Health care experiences of Black cancer survivors: A qualitative study exploring drivers of low and high Consumer Assessment of Healthcare Providers and Systems global ratings of care

Background: The purpose of this study was to understand the experiences of Black patients with cancer in health care by comparing drivers of high and low ratings. / Methods: Semistructured in-depth interviews were conducted with 18 Black patients with cancer recruited from cancer survivorship support groups and Facebook between May 2019 and March 2020. Interviews were coded across all transcripts by using a thematic analysis approach before comparing low- and high-rating groups. / Results: There were three major themes that influenced whether patients rated their care as low or high, which included the patient–provider relationship, health care staff interactions, and cancer care coordination. For example, the high-rating group described good communication with the health care team as physicians listening to their needs, being responsive to their concerns, and providing recommendations on how to address side effects. In contrast, the low-rating group described poor communication with their health care team as their needs being dismissed and being excluded from decision-making processes. Additionally, there were two distinct themes that influenced patients’ low ratings: insurance and financial toxicity issues and experiences of health care discrimination. / Conclusions: In an effort to promote equitable cancer care experiences for Black patients, it is important that health systems work to prioritize patient interactions with health care providers and staff, comprehensive care management for patients with cancer, and reductions in the financial burden of caring for cancer

Maternal nutrition at conception modulates DNA methylation of human metastable epialleles.

In experimental animals, maternal diet during the periconceptional period influences the establishment of DNA methylation at metastable epialleles in the offspring, with permanent phenotypic consequences. Pronounced naturally occurring seasonal differences in the diet of rural Gambian women allowed us to test this in humans. We show that significant seasonal variations in methyl-donor nutrient intake of mothers around the time of conception influence 13 relevant plasma biomarkers. The level of several of these maternal biomarkers predicts increased/decreased methylation at metastable epialleles in DNA extracted from lymphocytes and hair follicles in infants postnatally. Our results demonstrate that maternal nutritional status during early pregnancy causes persistent and systemic epigenetic changes at human metastable epialleles

Deep Learning for Cardiologist-level Myocardial Infarction Detection in Electrocardiograms

Myocardial infarction is the leading cause of death worldwide. In this paper, we design domain-inspired neural network models to detect myocardial infarction. First, we study the contribution of various leads. This systematic analysis, first of its kind in the literature, indicates that out of 15 ECG leads, data from the v6, vz, and ii leads are critical to correctly identify myocardial infarction. Second, we use this finding and adapt the ConvNetQuake neural network model--originally designed to identify earthquakes--to attain state-of-the-art classification results for myocardial infarction, achieving $99.43\%$ classification accuracy on a record-wise split, and $97.83\%$ classification accuracy on a patient-wise split. These two results represent cardiologist-level performance level for myocardial infarction detection after feeding only 10 seconds of raw ECG data into our model. Third, we show that our multi-ECG-channel neural network achieves cardiologist-level performance without the need of any kind of manual feature extraction or data pre-processing.Comment: Accepted to the European Medical and Biological Engineering Conference (EMBEC) 202

Encuesta sobre la formación PIR y MIR en salud mental en Andalucía.

Se presentan los resultados de una encuesta realizada a todo el personal en formación postgraduada en Salud Mental en Andalucía para evaluar la motivación y el grado de satisfacción sobre la formación recibida. Una alta gratificación personal del trabajo pero una escasa valoración del personal de staff hacia su supervisión teórica y práctica, hacia la investigación, tutorías y sesiones clínicas son algunos de los datos más interesantes obtenidos en la mism

Encuesta sobre la formación PIR y MIR en salud mental en Andalucía.

Se presentan los resultados de una encuesta realizada a todo el personal en formación postgraduada en Salud Mental en Andalucía para evaluar la motivación y el grado de satisfacción sobre la formación recibida. Una alta gratificación personal del trabajo pero una escasa valoración del personal de staff hacia su supervisión teórica y práctica, hacia la investigación, tutorías y sesiones clínicas son algunos de los datos más interesantes obtenidos en la mism

Encuesta sobre la formación PIR y MIR en salud mental en Andalucía.

Se presentan los resultados de una encuesta realizada a todo el personal en formación postgraduada en Salud Mental en Andalucía para evaluar la motivación y el grado de satisfacción sobre la formación recibida. Una alta gratificación personal del trabajo pero una escasa valoración del personal de staff hacia su supervisión teórica y práctica, hacia la investigación, tutorías y sesiones clínicas son algunos de los datos más interesantes obtenidos en la mism

Steady-state modulation of voltage-gated K+ channels in rat arterial smooth muscle by cyclic AMP-dependent protein kinase and protein phosphatase 2B

Voltage-gated potassium channels (Kv) are important regulators of membrane potential in vascular smooth muscle cells, which is integral to controlling intracellular Ca2+ concentration and regulating vascular tone. Previous work indicates that Kv channels can be modulated by receptor-driven alterations of cyclic AMP-dependent protein kinase (PKA) activity. Here, we demonstrate that Kv channel activity is maintained by tonic activity of PKA. Whole-cell recording was used to assess the effect of manipulating PKA signalling on Kv and ATP-dependent K+ channels of rat mesenteric artery smooth muscle cells. Application of PKA inhibitors, KT5720 or H89, caused a significant inhibition of Kv currents. Tonic PKA-mediated activation of Kv appears maximal as application of isoprenaline (a β-adrenoceptor agonist) or dibutyryl-cAMP failed to enhance Kv currents. We also show that this modulation of Kv by PKA can be reversed by protein phosphatase 2B/calcineurin (PP2B). PKA-dependent inhibition of Kv by KT5720 can be abrogated by pre-treatment with the PP2B inhibitor cyclosporin A, or inclusion of a PP2B auto-inhibitory peptide in the pipette solution. Finally, we demonstrate that tonic PKA-mediated modulation of Kv requires intact caveolae. Pre-treatment of the cells with methyl-β-cyclodextrin to deplete cellular cholesterol, or adding caveolin-scaffolding domain peptide to the pipette solution to disrupt caveolae-dependent signalling each attenuated PKA-mediated modulation of the Kv current. These findings highlight a novel, caveolae-dependent, tonic modulatory role of PKA on Kv channels providing new insight into mechanisms and the potential for pharmacological manipulation of vascular tone