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1.
Heart Lung Circ ; 32(1): 67-78, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36463077

RESUMEN

BACKGROUND AND AIM: COVID-19 can be transmitted through aerosolised respiratory particles. The degree to which exercise enhances aerosol production has not been previously assessed. We aimed to quantify the size and concentration of aerosol particles and evaluate the impact of physical distance and surgical mask wearing during high intensity exercise (HIE). METHODS: Using a prospective observational crossover study, three healthy volunteers performed high intensity cardiopulmonary exercise testing at 80% of peak capacity in repeated 5-minute bouts on a cycle ergometer. Aerosol size and concentration was measured at 35, 150 and 300 cm from the participants in an anterior and lateral direction, with and without a surgical face mask, using an Aerodynamic Particle Sizer (APS) and a Mini Wide Range Aerosol Spectrometer (MiniWRAS), with over 10,000 sample points. RESULTS: High intensity exercise generates aerosol in the 0.2-1 micrometre range. Increasing distance from the rider reduces aerosol concentrations measured by both MiniWRAS (p=0.003 for interaction) and APS (p=0.041). However, aerosol concentrations remained significantly increased above baseline measures at 300 cm from the rider. A surgical face mask reduced submicron aerosol concentrations measured anteriorly to the rider (p=0.031 for interaction) but not when measured laterally (p=0.64 for interaction). CONCLUSIONS: High intensity exercise is an aerosol generating activity. Significant concentrations of aerosol particles are measurable well beyond the commonly recommended 150 cm of physical distancing. A surgical face mask reduces aerosol concentration anteriorly but not laterally to an exercising individual. Measures for safer exercise should emphasise distance and airflow and not rely solely on mask wearing.


Asunto(s)
COVID-19 , Humanos , Estudios Cruzados , Aerosoles y Gotitas Respiratorias , Pulmón , Máscaras
2.
Pituitary ; 24(4): 499-506, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33469830

RESUMEN

PURPOSE: To determine the particle size, concentration, airborne duration and spread during endoscopic endonasal pituitary surgery in actual patients in a theatre setting. METHODS: This observational study recruited a convenience sample of three patients. Procedures were performed in a positive pressure operating room. Particle image velocimetry and spectrometry with air sampling were used for aerosol detection. RESULTS: Intubation and extubation generated small particles (< 5 µm) in mean concentrations 12 times greater than background noise (p < 0.001). The mean particle concentrations during endonasal access were 4.5 times greater than background (p = 0.01). Particles were typically large (> 75 µm), remained airborne for up to 10 s and travelled up to 1.1 m. Use of a microdebrider generated mean aerosol concentrations 18 times above baseline (p = 0.005). High-speed drilling did not produce aerosols greater than baseline. Pituitary tumour resection generated mean aerosol concentrations less than background (p = 0.18). Surgical drape removal generated small and large particles in mean concentrations 6.4 times greater than background (p < 0.001). CONCLUSION: Intubation and extubation generate large amounts of small particles that remain suspended in air for long durations and disperse through theatre. Endonasal access and pituitary tumour resection generate smaller concentrations of larger particles which are airborne for shorter periods and travel shorter distances.


Asunto(s)
Aerosoles/efectos adversos , Endoscopía/efectos adversos , Neoplasias Hipofisarias/cirugía , Extubación Traqueal/efectos adversos , Humanos , Intubación Intratraqueal/efectos adversos , Movimiento (Física) , Exposición Profesional/efectos adversos , Salud Laboral , Quirófanos , Tamaño de la Partícula , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo
3.
Labour Econ ; 72: 102060, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34493904

RESUMEN

The COVID-19 pandemic significantly affected data collection for the nation's primary source of household-level labor force data, the Current Population Survey (CPS). In the first four months of the pandemic period (March-June 2020) the average month-over-month nonresponse rate increased by 58 percent, while the size of newly entering cohorts declined by 37 percent relative to the prior 15 months. Together, these factors reduced the overall sample size of the CPS by around 16 percent. We hypothesize that these changes, and significant associated shifts in the demographic composition of the sample, were caused by the cessation of in-person interviewing. Geographic variation in nonresponse over this period does not appear related to variation in COVID case rates across metro areas or states. Using this change in interview method as a natural experiment, we compare labor market outcomes of those who entered the survey pre- and post-COVID pandemic and find that the change in how individuals were recruited into the survey affected estimates of unemployment and labor force participation. In an exercise generating a counterfactual group of "missing" respondents, we estimate that, between April and August of 2020, the average unemployment rate was 0.5 to 0.7 percentage points higher, and the labor force participation rate was 0.4 to 0.8 percentage points lower than estimates using the actual sample of respondents. One implication of these results is that web-based surveys, which are increasingly relied on in empirical labor market studies, may fail to reach important subpopulations of the labor market and that reweighting is unlikely to address the selection on outcomes we document.

4.
Demography ; 57(1): 323-346, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32030626

RESUMEN

In this article, we conduct a comprehensive analysis of the effect of parental involvement (PI) laws on the incidence of abortions to minors in the United States. We contribute to the extant literature in several ways. First, we explore differences in estimates of the effect of PI laws across time that may result from changes in contraception, the composition of pregnant minors, abortion access in nearby states, and differences in how these laws are enforced. We find that PI laws enacted before the mid-1990s are associated with a 15% to 20% reduction in abortions to minors, but PI laws enacted after this time are not associated with declines in abortions to minors. Second, we assess the role of out-of-state travel by minors and find that it is not a significant factor moderating the effect of PI laws. Third, we use a synthetic control approach to explore state-level heterogeneity in the effect of PI laws and find large differences in the effect of PI laws on abortions to minors by state that appear unrelated to the type of PI law or whether contiguous states have enacted PI laws. Finally, we show that estimates of the effect of PI laws using data from either the Centers for Disease Control or the Guttmacher Institute do not differ qualitatively once differences in the states and years available across these data are harmonized.


Asunto(s)
Aborto Inducido/legislación & jurisprudencia , Aborto Inducido/estadística & datos numéricos , Padres , Adolescente , Femenino , Humanos , Estados Unidos
5.
Sensors (Basel) ; 20(21)2020 Oct 27.
Artículo en Inglés | MEDLINE | ID: mdl-33120957

RESUMEN

Lysenin is a pore-forming protein extracted from the earthworm Eisenia fetida, which inserts large conductance pores in artificial and natural lipid membranes containing sphingomyelin. Its cytolytic and hemolytic activity is rather indicative of a pore-forming toxin; however, lysenin channels present intricate regulatory features manifested as a reduction in conductance upon exposure to multivalent ions. Lysenin pores also present a large unobstructed channel, which enables the translocation of analytes, such as short DNA and peptide molecules, driven by electrochemical gradients. These important features of lysenin channels provide opportunities for using them as sensors for a large variety of applications. In this respect, this literature review is focused on investigations aimed at the potential use of lysenin channels as analytical tools. The described explorations include interactions with multivalent inorganic and organic cations, analyses on the reversibility of such interactions, insights into the regulation mechanisms of lysenin channels, interactions with purines, stochastic sensing of peptides and DNA molecules, and evidence of molecular translocation. Lysenin channels present themselves as versatile sensing platforms that exploit either intrinsic regulatory features or the changes in ionic currents elicited when molecules thread the conducting pathway, which may be further developed into analytical tools of high specificity and sensitivity or exploited for other scientific biotechnological applications.

6.
Med Teach ; 41(4): 457-464, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30451051

RESUMEN

Introduction: ASPIRE Excellence Awards in Student Assessment are offered to medical schools with innovative and comprehensive assessment programmes adjudged by international experts, using evidence-based criteria. The journeys of three ASPIRE-winning medical schools toward "assessment excellence" are presented. These schools include Aga Khan University Medical College (AKU-MC), Pakistan, Southern Illinois University School of Medicine (SIUSOM), USA, and University of Leeds School of Medicine, UK. Methods: The unfolding journeys highlighting achievements, innovations, and essential components of each assessment programme were compared to identify differences and commonalities. Results: Cultural contextual differences included developed-versus-developing country, east-west, type of regulatory bodies, and institutional-versus-national certifying/licensing examinations, which influence curricula and assessments. In all, 12 essential commonalities were found: alignment with institutional vision; sustained assessment leadership; stakeholder engagement; communication between curriculum and assessment; assessment-for-learning and feedback; longitudinal student profiling of outcome achievement; assessment rigor and robustness; 360° feedback from-and-to assessment; continuous enrichment through rigorous quality assurance; societal sensitivity; influencing others; and a "wow factor." Conclusions: Although the journeys of the three medical schools were undertaken in different cultural contexts, similar core components highlight strong foundations in student assessment. The journeys continue as assessment programmes remain dynamic and measurement science expands. This article may be helpful to other institutions pursuing excellence in assessment.


Asunto(s)
Evaluación Educacional/métodos , Evaluación Educacional/normas , Aprendizaje , Facultades de Medicina/organización & administración , Distinciones y Premios , Comunicación , Curriculum , Países Desarrollados , Países en Desarrollo , Retroalimentación Formativa , Humanos , Liderazgo , Innovación Organizacional , Facultades de Medicina/normas
7.
Biosci Biotechnol Biochem ; 80(11): 2198-2207, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-27399872

RESUMEN

In rice, several allergens have been identified such as the non-specific lipid transfer protein-1, the α-amylase/trypsin-inhibitors, the α-globulin, the 33 kDa glyoxalase I (Gly I), the 52-63 kDa globulin, and the granule-bound starch synthetase. The goal of the present study was to define optimal rice extraction and detection methods that would allow a sensitive and reproducible measure of several classes of known rice allergens. In a three-laboratory ring-trial experiment, several protein extraction methods were first compared and analyzed by 1D multiplexed SDS-PAGE. In a second phase, an inter-laboratory validation of 2D-DIGE analysis was conducted in five independent laboratories, focusing on three rice allergens (52 kDa globulin, 33 kDa glyoxalase I, and 14-16 kDa α-amylase/trypsin inhibitor family members). The results of the present study indicate that a combination of 1D multiplexed SDS-PAGE and 2D-DIGE methods would be recommended to quantify the various rice allergens.

8.
Regul Toxicol Pharmacol ; 79: 149-155, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27105772

RESUMEN

Genetically modified (GM) crops have achieved success in the marketplace and their benefits extend beyond the overall increase in harvest yields to include lowered use of insecticides and decreased carbon dioxide emissions. The most widely grown GM crops contain gene/s for targeted insect protection, herbicide tolerance, or both. Plant expression of Bacillus thuringiensis (Bt) crystal (Cry) insecticidal proteins have been the primary way to impart insect resistance in GM crops. Although deemed safe by regulatory agencies globally, previous studies have been the basis for discussions around the potential immuno-adjuvant effects of Cry proteins. These studies had limitations in study design. The studies used animal models with extremely high doses of Cry proteins, which when given using the ig route were co-administered with an adjuvant. Although the presumption exists that Cry proteins may have immunostimulatory activity and therefore an adjuvanticity risk, the evidence shows that Cry proteins are expressed at very low levels in GM crops and are unlikely to function as adjuvants. This conclusion is based on critical review of the published literature on the effects of immunomodulation by Cry proteins, the history of safe use of Cry proteins in foods, safety of the Bt donor organisms, and pre-market weight-of-evidence-based safety assessments for GM crops.


Asunto(s)
Proteínas Bacterianas/genética , Seguridad de Productos para el Consumidor , Productos Agrícolas/genética , Endotoxinas/genética , Inocuidad de los Alimentos , Proteínas Hemolisinas/genética , Insectos/crecimiento & desarrollo , Control Biológico de Vectores/métodos , Plantas Modificadas Genéticamente/genética , Animales , Toxinas de Bacillus thuringiensis , Proteínas Bacterianas/inmunología , Proteínas Bacterianas/metabolismo , Productos Agrícolas/inmunología , Productos Agrícolas/metabolismo , Productos Agrícolas/parasitología , Endotoxinas/inmunología , Endotoxinas/metabolismo , Regulación de la Expresión Génica de las Plantas , Genotipo , Proteínas Hemolisinas/inmunología , Proteínas Hemolisinas/metabolismo , Interacciones Huésped-Parásitos , Humanos , Insectos/metabolismo , Fenotipo , Plantas Modificadas Genéticamente/inmunología , Plantas Modificadas Genéticamente/metabolismo , Plantas Modificadas Genéticamente/parasitología , Medición de Riesgo
9.
Regul Toxicol Pharmacol ; 73(2): 607-12, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26361852

RESUMEN

A biotechnology-derived corn variety, MON 87411, containing a suppression cassette that expresses an inverted repeat sequence that matches the sequence of western corn rootworm (WCR; Diabrotica virgifera virgifera) has been developed. The expression of the cassette results in the formation of a double-stranded RNA (dsRNA) transcript containing a 240 bp fragment of the WCR Snf7 gene (DvSnf7) that confers resistance to corn rootworm by suppressing levels of DvSnf7 mRNA in WCR after root feeding. Internationally accepted guidelines for the assessment of genetically modified crop products have been developed to ensure that these plants are as safe for food, feed, and environmental release as their non-modified counterparts (Codex, 2009). As part of these assessments MON 87411 must undergo an extensive environmental assessment that requires large quantities of DvSnf7 dsRNA that was produced by in vitro transcription (IVT). To determine if the IVT dsRNA is a suitable surrogate for the MON 87411-produced DvSnf7 dsRNA in regulatory studies, the nucleotide sequence, secondary structure, and functional activity of each were characterized and demonstrated to be comparable. This comprehensive characterization indicates that the IVT DvSnf7 dsRNA is equivalent to the MON 87411-produced DvSnf7 dsRNA and it is a suitable surrogate for regulatory studies.


Asunto(s)
Raíces de Plantas/genética , Plantas Modificadas Genéticamente/genética , ARN Bicatenario/genética , Zea mays/genética , Animales , Escarabajos , Relación Dosis-Respuesta a Droga , Control de Insectos/métodos , Control Biológico de Vectores/métodos , Raíces de Plantas/metabolismo , Plantas Modificadas Genéticamente/metabolismo , ARN Bicatenario/biosíntesis , Zea mays/metabolismo
10.
Palliat Support Care ; 13(6): 1541-5, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24139058

RESUMEN

OBJECTIVES: Delirium is characterized by disturbances of consciousness and changes in cognition that develop rapidly and fluctuate. It is common in palliative care, affecting up to 88% of patients with advanced cancer, yet often remains insufficiently diagnosed and managed. This study sought to compare rates of screening, documentation, and management of delirium across three palliative care settings - two hospices and one hospital team - and to determine whether definitive documentation of delirium as a diagnosis is associated with improved management of the disorder. METHODS: A retrospective review of patient case notes was performed in three U.K. palliative care settings for the presence of: cognitive screening tools on first assessment; the term "delirium" as a stated documented diagnosis; documented terms, descriptions, and synonyms suggestive of delirium; and management plans aimed at addressing delirium. RESULTS: We reviewed 319 notes. The prevalence of delirium as a documented diagnosis ranged from 0 to 8.4%, rising to 35.7-39.2% when both documented delirium and descriptions suggestive of delirium were taken into account. An abbreviated mental test score (AMTS) was determined for 19.6 (H1) and 26.8% (H2) of hospice admissions and for 0% of hospital assessments. Symptoms suggestive of delirium were managed in 56.3% of cases in hospital, compared with 66.7 (H1) and 72.2% (H2) in hospices. SIGNIFICANCE OF RESULTS: Use of the term "delirium" was infrequent in both hospital and hospice palliative care settings, as was the use of routine screening. Many identified cases did not receive targeted management. The definitive use of the term as a diagnosis was associated with clearer management plans in hospital patients. The authors suggest that better screening and identification remains the first step in improving delirium management.


Asunto(s)
Delirio/diagnóstico , Delirio/terapia , Documentación/métodos , Cuidados Paliativos/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Hospitales para Enfermos Terminales/estadística & datos numéricos , Humanos , Masculino , Tamizaje Masivo/métodos , Persona de Mediana Edad , Cuidados Paliativos/estadística & datos numéricos , Prevalencia , Estudios Retrospectivos , Reino Unido
11.
Regul Toxicol Pharmacol ; 70(1): 75-9, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24945742

RESUMEN

The measurement of endogenous allergens is required by the European Commission (EC) as part of the compositional analysis for GM products from host plants that are common causes of food allergy, such as soybean (EC Implementing Regulation No. 503/2013). In each case, the EC Implementing Regulation indicates that analysis be conducted on identified allergens as specified in the Organization of Economic Cooperation and Development (OECD) consensus documents on compositional considerations for new plant varieties. This communication discusses the methods available to measure endogenous allergens as well as the endogenous soybean allergens that should be analyzed. It is suggested herein that in conjunction with the 2012 OECD consensus document on soybean, any list of soybean allergens should be based on clinically relevant data among publicly available allergen databases and peer-reviewed scientific publications, and the ability to measure the identified allergen. Based on a detailed analysis of the scientific literature, the following key points are recommended: (1) the acceptance of serum-free, quantitative analytical method data as an alternative to traditional IgE reactivity qualitative or semi-quantitative data for evaluation of endogenous soybean allergen content; (2) eight of the 15 potential allergens listed in the OECD soybean consensus document (Gly m 3, Gly m 4, Gly m Bd28K, Gly m Bd30K, Gly m 5, Gly m 6, Gly m 8, and Kunitz trypsin inhibitor) have both appropriate supporting clinical data and sufficient sequence information to be evaluated in comparative endogenous soybean allergen studies; and (3) the remaining seven proteins (Gly m 1, Gly m 2, unknown 50kDa protein, unknown 39kDa protein, P-22-25, lipoxygenase and lectin) lack sufficient data for clear classification as confirmed allergens and/or available sequence information and should not be currently included in the measurement of endogenous soybean allergens in the compositional analysis for the EU.


Asunto(s)
Alérgenos/inmunología , Hipersensibilidad a los Alimentos/inmunología , Glycine max/inmunología , Plantas Modificadas Genéticamente/inmunología , Alérgenos/genética , Unión Europea , Hipersensibilidad a los Alimentos/genética , Humanos , Medición de Riesgo/métodos , Glycine max/genética
12.
Health Aff (Millwood) ; 43(9): 1329-1337, 2024 09.
Artículo en Inglés | MEDLINE | ID: mdl-39226495

RESUMEN

COVID-19-related school closures may have had unintended consequences affecting the ability of health professionals with school-age children to work-particularly female professionals, who often have disproportionate child care responsibilities. We combined labor-force participation data from the Current Population Survey with measures of school closures based on cell phone mobility data to examine the association between local school closures and labor supply among female nurses during the COVID-19 pandemic. During the six months after large-scale closure of schools at the end of the 2019-20 school year (March-August 2020), among counties with above-median school closure rates, the employment rate of female nurses with young children declined by 12.5 percentage points versus the rate during the prior four months (November 2019-February 2020); the change in the employment rate in below-median counties was not statistically significant. No statistically significant changes were observed among female nurses who had only older children or among male nurses. During public health emergencies, policies should consider how disruptions to schooling may affect the labor supply of health care professionals. Strategies might include direct provision of child care by health care facilities, subsidies and other aid to child care centers, or subsidies to health care workers for affordable child care.


Asunto(s)
COVID-19 , Empleo , Instituciones Académicas , Humanos , COVID-19/epidemiología , Femenino , Empleo/estadística & datos numéricos , Adulto , Estados Unidos , Niño , Enfermeras y Enfermeros/provisión & distribución , SARS-CoV-2 , Pandemias , Masculino
13.
Int J Pharm ; 642: 123132, 2023 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-37315638

RESUMEN

Through 3D printing (3DP), many parameters of solid oral dosage forms can be customised, allowing for truly personalised medicine in a way that traditional pharmaceutical manufacturing would struggle to achieve. One of the many options for customisation involves dose titration, allowing for gradual weaning of a medication at dose intervals smaller than what is available commercially. In this study we demonstrate the high accuracy and precision of 3DP dose titration of caffeine, selected due to its global prevalence as a behavioural drug and well-known titration-dependent adverse reactions in humans. This was achieved using a simple filament base of polyvinyl alcohol, glycerol, and starch, utilising hot melt extrusion coupled with fused deposition modelling 3DP. Tablets containing 25 mg, 50 mg, and 100 mg doses of caffeine were successfully printed with drug content in the accepted range prescribed for conventional tablets (90 - 110%), and excellent precision whereby the weights of all doses showed a relative standard deviation of no more than 3%. Importantly, these results proved 3D printed tablets to be far superior to splitting a commercially available caffeine tablet. Additional assessment of filament and tablet samples were reviewed by differential scanning calorimetry, thermogravimetric analysis, HPLC, and scanning electron microscopy, showing no evidence of degradation of caffeine or the raw materials, with smooth and consistent filament extrusion. Upon dissolution, all tablets achieved greater than 70% release between 50 and 60 min, showing a predictable rapid release profile regardless of dose. The outcomes of this study highlight the benefits that dose titration with 3DP can offer, especially to more commonly prescribed medications that can have even more harmful withdrawal-induced adverse reactions.


Asunto(s)
Cafeína , Alcohol Polivinílico , Humanos , Cafeína/química , Comprimidos/química , Alcohol Polivinílico/química , Tecnología de Extrusión de Fusión en Caliente , Impresión Tridimensional , Liberación de Fármacos , Tecnología Farmacéutica/métodos
14.
Sci Data ; 10(1): 471, 2023 07 20.
Artículo en Inglés | MEDLINE | ID: mdl-37474611

RESUMEN

In-situ marine cloud droplet number concentrations (CDNCs), cloud condensation nuclei (CCN), and CCN proxies, based on particle sizes and optical properties, are accumulated from seven field campaigns: ACTIVATE; NAAMES; CAMP2EX; ORACLES; SOCRATES; MARCUS; and CAPRICORN2. Each campaign involves aircraft measurements, ship-based measurements, or both. Measurements collected over the North and Central Atlantic, Indo-Pacific, and Southern Oceans, represent a range of clean to polluted conditions in various climate regimes. With the extensive range of environmental conditions sampled, this data collection is ideal for testing satellite remote detection methods of CDNC and CCN in marine environments. Remote measurement methods are vital to expanding the available data in these difficult-to-reach regions of the Earth and improving our understanding of aerosol-cloud interactions. The data collection includes particle composition and continental tracers to identify potential contributing CCN sources. Several of these campaigns include High Spectral Resolution Lidar (HSRL) and polarimetric imaging measurements and retrievals that will be the basis for the next generation of space-based remote sensors and, thus, can be utilized as satellite surrogates.

15.
Palliat Med ; 25(7): 701-5, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21310773

RESUMEN

Primary thromboprophylaxis (PTP) is a Department of Health priority in England. The NICE guidelines agree that PTP is inappropriate in the dying patient, but should be considered for those with reversible pathology. In the light of continued variation and uncertainty in UK hospice practice, we assessed PTP prescribing in three hospices. Case notes were reviewed from consecutive patients admitted before (300 patients) and after (350 patients) implementation of the Pan Birmingham Cancer Network (PBCN) venous thromboembolism prophylaxis (VTE) prevention guidelines. Just under half (43%; 40%) of patients had a contraindication to anticoagulation and PTP. Whilst just under a tenth (8.6%; 8.7%) in each group had a temporary increased risk of VTE, considerably fewer (3.6%; 6.3%) had a temporary increased risk of VTE without contraindication to PTP. Patients receiving PTP increased slightly from 1% to 3.6% and documentation of PTP decisions increased from 5% to 81%. Whilst the PBCN VTE tool is a useful tool to tailor an approach for this complex patient group, many questions remain. Clinical trials that include patients with advanced disease with relevant outcome measures are needed to help inform the clinicians who care for them.


Asunto(s)
Anticoagulantes/uso terapéutico , Cuidados Paliativos al Final de la Vida/métodos , Hospitales para Enfermos Terminales/estadística & datos numéricos , Tromboembolia Venosa/prevención & control , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Dolor en el Pecho , Contraindicaciones , Disnea , Edema , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/complicaciones , Prevención Primaria , Estudios Retrospectivos , Medición de Riesgo , Terapia Trombolítica/métodos , Reino Unido , Tromboembolia Venosa/etiología , Adulto Joven
16.
Regul Toxicol Pharmacol ; 61(3): 292-5, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-21906650

RESUMEN

Thermal stability has been reported as a shared characteristic among some of the major food allergens and appears to have originated from the observation that some cooked foods retain their ability to cause allergic reactions by Immunoglobulin E (IgE) binding and the subsequent cascade of events that mediate allergic reactions. Based on this observation, the thermal stability of novel food proteins, like those in transgenic crops, is considered correlative with allergenic risk and has prompted requests from some regulatory agencies for additional testing to address safety concerns. Because human testing and serum IgE screening are not feasible nor are they necessarily useful for evaluating the thermal stability of a novel food protein, a protein function assay is often used to assess the thermal stability in the context of an allergenicity risk assessment. Some regulatory authorities also require immunodetection using polyclonal IgG antibodies and gel based methods. Here we review why heat stability as measured by these functional and immunodetection assays does not correlate with allergenicity and provides no useful safety information in assessing the allergenic potential of novel food proteins.


Asunto(s)
Alérgenos/inmunología , Hipersensibilidad a los Alimentos/inmunología , Estabilidad Proteica , Proteínas/inmunología , Calor , Humanos , Inmunoglobulina E/inmunología , Técnicas Inmunológicas , Medición de Riesgo
17.
Regul Toxicol Pharmacol ; 60(1): 46-53, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21320564

RESUMEN

Bioinformatic tools are being increasingly utilized to evaluate the degree of similarity between a novel protein and known allergens within the context of a larger allergy safety assessment process. Importantly, bioinformatics is not a predictive analysis that can determine if a novel protein will ''become" an allergen, but rather a tool to assess whether the protein is a known allergen or is potentially cross-reactive with an existing allergen. Bioinformatic tools are key components of the 2009 CodexAlimentarius Commission's weight-of-evidence approach, which encompasses a variety of experimental approaches for an overall assessment of the allergenic potential of a novel protein. Bioinformatic search comparisons between novel protein sequences, as well as potential novel fusion sequences derived from the genome and transgene, and known allergens are required by all regulatory agencies that assess the safety of genetically modified (GM) products. The objective of this paper is to identify opportunities for consensus in the methods of applying bioinformatics and to outline differences that impact a consistent and reliable allergy safety assessment. The bioinformatic comparison process has some critical features, which are outlined in this paper. One of them is a curated, publicly available and well-managed database with known allergenic sequences. In this paper, the best practices, scientific value, and food safety implications of bioinformatic analyses, as they are applied to GM food crops are discussed. Recommendations for conducting bioinformatic analysis on novel food proteins for potential cross-reactivity to known allergens are also put forth.


Asunto(s)
Alérgenos/efectos adversos , Biotecnología/métodos , Proteínas en la Dieta/inmunología , Alimentos Modificados Genéticamente/efectos adversos , Industrias , Proteínas de Plantas/inmunología , Agricultura , Alérgenos/química , Alérgenos/clasificación , Secuencia de Aminoácidos , Biología Computacional , Seguridad de Productos para el Consumidor , Bases de Datos de Proteínas , Proteínas en la Dieta/análisis , Alimentos Modificados Genéticamente/clasificación , Directrices para la Planificación en Salud , Datos de Secuencia Molecular , Proteínas de Plantas/análisis , Plantas Modificadas Genéticamente
18.
J Orthop Sports Phys Ther ; 41(1): 22-31, 2011 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-20972343

RESUMEN

STUDY DESIGN: Prospective, longitudinal, observational cohort. OBJECTIVES: Primary aims were to determine (1) baseline prevalence of directional preference (DP) or no directional preference (no-DP) observed for patients with low back pain whose symptoms centralized (CEN), did not centralize (non-CEN), or could not be classified (NC), and (2) to determine if classifying patients at intake by DP or no-DP combined with CEN, non-CEN, or NC predicted functional status and pain intensity at discharge from rehabilitation. BACKGROUND: Although evidence suggests that patient response classification criteria DP or CEN improve outcomes, previous studies did not delineate relations between DP and CEN findings and outcomes. METHODS: Eight therapists classified patients using standardized definitions for DP and CEN. Prevalence rates for DP and no-DP and CEN,non-CEN, and NC were calculated. Ordinary least-squares multivariate regression models assessed whether multilevel classification combining DP and CEN (DP/CEN, DP/non-CEN, DP/NC, no-DP/non-CEN, and no-DP/NC categories) predicted discharge functional status (scale range, 0 to 100, with higher values representing better function) or pain intensity (scale range, 0 to 10, with higher values representing more pain). RESULTS: Overall prevalence of DP and CEN was 60% and 41%, respectively. For those with DP, prevalence rates for DP/CEN, DP/non-CEN, and DP/NC were 65%, 27%, and 8%, respectively. The amount of variance explained (R2 values) for function and pain models was 0.50 and 0.39, respectively. Compared to patients classified as DP/CEN, patients classified as DP/non-CEN or no-DP/non-CEN reported 7.7 and 11.6 functional status units less at discharge (P<.001), respectively, and patients classified as no-DP/non-CEN reported 1.7 pain units more at discharge (P<.001). CONCLUSIONS: Findings suggest that classification by pain pattern and DP can improve a therapist's ability to provide a short-term prognosis for function and pain outcomes. LEVEL OF EVIDENCE: Prognosis, level 1b-.


Asunto(s)
Dolor de la Región Lumbar/clasificación , Dolor de la Región Lumbar/fisiopatología , Dimensión del Dolor/clasificación , Índice de Severidad de la Enfermedad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Estudios Longitudinales , Dolor de la Región Lumbar/epidemiología , Vértebras Lumbares/fisiopatología , Masculino , Persona de Mediana Edad , Especialidad de Fisioterapia/estadística & datos numéricos , Prevalencia , Pronóstico , Rango del Movimiento Articular , Análisis de Regresión , Tennessee/epidemiología
19.
Health Aff (Millwood) ; 40(5): 837-843, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33881908

RESUMEN

The COVID-19 pandemic has disrupted access to medical care for millions of Americans, yet information on the individual characteristics associated with these disruptions is lacking. We used recently released data from the Current Population Survey's supplemental COVID-19 questions to provide the first evidence on associations between individual characteristics, including age, sex, race/ethnicity, education, health status, work-limiting disabilities, health insurance coverage, and employment, and the propensity to experience an involuntary care disruption resulting from the COVID-19 pandemic. Involuntary care disruption is defined as delayed or cancelled care that was not initiated by the patient. Results indicate that older age, being in fair or poor health, greater education, and having health insurance coverage were associated with greater likelihood of experiencing an involuntary delay in accessing medical care. In addition, White, non-Hispanic respondents had higher rates of involuntary care delays than respondents of other races/ethnicities. Our findings provide useful guidance for researchers examining the health consequences of COVID-19-related care disruptions and for policy makers developing tools to offset the potential harms of such disruptions.


Asunto(s)
COVID-19 , Pandemias , Anciano , Atención a la Salud , Humanos , SARS-CoV-2 , Estados Unidos , Población Blanca
20.
Membranes (Basel) ; 11(6)2021 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-34072746

RESUMEN

Liposomes are spherical-shaped vesicles that enclose an aqueous milieu surrounded by bilayer or multilayer membranes formed by self-assembly of lipid molecules. They are intensively exploited as either model membranes for fundamental studies or as vehicles for delivery of active substances in vivo and in vitro. Irrespective of the method adopted for production of loaded liposomes, obtaining the final purified product is often achieved by employing multiple, time consuming steps. To alleviate this problem, we propose a simplified approach for concomitant production and purification of loaded liposomes by exploiting the Electrodialysis-Driven Depletion of charged molecules from solutions. Our investigations show that electrically-driven migration of charged detergent and dye molecules from solutions that include natural or synthetic lipid mixtures leads to rapid self-assembly of loaded, purified liposomes, as inferred from microscopy and fluorescence spectroscopy assessments. In addition, the same procedure was successfully applied for incorporating PEGylated lipids into the membranes for the purpose of enabling long-circulation times needed for potential in vivo applications. Dynamic Light Scattering analyses and comparison of electrically-formed liposomes with liposomes produced by sonication or extrusion suggest potential use for numerous in vitro and in vivo applications.

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