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Early IL-17A production helps establish Mycobacterium intracellulare infection in mice
Get PDFNontuberculous mycobacteria (NTM) infection is common in patients with structural lung damage. To address how NTM infection is established and causes lung damage, we established an NTM mouse model by intranasal inoculation of clinical isolates of M. intracellulare. During the 39-week course of infection, the bacteria persistently grew in the lung and caused progressive granulomatous and fibrotic lung damage with mortality exceeding 50%. Lung neutrophils were significantly increased at 1 week postinfection, reduced at 2 weeks postinfection and increased again at 39 weeks postinfection. IL-17A was increased in the lungs at 1–2 weeks of infection and reduced at 3 weeks postinfection. Depletion of neutrophils during early (0–2 weeks) and late (32–34 weeks) infection had no effect on mortality or lung damage in chronically infected mice. However, neutralization of IL-17A during early infection significantly reduced bacterial burden, fibrotic lung damage, and mortality in chronically infected mice. Since it is known that IL-17A regulates matrix metalloproteinases (MMPs) and that MMPs contribute to the pathogenesis of pulmonary fibrosis, we determined the levels of MMPs in the lungs of M. intracellulare-infected mice. Interestingly, MMP-3 was significantly reduced by anti-IL-17A neutralizing antibody. Moreover, in vitro data showed that exogenous IL-17A exaggerated the production of MMP-3 by lung epithelial cells upon M. intracellulare infection. Collectively, our findings suggest that early IL-17A production precedes and promotes organized pulmonary M. intracellulare infection in mice, at least in part through MMP-3 production
Addressing Substance Use and Misuse in East Texas: Stakeholder-Driven Needs and Priorities
Get PDFBackground: This project sought to assess needs, perceived challenges, and priorities regarding substance use disorder (SUD) in East Texas and develop a community-driven research agenda to address those challenges. Methods: Data were gathered through nine focus-group discussions (FGDs) with stakeholders: people living with SUD, families, medical providers, counselors, representatives of community-based organizations, and law enforcement officers. We asked participants how substance use manifests in their communities, which challenges they confronted in coping with substance use and misuse, and in which order their needs should be prioritized. Findings were reported at community forums to confirm the list of challenges and prioritize needs. Results: Five themes emerged from the FGDs indicating major challenges: (a) access to SUD treatment and recovery resources, (b) mental health and resiliency, (c) education, training, and professional development to facilitate treatments, (d) care and service coordination, and (e) community/social support for people living with SUD and their families. Conclusions: Significant resources such as financing, collaboration across silos, and community education are needed to effectively manage this public health problem. Our findings can inform research and outreach to help East Texans develop interventions, research programs, and educational opportunities for clinicians, community-based organizations, law enforcement officers, and counselors to build capacity for SUD prevention, treatment, and recover
Electromechanical Effects on Micro and Nano Particles Generated from Drug Delivery Devices and their Implications in Flow and Deposition Efficiency
Get PDFThis experimental investigation was undertaken to quantify the electrostatic charge and aerodynamic size distribution of the medicinal drug particles inhaled through an in-vitro mouth-throat (MT) in order to compare the amount of drugs can be delivered to the human lung while mimicking a patient is either sitting or lying. The MT model is a cadaver-based replica cast of human oral-pharyngeal-laryngeal region. Tested drug aerosols were generated by a commercially available metered dose inhaler (MDI). The MT model was placed inside a humidity (95%) and temperature (37oC) controlled chamber. Its mouth-inlet was positioned horizontally and vertically to simulate sitting and lying administration, respectively. The laryngeal-exit was connected to the aerosol sampling chamber (ASC) and the ASC was also connected with an electronic single particle relaxation time analyzer (ESPARTA). In each run, the ASC was cleaned and evacuated down to 36 cm of mercury so that a bolus of 4 liters of aerosol could be drawn at a rate of 30 L/min for a period of 8 seconds. Aerosols were generated from a single puff (for each run) into a spacer (Valve Holding Chamber), and instantly inhaled through the MT as bolus. Once the ASC was filled after 8 seconds of inhalation, the valve between the ASC and the ESPARTA was shut and a circulating fan was started instantly. Then the ESPARTA was started characterizing aerosol particles’ aerodynamic diameter and electrostatic charge simultaneously in real time. The results show that deposition of total (charged and uncharged) particles in the MT was double for lying position compared to sitting, which can be explained by inertial impaction of the oral jet at the bend of oral cavity, and gravitational settling of the pharyngeal and laryngeal jets when flowing horizontally through these two regions. Whereas, charged particles deposition was ten folds for lying compared to sitting. In this case, an effect of electrostatic image charge force on particle deposition efficiency can explain the outcome. In addition, particle deposition in the sitting position did not suffer gravitational settling rather it helped aerosols to move faster beyond larynx
Adolescents with Depression Capstone Benchmark Project
Get PDFThis change project promotes the inclusion of adolescent involvement within the informed consenting process for recommended treatment plans for symptoms of depression. This project proposal will include the adolescent throughout the development of the treatment plan to promote compliance. The incorporation of this plan will encourage autonomy in the adolescent and aid with developing a plan that the adolescent agrees with. The current process does not include the adolescents\u27 desires or opinions, which results in poor efficacy of the treatment plan, thus exacerbating the symptoms of depression
Preoperative Education for Cardiac Surgical Patients Benchmark Study
Get PDFHeart surgery is a term that scares a lot of people and rightfully so, as the heart is one of, if not the, most vital organ in the human body. So naturally, one can imagine the amount of fear and anxiety that patients feel when they are told they need heart surgery. This fear and anxiety is not unwarranted, either. Heart surgery, in most cases, is a major and highly complex operation with a lot of potential complications and negatives. Despite this, the majority of the time the benefits do outweigh the risks and patients elect to go forward with their surgery. In addition to the stress of having a major operation, it is not uncommon for these patients to not be fully informed about the procedure they are about to undergo, leading to even more anxiety and nervousness (Gadler et al., 2016).
Current preoperative education practices and regimens have proven to be ineffective in many cases as well (Agnew and Jorgensen, 2012). Therefore, material is needed that can provide effective, higher quality preoperative education. This is why it is recommended that a concise, comprehensive education regimen be implemented to improve the postoperative outcomes of cardiac surgical patients
THE EFFECTS OF TASK NOVELTY ON MEMORY FOR EVERYDAY MEAL PREPARATION TASKS AMONG YOUNG ADULTS AND OLDER ADULTS
Get PDFThe use of nonsensical information in the study of learning and memory goes back to the beginning of the field of psychology. Nonsensical information makes it difficult to rely on previous learning, increasing task novelty and providing insight into the learning of new tasks. However, little research exists investigating the role of task novelty in everyday activities such as cooking, which involve overlearned skills. This study aims to investigate the role of task novelty in everyday memory for meal preparation tasks in virtual reality. Young adults (n = 41; age M = 18.77, SD = 1.40) and older adults (n = 40; age M = 74.35, SD = 6.44) and older adults with impaired cognition (n = 12; age M = 66.75, SD = 12.72) completed the Virtual Kitchen Protocol (VKP; Barnett et al., 2021), a virtual reality-based measure of learning and memory for cooking both familiar (e.g., cooking eggs and bacon) and nonsensical (e.g., making flowerpot juice) meals. Young adults had greater recall for both familiar and nonsensical meals than older adults. Among older adults, impaired cognition was associated with lower performance on the sensical meals, but older adults with normal cognition and impaired cognition did not differ in their ability to perform the nonsensical tasks. These results were consistent with the notion that familiarity may be of greater use than novelty. Novelty’s impact appears to impact impaired and normal cognition older adults more the young adults
How Would Medicaid Expansion Affect Texas Hospitals? Evidence From a Retrospective Quasi-Experimental Study
Get PDFThis study aims to estimate the impact of a potential Medicaid expansion on Texas hospitals. The Affordable Care Act (ACA) Medicaid expansion increased access to health care and improved health outcomes. Still, several states, including Texas, have not adopted the expansion. This is a retrospective quasi-experimental study. We obtained inpatient data containing discharges from Texas hospitals between 2010 and 2017 from the Texas Department of State Health Services. Texas hospitals receive a significant number of patients from the adjacent states. We use a difference-in-differences methodology, where the patients from the neighboring states that expanded Medicaid in 2014 are the treatment group, and those that reside in Texas are the control group. The outcome variables are the payer mix and the cost of treatment, proxied by Diagnoses Related Group (DRG) weights assigned by the Centers for Medicare and Medicaid Services (CMS). The Medicaid expansion is associated with 4.15% lower costs of treatment among the patients from the expansion states (P \u3c .01). Also, the uninsured rate decreased by 4.7 percentage points (from 11.3%, P \u3c .01), while the share of Medicaid patients increased by 10.9 percentage points (from 30.7%, P \u3c .01). There are no significant changes in the share of privately insured or Medicare patients. Texas hospitals can benefit significantly from Medicaid expansion due to reductions in average treatment costs and the share of the uninsured
Lost in a Strange Land: Taking Ownership of Your Dissertation Journey
No full textWriting a dissertation can feel like moving to a new country. You have some knowledge of the culture, but you don’t always understand what to do or where to go. Feeling lost and frustrated in the academic culture is a common experience for many doctoral students. If this describes your experience, this workshop can help. Learn how to exert ownership over your journey by implementing four strategies - traveling the best paved road towards completion, identifying landmarks and landmines, finding the right tour guides, and managing the mayor of your town (better known as your dissertation advisor)
Writing as Therapy: Using Fiction in the Classroom to Process Trauma
No full textThe purpose of this article is to show how bibliotherapy (De Vries, Brennan, Lankin, Morse, Rix, & Beck, 2017), with the YA novel The Bridge Home (Venkatraman, 2019), and writing (Feldman, 2011) can be used in the classroom to help students in processing their trauma through the lens of trauma theory. The author of The Bridge Home (2019), Dr. Padma Venkatraman, chose to write through her trauma to process what happened in her past and to heal (P. Venkatraman, personal communication, July 14, 2020). The author has also used the same method to process through her own trauma and emotions resulting from the massacre at Virginia Tech on April 16, 2007
What Matters? Grades or Effect Size in a Calculus Class?
No full textThe purpose of this paper is to explore the impact of transformations of a large data set (N\u3e100) from non-normal to normal distributions and the impact on parametric and nonparametric analytic choices. As part of the analyses, differences in, and the consequences for, parametric and nonparametric effect size interpretations will be discussed