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INTRODUCTION: Global climate change (global warming) has been identified as the primary factor responsible for the observed increase in frequency and severity of wildfires (also known as bushfires in some countries) throughout the majority of the world's vegetated environments. This trend is predicted to continue, causing significant adverse health effects to nearby residential populations and placing a potential strain on local emergency departments (EDs). STUDY OBJECTIVE: The aim of this literature review was to identify papers relating to wildfires and their impact on EDs, specifically patient presentation characteristics, resource utilization, and patient outcomes. METHOD: This integrative literature review was guided by the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) guidelines for data collection, and Whittemore and Knafl's framework for data analysis. Data were collected from OvidSP, MEDLINE, DARE, CINAHL, PubMed, and Scopus databases. Various Medical Subject Headings (MeSH) and keywords identified papers relevant to wildfires/bushfires and EDs. RESULTS: Literature regarding the relationship between ED presentations and wildfire events, however, is primarily limited to studies from the United States and Australia and indicates particulate matter (PM) is principally linked to adverse respiratory and cardiovascular outcomes. Observable trends in the literature principally included a significant increase in respiratory presentations, primarily with a lag of one to two days from the initial event. Respiratory and cardiovascular studies that stratified results by age indicated individuals under five, over 65, or those with pre-existing conditions formed the majority of ED presentations. CONCLUSION: Key learnings from this review included the need for effective and targeted community advisory programs/procedures, prior to and during wildfire events, as well as pre-event planning, development, and robust resilience strategies for EDs.
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Desastres , Incendios Forestales , Cambio Climático , Bases de Datos Factuales , Servicio de Urgencia en Hospital , Humanos , Estados UnidosRESUMEN
Immune checkpoint therapy has resulted in remarkable improvements in the outcome for certain cancers. To broaden the clinical impact of checkpoint targeting, we devised a strategy that couples targeting of the cytokine-inducible Src homology 2-containing (CIS) protein, a key negative regulator of interleukin 15 (IL-15) signaling, with fourth-generation "armored" chimeric antigen receptor (CAR) engineering of cord blood-derived natural killer (NK) cells. This combined strategy boosted NK cell effector function through enhancing the Akt/mTORC1 axis and c-MYC signaling, resulting in increased aerobic glycolysis. When tested in a lymphoma mouse model, this combined approach improved NK cell antitumor activity more than either alteration alone, eradicating lymphoma xenografts without signs of any measurable toxicity. We conclude that targeting a cytokine checkpoint further enhances the antitumor activity of IL-15-secreting armored CAR-NK cells by promoting their metabolic fitness and antitumor activity. This combined approach represents a promising milestone in the development of the next generation of NK cells for cancer immunotherapy.
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Sangre Fetal/citología , Inmunoterapia Adoptiva , Interleucina-15/genética , Células Asesinas Naturales/efectos de los fármacos , Proteínas de Neoplasias/antagonistas & inhibidores , Proteínas Supresoras de la Señalización de Citocinas/antagonistas & inhibidores , Aerobiosis , Animales , Antígenos CD19/inmunología , Linfoma de Burkitt/patología , Linfoma de Burkitt/terapia , Sistemas CRISPR-Cas , Línea Celular Tumoral , Técnicas de Inactivación de Genes , Glucólisis , Humanos , Inhibidores de Puntos de Control Inmunológico/farmacología , Interleucina-15/metabolismo , Células Asesinas Naturales/inmunología , Células Asesinas Naturales/metabolismo , Células Asesinas Naturales/trasplante , Diana Mecanicista del Complejo 1 de la Rapamicina/fisiología , Ratones , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/fisiología , Proteínas Proto-Oncogénicas c-akt/fisiología , Receptores Quiméricos de Antígenos , Transducción de Señal/fisiología , Proteínas Supresoras de la Señalización de Citocinas/genética , Proteínas Supresoras de la Señalización de Citocinas/fisiología , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
Passive and active ammonia (NH(3)) sampling devices have been tested for their nitrogen (N) capture potential and delta(15)N fractionation effects. Several sampling techniques produced significantly different delta(15)NH(3) signals when sampling the same NH(3) source released from field site fumigation campaigns. Conventional passive NH(3)-monitoring systems have shown to provide insufficient N for isotope-ratio mass spectrometry and various modified devices have been developed, based on existing diffusion tube designs, to overcome this problem. The final sampler design was then tested in a wind tunnel to verify that sampling NH(3) in different environmental conditions did not significantly fractionate the delta(15)N signal.
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Contaminantes Atmosféricos/análisis , Amoníaco/análisis , Atmósfera/análisis , Monitoreo del Ambiente/instrumentación , Análisis de Falla de Equipo , Espectrometría de Masas/instrumentación , Monitoreo del Ambiente/métodos , Diseño de Equipo , Espectrometría de Masas/métodos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Reino UnidoRESUMEN
Not only will healthcare investments in information technology (IT) continue, they are sure to increase. Just as other industries learned over time how to extract more value from IT investments, so too will the healthcare industry, and for the same reason: because they must. This article explores the types of business value IT has generated in other industries, what value it can generate in healthcare, and some of the barriers encountered in achieving that value. The article ends with management principles for IT investment.
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Administración de los Servicios de Salud , Sistemas de Información , Inversiones en Salud , Comercio , Comportamiento del Consumidor , Toma de Decisiones en la Organización , Difusión de Innovaciones , Competencia Económica , Eficiencia Organizacional , Administración de los Servicios de Salud/normas , Comercialización de los Servicios de Salud , Objetivos Organizacionales , Administración de Línea de Producción , Valores Sociales , Gestión de la Calidad Total , Estados UnidosRESUMEN
The extraction and identification of deoxyribonucleic acid (DNA) from human hair shafts is described, along with the effects of hair treatments on levels of DNA and suggestions of DNA location within the shaft. DNA was present at low levels in the hair shaft, and was identified using polymerase chain reaction amplification of the human leukocyte antigen (HLA)-DQA1 locus. The use of cleanup columns aided the success of PCR amplification. DNA appears to reside in the cuticle portion of the hair shaft. Levels of DNA were found to be higher at the root-end compared to the tip-end of hair and were also found to be lower after permanent colorant treatment. DNA was found to be lost with surfactant washing, with increased loss occurring with prolonged or an increasing number of washes. These results suggest that small amounts of residual DNA remain after differentiation and add to our knowledge of the constituents of hair.
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ADN/análisis , Cabello/química , Secuencia de Bases , ADN/genética , Cartilla de ADN , Antígenos HLA-DQ/genética , Cadenas alfa de HLA-DQ , Humanos , Microscopía Fluorescente , Reacción en Cadena de la PolimerasaRESUMEN
Antithrombin is a member of the serpin family of protease inhibitors and the major inhibitor of the blood coagulation cascade. It is unique amongst the serpins in that it circulates in a conformation that is inactive against its target proteases. Activation of antithrombin is brought about by a conformational change initiated upon binding heparin or heparan sulphate. Two isoforms exist in the circulation, alpha-antithrombin and beta-antithrombin, which differ in the amount of glycosylation present on the polypeptide chain; beta-antithrombin lacks the carbohydrate present at Asn135 in alpha-antithrombin. Of the two forms, beta-antithrombin has the higher affinity for heparin and thus functions as the major inhibitor in vivo even though it is the less abundant form. The reason for the differences in heparin affinity between the alpha and beta-forms have been shown to be due to the additional carbohydrate changing the rate of the conformational change. Here, we describe the most accurate structures of alpha-antithrombin and alpha-antithrombin+heparin pentasaccharide reported to date (2.6A and 2.9A resolution, respectively, both re-refinements using old data), and the structure of beta-antithrombin (2.6A resolution). The new structures have a remarkable degree of ordered carbohydrate and include parts of the antithrombin chain not modeled before. The structures have allowed a detailed comparison of the conformational differences between the three. They show that the structural basis of the lower affinity for heparin of alpha-antithrombin over beta-antithrombin is due to the conformational change that occurs upon heparin binding being sterically hindered by the presence of the additional bulky carbohydrate at Asn135.