7,373 research outputs found
Approaching Trans Healthcare Competency: The Implementation of Trans Health Education for Medical Providers in Appalachia
Barriers to competent and safe healthcare disproportionately impact people who are marginalized because of their race, ethnicity, gender, or socioeconomic status. It is well documented that transgender patients in particular experience barriers to both accessing care and receiving high quality, non-discriminatory care (Hatzenbuehler & Pachankis, 2016; James et al., 2016; Rahman et al., 2019; Safer et al., 2016). This lack of access to culturally competent healthcare services contributes to health disparities that disproportionately impact the trans community. Literature on barriers to competent care for trans patients indicates that providers experience discomfort related to their ability to provide competent care (Safer et al., 2016). Many providers endorse a median of only five hours of trans healthcare training across their entire medical school curriculum (Hughto et al., 2015), and in some cases, as little as 45 minutes per year (Sawning et al., 2017). Primary care clinics should be the place in which general health and wellbeing are addressed for trans patients, as has been true for cisgender people. Primary care providers should be competent in assessing eligibility for Hormone Replacement Therapy (HRT) and surgery (Wylie et al., 2016), as well as providing necessary preventative care. Thus, this makes primary care the ideal setting for the proposed medical education implementation project. The current study aimed to develop and implement a training program for medical residents in primary care in rural South Central Appalachia. A six-stage development and implementation study is described. The intervention was evaluated for pedagogical outcomes including sustainability for future use, usefulness to residents, and accessibility. Evaluation of effectiveness included analyses of changes in providers’ self-reported competency, awareness of discriminatory experiences, and attitudes towards treating trans patients. There were no significant differences in pre-post competency scores (r=22, M=33.29[SD=5.96]; r=31, M=37.33[SD=1.02], SD=8.00) or in pre-post attitudes scores (r=15, M=32.76[SE=0.8], SD=4.69; r=13, M=34.7273[SE=1.00], SD=4.692). Accessibility and sustainability were measured qualitatively and included data such as resident attendance and ease of use of material for future behavioral health provider trainers. These outcomes were found to be satisfactory based on stakeholder feedback. Usefulness included three data points (satisfaction, helpfulness, value of training)
LIPIcs, Volume 251, ITCS 2023, Complete Volume
LIPIcs, Volume 251, ITCS 2023, Complete Volum
Investigation of the metabolism of rare nucleotides in plants
Nucleotides are metabolites involved in primary metabolism, and specialized
metabolism and have a regulatory role in various biochemical reactions in all forms of life. While in other organisms, the nucleotide metabolome was characterized
extensively, comparatively little is known about the cellular concentrations of
nucleotides in plants. The aim of this dissertation was to investigate the nucleotide metabolome and enzymes influencing the composition and quantities of nucleotides in plants. For this purpose, a method for the analysis of nucleotides and nucleosides in plants and algae was developed (Chapter 2.1), which comprises efficient quenching of enzymatic
activity, liquid-liquid extraction and solid phase extraction employing a weak-anionexchange resin. This method allowed the analysis of the nucleotide metabolome of plants in great depth including the quantification of low abundant deoxyribonucleotides and deoxyribonucleosides. The details of the method were summarized in an article, serving as a laboratory protocol (Chapter 2.2).
Furthermore, we contributed a review article (Chapter 2.3) that summarizes the
literature about nucleotide analysis and recent technological advances with a focus on plants and factors influencing and hindering the analysis of nucleotides in plants, i.e., a complex metabolic matrix, highly stable phosphatases and physicochemical
properties of nucleotides. To analyze the sub-cellular concentrations of metabolites, a protocol for the rapid isolation of highly pure mitochondria utilizing affinity chromatography was developed (Chapter 2.4).
The method for the purification of nucleotides furthermore contributed to the
comprehensive analysis of the nucleotide metabolome in germinating seeds and in
establishing seedlings of A. thaliana, with a focus on genes involved in the synthesis of thymidilates (Chapter 2.5) and the characterization of a novel enzyme of purine nucleotide degradation, the XANTHOSINE MONOPHOSPHATE PHOSPHATASE (Chapter 2.6). Protein homology analysis comparing A. thaliana, S. cerevisiae, and H. sapiens led to the identification and characterization of an enzyme involved in the metabolite damage repair system of plants, the INOSINE TRIPHOSPHATE PYROPHOSPHATASE (Chapter 2.7). It was shown that this enzyme dephosphorylates deaminated purine nucleotide triphosphates and thus prevents their incorporation into nucleic acids. Lossof-function mutants senesce early and have a constitutively increased content of salicylic acid. Also, the source of deaminated purine nucleotides in plants was investigated and it was shown that abiotic factors contribute to nucleotide damage.Nukleotide sind Metaboliten, die am Primärstoffwechsel und an spezialisierten
Stoffwechselvorgängen beteiligt sind und eine regulierende Rolle bei verschiedenen
biochemischen Reaktionen in allen Lebensformen spielen. Während bei anderen
Organismen das Nukleotidmetabolom umfassend charakterisiert wurde, ist in Pflanzen
vergleichsweise wenig über die zellulären Konzentrationen von Nukleotiden bekannt.
Ziel dieser Dissertation war es, das Nukleotidmetabolom und die Enzyme zu
untersuchen, die die Zusammensetzung und Menge der Nukleotide in Pflanzen
beeinflussen. Zu diesem Zweck wurde eine Methode zur Analyse von Nukleotiden und
Nukleosiden in Pflanzen und Algen entwickelt (Kapitel 2.1), die ein effizientes Stoppen
enzymatischer Aktivität, eine Flüssig-Flüssig-Extraktion und eine
Festphasenextraktion unter Verwendung eines schwachen Ionenaustauschers
umfasst. Mit dieser Methode konnte das Nukleotidmetabolom von Pflanzen eingehend
analysiert werden, einschließlich der Quantifizierung von Desoxyribonukleotiden und
Desoxyribonukleosiden mit geringer Abundanz. Die Einzelheiten der Methode wurden
in einem Artikel zusammengefasst, der als Laborprotokoll dient (Kapitel 2.2).
Darüber hinaus wurde ein Übersichtsartikel (Kapitel 2.3) verfasst, der die Literatur
über die Analyse von Nukleotiden und die jüngsten technologischen Fortschritte
zusammenfasst. Der Schwerpunkt lag hierbei auf Pflanzen und Faktoren, die die
Analyse von Nukleotiden in Pflanzen beeinflussen oder behindern, d. h. eine komplexe
Matrix, hochstabile Phosphatasen und physikalisch-chemische Eigenschaften von
Nukleotiden.
Um die subzellulären Konzentrationen von Metaboliten zu analysieren, wurde ein
Protokoll für die schnelle Isolierung hochreiner Mitochondrien unter Verwendung einer
Affinitätschromatographie entwickelt (Kapitel 2.4).
Die Methode zur Analyse von Nukleotiden trug außerdem zu einer umfassenden
Analyse des Nukleotidmetaboloms in keimenden Samen und in sich etablierenden
Keimlingen von A. thaliana bei, wobei der Schwerpunkt auf Genen lag, die an der
Synthese von Thymidilaten beteiligt sind (Kapitel 2.5), sowie zu der Charakterisierung
eines neuen Enzyms des Purinnukleotidabbaus, der XANTHOSINE
MONOPHOSPHATE PHOSPHATASE (Kapitel 2.6). Eine Proteinhomologieanalyse, die A. thaliana, S. cerevisiae und H. sapiens
miteinander verglich führte zur Identifizierung und Charakterisierung eines Enzyms,
das an der Reparatur von geschädigten Metaboliten in Pflanzen beteiligt ist, der
INOSINE TRIPHOSPHATE PYROPHOSPHATASE (Kapitel 2.7). Es konnte gezeigt
werden, dass dieses Enzym desaminierte Purinnukleotidtriphosphate
dephosphoryliert und so deren Einbau in Nukleinsäuren verhindert.
Funktionsverlustmutanten altern früh und weisen einen konstitutiv erhöhten Gehalt an Salicylsäure auf. Außerdem wurde die Quelle der desaminierten Purinnukleotide in Pflanzen untersucht, und es wurde gezeigt, dass abiotische Faktoren zur
Nukleotidschädigung beitragen
Effects of municipal smoke-free ordinances on secondhand smoke exposure in the Republic of Korea
ObjectiveTo reduce premature deaths due to secondhand smoke (SHS) exposure among non-smokers, the Republic of Korea (ROK) adopted changes to the National Health Promotion Act, which allowed local governments to enact municipal ordinances to strengthen their authority to designate smoke-free areas and levy penalty fines. In this study, we examined national trends in SHS exposure after the introduction of these municipal ordinances at the city level in 2010.MethodsWe used interrupted time series analysis to assess whether the trends of SHS exposure in the workplace and at home, and the primary cigarette smoking rate changed following the policy adjustment in the national legislation in ROK. Population-standardized data for selected variables were retrieved from a nationally representative survey dataset and used to study the policy action’s effectiveness.ResultsFollowing the change in the legislation, SHS exposure in the workplace reversed course from an increasing (18% per year) trend prior to the introduction of these smoke-free ordinances to a decreasing (−10% per year) trend after adoption and enforcement of these laws (β2 = 0.18, p-value = 0.07; β3 = −0.10, p-value = 0.02). SHS exposure at home (β2 = 0.10, p-value = 0.09; β3 = −0.03, p-value = 0.14) and the primary cigarette smoking rate (β2 = 0.03, p-value = 0.10; β3 = 0.008, p-value = 0.15) showed no significant changes in the sampled period. Although analyses stratified by sex showed that the allowance of municipal ordinances resulted in reduced SHS exposure in the workplace for both males and females, they did not affect the primary cigarette smoking rate as much, especially among females.ConclusionStrengthening the role of local governments by giving them the authority to enact and enforce penalties on SHS exposure violation helped ROK to reduce SHS exposure in the workplace. However, smoking behaviors and related activities seemed to shift to less restrictive areas such as on the streets and in apartment hallways, negating some of the effects due to these ordinances. Future studies should investigate how smoke-free policies beyond public places can further reduce the SHS exposure in ROK
Towards greenhouse cultivation of Artemisia annua: The application of LEDs in regulating plant growth and secondary metabolism
Artemisinin is a sesquiterpene lactone produced in glandular trichomes of Artemisia annua, and is extensively used in the treatment of malaria. Growth and secondary metabolism of A. annua are strongly regulated by environmental conditions, causing unstable supply and quality of raw materials from field grown plants. This study aimed to bring A. annua into greenhouse cultivation and to increase artemisinin production by manipulating greenhouse light environment using LEDs. A. annua plants were grown in a greenhouse compartment for five weeks in vegetative stage with either supplemental photosynthetically active radiation (PAR) (blue, green, red or white) or supplemental radiation outside PAR wavelength (far-red, UV-B or both). The colour of supplemental PAR hardly affected plant morphology and biomass, except that supplemental green decreased plant biomass by 15% (both fresh and dry mass) compared to supplemental white. Supplemental far-red increased final plant height by 23% whereas it decreased leaf area, plant fresh and dry weight by 30%, 17% and 7%, respectively, compared to the treatment without supplemental radiation. Supplemental UV-B decreased plant leaf area and dry weight (both by 7%). Interestingly, supplemental green and UV-B increased leaf glandular trichome density by 11% and 9%, respectively. However, concentrations of artemisinin, arteannuin B, dihydroartemisinic acid and artemisinic acid only exhibited marginal differences between the light treatments. There were no interactive effects of far-red and UV-B on plant biomass, morphology, trichome density and secondary metabolite concentrations. Our results illustrate the potential of applying light treatments in greenhouse production of A. annua to increase trichome density in vegetative stage. However, the trade-off between light effects on plant growth and trichome initiation needs to be considered. Moreover, the underlying mechanisms of light spectrum regulation on artemisinin biosynthesis need further clarification to enhance artemisinin yield in greenhouse production of A. annua
Aquaporins and CO2 diffusion across biological membrane
Despite the physiological significance of effective CO2 diffusion across biological membranes, the underlying mechanism behind this process is not yet resolved. Particularly debatable is the existence of CO2-permeable aquaporins. The lipophilic characteristic of CO2 should, according to Overton’s rule, result in a rapid flux across lipid bilayers. However, experimental evidence of limited membrane permeability poses a challenge to this idea of free diffusion. In this review, we summarized recent progress with regard to CO2 diffusion, and discussed the physiological effects of altered aquaporin expression, the molecular mechanisms of CO2 transport via aquaporins, and the function of sterols and other membrane proteins in CO2 permeability. In addition, we highlight the existing limits in measuring CO2 permeability and end up with perspectives on resolving such argument either by determining the atomic resolution structure of CO2 permeable aquaporins or by developing new methods for measuring permeability
La culture du perfectionnement du corps professoral : la perspective des chefs de file au Canada
Background: Although the word culture is frequently mentioned in research on faculty development (FD), the concept is rarely explored. This research aimed to examine the culture of FD in Canada, through the eyes of leaders of FD in the health professions. Studying culture can help reveal the practices and implicit systems of beliefs and values that, when made explicit, could enhance programming.
Method: FD leaders from all Canadian medical schools were invited to participate in semi-structured telephone interviews between November 2016 and March 2017. The researchers used a constructivist methodology and theoretical framework located within cultural studies, borrowing from phenomenological inquiry to move beyond descriptions to interpretations of participants’ perceptions. Constant comparison was used to conduct a thematic analysis within and across participants’ interview transcripts.
Results: Fifteen FD leaders, representing 88% of medical schools (15/17) in Canada, participated in this study. Four themes characterized the culture of FD: balancing competing voices and priorities; cultivating relationships and networks; promoting active, practice-based learning; and negotiating recognition.
Conclusion: Although the culture of FD may vary from context to context, this study revealed shared values, practices, and beliefs, focused on the continuous improvement of individual and collective abilities and the attainment of excellence.Contexte : Culture est un mot qui revient souvent dans les études sur le perfectionnement du corps professoral (PCP) et pourtant, le concept en soi est rarement exploré. Notre objectif était d’examiner cette culture dans le contexte canadien du point de vue des chefs de file du perfectionnement du corps professoral dans les professions de la santé. En mettant en évidence les pratiques et les systèmes implicites de croyances et de valeurs, une telle analyse de la culture du PCP peut contribuer à l’amélioration des programmes.
Méthode : Des chefs de file du PCP de toutes les facultés de médecine canadiennes ont été invités à participer à des entretiens téléphoniques semi-structurés entre novembre 2016 et mars 2017. Les chercheurs ont utilisé une méthodologie et un cadre théorique constructivistes s’inscrivant dans les études culturelles, ainsi qu’une approche phénoménologique pour aller au-delà de la description et s’engager dans une interprétation des perceptions des participants. Nous avons effectué à une comparaison systématique dans le cadre de l’analyse thématique individuelle et transversale des transcriptions d’entretiens.
Résultats : Quinze leaders du PCP, représentant 88 % des facultés de médecine (15/17) au Canada, ont participé à cette étude. Quatre thèmes caractérisent la culture du PCP : concilier les voix et les priorités divergentes; cultiver les relations et les réseaux; promouvoir l’apprentissage actif et basé sur la pratique, et faciliter la reconnaissance.Â
Conclusion : Bien que la culture du PCP varie selon le contexte, cette étude a révélé l’existence de valeurs, de pratiques et de croyances communes axées sur l’amélioration continue des capacités individuelles et collectives et sur l’atteinte de l’excellence
Evaluating the sustainability and resiliency of local food systems
With an ever-rising global population and looming environmental challenges such as climate change and soil degradation, it is imperative to increase the sustainability of food production. The drastic rise in food insecurity during the COVID-19 pandemic has further shown a pressing need to increase the resiliency of food systems. One strategy to reduce the dependence on complex, vulnerable global supply chains is to strengthen local food systems, such as by producing more food in cities. This thesis uses an interdisciplinary, food systems approach to explore aspects of sustainability and resiliency within local food systems.
Lifecycle assessment (LCA) was used to evaluate how farm scale, distance to consumer, and management practices influence environmental impacts for different local agriculture models in two case study locations: Georgia, USA and England, UK. Farms were grouped based on urbanisation level and management practices, including: urban organic, peri-urban organic, rural organic, and rural conventional. A total of 25 farms and 40 crop lifecycles were evaluated, focusing on two crops (kale and tomatoes) and including impacts from seedling production through final distribution to the point of sale. Results were extremely sensitive to the allocation of composting burdens (decomposition emissions), with impact variation between organic farms driven mainly by levels of compost use. When composting burdens were attributed to compost inputs, the rural conventional category in the U.S. and the rural organic category in the UK had the lowest average impacts per kg sellable crop produced, including the lowest global warming potential (GWP). However, when subtracting avoided burdens from the municipal waste stream from compost inputs, trends reversed entirely, with urban or peri-urban farm categories having the lowest impacts (often negative) for GWP and marine eutrophication. Overall, farm management practices were the most important factor driving environmental impacts from local food supply chains.
A soil health assessment was then performed on a subset of the UK farms to provide insight to ecosystem services that are not captured within LCA frameworks. Better soil health was observed in organically-farmed and uncultivated soils compared to conventionally farmed soils, suggesting higher ecosystem service provisioning as related to improved soil structure, flood mitigation, erosion control, and carbon storage. However, relatively high heavy metal concentrations were seen on urban and peri-urban farms, as well as those located in areas with previous mining activity. This implies that there are important services and disservices on farms that are not captured by LCAs.
Zooming out from a focus on food production, a qualitative methodology was used to explore experiences of food insecurity and related health and social challenges during the COVID-19 pandemic. Fourteen individuals receiving emergency food parcels from a community food project in Sheffield, UK were interviewed. Results showed that maintaining food security in times of crisis requires a diverse set of individual, household, social, and place-based resources, which were largely diminished or strained during the pandemic. Drawing upon social capital and community support was essential to cope with a multiplicity of hardship, highlighting a need to develop community food infrastructure that supports ideals of mutual aid and builds connections throughout the food supply chain. Overall, this thesis shows that a range of context-specific solutions are required to build sustainable and resilient food systems. This can be supported by increasing local control of food systems and designing strategies to meet specific community needs, whilst still acknowledging a shared global responsibility to protect ecosystem, human, and planetary health
Using knowledge graphs to infer gene expression in plants
IntroductionClimate change is already affecting ecosystems around the world and forcing us to adapt to meet societal needs. The speed with which climate change is progressing necessitates a massive scaling up of the number of species with understood genotype-environment-phenotype (G×E×P) dynamics in order to increase ecosystem and agriculture resilience. An important part of predicting phenotype is understanding the complex gene regulatory networks present in organisms. Previous work has demonstrated that knowledge about one species can be applied to another using ontologically-supported knowledge bases that exploit homologous structures and homologous genes. These types of structures that can apply knowledge about one species to another have the potential to enable the massive scaling up that is needed through in silico experimentation.MethodsWe developed one such structure, a knowledge graph (KG) using information from Planteome and the EMBL-EBI Expression Atlas that connects gene expression, molecular interactions, functions, and pathways to homology-based gene annotations. Our preliminary analysis uses data from gene expression studies in Arabidopsis thaliana and Populus trichocarpa plants exposed to drought conditions.ResultsA graph query identified 16 pairs of homologous genes in these two taxa, some of which show opposite patterns of gene expression in response to drought. As expected, analysis of the upstream cis-regulatory region of these genes revealed that homologs with similar expression behavior had conserved cis-regulatory regions and potential interaction with similar trans-elements, unlike homologs that changed their expression in opposite ways.DiscussionThis suggests that even though the homologous pairs share common ancestry and functional roles, predicting expression and phenotype through homology inference needs careful consideration of integrating cis and trans-regulatory components in the curated and inferred knowledge graph
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