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1.
BMJ Open ; 14(4): e085472, 2024 Apr 17.
Article in English | MEDLINE | ID: mdl-38631834

ABSTRACT

INTRODUCTION: In over 50 years since the genetic counseling (GC) profession began, a systematic study of GC communication skills and patient-reported outcomes in actual sessions across multiple clinical specialties has never been conducted. To optimize GC quality and improve efficiency of care, the field must first be able to comprehensively measure GC skills and determine which skills are most critical to achieving positive patient experiences and outcomes. This study aims to characterise GC communication skills using a novel and pragmatic measure and link variations in communication skills to patient-reported outcomes, across clinical specialties and with patients from diverse backgrounds in the USA. Our community-engagement and provider-engagement approach is crucial to develop recommendations for quality, culturally informed GC care, which are greatly needed to improve GC practice. METHODS AND ANALYSIS: A mixed methods, sequential explanatory design will be used to collect and analyze: audio-recorded GC sessions in cancer, cardiac, and prenatal/reproductive genetic indications; pre-visit and post-visit quantitative surveys capturing patient experiences and outcomes and post-visit qualitative interview data. A novel, practical checklist will measure GC communication skills. Coincidence analysis will identify patterns of GC skills that are consistent with high scores on patient-reported measures. Two-level, multilevel models will be used to evaluate how GC communication skills and other session/patient characteristics predict patient-reported outcomes. Four community advisory boards (CABs) and a genetic counselor advisory board will inform the study design and analysis. ETHICS AND DISSEMINATION: This study has been approved by the single Institutional Review Board of the University of Minnesota. This research poses no greater than minimal risk to participants. Results from this study will be shared through national and international conferences and through community-based dissemination as guided by the study's CABs. A lay summary will also be disseminated to all participants.


Subject(s)
Genetic Counseling , Neoplasms , Humans , Patient Reported Outcome Measures , Research , Communication
2.
JMIRx Med ; 5: e42211, 2024 Mar 08.
Article in English | MEDLINE | ID: mdl-38488740

ABSTRACT

Background: Latino individuals experience disparities in the care of Alzheimer disease and related dementias (ADRD) and have disproportionately high COVID-19 infection and death outcomes. Objective: We aimed to gain an in-depth understanding of the impact of the COVID-19 pandemic among Latino families with ADRD in the United States. Methods: This was a qualitative study of 21 informal caregivers of Latino individuals with ADRD and 23 primary care providers who serve Latino patients. We recruited participants nationwide using convenience and snowball sampling methods and conducted remote interviews in English and Spanish. We organized the transcripts for qualitative review to identify codes and themes, using a pragmatic approach, a qualitative description methodology, and thematic analysis methods. Results: Qualitative analysis of transcripts revealed eight themes, including (1) the pandemic influenced mental and emotional health; (2) the pandemic impacted physical domains of health; (3) caregivers and care recipients lost access to engaging activities during the confinement; (4) the pandemic impacted Latino caregivers' working situation; (5) the pandemic impacted health care and community care systems; (6) health care and community care systems took measures to reduce the impact of the pandemic; (7) Latino families experienced barriers to remote communication during the pandemic; and (8) caregiver social support was critical for reducing social isolation and its sequalae. Conclusions: Latino families with ADRD experienced similar but also unique impacts compared to those reported in the general population. Unique impacts may result from Latino individuals' underserved status in the United States, commonly held cultural values, and their intersectionality with ADRD-related disability. Family caregiver social support was crucial during this time of adversity. These findings suggest the need for more equitable access, culturally appropriate and trustworthy content and delivery of health care and community services, as well as stronger financial and social supports for family caregivers.

4.
ACS Appl Mater Interfaces ; 16(7): 9068-9077, 2024 Feb 21.
Article in English | MEDLINE | ID: mdl-38345827

ABSTRACT

Metal-organic frameworks (MOFs), a sort of crystalline porous coordination polymers composed of metal ions and organic linkers, have been intensively studied for their ability to take up nonpolar gas-phase molecules such as ethane and ethylene. In this context, interpenetrated MOFs, where multiple framework nets are entwined, have been considered promising materials for capturing nonpolar molecules due to their relatively higher stability and smaller micropores. This study explores a solvent-assisted reversible strategy to interpenetrate and deinterpenetrate a Cu(II)-based MOF, namely, MOF-143 (noninterpenetrated form) and MOF-14 (doubly interpenetrated forms). Interpenetration was achieved using protic solvents with small molecular sizes such as water, methanol, and ethanol, while deinterpenetration was accomplished with a Lewis-basic solvent, pyridine. Additionally, this study investigates the adsorptive separation of ethane and ethylene, which is a significant application in the chemical industry. The results showed that interpenetrated MOF-14 exhibited higher ethane and ethylene uptakes compared to the noninterpenetrated MOF-143 due to narrower micropores. Furthermore, we demonstrate that pristine MOF-14 displayed higher ethane selectivity than transformed MOF-14 from MOF-143 by identifying the "fraction of micropore volume" as a key factor influencing ethane uptake. These findings highlight the potential of controlled transformations between interpenetrated and noninterpenetrated MOFs, anticipating that larger MOF crystals with narrower micropores and higher crystallinity will be more suitable for selective gas capture and separation applications.

5.
Transl Behav Med ; 14(2): 138-147, 2024 02 07.
Article in English | MEDLINE | ID: mdl-37715986

ABSTRACT

Despite the general positive outcomes of the Diabetes Prevention Program (DPP), the program's reach, adherence, and effectiveness among Latinos are still suboptimal. Text-message DPP can potentially overcome barriers and improve DPP outcomes for this group. We aimed to assess the feasibility, acceptability, and preliminarily effectiveness of a culturally and linguistically adapted text-message DPP for Latinos. We enrolled 26 eligible Spanish-speaking Latino adults at risk of developing type 2 diabetes (A1c = 5.7%-6.4%, body mass index ≥25) in a 6-month culturally and linguistically adapted text-message DPP. Participants received (i) two to three daily automated text-messages about healthy eating, physical activity, problem-solving skills, lifestyle change motivation, and logistics, (ii) on-demand keyword-driven messages, and (iii) on-demand chat messages with a DPP coach. Outcomes included feasibility (e.g. adherence), acceptability (e.g. satisfaction), and preliminary effectiveness (e.g. weight loss). Twenty-four participants completed the program and follow-up assessments. Participants' mean body weight changed from 191.2 to 186.7 pounds (P = .004); 45.8% of participants lost ≥3%, and 29.2% lost ≥5% of body weight. Body mass index and waist circumference were also reduced [0.9 kg/m2 (P = .003) and 1.1 cm (P = .03), pre-post]. Self-reported physical activity frequency was increased (P = .003). No statistically significant changes in diet quality were found. Most participants were satisfied with the program and perceived it to help prevent diabetes. Our pilot study of an innovative text-message DPP for Latinos demonstrated the program was acceptable, feasible, and potentially effective. Using text-message for DPP can reduce barriers to in-person participation by increasing the program's reach without compromising fidelity and effectiveness.


The Diabetes Prevention Program (DPP) is an in-person program that helps people to reduce their risk of having diabetes by supporting them to improve their lifestyles. However, the program is not working well for Latinos. It is possible that offering the program using text-messages for Latinos can support them in improving their lifestyles so they can reduce their chances of getting diabetes. We developed a text-message DPP for Latinos who speak Spanish to test if the program would work for them. A total of 26 Latinos received 2 to 3 daily text-messages about healthy eating, physical activity, and motivations to change lifestyles, for a period of 6 months. Participants also had the chance to send messages to coaches to get individualized responses. By the end of the 6 months, 24 Latinos completed the program. Participants reduced an average of 5.5 pounds in body weight. We also saw reductions in participants' waist circumferences. In addition, participants started to do more physical activity. Most participants were satisfied with the program and perceived it helped them prevent diabetes. In conclusion, we believe that our program worked well and was successful in helping Latinos to change their lifestyles to prevent diabetes.


Subject(s)
Diabetes Mellitus, Type 2 , Text Messaging , Humans , Diabetes Mellitus, Type 2/prevention & control , Pilot Projects , Feasibility Studies , Body Weight , Hispanic or Latino
6.
J Med Libr Assoc ; 111(4): 831-832, 2023 Oct 02.
Article in English | MEDLINE | ID: mdl-37928113

ABSTRACT

Spanish speaking healthcare providers, JUNTOS Center for Advancing Latino Health, and a medical librarian partnered to create a podcast on essential health topics relevant to the Latinx community. The podcasts were recorded in Spanish and included Spanish supplementary consumer health information from credible resources such as MedlinePlus en Espanol. The podcasts covered important topics about COVID-19 such as vaccines, clinical trials, and social distancing. It also includes other relevant topics that are affecting the Latinx community.


Subject(s)
Health Education , Librarians , Humans , Health Personnel , Hispanic or Latino , MedlinePlus , Webcasts as Topic
7.
Int J Surg Case Rep ; 111: 108886, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37804679

ABSTRACT

INTRODUCTION AND IMPORTANCE: Lumbar hernias are a rare type of hernia that occur in the posterior abdomen; they represent less than 3 % of all hernias, and approximately 350 cases have been reported in the medical literature. They can be categorized as congenital, traumatic, incisional, and spontaneous. Clinically they are not different from other hernias and the gold standard for diagnosis is computed tomography (CT) followed by tension-free plasty treatment. CASE PRESENTATION: We present the case of a 15-year-old female patient with a Petit's hernia, who was successfully treated using tension-free plasty. CLINICAL DISCUSSION: Petit's hernia occurs more commonly between the ages of 50 and 70 years. Our case involved a 15-year-old female patient with a clinical presentation of an uncomplicated hernia that was managed by tension-free plasty. CONCLUSION: Petit's hernia is an uncommon hernia that requires a high index of suspicion the support of imaging studies to confirm diagnosis and provide treatment.

8.
Circ Heart Fail ; 16(11): e010618, 2023 11.
Article in English | MEDLINE | ID: mdl-37703087

ABSTRACT

BACKGROUND: Obesity and adiposity are associated with an increased risk of heart failure with preserved ejection fraction (HFpEF); yet, specific underlying mechanisms remain unclear. We sought to examine the association of obesity-related biomarkers including adipokines (leptin, resistin, adiponectin), inflammatory markers (CRP [C-reactive protein], IL-6 [interleukin-6]), and insulin resistance (HOMA-IR) with HFpEF status, exercise capacity, and cardiovascular outcomes. METHODS: We studied 509 consecutive patients with left ventricular ejection fraction ≥50% and chronic dyspnea, who underwent clinically indicated cardiopulmonary exercise test with invasive hemodynamic monitoring between 2006 and 2017. We defined HFpEF based on the presence of elevated left ventricular filling pressures at rest or during exercise. Fasting blood samples collected at the time of the cardiopulmonary exercise test were used to assay obesity-related biomarkers. We examined the association of log-transformed biomarkers with HFpEF status and exercise traits using multivariable-adjusted logistic regression models. RESULTS: We observed associations of obesity-related biomarkers with measures of impaired exercise capacity including peak VO2 (P≤0.002 for all biomarkers). The largest effect size was seen with leptin, where a 1-SD higher leptin was associated with a 2.35 mL/kg per min lower peak VO2 (ß, -2.35±0.19; P<0.001). In addition, specific biomarkers were associated with distinct measures of exercise reserve including blood pressure (homeostatic model assessment of insulin resistance, leptin, adiponectin; P≤0.002 for all), and chronotropic response (CRP, IL-6, homeostatic model assessment of insulin resistance, leptin, and resistin; P<0.05 for all). Our findings suggest that among the obesity-related biomarkers studied, higher levels of leptin and CRP are independently associated with increased odds of HFpEF, with odds ratios of 1.36 (95% CI, 1.09-1.70) and 1.25 (95% CI, 1.03-1.52), respectively. CONCLUSIONS: Specific obesity-related pathways including inflammation, adipokine signaling, and insulin resistance may underlie the association of obesity with HFpEF and exercise intolerance.


Subject(s)
Heart Failure , Insulin Resistance , Humans , Heart Failure/diagnosis , Stroke Volume/physiology , Leptin , Resistin , Adiponectin , Ventricular Function, Left/physiology , Interleukin-6 , Obesity/complications , Biomarkers , Exercise Test , Exercise Tolerance/physiology
9.
J Am Heart Assoc ; 12(16): e028849, 2023 08 15.
Article in English | MEDLINE | ID: mdl-37548169

ABSTRACT

Background Premature and early menopause are independently associated with greater risk of cardiovascular disease (CVD). However, mechanisms linking age of menopause with CVD remain poorly characterized. Methods and Results We measured 71 circulating CVD protein biomarkers in 1565 postmenopausal women enrolled in the FHS (Framingham Heart Study). We examined the association of early menopause with biomarkers and tested whether early menopause modified the association of biomarkers with incident cardiovascular outcomes (heart failure, major CVD, and all-cause death) using multivariable-adjusted linear regression and Cox models, respectively. Among 1565 postmenopausal women included (mean age 62 years), 395 (25%) had a history of early menopause. Of 71 biomarkers examined, we identified 7 biomarkers that were significantly associated with early menopause, of which 5 were higher in women with early menopause including adrenomedullin and resistin, and 2 were higher in women without early menopause including insulin growth factor-1 and CNTN1 (contactin-1) (Benjamini-Hochberg adjusted P<0.1 for all). Early menopause also modified the association of specific biomarkers with incident cardiovascular outcomes including adrenomedullin (Pint<0.05). Conclusions Early menopause is associated with circulating levels of CVD protein biomarkers and appears to modify the association between select biomarkers with incident cardiovascular outcomes. Identified biomarkers reflect several distinct biological pathways, including inflammation, adiposity, and neurohormonal regulation. Further investigation of these pathways may provide mechanistic insights into the pathogenesis, prevention, and treatment of early menopause-associated CVD.


Subject(s)
Cardiovascular Diseases , Menopause, Premature , Female , Humans , Middle Aged , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/epidemiology , Adrenomedullin , Menopause , Biomarkers , Risk Factors
10.
Matern Child Health J ; 27(10): 1811-1822, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37369811

ABSTRACT

BACKGROUND: Latina women are less likely to start prenatal care in the first trimester and to attend the recommended amount of prenatal visits compared to their non-Latina white counterparts. OBJECTIVES: This study aimed to assess challenges and facilitators to first-trimester prenatal care (FTPNC) and prenatal care utilization (PNCU) in a Midwestern urban area with a growing immigrant Latino community. METHODS: This study used a mixed-method approach based on the Theoretical Domains Framework. Nine semi-structured interviews were conducted with healthcare professionals that worked in birth centers, clinics, or hospitals that provided prenatal care (PNC) services for Latina women. Eight focus groups and quantitative surveys were conducted with Latina women and their supporters in Kansas City metropolitan area. RESULTS: FTPNC was challenged by women's immigrant status, lack of healthcare coverage due to immigrant status, and complexity of Medicaid application. PNCU was challenged by the cost of PNC when diagnosed with gestational diabetes, lack of healthcare coverage, PNC literacy, late access to gynecologists/obstetricians, inadequate interpretation services, transportation, and mental health distress. Meanwhile, FTPNC was facilitated by social support and connectedness. PNCU was facilitated by Spanish-proficient providers and interpreters, effective nonverbal communication and education techniques, and pregnancy prevention access and education. CONCLUSIONS FOR PRACTICE: Results from this study highlight important targets to improve PNC for Latina women. Participants called for various types of support to address identified challenges, ranging from information on social media about PNC services to broader efforts such as building trust from the community toward PNC providers and making PNC services affordable for women with gestational diabetes.


Subject(s)
Diabetes, Gestational , Prenatal Care , Pregnancy , Female , Humans , Health Services Accessibility , Hispanic or Latino , Pregnancy Trimester, First
11.
J Community Genet ; 14(2): 121-133, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36930422

ABSTRACT

African American (AA) and Latino populations are impacted disproportionately by cancer incidence and mortality compared to the general US population. Contributing to these rates are multiple inheritable cancers that impact both men and women. Some of these diseases may be detected through genetic counseling and germline DNA testing; however, AA and Latinos are unaware and have limited knowledge and thus significantly underutilize these services and technologies. Research to detect influencing factors to testing uptake has also been slow due to multiple factors. The research team followed a community-based participatory research (CBPR) approach and worked with a Community Advisory Board composed of cancer survivors and co-survivors to design the exploratory study. Six focus groups were held with a pilot sample of African Americans and Latinos who self-reported to be at-risk for cancer (N = 53). The study was held over a 2-month period where attitudes, perceptions, and beliefs about cancer risk and preference regarding cancer-related genetic counseling and testing risk communication were explored. Themes that emerged included (1) the lack of knowledge about cancer-related genetic counseling and testing; (2) cancer is feared often; (3) cancer-related genetic testing was perceived as something that could help but was also perceived as unnecessary testing that exposed individuals to medical harm; and (4) benefits to test were perceived as favorable for medical personnel but not for the patient. Implications of the study provide a unique lens to explore how lived experiences among AA and Latinos may inform strategic risk communication about cancer-related genetic counseling and testing and help advance cancer health equity. Participants viewed cancer genetic testing as important cancer risk prevention strategies. Identification of perceptions of cancer risk and cancer-related genetic counseling and testing in collaboration with members of the community is needed to bolster communication efforts among these populations.

12.
Matern Child Health J ; 27(4): 621-631, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36840786

ABSTRACT

INTRODUCTION: Recognition of the importance of adolescents' environments in influencing their sexual and reproductive health (SRH) decision-making necessitates a deeper understanding of the role that community stakeholders play in shaping Adolescent and Young Adults (AYA) access to SRH education and care. We describe community stakeholders' knowledge, beliefs, and attitudes about AYA's SRH needs in three rural Latino communities in Kansas. METHODS: Key stakeholders completed a written survey incorporating the theory of Planned Behavior to assess attitudes, norms, and intentions to support AYA's SRH education and access to care. RESULTS: Across three rural immigrant community settings, respondents (N = 55) included 8 community health workers, 9 health care providers, 7 public health officials, 19 school health officials, and 12 community members. More than half self-identified as Latino (55%). Six (11%) participants, half of whom were in the health sector, thought SRH education would increase the likelihood that teens would engage in sexual activities. In contrast, other stakeholders thought that providing condoms (17, 30.9%), contraception other than condoms (14, 25.5%), and providing HPV immunization (5, 9.6%) would increase the likelihood of engaging in sexual activity. Ambivalence regarding support for SRH education and service provision prevailed across sectors, reflected even in the endorsement of the distribution of less effective contraceptive methods. Obstacles to care include immigration status, discrimination, lack of confidential services, and transportation. CONCLUSION: Key stakeholders living in rural communities revealed misconceptions, negative attitudes, and ambivalent beliefs related to the delivery of SRH education and services, potentially creating barriers to AYA's successful access to care.


Little is known about the knowledge, beliefs and attitudes held by key stakeholders in rural immigrant Latino communities regarding their level of support for AYA's SRH needs. Key stakeholders may harbor influential and ambivalent opinions regarding AYA's sexuality considering existing cultural norms, therefore, stigmatizing access to SRH education and care. We examined key community stakeholders' attitudes and norms as measures of intentions to support AYA's SRH education and care. We identify actionable steps needed to eliminate existing barriers to AYA's access to SRH education and care among at-risk immigrant Latino communities in the rural Midwest.


Subject(s)
Pregnancy in Adolescence , Reproductive Health Services , Pregnancy , Female , Adolescent , Young Adult , Humans , Rural Population , Contraception , Sex Education , Sexual Behavior , Reproductive Health , Hispanic or Latino
13.
ACS Appl Mater Interfaces ; 15(1): 1410-1417, 2023 Jan 11.
Article in English | MEDLINE | ID: mdl-36574291

ABSTRACT

Metal-organic frameworks have developed into a formidable heterogeneous catalysis platform in recent years. It is well established that thermolysis of coordinated solvents from MOF nodes can render highly reactive, coordinatively unsaturated metal complexes which are stabilized via site isolation and serve as active sites in catalysis. Such approaches are limited to frameworks featuring solvated transition-metal complexes and must be stable toward the formation of "permanent" open metal sites. Herein, we exploit the hemilability of metal-carboxylate bonds to generate transient open metal sites in an In(III) MOF, pertinent to In-centered catalysis. The transient open metal sites catalyze the Strecker reaction over multiple cycles without loss of activity or crystallinity. We employ computational and spectroscopic methods to confirm the formation of open metal sites via transient dissociation of In(III)-carboxylate bonds. Furthermore, the amount of transient open metal sites within the material and thus the catalytic performance can be temperature-modulated.

15.
Vaccine ; 40(45): 6489-6498, 2022 10 26.
Article in English | MEDLINE | ID: mdl-36195474

ABSTRACT

The rapid spread of COVID-19 on all continents and the mortality induced by SARS-CoV-2 virus, the cause of the pandemic coronavirus disease 2019 (COVID-19) has motivated an unprecedented effort for vaccine development. Inactivated viruses as well as vaccines focused on the partial or total sequence of the Spike protein using different novel platforms such us RNA, DNA, proteins, and non-replicating viral vectors have been developed. The high global need for vaccines, now and in the future, and the emergence of new variants of concern still requires development of accessible vaccines that can be adapted according to the most prevalent variants in the respective regions. Here, we describe the immunogenic properties of a group of theoretically predicted RBD peptides to be used as the first step towards the development of an effective, safe and low-cost epitope-focused vaccine. One of the tested peptides named P5, proved to be safe and immunogenic. Subcutaneous administration of the peptide, formulated with alumina, induced high levels of specific IgG antibodies in mice and hamsters, as well as an increase of IFN-γ expression by CD8+ T cells in C57 and BALB/c mice upon in vitro stimulation with P5. Neutralizing titers of anti-P5 antibodies, however, were disappointingly low, a deficiency that we will attempt to resolve by the inclusion of additional immunogenic epitopes to P5. The safety and immunogenicity data reported in this study support the use of this peptide as a starting point for the design of an epitope restricted vaccine.


Subject(s)
COVID-19 , Viral Vaccines , Cricetinae , Humans , Mice , Animals , SARS-CoV-2 , Epitopes , Spike Glycoprotein, Coronavirus/genetics , COVID-19 Vaccines , COVID-19/prevention & control , Antibodies, Viral , Immunoglobulin G , Peptides , RNA , Aluminum Oxide , Antibodies, Neutralizing
16.
J Acad Nutr Diet ; 122(11): 2097-2105, 2022 11.
Article in English | MEDLINE | ID: mdl-35589070

ABSTRACT

BACKGROUND: During pregnancy, Latina/x people experience nutrition and nutrition-related health inequities. Nutrition literacy is a potential factor impacted by these inequities. However, the nutrition literacy level of Latina/x people during pregnancy is not well investigated. OBJECTIVES: The study aimed to assess the nutrition literacy level of Latina/x people during pregnancy and explore the association of nutrition literacy with socioeconomic position. DESIGN: This was a cross-sectional study of data collected from 2016 to 2018 within the double-blinded, randomized clinical trial Assessment of Docosahexaenoic Acid on Reducing Early Preterm Birth. PARTICIPANTS/SETTING: A total of 112 Latina/x people during pregnancy from the Kansas City metro area were included in this study. MAIN OUTCOME MEASURES: Nutrition literacy level assessed between 12 and 20 gestational weeks using the Nutrition Literacy Assessment Instrument, both in English and Spanish. STATISTICAL ANALYSES PERFORMED: Descriptive measures were used to describe the nutrition literacy level during pregnancy. Multiple logistic regression models were used to examine the association between low nutrition literacy and socioeconomic position, adjusting for age and race. RESULTS: In this study, most participants demonstrated low nutrition literacy during pregnancy. Those with low nutrition literacy were 2 times more likely to have low annual household income (odds ratio [OR] = 2.74, 95% confidence interval [CI]: 0.99-7.59), 3 times more likely to prefer Spanish as their primary language of communication (OR = 3.03, 95% CI: 0.95-9.67), and 7 times more likely to be uninsured (OR = 7.47; 95% CI: 1.57-35.64). CONCLUSIONS: Nutrition literacy scores during pregnancy were associated with variables of socioeconomic position. Future research should focus on nutrition literacy associations with health outcomes during pregnancy and interventions to improve the nutrition literacy level of primarily Spanish-speaking people who have low household incomes and are uninsured.


Subject(s)
Health Literacy , Premature Birth , Female , Humans , Infant, Newborn , Pregnancy , Cross-Sectional Studies , Docosahexaenoic Acids , Hispanic or Latino , Socioeconomic Factors , Nutritional Status
17.
Brain Sci ; 12(4)2022 Apr 17.
Article in English | MEDLINE | ID: mdl-35448040

ABSTRACT

There is a relationship between obesity and cognitive functioning. Our aim was to assess weight loss influence on global cognition and executive functioning (EF) in adults with obesity under a multidisciplinary weight loss program. In this six-month longitudinal study, we assessed 81 adults (age < 50 years) with body mass index (BMI) ≥ 30. EF and global cognitive performance were evaluated with the Montreal Cognitive Assessment (MoCA), Neuropsychological Battery of Executive Functions (BANFE-2) and Trail Making Test-Part B (TMT-B). Median age was 40.0 years (IQR: 31.5−47, 61% women), and the median BMI was 41.4 (IQR: 36.7−45.9). At a six-month follow-up, the mean weight loss was 2.67% (29.6% of patients achieved ≥5% weight loss). There was an improvement in EF evaluated with BANFE (p = 0.0024) and global cognition with MoCA (p = 0.0024). Women experienced more remarkable change, especially in EF. Weight loss did not correlate with cognitive performance, except for TMT-B (r-0.258, p = 0.026). In the regression analysis, only years of education predicted the MoCA score. This study showed that patients improved cognitive performance during the follow-up; nevertheless, the magnitude of weight loss did not correlate with cognitive improvement. Future studies are warranted to demonstrate if patients achieving ≥5% weight loss can improve cognition, secondary to weight loss.

18.
Saúde Soc ; 31(1): e200891, 2022.
Article in Spanish | LILACS | ID: biblio-1352210

ABSTRACT

Resumen En este trabajo, analizamos la producción de certidumbre en una política en salud configurada desde el esquema epistémico de la medicina basada en la evidencia: el régimen de Garantías Explícitas en Salud en Chile. Con base en los estudios de ciencia y tecnología, el análisis de material producido mediante etnografías focalizadas en escenarios ministeriales, y considerando entrevistas a expertos y profesionales, exponemos cómo en estos escenarios los objetos vinculados con la evidencia llegan a servir para tres propósitos: reducir la complejidad de procesos globales, conectar lo local con lo global y, fundamentalmente, generar un nuevo continuo que vincula la verdad con la incertidumbre. Caracterizamos a estas entidades como "objetos especulativos", destacando su importante papel en la articulación de retóricas que permiten la configuración local de la biopolítica.


Abstract This article analyzes the production of certainty in a health policy shaped by the epistemic scheme of evidence-based medicine: the Regime of Explicit Health Guarantees in Chile. Based on studies on science and technology, the analysis of material produced through focused ethnographies in ministry settings, and interviews with experts and professionals, this study exposes how objects linked to the evidence serve for three purposes in these scenarios: to reduce the complexity of global processes, to connect the local with the global, and to generate a new continuum that links truth with uncertainty. These objects are characterized here as "speculative objects," highlighting their important role in the articulation of rhetoric that allows the local configuration of biopolitics.


Subject(s)
Humans , Male , Female , Public Health , Decision Making , Science, Technology and Society , Health Policy
19.
ACS Appl Mater Interfaces ; 13(33): 39363-39370, 2021 Aug 25.
Article in English | MEDLINE | ID: mdl-34378377

ABSTRACT

Metal-organic frameworks MIL-53(Al)-TDC and MIL-53(Al)-BDC were explored in the SO2 adsorption process. MIL-53(Al)-TDC was shown to behave as a rigid-like material upon SO2 adsorption. On the other hand, MIL-53(Al)-BDC exhibits guest-induced flexibility of the framework with the presence of multiple steps in the SO2 adsorption isotherm that was related through molecular simulations to the existence of three different pore opening phases narrow pore, intermediate pore, and large pore. Both materials proved to be exceptional candidates for SO2 capture, even under wet conditions, with excellent SO2 adsorption, good cycling, chemical stability, and easy regeneration. Further, we propose MIL-53(Al)-TDC and MIL-53(A)-BDC of potential interest for SO2 sensing and SO2 storage/transportation, respectively.

20.
Article in English | MEDLINE | ID: mdl-34205269

ABSTRACT

Previous studies have identified variants in genes encoding proteins associated with the degree of addiction, smoking onset, and cessation. We aimed to describe thirty-one single nucleotide polymorphisms (SNPs) in seven candidate genomic regions spanning six genes associated with tobacco-smoking in a cross-sectional study from two different interventions for quitting smoking: (1) thirty-eight smokers were recruited via multimedia to participate in e-Decídete! program (e-Dec) and (2) ninety-four attended an institutional smoking cessation program on-site. SNPs genotyping was done by real-time PCR using TaqMan probes. The analysis of alleles and genotypes was carried out using the EpiInfo v7. on-site subjects had more years smoking and tobacco index than e-Dec smokers (p < 0.05, both); in CYP2A6 we found differences in the rs28399433 (p < 0.01), the e-Dec group had a higher frequency of TT genotype (0.78 vs. 0.35), and TG genotype frequency was higher in the on-site group (0.63 vs. 0.18), same as GG genotype (0.03 vs. 0.02). Moreover, three SNPs in NRXN1, two in CHRNA3, and two in CHRNA5 had differences in genotype frequencies (p < 0.01). Cigarettes per day were different (p < 0.05) in the metabolizer classification by CYP2A6 alleles. In conclusion, subjects attending a mobile smoking cessation intervention smoked fewer cigarettes per day, by fewer years, and by fewer cumulative pack-years. There were differences in the genotype frequencies of SNPs in genes related to nicotine metabolism and nicotine dependence. Slow metabolizers smoked more cigarettes per day than intermediate and normal metabolizers.


Subject(s)
Smoking Cessation , Tobacco Use Disorder , Cross-Sectional Studies , Cytochrome P-450 CYP2A6/genetics , Genotype , Humans , Polymorphism, Single Nucleotide , Smoking/genetics , Tobacco Use Disorder/genetics
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