Furthermore, there were high rates of undiagnosed and untreated comorbidities, such as hypertension and dyslipidemia, that increase risk for cardiovascular disease. Baseline risk assessment using the ASCVD (Atherosclerotic Cardiovascular Disease) and QRISK3 calculators showed higher-than-expected cardiovascular risk, particularly given the young age of our patient population.

Transgender individuals are at high baseline cardiovascular risk. These data help fill some important knowledge gaps in this patient subgroup, and provide us with much-needed data to help guide our management and counseling of individuals seeking this type of care.

Transgender individuals are at high baseline cardiovascular risk. These data help fill some important knowledge gaps in this patient subgroup, and provide us with much-needed data to help guide our management and counseling of individuals seeking this type of care.

The vascular response to injury leads to the secretion of several factors, including platelet-derived growth factor (PDGF-BB). PDGF-BB stimulates smooth muscle cell (SMC) conversion to the synthetic phenotype, thereby enhancing proliferation and migration, and contributing to neointimal hyperplasia. Likewise, the cAMP response element binding protein (CREB) transcription factor has been shown to mediate SMC proliferation in response to various mitogens. We therefore investigated the contribution of CREB to PDGF-BB-dependent proliferation of SMCs with the intention of identifying signaling pathways involved both up and downstream of CREB activation.

Treatments were performed on vascular SMCs from a porcine coronary artery explant model. The role of CREB was examined via adenoviral expression of a dominant-negative CREB mutant (kCREB) as well as inhibition of CREB binding protein (CBP). Involvement of the p27

pathway was determined using a constitutively expressing p27

adenoviral vector. PDGF-BB stimulated transient CREB phosphorylation on Ser-133 via ERK1/2-, PI3-kinase- and Src-dependent pathways. Expression of kCREB decreased PDGF-BB-dependent cell proliferation. PCNA expression and Rb phosphorylation were also inhibited by kCREB. These cell cycle proteins are controlled via p27

expression in response to CREB-dependent post-translational modification of FoxO1. kCREB had no effect on Cyclin D1 expression, but did prevent PDGF-BB-induced Cyclin D1 nuclear translocation. An interaction inhibitor of CBP confirmed that Cyclin D1 is downstream of PDGF-BB and CREB.

CREB phosphorylation is required for SMC proliferation in response to PDGF-BB. This phenotypic change requires CBP and is mediated by Cyclin D1 and p27

as a result of changes in FoxO1 activity.

CREB phosphorylation is required for SMC proliferation in response to PDGF-BB. This phenotypic change requires CBP and is mediated by Cyclin D1 and p27kip as a result of changes in FoxO1 activity.Editor’s Note For over two decades, The Joint Commission has developed and disseminated Sentinel Event Alerts (SEAs). SEAs identify specific types of adverse events and high-risk conditions, describe their underlying causes, and recommend steps to reduce risk and prevent future occurrences. Health care organizations should consider the information in SEAs when designing or redesigning processes, including specific suggestions contained in the alerts to mitigate risks. Recently, The Joint Commission decided that co-publishing SEAs in the Journal would help expand dissemination efforts by reaching beyond health care organizations to the broader quality and safety community, including researchers and policymakers. In this issue, we are proud to publish Sentinel Event Alert 63 Optimizing Smart Infusion Pump Safety with DERS (dose error reduction software). The SEA describes actions health care organizations can take to reduce the risk of errors caused by the misuse of smart infusion pumps, especially errors that can be avoided by the optimal use of DERS. We will co-publish future SEAs that we think would be of interest to the Journal’s audience. We hope you enjoy this new addition to the Journal.

To explore how pregnant women with obesity feel about their bodies before and during pregnancy.

Qualitative descriptive design.

Obstetric and gynecologic offices in a rural setting in Maryland that employed physicians and midwives as prenatal care providers.

A purposive sampling technique was used to recruit a sample of 20 women. Inclusion criteria were pregnant women ages 18 to 35 years with a prepregnancy body mass index of greater than 30kg/m

, in the third trimester of the pregnancy (28-40weeks gestation), and receiving regular prenatal care from a licensed provider.

A typology analysis chart was used to group participants’ responses from their interviews in the areas of positive or negative feelings regarding their prepregnancy body and weight, and positive or negative feelings regarding their pregnant body.

Data were analyzed using a four-square matrix by identifying those participants who felt positive regarding their prepregnancy body/weight and pregnant body (n= 6), felt negative regarding their prepregnancy body/weight and pregnant body (n= 3), felt negative regarding their prepregnant body but positive regarding their pregnant body (n= 8), and felt positive regarding their prepregnant body but negative about their pregnant body (n= 3).

Pregnancy had allowed many of the women to gain a sense of achievement, where the growth of the fetus and subsequent weight gain were seen as positive attributes, and they embraced the functionality of their bodies.

Pregnancy had allowed many of the women to gain a sense of achievement, where the growth of the fetus and subsequent weight gain were seen as positive attributes, and they embraced the functionality of their bodies.Ambulance vehicles are an essential part of emergency clinical services. Bioburden control in ambulances, through cleaning and disinfection, is crucial to minimize hospital-acquired infections, cross contamination and exposure of patients and ambulances’ crew. In Portugal, firefighter crews are responsible, besides fire extinction, for first aid and urgent pre-hospital treatment. This study assessed the bioburden in Portuguese firefighters’ ambulances with a multi-approach protocol using active and passive sampling methods. Fungal resistance profile and mycotoxins detection in ambulances’ ambient, and S. buy DX3-213B aureus (SA) prevalence and resistance profile in ambulances’ ambient and colonization in workers were also investigated. Toxigenic fungi with clinical relevance, namely Aspergillus section Fumigati, were found on ambulance’s air in the hazardous dimension range. Interestingly, surface contamination was higher after cleaning in several sampling sites. Prevalence of S. aureus was 3% in environmental samples, of which 2% were methicillin-sensitive (MSSA) and 1% methicillin-resistant (MRSA).