Intern Self-Care: An Exploratory Study Into Strategy Use and Effectiveness

In this exploratory study, 363 interns were surveyed to assess the frequency of use and effectiveness of self-care strategies used during the internship year. Among the most frequently used strategies were family and friend social support, active problem solving, and humor. The most effective strategies were family and friend social support, seeking pleasurable experiences, and humor. A strong positive relationship was found between total scores for Frequency and Effectiveness subscales, and women reported significantly more use and effectiveness of strategies. Recommendations and resources are provided for interns and internship sites that seek to further understand and encourage intern self-care

Rural-Urban Differences in Inpatient Quality of Care in US Veterans With Ischemic Stroke

Purpose Differences in stroke care quality for patients in rural and urban locations have been suggested, but whether differences exist across Veteran Administration Medical Centers (VAMCs) is unknown. This study examines whether rural-urban disparities exist in inpatient quality among veterans with acute ischemic stroke. Methods In this retrospective study, inpatient stroke care quality was assessed in a national sample of veterans with acute ischemic stroke using 14 quality indicators (QIs). Rural-Urban Commuting Areas codes defined each VAMC's rural-urban status. A hierarchical linear model assessed the rural-urban differences across the 14 QIs, adjusting for patient and facility characteristics, and clustering within VAMCs. Findings Among 128 VAMCs, 18 (14.1%) were classified as rural VAMCs and admitted 284 (7.3%) of the 3,889 ischemic stroke patients. Rural VAMCs had statistically significantly lower unadjusted rates on 6 QIs: Deep vein thrombosis (DVT) prophylaxis, antithrombotic at discharge, antithrombotic at day 2, lipid management, smoking cessation counseling, and National Institutes of Health Stroke Scale completion, but they had higher rates of stroke education, functional assessment, and fall risk assessment. After adjustment, differences in 2 QIs remained significant—patients treated in rural VAMCs were less likely to receive DVT prophylaxis, but more likely to have documented functional assessment. Conclusions After adjustment for key demographic, clinical, and facility-level characteristics, there does not appear to be a systematic difference in inpatient stroke quality between rural and urban VAMCs. Future research should seek to understand the few differences in care found that could serve as targets for future quality improvement interventions

Metabolic rate and rates of protein turnover in food-deprived cuttlefish, Sepia officinalis (Linnaeus 1758)

To determine the metabolic response to food deprivation, cuttlefish (Sepia officinalis) juveniles were either fed, fasted (3 to 5 days food deprivation), or starved (12 days food deprivation). Fasting resulted in a decrease in triglyceride levels in the digestive gland, and after 12 days, these lipid reserves were essentially depleted. Oxygen consumption was decreased to 53% and NH4 excretion to 36% of the fed group following 3-5 days of food deprivation. Oxygen consumption remained low in the starved group, but NH4 excretion returned to the level recorded for fed animals during starvation. The fractional rate of protein synthesis of fasting animals decreased to 25% in both mantle and gill compared with fed animals and remained low in the mantle with the onset of starvation. In gill, however, protein synthesis rate increased to a level that was 45% of the fed group during starvation. In mantle, starvation led to an increase in cathepsin A-, B-, H-, and L-like enzyme activity and a 2.3-fold increase in polyubiquitin mRNA that suggested an increase in ubiquitin-proteasome activity. In gill, there was a transient increase in the polyubiquitin transcript levels in the transition from fed through fasted to the starved state and cathepsin A-, B-, H-, and L-like activity was lower in starved compared with fed animals. The response in gill appears more complex, as they better maintain rates of protein synthesis and show no evidence of enhanced protein breakdown through recognized catabolic processes

Inpatient stroke care quality for Veterans: Are there differences between VA medical centers in the stroke belt and other areas?

Background Stroke mortality has been found to be much higher among residents in the stroke belt region than in the rest of United States, but it is not known whether differences exist in the quality of stroke care provided in Department of Veterans Affairs medical centers in states inside and outside this region. Objective We compared mortality and inpatient stroke care quality between Veterans Affairs medical centers inside and outside the stroke belt region. Methods Study patients were veterans hospitalized for ischemic stroke at 129 Veterans Affairs medical centers. Inpatient stroke care quality was assessed by 14 quality indicators. Multivariable logistic regression models were fit to examine differences in quality between facilities inside and outside the stroke belt, adjusting for patient characteristics and Veterans Affairs medical centers clustering effect. Results Among the 3909 patients, 28·1% received inpatient ischemic stroke care in 28 stroke belt Veterans Affairs medical centers, and 71·9% obtained care in 101 non-stroke belt Veterans Affairs medical centers. Patients cared for in stroke belt Veterans Affairs medical centers were more likely to be younger, Black, married, have a higher stroke severity, and less likely to be ambulatory pre-stroke. We found no statistically significant differences in short- and long-term post-admission mortality and inpatient care quality indicators between the patients cared for in stroke belt and non-stroke belt Veterans Affairs medical centers after risk adjustment. Conclusions These data suggest that a stroke belt does not exist within the Veterans Affairs health care system in terms of either post-admission mortality or inpatient care quality

Composition, taxonomy and functional diversity of the oropharynx microbiome in individuals with schizophrenia and controls.

The role of the human microbiome in schizophrenia remains largely unexplored. The microbiome has been shown to alter brain development and modulate behavior and cognition in animals through gut-brain connections, and research in humans suggests that it may be a modulating factor in many disorders. This study reports findings from a shotgun metagenomic analysis of the oropharyngeal microbiome in 16 individuals with schizophrenia and 16 controls. High-level differences were evident at both the phylum and genus levels, with Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria dominating both schizophrenia patients and controls, and Ascomycota being more abundant in schizophrenia patients than controls. Controls were richer in species but less even in their distributions, i.e., dominated by fewer species, as opposed to schizophrenia patients. Lactic acid bacteria were relatively more abundant in schizophrenia, including species of Lactobacilli and Bifidobacterium, which have been shown to modulate chronic inflammation. We also found Eubacterium halii, a lactate-utilizing species. Functionally, the microbiome of schizophrenia patients was characterized by an increased number of metabolic pathways related to metabolite transport systems including siderophores, glutamate, and vitamin B12. In contrast, carbohydrate and lipid pathways and energy metabolism were abundant in controls. These findings suggest that the oropharyngeal microbiome in individuals with schizophrenia is significantly different compared to controls, and that particular microbial species and metabolic pathways differentiate both groups. Confirmation of these findings in larger and more diverse samples, e.g., gut microbiome, will contribute to elucidating potential links between schizophrenia and the human microbiota

The reductive activation of CO2 across a Ti═Ti double bond: synthetic, structural, and mechanistic studies

[Image: see text] The reactivity of the bis(pentalene)dititanium double-sandwich compound Ti(2)Pn(†)(2) (1) (Pn(†) = 1,4-{Si(i)Pr(3)}(2)C(8)H(4)) with CO(2) is investigated in detail using spectroscopic, X-ray crystallographic, and computational studies. When the CO(2) reaction is performed at −78 °C, the 1:1 adduct 4 is formed, and low-temperature spectroscopic measurements are consistent with a CO(2) molecule bound symmetrically to the two Ti centers in a μ:η(2),η(2) binding mode, a structure also indicated by theory. Upon warming to room temperature the coordinated CO(2) is quantitatively reduced over a period of minutes to give the bis(oxo)-bridged dimer 2 and the dicarbonyl complex 3. In situ NMR studies indicated that this decomposition proceeds in a stepwise process via monooxo (5) and monocarbonyl (7) double-sandwich complexes, which have been independently synthesized and structurally characterized. 5 is thermally unstable with respect to a μ-O dimer in which the Ti–Ti bond has been cleaved and one pentalene ligand binds in an η(8) fashion to each of the formally Ti(III) centers. The molecular structure of 7 shows a “side-on” bound carbonyl ligand. Bonding of the double-sandwich species Ti(2)Pn(2) (Pn = C(8)H(6)) to other fragments has been investigated by density functional theory calculations and fragment analysis, providing insight into the CO(2) reaction pathway consistent with the experimentally observed intermediates. A key step in the proposed mechanism is disproportionation of a mono(oxo) di-Ti(III) species to yield di-Ti(II) and di-Ti(IV) products. 1 forms a structurally characterized, thermally stable CS(2) adduct 8 that shows symmetrical binding to the Ti(2) unit and supports the formulation of 4. The reaction of 1 with COS forms a thermally unstable complex 9 that undergoes scission to give mono(μ-S) mono(CO) species 10. Ph(3)PS is an effective sulfur transfer agent for 1, enabling the synthesis of mono(μ-S) complex 11 with a double-sandwich structure and bis(μ-S) dimer 12 in which the Ti–Ti bond has been cleaved

Multiple sodium channel isoforms mediate the pathological effects of Pacific ciguatoxin-1

This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/Human intoxication with the seafood poison ciguatoxin, a dinoflagellate polyether that activates voltage-gated sodium channels (NaV), causes ciguatera, a disease characterised by gastrointestinal and neurological disturbances. We assessed the activity of the most potent congener, Pacific ciguatoxin-1 (P-CTX-1), on NaV1.1–1.9 using imaging and electrophysiological approaches. Although P-CTX-1 is essentially a non-selective NaV toxin and shifted the voltage-dependence of activation to more hyperpolarising potentials at all NaV subtypes, an increase in the inactivation time constant was observed only at NaV1.8, while the slope factor of the conductance-voltage curves was significantly increased for NaV1.7 and peak current was significantly increased for NaV1.6. Accordingly, P-CTX-1-induced visceral and cutaneous pain behaviours were significantly decreased after pharmacological inhibition of NaV1.8 and the tetrodotoxin-sensitive isoforms NaV1.7 and NaV1.6, respectively. The contribution of these isoforms to excitability of peripheral C- and A-fibre sensory neurons, confirmed using murine skin and visceral single-fibre recordings, reflects the expression pattern of NaV isoforms in peripheral sensory neurons and their contribution to membrane depolarisation, action potential initiation and propagation

Physicochemical characterization and antimicrobial activity of mucus of Achatina fulica

Introducción: El caracol gigante africano Achatina fulica es reconocido como una plaga que afectala biodiversidad, la Salud Pública y la productividad. Sin embargo, se ha demostrado que su secreción mucosa tiene propiedades cosméticas, cicatrizantes y antimicrobianas. Objetivo: Determinar las características físico-químicas y evaluar la actividad antimicrobiana de la secreción mucosa de Achatina fulica. Metodología: Se hicieron pruebas bioquímicas para la determinación cualitativa y cuantitativa de glúcidos, proteínas y lípidos. Se determinó el contenido de Calcio, Potasio, cloruros, Sodio y Magnesio. Se midieron los parámetros de conductividad eléctrica, potencial óxido-reducción, saturación de oxígeno, oxígeno total disuelto, pH, sólidos disueltos totales. Se realizó un ensayo de actividad antibacteriana por la técnica de microdilución en caldo. Resultados: Se encontraron glúcidos en concentraciones de 582 μg/mL en la fracción soluble y de 62.1 μg/mL en la fracción de mucinas, y proteínas en concentraciones de 836 μg/mL en la fracción soluble y de 1413 μg/mL en la fracción de mucinas. Se observó actividad antimicrobiana frente a las tres cepas ensayadas. Streptococcus agalactiae alcanzó un MIC90 a una concentración de 3,6 mg/mL con la fracción de mucinas; Staphylococcus aureus resistente a meticilina tuvo un MIC50 de 3,3 mg/mL y Escherichia coli un MIC 70 de 3.8 mg/mL. Conclusiones: Se reportan por primera vez las características físicas y los oligoelementos presente en la secreción de Achatina fulica. La actividad antibacteriana obtenida frente a cepas Gram positivas y Gram negativas plantea la necesidad de realizar estudios para purificar las moléculas con dicha actividad, conocer los mecanismos de acción y establecer la inocuidad, entre otros.Introduction: The giant African snail Achatina fulica is recognized as a scourge affecting biodiversity,public health and productivity. However, it has been shown that the mucus has cosmetic, healing and antimicrobial properties. Objective: Determine physico-chemical characteristics and evaluate the antimicrobial activity of the mucus. Methodology: Qualitative and quantitative determinations of carbohydrates, proteins and lipids were made by biochemical tests. Using multiparameter meter parameters of electrical conductivity, redox potential, oxygen saturation, the total dissolved oxygen, pH, total dissolved solids were measured. Content of Calcium, Potassium, chloride, Sodium and Magnesium was determined. Antibacterial activity assay was performed by broth microdilution method against Gram positive and Gram negative bacteria. Results: Carbohydrates were found in concentrations of 582 μg/mL in soluble fraction and 62.1 μg/mL in mucin fraction, and protein concentration of 836 μg/mL in the soluble fraction and 1413 μg/mL in mucin fraction. Antimicrobial activity was demonstrated against the three strains tested. Streptococcus agalactiae reached MIC90 at a concentration of 3.6 μg/mL with mucin fraction; Methicillin-Resistant Staphylococcus aureus had a MIC50 of 3.3 mg / mL and Escherichia coli had a MIC70 of 3.8 mg / mL. Conclusions: This is the first report of the physical and trace elements in the secretion of Achatina fulica. The antibacterial activity obtained against Gram positive and Gram negative strains raises the need for studies to purify the molecules with such activity, understanding the mechanisms of action and establish the safety, among others

Prevalence of selected infectious disease agents in stray cats in Catalonia, Spain

The objective of the current study was to investigate the prevalence rates of the following infectious agents in 116 stray cats in the Barcelona area of Spain: Anaplasma phagocytophilum, Bartonella species, Borrelia burgdorferi, Chlamydia felis, Dirofilaria immitis, Ehrlichia species, feline calicivirus (FCV), feline herpesvirus-1 (FHV-1), feline leukaemia virus (FeLV), feline immunodeficiency virus (FIV), haemoplasmas, Mycoplasma species and Rickettsia species. Serum antibodies were used to estimate the prevalence of exposure to A phagocytophilum, Bartonella species, B burgdorferi, Ehrlichia species and FIV; serum antigens were used to assess for infection by D immitis and FeLV; and molecular assays were used to amplify nucleic acids of Anaplasma species, Bartonella species, C felis, D immitis, Ehrlichia species, FCV, FHV-1, haemoplasmas, Mycoplasma species and Rickettsia species from blood and nasal or oral swabs. Of the 116 cats, 63 (54.3%) had evidence of infection by Bartonella species, FeLV, FIV or a haemoplasma. Anaplasma species, Ehrlichia species or Rickettsia species DNA was not amplified from these cats. A total of 18/116 cats (15.5%) were positive for FCV RNA (six cats), Mycoplasma species DNA (six cats), FHV-1 DNA (three cats) or C felis DNA (three cats). This study documents that shelter cats in Catalonia are exposed to many infectious agents with clinical and zoonotic significance, and that flea control is indicated for cats in the region

Physicochemical characterization and antimicrobial activity of mucus of Achatina fulica

Introducción: El caracol gigante africano Achatina fulica es reconocido como una plaga que afectala biodiversidad, la Salud Pública y la productividad. Sin embargo, se ha demostrado que su secreción mucosa tiene propiedades cosméticas, cicatrizantes y antimicrobianas. Objetivo: Determinar las características físico-químicas y evaluar la actividad antimicrobiana de la secreción mucosa de Achatina fulica. Metodología: Se hicieron pruebas bioquímicas para la determinación cualitativa y cuantitativa de glúcidos, proteínas y lípidos. Se determinó el contenido de Calcio, Potasio, cloruros, Sodio y Magnesio. Se midieron los parámetros de conductividad eléctrica, potencial óxido-reducción, saturación de oxígeno, oxígeno total disuelto, pH, sólidos disueltos totales. Se realizó un ensayo de actividad antibacteriana por la técnica de microdilución en caldo. Resultados: Se encontraron glúcidos en concentraciones de 582 μg/mL en la fracción soluble y de 62.1 μg/mL en la fracción de mucinas, y proteínas en concentraciones de 836 μg/mL en la fracción soluble y de 1413 μg/mL en la fracción de mucinas. Se observó actividad antimicrobiana frente a las tres cepas ensayadas. Streptococcus agalactiae alcanzó un MIC90 a una concentración de 3,6 mg/mL con la fracción de mucinas; Staphylococcus aureus resistente a meticilina tuvo un MIC50 de 3,3 mg/mL y Escherichia coli un MIC 70 de 3.8 mg/mL. Conclusiones: Se reportan por primera vez las características físicas y los oligoelementos presente en la secreción de Achatina fulica. La actividad antibacteriana obtenida frente a cepas Gram positivas y Gram negativas plantea la necesidad de realizar estudios para purificar las moléculas con dicha actividad, conocer los mecanismos de acción y establecer la inocuidad, entre otros.Introduction: The giant African snail Achatina fulica is recognized as a scourge affecting biodiversity,public health and productivity. However, it has been shown that the mucus has cosmetic, healing and antimicrobial properties. Objective: Determine physico-chemical characteristics and evaluate the antimicrobial activity of the mucus. Methodology: Qualitative and quantitative determinations of carbohydrates, proteins and lipids were made by biochemical tests. Using multiparameter meter parameters of electrical conductivity, redox potential, oxygen saturation, the total dissolved oxygen, pH, total dissolved solids were measured. Content of Calcium, Potassium, chloride, Sodium and Magnesium was determined. Antibacterial activity assay was performed by broth microdilution method against Gram positive and Gram negative bacteria. Results: Carbohydrates were found in concentrations of 582 μg/mL in soluble fraction and 62.1 μg/mL in mucin fraction, and protein concentration of 836 μg/mL in the soluble fraction and 1413 μg/mL in mucin fraction. Antimicrobial activity was demonstrated against the three strains tested. Streptococcus agalactiae reached MIC90 at a concentration of 3.6 μg/mL with mucin fraction; Methicillin-Resistant Staphylococcus aureus had a MIC50 of 3.3 mg / mL and Escherichia coli had a MIC70 of 3.8 mg / mL. Conclusions: This is the first report of the physical and trace elements in the secretion of Achatina fulica. The antibacterial activity obtained against Gram positive and Gram negative strains raises the need for studies to purify the molecules with such activity, understanding the mechanisms of action and establish the safety, among others