RESUMO
Although authoritative school climate-strict, yet fair enforcement of rules alongside strong adult support-is associated with lower rates of bullying victimization, less is known about whether it influences how negatively adolescents feel after being victimized at school. Further, it is unclear whether boys and girls respond differently to an authoritative climate. Identifying ways that schools can reduce negative feelings after being bullied is important given the long term psychological ramifications of bullying that, if left unaddressed, can extend into adulthood. To address these gaps, this study examined whether authoritative school climate related to how negatively adolescents felt about their schoolwork, relationships, physical health and self-perception after being bullied. Differences between boys and girls were also investigated. Analyses were conducting using national data from the 2017 School Crime Supplement on a sample of 1,331 adolescents aged 12 to 18 years (Mage = 14.3 years; 59% girls). Findings from a set of ordinal regression models with a robust set of student, parent and school controls demonstrated that adolescents in more supportive schools were less likely to report that bullying victimization negatively impacted their schoolwork and feelings about themselves. Similar results were found for girls but not boys. By investing in supportive school climates, schools can be potentially transformative places where adolescents, especially girls, can feel more positively about themselves despite being bullied.
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Comportamento do Adolescente , Bullying , Vítimas de Crime , Adolescente , Comportamento do Adolescente/psicologia , Adulto , Bullying/psicologia , Vítimas de Crime/psicologia , Feminino , Humanos , Masculino , Instituições Acadêmicas , Estudantes/psicologiaRESUMO
The battle of COVID-19 is currently at different levels of intensity in each country and even each city. The authors have prepared succinct recommendations regarding the care of patients with breast cancer, divided into phases that can easily be adapted to each units' needs and resources, and stepped up or stepped down according to escalating and de-escalating circumstances. The structure can also be transposed easily to different cancer types, enabling continued provision of best standards of care despite unprecedented stressors. Surgery must go on.
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Betacoronavirus , Neoplasias da Mama/complicações , Infecções por Coronavirus/epidemiologia , Gerenciamento Clínico , Assistência de Longa Duração/métodos , Pneumonia Viral/epidemiologia , Telemedicina/métodos , Neoplasias da Mama/terapia , COVID-19 , Infecções por Coronavirus/complicações , Feminino , Humanos , Pandemias , Pneumonia Viral/complicações , SARS-CoV-2RESUMO
Monoclonal antibodies that disrupt CD40-CD40 ligand (CD40L) interactions are likely to have use in human transplantation. However, the extent of the immunosuppressive effects of CD40-CD40L blockade in humans is unknown. Hyper-IgM syndrome (HIGM) is a rare primary immunodeficiency syndrome characterized by defects in the CD40-CD40L pathway, severe immune deficiency (IgG), and high or normal IgM levels. However, the effects of CD40L deficiency on T- and natural killer (NK)-cell function is not established. Here, we present a patient with HIGM syndrome who underwent liver transplantation for hepatitis C virus infection. Posttransplantation, NK-cell antibody-dependent cytokine release (γ-interferon) to alloantigens and T cell responses to viral antigens and mitogens were assessed and showed normal CD4+ , CD8+ , and NK-cell responses. We also examined antibody-dependent cellular cytotoxicity against a CD40+ and HLA-expressing cell line. These experiments confirmed that the patient's NK cells were equivalent to those of normal subjects in mediating antibody-dependent cellular cytotoxicity despite the absence of CD40-CD40L interactions. Mitogenic stimulation of the patient's peripheral blood mononuclear cells showed no expression of CD40L on T and NK cells compared with increased expression in normal subjects. Taken together, these data suggest that absence of CD40L expression is responsible for aberrant B cell immunity but had little impact on NK- and T cell immune responses in vitro.
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Infection with Shiga toxin-producing Escherichia coli (STEC) by serotypes other than O157 (non-O157) have been increasingly reported in the United States. This increase in reporting is primarily due to the improvements in diagnostic tests. We analysed 1497 STEC cases reported in Michigan from 2001 to 2012. A significant increase in the number of non-O157 STEC cases was observed over time, and similar incidence rates were observed for O157 and non-O157 STEC cases in certain time periods. The odds of hospitalization was two times higher in O157 STEC cases relative to non-O157 STEC cases when adjusted for age and gender, suggesting that O157 STEC causes more severe clinical outcomes in all age groups. The use of population-based surveillance to better define trends and associations with disease severity are critical to enhance our understanding of STEC infections and improve upon current prevention and control efforts.
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Infecções por Escherichia coli/epidemiologia , Síndrome Hemolítico-Urêmica/epidemiologia , Escherichia coli Shiga Toxigênica/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Infecções por Escherichia coli/microbiologia , Feminino , Síndrome Hemolítico-Urêmica/microbiologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Michigan/epidemiologia , Pessoa de Meia-Idade , Adulto JovemRESUMO
As climate regimes shift in many ecosystems worldwide, evolution may be a critical process allowing persistence in rapidly changing environments. Organisms regularly interact with other species, yet whether climate-mediated evolution can occur in the context of species interactions is not well understood. We tested whether a species interaction could modify evolutionary responses to temperature. We demonstrate that predation pressure by Dipteran larvae (Chaoborus americanus) modified the evolutionary response of a freshwater crustacean (Daphnia pulex) to its thermal environment over approximately seven generations in laboratory conditions. Daphnia kept at 21°C evolved higher population growth rates than those kept at 18°C, but only in those populations that were also reared with predators. Furthermore, predator-mediated selection resulted in the evolution of elevated Daphnia thermal plasticity. This laboratory natural selection experiment demonstrates that biotic interactions can modify evolutionary adaptation to temperature. Understanding the interplay between multiple selective forces can improve predictions of ecological and evolutionary responses of organisms to rapid environmental change.
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Evolução Biológica , Daphnia/fisiologia , Comportamento Predatório , Seleção Genética , Temperatura , Adaptação Fisiológica , Animais , Daphnia/genética , Dípteros/fisiologia , Ecossistema , Larva/fisiologia , FenótipoRESUMO
This descriptive longitudinal study was conducted to investigate the faecal shedding of Shiga toxin-producing E. coli (STEC) in finishing swine and to characterize the swine STEC isolates that were recovered. Three cohorts of finishing swine (n = 50/cohort; total 150 pigs) were included in the longitudinal study. Individual faecal samples were collected every 2 weeks (8 collections/pig) from the beginning (pig age 10 weeks) to the end (pig age 24 weeks) of the finishing period. STEC isolates were recovered in at least one sample from 65·3% (98/150) of the pigs, and the frequency distribution of first-time STEC detection during the finishing period resembled a point-source outbreak curve. Nineteen O:H serotypes were identified among the STEC isolates. Most STEC isolates (n = 148) belonged to serotype O59:H21 and carried the stx 2e gene. One O49:H21 STEC isolate carried the stx 2e and eae genes. High prevalence rates of STEC during the finishing period were observed, and STEC isolates in various non-O157 serogroups were recovered. These data enhance understanding of swine STEC epidemiology, and future research is needed to confirm whether or not swine STEC are of public health concern.
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Infecções por Escherichia coli/veterinária , Fezes/microbiologia , Escherichia coli Shiga Toxigênica/isolamento & purificação , Doenças dos Suínos/microbiologia , Adesinas Bacterianas/genética , Animais , Infecções por Escherichia coli/microbiologia , Proteínas de Escherichia coli/genética , Genótipo , Estudos Longitudinais , Prevalência , Sorogrupo , Toxina Shiga/genética , Escherichia coli Shiga Toxigênica/classificação , Escherichia coli Shiga Toxigênica/genética , SuínosRESUMO
Thrips, the sole vector of plant Tospovirus, are major pests of many agricultural crops throughout the world. Molecular approaches have been applied in recent decades to identify these minute and morphologically difficult to distinguish insects. In this study, sequences of internal transcribed spacer 1 (ITS1) region of 15 agronomically important thrips, including several virus transmission species, have been analyzed in order to design species-specific primers for multiplex PCR and probes for microarray assay. That the ITS1 sequence distances within species were smaller than those among species suggests that the ITS1 fragment can be used for thrips species identification. The specificity and stability of these primers, combined with universal paired primers, were tested and verified in multiplex PCR. Using these specific primers as probes, microarray assay showed that PCR products of all thrips species hybridized consistently to their corresponding probes, though some signals were weak. We have demonstrated that multiplex PCR using specific primers based on ITS1 sequences is a simple, reliable, and cost-effective diagnostic tool for thrips species identification. Moreover, the DNA microarray assay is expected to extend into a reliable high-throughput screening tool for the vast numbers of thrips.
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Controle de Insetos/métodos , Reação em Cadeia da Polimerase Multiplex , Análise de Sequência com Séries de Oligonucleotídeos , Tisanópteros/genética , Animais , Primers do DNA/genética , DNA Espaçador Ribossômico , Dados de Sequência Molecular , Análise de Sequência de DNA , Especificidade da Espécie , Taiwan , Tisanópteros/classificaçãoRESUMO
While morphological identification of thrips species has been difficult because of their minute size and a lack of easily recognizable characteristics, molecular identification based on the development of specific molecular markers can be easily and reliably carried out. Among the known molecular markers, the nuclear internal transcribed spacer (ITS) exhibits distinguishable variations among thrips species. In this study, sequences of ITS2 region of 10 agriculturally important thrips were established to design species-specific primers for polymerase chain reaction (PCR). ITS2 sequence variations within these species were far less than those among species, indicating the suitability of this marker for species-specific primers design. These primers, though with one or two sporadically variable positions, showed a good efficacy within species. The specificity of these primers, examined on thrips species belonging to 15 genera, proved satisfactory. Furthermore, a multiplex PCR was used successfully for identifying Frankliniella occidentalis (Pergande), an insect pest monitored for quarantine purpose, and three additional thrips also commonly found in imported agricultural products and field samples, i.e., Thrips tabaci Lindeman, Thrips hawaiiensis (Morgan), and Frankliniella intonsa (Trybom). This study has demonstrated that specific primers and multiplex PCR based on ITS2 are reliable, convenient, and diagnostic tool to discriminate thrips species of quarantine and agricultural importance.
Assuntos
DNA Intergênico/genética , Tisanópteros/classificação , Tisanópteros/genética , Animais , Primers do DNA/análise , Reação em Cadeia da Polimerase Multiplex , Filogenia , Quarentena , Análise de Sequência de DNA , Especificidade da EspécieRESUMO
BACKGROUND: School belonging has been linked to students' health and well-being. As US schools become more ethnically diverse, it is important to understand how schools can contribute to a sense of belonging for students from all ethnic groups. METHODS: The present study examines the association between school interethnic climate, school belonging, and 3 well-being indicators (psychological, physical, and academic) among 657 10th graders across 2 states. RESULTS: Positive school interethnic climate was associated with stronger feelings of school belonging, and was indirectly associated with better psychological adjustment, fewer physical symptoms, and better grades via school belonging. There were no differences between White and non-White students in the findings. CONCLUSIONS: Focusing on fostering a positive interethnic atmosphere may be a useful target for schools to support students' health and well-being as well as academic performance.
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Desempenho Acadêmico , Instituições Acadêmicas , Emoções , Etnicidade , Humanos , Estudantes/psicologiaRESUMO
OBJECTIVES: In Taiwan, older adults with cognitive impairment who undergo hip-fracture surgery are routinely cared for by family members. This study aimed to determine if nutritional status influenced the effects of a family-centered intervention for older adults with cognitive impairment recovering from hip-fracture surgery. DESIGN: Secondary data analysis of data from a randomized controlled trial was conducted to examine the influences of nutritional status 1 month after hospital discharge on the effects of a family-centered care intervention model, which was designed for older adults with hip fracture and cognitive impairment. Outcomes were compared among participants according to nutrition status (well-nourished/poorly-nourished) and treatment approach (control/intervention). SETTING: The original study was conducted at a 3000-bed medical center from July 2015 to October 2019. PARTICIPANTS: Participants were older adults with cognitive impairment who had undergone hip-fracture surgery. Participants were assessed as poorly-nourished or well-nourished with the Mini-Nutritional Assessment (MNA) 1-month post-discharge and were then randomly assigned to either the intervention group or control group. INTERVENTION: A family-centered intervention model for family caregivers of older adults with cognitive impairment recovering from hip-fracture surgery was implemented. The intervention was delivered by geriatric nurses, which included instructions for family caregivers in overseeing exercises for strengthening the hip, understanding dietary requirements, and managing behavioral problems associated with cognitive impairment. MEASUREMENTS: Outcome measures included activities of daily living (ADLs), instrumental ADLs, hip range of motion, hip muscle strength, depression, measured with the Geriatric Depressive Scale, and physical and mental health related quality of life, measured with the Short Form Survey (SF-36), Taiwanese version. Participants were assessed at 1-, 3-, 6-, and 12-months post-discharge. RESULTS: Most of the 134 participants were assessed as poorly nourished (n = 122); 57 were the control group and 65 received the intervention. For the well-nourished participants (n = 12), four were in the intervention group and eight were controls. There were no significant differences in any outcome variables for poorly nourished participants who received the intervention compared with controls. For the sample of well-nourished participants, those who received the intervention performed significantly better in outcomes of IADLs (b = 1.74, p < .05), hip muscle strength (b = 9.64, p < .01), and physical health related quality of life (b = 10.47, p < .01). CONCLUSION: The family-centered care intervention was only effective for older adults with cognitive impairment recovering from hip-fracture surgery who were well-nourished at 1 month following hospital discharge, but not for those at risk of malnutrition. Interventions should focus on enhancing nutritional status following hip surgery which could allow the family-centered in-home intervention to be beneficial for more older adults with cognitive impairment recovering from hip-fracture surgery.
Assuntos
Disfunção Cognitiva , Fraturas do Quadril , Humanos , Idoso , Estado Nutricional , Atividades Cotidianas , Qualidade de Vida , Análise de Dados Secundários , Assistência ao Convalescente , Alta do Paciente , Fraturas do Quadril/complicações , Fraturas do Quadril/cirurgia , Disfunção Cognitiva/complicações , Assistência Centrada no PacienteRESUMO
BACKGROUND: Angiogenic factors have an essential role in normal and pathologic angiogenesis. However, the clinical implication of angiogenic factor expression in myelodysplastic syndromes (MDS) remains unclear. METHODS: In this study, we sought to investigate the prognostic impact of the expression of genes encoding angiopoietin-1 (Ang-1), Ang-2, the receptor Tie2, vascular endothelial growth factor-A (VEGF-A) and VEGF-C in the bone marrow (BM) in 208 patients with newly diagnosed primary MDS. RESULTS: BM Ang-1 expression was significantly higher in MDS patients, especially those with higher-risk subtypes, than in normal controls. With a median follow-up time of 32.9 months, the disease transformed to acute leukaemia more frequently in the patients bearing higher Ang-1 expression than in those with lower expression (31.5% vs 18.6%, P=0.023). The MDS patients with higher Ang-1 expression had shorter overall survival than those with lower expression (median 20.8±4.5 months vs 63.3±17.8 months, P<0.001). Multivariate analyses showed that higher Ang-1 expression was an independent unfavourable prognostic factor for overall survival. There was no impact of the expression of other angiogenic factors on survival. CONCLUSION: BM Ang-1 expression may serve as a new biomarker to predict clinical outcome in MDS patients.
Assuntos
Angiopoietina-1/metabolismo , Medula Óssea/metabolismo , Síndromes Mielodisplásicas/metabolismo , Síndromes Mielodisplásicas/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiopoietina-1/genética , Angiopoietina-2/genética , Angiopoietina-2/metabolismo , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Técnicas Imunoenzimáticas , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/genética , Prognóstico , RNA Mensageiro/genética , Receptor TIE-2/genética , Receptor TIE-2/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Taxa de Sobrevida , Fator A de Crescimento do Endotélio Vascular/genética , Fator A de Crescimento do Endotélio Vascular/metabolismo , Fator C de Crescimento do Endotélio Vascular/genética , Fator C de Crescimento do Endotélio Vascular/metabolismo , Adulto JovemRESUMO
A novel actinomycete, designated strain 06182M-1(T), was isolated from a mangrove soil sample collected from Chiayi County in Taiwan. Phylogenetic analysis based on 16S rRNA gene sequences revealed levels of similarity of 97.0-98.8â% to the type strains of recognized species of the genus Isoptericola. Chemotaxonomic data also supported the placement of strain 06182M-1(T) within the genus Isoptericola. However, the low levels of DNA-DNA relatedness between the novel strain and the type strains of recognized species of the genus Isoptericola, in combination with differential phenotypic data, demonstrate that strain 06182M-1(T) represents a novel species of the genus Isoptericola, for which the name Isoptericola chiayiensis sp. nov. is proposed. The type strain is 06182M-1(T) (â=âBCRC 16888(T) â=âKCTC 19740(T)).
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Actinomycetales/classificação , Filogenia , Microbiologia do Solo , Actinomycetales/genética , Actinomycetales/isolamento & purificação , Técnicas de Tipagem Bacteriana , Composição de Bases , DNA Bacteriano/genética , Ácidos Graxos/química , Glicolipídeos/química , Dados de Sequência Molecular , Hibridização de Ácido Nucleico , Peptidoglicano/química , Fosfolipídeos/química , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Taiwan , Vitamina K 2/análogos & derivados , Vitamina K 2/químicaRESUMO
Statins were shown to have neuroprotective effects, with reduced vasospasm and delayed ischemic deficits in statin-treated patients after aneurysmal subarachnoid hemorrhage in two small, randomized, controlled clinical trials published in 2005. This review consolidated data from available published studies evaluating statin treatment for subarachnoid hemorrhage. A literature search was conducted to identify original research studies published through October 2010 testing immediate treatment with a statin in statin-naïve patients following aneurysmal SAH. Six randomized controlled clinical trials and four observational studies were identified. Despite inconsistent results among studies, a meta-analysis of randomized controlled data showed a significant reduction in delayed ischemic deficits with statins. Effect on vasospasm was more difficult to determine, due to differences in definitions used among studies. Interpretations from observational studies were limited by the use of relatively small sample sizes, historical controls, and treatment variability.
Assuntos
Isquemia Encefálica/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hemorragia Subaracnóidea/tratamento farmacológico , Vasoespasmo Intracraniano/tratamento farmacológico , Doença Aguda , Isquemia Encefálica/etiologia , Cuidados Críticos/métodos , Humanos , Hemorragia Subaracnóidea/complicações , Vasoespasmo Intracraniano/etiologiaRESUMO
BACKGROUND: Children with atopic dermatitis (AD) are more frequently colonized by Staphylococcus aureus than healthy children. OBJECTIVES: To assess whether any relationship exists between nasal meticillin-resistant S. aureus (MRSA) colonization and subsequent skin and soft-tissue infections (SSTI). PATIENTS AND METHODS: From 2005 through 2006, comparative molecular analyses of 23 MRSA-colonizing isolates from 133 children with AD, 44 MRSA-colonizing isolates from 490 healthy controls, and 12 MRSA-infecting isolates from 20 children with AD and concurrent SSTI were conducted. RESULTS: Nasal MRSA colonization in children with AD was significantly higher compared with normal individuals (17.3% vs. 9.0%; P = 0.01). The molecular characteristics differed significantly between the MRSA isolates from children with AD and the MRSA-colonizing isolates from healthy controls. The clone characterized as sequence type (ST)59 (338)/pulsotype B/staphylococcal cassette chromosome mec (SCCmec) V(T)/Panton-Valentine leucocidin (PVL)-positive/staphylococcal enterotoxin B (SEB)-positive accounted for half of the MRSA isolates from children with AD, and another clone, characterized as ST59/pulsotype A/SCCmec IV/PVL-negative/SEB-positive accounted for 61% of the MRSA-colonizing isolates from healthy controls. CONCLUSIONS: We found MRSA colonizing the anterior nares of a large number of Taiwanese children, especially among those with AD. Analysis of our data provides evidence that links MRSA-colonizing isolates to MRSA-infecting isolates from concurrent SSTI in children with AD.
Assuntos
Dermatite Atópica/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/microbiologia , Adolescente , Toxinas Bacterianas/genética , Técnicas de Tipagem Bacteriana/métodos , Criança , Pré-Escolar , Dermatite Atópica/complicações , Exotoxinas/genética , Feminino , Genes Bacterianos , Genótipo , Humanos , Lactente , Recém-Nascido , Leucocidinas/genética , Masculino , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/genética , Testes de Sensibilidade Microbiana/métodos , Cavidade Nasal/microbiologia , Infecções dos Tecidos Moles/complicações , Infecções dos Tecidos Moles/microbiologia , Infecções Estafilocócicas/complicações , Infecções Cutâneas Estafilocócicas/complicações , Infecções Cutâneas Estafilocócicas/microbiologiaRESUMO
Lattice mismatch stresses, which severely restrict heteroepitaxial growth, are greatly minimized when thin alumina films are grown by means of van der Waals forces on inert mica substrates. A 10-nanometer-thick epitaxial film exhibits crystallographic sixfold symmetry, a lattice constant close to that of the basal plane [0001] of alpha-alumina (sapphire), and an aluminum: oxygen atomic ratio of 1:1.51 +/- 0.02 (measured by x-ray photoelectron spectroscopy), again the same as for bulk sapphire. The film is free of steps and grain boundaries over large areas and appears to be an ideal model system for studying adhesion, tribology, and other surface phenomena at atomic scales.
RESUMO
Morphometric and genetic data were used to compare two sympatric and morphologically similar species, Acanthopagrus berda and Acanthopagrus taiwanensis, in Dapeng Bay, South-western Taiwan. A principle component analysis of morphological data indicated a distinction between the two species, with pectoral fin length and eye diameter accounting for 32.27% of the variation. Interspecific sequence divergence, based on mtDNA cytochrome b (0.118 +/- 0.01), was larger than intraspecific divergences between haplotypes (0.007 for A. taiwanensis and 0.003 for A. berda). Individuals of the two species clustered into different groups in three phylogenetic trees with 100% bootstrap support. The mean observed heterozygosity for eight microsatellite loci was 0.471 +/- 0.202 for A. taiwanensis and 0.637 +/- 0.145 for A. berda. Nei's unbiased measure of interspecific genetic distance (D(S)) was 1.334. F(ST) (0.134) and R(ST) (0.404) values indicated significant differentiation between species. An unrooted neighbour-joining tree was constructed by allele-sharing distances and the factorial correspondence analysis split all specimens into two distinct clusters. The results of morphometric, mtDNA and microsatellite analyses indicated the presence of two species, A. taiwanensis and A. berda.
Assuntos
Variação Genética , Perciformes/classificação , Filogenia , Animais , Citocromos b/genética , DNA Mitocondrial/genética , Haplótipos , Repetições de Microssatélites , Perciformes/anatomia & histologia , Perciformes/genética , Análise de Sequência de DNA , TaiwanRESUMO
Understanding whether populations and communities can evolve fast enough to keep up with ongoing climate change is one of the most pressing issues in biology today. A growing number of studies have documented rapid evolutionary responses to warming, suggesting that populations may be able to persist despite temperature increases. The challenge now is to better understand how species interactions, which are ubiquitous in nature, mediate these population responses to warming. Here, we use laboratory natural selection experiments in a freshwater community to test hypotheses related to how thermal evolution of Daphnia pulex to two selection temperatures (12 and 18°C) is mediated by rapid thermal evolution of its algal resource (Scenedesmus obliquus) or by the presence of the zooplankton predator Chaoborus americanus. We found that cold-evolved algae (a high-quality resource) facilitated the evolution of increased thermal plasticity in Daphnia populations selected at 12°C, for both body size and per capita growth rates (r). Conversely, warm-evolved algae facilitated the evolution of increased r thermal plasticity for Daphnia selected at 18°C. Lastly, we found that the effect of selection temperature on evolved Daphnia body size was more pronounced when Daphnia were also reared with predators. These data demonstrate that trait evolution of a focal population to the thermal environment can be affected by both bottom-up and top-down species interactions and that rapid temperature evolution of a resource can have cascading effects on consumer thermal evolution. Our study highlights the importance of incorporating species interactions when estimating ecological and evolutionary responses of populations and communities to ongoing temperature warming.
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Background Ulnar nerve compression at the cubital tunnel is the second commonest upper limb neuropathy. Unlike carpal tunnel surgery, most of decompression procedures for this condition are undertaken using general anesthesia (GA). This has inherent economic and patient safety implications. We aimed to assess if there is a difference in early and medium-term outcome scores in patients who have cubital tunnel decompression under general versus local anesthesia (LA). Materials and Methods We undertook a patient outcome evaluation of patients who were under the care of two upper limb surgeons. Patients were evaluated postoperatively using the patient-related ulnar nerve evaluation (PRUNE) questionnaire. Patients were contacted by phone, mail, and face to face in clinics. Results A total of 34 patients were identified in the study. Eleven were excluded from the study. Thirteen patients underwent surgery under LA. The LA group had their procedures performed using local infiltration of the surgical site with 20 mL of 0.5% bupivacaine with adrenaline. Ten patients had their procedures using standard GA and tourniquet. The average PRUNE score in the LA group was 33.8, and that in the GA group was 34.1. This difference in PRUNE score was not statistically significant p > 0.05. Discussion Our data suggest that there is no significant difference in early and midterm outcomes between patients who undergo cubital tunnel decompression using either GA or LA. We advocate the use of LA as it does lead to decreased anesthetic risk and has obvious economic benefits such as lowering the demands on theater and anesthetic resources.
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Aberrant centrosome numbers are detected in virtually all human cancers where they can contribute to chromosomal instability by promoting mitotic spindle abnormalities. Despite their widespread occurrence, the molecular mechanisms that underlie centrosome amplification are only beginning to emerge. Here, we present evidence for a novel regulatory circuit involved in centrosome overduplication that centers on RNA polymerase II (pol II). We found that human papillomavirus type 16 E7 (HPV-16 E7)- and hydroxyurea (HU)-induced centriole overduplication are abrogated by alpha-amanitin, a potent and specific RNA pol II inhibitor. In contrast, normal centriole duplication proceeded undisturbed in alpha-amanitin-treated cells. Centriole overduplication was significantly reduced by siRNA-mediated knock down of CREB-binding protein (CBP), a transcriptional co-activator. We identified cyclin A2 as a key transcriptional target of RNA pol II during HU-induced centriole overduplication. Collectively, our results show that ongoing RNA pol II transcription is required for centriole overduplication whereas it may be dispensable for normal centriole duplication. Given that many chemotherapeutic agents function through inhibition of transcription, our results may help to develop strategies to target centrosome-mediated chromosomal instability for cancer therapy and prevention.
Assuntos
Centrossomo/fisiologia , Inibidores Enzimáticos/farmacologia , Hidroxiureia/farmacologia , Proteínas Oncogênicas Virais/farmacologia , RNA Polimerase II/genética , Transcrição Gênica , Amanitinas/farmacologia , Neoplasias Ósseas/metabolismo , Neoplasias Ósseas/patologia , Proteína de Ligação a CREB/antagonistas & inibidores , Proteína de Ligação a CREB/genética , Proteína de Ligação a CREB/metabolismo , Ciclina A/metabolismo , Ciclina A2 , Fase G2/efeitos dos fármacos , Humanos , Osteossarcoma/metabolismo , Osteossarcoma/patologia , Proteínas E7 de Papillomavirus , RNA Polimerase II/antagonistas & inibidores , RNA Polimerase II/metabolismo , RNA Interferente Pequeno/farmacologia , Células Tumorais CultivadasRESUMO
Blood transfusions and intravenous fluids are commonly employed as rescue therapy for delayed cerebral ischaemia following aneurysmal subarachnoid haemorrhage (aSAH). We sought to determine effects of various fluid supplements on clinical outcome in patients following aSAH. Clinical events and laboratory data of 160 aSAH patients were prospectively collected as part of 2 randomised controlled trials. Outcomes at discharge and at 6 months were measured with Glasgow Outcome Scale (GOS). Favourable outcome was defined as good recovery or moderate disability on GOS. All of the 160 patients received intravenous fluid supplements with crystalloids; 122 (76.3%) also received synthetic colloids (4% succinylated gelatine or 6% pentastarch). A higher daily dose of synthetic colloids for initial resuscitation seemed to be associated with more requirements for blood transfusions (p = 0.003) and occurrence of vasospasm in poor-grade patients (p = 0.081), but blood transfusions themselves were not associated with occurrence of vasospasm. Compared with patients not receiving synthetic colloids, those receiving synthetic colloids had increased haemodilution, elevated inflammatory profiles, and decreased duration and strength of intact cerebral autoregulation. Multivariate analyses identified that blood transfusions (odds ratio, OR 3.38, p = 0.035) were associated with unfavourable outcome at discharge. Colloid fluids (OR 2.53/L/day, p = 0.025) promoted unfavourable outcome at 6 months (OR 4.45, p = 0.035), while crystalloids decreased unfavourable outcome (OR 0.27/L/day, p = 0.005). Associations between synthetic colloids and crystalloids with GOS at 6 months were dose-related. Intravenous fluid therapy using synthetic colloids or blood transfusions may be associated with increased unfavourable outcome following aSAH.