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1.
Front Plant Sci ; 15: 1435837, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39139719

RESUMO

Bread wheat germplasm is accessed from the International Maize and Wheat Improvement Centre (CIMMYT) and the International Centre for Agricultural Research in the Dry Areas (ICARDA) by Australian wheat breeders and researchers through the CIMMYT Australia ICARDA Germplasm Evaluation (CAIGE) program. The CAIGE program coordinates the selection, importation, quarantine, dissemination, and evaluation of the imported bread wheat germplasm and the management of associated data and information. This paper describes the CAIGE model and assesses both the genetic and economic impacts of these materials on the Australian wheat industry after commercialisation of wheat breeding in the early 21st century and the establishment of CAIGE. The CAIGE concept was validated using data collected and analysed from multi-environment trials between 2017 and 2020. The impact of cultivars with and without CAIGE contribution to pedigree on yield was estimated using production-by-variety statistics. Net gain in yield, estimated as the yield difference between CAIGE and Non-CAIGE varieties, was multiplied by the percentage contribution to pedigree to estimate the additional yield. The CAIGE bread wheat program identified diverse, high-yielding, and disease-resistant germplasm and significantly improved the capture and dissemination of information. The benefit-cost ratio, calculated as the sum of benefits divided by investments, indicated that, for every dollar invested in CAIGE, a further $20 was generated in benefits. The internal rate of return was estimated at 163% and the modified rate at 18%. The benefits of these international materials to Australian wheat breeding remained significant.

2.
Nat Commun ; 15(1): 5427, 2024 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-38926342

RESUMO

Cardiomyocytes derived from human induced pluripotent stem cells (hiPSC-CMs) are powerful in vitro models to study the mechanisms underlying cardiomyopathies and cardiotoxicity. Quantification of the contractile function in single hiPSC-CMs at high-throughput and over time is essential to disentangle how cellular mechanisms affect heart function. Here, we present CONTRAX, an open-access, versatile, and streamlined pipeline for quantitative tracking of the contractile dynamics of single hiPSC-CMs over time. Three software modules enable: parameter-based identification of single hiPSC-CMs; automated video acquisition of >200 cells/hour; and contractility measurements via traction force microscopy. We analyze >4,500 hiPSC-CMs over time in the same cells under orthogonal conditions of culture media and substrate stiffnesses; +/- drug treatment; +/- cardiac mutations. Using undirected clustering, we reveal converging maturation patterns, quantifiable drug response to Mavacamten and significant deficiencies in hiPSC-CMs with disease mutations. CONTRAX empowers researchers with a potent quantitative approach to develop cardiac therapies.


Assuntos
Células-Tronco Pluripotentes Induzidas , Contração Miocárdica , Miócitos Cardíacos , Software , Células-Tronco Pluripotentes Induzidas/citologia , Células-Tronco Pluripotentes Induzidas/efeitos dos fármacos , Humanos , Miócitos Cardíacos/efeitos dos fármacos , Miócitos Cardíacos/citologia , Miócitos Cardíacos/fisiologia , Contração Miocárdica/efeitos dos fármacos , Contração Miocárdica/fisiologia , Diferenciação Celular/efeitos dos fármacos , Análise de Célula Única/métodos , Células Cultivadas
4.
J Public Health Policy ; 45(1): 137-151, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38216689

RESUMO

Using scoping review methods, we systematically searched multiple online databases for publications in the first year of the pandemic that proposed pragmatic population or health system-level solutions to health inequities. We found 77 publications with proposed solutions to pandemic-related health inequities. Most were commentaries, letters, or editorials from the USA, offering untested solutions, and no robust evidence on effectiveness. Some of the proposed solutions could unintentionally exacerbate health inequities. We call on health policymakers to co-create, co-design, and co-produce equity-focussed, evidence-based interventions with communities, focussing on those most at risk to protect the population as a whole. Epidemiologists collaborating with people from other relevant disciplines may provide methodological expertise for these processes. As epidemiologists, we must interrogate our own methods to avoid propagating any unscientific biases we may hold. Epidemiology must be used to address, and never exacerbate, health inequities-in the pandemic and beyond.


Assuntos
COVID-19 , Equidade em Saúde , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Desigualdades de Saúde , Política de Saúde , SARS-CoV-2
5.
Psychol Med ; 54(5): 993-1003, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37845827

RESUMO

BACKGROUND: Hippocampal hyperperfusion has been observed in people at Clinical High Risk for Psychosis (CHR), is associated with adverse longitudinal outcomes and represents a potential treatment target for novel pharmacotherapies. Whether cannabidiol (CBD) has ameliorative effects on hippocampal blood flow (rCBF) in CHR patients remains unknown. METHODS: Using a double-blind, parallel-group design, 33 CHR patients were randomized to a single oral 600 mg dose of CBD or placebo; 19 healthy controls did not receive any drug. Hippocampal rCBF was measured using Arterial Spin Labeling. We examined differences relating to CHR status (controls v. placebo), effects of CBD in CHR (placebo v. CBD) and linear between-group relationships, such that placebo > CBD > controls or controls > CBD > placebo, using a combination of hypothesis-driven and exploratory wholebrain analyses. RESULTS: Placebo-treated patients had significantly higher hippocampal rCBF bilaterally (all pFWE<0.01) compared to healthy controls. There were no suprathreshold effects in the CBD v. placebo contrast. However, we found a significant linear relationship in the right hippocampus (pFWE = 0.035) such that rCBF was highest in the placebo group, lowest in controls and intermediate in the CBD group. Exploratory wholebrain results replicated previous findings of hyperperfusion in the hippocampus, striatum and midbrain in CHR patients, and provided novel evidence of increased rCBF in inferior-temporal and lateral-occipital regions in patients under CBD compared to placebo. CONCLUSIONS: These findings suggest that hippocampal blood flow is elevated in the CHR state and may be partially normalized by a single dose of CBD. CBD therefore merits further investigation as a potential novel treatment for this population.


Assuntos
Canabidiol , Transtornos Psicóticos , Humanos , Canabidiol/farmacologia , Transtornos Psicóticos/diagnóstico por imagem , Transtornos Psicóticos/tratamento farmacológico , Hipocampo/diagnóstico por imagem , Corpo Estriado , Método Duplo-Cego
6.
Am J Physiol Heart Circ Physiol ; 326(1): H190-H202, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37921665

RESUMO

Myoendothelial feedback (MEF), the endothelium-dependent vasodilation following sympathetic vasoconstriction (mediated by smooth muscle to endothelium gap junction communication), has been well studied in resistance arteries of males, but not females. We hypothesized that MEF responses would be similar between the sexes, but different in the relative contribution of the underlying nitric oxide and hyperpolarization mechanisms, given that these mechanisms differ between the sexes in agonist-induced endothelium-dependent dilation. We measured MEF responses (diameter changes) of male and female first- to second-order mouse mesenteric arteries to phenylephrine (10 µM) over 30 min using isolated pressure myography ± blinded inhibition of nitric oxide synthase (NOS) using Nω-nitro-l-arginine methyl ester (l-NAME; 0.1-1.0 mM), hyperpolarization using 35 mM KCl, or transient receptor potential vanilloid 4 (TRPV4) channels using GSK219 (0.1-1.0 µM) or RN-1734 (30 µM). MEF was similar [%dilation (means ± SE): males = 26.7 ± 2.0 and females = 26.1 ± 1.9 at 15 min] and significantly inhibited by l-NAME (1.0 mM) at 15 min [%dilation (means ± SE): males = 8.2 ± 3.3, P < 0.01; females = 6.8 ± 1.9, P < 0.001] and over time (P < 0.01) in both sexes. l-NAME (0.1 mM) + 35 mM KCl nearly eliminated MEF in both sexes (P < 0.001-0.0001). Activation of TRPV4 with GSK101 (0.1-10 µM) induced similar dilation between the sexes. Inhibition of TRPV4, which is reportedly involved in the hyperpolarization mechanism, did not inhibit MEF in either sex. Similar expression of eNOS was found between the sexes with Western blot. Thus, MEF is prominent and similar in murine first- and second-order mesenteric resistance arteries of both sexes, and reliant primarily on NOS and secondarily on hyperpolarization, but not TRPV4.NEW & NOTEWORTHY We found that female mesenteric resistance arteries have similar postconstriction dilatory responses (i.e., myoendothelial feedback) to a sympathetic neurotransmitter analog as male arteries. Both sexes use nitric oxide synthase (NOS) and hyperpolarization, but not TRPV4, in this response. Moreover, the key protein involved in this pathway (eNOS) is similarly expressed in these arteries between the sexes. These similarities are surprising given that agonist-induced endothelium-dependent dilatory mechanisms differ in these arteries between the sexes.


Assuntos
Óxido Nítrico Sintase , Canais de Cátion TRPV , Camundongos , Masculino , Feminino , Animais , NG-Nitroarginina Metil Éster/farmacologia , Retroalimentação , Canais de Cátion TRPV/metabolismo , Artérias Mesentéricas/metabolismo , Vasodilatação , Óxido Nítrico/metabolismo , Endotélio Vascular/metabolismo
7.
Nat Commun ; 14(1): 6900, 2023 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-37903764

RESUMO

Inter-organelle contact and communication between mitochondria and sarco/endoplasmic reticulum (SR/ER) maintain cellular homeostasis and are profoundly disturbed during tissue ischemia. We tested the hypothesis that the formin Diaphanous-1 (DIAPH1), which regulates actin dynamics, signal transduction and metabolic functions, contributes to these processes. We demonstrate that DIAPH1 interacts directly with Mitofusin-2 (MFN2) to shorten mitochondria-SR/ER distance, thereby enhancing mitochondria-ER contact in cells including cardiomyocytes, endothelial cells and macrophages. Solution structure studies affirm the interaction between the Diaphanous Inhibitory Domain and the cytosolic GTPase domain of MFN2. In male rodent and human cardiomyocytes, DIAPH1-MFN2 interaction regulates mitochondrial turnover, mitophagy, and oxidative stress. Introduction of synthetic linker construct, which shorten the mitochondria-SR/ER distance, mitigated the molecular and functional benefits of DIAPH1 silencing in ischemia. This work establishes fundamental roles for DIAPH1-MFN2 interaction in the regulation of mitochondria-SR/ER contact networks. We propose that targeting pathways that regulate DIAPH1-MFN2 interactions may facilitate recovery from tissue ischemia.


Assuntos
Células Endoteliais , Mitocôndrias , Humanos , Masculino , Retículo Endoplasmático/metabolismo , Células Endoteliais/metabolismo , Forminas/metabolismo , GTP Fosfo-Hidrolases/genética , GTP Fosfo-Hidrolases/metabolismo , Isquemia/genética , Isquemia/metabolismo , Mitocôndrias/metabolismo , Proteínas Mitocondriais/metabolismo , Transdução de Sinais , Animais
8.
Zookeys ; 1182: 35-134, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37868122

RESUMO

Nereididae is among the most familiar of marine annelid families, common and well-studied in most marine environments but paradoxically no recent key or identification guide exists to the world's genera. Here updated generic descriptions, a list of characters, a linear key to genera, and minimal diagnoses that distinguish each genus from all others in the family are provided. This information is generated from a Delta database of 186 morphological characters and a link is provided to downloadable software allowing the same data to be interrogated using the open-source Delta program Intkey - a nonlinear multiple entry point computerised interactive key. For each genus the recent literature is also summarised, comments on taxonomic status provided, and published keys to species cited. Nexus format matrices are provided for all 45 genera and 158 Nereididae species, representing all genera, scored for 146 multistate characters from the same character list to facilitate future phylogenetic studies.

9.
Obesity (Silver Spring) ; 31(7): 1825-1843, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37231626

RESUMO

OBJECTIVE: Optimal body mass and composition as well as metabolic fitness require tightly regulated and interconnected mechanisms across tissues. Disturbances in these regulatory networks tip the balance between metabolic health versus overweight and obesity and their complications. The authors previously demonstrated roles for the receptor for advanced glycation end products (RAGE) in obesity, as global- or adipocyte-specific deletion of Ager (the gene encoding RAGE) protected mice from high-fat diet-induced obesity and metabolic dysfunction. METHODS: To explore translational strategies evoked by these observations, a small molecule antagonist of RAGE signaling, RAGE229, was administered to lean mice and mice with obesity undergoing diet-induced weight loss. Body mass and composition and whole body and adipose tissue metabolism were examined. RESULTS: This study demonstrates that antagonism of RAGE signaling reduced body mass and adiposity and improved glucose, insulin, and lipid metabolism in lean male and female mice and in male mice with obesity undergoing weight loss. In adipose tissue and in human and mouse adipocytes, RAGE229 enhanced phosphorylation of protein kinase A substrates, which augmented lipolysis, mitochondrial function, and thermogenic programs. CONCLUSIONS: Pharmacological antagonism of RAGE signaling is a potent strategy to optimize healthful body mass and composition and metabolic fitness.


Assuntos
Tecido Adiposo , Obesidade , Masculino , Camundongos , Feminino , Humanos , Animais , Receptor para Produtos Finais de Glicação Avançada/genética , Receptor para Produtos Finais de Glicação Avançada/metabolismo , Tecido Adiposo/metabolismo , Obesidade/metabolismo , Dieta Hiperlipídica , Termogênese/genética , Redução de Peso
10.
J Occup Environ Med ; 65(7): 595-604, 2023 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-37015736

RESUMO

OBJECTIVE: The aim of this study was to investigate whether risk estimates for childhood acute lymphoblastic leukemia change when restricting model comparison groups to "nonpesticide exposure" (NPE10) households. METHODS: Cases ( n = 1810) 15 years or younger were identified through Children's Cancer Group institutions between 1989 and 1993 and age-/sex-matched to controls ( n = 1951). Household pesticide use during pregnancy/month prior was collected via telephone. NPE10 comparison group reporting no parental exposure to 10 pesticide classes was identified. RESULTS: Adjusted odds ratios increased from 15% to 49% when limiting the comparison to NPE10. Maternal termite insecticide exposure was associated with greatest risk (adjusted odds ratio, 4.21; 95% confidence interval, 2.00-8.88). There was minimal evidence of interaction by child sex or occupational pesticide exposure, and no monotonic dose-response pattern with frequency of use (times per year). CONCLUSIONS: Elevated risks are consistent with published pooled-/meta-analyses and DNA damage. The consistency and magnitude of these associations warrant product labeling, exposure reduction interventions, or both.


Assuntos
Praguicidas , Leucemia-Linfoma Linfoblástico de Células Precursoras , Efeitos Tardios da Exposição Pré-Natal , Criança , Masculino , Gravidez , Feminino , Humanos , Lactente , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Praguicidas/toxicidade , Fatores de Risco , Exposição Paterna/efeitos adversos , Exposição Materna/efeitos adversos , Leucemia-Linfoma Linfoblástico de Células Precursoras/induzido quimicamente , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Estudos de Casos e Controles
11.
Cancer Epidemiol Biomarkers Prev ; 32(5): 697-707, 2023 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-36788426

RESUMO

BACKGROUND: Little is known regarding factors associated with calcitriol and a relative measure of calcitriol, the calcitriol-24,25-dihydroxyvitamin D3-calcifediol proportion ratio (C24CPR). METHODS: Using a cross-sectional study design, healthy young adults of African and European descent, matched (1:1) on age (±5 years) provided a blood sample in non-summer months (N = 376). Vitamin D metabolites were measured in plasma with HPLC/MS-MS. West African genetic ancestry proportion (WGA) was estimated using STRUCTURE modeling of genetic ancestry-informative markers. Multivariable regression models were used to estimate the association of WGA and vitamin D-pathway gene variants with calcitriol and C24CPR, controlling for days from summer solstice, age, sex, blood pressure, body mass index, dietary vitamin D intake, oral contraceptive/medroxyprogesterone acetate use, smoking, tanning bed use, and time of day. RESULTS: Calcitriol and C24CPR were not highly correlated (rho = 0.14), although both were significantly, positively, and monotonically associated with WGA (Ptrend 0.025 and <0.001, respectively). In fully adjusted models, genetic factors explained a greater proportion of variability in C24CPR (R2 = 0.121 and 0.310, respectively). Variants in genes with associated with calcitriol (CALB1, CYP27B1, GC, and PPARGC1A) differed from those associated with C24CPR (CYP3A43, FGF23, KL, and VDR). CONCLUSIONS: Both absolute and relative measures of calcitriol were significantly higher among African Americans. Otherwise, these biomarkers appear to be genetically distinct. IMPACT: C24CPR may be better suited to personalized medicine, due to a higher proportion of population variability explained by genetic variation and a less skewed distribution.


Assuntos
Calcitriol , Vitamina D , Adulto Jovem , Humanos , Calcitriol/metabolismo , Estudos Transversais , Calcifediol/metabolismo , Vitaminas , Receptores de Calcitriol/genética
12.
Psychol Med ; 53(10): 4732-4741, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-35775365

RESUMO

BACKGROUND: The mechanisms underlying the antipsychotic potential of cannabidiol (CBD) remain unclear but growing evidence indicates that dysfunction in the insula, a key brain region involved in the processing of motivationally salient stimuli, may have a role in the pathophysiology of psychosis. Here, we investigate whether the antipsychotic mechanisms of CBD are underpinned by their effects on insular activation, known to be involved in salience processing. METHODS: A within-subject, crossover, double-blind, placebo-controlled investigation of 19 healthy controls and 15 participants with early psychosis was conducted. Administration of a single dose of CBD was compared with placebo in psychosis participants while performing the monetary incentive delay task, an fMRI paradigm. Anticipation of reward and loss were used to contrast motivationally salient stimuli against a neutral control condition. RESULTS: No group differences in brain activation between psychosis patients compared with healthy controls were observed. Attenuation of insula activation was observed following CBD, compared to placebo. Sensitivity analyses controlling for current cannabis use history did not affect the main results. CONCLUSION: Our findings are in accordance with existing evidence suggesting that CBD modulates brain regions involved in salience processing. Whether such effects underlie the putative antipsychotic effects of CBD remains to be investigated.


Assuntos
Antipsicóticos , Canabidiol , Transtornos Psicóticos , Humanos , Antipsicóticos/farmacologia , Encéfalo , Canabidiol/farmacologia , Método Duplo-Cego , Imageamento por Ressonância Magnética , Motivação , Transtornos Psicóticos/diagnóstico por imagem , Transtornos Psicóticos/tratamento farmacológico
13.
Schizophr Bull Open ; 4(1): sgad022, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-39145348

RESUMO

Background: Preclinical and human data suggest that psychosis onset involves hippocampal glutamatergic dysfunction, driving hyperactivity and hyperperfusion in a hippocampal-midbrain-striatal circuit. Whether glutamatergic dysfunction is related to cerebral perfusion in patients at clinical high risk (CHR) for psychosis, and whether cannabidiol (CBD) has ameliorative effects on glutamate or its relationship with perfusion remains unknown. Methods: Using a double-blind, parallel-group design, 33 CHR patients were randomized to a single 600 mg dose of CBD or placebo; 19 healthy controls did not receive any drug. Proton magnetic resonance spectroscopy was used to measure glutamate concentrations in left hippocampus. We examined differences relating to CHR status (controls vs placebo), effects of CBD (placebo vs CBD), and linear between-group effects, such that placebo>CBD>controls or controls>CBD>placebo. We also examined group × glutamate × cerebral perfusion (measured using Arterial Spin Labeling) interactions. Results: Compared to controls, CHR-placebo patients had significantly lower hippocampal glutamate (P =.015) and a significant linear relationship was observed across groups, such that glutamate was highest in controls, lowest in CHR-placebo, and intermediate in CHR-CBD (P =.031). Moreover, there was a significant interaction between group (controls vs CHR-placebo), hippocampal glutamate, and perfusion in the putamen and insula (P FWE =.012), with a strong positive correlation in CHR-placebo vs a negative correlation in controls. Conclusions: Our findings suggest that hippocampal glutamate is lower in CHR patients and may be partially normalized by a single dose of CBD. Furthermore, we provide the first in vivo evidence of an abnormal relationship between hippocampal glutamate and perfusion in the striatum and insula in CHR.

14.
Cardiovasc Res ; 2022 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-36448548

RESUMO

Overweight and obesity are leading causes of cardiometabolic dysfunction. Despite extensive investigation, the mechanisms mediating the increase in these conditions are yet to be fully understood. Beyond endogenous formation of advanced glycation end products (AGEs) in overweight and obesity, exogenous sources of AGEs accrue through the heating, production and consumption of highly-processed foods. Evidence from cellular and mouse model systems indicates that the interaction of AGEs with their central cell surface receptor for AGE (RAGE) in adipocytes suppresses energy expenditure and that AGE/RAGE contributes to increased adipose inflammation and processes linked to insulin resistance. In human subjects, the circulating soluble forms of RAGE, which are mutable, may serve as biomarkers of obesity and weight loss. Antagonists of RAGE signaling, through blockade of the interaction of the RAGE cytoplasmic domain with the formin, Diaphanous-1 (DIAPH1), target aberrant RAGE activities in metabolic tissues. This review focuses on the potential roles for AGEs and other RAGE ligands and RAGE/DIAPH1 in the pathogenesis of overweight and obesity and their metabolic consequences.

15.
Artigo em Inglês | MEDLINE | ID: mdl-35805627

RESUMO

The popularity of intermittent fasting (IF) and high intensity (sprint) interval training (SIT) has increased in recent years amongst the general public due to their purported health benefits and feasibility of incorporation into daily life. The number of scientific studies investigating these strategies has also increased, however, very few have examined the combined effects, especially on body composition and cardiometabolic biomarkers, which is the primary aim of this investigation. A total of thirty-four male and female participants (age: 35.4 ± 8.4 y, body mass index (BMI): 31.3 ± 3.5 kg/m2, aerobic capacity (VO2peak) 27.7 ± 7.0 mL·kg−1·min−1) were randomized into one of three 16-week interventions: (1) 5:2 IF (2 non-consecutive days of fasting per week, 5 days on ad libitum eating), (2) supervised SIT (3 bouts per week of 20s cycling at 150% VO2peak followed by 40 s of active rest, total 10 min duration), and (3) a combination of both interventions. Body composition, haemodynamic and VO2peak were measured at 0, 8 and 16 weeks. Blood samples were also taken and analysed for lipid profiles and markers of glucose regulation. Both IF and IF/SIT significantly decreased body weight, fat mass and visceral fat compared to SIT only (p < 0.05), with no significant differences between diet and diet + exercise combined. The effects of diet and/or exercise on cardiometabolic biomarkers were mixed. Only exercise alone or with IF significantly increased cardiorespiratory fitness. The results suggest that energy restriction was the main driver of body composition enhancement, with little effect from the low volume SIT. Conversely, to achieve benefits in cardiorespiratory fitness, exercise is required.


Assuntos
Doenças Cardiovasculares , Treinamento Intervalado de Alta Intensidade , Adulto , Biomarcadores , Composição Corporal , Feminino , Humanos , Masculino , Obesidade , Sobrepeso
16.
J Public Health Policy ; 43(2): 292-303, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35322177

RESUMO

A well-recognized gap exists between findings from public health research and their use in public health practice to improve outcomes. The World Health Organization (WHO) has identified implementation research as vital to improving the adaptation and dissemination of public health interventions into real-world settings. Implementation research encompasses multimethod evaluation approaches; 'mixed methods', the planned integration of qualitative and quantitative methods, is a key tool. We argue that mixed methods designs are crucial for design and evaluation of public health interventions, provide illustrative case studies, discuss key analytic approaches in mixed methods design, identify resources for mixed methods research and advocate for more training. On behalf of the International Network for Epidemiology in Policy (INEP), an international non-profit organization of 24 member societies that promotes the development of equitable, evidence-based health policies, we call for increased collaboration between qualitative and quantitative research teams to improve the design and evaluation of public health interventions.


Assuntos
Prática de Saúde Pública , Saúde Pública , Medicina Baseada em Evidências , Humanos
17.
Hastings Cent Rep ; 52(1): 28-31, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35143067

RESUMO

The practice of nonconsensual intimate exams performed on unconscious patients by medical students during their training has received significant attention in the last several years. Clinicians, medical students, bioethicists, lawyers, and the public have called for explicit and specific consent to take place before all educational intimate examinations of unconscious patients. In response, since January of 2019, dozens of bills have been proposed in more than twenty states, and thirteen of these have been signed into law (in addition to six that passed before 2019). Here, we consider the content of these enacted bills, drawing attention to five variable features and offering these five corresponding legislative recommendations, in hopes of narrowing in on the appropriate ethical scope of consent laws surrounding educational intimate exams: (1) use gender-neutral language; (2) include all intimate exams, not solely pelvic exams; (3) focus on unconscious patients; (4) focus on educational exams; and (5) regulate systems, not individuals.


Assuntos
Consentimento Livre e Esclarecido , Estudantes de Medicina , Humanos , Princípios Morais , Exame Físico
18.
Cancer Causes Control ; 33(1): 91-99, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34652593

RESUMO

PURPOSE: To determine whether higher coffee intake may reduce the risk of renal cell cancer (RCC) associated with lead (Pb) and other heavy metals with known renal toxicity. METHODS: We conducted a nested case-control study of male smokers (136 RCC cases and 304 controls) within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Cases diagnosed with RCC at 5 or more years following cohort enrollment were matched to controls on age (± 7 years) and whole blood draw date (± 30 days). Conditional logistic regression (using two-sided tests) was used to test for main effects and additive models of effect modification. RESULTS: After a mean follow-up of 16.3 years, coffee consumption was not significantly associated with renal cell cancer risk, when adjusting for blood concentrations of Cd, Hg, and Pb and RCC risk factors (age, smoking, BMI, and systolic blood pressure) (p-trend, 0.134). The association with above median blood Pb and RCC (HR = 1.69, 95% CI 1.06, 2.85) appeared to be modified by coffee consumption, such that RCC risk among individuals with both increased coffee intake and higher blood lead concentration were more than threefold higher RCC risk (HR = 3.40, 95% CI 1.62, 7.13; p-trend, 0.003). CONCLUSION: Contrary to our initial hypothesis, this study suggests that heavy coffee consumption may increase the previously identified association between higher circulating lead (Pb) concentrations and increased RCC risk. Improved assessment of exposure, including potential trace element contaminants in coffee, is needed.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Oligoelementos , Carcinoma de Células Renais/epidemiologia , Carcinoma de Células Renais/etiologia , Estudos de Casos e Controles , Café/efeitos adversos , Humanos , Neoplasias Renais/epidemiologia , Neoplasias Renais/etiologia , Masculino , Fatores de Risco , Fumantes
19.
J Hum Hypertens ; 36(9): 839-845, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-34285353

RESUMO

Hypertension and vitamin D concentrations have heritable components, although these factors remain uninvestigated in young adults. The objective of this study was to investigate hypertension risk among young adults with respect to family history of hypertension, adjusting for vitamin D status. Resting blood pressure (BP) was measured in 398 individuals aged 18-35 and classified according to the 2017 American Heart Association criteria. Plasma vitamin D metabolite (25(OH)D3; 24,25(OH)2D3; 1,25(OH)2D3) concentrations were determined using liquid chromatography tandem mass spectrometry (LC-MS/MS). Stepwise logistic regression was used to select covariates. Participants' mean age was 21, 30.3% had hypertension, and nearly all unaware of their hypertensive status (90.7%). Compared with no parental history, the adjusted odds ratio (AOR) for hypertension was elevated among participants with two parents having hypertension (AOR = 4.5, 95% CI: 1.70-11.76), adjusting for sex, body mass index, physical activity, and plasma 25(OH)D3. Results for systolic hypertension (SH) were similar but more extreme (two parents AOR = 7.1, 95% CI: 2.82, 17.66), although dihydroxy metabolites (1,25(OH)2D3 and 24,25(OH)2D3) were significant. There was a strong, independent association with dual parental history and hypertension status, regardless of vitamin D status. Hypertension was prevalent in nearly one-third of the sample and underscores the need for targeted prevention for young adults.


Assuntos
Hipertensão , Vitamina D , Cromatografia Líquida/métodos , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Estudantes , Espectrometria de Massas em Tandem/métodos , Estados Unidos , Adulto Jovem
20.
Eur Arch Psychiatry Clin Neurosci ; 272(3): 461-475, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34480630

RESUMO

Evidence suggests that people at Clinical High Risk for Psychosis (CHR) have a blunted cortisol response to stress and altered mediotemporal activation during fear processing, which may be neuroendocrine-neuronal signatures of maladaptive threat responses. However, whether these facets are associated with each other and how this relationship is affected by cannabidiol treatment is unknown. We examined the relationship between cortisol response to social stress and mediotemporal function during fear processing in healthy people and in CHR patients. In exploratory analyses, we investigated whether treatment with cannabidiol in CHR individuals could normalise any putative alterations in cortisol-mediotemporal coupling. 33 CHR patients were randomised to 600 mg cannabidiol or placebo treatment. Healthy controls (n = 19) did not receive any drug. Mediotemporal function was assessed using a fearful face-processing functional magnetic resonance imaging paradigm. Serum cortisol and anxiety were measured immediately following the Trier Social Stress Test. The relationship between cortisol and mediotemporal blood-oxygen-level-dependent haemodynamic response was investigated using linear regression. In healthy controls, there was a significant negative relationship between cortisol and parahippocampal activation (p = 0.023), such that the higher the cortisol levels induced by social stress, the lower the parahippocampal activation (greater deactivation) during fear processing. This relationship differed significantly between the control and placebo groups (p = 0.033), but not between the placebo and cannabidiol groups (p = 0.67). Our preliminary findings suggest that the parahippocampal response to fear processing may be associated with the neuroendocrine (cortisol) response to experimentally induced social stress, and that this relationship may be altered in patients at clinical high risk for psychosis.


Assuntos
Canabidiol , Transtornos Psicóticos , Canabidiol/farmacologia , Medo , Humanos , Hidrocortisona , Sistema Hipotálamo-Hipofisário , Transtornos Psicóticos/tratamento farmacológico , Estresse Psicológico/tratamento farmacológico
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