Search

Natural transformation is the process by which bacteria actively take up and integrate extracellular DNA into their genomes. In cyanobacteria, natural transformation has only been experimentally demonstrated in a few species. Although cyanobacteria are important model systems for studying photosynthesis and circadian cycling, natural transformation in cyanobacteria has not been characterized to the degree that the process has been studied in other Gram-negative bacteria. Two cyanobacterial species that are 99.8% genetically identical provide a unique opportunity to better understand the nuances of natural transformation in cyanobacteria: Synechococcus elongatus PCC 7942 and Synechococcus elongatus UTEX 2973 (hereafter called Synechococcus 7942 and Synechococcus 2973, respectively). Synechococcus 7942 is a naturally transformable model system, while Synechococcus 2973 is a recently discovered species that is not naturally competent. Taking only 1.5 h to replicate, Synechococcus 2973 is the fastest-growing cyanobacterial species known and thus is a strong candidate for serving as a model organism. However, its inability to undergo natural transformation has prevented it from becoming a widely used model system. By substituting polymorphic alleles from Synechococcus 7942 for native Synechococcus 2973 alleles, natural transformation was introduced into Synechococcus 2973. Two genetic loci were found to be involved in differential natural competence between the two organisms: transformation pilus component pilN and circadian transcriptional master regulator rpaA. By using targeted genome editing and enrichment outgrowth, a strain that was both naturally transformable and fast-growing was created. This new Synechococcus 2973-T strain will serve as a valuable resource to the cyanobacterial research community. [ABSTRACT FROM AUTHOR]

Novel models that improve generalist-level palliative care for cystic fibrosis (CF) are needed to address the burden of this illness. A screening-and-triage model has the potential to identify clinical problems requiring immediate follow-up by CF professionals. This study describes such a model and its immediate impact on care delivery for CF patients during a two-year period. Eligible adults completed monthly online screening for sources of distress. If results revealed one or more "indicators of concern" on two consecutive screenings, this triggered an attempted triage by a social worker. Completed triages led to prompt follow-up by CF professionals for clinical problems, if indicated. Process data were summarized and generalized linear mixed models were used to evaluate baseline patient characteristics (symptom distress, quality of life, and sociodemographics) associated with the need for prompt follow-up. A total of 1,015 monthly surveys were completed by 74 patients; 634 (66 patients) had > 1 indicators of concern; and 164 surveys (46 patients) had > 1 indicators for two consecutive surveys (e.g., global distress, pain, dyspnea, and psychological symptoms). The 164 attempted triages yielded 84 completed triages (51.2%), of which 39 (46.4%) required prompt follow-up. In multivariable analyses, older patients and those with higher symptom distress at baseline were more likely to require prompt follow-up (p <.05). Web-based screening that assesses varied domains of distress or burden can identify a subset of CF patients whose clinical problems may benefit from immediate medical or psychological attention. Additional investigations should improve screening efficiency. [ABSTRACT FROM AUTHOR]

Background ATX-101 (deoxycholic acid injection, Kythera Biopharmaceuticals, Inc.) is a proprietary formulation of pure synthetic deoxycholic acid ( DCA). It is undergoing clinical investigation as an injectable drug for contouring the submental area by reducing submental fat ( SMF). When injected into subcutaneous fat, ATX-101 causes focal adipocytolysis, the targeted destruction of fat cells. Objectives This phase 1 study evaluated the safety, pharmacokinetics ( PK), and pharmacodynamic effects of ATX-101 (100-mg total dose). Methods Following PK evaluation of baseline endogenous DCA, lipids, and adipokines in the initial stage of the study (samples collected at hours 0.25, 0.5, 1, 1.5, 2, 4, 6, 12, 15.5, and 24.5), 10 subjects received subcutaneous injections of ATX-101 into abdominal fat. PK evaluation of DCA, lipids, and adipokines was repeated in the second phase of the study. Results After ATX-101 injections, plasma concentration of DCA increased transiently, reached a maximum plasma concentration rapidly, and returned to endogenous concentrations within 12 h postdose. ATX-101 injection was not associated with any clinically meaningful changes in systemic concentrations of total cholesterol, total triglycerides, free fatty acids, C-reactive protein, or interleukin-6. Adverse events were mild in severity, transient, and showed a temporal relationship to dosing. Conclusions This study demonstrated favorable safety and PK profiles, and no clinically meaningful changes in DCA, lipids, and proinflammatory cytokines following subcutaneous injection of ATX-101. Our results support continued clinical investigation of ATX-101 as an injectable drug to reduce SMF. [ABSTRACT FROM AUTHOR]

Although collaboration is not a new idea, new opportunities for collaboration exist in this 21st century global-knowledge and information-driven economy. Technology has reduced time and space while enhancing communication, thereby opening the possibilities of exploring new boundaries in the area of interdisciplinary collaboration. The goal of this article is to assist leaders in changing the language of organizations so that new technologies can enhance collaboration. A systematic approach for leaders to use in assisting assist persons, groups, and organizations in integrating new technologies into their organizations locally and globally is offered, along with a summary of new, and several established, collaboration techniques. [ABSTRACT FROM AUTHOR]

Smoking cessation among African Americans is a primary health objective for the nation. African American women are more likely than their counterparts to have a high dependency upon nicotine. Studies with African American women report lower quit rates than those for whites. A culturally sensitive pilot project was designed for African American women to investigate smoking, perception of family environment (FES-R, Life Events Scale, family survey), feasibility of family-focused followup sessions, and an exercise program. Baseline cigarettes were negatively correlated with the FES-R subscales for cohesion, active-recreational orientation, and moral/ religious emphasis; they were positively correlated with negativity in an important relationship. Predictors of ending cigarettes were scores for life events internal to the family and the FES-R subscale for independence. Interview and survey data identified potential sources of social support and perceived relational injustices. Future studies will explore expressed emotion, relational ethics, and interventions that improve relationships. [ABSTRACT FROM AUTHOR]

Presents information on a study that determined the protection provided by the immunostimulatory CpG-containing oligodeoxynucleotides, known for promoting T helper 1 immune response, from Leishmania infection coinjected in a BALB/c mice. Materials and methods; Results; Discussion.

An estimated 257 million persons worldwide have chronic hepatitis B virus (HBV) infection (1). CDC recommends HBV testing for persons from countries with intermediate to high HBV prevalence (≥2%), including newly arriving refugees (2). Complications of chronic HBV infection include liver cirrhosis and hepatocellular carcinoma, which develop in 15%-25% of untreated adults infected in infancy or childhood (3). HBV-infected patients require regular monitoring for both infection and sequelae. Several studies have evaluated initial linkage to HBV care for both refugee and nonrefugee immigrant populations (4-9), but none contained standardized definitions for either linkage to or long-term retention in care for chronic HBV-infected refugees. To assess chronic HBV care, three urban sites that perform refugee domestic medical examinations and provide primary care collaborated in a quality improvement evaluation. Sites performed chart reviews and prospective outreach to refugees with positive test results for presumed HBV infection during domestic medical examinations. Linkage to care (29%-53%), retention in care (11%-21%), and outreach efforts (22%-71% could not be located) demonstrated poor access to initial and ongoing HBV care. Retrospective outreach was low-yield. Interventions that focus on prospective outreach and addressing issues related to access to care might improve linkage to and retention in care. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article about the attention and care that should be directed to refugee camps and vulnerable population to stop the transmission of infectious disease like eosinophilia among refugees.

The present study examined costs of two residential substance abuse treatment programs designed for urban American Indians and Alaska Natives (AI/ANs). Costs for one agency were well within national norms, while costs at the other program were less than expected from nationwide data. Economies of scale accounted for much of the difference between observed and expected costs. Culturally specific residential substance abuse treatment services can be provided to urban AI/ANs within budgets typically found at mainstream programs. [ABSTRACT FROM AUTHOR]

Although residential substance abuse treatment is utilized extensively by urban American Indians and Alaska Natives (AI/ANs), there are few detailed descriptions of this care. This study delineated services provided by and interviewed staff working at residential programs designed for chemically dependent urban AI/ANs. Study agencies were compared to national data from residential programs serving general population clients. Study agencies delivered arrays of services substantially broader than those provided by general population programs. As well as culturally specific programs tailored for AI/ANs plus so-called "mainstream" substance abuse treatments, study facilities provided numerous ancillary services, such as care for clients' children. [ABSTRACT FROM AUTHOR]

Background Cystic fibrosis (CF) causes high illness burden. Screening may identify patients who could potentially benefit from interventions for symptoms or other sources of distress. We evaluated the feasibility of a web-based system for routine monitoring. Methods Adult CF patients enrolled in a study of palliative care service delivery completed web-based assessments every 30 days on global distress, physical and psychological symptom distress, and the perceived benefits of discussing advance care planning (ACP) with CF clinicians. Feasibility was assessed by the rate of survey completion, survey reminders, and missed surveys during a 9-month rolling enrollment period. Results Of 74 participants (47.3% women, 94.4% white), 36.7% had comorbid diabetes, and 56.9% had an FEV1% predicted score of 40–69. In total, patients completed 456 (80.6%) of 566surveys every 30 days over the assessment period. Sixty-five (87.8%) completed 405 (79.7%) of 508 surveys online and 9 (12.2%) completed 51 (88.0%) of 58 surveys using a combination of online, telephone, and mail-based methods. Many surveys were completed without reminders (online: 261 [64.4%] of 405; combined methods: 29 [56.9%] of 51), with 166 (36.4%) surveys requiring 1 or more reminders. Further, 23.0% (17) of patients noted elevated global distress; 20.3% (15) endorsed physical symptom distress, 12.2% (9) had psychological distress, and 58.1% (43) reported that discussing ACP would be beneficial. Conclusions Repeated web-based screening for symptom distress and ACP preferences is feasible in adult CF patients. Future studies should assess the system's generalizability and staff resources when implementing reminders and non-web methods of completion. [ABSTRACT FROM AUTHOR]

Discusses alcohol and drug education in schools of nursing. Provision of minimal exposure to important concepts in addictions; Intervention with chemically dependent patients; Chemical dependency training.

Background: Despite achievements in the reduction of malaria globally, imported malaria cases to the United States by returning international travelers continue to increase. Immigrants to the United States from sub-Saharan Africa (SSA) who then travel back to their homelands to visit friends and relatives (VFRs) experience a disproportionate burden of malaria illness. Various studies have explored barriers to malaria prevention among VFRs and non-VFRs–travelers to the same destinations with other purpose for travel–but few employed robust epidemiologic study designs or performed comparative analyses of these two groups. To better quantify the key barriers that VFRs face to implement effective malaria prevention measures, we conducted a comprehensive community-based, cross-sectional, survey to identify differences in malaria prevention knowledge, attitudes, and practices (KAP) among VFRs and others traveling to Africa and describe the differences between VFRs and other types of international travelers. Methods and findings: Three distinct populations of travelers with past or planned travel to malaria-endemic countries of SSA were surveyed: VFRs diagnosed with malaria as reported through a state health department; members of the general VFR population (community); and VFR and non-VFR travelers presenting to a travel health clinic, both before their pretravel consultation and again, after return from travel. A Community Advisory Board of African immigrants and prior qualitative research informed survey development and dissemination. Across the three groups, 489 travelers completed surveys: 351 VFRs and 138 non-VFRs. VFRs who reported taking antimalarials on their last trip rated their concern about malaria higher than those who did not. Having taken five or more trips to SSA was reported more commonly among VFRs diagnosed with malaria than community VFRs (44.0% versus 20.4%; p = 0.008). Among travel health clinic patients surveyed before and after travel, VFR travelers were less successful than non-VFRs in adhering to their planned use of antimalarials (82.2% versus 98.7%; p = 0.001) and employing mosquito bite avoidance techniques (e.g., using bed nets: 56.8% versus 81.8%; p = 0.009). VFRs who visited the travel health clinic were more likely than VFR respondents from the community to report taking an antimalarial (83.0% versus 61.9%; p = 0.009), or to report bite avoidance behaviors (e.g., staying indoors when mosquitoes were out: 80.9% versus 59.5%; p = 0.009). Conclusions: We observed heterogeneity in malaria prevention behaviors among VFRs and between VFR and non-VFR traveler populations. Although VFRs attending the travel health clinic appear to demonstrate better adherence to malaria prevention measures than VFR counterparts surveyed in the community, specialized pretravel care is not sufficient to ensure chemoprophylaxis use and bite avoidance behaviors among VFRs. Even when seeking specialized pretravel care, VFRs experience greater barriers to the use of malaria prevention than non-VFRs. Addressing access to health care and upstream barrier reduction strategies that make intended prevention more achievable, affordable, easier, and resonant among VFRs may improve malaria prevention intervention effectiveness. [ABSTRACT FROM AUTHOR]

Background: Plasma cell dyscrasias (PCD) are a spectrum of disorders resulting from the clonal expansion of plasma cells, ranging from the pre-malignant condition monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma (MM). MM generates a significant burden of disease on the community and it is predicted that it will increase in both incidence and prevalence owing to an ageing population and longer survival secondary to new therapeutic options. Robust and comprehensive clinical data are currently lacking but are required to define current diagnostic, investigational and management patterns in Australia and New Zealand (ANZ) for comparison to both local and international guidelines for standards of care. A clinical registry can provide this information and subsequently support development of strategies to address any differences, including providing a platform for clinical trials. The Myeloma and Related Diseases Registry (MRDR) was developed to monitor and explore variations in practices, processes and outcomes in ANZ and provide benchmark outcomes nationally and internationally for PCD. This paper describes the MRDR aims, development and implementation and discusses challenges encountered in the process. Methods: The MRDR was established in 2012 as an online database for a multi-centre collaboration across ANZ, collecting prospective data on patients with a diagnosis of MGUS, MM, solitary plasmacytoma or plasma cell leukaemia. Development of the MRDR required multi-disciplinary team participation, IT and biostatistical support as well as financial resources. Results: More than 1250 patients have been enrolled at 23 sites to date. Here we describe how database development, data entry and securing ethics approval have been major challenges for participating sites and the coordinating centre, and our approaches to resolving them. Now established, the MRDR will provide clinically relevant and credible monitoring, therapy and 'real world' outcome data, to support the conduction of high quality studies. In addition, the Myeloma 1000 sub-study is establishing a repository of paired peripheral blood specimens from registry patients to study mechanisms underlying disease progression. Conclusion: Establishment of the MRDR has been challenging, but it is a valuable investment that will provide a platform for coordinated national and international collaboration for clinical research in PCD in ANZ. [ABSTRACT FROM AUTHOR]

Discusses the health factors of the populations of immigrants and refugees, as it relates to the transmission of infectious diseases. Limitation of the global ability to generate numerators; What the migrant populations have been displaced by; Portrayal of appreciation by public health workers; Examination of chlorea, which is a disease that affects migrant populations.

Introduction: When Hmong refugees arrived in the U.S. from 1975 to 1997, no epidemiological studies measured the prevalence of or development of cardiovascular diseases (CVD) (such as hypertension and diabetes) or CVD risk factors (such as obesity, high blood pressure, and high cholesterol). Some recent studies on convenience samples estimated prevalence rates as: overweight 49%, obesity 31%, hypertension 18-24%, and diabetes 13-40%. This study measured the prevalence of CVD and CVD risk factors in Hmong refugees recently arrived from an unofficial refugee camp at War Tham Krabok (WTK), Thailand. Methods: Cross-sectional descriptive epidemiological study of 1462 Hmong refugees from WTK who received refugee screening exams at seven primary care clinics in St. Paul MN, from June 2004 to December 2005. Results: Significant percents of adults and children/adolescents had CVD risk factors. Of 448 people >20 years old, 48.2% were overweight or obese (BMI >=25). Using Asian BMI, 71.7% were overweight or obese (BMI >=23). Also, 16.5% had hypertension (BP-systolic > 140 or BP-diastolic >90) and 36.2% had pre-hypertension (BP-systolic 120-139 or BP-diastolic 80-89). For a subset, 2.8% had diabetes mellitus (glucose >200), 31.7% had hyperglycemia (glucose 100-199), 25.8% had hyperlipidemia (total cholesterol >200), 7.4% had renal failure (GFR7.5 female, >8.2 male). For 988 people 0-20 years old, 13.7% were overweight and 9.6% had hypertension. For a subset, 20.7% had hyperglycemia, and 13.% had hyperlipidemia. Conclusion: Hmong refugees had significant CVD risk factors on arrival, and are at risk for developing significant CVD over time. Community health programs need to be implemented to decrease the development of CVD for the Hmong community, whether people arrived in 1975-1997 or 2004-2005. And an epidemiological study measuring CVD incidence needs to be conducted. [ABSTRACT FROM AUTHOR]