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1.
Nature ; 621(7980): 723-727, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37758889

RESUMO

Heat engines convert thermal energy into mechanical work both in the classical and quantum regimes1. However, quantum theory offers genuine non-classical forms of energy, different from heat, which so far have not been exploited in cyclic engines. Here we experimentally realize a quantum many-body engine fuelled by the energy difference between fermionic and bosonic ensembles of ultracold particles that follows from the Pauli exclusion principle2. We employ a harmonically trapped superfluid gas of 6Li atoms close to a magnetic Feshbach resonance3 that allows us to effectively change the quantum statistics from Bose-Einstein to Fermi-Dirac, by tuning the gas between a Bose-Einstein condensate of bosonic molecules and a unitary Fermi gas (and back) through a magnetic field4-10. The quantum nature of such a Pauli engine is revealed by contrasting it with an engine in the classical thermal regime and with a purely interaction-driven device. We obtain a work output of several 106 vibrational quanta per cycle with an efficiency of up to 25%. Our findings establish quantum statistics as a useful thermodynamic resource for work production.

2.
Proc Natl Acad Sci U S A ; 119(1)2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-34983842

RESUMO

Relaxation of quantum systems is a central problem in nonequilibrium physics. In contrast to classical systems, the underlying quantum dynamics results not only from atomic interactions but also from the long-range coherence of the many-body wave function. Experimentally, nonequilibrium states of quantum fluids are usually created using moving objects or laser potentials, directly perturbing and detecting the system's density. However, the fate of long-range phase coherence for hydrodynamic motion of disordered quantum systems is less explored, especially in three dimensions. Here, we unravel how the density and phase coherence of a Bose-Einstein condensate of 6Li2 molecules respond upon quenching on or off an optical speckle potential. We find that, as the disorder is switched on, long-range phase coherence breaks down one order of magnitude faster than the density of the quantum gas responds. After removing it, the system needs two orders of magnitude longer times to reestablish quantum coherence, compared to the density response. We compare our results with numerical simulations of the Gross-Pitaevskii equation on large three-dimensional grids, finding an overall good agreement. Our results shed light on the importance of long-range coherence and possibly long-lived phase excitations for the relaxation of nonequilibrium quantum many-body systems.

3.
BMC Med Educ ; 24(1): 72, 2024 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-38233807

RESUMO

BACKGROUND: Equitable assessment is critical in competency-based medical education. This study explores differences in key characteristics of qualitative assessments (i.e., narrative comments or assessment feedback) of internal medicine postgraduate resident performance associated with gender and race and ethnicity. METHODS: Analysis of narrative comments included in faculty assessments of resident performance from six internal medicine residency programs was conducted. Content analysis was used to assess two key characteristics of comments- valence (overall positive or negative orientation) and specificity (detailed nature and actionability of comment) - via a blinded, multi-analyst approach. Differences in comment valence and specificity with gender and race and ethnicity were assessed using multilevel regression, controlling for multiple covariates including quantitative competency ratings. RESULTS: Data included 3,383 evaluations with narrative comments by 597 faculty of 698 residents, including 45% of comments about women residents and 13.2% about residents who identified with race and ethnicities underrepresented in medicine. Most comments were moderately specific and positive. Comments about women residents were more positive (estimate 0.06, p 0.045) but less specific (estimate - 0.07, p 0.002) compared to men. Women residents were more likely to receive non-specific, weakly specific or no comments (adjusted OR 1.29, p 0.012) and less likely to receive highly specific comments (adjusted OR 0.71, p 0.003) or comments with specific examples of things done well or areas for growth (adjusted OR 0.74, p 0.003) than men. Gendered differences in comment specificity and valence were most notable early in training. Comment specificity and valence did not differ with resident race and ethnicity (specificity: estimate 0.03, p 0.32; valence: estimate - 0.05, p 0.26) or faculty gender (specificity: estimate 0.06, p 0.15; valence: estimate 0.02 p 0.54). CONCLUSION: There were significant differences in the specificity and valence of qualitative assessments associated with resident gender with women receiving more praising but less specific and actionable comments. This suggests a lost opportunity for well-rounded assessment feedback to the disadvantage of women.


Assuntos
Internato e Residência , Masculino , Humanos , Feminino , Etnicidade , Competência Clínica , Docentes de Medicina , Medicina Interna/educação
4.
BMC Med Educ ; 23(1): 932, 2023 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-38066551

RESUMO

INTRODUCTION: Evidence suggests gender disparities in medical education assessment, including differences in ratings of competency and narrative comments provided in resident performance assessments. This study explores how gender manifests within the content of qualitative assessments (i.e., narrative comments or performance feedback) of resident performance. METHODS: Qualitative content analysis was used to explore gender-based differences in narrative comments included in faculty assessments of resident performance during inpatient medicine rotations at six Internal Medicine residency programs, 2016-2017. A blinded, multi-analyst approach was employed to identify themes across comments. Patterns in themes with resident gender and post-graduate year (PGY) were explored, focusing on PGY2 and PGY3 when residents are serving in the team leader role. RESULTS: Data included 3,383 evaluations with narrative comments of 385 men (55.2%) and 313 women residents (44.8%). There were thematic differences in narrative comments received by men and women residents and how these themes manifested within comments changed with training time. Compared to men, comments about women had a persistent relationship-orientation and emphasized confidence over training including as interns and in PGY2 and PGY3, when serving as team leader. The relationship-orientation was characterized not only by the residents' communal attributes but also their interpersonal and communication skills, including efforts supporting others and establishing the tone for the team. Comments about women residents often highlighted confidence, including recommendations around behaviors that convey confidence in decision-making and team leadership. DISCUSSION: There were gender-based thematic differences in qualitative assessments. Comments about women resident team leaders highlight relationship building skills and urge confidence and actions that convey confidence as team leader. Persistent attention to communal skills suggests gendered expectations for women resident team leaders and a lost opportunity for well-rounded feedback to the disadvantage of women residents. These findings may inform interventions to promote equitable assessment, such as providing feedback across the competencies.


Assuntos
Internato e Residência , Masculino , Humanos , Feminino , Competência Clínica , Avaliação Educacional , Processos Mentais , Docentes de Medicina
5.
J Interprof Care ; 37(4): 623-628, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36373206

RESUMO

In-hospital cardiac arrest resuscitation training often happens in silos, with minimal interprofessional training. The aim of this study was to implement and evaluate a simulation-enhanced, interprofessional cardiac arrest curriculum in a university hospital. The curriculum ran monthly for 12 months, training interprofessional teams of internal medicine residents, nurses, respiratory therapists, and pharmacy residents. Teams participated in a 90-min high-fidelity simulation including "code blue" (30 min) followed by a 30-min debriefing and a repeat identical simulated "code blue" scenario. Teams were tested in an unannounced mock Code Blue the following month. Advanced Cardiac Life Support (ACLS) algorithm adherence was assessed using a standardized checklist. In-hospital cardiac arrest (IHCA) incidence and survival was tracked for 2 years prior, during, and 1 year after curriculum implementation. Team ACLS-algorithm adherence at baseline varied from 47% to 90% (mean of 71 ± 11%) and improved immediately following training (mean 88 ± 4%, range 80-93%, p = .011). This improvement persisted but decreased in magnitude over 1 month (mean 81 ± 7%, p = .013). Medical resident self-reported comfort levels with resuscitation skills varied widely at baseline, but improved for all skills post-curriculum. This simulation-enhanced, spaced practice, interprofessional curriculum resulted in a sustained improvement in team ACLS algorithm adherence.


Assuntos
Suporte Vital Cardíaco Avançado , Parada Cardíaca , Humanos , Suporte Vital Cardíaco Avançado/educação , Relações Interprofissionais , Currículo , Parada Cardíaca/terapia , Avaliação Educacional , Competência Clínica
6.
Phys Rev Lett ; 128(23): 233601, 2022 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-35749186

RESUMO

We study experimentally the dissipative dynamics of ultracold bosonic gases in a dynamic disorder potential with tunable correlation time. First, we measure the heating rate of thermal clouds exposed to the dynamic potential and present a model of the heating process, revealing the microscopic origin of dissipation from a thermal, trapped cloud of bosons. Second, for Bose-Einstein condensates, we measure the particle loss rate induced by the dynamic environment. Depending on the correlation time, the losses are either dominated by heating of residual thermal particles or the creation of excitations in the superfluid, a notion we substantiate with a rate model. Our results illuminate the interplay between superfluidity and time-dependent disorder and on more general grounds establish ultracold atoms as a platform for studying spatiotemporal noise and time-dependent disorder.

7.
J Gen Intern Med ; 37(9): 2194-2199, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35710653

RESUMO

BACKGROUND: Disparities in objective assessments in graduate medical education such as the In-Training Examination (ITE) that disadvantage women and those self-identifying with race/ethnicities underrepresented in medicine (URiM) are of concern. OBJECTIVE: Examine ITE trends longitudinally across post-graduate year (PGY) with gender and race/ethnicity. DESIGN: Longitudinal analysis of resident ITE metrics at 7 internal medicine residency programs, 2014-2019. ITE trends across PGY of women and URiM residents compared to non-URiM men assessed via ANOVA. Those with ITE scores associated with less than 90% probability of passing the American Board of Internal Medicine certification exam (ABIM-CE) were identified and odds of being identified as at-risk between groups were assessed with chi square. PARTICIPANTS: A total of 689 IM residents, including 330 women and URiM residents (48%). MAIN MEASURES: ITE score KEY RESULTS: There was a significant difference in ITE score across PGY for women and URiM residents compared to non-URiM men (F(2, 1321) 4.46, p=0.011). Adjusting for program, calendar year, and baseline ITE, women and URiM residents had smaller ITE score gains (adjusted mean change in score between PGY1 and PGY3 (se), non-URiM men 13.1 (0.25) vs women and URiM residents 11.4 (0.28), p<0.001). Women and URiM residents had greater odds of being at potential risk for not passing the ABIM-CE (OR 1.75, 95% CI 1.10 to 2.78) with greatest odds in PGY3 (OR 3.13, 95% CI 1.54 to 6.37). CONCLUSION: Differences in ITE over training were associated with resident gender and race/ethnicity. Women and URiM residents had smaller ITE score gains across PGY translating into greater odds of potentially being seen as at-risk for not passing the ABIM-CE. Differences in ITE over training may reflect differences in experiences of women and URiM residents during training and may lead to further disparities.


Assuntos
Internato e Residência , Competência Clínica , Educação de Pós-Graduação em Medicina , Avaliação Educacional , Etnicidade , Feminino , Humanos , Medicina Interna/educação , Masculino , Estados Unidos/epidemiologia
8.
New For (Dordr) ; : 1-22, 2022 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-35344318

RESUMO

Emerald ash borer (Agrilus planipennis; EAB) has devastated populations of ash (Fraxinus spp.) trees in dozens of U.S. states and Canada over the past few decades. The continued survival of scattered ash trees known as "lingering ash" in heavily infested natural stands, however, offers evidence of genetic resistance or tolerance to EAB. These surviving or "lingering" ash individuals may form the basis for reforestation programs in EAB-impacted areas, and clonal mass-propagation of these genotypes can help accelerate these efforts. Between 2013 and 2018, we initiated embryogenic cultures by culturing immature zygotic embryos from open-pollinated (OP) seeds collected from several surviving white ash and green ash trees in Michigan and Pennsylvania. In addition, in 2018, we initiated cultures from crosses made between lingering green ash parents from the USDA Forest Service ash breeding program in Ohio. Somatic embryos were produced by growing cultures in liquid suspension, followed by fractionation and plating on semisolid medium to produce developmentally synchronous populations of somatic embryos. Somatic embryo germination and conversion were enhanced by a combination of pre-germination cold treatment and inclusion of activated charcoal and gibberellic acid in the germination medium. Ash somatic seedlings derived from OP explants grew rapidly following transfer to potting mix and somatic seedlings representing nine ash clones were acclimatized, grown in the greenhouse and planted in a preliminary field test, along with EAB-resistant Manchurian ash (F. mandshurica) and EAB-susceptible control seedlings. Somatic seedlings have now been produced from cultures that originated from seeds derived from the progeny of lingering green ash parents and an ex vitro germination protocol has shown some promise for accelerating early somatic seedling growth. Results of this research could provide the basis for scaled-up production of EAB-resistant ash varieties for seed orchard production for forest restoration and cultivar development for urban tree restoration.

9.
Exp Brain Res ; 239(10): 2999-3005, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34331083

RESUMO

Recent animal and human studies connected the Morc family CW-type zinc finger 1 (Morc1) gene with early life stress and depression. Moreover, the Morc superfamily is related to epigenetic regulation in diverse nuclear processes. So far, the Morc1 gene was mainly studied in spermatogenesis, whereas its distribution and function in the brain are still unknown. In a first attempt to characterize Morc1 in the brain, we performed a Western Blot analysis as well as a real-time PCR analysis during different stages of development. Additionally, we detected Morc1 mRNA using real-time PCR in different mood-regulating brain areas in adult rats. We found that MORC1 protein as well as Morc1 mRNA is already expressed in the brain at embryonic day 14 and is stably expressed until adulthood. Furthermore, Morc1 mRNA is present in many important brain areas of mood regulation like the medial prefrontal cortex, the nucleus accumbens, the hippocampus, the hypothalamus, and the amygdala. The ample distribution in the brain and its molecular structure as a zinc finger protein indicate that Morc1 might act as a transcription factor. This function and its expression in mood-regulating areas already in the early brain development turn Morc1 into a possible candidate gene for mediating early life stress and depression.


Assuntos
Epigênese Genética , Fatores de Transcrição , Animais , Encéfalo , Hipocampo , Masculino , RNA Mensageiro , Ratos
10.
Plant Mol Biol ; 99(3): 251-264, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30604323

RESUMO

KEY MESSAGE: The genetic linkage map for green ash (Fraxinus pennsylvanica) contains 1201 DNA markers in 23 linkage groups spanning 2008.87cM. The green ash map shows stronger synteny with coffee than tomato. Green ash (Fraxinus pennsylvanica) is an outcrossing, diploid (2n = 46) hardwood tree species, native to North America. Native ash species in North America are being threatened by the rapid spread of the emerald ash borer (EAB, Agrilus planipennis), an invasive pest from Asia. Green ash, the most widely distributed ash species, is severely affected by EAB infestation, yet few genomic resources for genetic studies and improvement of green ash are available. In this study, a total of 5712 high quality single nucleotide polymorphisms (SNPs) were discovered using a minimum allele frequency of 1% across the entire genome through genotyping-by-sequencing. We also screened hundreds of genomic- and EST-based microsatellite markers (SSRs) from previous de novo assemblies (Staton et al., PLoS ONE 10:e0145031, 2015; Lane et al., BMC Genom 17:702, 2016). A first genetic linkage map of green ash was constructed from 90 individuals in a full-sib family, combining 2719 SNP and 84 SSR segregating markers among the parental maps. The consensus SNP and SSR map contains a total of 1201 markers in 23 linkage groups spanning 2008.87 cM, at an average inter-marker distance of 1.67 cM with a minimum logarithm of odds of 6 and maximum recombination fraction of 0.40. Comparisons of the organization the green ash map with the genomes of asterid species coffee and tomato, and genomes of the rosid species poplar and peach, showed areas of conserved gene order, with overall synteny strongest with coffee.


Assuntos
Mapeamento Cromossômico , Fraxinus/genética , Ligação Genética , Genoma de Planta/genética , Polimorfismo de Nucleotídeo Único/genética , Sintenia/genética , Animais , Café/genética , Besouros , Frequência do Gene , Técnicas de Genotipagem , Solanum lycopersicum/genética , Repetições de Microssatélites/genética
11.
J Gen Intern Med ; 34(5): 712-719, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30993611

RESUMO

BACKGROUND: Competency-based medical education relies on meaningful resident assessment. Implicit gender bias represents a potential threat to the integrity of resident assessment. We sought to examine the available evidence of the potential for and impact of gender bias in resident assessment in graduate medical education. METHODS: A systematic literature review was performed to evaluate the presence and influence of gender bias on resident assessment. We searched Medline and Embase databases to capture relevant articles using a tiered strategy. Review was conducted by two independent, blinded reviewers. We included studies with primary objective of examining the impact of gender on resident assessment in graduate medical education in the USA or Canada published from 1998 to 2018. RESULTS: Nine studies examined the existence and influence of gender bias in resident assessment and data included rating scores and qualitative comments. Heterogeneity in tools, outcome measures, and methodologic approach precluded meta-analysis. Five of the nine studies reported a difference in outcomes attributed to gender including gender-based differences in traits ascribed to residents, consistency of feedback, and performance measures. CONCLUSION: Our review suggests that gender bias poses a potential threat to the integrity of resident assessment in graduate medical education. Future study is warranted to understand how gender bias manifests in resident assessment, impact on learners and approaches to mitigate this bias.


Assuntos
Educação de Pós-Graduação em Medicina/normas , Avaliação Educacional/normas , Sexismo/estatística & dados numéricos , Educação Baseada em Competências/normas , Feminino , Humanos , Internato e Residência/normas , Masculino
13.
J Environ Manage ; 247: 29-37, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31229783

RESUMO

Globally, the production of food, feed, bioenergy, and biomaterials has increased considerably during the past decades. This was achieved by the expansion of agricultural land and the intensification of agricultural management. Due to the conversion of natural ecosystems and the increasing use of pesticides and fertilizers, these processes are recognized as important causes of biodiversity loss. This study focuses on the African continent and analyses the potentials to achieve a stable food provision for a growing population, and at the same time, reduce further losses of biodiversity. These targets are important elements of the UN Agenda 2030. Using the spatially explicit land-use model LandSHIFT, we assessed the effectiveness of different land-sparing and land-sharing strategies to achieve these targets until the year 2030. The simulation results indicate that under the assumptions tested, the land sparing approach yields the most desirable results both, on the continental and the regional level. However, the land sharing/sparing framework in general, and the research presented here only analyse the effect of two factors of many (food production and biodiversity conservation). Hence, this study should not be understood to provide specific management recommendations. Further studies, from the regional to the local level, are required that apply a systems approach to understand and explain the multiple dimensions of sustainable food production on the African continent.


Assuntos
Conservação dos Recursos Naturais , Ecossistema , Agricultura , Biodiversidade , Abastecimento de Alimentos
14.
Exp Brain Res ; 236(11): 3053-3064, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30121740

RESUMO

We used near-infrared spectroscopy to examine dorsolateral prefrontal cortex (DLPFC) activation over time in 10 children with or at-risk-for developmental coordination disorder (DCD) and 11 typically developing children (ages 8-12) during tasks involving executive processing. The groups performed with similar accuracy on the Stroop and Wisconsin card sort (WCST), but their underlying neural activation differed. Typically developing children modulated DLPFC activity over time and showed rightward lateralization during Stroop but no lateralization during WCST. The DCD group exhibited high and sustained activation across hemispheres and tasks, which we suggest is a compensatory effort to maintain response accuracy.


Assuntos
Função Executiva/fisiologia , Transtornos das Habilidades Motoras/diagnóstico por imagem , Córtex Pré-Frontal/diagnóstico por imagem , Mapeamento Encefálico , Criança , Feminino , Humanos , Masculino , Desempenho Psicomotor/fisiologia , Espectroscopia de Luz Próxima ao Infravermelho , Teste de Stroop , Teste de Classificação de Cartas de Wisconsin
15.
BMC Genomics ; 18(1): 547, 2017 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-28728575

RESUMO

BACKGROUND: The American Beech tree (Fagus grandifolia Ehrh.), native to eastern North America, is ecologically important and provides high quality wood products. This species is susceptible to beech bark disease (BBD) and is facing high rates of mortality in North America. The disease occurs from an interaction between the woolly beech scale insect (Cryptococcus fagisuga), one of two species of the fungus Neonectria (N. faginata or N. ditissima), and American Beech trees. METHODS: In this case-control genome-wide association study (GWAS), we tested 16 K high quality SNPs using the Affymetrix Axiom 1.5 K - 50 K assay to genotype an association population of 514 individuals. We also conducted linkage analysis in a full-sib family of 115 individuals. Fisher's exact test and logistic regression tests were performed to test associations between SNPs and phenotypes. RESULTS: Association tests revealed four highly significant SNPs on chromosome (Chr) 5 for a single gene (Mt), which encodes a mRNA for metallothionein-like protein (metal ion binding) in Fagus sylvatica. Metallothioneins represent Cys-rich metal chelators able to coordinate metal atoms and may play an important role in the resistance mechanisms against beech scale insect. CONCLUSION: The GWAS study has identified a single locus of major effect contributing to beech bark disease resistance. Knowledge of this genetic locus contributing to resistance might be used in applied breeding, conservation and restoration programs.


Assuntos
Resistência à Doença/genética , Fagus/genética , Fagus/imunologia , Estudo de Associação Genômica Ampla , Doenças das Plantas/imunologia , Fagus/microbiologia , Perfilação da Expressão Gênica , Desequilíbrio de Ligação , Polimorfismo de Nucleotídeo Único
16.
BMC Genomics ; 17: 702, 2016 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-27589953

RESUMO

BACKGROUND: To develop a set of transcriptome sequences to support research on environmental stress responses in green ash (Fraxinus pennsylvanica), we undertook deep RNA sequencing of green ash tissues under various stress treatments. The treatments, including emerald ash borer (EAB) feeding, heat, drought, cold and ozone, were selected to mimic the increasing threats of climate change and invasive pests faced by green ash across its native habitat. RESULTS: We report the generation and assembly of RNA sequences from 55 green ash samples into 107,611 putative unique transcripts (PUTs). 52,899 open reading frames were identified. Functional annotation of the PUTs by comparison to the Uniprot protein database identified matches for 63 % of transcripts and for 98 % of transcripts with ORFs. Further functional annotation identified conserved protein domains and assigned gene ontology terms to the PUTs. Examination of transcript expression across different RNA libraries revealed that expression patterns clustered based on tissues regardless of stress treatment. The transcripts from stress treatments were further examined to identify differential expression. Tens to hundreds of differentially expressed PUTs were identified for each stress treatment. A set of 109 PUTs were found to be consistently up or down regulated across three or more different stress treatments, representing basal stress response candidate genes in green ash. In addition, 1956 simple sequence repeats were identified in the PUTs, of which we identified 465 high quality DNA markers and designed flanking PCR primers. CONCLUSIONS: North American native ash trees have suffered extensive mortality due to EAB infestation, creating a need to breed or select for resistant green ash genotypes. Stress from climate change is an additional concern for longevity of native ash populations. The use of genomics could accelerate management efforts. The green ash transcriptome we have developed provides important sequence information, genetic markers and stress-response candidate genes.


Assuntos
Fraxinus/genética , Genes de Plantas , Estresse Fisiológico/genética , Transcriptoma , Mudança Climática , Análise por Conglomerados , Biologia Computacional/métodos , Secas , Perfilação da Expressão Gênica , Regulação da Expressão Gênica de Plantas , Ontologia Genética , Sequenciamento de Nucleotídeos em Larga Escala , Repetições de Microssatélites , Missouri , Anotação de Sequência Molecular , Especificidade de Órgãos/genética
17.
Anesth Analg ; 122(4): 1132-40, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26745756

RESUMO

BACKGROUND: Respiratory depression in children receiving postoperative opioid infusions is a significant risk because of the interindividual variability in analgesic requirement. Detection of respiratory depression (or apnea) in these children may be improved with the introduction of automated acoustic respiratory rate (RR) monitoring. However, early detection of adverse events must be balanced with the risk of alarm fatigue. Our objective was to evaluate the use of acoustic RR monitoring in children receiving opioid infusions on a postsurgical ward and identify the causes of false alarm and optimal alarm thresholds. METHODS: A video ethnographic study was performed using an observational, mixed methods approach. After surgery, an acoustic RR sensor was placed on the participant's neck and attached to a Rad87 monitor. The monitor was networked with paging for alarms. Vital signs data and paging notification logs were obtained from the central monitoring system. Webcam videos of the participant, infusion pump, and Rad87 monitor were recorded, stored on a secure server, and subsequently analyzed by 2 research nurses to identify the cause of the alarm, response, and effectiveness. Alarms occurring within a 90-second window were grouped into a single-alarm response opportunity. RESULTS: Data from 49 patients (30 females) with median age 14 (range, 4.4-18.8) years were analyzed. The 896 bedside vital sign threshold alarms resulted in 160 alarm response opportunities (44 low RR, 74 high RR, and 42 low SpO2). In 141 periods (88% of total), for which video was available, 65% of alarms were deemed effective (followed by an alarm-related action within 10 minutes). Nurses were the sole responders in 55% of effective alarms and the patient or parent in 20%. Episodes of desaturation (SpO2 < 90%) were observed in 9 patients: At the time of the SpO2 paging trigger, the RR was >10 bpm in 6 of 9 patients. Based on all RR samples observed, the default alarm thresholds, to serve as a starting point for each patient, would be a low RR of 6 (>10 years of age) and 10 (4-9 years of age). CONCLUSIONS: In this study, the use of RR monitoring did not improve the detection of respiratory depression. An RR threshold, which would have been predictive of desaturations, would have resulted in an unacceptably high false alarm rate. Future research using a combination of variables (e.g., SpO2 and RR), or the measurement of tidal volumes, may be needed to improve patient safety in the postoperative ward.


Assuntos
Estimulação Acústica , Analgésicos Opioides/administração & dosagem , Monitorização Neurofisiológica Intraoperatória/normas , Cuidados Pós-Operatórios/normas , Insuficiência Respiratória/induzido quimicamente , Insuficiência Respiratória/diagnóstico , Adolescente , Analgésicos Opioides/efeitos adversos , Antropologia Cultural , Criança , Pré-Escolar , Feminino , Humanos , Monitorização Neurofisiológica Intraoperatória/métodos , Masculino , Cuidados Pós-Operatórios/métodos
18.
J Exp Pharmacol ; 16: 13-24, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38249320

RESUMO

Background: Viloxazine ER (viloxazine extended-release capsules; Qelbree®), a nonstimulant attention-deficit/hyperactivity disorder (ADHD) treatment, has known activity as a norepinephrine (NE) transporter (NET) inhibitor. In vitro studies have also shown direct pharmacological effects on specific serotonin (5-HT) receptors, but not on the serotonin transporter (SERT). An in vivo microdialysis study in rats showed viloxazine (50 mg/kg i.p.) increased extracellular 5-HT, NE, and dopamine (DA) in the prefrontal cortex (PFC), a key brain region in ADHD pathology. This study evaluated whether these effects occur at clinically relevant concentrations. Methods: Microdialysis experiments were conducted in freely-moving, Sprague-Dawley rats (males, 8 weeks). Viloxazine (1, 3, 10, 30 mg/kg) was administered intraperitoneally to establish the dose range in rats at which viloxazine plasma concentrations aligned with those of individuals with ADHD administered therapeutic doses of viloxazine ER. Concentrations of unbound viloxazine, NE, 5-HT, DA, and NE and 5-HT metabolites (3,5-dihydroxyphenylglycol [DHPG] and 5-hydroxyindoleacetic acid [5-HIAA]) were measured in PFC interstitial fluid. After identifying a therapeutically relevant dose (30 mg/kg), the experiment was repeated using 30 and 50 mg/kg viloxazine (as 50 mg/kg increased NE, 5-HT, and DA in prior studies). Results: Viloxazine unbound (free drug) plasma concentrations in rats at 30 mg/kg were comparable to free drug concentrations in individuals with ADHD taking clinically effective doses (based on validated population PK models). Viloxazine 30 mg/kg significantly increased extracellular NE, 5-HT, and DA PFC levels compared to vehicle. Concomitant decreases in DHPG, but not 5-HIAA, support the inhibitory effect of viloxazine on NET but not SERT. Conclusion: At clinically relevant concentrations, viloxazine increases PFC NE, DA, and 5-HT. Prefrontal augmentation of 5-HT does not appear to result from 5-HT reuptake inhibition but may be related to activation of 5-HT neurons. The potential therapeutic role of serotonergic effects in ADHD treatment merits further exploration.

19.
PLoS One ; 19(5): e0294829, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38753718

RESUMO

In North America, a comparatively small number of Fraxinus (ash) cultivars were planted in large numbers in both urban and rural environments across the entire range of Fraxinus pennsylvanica Marsh (green ash) over the last 80 years. Undetected cultivar gene flow, if extensive, could significantly lower genetic diversity within populations, suppress differentiation between populations, generate interspecific admixture not driven by long-standing natural processes, and affect the impact of abiotic and biotic threats. In this investigation we generated the first range-wide genetic assessment of F. pennsylvanica to detect the extent of cultivar gene flow into natural stands. We used 16 EST-SSR markers to genotype 48 naturally regenerated populations of F. pennsylvanica distributed across the native range (1291 trees), 19 F. pennsylvanica cultivars, and one F. americana L. (white ash) cultivar to detect cultivar propagule dispersal into these populations. We detected first generation cultivar parentage with high confidence in 171 individuals in 34 of the 48 populations and extensive cultivar parentage (23-50%) in eight populations. The incidence of cultivar parentage was negatively associated with allele richness (R2 = 0.151, p = 0.006). The evidence for a locally high frequency of cultivar propagule dispersal and the interspecific admixture in eastern populations will inform Fraxinus gene pool conservation strategies and guide the selection of individuals for breeding programs focused on increasing resistance to the emerald ash borer (Agrilus planipennis Fairmaire), an existential threat to the Fraxinus species of North America.


Assuntos
Alelos , Fraxinus , Fluxo Gênico , Variação Genética , Fraxinus/genética , Genótipo , Repetições de Microssatélites/genética
20.
Proteome Sci ; 11(1): 2, 2013 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-23317283

RESUMO

BACKGROUND: Beech bark disease is an insect-fungus complex that damages and often kills American beech trees and has major ecological and economic impacts on forests of the northeastern United States and southeastern Canadian forests. The disease begins when exotic beech scale insects feed on the bark of trees, and is followed by infection of damaged bark tissues by one of the Neonectria species of fungi. Proteomic analysis was conducted of beech bark proteins from diseased trees and healthy trees in areas heavily infested with beech bark disease. All of the diseased trees had signs of Neonectria infection such as cankers or fruiting bodies. In previous tests reported elsewhere, all of the diseased trees were demonstrated to be susceptible to the scale insect and all of the healthy trees were demonstrated to be resistant to the scale insect. Sixteen trees were sampled from eight geographically isolated stands, the sample consisting of 10 healthy (scale-resistant) and 6 diseased/infested (scale-susceptible) trees. RESULTS: Proteins were extracted from each tree and analysed in triplicate by isoelectric focusing followed by denaturing gel electrophoresis. Gels were stained and protein spots identified and intensity quantified, then a statistical model was fit to identify significant differences between trees. A subset of BBD differential proteins were analysed by mass spectrometry and matched to known protein sequences for identification. Identified proteins had homology to stress, insect, and pathogen related proteins in other plant systems. Protein spots significantly different in diseased and healthy trees having no stand or disease-by-stand interaction effects were identified. CONCLUSIONS: Further study of these proteins should help to understand processes critical to resistance to beech bark disease and to develop biomarkers for use in tree breeding programs and for the selection of resistant trees prior to or in early stages of BBD development in stands. Early identification of resistant trees (prior to the full disease development in an area) will allow forest management through the removal of susceptible trees and their root-sprouts prior to the onset of disease, allowing management and mitigation of costs, economic impact, and impacts on ecological systems and services.

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