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1.
Ann Am Thorac Soc ; 2024 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-39052070

RESUMO

RATIONALE: Effective interventions to prevent burnout among intensive care unit (ICU) clinicians are urgently needed. Death Cafés, group discussions about death, build a sense of community and create a space for reflection on distressing events. OBJECTIVE: To assess whether participation in regular Death Cafés can prevent burnout in ICU clinicians (physicians, nurses, pharmacists, therapists). METHODS: A randomized clinical trial was conducted from July 2020-December 2022 in ten ICUs in Louisiana. Subjects were randomized to attend four psychotherapist-facilitated, virtual Death Cafés or to a control arm. MEASUREMENTS AND MAIN RESULTS: The primary outcome was burnout defined by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) at 6 months. Depression and anxiety scores were measured as well as qualitative data on stressors, coping, and Death Café experience. Among 340 clinicians screened and consented (171 physicians; 169 non-physicians), 251 participated (mean age 31.06.8 years, 63% female, 72% white, 37% nurses, 27% residents, 25% interns, 11% other). Burnout prevalence was 19% at baseline. Of 136 participants who completed 6-month follow-up, no significant differences were found between intervention and control for the primary outcome (18% versus 25%, unadjusted OR 0.64 [95% CI 0.26-1.57], p=0.33). There were no differences in anxiety or depression. Notably, the study was limited by an inability to achieve target enrollment and high attrition rate (46%). CONCLUSIONS: Virtual Death Cafés were unable to reduce burnout, although the study was underpowered to detect differences between groups. Clinical trial registered with Clinicaltrials.gov (NCT04347811).

2.
J Clin Virol Plus ; 1(4): 100047, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35262027

RESUMO

Serologic testing of residual blood samples from 812 children from a hospital in New Orleans, LA, between March and May 2020, demonstrated a SARS-CoV-2 seroprevalence of 6.8% based on S and N protein IgG; Black and Hispanic children, and children living in zip codes with lower household incomes were over-represented.

3.
Sci Rep ; 8(1): 11044, 2018 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-30038391

RESUMO

Cathepsin S (CTSS) activity is elevated in Sjögren's Syndrome (SS) patient tears. Here we tested whether protease inhibition and cystatin C (Cys C) levels are reduced in SS tears, which could lead to enhanced CTSS-driven degradation of tear proteins. CTSS activity against Cys C, LF and sIgA was tested in SS or healthy control tears. Tears from 156 female subjects (33, SS; 33, rheumatoid arthritis; 31, other autoimmune diseases; 35, non-autoimmune dry eye (DE); 24, healthy controls) were analyzed for CTSS activity and Cys C, LF, and sIgA levels. Cys C and LF showed enhanced degradation in SS tears supplemented with recombinant CTSS, but not supplemented healthy control tears. CTSS activity was significantly increased, while Cys C, LF and sIgA levels were significantly decreased, in SS tears compared to other groups. While tear CTSS activity remained the strongest discriminator of SS in autoimmune populations, combining LF and CTSS improved discrimination of SS beyond CTSS in DE patients. Reductions in Cys C and other endogenous proteases may enhance CTSS activity in SS tears. Tear CTSS activity is reconfirmed as a putative biomarker of SS in an independent patient cohort while combined LF and CTSS measurements may distinguish SS from DE patients.


Assuntos
Catepsinas/metabolismo , Proteínas do Olho/metabolismo , Síndrome de Sjogren/metabolismo , Animais , Catepsinas/genética , Cistatina C/genética , Cistatina C/metabolismo , Proteínas do Olho/genética , Feminino , Humanos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos NOD , Pessoa de Meia-Idade , Síndrome de Sjogren/genética
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