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1.
Mol Cell Proteomics ; 23(3): 100718, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38224738

RESUMEN

A functional role has been ascribed to the human dihydrofolate reductase 2 (DHFR2) gene based on the enzymatic activity of recombinant versions of the predicted translated protein. However, the in vivo function is still unclear. The high amino acid sequence identity (92%) between DHFR2 and its parental homolog, DHFR, makes analysis of the endogenous protein challenging. This paper describes a targeted mass spectrometry proteomics approach in several human cell lines and tissue types to identify DHFR2-specific peptides as evidence of its translation. We show definitive evidence that the DHFR2 activity in the mitochondria is in fact mediated by DHFR, and not DHFR2. Analysis of Ribo-seq data and an experimental assessment of ribosome association using a sucrose cushion showed that the two main Ensembl annotated mRNA isoforms of DHFR2, 201 and 202, are differentially associated with the ribosome. This indicates a functional role at both the RNA and protein level. However, we were unable to detect DHFR2 protein at a detectable level in most cell types examined despite various RNA isoforms of DHFR2 being relatively abundant. We did detect a DHFR2-specific peptide in embryonic heart, indicating that the protein may have a specific role during embryogenesis. We propose that the main functionality of the DHFR2 gene in adult cells is likely to arise at the RNA level.


Asunto(s)
ARN , Tetrahidrofolato Deshidrogenasa , Humanos , Línea Celular , Péptidos/metabolismo , Biosíntesis de Proteínas , Ribosomas/metabolismo , ARN/metabolismo , ARN Mensajero/metabolismo , Tetrahidrofolato Deshidrogenasa/genética , Tetrahidrofolato Deshidrogenasa/metabolismo
2.
Undersea Hyperb Med ; 50(4): 343-358, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38055875

RESUMEN

Introduction: Since the U.S. Navy transitioned from the MK10 to the MK11 submarine escape and immersion equipment (SEIE), there has been an increase in the incident rate of pulmonary barotrauma during submarine escape training. This study compares the ascent rate profiles of the MK10 and MK11 SEIE to determine if ascent rate differences between the escape suits are associated with increased pulmonary barotraumas. Methods: Buoyant ascent rates of the MK10 and MK11 SEIE were compared using weighted manikins equivalent to the 1st, 50th, and 99th percentile body weight of a submariner. Human ascents using the MK11 (n=126) were compared to human ascents in the same trainer wearing the MK10 (n=124). Results: Manikin mean ascent times were faster for the MK10 than the MK11 (5.19 seconds vs 5.28 seconds, p ≺ 0.05). Terminal velocity (Vt) was affected by manikin weight (p ≺ 0.001). Human trials confirmed the manikin results. The average mean ascent velocity for the MK10 group was 0.155 meters/ second faster than the MK11 group's mean ascent velocity (p ≺ 0.001). Mean ascent velocity was inversely correlated with all anthropometrics for the MK10 group (p ≺ 0.01). Neither height nor body mass index showed a significant association with mean ascent velocity for the MK11 group. Conclusions: The Vt of buoyant ascents is significantly affected by body weight. As the mean ascent rate of the MK11 is slower than that of the MK10, ascent rate profile differences between the suits do not appear to explain the recent increase in pulmonary barotrauma incident rates during escape training.


Asunto(s)
Barotrauma , Medicina Submarina , Humanos , Inmersión , Peso Corporal , Medicina Submarina/métodos
3.
Undersea Hyperb Med ; 49(1): 13-28, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35226973

RESUMEN

PURPOSE: To identify the most prevalent health conditions among divers during their last year of Navy service. METHODS: For this retrospective descriptive study we used data from the Dive Jump Reporting System to identify 4,623 active-duty divers who separated between 2008 and 2018. Medical records, dive histories, and personnel files were merged, linked and analyzed at the individual level. RESULTS: On average, 420 divers separated each year. Among the separating divers, 99% were male, 26% were aged 25 to 29 years old with a mean age of 35 (SD = 9, range 18 to 65). The major medical categories with the highest numbers of divers affected were: musculoskeletal system diseases (prevalence rate (PR) = 515.2 per 1,000 divers/year); nervous system (PR = 411.9); injury and poisonings (PR = 249.8); and mental disorders (PR = 237.3). Of the 50 specific conditions that affected the most divers the top four were joint disorders (PR = 34.5), disorders of refraction and accommodation (PR = 30.1), back disorders (PR = 26.8) and organic sleep disorders (PR = 21.6). Compared to divers with fewer than 29 dives, divers with 49-plus dives were about twice as likely to have diagnoses related to symptoms involving head and neck. CONCLUSIONS: The study found high rates of conditions such as musculoskeletal disorders, joint and back disorders, and some mental health related disorders. Special warfare divers have high rates of hearing loss, and other disorders of ear. The results show the need and to develop and implement group-specific mitigation programs.


Asunto(s)
Buceo , Pérdida Auditiva , Adulto , Buceo/efectos adversos , Humanos , Masculino , Prevalencia , Estudios Retrospectivos
4.
Undersea Hyperb Med ; 49(4): 425-445, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36446289

RESUMEN

Introduction: This is the first study to examine population medication prescription rates among U.S. submariners by common therapeutic classifications. Methods: Individual-level pharmacy records during the years 2007 to 2018 were extracted from the Military Health System's Pharmacy Data Transaction Service (PDTS) file. Demographic and military factors captured from Navy personnel files were linked to PDTS records. Logistic regression models were used to identify characteristics and trends associated with prevalence. Published total rates for other active-duty components were compared to submariner rates. Results: There were data for 50,720 submariners, among whom 576,782 prescriptions were filled. Prevalence rates decreased significantly from 2007-2018 among most drug classes. Central nervous system agents accounted for 31% of the total prescriptions, followed by 12% for eye, ear, nose, and throat preparations, and 10% for anti-infective agents. Higher prescription rates were associated with being enlisted, younger, a woman, lower-ranked, or Hispanic. The mean yearly prescription rate was 2.7 per submariner, less than half of the overall rate of all military components. Conclusion: The survival benefit of HBO2 therapy observed in our unadjusted analysis suggests that there may be therapeutic benefits of HBO2 in treating COVID-19 hypoxia as an adjunct to standard care.


Asunto(s)
COVID-19 , Personal Militar , Femenino , Humanos , Prescripciones , Hipoxia , Modelos Logísticos
5.
Healthc Q ; 22(SP): 129-134, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32049623

RESUMEN

As the co-chair of Patients for Patient Safety Canada (PFPSC), I have had the opportunity to be a guest editor for this Special Issue of Healthcare Quarterly and, consequently, have reviewed and critiqued each article. I also was a patient partner in the National Patient Safety Consortium, the work of which is the basis for the articles in this issue. Patient safety is a serious issue in Canada. In fact, unintended harm while receiving healthcare is the third leading cause of death in Canada (RiskAnalytica 2017). The papers in this issue describe initiatives that have the potential to and/or have contributed to reducing patient harm if implemented across our system and in such a way that patients and families are an integral part of the process.


Asunto(s)
Participación del Paciente , Seguridad del Paciente , Canadá , Familia , Humanos , Errores Médicos/prevención & control
6.
Healthc Q ; 22(SP): 6-9, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32049611

RESUMEN

Patient safety has come a long way since the release of the 1999 Institute of Medicine report To Err Is Human. This report revealed the immense size of the problem of preventable adverse events - events that in the past we assumed were "just complications" occurring in the normal course of diagnosis and treatment. Simultaneously, shining the light on patient safety "took the lid off quality." Those of us involved in healthcare provision always had a commitment to providing high-quality care, yet the focus of many key stakeholders on the importance of high-quality healthcare had been limited. The focus tended to be disproportionately on the rising cost of healthcare rather than a balanced focus on quality. Now, we respect the imperative of achieving high-quality healthcare.


Asunto(s)
Seguridad del Paciente , Calidad de la Atención de Salud , Humanos , Errores Médicos/prevención & control
7.
J Psychosoc Nurs Ment Health Serv ; 55(6): 23-29, 2017 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-28585664

RESUMEN

Perinatal mood and anxiety disorders (PMAD) are the most common, yet under-diagnosed and undertreated complication of pregnancy, affecting up to 50% of pregnant and parenting teens. PMAD are a global health issue that can have devastating effects on the mental, physical, emotional, developmental health, and social life of the mother, infant, and family. Adolescents present with similar symptoms of PMAD as their adult counterparts, but also experience isolation from their peer group and lack of resources and coping strategies, as well as difficulty sleeping and lack of concentration and ability to focus. Nurses and nurse practitioners are in an ideal position to assess preexisting risk factors for PMAD. The current applied evidence-based article addresses the diagnosis of PMAD, provides a conceptual framework for understanding the intra- and interpersonal dynamics affecting teens with PMAD, and suggests a new screening tool to guide diagnosis. An easy to recall mnemonic for diagnosis and referral (SAIL AHEAD) is proposed. By using the SAIL AHEAD mnemonic, providers will impact adolescents' parenting success and resiliency, thereby enhancing their future success in life. [Journal of Psychosocial Nursing and Mental Health Services, 55(6), 23-29.].


Asunto(s)
Ansiedad/diagnóstico , Depresión/diagnóstico , Atención Perinatal/estadística & datos numéricos , Encuestas y Cuestionarios , Adolescente , Ansiedad/terapia , Depresión/terapia , Depresión Posparto/diagnóstico , Emociones , Femenino , Humanos , Servicios de Salud Mental/estadística & datos numéricos , Responsabilidad Parental/psicología , Embarazo , Factores de Riesgo
8.
PLoS Genet ; 8(3): e1002552, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22412385

RESUMEN

Type 1 diabetes (T1D) is an autoimmune disease in which pancreatic beta cells are killed by infiltrating immune cells and by cytokines released by these cells. Signaling events occurring in the pancreatic beta cells are decisive for their survival or death in diabetes. We have used RNA sequencing (RNA-seq) to identify transcripts, including splice variants, expressed in human islets of Langerhans under control conditions or following exposure to the pro-inflammatory cytokines interleukin-1ß (IL-1ß) and interferon-γ (IFN-γ). Based on this unique dataset, we examined whether putative candidate genes for T1D, previously identified by GWAS, are expressed in human islets. A total of 29,776 transcripts were identified as expressed in human islets. Expression of around 20% of these transcripts was modified by pro-inflammatory cytokines, including apoptosis- and inflammation-related genes. Chemokines were among the transcripts most modified by cytokines, a finding confirmed at the protein level by ELISA. Interestingly, 35% of the genes expressed in human islets undergo alternative splicing as annotated in RefSeq, and cytokines caused substantial changes in spliced transcripts. Nova1, previously considered a brain-specific regulator of mRNA splicing, is expressed in islets and its knockdown modified splicing. 25/41 of the candidate genes for T1D are expressed in islets, and cytokines modified expression of several of these transcripts. The present study doubles the number of known genes expressed in human islets and shows that cytokines modify alternative splicing in human islet cells. Importantly, it indicates that more than half of the known T1D candidate genes are expressed in human islets. This, and the production of a large number of chemokines and cytokines by cytokine-exposed islets, reinforces the concept of a dialog between pancreatic islets and the immune system in T1D. This dialog is modulated by candidate genes for the disease at both the immune system and beta cell level.


Asunto(s)
Diabetes Mellitus Tipo 1 , Células Secretoras de Insulina , Interferón gamma , Interleucina-1beta , Islotes Pancreáticos , Transducción de Señal , Adulto , Anciano , Anciano de 80 o más Años , Empalme Alternativo/genética , Animales , Apoptosis , Línea Celular , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/inmunología , Femenino , Regulación de la Expresión Génica , Estudios de Asociación Genética , Humanos , Sistema Inmunológico , Insulina/metabolismo , Secreción de Insulina , Células Secretoras de Insulina/inmunología , Células Secretoras de Insulina/metabolismo , Interferón gamma/genética , Interferón gamma/metabolismo , Interleucina-1beta/genética , Interleucina-1beta/metabolismo , Islotes Pancreáticos/inmunología , Islotes Pancreáticos/metabolismo , Masculino , Ratones , Persona de Mediana Edad , Ratas , Ratas Wistar , Análisis de Secuencia de ARN , Transcriptoma/genética
9.
Res Nurs Health ; 38(5): 403-16, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26074447

RESUMEN

Decisional involvement is widely recognized as an essential component of a professional nursing practice environment. In recent years, researchers have added to the conceptualization of nurses' role in decision-making to differentiate between the content and context of nursing practice. Yet, instruments that clearly distinguish between these two dimensions of practice are lacking. The purpose of this study was to examine the factorial validity of the Decisional Involvement Scale (DIS) as a measure of both the content and context of nursing practice. This secondary analysis was conducted using data from a longitudinal action research project to improve the quality of nursing practice and patient care in six hospitals (N = 1,034) in medically underserved counties of Pennsylvania. A cross-sectional analysis of baseline data from the parent study was used to compare the factor structure of two models (one nested within the other) using confirmatory factor analysis. Although a comparison of the two models indicated that the addition of second-order factors for the content and context of nursing practice improved model fit, neither model provided optimal fit to the data. Additional model-generating research is needed to develop the DIS as a valid measure of decisional involvement for both the content and context of nursing practice.


Asunto(s)
Investigación en Enfermería Clínica/organización & administración , Toma de Decisiones , Modelos de Enfermería , Rol de la Enfermera , Atención de Enfermería/organización & administración , Personal de Enfermería en Hospital/organización & administración , Poder Psicológico , Adulto , Estudios Transversales , Análisis Factorial , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pennsylvania , Psicometría , Adulto Joven
10.
Plant Cell ; 23(3): 873-94, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21447789

RESUMEN

Leaf senescence is an essential developmental process that impacts dramatically on crop yields and involves altered regulation of thousands of genes and many metabolic and signaling pathways, resulting in major changes in the leaf. The regulation of senescence is complex, and although senescence regulatory genes have been characterized, there is little information on how these function in the global control of the process. We used microarray analysis to obtain a high-resolution time-course profile of gene expression during development of a single leaf over a 3-week period to senescence. A complex experimental design approach and a combination of methods were used to extract high-quality replicated data and to identify differentially expressed genes. The multiple time points enable the use of highly informative clustering to reveal distinct time points at which signaling and metabolic pathways change. Analysis of motif enrichment, as well as comparison of transcription factor (TF) families showing altered expression over the time course, identify clear groups of TFs active at different stages of leaf development and senescence. These data enable connection of metabolic processes, signaling pathways, and specific TF activity, which will underpin the development of network models to elucidate the process of senescence.


Asunto(s)
Proteínas de Arabidopsis/análisis , Arabidopsis/genética , Regulación de la Expresión Génica de las Plantas , Hojas de la Planta/metabolismo , Análisis de Varianza , Arabidopsis/crecimiento & desarrollo , Arabidopsis/metabolismo , Proteínas de Arabidopsis/genética , Clorofila/análisis , Análisis por Conglomerados , Perfilación de la Expresión Génica , Análisis por Micromatrices/métodos , Modelos Biológicos , Familia de Multigenes , Reguladores del Crecimiento de las Plantas/análisis , Hojas de la Planta/genética , Hojas de la Planta/crecimiento & desarrollo , Regiones Promotoras Genéticas , ARN de Planta/genética , Factores de Transcripción/metabolismo
11.
Urol Nurs ; 34(6): 281-9, 311, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-26298924

RESUMEN

The limitations of PSA and DRE screening for prostate cancer have prompted much research into genetic-based screenings. This survey of innovations and obstacles in genomic testing will help prepare urologic clinicians for future interventions.


Asunto(s)
Pruebas Genéticas/métodos , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/genética , Biomarcadores de Tumor/análisis , Detección Precoz del Cáncer , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Masculino
12.
Tob Control ; 22(e1): e66-72, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-22871902

RESUMEN

OBJECTIVE: To evaluate the effectiveness of the US Navy and Marine Corps tobacco policy in protecting submariners from secondhand smoke (SHS) by determining if non-tobacco users experienced a significant increase in urinary cotinine levels at sea when compared with in port levels. METHODS: From February to August 2009, 634 volunteers recruited from nine US Navy submarines completed a survey to collect demographic data, information on tobacco use and pre-deployment exposure to SHS. Non-tobacco users (n=239) were requested to provide two urine samples (pre-deployment and while at sea) to quantify exposure to SHS using urinary cotinine as a biomarker. Matched samples were analysed using liquid chromatography-tandem mass spectrometry. RESULTS: Overall, deployed cotinine levels were 2.1 times the in port levels in non-tobacco using submariners (95% CI 1.8 to 2.4, p<0.001, n=197). A significant increase in deployed urinary cotinine levels was found aboard six of nine submarines (p<0.05). A subgroup of submariners (n=91) who reported no SHS exposure within 10 days prior to in port cotinine sampling had deployed cotinine levels 2.7 times the in port levels (95% CI 2.2 to 3.3, p<0.001). Applying a 4.5:1 urine cotinine to serum cotinine correction factor, submariners' deployed geometric means are similar to recent US male population values at the 75th percentile. CONCLUSIONS: This study provides evidence that non-tobacco using submariners were exposed to SHS. Exposure was seen in all submarine classes and was not limited to personnel working in proximity to the smoking area. The existing policy was inadequate to protect non-smokers from exposure to SHS and required revision. As a result of a policy review, informed by this study, smoking below decks was banned aboard all US Navy submarines effective 31 December 2010.


Asunto(s)
Personal Militar , Política para Fumadores , Contaminación por Humo de Tabaco/análisis , Adulto , Contaminación del Aire Interior/análisis , Contaminación del Aire Interior/prevención & control , Biomarcadores/orina , Cotinina/orina , Exposición a Riesgos Ambientales/análisis , Monitoreo del Ambiente/métodos , Humanos , Masculino , Exposición Profesional/análisis , Exposición Profesional/prevención & control , Prevalencia , Fumar/epidemiología , Prevención del Hábito de Fumar , Medicina Submarina/métodos , Contaminación por Humo de Tabaco/prevención & control , Estados Unidos/epidemiología
13.
J Radiol Prot ; 33(2): 261-79, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23482389

RESUMEN

Measured concentrations of Cs-137, tritium, Tc-99, Pu-239+240 and Am-241 in representative materials from the Irish Sea were investigated with reference to continuing remobilisation from sediments. Long time series of monitoring data since the 1960s were employed.Cs-137 in sea water and fish shows peaks in concentrations normalised to discharge rate (NACs) from 1985 to 1989. This is consistent with the time needed for dispersion in sea water following the preceding reductions in discharges; continuing enhancements of NACs above pre-1970s levels follow, consistent with the effect of activity remobilised from sediment. It is estimated that about 300 TBq of Cs-137 was remobilised from the immediate tidal area around Sellafield from 1989 to 2009. The enhancements in concentrations continue to this day, with the effect of remobilisation at present being ∼6 TBq y(-1), approximately doubling the effect of direct discharges. To provide an indication for the future, the rate of Cs-137 remobilisation is decreasing with a half-time of ∼6 years.The data for tritium and Tc-99 were examined in view of the interest in these radionuclides. The concentrations broadly reflect the levels of discharges and the need for dispersion. As expected, there is no evidence of sustained remobilisation of tritium, due to its mobility (or low Kd). The same lack of evidence was found to apply for Tc-99 despite known sorption of a small proportion of the discharged activity by Irish Sea sediments.Pu-239+240, by contrast, shows much evidence of the effect of remobilisation; concentrations in sea water near Sellafield have reduced much more slowly than discharges. At Southerness, ∼50 km away, there was no significant reduction in sea water concentrations from 1985 to 1996, and winkles showed an increase then decrease in concentrations over this period, consistent with a spreading of activity. This effect was replicated in mud at Garlieston, ∼70 km from Sellafield.For Am-241, the rate of grow-in from Pu-241 has dominated direct discharges since the late 1970s. Grow-in continues today in the Irish Sea at the rate of ∼8 TBq y(-1), ∼200 times the rate of direct discharge. Winkles at Southerness show evidence of a spreading effect of Am-241, with an increase then decrease from 1985 to 1996. At Garlieston there was an increase in concentrations in mud from 1985 to 1997, and at Carlingford in Northern Ireland the concentration of Am-241 in mud appears to be increasing still. This effect of the spread of activity away from Sellafield may continue, at least in the near future.


Asunto(s)
Sedimentos Geológicos/química , Monitoreo de Radiación/métodos , Radioisótopos/análisis , Agua de Mar/química , Contaminantes Radiactivos del Suelo/análisis , Contaminantes Radiactivos del Agua/análisis , Sedimentos Geológicos/análisis , Irlanda , Océanos y Mares , Agua de Mar/análisis
14.
Mil Med ; 188(Suppl 6): 215-224, 2023 11 08.
Artículo en Inglés | MEDLINE | ID: mdl-37948206

RESUMEN

INTRODUCTION: Although women have always served in the U.S. Armed Forces, it has only been in the last half century that systematic examinations have been done on the health issues experienced by military women. Still, little is known about how occupational health risks among Navy divers might vary between men and women. Our objective was to use available data to examine health issues among all separating divers and then determine how prevalence rates varied between men and women for diagnoses made within the diver's last year of active duty service. MATERIALS AND METHODS: For this retrospective observational study, medical records and personnel data were linked with dive logs at the individual level. We calculated sex-specific prevalence rates and relative risks per 1,000 divers by major diagnostic categories and by specific disease diagnoses. RESULTS: We identified 47 women among the 4,623 active duty Navy divers (1.0%) who separated between 2008 and 2018. Ages varied between 19 and 54 years (M = 33, SD = 8) for women, compared to men who were 18-65 years (M = 35, SD = 9). When compared to men, women had about six times the rate of diseases of the genitourinary system, twice the rate of respiratory system diseases, and about four times as many diagnoses of disorders of the lacrimal system. CONCLUSIONS: The findings of much higher relative risks for women for conditions such as genitourinary disease, skin conditions, and acute respiratory infections require follow-up research to look for causes and potential risk reduction interventions. Future research must determine specific and relative risks as a necessary precursor to developing, implementing, and testing potentially sex-specific risk reduction and health improvement interventions.


Asunto(s)
Buceo , Personal Militar , Femenino , Humanos , Masculino , Buceo/efectos adversos , Examen Físico , Estudios Retrospectivos , Riesgo , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano
15.
Int J Cancer ; 130(9): 1991-2002, 2012 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-21618523

RESUMEN

Melanoma-associated antigen (MAGE) family members are generally described as tumor-specific antigens. An association between MAGE-D4B and breast cancer has yet to be reported and the functional role of the encoded protein has never been established. We performed microarray analysis of 104 invasive breast tumors and matched non-cancerous breast biopsies. qPCR was used for validation in an independent biobank. To investigate the biological relevance of MAGE-D4B in breast tumorigenesis, its phenotypic effects were assessed in vitro. Overall, MAGE-D4B was detected in 43% of tumors while undetected in normal breast tissue. MAGE-D4B was found to correlate with tumor progression and to be an independent prognostic marker for poor outcome in term of relapse-free and overall survival, with potential predictive relevance in relation to response to chemotherapy. RNA interference-mediated knockdown of MAGE-D4B significantly hampered the invasive properties of Hs578T cells by affecting anchorage-independent growth, adhesion, migration and invasion affecting anchorage-independent growth, adhesion, migration and invasion and by modulating expression of invasion-suppressor gene E-cadherin.


Asunto(s)
Antígenos de Neoplasias/metabolismo , Biomarcadores de Tumor/genética , Neoplasias de la Mama/genética , Proteínas de Neoplasias/genética , Adulto , Anciano , Anciano de 80 o más Años , Antígenos de Neoplasias/genética , Biomarcadores de Tumor/metabolismo , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/patología , Cadherinas/genética , Cadherinas/metabolismo , Adhesión Celular , Línea Celular Tumoral , Movimiento Celular , Femenino , Estudios de Seguimiento , Regulación Neoplásica de la Expresión Génica , Silenciador del Gen , Humanos , Estimación de Kaplan-Meier , Persona de Mediana Edad , Invasividad Neoplásica , Proteínas de Neoplasias/metabolismo , Estadificación de Neoplasias , Análisis de Secuencia por Matrices de Oligonucleótidos/métodos , Pronóstico , Resultado del Tratamiento
16.
J Nurs Adm ; 42(10 Suppl): S27-36, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22976891

RESUMEN

BACKGROUND: Describing the safety climate in hospitals is an important first step in creating work environments where safety is a priority. Yet, little is known about the patient safety climate on medical-surgical units. PURPOSES: Study purposes were to describe quality and strength of the patient safety climate on medical-surgical units and explore hospital and unit characteristics associated with this climate. METHODOLOGY: Data came from a larger organizational study to investigate hospital and unit characteristics associated with organizational, nurse, and patient outcomes. The sample for this study was 3,689 RNs on 286 medical-surgical units in 146 hospitals. FINDINGS: Nursing workgroup and managerial commitment to safety were the two most strongly positive attributes of the patient safety climate. However, issues surrounding the balance between job duties and safety compliance and nurses' reluctance to reveal errors continue to be problematic. Nurses in Magnet hospitals were more likely to communicate about errors and participate in error-related problem solving. Nurses on smaller units and units with lower work complexity reported greater safety compliance and were more likely to communicate about and reveal errors. Nurses on smaller units also reported greater commitment to patient safety and participation in error-related problem solving. PRACTICE IMPLICATIONS: Nursing workgroup commitment to safety is a valuable resource that can be leveraged to promote a sense of personal responsibility for and shared ownership of patient safety. Managers can capitalize on this commitment by promoting a work environment in which control over nursing practice and active participation in unit decisions are encouraged and by developing channels of communication that increase staff nurse involvement in identifying patient safety issues, prioritizing unit-level safety goals, and resolving day-to-day operational problems the have the potential to jeopardize patient safety.

17.
Policy Polit Nurs Pract ; 13(1): 54-63, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22585672

RESUMEN

Delayed access to physicians has been identified as a factor in preventable adverse patient events during hospitalization. Nurses as front-line providers are well positioned to provide a timely response to the needs of patients. Yet legal regulations and hospital policies limit the actions nurses can initiate without physician authorization. The purpose of this qualitative study was to describe what experienced critical care nurses do when they recognize a problem that warrants treatment but lack physician authorization to intervene. The 13 nurses who participated in this study bridged the gap between problem recognition and treatment by communicating proactively, being persistent, running interference for other nurses, and, in some situations, acting without physician authorization. Revising legal regulations and hospital policies to incorporate greater acknowledgment of the overlapping functions between medicine and nursing and recognition of the knowledge and expertise of experienced nurses may be important in reducing unnecessary treatment delays during hospitalization.


Asunto(s)
Hospitalización , Enfermeras Clínicas/organización & administración , Evaluación en Enfermería , Grupo de Atención al Paciente/organización & administración , Relaciones Médico-Enfermero , Cuidados Críticos/organización & administración , Diagnóstico Precoz , Femenino , Política de Salud , Humanos , Masculino , Rol de la Enfermera , Personal de Enfermería en Hospital/organización & administración , Evaluación de Resultado en la Atención de Salud , Atención al Paciente/normas , Atención al Paciente/tendencias , Formulación de Políticas , Competencia Profesional , Investigación Cualitativa , Estados Unidos
18.
Ann Work Expo Health ; 66(1): 60-68, 2022 01 07.
Artículo en Inglés | MEDLINE | ID: mdl-34698335

RESUMEN

OBJECTIVES: To investigate the change in hearing and perceived comfort over 1 year related to using an active hearing protection device (HPD) among United States Marine Corps (USMC) personnel routinely exposed to hazardous noise. METHODS: USMC Weapons Instructors (n = 127) were issued an active earmuff that met military standards and was compatible with other protective equipment. These participants completed pre- and post-hearing tests and comfort surveys. A control cohort (n = 94) was also included to compare individual changes in high-frequency pure tone average (HF-PTA) over 1 year. RESULTS: The control group's HF-PTA was 3 dB worse than the intervention group after only 1 year. Survey responses revealed perceived improvements in the ability to hear and understand, situational awareness, and safety. CONCLUSIONS: Active HPDs can reduce hearing loss and improve hearing-related occupational tasks.


Asunto(s)
Pérdida Auditiva Provocada por Ruido , Personal Militar , Ruido en el Ambiente de Trabajo , Exposición Profesional , Dispositivos de Protección de los Oídos , Audición , Pérdida Auditiva Provocada por Ruido/epidemiología , Pérdida Auditiva Provocada por Ruido/prevención & control , Pruebas Auditivas , Humanos , Ruido en el Ambiente de Trabajo/prevención & control , Exposición Profesional/análisis , Estados Unidos
19.
Mil Med ; 2022 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-35284923

RESUMEN

INTRODUCTION: Maintaining healthy, well-trained, and highly qualified armed forces is critical for ensuring military readiness. The purpose of this article is to contribute to the body of research focused on the health of U.S. Navy submariners and to identify the health conditions of U.S. Navy submariners during their final year of active duty service. MATERIALS AND METHODS: In this retrospective cohort study, we examined medical records and personnel files of separating U.S. Navy sailors who were: (1) active duty between 2009 and 2018; (2) separated before 2019; and (3) were assigned to a submarine for at least 30 days. Both officers and enlisted service members were included. We linked, described, and analyzed data from the Defense Health Agency, Military Health System Data Repository (MDR), and the Bureau of Naval Personnel (BUPERS). International Classification of Diseases (ICD) diagnoses codes were obtained from MDR. Data collected from BUPERS include age, sex, and rank. We determined the number of individuals who had at least one diagnosed condition (identified as a three-digit ICD code). We report the number of diagnoses and calculate prevalence rates and confidence intervals per condition, as well as prevalence rates per year, using standard formulas. The study was approved by the Naval Submarine Medical Research Laboratory Institutional Review Board. RESULTS: During the study period, 26,014 submariners separated from the Navy. The average number of separations per year was 2,601. About a third of the separating submariners were in the 25 to 29 age group and over 50% were under 30 years of age. Of the three-digit individual ICD codes, some of the highest operationally relevant rates over the 10-year study period (2009-2018) were for joint disorders (prevalence rate [PR] = 180 per 1,000 submariners), back disorders (PR = 128), and sleep disorders (PR = 134). Three mental-health-related conditions were also among the 20 conditions with the highest rates. CONCLUSIONS: High rates of specific diagnoses such as joint disorders indicate the need for additional study to examine causal relationships, to determine which conditions may contribute to lost work time, early separations, or low rates of reenlistment and which conditions might be a result of specific military occupations or duties. Study strengths are the large number of subjects and the long period of observations. A study weakness was the inability to identify submariners who separated because of health conditions. The overall impact of the study is that it identifies urgent health risks and establishes a way to prioritize future research. Future research should include a focus on medically separated personnel; compare rates for submariners to other military groups including all-Navy and all-Department of Defense; and determine specific and relative risks as a necessary precursor to developing, implementing, and testing risk reduction and health improvement interventions.

20.
Mol Plant Microbe Interact ; 24(7): 827-38, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21361788

RESUMEN

RPP5 is the seminal example of a cytoplasmic NB-LRR receptor-like protein that confers downy mildew resistance in Arabidopsis thaliana. In this study, we describe the cloning and molecular characterization of the gene encoding ATR5(Emoy2), an avirulence protein from the downy mildew pathogen Hyaloperonospora arabidopsidis isolate Emoy2. ATR5(Emoy2) triggers defense response in host lines expressing the functional RPP5 allele from Landsberg erecta (Ler-0). ATR5(Emoy2) is embedded in a cluster with two additional ATR5-like (ATR5L) genes, most likely resulting from gene duplications. ATR5L proteins do not trigger RPP5-mediated resistance and the copy number of ATR5L genes varies among H. arabidopsidis isolates. ATR5(Emoy2) and ATR5L proteins contain a signal peptide, canonical EER motif, and an RGD motif. However, they lack the canonical translocation motif RXLR, which characterizes most oomycete effectors identified so far. The signal peptide and the N-terminal regions including the EER motif of ATR5(Emoy2) are not required to trigger an RPP5-dependent immune response. Bioinformatics screen of H. arabidopsidis Emoy2 genome revealed the presence of 173 open reading frames that potentially encode for secreted proteins similar to ATR5(Emoy2), in which they share some motifs such as EER but there is no canonical RXLR motif.


Asunto(s)
Proteínas de Arabidopsis/metabolismo , Arabidopsis/metabolismo , Genes , Oomicetos/genética , Enfermedades de las Plantas , Secuencia de Aminoácidos , Análisis del Polimorfismo de Longitud de Fragmentos Amplificados , Arabidopsis/genética , Proteínas de Arabidopsis/genética , Secuencia de Bases , Clonación Molecular , Resistencia a la Enfermedad , Duplicación de Gen , Perfilación de la Expresión Génica , Regulación de la Expresión Génica de las Plantas , Datos de Secuencia Molecular , Familia de Multigenes , Proteínas/química , Proteínas/genética , Proteínas/fisiología , Alineación de Secuencia , Análisis de Secuencia de ADN
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