How organisational arrangements affect service provision

This research shows the importance of good organisational support for care giving. Organisational arrangements can shape what individual staff members do in the highly skilled work of meeting resident needs. This may challenge traditional views about care quality that focus attention only on care workers

Adult Patients Living with Human Immunodeficiency Virus Hospitalized for Community-Acquired Pneumonia in the United States: Incidence and Outcomes

Background: Community-acquired pneumonia (CAP) is a common infectious reason for hospitalization of adults in the United States (US), including those with Human Immunodeficiency Virus (HIV). While there are studies detailing the incidence and outcomes for all adults with CAP we are not aware of a recent study detailing incidence and outcomes in adult HIV patients hospitalized with CAP. The objectives of this study were (1) to define the current incidence and outcomes of adult HIV patients hospitalized with CAP in Louisville, Kentucky, and (2) to estimate the burden of CAP in the US HIV adult population. Methods: This was a secondary analysis of The University of Louisville Pneumonia Study; a prospective population-based cohort study of all hospitalized adults with CAP who were residents of Louisville, Kentucky, from 1 June 2014 to 31 May 2016. Results: A total of 110 unique patients living with HIV were hospitalized with CAP during our two-year study. The annual incidence of adults living with HIV hospitalized with CAP is estimated to be 1,950 per 100,000. Of the estimated 1.1 million adults living with HIV in the US currently we predict that 21,450 will be hospitalized with CAP annually. The median time to clinical stability in adult patients living with HIV hospitalized with CAP was 2 (IQR: [1, 3]) days. The median length of stay for adult patients living with HIV hospitalized with CAP was 4 (IQR: [3, 7]) days. Mortality occurred as follows; in-hospital: 1.8%, 30-day 6.8%, 6-month 15.5%, and 1 year 20.2%. Conclusion: The estimated annual incidence of adult patients living with HIV and hospitalized with CAP was found to be 1,950 per 100,000 suggesting that 21,450 adults living with HIV will be admitted with CAP yearly across the US. This is a similar incidence to that recently predicted for the elderly. Mortality occurred as follows; in-hospital: 1.8%, 30-day 6.8%, 6-month 15.5%, and 1 year 20.2%. Our 30-day mortality rate for adult patients living with HIV hospitalized for CAP was similar to other figures in the literature

A novel method for comparison of arterial remodeling in hypertension: Quantification of arterial trees and recognition of remodeling patterns on histological sections

Remodeling of spatially heterogeneous arterial trees is routinely quantified on tissue sections by averaging linear dimensions, with lack of comparison between different organs and models. The impact of experimental models or hypertension treatment modalities on organ-specific vascular remodeling remains undefined. A wide variety of arterial remodeling types has been demonstrated for hypertensive models, which include differences across organs. The purpose of this study was to reassess methods for measurement of arterial remodeling and to establish a morphometric algorithm for standard and comparable quantification of vascular remodeling in hypertension in different vascular beds. We performed a novel and comprehensive morphometric analysis of terminal arteries in the brain, heart, lung, liver, kidney, spleen, stomach, intestine, skin, skeletal muscle, and adrenal glands of control and Goldblatt hypertensive rats on routinely processed tissue sections. Mean dimensions were highly variable but grouping them into sequential 5 μm intervals permitted creation of reliable linear regression equations and complex profiles. Averaged arterial dimensions demonstrated seven remodeling patterns that were distinct from conventional inward-outward and hypertrophic-eutrophic definitions. Numerical modeling predicted at least nineteen variants of arterial spatial conformations. Recognition of remodeling variants was not possible using averaged dimensions, their ratios, or the remodeling and growth indices. To distinguish remodeling patterns, a three dimensional modeling was established and tested. The proposed algorithm permits quantitative analysis of arterial remodeling in different organs and may be applicable for comparative studies between animal hypertensive models and human hypertension. Arterial wall tapering is the most important factor to consider in arterial morphometry, while perfusion fixation with vessel relaxation is not necessary. Terminal arteries in organs undergo the same remodeling pattern in Goldblatt rats, except for organs with hemodynamics affected by the arterial clip. The existing remodeling nomenclature should be replaced by a numerical classification applicable to any type of arterial remodeling

Heart Development, Coronary Vascularization and Ventricular Maturation in a Giant Danio (Devario malabaricus)

Giant danios (genus Devario), like zebrafish, are teleosts belonging to the danioninae subfamily of cyprinids. Adult giant danios are used in a variety of investigations aimed at understanding cellular and physiological processes, including heart regeneration. Despite their importance, little is known about development and growth in giant danios, or their cardiac and coronary vessels development. To address this scarcity of knowledge, we performed a systematic study of a giant danio (Devario malabaricus), focusing on its cardiac development, from the segmentation period to ten months post-fertilization. Using light and scanning electron microscopy, we documented that its cardiovascular development and maturation proceed along well defined dynamic and conserved morphogenic patterns. The overall size and cardiovascular expansion of this species was significantly impacted by environmental parameters such as rearing densities. The coronary vasculature began to emerge in the late larval stage. More importantly, we documented two possible loci of initiation of the coronary vasculature in this species, and compared the emergence of the coronaries to that of zebrafish and gourami. This is the first comprehensive study of the cardiac growth in a Devario species, and our findings serve as an important reference for further investigations of cardiac biology using this species

A demonstration of an affinity between pyrite and organic matter in a hydrothermal setting

One of the key-principles of the iron-sulphur world theory is to bring organic molecules close enough to interact with each other, using the surface of pyrite as a substrate in a hydrothermal setting. The present paper explores the relationship of pyrite and organic matter in a hydrothermal setting from the geological record; in hydrothermal calcite veins from Carboniferous limestones in central Ireland. Here, the organic matter is accumulated as coatings around, and through, pyrite grains. Most of the pyrite grains are euhedral-subhedral crystals, ranging in size from ca 0.1-0.5 mm in diameter, and they are scattered throughout the matrix of the vein calcite. The organic matter was deposited from a hydrothermal fluid at a temperature of at least 200°C, and gives a Raman signature of disordered carbon. This study points to an example from a hydrothermal setting in the geological record, demonstrating that pyrite can have a high potential for the concentration and accumulation of organic materials

A list of tools is NOT enough! Professionals’ advice on how to implement a Core Outcome Set in practice

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Lanthanopolyoxotungstates in silica nanoparticles: multi-wavelength photoluminescent core/shell materials

We thank Dr Marc Willinger and the RNME (National Electronic Microscopy Network, Portugal) for HRTEM images. Electronic supplementary information (ESI) available: FT-IR and FT-Raman spectra, additional HRTEM images and complementary photoluminescence spectra details, see DOI: 10.1039/b919691a.Photoluminescent lanthanopolyoxotungstate core/shell nanoparticles are prepared by the encapsulation of lanthanide-containing polyoxometalates (POMs) with amorphous silica shells. The preparation of morphological well-defined core/shell nanoparticles is achieved by the hydrolysis of tetraethoxysilane in the presence of POMs using a reverse microemulsion method. The POMs used are decatungstolanthanoates of [Ln(W(5)O(18))(2)](9-) type (Ln(III) = Eu, Gd and Tb). Photoluminescence studies show that there is efficient emission from the POM located inside the SiO(2) shells, through excitation paths that involve O --> Eu/Tb and O --> W ligand-to-metal charge transfer. It is also shown that the excitation of the POM containing europium(III) may be tuned towards longer wavelengths via an antenna effect, by coordination of an organic ligand such as 3-hydroxypicolinate. The POM/SiO(2) nanoparticles form stable suspensions in aqueous solution having the advantage of POM stabilization inside the core and the possibility of further surface grafting of chemical moieties via well known derivatization procedures for silica surfaces. These features together with the possibility of tuning the excitation wavelength by modifying the coordination sphere in the lanthanopolyoxometalate, make this strategy promising to develop a new class of optical bio-tags composed of silica nanobeads with multi-wavelength photoluminescent lanthanopolyoxometalate cores.FCT- POCI/QUI/58887/2004FCT- PTDC/ QUI/67712/2006FCT- SFRH/BD/30137/2006FCT- SFRH/BPD/14954/200

Modulación de la microbiota intestinal de un niño obeso con cepas aisladas de leche materna

Una incorrecto desarrollo de la microbiota intestinal ha sido señalado como un factor temprano clave involucrado en la aparición de enfermedades metabólicas como obesidad y diabetes tipo 2, junto a otros factores como cesárea, alimentación inadecuada, sedentarismo y estrés. La intervención temprana en la obesidad infantil ha sido propuesta por la Organización Mundial de la Salud, en este sentido los probióticos y prebióticos han demostrado resultados prometedores mediante la modulación de la microbiota intestinal y sus metabólitos, como los ácidos grasos de cadena corta (AGCC) y los iones amonio. Modelos dinámicos in vitro del tracto gastrointestinal humano como el SHIME (Simulator of the Human Intestinal Microbial Ecosystem), permiten el estudio de nuevos probióticos. El SHIME es un sistema capaz de simular las condiciones fisiológicas de diferentes secciones del tracto gastrointestinal (estómago, duodeno y colon), permitiendo el análisis de la comunidad microbiana del colon. El objetivo de este trabajo fue evaluar el impacto de 2 cepas probióticas aisladas de leche materna, Lactobacillus plantarum 73A y Bifidobacterium animalis subsp. lactis INL1, sobre la microbiota intestinal obtenida de un niño con obesidad utilizando el SHIME.Fil: Oddi, Sofia Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Lactología Industrial. Universidad Nacional del Litoral. Facultad de Ingeniería Química. Instituto de Lactología Industrial; ArgentinaFil: Huber, Maria Paula. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto Nacional de Limnología. Universidad Nacional del Litoral. Instituto Nacional de Limnología; ArgentinaFil: Reinheimer, Jorge Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Lactología Industrial. Universidad Nacional del Litoral. Facultad de Ingeniería Química. Instituto de Lactología Industrial; ArgentinaFil: Burns, Patricia Graciela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Lactología Industrial. Universidad Nacional del Litoral. Facultad de Ingeniería Química. Instituto de Lactología Industrial; ArgentinaFil: Duque, Ana Luisa. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilFil: Vinderola, Celso Gabriel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Lactología Industrial. Universidad Nacional del Litoral. Facultad de Ingeniería Química. Instituto de Lactología Industrial; ArgentinaFil: Sivieri, Katia. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilXV Congreso Argentino de Microbiología (CAM 2019); V Congreso Argentino de Microbiología de Alimentos (V CAMA); V Congreso Latinoamericano de Microbiología de Medicamentos y Cosméticos (CLAMME 2019); XIV Congreso Argentino de Microbiología General (XIV SAMIGE)ArgentinaAsociación Argentina de Microbiologí