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1.
We have determined that abnormal DNA methylation in T cells coincides with the development of autoimmunity, using a mouse model that exhibits an age-dependent lupus-like disease (MRL/lpr mice). Splenic CD4(+) T cells were isolated from these mice at 5 and 16 wk of age (before and after autoimmunity is established) and the expression of DNA methyltransferase 1 (Dnmt1) and the methylation-sensitive gene Tnfsf7 (CD70) was measured. Bisulfite DNA sequencing was used to monitor the methylation status of the Tnfsf7 gene. We found that Dnmt1 steady-state mRNA levels were significantly lower in 16-wk-old MRL/lpr mice, which had established autoimmunity, compared to the 5-wk-old MRL/lpr mice. Furthermore, the expression of CD70 was higher in MRL/lpr mice at 16 wk. CD70 was overexpressed in MRL/lpr mice compared to age- and sex-matched MRL(+/+) controls. Bisulfite DNA sequencing of the Tnfsf7 gene in MRL/lpr mice revealed that at 16 wk, CG pairs were hypomethylated compared to 5-wk-old mice, and that Tnfsf7 from MRL/lpr mice was hypomethylated at 16 wk relative to age-matched MRL(+/+) controls. Our data indicate that decreased expression of Dnmt1 and the corresponding T cell DNA hypomethylation correlate with the development of age-dependent autoimmunity in MRL/lpr mice.  相似文献   
2.
Annals of Surgical Oncology - Using explanatory mixed methods, we characterize the education that patients with breast cancer received about potential sexual health effects of treatment and explore...  相似文献   
3.

Objective

To examine situations where shared decision making (SDM) in practice does not achieve the goal of a patient-centered decision.

Methods

We explore circumstances in which elements necessary to realize SDM – patient readiness to participate and understanding of the decision – are not present. We consider the influence of contextual factors on decision making.

Results

Patients’ preference and readiness for participation in SDM are influenced by multiple interacting factors including the patient’s comprehension of the decision, their emotional state, the strength of their relationship with the clinician, and the nature of the decision. Uncertainty often inherent in information can lead to misconceptions and ill-formed opinions that impair patients’ understanding. In combination with cognitive biases, these factors may result in decisions that are incongruent with patients’ preferences. The impact of suboptimal understanding on decision making may be augmented by the context.

Conclusions

There are circumstances in which basic elements required for SDM are not present and therefore the clinician may not achieve the goal of a patient-centered decision.

Practice Implications

A flexible and tailored approach that draws on the full continuum of decision making models and communication strategies is required to achieve the goal of a patient-centered decision.  相似文献   
4.

Objective

The objective of this paper is to understand patient, caregiver and hospice admission nurses needs during the hospice admission conversation so patients and their caregivers can make informed decisions about hospice.

Methods

Resulting data set from this qualitative study included 60?h of observation and a total of 30 interviews with caregivers, patients and hospice admission nurses. Participants were from a large non-profit hospice; observation settings included: home, hospital and skilled nursing facility.

Results

Four themes were identified: (1) Wide variation in patient knowledge of hospice care prior to the admission conversation, (2) competing expectations and objectives for the admission conversation between patients, caregivers and hospice admission team members, (3) organizational influences around the goals of the admission conversation, (4) importance of integrating the patient and caregiver perspective to improve the quality of admission conversations.

Conclusion

Hospice services provided may be inconsistently explained by hospice personnel and therefore, can be misunderstood by patients and families. With the ubiquitous challenges surrounding hospice admission consults, there is a critical need for complete and accurate information during the admission process.

Practice Implications

Providing accurate and pertinent information at the time of the admission consult can help mitigate misinformed expectations of services provided.  相似文献   
5.
A comparative evaluation of the following commercial immunoassays for the determination of antibodies to Toxoplasma gondii was performed: Behring Diagnostics OPUS Toxo G and Toxo M, Abbott Diagnostics IMX Toxo-IgG 2.0 and Toxo-IgM, Sanofi Diagnostics Pasteur Platelia Toxo IgG and Toxo IgM, and bioMérieux Vitek VIDAS Toxo IgG and IgM. Of 676 specimens that were tested for Toxoplasma-specific immunoglobulin G (IgG) antibodies, 26% were reactive by all methods while 8% displayed some discrepancy. Of 718 specimens that were tested for Toxoplasma-specific IgM antibodies, 3% were reactive by all methods while 10% displayed some discrepancy. Analysis of discrepant specimens revealed performance shortcomings with all IgM-specific assays. The impact of such shortcomings is magnified in a population with a low prevalence of toxoplasmosis.  相似文献   
6.
BackgroundAbnormally high serum uric acid levels have been associated with several disease conditions including gout and kidney stone disease. More recently, it was shown that uric acid crystals stimulate dendritic cell maturation, activate the NALP3 inflammasome, and enhance antigen-specific immune responses. We hypothesize that uric acid can also stimulate T cells directly and in the absence of antigen presentation.MethodsPurified primary human T cells were incubated with and without uric acid at concentrations of 50, 100, 150, and 200 μg/mL. The expression of T-cell activation markers CD25 and CD70 was assessed by flow cytometry. In other experiments, Jurkat T cells were used and the expression of the costimulatory molecule CD70 was determined at the mRNA level.ResultsUric acid directly activates primary human T cells in the absence of antigen presentation. Furthermore, primary human T cells and Jurkat T cells treated with uric acid overexpress the costimulatory molecule CD70, which plays an important role in T cell-B cell interaction and antibody production.ConclusionsThe finding that uric acid directly promotes T-cell activation in an antigen-independent system is novel and might play a mechanistic role in the inflammatory response observed in gouty arthritis and other immune-mediated diseases.  相似文献   
7.
The Stereotyped Behavior Scale (SBS) is an empirically developed behavior rating scale for adolescents and adults with mental retardation (Rojahn, Tassé & Sturmey, 1997). Since the original publication, one item was deleted and two items were merged, leaving 24 items. In an additional change, severity scales were added to the frequency scales. In this paper, psychometric properties and (relative) norms for the new SBS are presented. In the psychometric study, 45 adults with mental retardation from a residential facility participated. Of these, 15 were selected for high-rates or very severe forms of stereotyped behaviors, 15 for mild to moderate rates or less severe stereotypies, and 15 for the low rates or absence of stereotyped behaviors. Direct care staff familiar with the participants completed the SBS and the "Stereotypy" subscale of the Aberrant Behavior Checklist-Residential (ABC-R) (Aman, Singh, Stewart & Field, 1985). For 15 participants, two raters independently completed the SBS. In addition, 45-min direct behavior observations were conducted on 16 participants. After approximately four weeks, the instruments were completed a second time by the same raters. As for reliability, the SBS frequency and severity scale total scores yielded test-retest intraclass coefficients (ICC) of 0.93 and 0.71, ICC interrater agreement of 0.76 and 0.75, and each had an internal consistency a of 0.91. For criterion validity, the SBS frequency and severity scores correlated with the ABC-R "Stereotypy" score at 0.80 and 0.84 (Pearson r), with systematic behavior observations at 0.50 and 0.65 (Pearson r), and with the a priori classification at 0.50 and 0.65 (Spearman p). From a previous data set of 550 individuals with stereotypic behavior, normative data (percentile ranks and T-scores) were derived. The data were presented in two tables, one showing a breakdown of gender by age groups, and the second one of age groups by level of functioning.  相似文献   
8.
The role that endocrine disruption could play in sexual selection remains relatively untested, and although estrogens occur in insects, little information exists about their biological role in insect reproduction. Atrazine is a commonly applied herbicide that mimics estrogen in vertebrates. Tenebrio molitor were raised from egg to adult under a gradation of environmentally relevant atrazine exposures and a non-treated control. Atrazine was delivered in the drinking water ad libitum. Female T. molitor were provided with a choice between unrelated males raised under three levels of atrazine exposures. Female preference for males demonstrated a non-monotonic inverted U-shaped response to atrazine exposure. There was no significant difference between the control and the high exposure to atrazine. Excluding the control, female preference increased as exposure concentration increased. These results have important repercussions for nonlethal effects of endocrine disruption on populations, their capacity to interfere with sexual selection, and the role of estrogen in pheromone communication among insects.  相似文献   
9.
A local exhaust hood was designed and built to capture and contain aerosol emissions of ribavirin during drug administration. The newly designed over-the-head hood is similar to the single hood currently used to administer the drug. This new hood was surrounded by an exhaust plenum to form a compound hood configuration. The exhaust plenum was connected to a filtered local exhaust air system to remove the waste aerosol. The compound hood and local exhaust ventilation system were evaluated for leak rate and inside hood aerosol concentration as a function of exhaust flow rates. This hood reduced the leak rate from an average of 98% with the traditional head hood to an average of less than 1% with the compound hood with exhaust port. The compound hood did not perform quite as well when not in use (set aside during infant caretaking) with the nebulizer remaining on. The leak rate was found to increase from an average of less than 1% to an average of 12% when trials were conducted that used a doll as a simulated patient versus trials without a doll, respectively. As regards therapeutic dose inside the hood, the system's performance may lead to an 18% to 25% decrease in inside hood concentration of aerosol entering the hood. Optimum hood operating parameters were identified. An exhaust flow rate in the range from 1.0 Lpm below to 1.0 Lpm above inlet flow rate from the small particle aerosol generator (SPAG nebulizer) reduced the leak rate to an average of less than 1%.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   
10.
A case is presented of a primigravida with transient diabetes insipidus, gestational hypertension, and multiple seizures resistant to magnesium sulfate and diazepam. After addition of phenytoin, no further seizures occurred. Transient diabetes insipidus in pregnancy has been previously associated with hypertension, liver dysfunction, and fetal distress. Considered with previous cases, it is suggested that seizures may frequently be part of this syndrome.  相似文献   
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