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1.
Pediatr Res ; 2020 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-32172280

RESUMO

BACKGROUND: Hurricane Maria struck Puerto Rico on 20 September 2017 causing catastrophic devastation. Prolonged shortage of food had been a substantial challenge to the residents after Maria. Experiencing food insecurity in utero has been associated with negative health outcomes later in life. We aim to examine whether there is any alteration in the infant gut microbiome that is associated with prenatal food insecurity. METHODS: We established a cohort of infants aged 2-6 months who were exposed in utero to Hurricane Maria near San Juan, Puerto Rico and examined the gut microbiota (n = 29) using 16S ribosomal RNA gene sequencing. RESULTS: Among the enrolled infants, 30% of their mothers experienced "post-Maria poor access to food" for at least 1 month during pregnancy. The relative abundance of gut Veillonella spp. is significantly decreased among infants who experienced prenatal food insecurity, compared to those who did not (adjusted p = 0.025). There is no significant difference observed by prenatal food insecurity at the microbial community level in this cohort. CONCLUSIONS: Our finding indicated that infants who experienced prenatal food insecurity post hurricane harbor microbial alternations of specific bacterial taxa, which may further influence the microbial maturation and place the individual at a high-risk health trajectory. IMPACT: We identified that in utero exposure to food insecurity post Hurricane Maria is associated with decreased abundance of Veillonella in the infant gut. Our findings indicated that infants who experienced prenatal food insecurity post hurricane may harbor alterations of specific bacterial taxa in their gut microbiota. This study showed the association between prenatal adverse exposure and alterations of gut microbiome early in life in the context of an extreme event. This study provided insights into the mechanisms underlying prenatal adverse exposure and increased disease risks later in life. Our findings will potentially raise awareness of the negative impact of extreme climate events on the unborn.

2.
Epigenomics ; 12(2): 101-125, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31920098

RESUMO

Aim: Circular RNAs (circRNAs) still have many potential functions in the process of tumor development that are not completely understood. The study aims to explore novel circRNAs and their mechanisms of action in breast cancer (BCa). Materials & methods: A combination strategy of RNA-sequencing (RNA-seq) technique, quantitative real-time PCR and bioinformatic analysis was employed to identify the potential mechanisms involving differentially expressed circRNAs in the serum exosomes and tissues of BCa patients. Results: The expression levels of hsa-circRNA-0005795 and hsa-circRNA-0088088 were significantly different both in serum exosomes and tissues and might function as competing endogenous RNAs and play vital roles in BCa development. Conclusion: We constructed two circRNA-miRNA networks and provided new insight into the prognosis and therapy of BCa using circRNAs from serum exosomes.

3.
Ying Yong Sheng Tai Xue Bao ; 31(1): 309-318, 2020 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-31957409

RESUMO

Procambarus clarkii was introduced into China as an important aquatic product in early 20th century. It has characteristics of high fertility, rapid growth, adaptability and digging burrows, which could cause damage of crops, cropland and facilities, decrease local biodiversity and thus threaten local ecosystem. Thus, predicting the potential distribution of P. clarkii in response to climate change was essential for preventing and monitoring this species. Based on the distribution of P. clarkii, the maximum entropy (MaxEnt) and genetic algorithm for rule-set production (GARP) models were used to predict its distribution in China under current climate and four climate scenarios (RCP 2.6, RCP 4.5, RCP 6.0, RCP 8.5) in two periods, 2041-2060 and 2061-2080. Then, the modeling results were tested by ROC curves. The results showed that under current climate, the highly suitable region for distribution predicted by the MaxEnt and GARP models were Shanghai, Jiangsu, Zhejiang and Anhui along the Yangtze River. The main environmental variables affecting its distribution were mean temperature of the coldest quarter, minimum temperature of the warmest month, and temperature seasonality, maximum temperature of the warmest month, precipitation of the driest month. Under the future climate scenarios, the suitable area of P. clarkii distribution varied in 2061-2080. The total suitable area of P. clarkii would increase under RCP2.6 and RCP 4.5, whereas under RCP 8.5 the suitable area of P. clarkii would increase, and then decrease. In RCP 6.0, there was no change. The suitable areas of P. clarkii would disperse to different latitude areas and migrate toward high altitude.


Assuntos
Ecossistema , Espécies Introduzidas , Animais , Astacoidea , China , Mudança Climática
4.
J Mater Chem B ; 8(5): 878-894, 2020 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-31956883

RESUMO

Continuous blood purification technology such as hemodiafiltration has been used worldwide for saving patients suffering from severe diseases or organ function failure, especially in the intensive care unit and emergency setting. The filters as core devices are commonly made of polymer materials as hollow fiber membranes. However, the membrane is often inductively blocked by blood clot formation due to its interactions with blood components. Heparin is the anticoagulant often used in clinical practice for anti-coagulation. Recently, heparin is also employed to modify the hollow fiber membranes either chemically or physically to improve the filtration performance. This review summarizes recent advances in methodology for surface heparinization of such hollow fiber membranes, and their filtration performance improvement. The review also provides expert opinions for further research in this rapidly expanding field.

5.
Mol Cell Biochem ; 466(1-2): 91-102, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31989367

RESUMO

Purine signaling pathway plays an important role in inflammation and tissue damage. To investigate the role of purine signaling pathway in acute alcoholic liver injury and chronic alcoholic liver fibrosis, we replicated two animal models and two cellular models. We found that body weights, liver indexes, serum biochemical parameters, serum fibrosis indexes, and pathological and immunohistochemical results had significant changes in two treatment groups compared with two control groups. In addition, gene expressions of purine receptors, inflammatory cytokines, fibrogenic cytokines, and inflammasomes increased obviously in two animal models and two cellular models. Furthermore, purine receptor inhibitors could significantly inhibit protein expressions of purine receptors and reduce protein expressions of inflammatory cytokines, fibrogenic cytokines, and inflammasomes. Besides, P2X7R small interfering ribonucleic acid (siRNA) had the same effects. Meanwhile, we detected protein expressions of inflammatory cytokines secreted by inflammasomes, and we found that purine receptor-mediated inflammasomes activation was a key event in the process of chronic alcoholic liver fibrosis. In summary, this study shows that inhibition of purine receptors can alleviate acute alcoholic liver injury and chronic alcoholic liver fibrosis in mice. Therefore, purine receptor is a potential new target for the treatment of acute alcoholic liver injury and chronic alcoholic fibrosis.

6.
Epigenomics ; 12(4): 303-317, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31920104

RESUMO

Aim: We aimed to explore the roles of circular RNA, circVAPA in regulating cell migration and invasion of breast cancer. Materials & methods: CircVAPA expression was detected in breast cancer tissues and cells. The role of circVAPA was evaluated by MTT assay, wound-healing and transwell assay. The relationship between circVAPA and miR-130a-5p and the location of circVAPA were explored. Results: We discovered that circVAPA was dysregulated in breast cancer tissues and cells. Ectopic circVAPA regulated breast cancer migration, invasion and proliferation. CircVAPA was mainly expressed in the cytoplasm and could act as a miRNA sponge for miR-130a-5p, but did not regulate its parental gene. Conclusion: CircVAPA may promote migration and invasion capacity of breast cancer via harboring miR-130a-5p.

7.
Alzheimers Dement ; 15(9): 1208-1217, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31399333

RESUMO

INTRODUCTION: We aimed to estimate the frequency of each AT(N) (ß-amyloid deposition [A], pathologic tau [T], and neurodegeneration [N]) profile in different clinical diagnosis groups and to describe the longitudinal change in clinical outcomes of individuals in each group. METHODS: Longitudinal change in clinical outcomes and conversion risk of AT(N) profiles are assessed using linear mixed-effects models and multivariate Cox proportional-hazard models, respectively. RESULTS: Participants with A+T+N+ showed faster clinical progression than those with A-T-N- and A+T±N-. Compared with A-T-N-, participants with A+T+N± had an increased risk of conversion from cognitively normal (CN) to incident prodromal stage of Alzheimer's disease (AD), and from MCI to AD dementia. A+T+N+ showed an increased conversion risk when compared with A+T±N-. DISCUSSION: The 2018 research framework may provide prognostic information of clinical change and progression. It may also be useful for targeted recruitment of participants with AD into clinical trials.

9.
J Colloid Interface Sci ; 556: 258-265, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31450020

RESUMO

Layered double hydroxide nanoparticles (LDHs) have shown the excellent capability and good adjuvant function as a nanocarrier for protein antigen delivery to enhance the immune response. Furthermore, LDHs have good biocompatibility and low cytotoxicity. However, their oral vaccine delivery efficiency is limited due to acidic/enzyme degradation in the stomach and low bioavailability in the small intestine. To overcome these challenges, alginate-chitosan coated LDHs nanocomposites (ALG-CHT-LDH) have been developed and used as a carrier for oral protein vaccine delivery. The physicochemical properties of ALG-CHT-LDH have been determined by dynamic light scattering (DLS), transmission electron microscopy (TEM), and ultraviolet visible (UV-Vis) spectroscopy. Protein release properties of LDHs with/without polymer coating have been investigated at various pHs. The protein release profile of ALG-CHT-LDH nanocomposites indicated that ALG-CHT coating could partially protect protein release at the acidic condition (pH 1.2). The cellular uptake efficiency of protein delivered by ALG-CHT-LDH for the intestine cells and macrophages were studied. After alginate layer falls from ALG-CHT-LDH nanocomposite, flow cytometry analysis (FACS) data suggest that chitosan-coated LDHs significantly enhance the internalization of proteins at the Caco2 and macrophage cells.


Assuntos
Alginatos , Quitosana , Portadores de Fármacos , Hidróxidos , Nanocompostos , Vacinas , Administração Oral , Alginatos/química , Alginatos/farmacologia , Animais , Células CACO-2 , Quitosana/química , Quitosana/farmacologia , Portadores de Fármacos/química , Portadores de Fármacos/farmacologia , Células HT29 , Humanos , Hidróxidos/química , Hidróxidos/farmacologia , Camundongos , Nanocompostos/química , Nanocompostos/uso terapêutico , Células RAW 264.7 , Vacinas/química , Vacinas/farmacologia
10.
Oncol Lett ; 18(3): 2923-2930, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31452773

RESUMO

The regulatory roles of circular RNAs (circRNAs) in cancer are attracting increasing attention. The aim of the present study was to explore the roles of circRNAs in pancreatic ductal adenocarcinoma (PDAC) using microarray data. The circRNA and microRNA (miRNA) microarray data were downloaded from Gene Expression Omnibus. A total of 256 differentially expressed circRNAs were obtained by analyzing the circRNA microarray data from 26 pairs of PDAC and adjacent normal tissues. Differentially expressed miRNAs were analyzed using a dataset of 6 PDAC tissues and 5 non-neoplastic pancreas samples (GSE43796); 20 differentially expressed miRNAs were detected. circRNA/miRNA interactions were predicted between differentially expressed circRNAs and miRNAs using miRanda and RNAhybrid algorithms and 51 circRNA/miRNA interactions were obtained. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis using gene symbols of differentially expressed circRNAs demonstrated that 41 circRNAs were enriched in 17 pathways. Subnetworks that were associated with apoptosis or proliferation were extracted from the 17 pathways and a new network was constructed using Cytoscape software, which identified that mitogen-activated protein kinase, PI3K/AKT and WNT/ß-catenin signaling pathways may be associated with PDAC development. In conclusion, 256 differentially expressed circRNAs and 20 differentially expressed miRNAs were identified in PDAC tissues compared with normal tissues; the circRNA/miRNA interactions and the networks of KEGG pathways provided a global view of the function of these differentially expressed circRNAs and miRNAs.

11.
ChemSusChem ; 12(17): 4046-4053, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31257701

RESUMO

Metallic-state 2D SnS2 nanosheets with expanded lattice spacing and a defect-rich structure were synthesized by the intercalation of Ni into the van der Waals gap of SnS2 . The expanded lattice spacing efficiently enhanced the electrochemical performance of the SnS2 for sodium-ion batteries owing to the change electron state density and energy band structure. In operando synchrotron XRD and theoretical calculations were used to gain insight into the influence of foreign metal-ion doping and its location. The optimized architecture obtained by in situ uniform growth of nanosheets on carbon fibers significantly enhanced the electrochemical performance. The inherent advantages of this architecture are shorter paths for ion insertion and extraction, larger contact area for more sodium diffusion pathways, and superior electrolyte penetration. Benefiting from the Ni intercalated SnS2 bilayer, the internal adjustment of the electronic state and the enlarged interlayer spacing significantly enhanced the electron transport kinetics, which can be explained by the metallic-state properties. The integrated electrode exhibited an initial high reversible capacity of 795 mAh g-1 at 0.1 A g-1 , with a stable capacity retention of 666 mAh g-1 after 100 cycles. Good rate capability was also exhibited with specific capacities of 691, 564, 437 mAh g-1 at current densities of 200, 500, and 1000 mA g-1 , respectively.

12.
Int Immunopharmacol ; 75: 105765, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31336335

RESUMO

Hepatic fibrosis is the most common pathological feature of most chronic liver diseases, and its continuous deterioration gradually develops into liver cirrhosis and eventually leads to liver cancer. At present, there are many kinds of drugs used to treat liver fibrosis. However, Western drugs tend to only target single genes/proteins and induce many adverse reactions. Most of the mechanisms and active ingredients of traditional Chinese medicine (TCM) are not clear, and there is a lack of unified diagnosis and treatment standards. Natural products, which are characterized by structural diversity, low toxicity, and origination from a wide range of sources, have unique advantages and great potential in anti-liver fibrosis. This article summarizes the work done over the previous decade, on the active ingredients in natural products that are reported to have anti-hepatic fibrosis effects. The effective anti-hepatic fibrosis ingredients identified can be generally divided into flavonoids, saponins, polysaccharides and alkaloids. Mechanisms of anti-liver fibrosis include inhibition of liver inflammation, anti-lipid peroxidation injury, inhibition of the activation and proliferation of hepatic stellate cells (HSCs), modulation of the synthesis and secretion of pro-fibrosis factors, and regulation of the synthesis and degradation of the extracellular matrix (ECM). This review provides suggestions for the development of anti-hepatic fibrosis drugs.


Assuntos
Produtos Biológicos/uso terapêutico , Cirrose Hepática/tratamento farmacológico , Animais , Produtos Biológicos/farmacologia , Humanos , Cirrose Hepática/imunologia , Cirrose Hepática/metabolismo , Cirrose Hepática/patologia
13.
Eur Arch Otorhinolaryngol ; 276(9): 2565-2576, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31240455

RESUMO

PURPOSE: Nasopharyngeal carcinoma (NPC) is one of the most malignant head and neck carcinomas with unique epidemiological features. In this study, we aimed to identify the novel NPC-related genes and biological pathways, shedding light on the potential molecular mechanisms of NPC. METHODS: Based on Gene Expression Omnibus (GEO) database, an integrated analysis of microarrays studies was performed to identify differentially expressed genes (DEGs) and differentially methylated genes (DMGs) in NPC compared to normal control. The genes which were both differentially expressed and differentially methylated were identified. Functional annotation and protein-protein interaction (PPI) network construction were used to uncover biological functions of DEGs. RESULTS: Two DNA methylation and five gene expression datasets were incorporated. A total of 1074 genes were up-regulated and 939 genes were down-regulated in NPC were identified. A total of 719 differential methylation CpG sites (DMCs) including 1 hypermethylated sites and 718 hypomethylated sites were identified. Among which, 11 genes were both DEGs and DMGs in NPC. Pathways in cancer, p53 signaling pathway and Epstein-Barr virus infection were three pathways significantly enriched pathways in DEmRNAs of NPC. The PPI network of top 50 DEGs were consisted of 191 nodes and 191 edges. CONCLUSIONS: Our study was helpful to elucidate the underlying mechanism of NPC and provide clues for therapeutic methods.


Assuntos
Metilação de DNA/genética , Regulação Neoplásica da Expressão Gênica , Carcinoma Nasofaríngeo , Infecções por Vírus Epstein-Barr/genética , Redes Reguladoras de Genes/fisiologia , Estudo de Associação Genômica Ampla , Humanos , Carcinoma Nasofaríngeo/genética , Carcinoma Nasofaríngeo/patologia , Mapas de Interação de Proteínas , Transdução de Sinais
14.
Nat Immunol ; 20(8): 980-991, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31209406

RESUMO

Innate lymphoid cells (ILCs) are tissue-resident lymphocytes categorized on the basis of their core regulatory programs and the expression of signature cytokines. Human ILC3s that produce the cytokine interleukin-22 convert into ILC1-like cells that produce interferon-γ in vitro, but whether this conversion occurs in vivo remains unclear. In the present study we found that ILC3s and ILC1s in human tonsils represented the ends of a spectrum that included additional discrete subsets. RNA velocity analysis identified an intermediate ILC3-ILC1 cluster, which had strong directionality toward ILC1s. In humanized mice, the acquisition of ILC1 features by ILC3s showed tissue dependency. Chromatin studies indicated that the transcription factors Aiolos and T-bet cooperated to repress regulatory elements active in ILC3s. A transitional ILC3-ILC1 population was also detected in the human intestine. We conclude that ILC3s undergo conversion into ILC1-like cells in human tissues in vivo, and that tissue factors and Aiolos were required for this process.


Assuntos
Imunidade Inata/imunologia , Interferon gama/metabolismo , Interleucinas/metabolismo , Mucosa Intestinal/imunologia , Linfócitos/imunologia , Tonsila Palatina/imunologia , Animais , Diferenciação Celular/imunologia , Células Cultivadas , Criança , Pré-Escolar , Humanos , Fator de Transcrição Ikaros/metabolismo , Mucosa Intestinal/citologia , Linfócitos/classificação , Linfócitos/citologia , Camundongos , Proteínas com Domínio T/metabolismo
15.
Biosci Rep ; 39(6)2019 06 28.
Artigo em Inglês | MEDLINE | ID: mdl-31160488

RESUMO

Breast cancer (BCa) is one of the most frequently diagnosed cancers and leading cause of cancer deaths among females worldwide. Circular RNAs (circRNAs) are a new class of endogenous regulatory RNAs characterized by circular shape resulting from covalently closed continuous loops that are capable of regulating gene expression at transcription or post-transcription levels. With the unique structures, circRNAs are resistant to exonuclease RNase R and maintain stability more easily than linear RNAs. Recently, an increasing number of circRNAs are discovered and reported to show different expression in BCa and these dysregulated circRNAs were correlated with patients' clinical characteristics and grade in the progression of BCa. CircRNAs participate in the bioprocesses of carcinogenesis of BCa, including cell proliferation, apoptosis, cell cycle, tumorigenesis, vascularization, cell invasion, migration as well as metastasis. Here we concentrated on biogenesis and function of circRNAs, summarized their implications in BCa and discussed their potential as diagnostic and therapeutic targets for BCa.

16.
Biosci Rep ; 39(5)2019 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-30988071

RESUMO

Homo sapiens ceramide synthase 2 (CerS-2) plays an important role in inhibiting invasion and metastasis of tumor cells and has been reported as a tumor metastasis suppressor gene in diverse cancers. Thus, low level of CerS-2 protein might suggest a bad prognosis and up-regulation of CerS-2 protein might act as a promising therapeutic strategy for malignant tumors. In this review, we discussed the expression, as well as the clinical and pathological significance of CerS-2 in diverse human cancers. The pathological processes and molecular pathways regulated by CerS-2 were also summarized.

17.
Epigenomics ; 11(2): 199-213, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30657346

RESUMO

AIM: The study aimed to investigate the role of circular RNA circASS1 in breast cancer cells. MATERIALS & METHODS: Circular RNAs microarray expression profile were analyzed in MCF-7, MDA-MB-231, and qRT-PCR and western blotting were used to quantify expression of circASS1 and its parental gene ASS1. Wound healing, migration and invasion assay were performed. Luciferase assay system was used to detect harbored miRNA. RESULTS: CircASS1 in MDA-MB-231 is downregulated comparing to MCF-7, and overexpression of circASS1 could suppress invasion and migration. While silence, it could promote invasion and migration. MiR-4443 functioning as a tumor promoter gene could be captured by circASS1. ASS1 is upregulated in loss-of-function experiments, while downregulated in gain-of-function experiments. CONCLUSION: CircASS1 suppresses invasion and migration capacity of breast cancer cells and harbored miR-4443.

18.
Nat Prod Res ; 33(1): 47-52, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29376404

RESUMO

A new benzofuran compound, named 2-[5-hydroxy-4-methoxy-2-(3-p-henyl-trans-allyloxy)benzyl]-5-hydroxy-6-methoxy-3-phenylbenzofuran (1), together with (+)-obtusafuran (2) and isoparvifuran (3), was isolated from the heartwood of Dalbergia latifolia. Their structures were elucidated by a combination of spectroscopic methods and comparison with the literature. Compounds 2 and 3 were obtained from this plant for the first time. Compound 1 exhibited moderated antioxidant effect for scavenging 1,1-diphenyl-2-picryhydrazyl (DPPH) free radical (IC50 = 96.7 ± 8.9 µM).


Assuntos
Benzofuranos/isolamento & purificação , Dalbergia/química , Antioxidantes , Benzofuranos/química , Compostos de Bifenilo , Depuradores de Radicais Livres , Estrutura Molecular , Análise Espectral , Relação Estrutura-Atividade
19.
Discov Med ; 26(143): 155-166, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30586539

RESUMO

Currently, platinum-based chemotherapy is the standard first-line treatment for advanced non-small cell lung cancer (NSCLC) that is not driven by identifiable genetic events, such as sensitizing mutations of epidermal growth factor receptor (EGFR) and translocations of anaplastic lymphoma kinase (ALK). Immune checkpoint inhibitors, which unleash a patient's own T cells to attack tumors, are revolutionizing the treatment paradigm of lung cancer. Anti-programmed death 1 (anti-PD-1) antibodies, pembrolizumab and nivolumab, and anti-programmed death ligand 1 (anti-PD-L1) antibody atezolizumab have shown a significantly longer survival and manageable safety profile, being approved as first or second-line treatment options in patients with advanced non-small cell lung cancer. Only the pembrolizumab approval is limited to the PD-L1-positive NSCLC; both nivolumab and atezolizumab can be currently used irrespective of tumor PD-L1 expression. Biomarkers for the response to PD-1/PD-LI checkpoint inhibitors beyond PD-L1 expression levels are being investigated in order to select patients who are most likely to benefit from antibodies targeting the PD-1 axis.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Nivolumabe/uso terapêutico , Biomarcadores Tumorais/metabolismo , Carcinoma Pulmonar de Células não Pequenas/epidemiologia , Carcinoma Pulmonar de Células não Pequenas/patologia , Progressão da Doença , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Humanos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/patologia , Resultado do Tratamento
20.
J Am Osteopath Assoc ; 118(11): 703-712, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30398568

RESUMO

Context: To improve chronic disease self-management among an underserved population and to improve the skills of second-year osteopathic medical students, an educational curriculum, The Other 45, was developed. In addition to a typical 15-minute office visit, this program allows second-year students to provide chronic disease education to patients for 45 minutes in an effort to improve patient disease self-management and associated health outcomes. Objective: To determine whether patients who participate in The Other 45 report improvements in their ability to manage their chronic disease(s) and their health outcomes and whether second-year osteopathic medical students report changes in patient-centered care, clinical confidence, and medical/teaching knowledge. Methods: Patients with a previously diagnosed chronic disease participated in 3 visits for The Other 45. Chronic disease self-management and health outcomes were measured using the Health Education Impact Questionnaire, which participants completed at each visit. Students received a formal presentation on teaching skills, and those who participated in The Other 45 completed a pre- and postclinic survey measuring 3 focused domains: patient-centered care, clinical confidence, and medical/teaching knowledge. Results: A total of 47 patients and 69 students participated in the study. As measured by the Health Education Impact Questionnaire, patients' skill and technique acquisition (P=.01), constructive attitudes and approaches (P=.01), and health services navigation (P=.03) showed significant improvement at the 3-week follow-up visit, and self-monitoring and insight showed significant improvement (P=.01) at the 3-month follow-up visit. Patients' positive and active engagement in life (P=.04 and P=.03) and emotional well-being (P=.003 and P=.0007) significantly improved at the 3-week and 3-month follow-up, respectively. The students improved significantly in all 3 domains as a result of participating in the program: patient-centered care (P=.012), clinical confidence (P<.001), and medical/teaching knowledge (P=.002). Conclusions: The Other 45 was effective in improving patients' ability to manage their chronic disease(s), as well as improving second-year osteopathic medical students' ability to educate a patient with chronic disease. Implementing this type of program has the potential to affect patients with chronic disease as well as medical students in a rural underserved setting.


Assuntos
Doença Crônica/terapia , Educação de Graduação em Medicina/organização & administração , Medicina Osteopática/educação , Melhoria de Qualidade , Autogestão/educação , Comunicação , Currículo , Avaliação Educacional , Feminino , Humanos , Estudos Longitudinais , Masculino , Área Carente de Assistência Médica , Avaliação de Programas e Projetos de Saúde , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
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