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Andy |
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Simulation |
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Manual |
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32423 |
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refbase @ admin @ |
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22435 |
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salum |
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information |
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Journal Article |
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19888 |
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tanzania |
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nil |
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2673773 |
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2/5/1968 |
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2 |
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love is good |
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love is good |
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dar es salaam |
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sami |
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sami |
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no |
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refbase @ user @ |
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53986 |
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Author |
Gouveia, N.; Junger, W.L. |
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Title |
Effects of air pollution on infant and children respiratory mortality in four large Latin-American cities |
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Journal Article |
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Year |
2018 |
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Environmental Pollution (Barking, Essex : 1987) |
Abbreviated Journal |
Environ Pollut |
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232 |
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385-391 |
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Keywords |
Air pollution; Children mortality; Infant mortality; Respiratory diseases; Time series |
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OBJECTIVES: Air pollution is an important public health concern especially for children who are particularly susceptible. Latin America has a large children population, is highly urbanized and levels of pollution are substantially high, making the potential health impact of air pollution quite large. We evaluated the effect of air pollution on children respiratory mortality in four large urban centers: Mexico City, Santiago, Chile, and Sao Paulo and Rio de Janeiro in Brazil. METHODS: Generalized Additive Models in Poisson regression was used to fit daily time-series of mortality due to respiratory diseases in infants and children, and levels of PM10 and O3. Single lag and constrained polynomial distributed lag models were explored. Analyses were carried out per cause for each age group and each city. Fixed- and random-effects meta-analysis was conducted in order to combine the city-specific results in a single summary estimate. RESULTS: These cities host nearly 43 million people and pollution levels were above the WHO guidelines. For PM10 the percentage increase in risk of death due to respiratory diseases in infants in a fixed effect model was 0.47% (0.09-0.85). For respiratory deaths in children 1-5 years old, the increase in risk was 0.58% (0.08-1.08) while a higher effect was observed for lower respiratory infections (LRI) in children 1-14 years old [1.38% (0.91-1.85)]. For O3, the only summarized estimate statistically significant was for LRI in infants. Analysis by season showed effects of O3 in the warm season for respiratory diseases in infants, while negative effects were observed for respiratory and LRI deaths in children. DISCUSSION: We provided comparable mortality impact estimates of air pollutants across these cities and age groups. This information is important because many public policies aimed at preventing the adverse effects of pollution on health consider children as the population group that deserves the highest protection. |
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Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, UERJ, Rio de Janeiro, Brazil |
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ESCALA investigators |
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0269-7491 |
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PMID:28966023 |
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no |
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ref @ user @ |
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97158 |
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Li, M.; Xiao, A.; Floyd, D.; Olmez, I.; Lee, J.; Godlewski, J.; Bronisz, A.; Bhat, K.P.L.; Sulman, E.P.; Nakano, I.; Purow, B. |
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Title |
CDK4/6 inhibition is more active against the glioblastoma proneural subtype |
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Journal Article |
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Year |
2017 |
Publication |
Oncotarget |
Abbreviated Journal |
Oncotarget |
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Volume |
8 |
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33 |
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55319-55331 |
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Cdk4/6; glioblastoma; mesenchymal; palbociclib; proneural |
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Glioblastoma (GBM) is the most common and lethal brain tumor. Gene expression profiling has classified GBM into distinct subtypes, including proneural, mesenchymal, and classical, and identifying therapeutic vulnerabilities of these subtypes is an extremely high priority. We leveraged The Cancer Genome Atlas (TCGA) data, in particular for microRNA expression, to seek druggable core pathways in GBM. The E2F1-regulated miR-17 92 cluster and its analogs are shown to be highly expressed in proneural GBM and in GSC lines, suggesting the E2F cell cycle pathway might be a key driver in proneural GBM. Consistently, CDK4/6 inhibition with palbociclib preferentially inhibited cell proliferation in vitro in a majority of proneural GSCs versus those of other subtypes. Palbociclib treatment significantly prolonged survival of mice with established intracranial xenografts of a proneural GSC line. We show that most of these sensitive PN GSCs expressed higher levels of CDK6 and had intact Rb1, while two GSC lines with CDK4 overexpression and null Rb1 were highly resistant to palbociclib. Importantly, palbociclib treatment of proneural GSCs upregulated mesenchymal-associated markers and downregulated proneural-associated markers, suggesting that CDK4/6 inhibition induced proneural-mesenchymal transition and underscoring the enhanced role of the E2F cell cycle pathway in the proneural subtype. Lastly, the combination of palbociclib and N,N-diethylaminobenzaldehyde, an inhibitor of the mesenchymal driver ALDH1A3, showed strong synergistic inhibitory effects against proneural GSC proliferation. Taken together, our results reveal that proneural GBM has increased vulnerability to CDK4/6 inhibition, and the proneural subtype undergoes dynamic reprogramming upon palbociclib treatment-suggesting the need for a combination therapeutic strategy. |
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Neuro-Oncology Division, Department of Neurology, University of Virginia, Charlottesville, VA, USA |
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1949-2553 |
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PMID:28903422 |
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no |
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ref @ user @ |
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96569 |
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Author |
Cole, D.C.; Giordano, C.R.; Vasilopoulos, T.; Fahy, B.G. |
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Title |
Resident Physicians Improve Nontechnical Skills When on Operating Room Management and Leadership Rotation |
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Journal Article |
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Year |
2017 |
Publication |
Anesthesia and Analgesia |
Abbreviated Journal |
Anesth Analg |
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124 |
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1 |
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300-307 |
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BACKGROUND: Anesthesiology residency primarily emphasizes the development of medical knowledge and technical skills. Yet, nontechnical skills (NTS) are also vital to successful clinical practice. Elements of NTS are communication, teamwork, situational awareness, and decision making. METHODS: The first 10 consecutive senior residents who chose to participate in this 2-week elective rotation of operating room (OR) management and leadership training were enrolled in this study, which spanned from March 2013 to March 2015. Each resident served as the anesthesiology officer of the day (AOD) and was tasked with coordinating OR assignments, managing care for 2 to 4 ORs, and being on call for the trauma OR; all residents were supervised by an attending AOD. Leadership and NTS techniques were taught via a standardized curriculum consisting of leadership and team training articles, crisis management text, and daily debriefings. Resident self-ratings and attending AOD and charge nurse raters used the Anaesthetists' Non-Technical Skills (ANTS) scoring system, which involved task management, situational awareness, teamwork, and decision making. For each of the 10 residents in their third year of clinical anesthesiology training (CA-3) who participated in this elective rotation, there were 14 items that required feedback from resident self-assessment and OR raters, including the daily attending AOD and charge nurse. Results for each of the items on the questionnaire were compared between the beginning and the end of the rotation with the Wilcoxon signed-rank test for matched samples. Comparisons were run separately for attending AOD and charge nurse assessments and resident self-assessments. Scaled rankings were analyzed for the Kendall coefficient of concordance (omega) for rater agreement with associated chi and P value. RESULTS: Common themes identified by the residents during debriefings were recurrence of challenging situations and the skills residents needed to instruct and manage clinical teams. For attending AOD and charge nurse assessments, resident performance of NTS improved from the beginning to the end of the rotation on 12 of the 14 NTS items (P < .05), whereas resident self-assessment improved on 3 NTS items (P < .05). Interrater reliability (across the charge nurse, resident, and AOD raters) ranged from omega = .36 to .61 at the beginning of the rotation and omega = .27 to .70 at the end of the rotation. CONCLUSIONS: This rotation allowed for teaching and resident assessment to occur in a way that facilitated resident education in several of the skills required to meet specific milestones. Resident physicians are able to foster NTS and build a framework for clinical leadership when completing a 2-week senior elective as an OR manager. |
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From the Department of Anesthesiology, University of Florida, College of Medicine, Gainesville, Fla |
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0003-2999 |
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PMID:27918336 |
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Call Number |
ref @ user @ |
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95061 |
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