exposed to trauma at ages 26-38. Complete data were available on 928 participants. RESULTS: Severe maltreatment in the first decade of life, experienced by 8.5% of the sample, was associated significantly with the risk of PTSD among those exposed to adult trauma [odds ratio (OR) 2.64, 95% confidence interval (CI) 1.16-6.01], compared to no maltreatment. Moderate maltreatment, experienced by 27.2%, was not associated significantly with that risk (OR 1.55, 95% CI 0.85-2.85). However, the two estimates did not differ significantly from one another. Juvenile disorders (ages 11-15), experienced by 35% of the sample, independent of childhood maltreatment, were associated significantly with the risk of PTSD response to adult trauma (OR 2.35, 95% CI 1.32-4.18). CONCLUSIONS: Severe maltreatment is associated with risk of PTSD response to adult trauma, compared to no maltreatment, and juvenile disorders, independent of earlier maltreatment, are associated with that risk. The role of moderate maltreatment remains unresolved. Larger longitudinal studies are needed to assess the impact of moderate maltreatment, experienced by the majority of adult trauma victims with a history of maltreatment.


Asunto(s)
Trastornos de Ansiedad/epidemiología , Déficit de la Atención y Trastornos de Conducta Disruptiva/epidemiología , Maltrato a los Niños/estadística & datos numéricos , Trastorno Depresivo/epidemiología , Trastornos por Estrés Postraumático/epidemiología , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Nueva Zelanda/epidemiología , Estudios Prospectivos , Trastornos por Estrés Postraumático/etiología
8.
Dis Esophagus ; 27(6): 568-73, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23442059

RESUMEN

A systematic review of the literature was performed to assess the necessity of a pyloric drainage procedure during an esophagectomy with gastric conduit reconstruction. Earlier data recommend performing a pyloric drainage procedure for all esophagectomies; however, recent studies have questioned this. A thorough literature search (January 2001-November 2011) was performed using the terms esophagectomy, pyloroplasty, pyloromyotomy, botulinum toxin, and pyloric drainage. Only studies that compared patient outcome after undergoing an esophagectomy with a pyloric drainage procedure with those undergoing an esophagectomy without a pyloric drainage procedure were selected. Only four studies, comprising 668 patients in total, were identified that compared patient outcome after undergoing an esophagectomy with or without a pyloric drainage procedure, and two additional meta-analyses were identified and selected for discussion. All studies were retrospective, and because of the heterogeneity of studies, patient demographics, reporting, and statistical analysis of patient outcome, pooling of data and meta-analysis could not be performed. Careful analysis demonstrated that pyloric drainage procedure was associated with a non-significant trend for delayed gastric emptying and biliary reflux, while not affecting the incidence of dumping. No correlation was determined between a pyloric drainage procedure and anastomotic leaks, postoperative pulmonary complications, length of hospital stay, and overall perioperative morbidity. While there are risks associated with a pyloric drainage procedure and data exist supporting its omission during an esophagectomy, no good conclusion can be drawn from the current literature. Larger multi-institutional, prospective studies are required to definitively answer this question.


Asunto(s)
Drenaje , Esofagectomía/métodos , Píloro/cirugía , Reflujo Biliar/etiología , Drenaje/efectos adversos , Síndrome de Vaciamiento Rápido/etiología , Esofagectomía/efectos adversos , Vaciamiento Gástrico , Humanos
9.
Clin Oncol (R Coll Radiol) ; 35(6): e352-e361, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37031075

RESUMEN

AIMS: Clinical equipoise exists regarding early-stage lung cancer treatment among patients as trials comparing stereotactic body radiation therapy (SBRT) and surgical resection are unavailable. Given the potential differences in treatment effectiveness and side-effects, we sought to determine the associations between treatment type, decision regret and depression. MATERIALS AND METHODS: A multicentre, prospective study of patients with stage IA-IIA non-small cell lung cancer (NSCLC) with planned treatment with SBRT or surgical resection was conducted. Decision regret and depression were measured using the Decision Regret Scale (DRS) and Patient Health Questionnaire-4 (PHQ-4) at 3, 6 and 12 months post-treatment, respectively. Mixed linear regression modelling examined associations between treatment and decision regret adjusting for patient sociodemographics. RESULTS: Among 211 study participants with early-stage lung cancer, 128 (61%) patients received SBRT and 83 (39%) received surgical resection. The mean age was 73 years (standard deviation = 8); 57% were female; 79% were White non-Hispanic. In the entire cohort at 3 months post-treatment, 72 (34%) and 57 (27%) patients had mild and severe decision regret, respectively. Among patients who received SBRT or surgery, 71% and 46% of patients experienced at least mild decision regret at 3 months, respectively. DRS scores increased at 6 months and decreased slightly at 12 months of follow-up in both groups. Higher DRS scores were associated with SBRT treatment (adjusted mean difference = 4.18, 95% confidence interval 0.82 to 7.54) and depression (adjusted mean difference = 3.49, 95% confidence interval 0.52 to 6.47). Neither patient satisfaction with their provider nor decision-making role concordance was associated with DRS scores. CONCLUSIONS: Most early-stage lung cancer patients experienced at least mild decision regret, which was associated with SBRT treatment and depression symptoms. Findings suggest patients with early-stage lung cancer may not be receiving optimal treatment decision-making support. Therefore, opportunities for improved patient-clinician communication probably exist.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Radiocirugia , Humanos , Femenino , Anciano , Masculino , Carcinoma de Pulmón de Células no Pequeñas/radioterapia , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Carcinoma de Pulmón de Células no Pequeñas/patología , Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/cirugía , Neoplasias Pulmonares/patología , Estudios Prospectivos , Resultado del Tratamiento , Radiocirugia/efectos adversos , Emociones , Estadificación de Neoplasias
10.
Contemp Clin Trials ; 122: 106928, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36116756

RESUMEN

INTRODUCTION: Chronic stress and burnout are highly prevalent among academically trained healthcare professionals, negatively affecting their well-being and capacity to engage in their work. Resilience to stress develops early in one's career path, hence offering resilience training to university students in these professions is one approach to fostering well-being and mental health. The aim of this study is to assess whether offering mindfulness-based resilience training to university students in healthcare professions reduces their perceived chronic stress. METHODS AND ANALYSIS: The study has a hybrid design combining a longitudinal observational cohort with a nested randomized controlled trial (RCT) with sequential multiple assignment and multistage adaptive interventions while taking participants' preferences into account. All students in healthcare related programmes at the Erasmus University Rotterdam are invited to participate. Within the observational cohort, students with a score of 14 or higher on the Perceived Stress Scale (PSS) are invited to take part in the RCT (n = 706). Eligible participants are randomized to control or active intervention in a ratio of 1:6. Those randomized to the control group and non-randomized participants in the cohort receive passive web-based psychoeducation about chronic stress and burnout through referral to specific websites. Participants randomized to the intervention group receive one of 8 active mindfulness-based interventions. They select a rank order of 4 preferred interventions and are randomized across these with equal probability. Non-response to the intervention is followed by sequential randomized assignment to another intervention, for a total maximum of 3 sequential interventions. All participants receive questionnaires at baseline, before and after each 8-week intervention period, and at 1- and 2-year follow-up. The primary outcome is perceived chronic stress measured with the PSS. Secondary outcomes include mental well-being, burnout, quality of life, healthcare utilization, drug use, bodyweight, mental and physical stress-related symptoms, resilience, and study progress. ETHICS AND REGISTRATION: Approval from the Medical Ethics Review Committee was obtained under protocol number MEC-2018-1645. The trial is registered in the Netherlands National Trial Register by registration number NL7623, 22/03/2019, https://www.trialregister.nl/.


Asunto(s)
Atención Plena , Humanos , Atención Plena/métodos , Estudiantes/psicología , Universidades , Salud Mental , Estudios de Cohortes , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Observacionales como Asunto
11.
Protein Expr Purif ; 75(2): 177-85, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-20933089

RESUMEN

A purification process for the manufacture of a recombinant C-terminus heavy chain fragment from botulinum neurotoxin serotype C [rBoNTC(H(c))], a potential vaccine candidate, has been defined and successfully scaled-up. The rBoNTC(H(c)) was produced intracellularly in Pichia pastoris X-33 using a three step fermentation process, i.e., glycerol batch phase, a glycerol fed-batch phase to achieve high cell densities, followed by a methanol induction phase. The rBoNTC(H(c)) was captured from the soluble protein fraction of cell lysate using hydrophobic charge induction chromatography (HCIC; MEP HyperCel™), and then further purified using a CM 650M ion exchange chromatography step followed by a polishing step using HCIC once again. Method development at the bench scale was achieved using 5-100mL columns and the process was performed at the pilot scale using 0.6-1.6L columns in preparation for technology transfer to cGMP manufacturing. The process yielded approximately 2.5 g of rBoNTC(H(c))/kg wet cell weight (WCW) at the bench scale and 1.6 g rBoNTC(H(c))/kg WCW at the pilot scale. The purified rBoNTC(H(c)) was stable for at least 3 months at 5 and -80°C as determined by reverse phase-HPLC and SDS-PAGE and was stable for 24 months at -80 °C based on mouse potency bioassay. N-Terminal amino acid sequencing confirmed that the N-terminus of the purified rBoNTC(H(c)) was intact.


Asunto(s)
Toxinas Botulínicas , Clostridium botulinum/química , Pichia , Proteínas Recombinantes , Secuencia de Aminoácidos , Animales , Vacunas Bacterianas/genética , Vacunas Bacterianas/inmunología , Vacunas Bacterianas/metabolismo , Biotecnología , Bioterrorismo/prevención & control , Toxinas Botulínicas/genética , Toxinas Botulínicas/inmunología , Toxinas Botulínicas/aislamiento & purificación , Toxinas Botulínicas/metabolismo , Cromatografía , Clonación Molecular , Femenino , Fermentación , Ratones , Datos de Secuencia Molecular , Proyectos Piloto , Proteínas Recombinantes/genética , Proteínas Recombinantes/inmunología , Proteínas Recombinantes/aislamiento & purificación , Proteínas Recombinantes/metabolismo , Transferencia de Tecnología
12.
Nat Med ; 5(6): 686-93, 1999 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-10371508

RESUMEN

CD154 is the ligand for the receptor CD40. This ligand-receptor pair mediates endothelial and antigen-presenting cell activation, and facilitates the interaction of these cells with T cells and platelets. We demonstrate here that administration of a CD154-specific monoclonal antibody (hu5C8) allows for renal allotransplantation in outbred, MHC-mismatched rhesus monkeys without acute rejection. The effect persisted for more than 10 months after therapy termination, and no additional drug was required to achieve extended graft survival. Indeed, the use of tacrolimus or chronic steroids seemed to antagonize the anti-rejection effect. Monkeys treated with antibody against CD154 remained healthy during and after therapy. The mechanism of action does not require global depletion of T or B cells. Long-term survivors lost their mixed lymphocyte reactivity in a donor-specific manner, but still formed donor-specific antibody and generated T cells that infiltrated the grafted organ without any obvious effect on graft function. Thus, therapy with antibody against CD154 is a promising agent for clinical use in human allotransplantation.


Asunto(s)
Anticuerpos Monoclonales/farmacología , Rechazo de Injerto/tratamiento farmacológico , Trasplante de Riñón , Glicoproteínas de Membrana/inmunología , Animales , Formación de Anticuerpos , Ligando de CD40 , Rechazo de Injerto/inmunología , Humanos , Inmunosupresores/farmacología , Interleucinas/genética , Interleucinas/metabolismo , Riñón/metabolismo , Selectina L/genética , Selectina L/metabolismo , Recuento de Leucocitos , Linfocitos/efectos de los fármacos , Linfocitos/metabolismo , Macaca mulatta , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/farmacología , ARN/análisis , Receptores de Antígenos de Linfocitos T/genética , Receptores de Antígenos de Linfocitos T/metabolismo , Linfocitos T/efectos de los fármacos , Linfocitos T/inmunología , Tacrolimus/farmacología , Resultado del Tratamiento
13.
Psychol Med ; 40(10): 1735-44, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20047706

RESUMEN

OBJECTIVE: Anorexia nervosa (AN) and bulimia nervosa (BN) are marked by longitudinal symptom fluctuations. DSM-IV-TR does not address how to classify eating disorder (ED) presentations in individuals who no longer meet full criteria for these disorders. To consider this issue, we examined subthreshold presentations in women with initial diagnoses of AN and BN. METHOD: A total of 246 women with AN or BN were followed for a median of 9 years; weekly symptom data were collected at frequent intervals using the Longitudinal Interval Follow-up Evaluation of Eating Disorders (LIFE-EAT-II). Outcomes were ED presentations that were subthreshold for 3 months, including those narrowly missing full criteria for AN or BN, along with binge eating disorder (BED) and purging disorder. RESULTS: During follow-up, most women (77.6%) experienced a subthreshold presentation. Subthreshold presentation was related to intake diagnosis (Wald chi2=8.065, df=2, p=0.018). Individuals with AN most often developed subthreshold presentations resembling AN; those with BN were more likely to develop subthreshold BN. Purging disorder was experienced by half of those with BN and one-quarter of those with AN binge/purge type (ANBP); BED occurred in 20% with BN. Transition from AN or BN to most subthreshold types was associated with improved psychosocial functioning (p<0.001). CONCLUSIONS: Subthreshold presentations in women with lifetime AN and BN were common, resembled the initial diagnosis, and were associated with modest improvements in psychosocial functioning. For most with lifetime AN and BN, subthreshold presentations seem to represent part of the course of illness and to fit within the original AN or BN diagnosis.


Asunto(s)
Anorexia/clasificación , Bulimia Nerviosa/clasificación , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos de Alimentación y de la Ingestión de Alimentos/clasificación , Anorexia/diagnóstico , Anorexia/psicología , Bulimia Nerviosa/diagnóstico , Bulimia Nerviosa/psicología , Distribución de Chi-Cuadrado , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Femenino , Humanos , Entrevistas como Asunto , Modelos Lineales , Estudios Longitudinales , Cadenas de Markov , Psicología , Ajuste Social , Adulto Joven
14.
Am J Nephrol ; 29(4): 327-33, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-18849603

RESUMEN

BACKGROUND: We report the influence of race on transplant outcomes in the Department of Defense (DOD) system. METHODS: Retrospective cohort analysis of all kidney transplants performed at WRAMC from 1996 to 2005. Kaplan-Meier analysis was used to assess for differences in graft survival, and Cox regression was used to calculate adjusted hazard ratios for graft loss. For our analyses, we used the cutoff of 6 years (year 2000) when we introduced thymoglobulin induction; maintenance immunosuppression consisted of mycophenolate mofetil and tacrolimus, and rapid steroid taper (completed withdrawal at 6 weeks) was used for all patients. RESULTS: There were 220 transplants (91 Blacks, 107 Caucasians and 22 Asians). Because the curve for graft survival for Blacks over time violated the proportional hazards assumption (at 6 years post-transplant), analysis was segregated into two segments. Through 6 years of follow-up, graft survival was 77% for Blacks and 81% for non-Blacks (p = 0.74 by log rank). Through 9 potential years of follow-up, graft survival for Blacks was 56% and 78% for Whites (p = 0.005). In Cox regression analysis, Black race, compared with non-Black race, was not significantly associated with graft loss at 6 years, but was significantly associated with graft loss occurring after 6 years. CONCLUSIONS: In the DOD health system, no significant differences were seen in graft survival among recipients of different races at 6 years. Black recipients who received a kidney transplant before the year 2000 showed decreased graft survival compared to non-Blacks. This was consistent with change in immunosuppressive regimen in our institution with the introduction of thymoglobulin induction and maintenance therapy with tacrolimus, mycophenolate mofetil and withdrawal of prednisone at 6 weeks.


Asunto(s)
Rechazo de Injerto/etnología , Supervivencia de Injerto , Trasplante de Riñón/etnología , Medicina Militar/estadística & datos numéricos , Grupos Raciales/estadística & datos numéricos , United States Government Agencies/estadística & datos numéricos , Adulto , Asiático/estadística & datos numéricos , Población Negra/estadística & datos numéricos , Femenino , Estudios de Seguimiento , Rechazo de Injerto/tratamiento farmacológico , Humanos , Inmunosupresores/uso terapéutico , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Estados Unidos/epidemiología , Población Blanca/estadística & datos numéricos
15.
Science ; 252(5006): 675-9, 1991 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-2024119

RESUMEN

In Saccharopolyspora erythraea, the genes that govern synthesis of the polyketide portion of the macrolide antibiotic erythromycin are organized in six repeated units that encode fatty acid synthase (FAS)-like activities. Each repeated unit is designated a module, and two modules are contained in a single open reading frame. A model for the synthesis of this complex polyketide is proposed, where each module encodes a functional synthase unit and each synthase unit participates specifically in one of the six FAS-like elongation steps required for formation of the polyketide. In addition, genetic organization and biochemical order of events appear to be colinear. Evidence for the model is provided by construction of a selected mutant and by isolation of a polyketide of predicted structure.


Asunto(s)
Complejos Multienzimáticos/genética , Secuencia de Aminoácidos , Sitios de Unión , Clonación Molecular , ADN Bacteriano/genética , Eritromicina/análogos & derivados , Eritromicina/biosíntesis , Eritromicina/química , Genes Bacterianos , Bacterias Grampositivas/enzimología , Bacterias Grampositivas/genética , Hidroxilación , Modelos Moleculares , Datos de Secuencia Molecular , Estructura Molecular , Mutación , Hibridación de Ácido Nucleico , Secuencias Repetitivas de Ácidos Nucleicos
16.
Science ; 252(5002): 114-7, 1991 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-2011746

RESUMEN

Derivatives of erythromycin with modifications at their C-6 position are generally sought for their increased stability at acid pH, which in turn may confer improved pharmacological properties. A recombinant mutant of the erythromycin-producing bacterium, Saccharopolyspora erythraea, produced an erythromycin derivative, 6-deoxyerythromycin A, that could not be obtained readily by chemical synthesis. This product resulted from targeted disruption of the gene, designated eryF (systematic nomenclature, CYP107), that apparently codes for the cytochrome P450, 6-deoxyerythronolide B (DEB) hydroxylase, which converts DEB to erythronolide B (EB). Enzymes normally acting on EB can process the alternative substrate DEB to form the biologically active erythromycin derivative lacking the C-6 hydroxyl group.


Asunto(s)
Sistema Enzimático del Citocromo P-450/genética , Eritromicina/biosíntesis , Genes Bacterianos , Oxigenasas de Función Mixta/genética , Secuencia de Aminoácidos , Bacterias/genética , Proteínas Bacterianas , Secuencia de Bases , Análisis Mutacional de ADN , ADN Bacteriano/genética , Eritromicina/análogos & derivados , Datos de Secuencia Molecular , Plásmidos , Mapeo Restrictivo
17.
J Econ Entomol ; 112(6): 2703-2712, 2019 12 09.
Artículo en Inglés | MEDLINE | ID: mdl-31265727

RESUMEN

Fulmekiola serrata (Kobus) was observed infesting sugarcane, Saccharum spp. hybrids, in the United States for the first time in January 2017 in Florida. Field studies were conducted to determine F. serrata infestation levels on popular sugarcane cultivars and to determine the efficacy of foliar insecticide treatments that could be used for management. Cultivar evaluations comparing six and five commercial cultivars representing >46% of the sugarcane production area in Florida were conducted in 2017 and 2018, respectively. Fulmekiola serrata infestation levels did not differ among cultivars in 2017. However, infestation levels on CP 00-1101 were greater than on CP 96-1252 grown on organic soils, and infestation levels on CP 96-1252 were greater than on CPCL 97-2730 grown on mineral soils in 2018. Three insecticide evaluations, two in 2017 and one in 2018, were conducted. The pyrethroid lambda-cyhalothrin, which is registered for use on sugarcane, was consistently associated with the greatest decreases in F. serrata infestation levels. The neonicotinoids imidacloprid and thiamethoxam, as well as the butenolide flupyradifurone, decreased infestation levels but to a lesser extent than did lambda-cyhalothrin. The spinosyn spinetoram was associated with the lowest decreases in F. serrata infestation levels. Our results supported short-term F. serrata management recommendations: Popular Florida sugarcane cultivars should be considered equally susceptible to F. serrata until additional evaluations are conducted and F. serrata outbreaks can be treated with lambda-cyhalothrin when infestations stress the crop beyond acceptable levels.


Asunto(s)
Insecticidas , Saccharum , Thysanoptera , Animales , Florida , Suelo
18.
Plant Cell ; 8(12): 2211-2221, 1996 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-12239377

RESUMEN

The roles of gibberellic acid (GA3) and abscisic acid (ABA) in the regulation of vacuolar pH (pHv) in aleurone cells of barley were investigated using the pH-sensitive fluorescent dye 2[prime],7[prime]-bis(2-carboxyethyl)-5(6)-carboxyfluorescein (BCECF). BCECF accumulated in vacuoles of aleurone cells, but sequestration of the dye did not affect its sensitivity to pH. BCECF-loaded aleurone cells retained their ability to respond to both GA3 and ABA. The pHv of freshly isolated aleurone cells is 6.6, but after incubation in GA3, the pHv fell to 5.8. The pHv of cells not incubated in hormones or in the presence of ABA showed little or no acidification. The aleurone tonoplast contains both vacuolar ATPase and vacuolar pyrophosphatase, but the levels of pump proteins were not affected by incubation in the presence or absence of hormones. We conclude that GA3 affects the pHv in aleurone cells by altering the activities of tonoplast H+ pumps but not the amounts of pump proteins.

20.
J Soil Water Conserv ; 72(2): 168-182, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-30245529

RESUMEN

Pollutants can be reduced, ameliorated, or assimilated when riparian ecosystems have the vegetation, water, and soil/landform needed for riparian functions. Loss of physical form and ecological function unravels assimilation processes, increasing supply and transport of pollutants. Water quality and aquatic organisms are response measures of accumulated upstream discharges, and ultimately of changes in riparian functions. Thus, water quality monitoring often fails to identify or lags behind many causes of pollution or remediation from riparian degradation. This paper reviews the interagency riparian proper functioning condition (PFC) assessment for lotic (running water) riparian ecosystems and outlines connections between PFC and water quality attributes (sediment, nutrients, temperature, and dissolved oxygen [DO]). The PFC interaction of hydrology, vegetation, and soils/landforms influences water quality by dissipating energy associated with high waterflow, thereby reducing vertical instability and lateral erosion while developing floodplains with captured sediment and nutrients. Slowing flood water enables aquifer recharge, deposition, and plant nutrient uptake. Water-loving, densely rooted streambank stabilizing vegetation and/or wood helps integrate riparian functions to maintain channel pattern, profile, and dimension with characteristics for a diversity of habitats. A complex food web helps slow the nutrient spiral with uptake and storage. Temperature fluctuations are dampened by delayed discharges, narrower and deeper active channels, coarser substrates that enhance hyporheic interchange, and shade from riparian vegetation. After assessment and implementation, monitoring recovery of impaired riparian function attributes (e.g., streambank plant species) naturally focuses on persistent drivers of water quality and aquatic habitat. This provides timely environmental indicators of stream ecological health and water quality remediation projects or land management.

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