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1.
Sch Psychol ; 2024 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-38934898

RESUMEN

The increase in social media mental health (MH) campaigns provides an opportunity to improve awareness and attitudes toward MH. However, racial disparities remain in these social media campaigns. Black youth who participated in MH social media campaigns reported lower levels of improvement in stigma and help-seeking than their White peers. We employed a youth participatory action research (YPAR) process to expand on a previous community-wide MH social media campaign (A. Thompson et al., 2021), focusing on a Central Midwest community. We studied Black adolescents' perceptions of MH stigma and help-seeking to determine essential features of a culturally responsive MH social media campaign for Black youth. With a lead youth-research collaborator, the research team designed the following two-staged study. The first stage consisted of four semistructured focus group interviews (FGIs) (N = 20), analyzed by using a rapid analysis strategy to obtain results for the development of the campaign. In the second stage, using YPAR's iterative and action-based process, five youth researchers collaborated with the research team on the campaign's design. Following the two stages, the researcher's thematic analysis resulted in three themes: (a) broadening horizons for campaign designers and MH professionals; (b) considering mistrust of schools and school personnel; and (c) diverse experiences, sustainability, and accessibility in a campaign. Findings indicated that while culturally responsive social media campaigns to promote MH can be designed, mistrust of adults in schools is likely to hinder the impact of such campaigns. Implications for school psychology practice and research are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

3.
J Sch Psychol ; 105: 101317, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38876545

RESUMEN

Scholars have developed culturally responsive frameworks and interventions to support educators as they aim to create inclusive and equitable classroom environments. Despite the number of frameworks on the topic, research on culturally responsive practices (CRPs) is limited by the lack of clear definitions or evidence on the effectiveness of in-classroom culturally responsive interventions. With the aim to understand which characteristics are important for in-classroom CRPs, this qualitative study explored students' perceptions of practices teachers use to respond to students' learning and cultural identities. We conducted 23 focus groups with 103 Black, Latine, and White students in middle and high school from two midwestern schools. After analyzing the data, we identified four overarching themes: (a) inclusive classroom instruction, (b) emotional safety in the classroom, (c) relational quality with the teachers, and (d) racism and other "isms" in the classroom. Students consistently commented on the importance of teacher support for students' emotional and academic well-being while also describing teachers that demeaned them or their peers, in turn, obstructing their learning. The findings hold promise to clarify and strengthen professional development CRP interventions as students offer insight about teacher cultural responsiveness and non-responsiveness.


Asunto(s)
Grupos Focales , Instituciones Académicas , Estudiantes , Humanos , Estudiantes/psicología , Masculino , Femenino , Niño , Investigación Cualitativa , Adolescente , Competencia Cultural , Maestros/psicología , Racismo
4.
J Sch Psychol ; 105: 101314, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38876543

RESUMEN

Teacher-student relationships are beneficial for students and especially important in the middle school context. Suspensions are critical to reduce as it can be detrimental to the educational trajectory of students, particularly for marginalized students in underfunded schools. This study looked at the relations between teacher-student relationships and suspensions across the academic year in a sample of students (N = 541) and teachers (N = 51) in two urban school districts in the Midwest. A brief measure of teachers' perceptions of relationships with students completed in the fall of the academic year predicted the odds of receiving in-school suspension (ISS; odds ratio [OR] = 0.65) and out-of-school suspension (OSS; OR = 0.72) by the end of the school year. Student reports of the relationships were also associated with ISS (OR = 0.94), but not OSS. On average, teachers' report on the scale improved over the course of the school year (d = 0.11); however, student report of the relationships worsened (d = 0.30). The difference in the student report of the relationships from fall to spring was also associated with the odds of receiving ISS and OSS (ORs = 0.94). These findings suggest that student and teacher perceptions together are associated with harsh discipline practices that can negatively impact students' developmental trajectories. Relationships can change but direct action is necessary to develop, maintain, and repair relationships during the academic year.


Asunto(s)
Relaciones Interpersonales , Maestros , Instituciones Académicas , Estudiantes , Humanos , Estudiantes/psicología , Maestros/psicología , Femenino , Masculino , Niño , Adolescente , Castigo/psicología
5.
J Plast Reconstr Aesthet Surg ; 94: 50-53, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38759511

RESUMEN

This study evaluated trends in Medicare reimbursement for commonly performed breast oncologic and reconstructive procedures. Average national relative value units (RVUs) for physician-based work, facilities, and malpractice were collected along with the corresponding conversion factors for each year. From 2010 to 2021, there was an overall average decrease of 15% in Medicare reimbursement for both breast oncology (-11%) and reconstructive procedures (-16%). Based on these findings, breast and reconstructive surgeons should advocate for reimbursement that better reflects the costs of their practice.


Asunto(s)
Neoplasias de la Mama , Mamoplastia , Medicare , Humanos , Estados Unidos , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/economía , Medicare/economía , Femenino , Mamoplastia/economía , Mamoplastia/tendencias , Reembolso de Seguro de Salud/economía , Reembolso de Seguro de Salud/tendencias , Mecanismo de Reembolso
6.
Sch Psychol ; 39(3): 237-242, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38815121

RESUMEN

This special issue of School Psychology is focused on promoting scholarship on school personnel well-being and safety as well as systemic factors that can be leveraged to make schools healthier places for all. This includes understanding social-ecological factors related to educator sense of personal safety and wellness, as well as focusing on school psychologists' role in promoting adaptive school environments. In this introduction to the special issue, we provide a synthesis of nine articles that capture the role of context and competence in educator well-being. Next, we reflect on what we learned from these studies about theories, measures, methods, and models related to educator well-being. We conclude with recommendations for future research directions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Maestros , Humanos , Instituciones Académicas , Competencia Profesional/normas
7.
Vaccines (Basel) ; 12(5)2024 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-38793762

RESUMEN

We developed and tested MivacunaLA/MyshotLA, a community-informed mobile phone intervention, to increase COVID-19 vaccination among Latino parents/caretakers of minors in under-resourced areas of Los Angeles by addressing misinformation and building trust. We recruited Latino parents/caregivers with at least one unvaccinated child in East and South Los Angeles in the summer of 2021 and evaluated MivacunaLA as a randomized controlled trial with a wait-list control group. A difference-in-difference analysis showed Latino parents/caregivers that participated in MivacunaLA (n = 246), in comparison to the control group, were 15 percentage points more likely (p = 0.04) to report vaccination of minors aged 12-17 years, and 12 percentage points more likely (p = 0.03) to report a positive intention to vaccinate minors aged 2-11 years (when COVID-19 vaccines became available). Mobile phone-delivered digital interventions using videos and culturally tailored educational material to promote COVID-19 vaccine confidence can be an effective way to combat misinformation and deliver timely information to marginalized communities. Community-based participatory research approaches are crucial to advance health equity among minority communities, especially immigrant Spanish-speaking underserved communities.

8.
Cureus ; 16(4): e59003, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38800332

RESUMEN

INTRODUCTION: Information on whether race and ethnicity are associated with a greater risk of recurrent hyperkalemia is limited. The aim of this study was to examine the association between race or ethnicity and recurrent hyperkalemia in a population of US veterans. METHODS: This retrospective study used the US Veterans Affairs database to identify adults (aged ≥18 years) with at least one serum potassium measurement during the study period who ever experienced hyperkalemia (serum potassium > 5.0 mmol/L). The proportion of patients with hyperkalemia recurrence (≥1 subsequent event) within one year was determined for different race and ethnicity groups. The association between patient race and ethnicity and the risk of hyperkalemia recurrence within one year after the index hyperkalemia event was analyzed using competing risk regression. RESULTS: Among a total of 1,493,539 veterans with incident hyperkalemia (median age (interquartile range): 61.0 years (54.0, 71.0)), recurrence within one year occurred in 19.1% of Black, 16.0% of Native Hawaiian/other Pacific Islander, 15.1% of White, 14.9% of American Indian/Alaska Native, and 13.1% of Asian patient groups. Recurrent hyperkalemia occurred in 18.1% of Hispanic and 15.6% of non-Hispanic patient groups. In a fully-adjusted regression model, recurrent hyperkalemia risk was significantly higher in Black versus White patient groups (subhazard ratio (sHR), 1.17; 95% confidence interval (CI), 1.16-1.19; p< 0.0001) and in Hispanic versus non-Hispanic patient groups (sHR, 1.30; 95% CI, 1.28-1.33; p< 0.0001). DISCUSSION/CONCLUSION: Among US veterans with incident hyperkalemia, the risk of recurrent hyperkalemia was higher in Black and Hispanic patient groups. This information may be useful for health system screenings to risk stratify patient groups and both guide the frequency of serum potassium monitoring and better understand the root causes of group differences.

9.
J Clin Lipidol ; 18(3): e308-e319, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38565461

RESUMEN

Since the 2019 National Lipid Association (NLA) Scientific Statement on Use of Lipoprotein(a) in Clinical Practice was issued, accumulating epidemiological data have clarified the relationship between lipoprotein(a) [Lp(a)] level and cardiovascular disease risk and risk reduction. Therefore, the NLA developed this focused update to guide clinicians in applying this emerging evidence in clinical practice. We now have sufficient evidence to support the recommendation to measure Lp(a) levels at least once in every adult for risk stratification. Individuals with Lp(a) levels <75 nmol/L (30 mg/dL) are considered low risk, individuals with Lp(a) levels ≥125 nmol/L (50 mg/dL) are considered high risk, and individuals with Lp(a) levels between 75 and 125 nmol/L (30-50 mg/dL) are at intermediate risk. Cascade screening of first-degree relatives of patients with elevated Lp(a) can identify additional individuals at risk who require intervention. Patients with elevated Lp(a) should receive early, more-intensive risk factor management, including lifestyle modification and lipid-lowering drug therapy in high-risk individuals, primarily to reduce low-density lipoprotein cholesterol (LDL-C) levels. The U.S. Food and Drug Administration approved an indication for lipoprotein apheresis (which reduces both Lp(a) and LDL-C) in high-risk patients with familial hypercholesterolemia and documented coronary or peripheral artery disease whose Lp(a) level remains ≥60 mg/dL [∼150 nmol/L)] and LDL-C ≥ 100 mg/dL on maximally tolerated lipid-lowering therapy. Although Lp(a) is an established independent causal risk factor for cardiovascular disease, and despite the high prevalence of Lp(a) elevation (∼1 of 5 individuals), measurement rates are low, warranting improved screening strategies for cardiovascular disease prevention.


Asunto(s)
Enfermedades Cardiovasculares , Lipoproteína(a) , Humanos , Lipoproteína(a)/sangre , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/sangre , Factores de Riesgo , Hipolipemiantes/uso terapéutico
10.
Am Heart J Plus ; 38: 100350, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38510747

RESUMEN

Elevated lipoprotein(a) (Lp[a]) is an independent, genetic risk factor for atherosclerotic cardiovascular disease (ASCVD) that impacts ~1.4 billion people globally. Generally, Lp(a) levels remain stable over time; thus, most individuals need only undergo Lp(a) testing through a non-fasting blood draw once in their lifetime, unless elevated Lp(a) is identified. Despite the convenience of the test for clinicians and patients, routine Lp(a) testing has not been widely adopted. This review provides a guide to the benefits of Lp(a) testing and solutions for overcoming common barriers in practice, including access to testing and lack of awareness. Lp(a) testing provides the opportunity to reclassify ASCVD risk and drive intensive cardiovascular risk factor management in individuals with elevated Lp(a), and to identify patients potentially less likely to respond to statins. Moreover, cascade screening can help to identify elevated Lp(a) in relatives of individuals with a personal or family history of premature ASCVD. Overall, given the profound impact of elevated Lp(a) on cardiovascular risk, Lp(a) testing should be an essential component of risk assessment by primary and specialty care providers.

11.
BMC Med Educ ; 24(1): 292, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38491363

RESUMEN

BACKGROUND: Narrative medicine demonstrated positive impact on empathy in medicine and nursing students. However, this pedagogical approach had not been evaluated in pharmacy education. This study sought to apply and evaluate the narrative medicine approach in extending empathy in Asian undergraduate pharmacy students. METHODS: Narrative medicine was applied through workshops which used narratives of people with different experiences and perspectives. First-year undergraduate pharmacy students who volunteered and attended these workshops formed the intervention group (N = 31) and the remaining first-year cohort formed the control group (N = 112). A sequential explanatory mixed methods approach was adopted in which quantitative methods were first used to measure impact on pharmacy students' empathy using the Jefferson Scale of Empathy- Health Professions Student (JSE-HPS), and qualitative methods (i.e. group interviews) were then used to assess pharmacy students' emotional responses to narratives, and the perspectives of pharmacy students and faculty of this pedagogical approach. RESULTS: There was no difference in JSE-HPS scores between intervention and control groups across baseline (i.e. upon matriculation), pre-intervention, and post-intervention timepoints. Pharmacy students in the intervention group had lower scores in Factor 3 ("Standing in People's Shoes") following the intervention. Five themes, guided by internal and external factors in cognition, emerged from the Group Interviews: (1) incongruence between students' motivation and faculty's perception, (2) learning context, (3) academic context, (4) cognitive system, and (5) affective system. Themes 1, 4 and 5 referred to internal factors such as students' motivation, perceived learnings, and feelings. Themes 2 and 3 referred to external factors including workshop materials, activities, content, and facilitation. CONCLUSION: This study is the first to demonstrate that pharmacy students engaged with the narrative medicine approach as narratives elicited emotional responses, exposed them to diverse perspectives, and deepened their appreciation of the importance of empathy and complexities of understanding patients' perspectives. Scaffolded educational interventions using narratives and real-life patient encounters, alongside longitudinal measurements of empathy, are necessary to bring about meaningful and sustained improvements in empathy.


Asunto(s)
Educación en Farmacia , Medicina Narrativa , Estudiantes de Medicina , Humanos , Singapur , Estudiantes de Medicina/psicología , Empatía , Personal de Salud
12.
Artículo en Inglés | MEDLINE | ID: mdl-38502632

RESUMEN

Skeleton-based exercise assessment focuses on evaluating the correctness or quality of an exercise performed by a subject. Skeleton data provide two groups of features (i.e., position and orientation), which existing methods have not fully harnessed. We previously proposed an ensemble-based graph convolutional network (EGCN) that considers both position and orientation features to construct a model-based approach. Integrating these types of features achieved better performance than available methods. However, EGCN lacked a fusion strategy across the data, feature, decision, and model levels. In this paper, we present an advanced framework, EGCN++, for rehabilitation exercise assessment. Based on EGCN, a new fusion strategy called MLE-PO is proposed for EGCN++; this technique considers fusion at the data and model levels. We conduct extensive cross-validation experiments and investigate the consistency between machine and human evaluations on three datasets: UI-PRMD, KIMORE, and EHE. Results demonstrate that MLE-PO outperforms other EGCN ensemble strategies and representative baselines. Furthermore, the MLE-PO's model evaluation scores are more quantitatively consistent with clinical evaluations than other ensemble strategies.

13.
Inorg Chem ; 63(11): 4947-4956, 2024 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-38437618

RESUMEN

A series of photosensitizers comprised of both an inorganic and an organic chromophore are investigated in a joint synthetic, spectroscopic, and theoretical study. This bichromophoric design strategy provides a means by which to significantly increase the excited state lifetime by isolating the excited state away from the metal center following intersystem crossing. A variable bridging group is incorporated between the donor and acceptor units of the organic chromophore, and its influence on the excited state properties is explored. The Franck-Condon (FC) photophysics and subsequent excited state relaxation pathways are investigated with a suite of steady-state and time-resolved spectroscopic techniques in combination with scalar-relativistic quantum chemical calculations. It is demonstrated that the presence of an electronically conducting bridge that facilitates donor-acceptor communication is vital to generate long-lived (32 to 45 µs), charge-separated states with organic character. In contrast, when an insulating 1,2,3-triazole bridge is used, the excited state properties are dominated by the inorganic chromophore, with a notably shorter lifetime of 60 ns. This method of extending the lifetime of a molecular photosensitizer is, therefore, of interest for a range of molecular electronic devices and photophysical applications.

14.
Jt Comm J Qual Patient Saf ; 50(6): 416-424, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38433070

RESUMEN

BACKGROUND: Health equity in pain management during the perioperative period continues to be a topic of interest. The authors evaluated the association of race and ethnicity with regional anesthesia in patients who underwent colorectal surgery and characterized trends in regional anesthesia. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program database from 2015 to 2020, the research team identified patients who underwent open or laparoscopic colorectal surgery. Associations between race and ethnicity and use of regional anesthesia were estimated using logistic regression models. RESULTS: The final sample size was 292,797, of which 15.6% (n = 45,784) received regional anesthesia. The unadjusted rates of regional anesthesia for race and ethnicity were 15.7% white, 15.1% Black, 12.8% Asian, 29.6% American Indian or Alaska Native, 16.3% Native Hawaiian or Pacific Islander, and 12.4% Hispanic. Black (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.90-0.96, p < 0.001) and Asian (OR 0.76, 95% CI 0.71-0.80, p < 0.001) patients had lower odds of regional anesthesia compared to white patients. Hispanic patients had lower odds of regional anesthesia compared to non-Hispanic patients (OR 0.72, 95% CI 0.68-0.75, p < 0.001). There was a significant annual increase in regional anesthesia from 2015 to 2020 for all racial and ethnic cohorts (p < 0.05). CONCLUSION: There was an annual increase in the use of regional anesthesia, yet Black and Asian patients (compared to whites) and Hispanics (compared to non-Hispanics) were less likely to receive regional anesthesia for colorectal surgery. These differences suggest that there are racial and ethnic differences in regional anesthesia use for colorectal surgery.


Asunto(s)
Anestesia de Conducción , Etnicidad , Grupos Raciales , Humanos , Anestesia de Conducción/estadística & datos numéricos , Femenino , Masculino , Persona de Mediana Edad , Grupos Raciales/estadística & datos numéricos , Anciano , Etnicidad/estadística & datos numéricos , Estados Unidos , Cirugía Colorrectal/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Disparidades en Atención de Salud/etnología , Adulto
15.
Am J Med Sci ; 368(1): 9-17, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38556001

RESUMEN

BACKGROUND: Favorable neighborhood-level social determinants of health (SDoH) are associated with lower cardiovascular disease risk. Less is known about their influence on cardioprotective behaviors. We evaluated the associations between neighborhood-level SDoH and cardioprotective behaviors among church members in Louisiana. METHODS: Participants were surveyed between November 2021 to February 2022, and were asked about health behaviors, aspects of their neighborhood, and home address (to link to census tract and corresponding social deprivation index [SDI] data). Logistic regression models were used to assess the relation of neighborhood factors with the likelihood of engaging in cardioprotective behaviors: 1) a composite of healthy lifestyle behaviors [fruit and vegetable consumption, physical activity, and a tobacco/nicotine-free lifestyle], 2) medication adherence, and 3) receipt of routine medical care within the past year. RESULTS: Participants (n = 302, mean age: 63 years, 77% female, 99% Black) were recruited from 12 churches in New Orleans. After adjusting for demographic and clinical factors, perceived neighborhood walkability or conduciveness to exercise (odds ratio [OR]=1.25; 95% CI: 1.03, 1.53), availability of fruits and vegetables (OR=1.23; 95% CI: 1.07, 1.42), and social cohesion (OR=1.55; 95% CI: 1.22, 1.97) were positively associated with the composite of healthy lifestyle behaviors. After multivariable adjustment, SDI was in the direction of association with all three cardioprotective behavior outcomes, but associations were not statistically significant. CONCLUSIONS: In this predominantly Black, church-based population, neighborhood-level SDoH including the availability of fruits and vegetables, walkability or conduciveness to exercise, and social cohesion were associated with cardioprotective behaviors. Findings reiterate the need to address adverse neighborhood-level SDoH in the design and implementation of health interventions.


Asunto(s)
Conductas Relacionadas con la Salud , Características de la Residencia , Determinantes Sociales de la Salud , Humanos , Femenino , Masculino , Persona de Mediana Edad , Anciano , Nueva Orleans , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/epidemiología , Ejercicio Físico , Louisiana
16.
Public Health Nutr ; 27(1): e74, 2024 Feb 16.
Artículo en Inglés | MEDLINE | ID: mdl-38361460

RESUMEN

OBJECTIVE: The primary objective of this study was to determine whether Healthy Eating Index (HEI) and Alternative Healthy Eating Index (AHEI) scores were associated with incident metabolic syndrome. DESIGN: This study is a secondary analysis of data from the Jackson Heart Study. HEI and AHEI scores were divided into quintiles and Cox proportional hazards regression models were analysed for 1864 African American adults free from metabolic syndrome at Exam 1 to examine the incidence of metabolic syndrome by quintile of dietary quality score. SETTING: Hinds, Madison and Rankin counties, Mississippi, USA. PARTICIPANTS: African American adults, ages 21-94 years, 60·9 % female. RESULTS: Over a mean follow-up time of 6·7 years, we observed 932 incident cases of metabolic syndrome. After adjusting for multiple covariates, a higher HEI score at Exam 1 was not associated with the risk of incident metabolic syndrome, except when looking at the trend analysis for the subgroup of adults with two metabolic syndrome components at Exam 1 (P-trend = 0·03). A higher AHEI score at Exam 1 was associated with the risk of incident metabolic syndrome (hazard ratio for those in the highest quintile compared to the lowest: 0·80 (95 % CI: 0·65, 0·99), P-trend = 0·03). CONCLUSION: These findings suggest that a dietary pattern that scores higher on the AHEI may help reduce the risk of metabolic syndrome, even for adults who already have two of the minimum of three components required for a diagnosis of metabolic syndrome.


Asunto(s)
Dieta Saludable , Síndrome Metabólico , Adulto , Femenino , Humanos , Masculino , Negro o Afroamericano , Dieta , Estudios Longitudinales , Síndrome Metabólico/epidemiología , Factores de Riesgo , Adulto Joven , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años
17.
Sci Rep ; 14(1): 3126, 2024 02 07.
Artículo en Inglés | MEDLINE | ID: mdl-38326368

RESUMEN

Disease outbreaks can drastically disturb the environment of surviving animals, but the behavioural, ecological, and epidemiological consequences of disease-driven disturbance are poorly understood. Here, we show that an outbreak of High Pathogenicity Avian Influenza Virus (HPAIV) coincided with unprecedented short-term behavioural changes in Northern gannets (Morus bassanus). Breeding gannets show characteristically strong fidelity to their nest sites and foraging areas (2015-2019; n = 120), but during the 2022 HPAIV outbreak, GPS-tagged gannets instigated long-distance movements beyond well-documented previous ranges and the first ever recorded visits of GPS-tagged adults to other gannet breeding colonies. Our findings suggest that the HPAIV outbreak triggered changes in space use patterns of exposed individuals that amplified the epidemiological connectivity among colonies and may generate super-spreader events that accelerate disease transmission across the metapopulation. Such self-propagating transmission from and towards high density animal aggregations may explain the unexpectedly rapid pan-European spread of HPAIV in the gannet.


Asunto(s)
Virus de la Influenza A , Gripe Aviar , Animales , Aves , Brotes de Enfermedades , Conducta Alimentaria , Gripe Aviar/epidemiología , Virulencia
18.
Nature ; 626(7999): 500-504, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38356071

RESUMEN

Magnetars are neutron stars with extremely high magnetic fields (≳1014 gauss) that exhibit various X-ray phenomena such as sporadic subsecond bursts, long-term persistent flux enhancements and variable rotation-period derivative1,2. In 2020, a fast radio burst (FRB), akin to cosmological millisecond-duration radio bursts, was detected from the Galactic magnetar SGR 1935+2154 (refs. 3-5), confirming the long-suspected association between some FRBs and magnetars. However, the mechanism for FRB generation in magnetars remains unclear. Here we report the X-ray observation of two glitches in SGR 1935+2154 within a time interval of approximately nine hours, bracketing an FRB that occurred on 14 October 20226,7. Each glitch involved a significant increase in the magnetar's spin frequency, being among the largest abrupt changes in neutron-star rotation8-10 observed so far. Between the glitches, the magnetar exhibited a rapid spin-down phase, accompanied by an increase and subsequent decline in its persistent X-ray emission and burst rate. We postulate that a strong, ephemeral, magnetospheric wind11 provides the torque that rapidly slows the star's rotation. The trigger for the first glitch couples the star's crust to its magnetosphere, enhances the various X-ray signals and spawns the wind that alters magnetospheric conditions that might produce the FRB.

19.
Hypertension ; 81(5): 1095-1105, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38314554

RESUMEN

BACKGROUND: The SPYRAL HTN-ON MED (Global Clinical Study of Renal Denervation With the Symplicity Spyral Multi-electrode Renal Denervation System in Patients With Uncontrolled Hypertension in the Absence of Antihypertensive Medications)trial showed significant office and nighttime systolic blood pressure (BP) reductions in patients with hypertension following renal denervation (RDN) compared with sham-control patients, despite similar 24-hour BP reductions. We compared antihypertensive medication and BP changes among prespecified subpopulations. METHODS: The multicenter, randomized, sham-controlled, blinded SPYRAL HTN-ON MED trial (n=337) evaluated BP changes after RDN compared with a sham procedure in patients with hypertension prescribed 1 to 3 antihypertensive drugs. Most patients (n=187; 54%) were enrolled outside the United States, while 156 (46%) US patients were enrolled, including 60 (18%) Black Americans. RESULTS: Changes in detected antihypertensive drugs were similar between RDN and sham group patients in the outside US cohort, while drug increases were significantly more common in the US sham group compared with the RDN group. Patients from outside the United States showed significant reductions in office and 24-hour mean systolic BP at 6 months compared with the sham group, whereas BP changes were similar between RDN and sham in the US cohort. Within the US patient cohort, Black Americans in the sham control group had significant increases in medication burden from baseline through 6 months (P=0.003) but not in the RDN group (P=0.44). CONCLUSIONS: Patients enrolled outside the United States had minimal antihypertensive medication changes between treatment groups and had significant office and 24-hour BP reductions compared with the sham group. Increased antihypertensive drug burden in the US sham cohort, especially among Black Americans, may have diluted the treatment effect in the combined trial population. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02439775.


Asunto(s)
Antihipertensivos , Hipertensión , Humanos , Antihipertensivos/uso terapéutico , Riñón , Presión Sanguínea/fisiología , Desnervación/métodos , Simpatectomía/métodos , Resultado del Tratamiento
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