157 research outputs found
Physician assistant burnout and emotional resilience in emergency medicine
The physician assistant profession has grown from its original emergence as a strategy to improve family practice and rural healthcare. Rising emergency department visits and the plateau of physicians entering the profession has contributed to a growing number of PA positions in emergency medicine. Currently, emergency medicine is the third largest practice setting, employing 13% of certified PAs. Unfortunately, little is known about the factors contributing to their resilience to remain in a high stress work environment. The literature review in this study is composed of past research on burnout, uncertainty intolerance, and resilience in emergency medicine practitioners. In summary, the comprehensive review suggests that emergency medicine practitioners, including PAs, suffer a high degree of burnout. However, the factors contributing to this burnout differ between physicians and PAs. Self-directedness, persistence, and cooperation are associated with resilience among family medicine practitioners, but there is a lack of research on the personality traits that affect emergency medicine and EMPAs. This thesis proposes a longitudinal cohort study that will investigate burnout, stress resilience, and personality trait patterns among emergency medicine PAs compared to the general PA population. The study will match emergency medicine PAs with general population PAs based on demographics. Data on burnout, stress resilience, and personality dimensions will be analyzed using a chi-square test and Pearson correlation coefficient to elucidate any differences. The proposed research is meant to better understand and prevent the burnout syndrome, which is associated with negative patient outcomes, higher healthcare costs, and serious mental health strain
Naturally occuring peptides recognized by cytotoxic T lymphocytes (CTS) : peptide abundance as a determinant of CTL function
Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Biology, 1996.Includes bibliographical references.by Theodore J. Tsomides.Ph.D
Algal bioassessment metrics for wadeable streams and rivers of Maine, USA
Many state water-quality agencies use biological assessment methods based on lotic fish and macroinvertebrate communities, but relatively few states have incorporated algal multimetric indices into monitoring programs. Algae are good indicators for monitoring water quality because they are sensitive to many environmental stressors. We evaluated benthic algal community attributes along a landuse gradient affecting wadeable streams and rivers in Maine, USA, to identify potential bioassessment metrics. We collected epilithic algal samples from 193 locations across the state. We computed weighted-average optima for common taxa for total P, total N, specific conductance, % impervious cover, and % developed watershed, which included all land use that is no longer forest or wetland. We assigned Maine stream tolerance values and categories (sensitive, intermediate, tolerant) to taxa based on their optima and responses to watershed disturbance. We evaluated performance of algal community metrics used in multimetric indices from other regions and novel metrics based on Maine data. Metrics specific to Maine data, such as the relative richness of species characterized as being sensitive in Maine, were more correlated with % developed watershed than most metrics used in other regions. Few community-structure attributes (e.g., species richness) were useful metrics in Maine. Performance of algal bioassessment models would be improved if metrics were evaluated with attributes of local data before inclusion in multimetric indices or statistical models
TB208: Biological Water Quality Standards to Achieve Biological Condition Goals in Maine Rivers and Streams: Science and Policy
This publication describes the philosophy, history, methodology, and management applications of numeric biological criteria in water quality standards in Maine. The presentation describes the decision-making process used by the Maine Department of Environmental Protection (MDEP) for assessing attainment of aquatic life uses in water quality standards using benthic macroinvertebrates in Maine streams and rivers including eight case studies of management applications and the improved environmental outcomes that have resulted. The MDEP, University of Maine, and business and nonprofit stakeholders participated in the development and testing of Maine’s numeric biological criteria. This publication further discusses the broader relevance of numeric biological criteria in water quality management at both the state and federal levels and considers parallels and differences between Maine’s biological criteria and other biological assessment methods in the United States and the European Union.https://digitalcommons.library.umaine.edu/aes_techbulletin/1205/thumbnail.jp
Selenoprotein H is an essential regulator of redox homeostasis that cooperates with p53 in development and tumorigenesis
Selenium, an essential micronutrient known for its cancer prevention properties, is incorporated into a class of selenocysteine-containing proteins (selenoproteins). Selenoprotein H (SepH) is a recently identified nucleolar oxidoreductase whose function is not well understood. Here we report that seph is an essential gene regulating organ development in zebrafish. Metabolite profiling by targeted LC-MS/MS demonstrated that SepH deficiency impairs redox balance by reducing the levels of ascorbate and methionine, while increasing methionine sulfoxide. Transcriptome analysis revealed that SepH deficiency induces an inflammatory response and activates the p53 pathway. Consequently, loss of seph renders larvae susceptible to oxidative stress and DNA damage. Finally, we demonstrate that seph interacts with p53 deficiency in adulthood to accelerate gastrointestinal tumor development. Overall, our findings establish that seph regulates redox homeostasis and suppresses DNA damage. We hypothesize that SepH deficiency may contribute to the increased cancer risk observed in cohorts with low selenium levels.National Cancer Institute (U.S.) (Grant R01 DK090311)National Cancer Institute (U.S.) (Grant R24OD017870
Host genotype and time dependent antigen presentation of viral peptides: predictions from theory
The rate of progression of HIV infected individuals to AIDS is known to vary with the genotype of the host, and is linked to their allele of human leukocyte antigen (HLA) proteins, which present protein degradation products at the cell surface to circulating T-cells. HLA alleles are associated with Gag-specific T-cell responses that are protective against progression of the disease. While Pol is the most conserved HIV sequence, its association with immune control is not as strong. To gain a more thorough quantitative understanding of the factors that contribute to immunodominance, we have constructed a model of the recognition of HIV infection by the MHC class I pathway. Our model predicts surface presentation of HIV peptides over time, demonstrates the importance of viral protein kinetics, and provides evidence of the importance of Gag peptides in the long-term control of HIV infection. Furthermore, short-term dynamics are also predicted, with simulation of virion-derived peptides suggesting that efficient processing of Gag can lead to a 50% probability of presentation within 3 hours post-infection, as observed experimentally. In conjunction with epitope prediction algorithms, this modelling approach could be used to refine experimental targets for potential T-cell vaccines, both for HIV and other viruses
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