865 resultados para human reliability assessment


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HIV entry into human cells is mediated by CD4 acting in concert with one of several members of the chemokine receptor superfamily. The resistance to HIV infection observed in individuals with defective CCR5 alleles indicated that this particular chemokine receptor plays a crucial role in the initiation of in vivo HIV infection. Expression of human CD4 transgene does not render mice susceptible to HIV infection because of structural differences between human and mouse CCR5. To ascertain whether expression of human CD4 and CCR5 is sufficient to make murine T lymphocytes susceptible to HIV infection, the lck promoter was used to direct the T cell-specific expression of human CD4 and CCR5 in transgenic mice. Peripheral blood mononuclear cells and splenocytes isolated from these mice expressed human CD4 and CCR5 and were infectible with selected M-tropic HIV isolates. After in vivo inoculation, HIV-infected cells were detected by DNA PCR in the spleen and lymph nodes of these transgenic mice, but HIV could not be cultured from these cells. This indicated that although transgenic expression of human CD4 and CCR5 permitted entry of HIV into the mouse cells, significant HIV infection was prevented by other blocks to HIV replication present in mouse cells. In addition to providing in vivo verification for the important role of CCR5 in T lymphocyte HIV infection, these transgenic mice represent a new in vivo model for understanding HIV pathogenesis by delineating species-specific cellular factors required for productive in vivo HIV infection. These mice should also prove useful for the assessment of potential therapeutic and preventative modalities, particularly vaccines.

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Accurate and automated methods for measuring the thickness of human cerebral cortex could provide powerful tools for diagnosing and studying a variety of neurodegenerative and psychiatric disorders. Manual methods for estimating cortical thickness from neuroimaging data are labor intensive, requiring several days of effort by a trained anatomist. Furthermore, the highly folded nature of the cortex is problematic for manual techniques, frequently resulting in measurement errors in regions in which the cortical surface is not perpendicular to any of the cardinal axes. As a consequence, it has been impractical to obtain accurate thickness estimates for the entire cortex in individual subjects, or group statistics for patient or control populations. Here, we present an automated method for accurately measuring the thickness of the cerebral cortex across the entire brain and for generating cross-subject statistics in a coordinate system based on cortical anatomy. The intersubject standard deviation of the thickness measures is shown to be less than 0.5 mm, implying the ability to detect focal atrophy in small populations or even individual subjects. The reliability and accuracy of this new method are assessed by within-subject test–retest studies, as well as by comparison of cross-subject regional thickness measures with published values.

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Apolipoprotein E (apoE) mediates the redistribution of lipids among cells and is expressed at highest levels in brain and liver. Human apoE exists in three major isoforms encoded by distinct alleles (ɛ2, ɛ3, and ɛ4). Compared with APOE ɛ2 and ɛ3, APOE ɛ4 increases the risk of cognitive impairments, lowers the age of onset of Alzheimer’s disease (AD), and decreases the response to AD treatments. Besides age, inheritance of the APOE ɛ4 allele is the most important known risk factor for the development of sporadic AD, the most common form of this illness. Although numerous hypotheses have been advanced, it remains unclear how APOE ɛ4 might affect cognition and increase AD risk. To assess the effects of distinct human apoE isoforms on the brain, we have used the neuron-specific enolase (NSE) promoter to express human apoE3 or apoE4 at similar levels in neurons of transgenic mice lacking endogenous mouse apoE. Compared with NSE-apoE3 mice and wild-type controls, NSE-apoE4 mice showed impairments in learning a water maze task and in vertical exploratory behavior that increased with age and were seen primarily in females. These findings demonstrate that human apoE isoforms have differential effects on brain function in vivo and that the susceptibility to apoE4-induced deficits is critically influenced by age and gender. These results could be pertinent to cognitive impairments observed in human APOE ɛ4 carriers. NSE-apoE mice and similar models may facilitate the preclinical assessment of treatments for apoE-related cognitive deficits.

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There is substantial scientific evidence to support the notion that bovine spongiform encephalopathy (BSE) has contaminated human beings, causing variant Creutzfeldt–Jakob disease (vCJD). This disease has raised concerns about the possibility of an iatrogenic secondary transmission to humans, because the biological properties of the primate-adapted BSE agent are unknown. We show that (i) BSE can be transmitted from primate to primate by intravenous route in 25 months, and (ii) an iatrogenic transmission of vCJD to humans could be readily recognized pathologically, whether it occurs by the central or peripheral route. Strain typing in mice demonstrates that the BSE agent adapts to macaques in the same way as it does to humans and confirms that the BSE agent is responsible for vCJD not only in the United Kingdom but also in France. The agent responsible for French iatrogenic growth hormone-linked CJD taken as a control is very different from vCJD but is similar to that found in one case of sporadic CJD and one sheep scrapie isolate. These data will be key in identifying the origin of human cases of prion disease, including accidental vCJD transmission, and could provide bases for vCJD risk assessment.

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When the human prostate cancer cell line, LNCaP 104-S, the growth of which is stimulated by physiological levels of androgen, is cultured in androgen-depleted medium for > 100 passages, the cells, now called LNCaP 104-R2, are proliferatively repressed by low concentrations of androgens. LNCaP 104-R2 cells formed tumors in castrated male athymic nude mice. Testosterone propionate (TP) treatment prevented LNCaP 104-R2 tumor growth and caused regression of established tumors in these mice. Such a tumor-suppressive effect was not observed with tumors derived from LNCaP 104-S cells or androgen receptor-negative human prostate cancer PC-3 cells. 5 alpha-Dihydrotestosterone, but not 5 beta-dihydrotestosterone, 17 beta-estradiol, or medroxyprogesterone acetate, also inhibited LNCaP 104-R2 tumor growth. Removal of TP or implantation of finasteride, a 5 alpha-reductase inhibitor, in nude mice bearing TP implants resulted in the regrowth of LNCaP 104-R2 tumors. Within 1 week after TP implantation, LNCaP 104-R2 tumors exhibited massive necrosis with severe hemorrhage. Three weeks later, these tumors showed fibrosis with infiltration of chronic inflammatory cells and scattered carcinoma cells exhibiting degeneration. TP treatment of mice with LNCaP 104-R2 tumors reduced tumor androgen receptor and c-myc mRNA levels but increased prostate-specific antigen in serum- and prostate-specific antigen mRNA in tumors. Although androgen ablation has been the standard treatment for metastatic prostate cancer for > 50 years, our study shows that androgen supplementation therapy may be beneficial for treatment of certain types of human prostate cancer and that the use of 5 alpha-reductase inhibitors, such as finasteride or anti-androgens, in the general treatment of metastatic prostate cancer may require careful assessment.

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Detection of loss of heterozygosity (LOH) by comparison of normal and tumor genotypes using PCR-based microsatellite loci provides considerable advantages over traditional Southern blotting-based approaches. However, current methodologies are limited by several factors, including the numbers of loci that can be evaluated for LOH in a single experiment, the discrimination of true alleles versus "stutter bands," and the use of radionucleotides in detecting PCR products. Here we describe methods for high throughput simultaneous assessment of LOH at multiple loci in human tumors; these methods rely on the detection of amplified microsatellite loci by fluorescence-based DNA sequencing technology. Data generated by this approach are processed by several computer software programs that enable the automated linear quantitation and calculation of allelic ratios, allowing rapid ascertainment of LOH. As a test of this approach, genotypes at a series of loci on chromosome 4 were determined for 58 carcinomas of the uterine cervix. The results underscore the efficacy, sensitivity, and remarkable reproducibility of this approach to LOH detection and provide subchromosomal localization of two regions of chromosome 4 commonly altered in cervical tumors.

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Hepatitis C virus (HCV) is a major cause of chronic hepatitis. The virus does not replicate efficiently in cell cultures, and it is therefore difficult to assess infection-neutralizing antibodies and to evaluate protective immunity in vitro. To study the binding of the HCV envelope to cell-surface receptors, we developed an assay to assess specific binding of recombinant envelope proteins to human cells and neutralization thereof. HCV recombinant envelope proteins expressed in various systems were incubated with human cells, and binding was assessed by flow cytometry using anti-envelope antibodies. Envelope glycoprotein 2 (E2) expressed in mammalian cells, but not in yeast or insect cells, binds human cells with high affinity (Kd approximately 10(-8) M). We then assessed antibodies able to neutralize E2 binding in the sera of both vaccinated and carrier chimpanzees, as well as in the sera of humans infected with various HCV genotypes. Vaccination with recombinant envelope proteins expressed in mammalian cells elicited high titers of neutralizing antibodies that correlated with protection from HCV challenge. HCV infection does not elicit neutralizing antibodies in most chimpanzees and humans, although low titers of neutralizing antibodies were detectable in a minority of infections. The ability to neutralize binding of E2 derived from the HCV-1 genotype was equally distributed among sera from patients infected with HCV genotypes 1, 2, and 3, demonstrating that binding of E2 is partly independent of E2 hypervariable regions. However, a mouse monoclonal antibody raised against the E2 hypervariable region 1 can partially neutralize binding of E2, indicating that at least two neutralizing epitopes, one of which is hypervariable, should exist on the E2 protein. The neutralization-of-binding assay described will be useful to study protective immunity to HCV infection and for vaccine development.

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It is becoming clear that an adequate level of long-chain highly unsaturated fatty acids in the nervous system is required for optimal function and development; however, the ability of infants to biosynthesize long-chain fatty acids is unknown. This study explores the capacity of human infants to convert 18-carbon essential fatty acids to their elongated and desaturated forms, in vivo. A newly developed gas chromatography/negative chemical ionization/mass spectrometry method employing 2H-labeled essential fatty acids allowed assessment of this in vivo conversion with very high sensitivity and selectivity. Our results demonstrate that human infants have the capacity to convert dietary essential fatty acids administered enterally as 2H-labeled ethyl esters to their longer-chain derivatives, transport them to plasma, and incorporate them into membrane lipids. The in vivo conversion of linoleic acid (18:2n6) to arachidonic acid (20:4n6) is demonstrated in human beings. All elongases/desaturases necessary for the conversion of linolenic acid (18:3n3) to docosahexaenoic acid (22:6n3) are also active in the first week after birth. Although the absolute amounts of n-3 fatty acid metabolites accumulated in plasma are greater than those of the n-6 family, estimates of the endogenous pools of 18:2n6 and 18:3n3 indicate that n-6 fatty acid conversion rates are greater than those of the n-3 family. While these data clearly demonstrate the capability of infants to biosynthesize 22:6n3, a lipid that is required for optimal neural development, the amounts produced in vivo from 18:3n3 may be inadequate to support the 22:6n3 level observed in breast-fed infants.

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La presente tesi analizza il reato di traffico di esseri umani in Europa, con particolare attenzione al fenomeno dello sfruttamento sessuale. La ricerca è stata condotta in parte nell’ambito del progetto “FIDUCIA. New European crimes and trust-based policy” (www.fiduciaproject.eu). La tesi è composta da 5 capitoli. Il primo capitolo introduce il reato di tratta di esseri umani, a livello globale e, successivamente, nello specifico, in Europa. Vengono presentati i fattori determinanti e le origini del fenomeno. Inoltre, ne vengono fornite le definizioni e le principali caratteristiche, in linea con i più importanti documenti internazionali sul tema. Il capitolo si chiude con una panoramica statistica, che affronta anche le criticità della raccolta di dati relativi ai reati. Il secondo capitolo analizza l’approccio correntemente adottato a livello domestico ed europeo contro la tratta. Le misure vengono presentate prima dal punto di vista teorico; successivamente ne vengono forniti esempi concreti, ad esempio convenzioni internazionali, direttive, ma anche progetti di ricerca, collaborazioni internazionali tra autorità ed ONG. Il terzo capitolo si concentra sulla tratta a fini di sfruttamento sessuale. Vengono analizzati il potenziale legame con la prostituzione, e l’approccio europeo. Segue un approfondimento dei modelli legali implementati a livello europeo ed uno studio comparato di cinque paesi membri, rappresentativi dei vari modelli di regolamentazione della prostituzione (Italia, Belgio, Polonia, Germania e Svezia). Il quarto capitolo raccoglie le interviste condotte con diversi esperti che si occupano di contrasto alla tratta: ONG italiane e straniere, referenti nazionali anti-tratta di Italia, Belgio e Germania, FRONTEX, membri del Parlamento Europeo. Nelle conclusioni, vengono proposte prima una valutazione complessiva del quadro attuale, e poi alcune raccomandazioni ai governi nazionali e agli organismi sopranazionali. In particolare, visto l’obiettivo di un contrasto omogeneo e coordinato della tratta (per sfruttamento sessuale specificamente) a livello europeo, si ritiene che un modello regolamentare uniforme della prostituzione negli stati membri possa contribuire a migliorare uniformità ad efficacia dell’approccio europeo alla tratta.

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The aim of this thesis was to validate the use of infrared thermography (IRT) to non-invasively measure emotional reactions to different situations in pet dogs (Canis familiaris). A preliminary test, aimed to evaluate the correlation between eye-temperature and rectal temperature in dog, was performed. Then, in three different situations, negative (veterinary visit), positive (palatable food rewards), and mildly stressing followed by mildly positive (separation from and reunion with the owner), variations in heat emitted from lacrimal caruncle (referred to as eye temperature) were measured with an infrared thermographic camera. In addition, heart rate and heart rate variability parameters were collected using a non-invasive heart rate monitor designed for human use and validated on dogs. All experiments were video recorded to allow behavioral coding. During the negative situation dogs’ level of activity and stress related behaviors varied across compared to the baseline and dogs showed an increase in eye temperature despite having a significant decrease in the level of activity. The positive situation was characterized by a peak in eye temperature and mean HR and dogs engaged in behaviors indicating a positive arousal, focusing on food treats and tail wagging but there were not variations in HRV during stimulation but only an increment in SDNN immediately after the stimulus. In the separation from and reunion with the owner dogs’ eye temperature and mean HR did not vary neither in the stressful nor in the positive situations, RMSSD increased after the positive episode, SDNN dropped during the two stimulations and it increased after the stimulations. During the separation from the owner dogs were mainly directed to the door or to the experimenter while during the reunion with the owner dogs were focused mainly on the owner and on the environment, exhibiting safe base effect. A different approach was used to assess the welfare of shelter dogs. Dogs were implanted with a telemeter and after implantation dogs were housed in sequence in four different situations lasting 1 week: alone, alone with toys and a stretch cot for sleeping, with an unknown, spayed, female, and alone with a daily 2-hours interaction with an experimenter. Two different approaches were tried: partially random extracted fragments from every week, behaviors from 8 a.m. to 4 p.m. were continuous during baseline and the female situation. Results showed different reactions by dogs to the different situations and interestingly not all enrichments were enjoyed by the dogs improving their welfare. Overall results suggest that IRT may represent a useful tool to investigate emotional reactions in dogs. Nevertheless, further research is needed to establish the specificity and sensivity of IRT in this context and to assess how different dogs’ characteristics, breed, previous experience and the valence and arousal elicited by the stimulus could influence the magnitude and type of the response. The role of HRV in understanding emotional valence and the one of telemeters in understanding long-term effects on sheltered dogs’ welfare is also discussed.

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Stories, fables, and myths have been used for a long time in human history. They serve as a way for cultures and people to communicate, preserve important cultural values, and create meaning. The use of narratives has been recognized as a helpful technique in the field of psychology and can be found in many orientations and intervention techniques (Dwivedi, 2006; Roberts, 2000). Narrative therapy, bibliotherapy, trauma narratives, and Therapeutic Assessment (TA) are some of the areas in which the benefits of using written stories are incorporated into work with clients. In this paper, the clinical utility of using Therapeutic Assessment style fables in the termination phase of psychotherapy is explored. The termination phase is a challenging time for both therapists and clients. The use of rituals in the process of termination has been found to have a positive impact on the experience (Gutheil, 1993). This paper presents several case studies and examines the subsequent impact and clinical benefits of using termination fables in psychotherapy.

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As the demography of the U.S. population becomes increasingly older and culturally diverse, psychologists must develop greater multicultural competency and abilities to provide culturally and linguistically appropriate clinical services. This paper focuses on the dire need for the development of multicultural approach to medical decisional capacity evaluation. The purpose of this paper is to examine the common clinical and ethical dilemmas faced by psychologists when evaluating culturally diverse geriatric population. For instance, the lack of culturally and linguistically appropriate cognitive and functional assessment measures with sound reliability, validity, and normative properties is discussed in detail. This paper introduces possible solutions to the dilemmas and aims to ultimately contribute to increased multicultural awareness within the U.S. healthcare system.

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Background: The harmonization of European health systems brings with it a need for tools to allow the standardized collection of information about medical care. A common coding system and standards for the description of services are needed to allow local data to be incorporated into evidence-informed policy, and to permit equity and mobility to be assessed. The aim of this project has been to design such a classification and a related tool for the coding of services for Long Term Care (DESDE-LTC), based on the European Service Mapping Schedule (ESMS). Methods: The development of DESDE-LTC followed an iterative process using nominal groups in 6 European countries. 54 researchers and stakeholders in health and social services contributed to this process. In order to classify services, we use the minimal organization unit or “Basic Stable Input of Care” (BSIC), coded by its principal function or “Main Type of Care” (MTC). The evaluation of the tool included an analysis of feasibility, consistency, ontology, inter-rater reliability, Boolean Factor Analysis, and a preliminary impact analysis (screening, scoping and appraisal). Results: DESDE-LTC includes an alpha-numerical coding system, a glossary and an assessment instrument for mapping and counting LTC. It shows high feasibility, consistency, inter-rater reliability and face, content and construct validity. DESDE-LTC is ontologically consistent. It is regarded by experts as useful and relevant for evidence-informed decision making. Conclusion: DESDE-LTC contributes to establishing a common terminology, taxonomy and coding of LTC services in a European context, and a standard procedure for data collection and international comparison.

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Background: The assessment of attitudes toward school with the objective of identifying adolescents who may be at risk of underachievement has become an important area of research in educational psychology, although few specific tools for their evaluation have been designed to date. One of the instruments available is the School Attitude Assessment Survey-Revised (SAAS-R). Method: The objective of the current research is to test the construct validity and to analyze the psychometric properties of the Spanish version of the SAAS-R. Data were collected from 1,398 students attending different high schools. Students completed the SAAS-R along with measures of the g factor, and academic achievement was obtained from school records. Results: Confirmatory factor analysis, multivariate analysis of variance and analysis of variance tests supported the validity evidence. Conclusions: The results indicate that the Spanish version of the SAAS-R is a useful measure that contributes to identification of underachieving students. Lastly, the results obtained and their implications for education are discussed.

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The goals of this program of research were to examine the link between self-reported vulvar pain and clinical diagnoses, and to create a user-friendly assessment tool to aid in that process. These goals were undertaken through a series of four empirical studies (Chapters 2-6): one archival study, two online studies, and one study conducted in a Women’s Health clinic. In Chapter 2, the link between self-report and clinical diagnosis was confirmed by extracting data from multiple studies conducted in the Sexual Health Research Laboratory over the course of several years. We demonstrated the accuracy of diagnosis based on multiple factors, and explored the varied gynecological presentation of different diagnostic groups. Chapter 3 was based on an online study designed to create the Vulvar Pain Assessment Questionnaire (VPAQ) inventory. Following the construct validation approach, a large pool of potential items was created to capture a broad selection of vulvar pain symptoms. Nearly 300 participants completed the entire item pool, and a series of factor analyses were utilized to narrow down the items and create scales/subscales. Relationships were computed among subscales and validated scales to establish convergent and discriminant validity. Chapters 4 and 5 were conducted in the Department of Obstetrics & Gynecology at Oregon Health & Science University. The brief screening version of the VPAQ was employed with patients of the Program in Vulvar Health at the Center for Women’s Health. The accuracy and usefulness of the VPAQscreen was determined from the perspective of patients as well as their health care providers, and the treatment-seeking experiences of patients was explored. Finally, a second online study was conducted to confirm the factor structure, internal consistency, and test-retest reliability of the VPAQ inventory. The results presented in these chapters confirm the link between targeted questions and accurate diagnoses, and provide a guideline that is useful and accessible for providers and patients.