1,591 research outputs found

    Can Phytoremediation-Induced Changes in the Microbiome Improve Saline/Sodic Soil and Plant Health?

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    Increasing soil salinity and/or sodicity is an expanding problem in the Northern Great Plains (NGP) of North America. This study investigated the impact of phytoremediation on the soil microbiome and if changes, in turn, had positive or negative effects on plant establishment. Amplicon sequencing and gas chromatograph/mass spectrometer analysis compared root metabolites and microbial composition of bulk vs. rhizosphere soils between two soil types (productive and saline/sodic). Beta-diversity analysis indicated that bacterial and fungal communities from both the bulk and rhizosphere soils from each soil type clustered separately, indicating dissimilar microbial composition. Plant species also influenced both root-associated bacterial and fungal communities with separate clustering of operational taxonomic units (OTUs) identified. Canonical correlation analysis (CCA) found a clear association between specific soil characteristics and soil types. Bacterial and fungal OTUs from productive soil were correlated with greater %Ca Sat, %H Sat, and potassium (ppm), especially for OTUs differentially enriched in productive soil. Both bacterial and fungal OTUs from saline/sodic soil are associated with increased Ca (ppm), soil pH, %Na Sat and CEC. Metabolite analysis showed that kochia (Bassia scoparia) roots from the saline/sodic soil had a 4.4-fold decrease in pantothenate accumulation (p = 0.004). Moreover, two endophytic bacterial isolates, a Bacillus spp. and a previously uncultured halophile, isolated from creeping foxtail (Alopecurus arundinaceus) grown in saline/sodic soil and used as buckwheat (Fagopyrum esculentum) seed inoculants, significantly increased seed germination by \u3e30% and vigor index by 0.2 under osmotic stress (0.2 M NaCl) (p \u3c 0.05). This study revealed the importance of soil, root-associated, and endophytic microbiomes. Using native microbes as seed inoculants may help in establishment and growth of species used for phytoremediation of saline/sodic soil

    Measures for assessing practice change in medical practitioners

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    BACKGROUND: There are increasing numbers of randomised trials and systematic reviews examining the efficacy of interventions designed to bring about a change in clinical practice. The findings of this research are being used to guide strategies to increase the uptake of evidence into clinical practice. Knowledge of the outcomes measured by these trials is vital not only for the interpretation and application of the work done to date, but also to inform future research in this expanding area of endeavour and to assist in collation of results in systematic reviews and meta-analyses. METHODS: The objective of this review was to identify methods used to measure change in the clinical practices of health professionals following an intervention aimed at increasing the uptake of evidence into practice. All published trials included in a recent, comprehensive Health Technology Assessment of interventions to implement clinical practice guidelines and change clinical practice (n = 228) formed the sample for this study. Using a standardised data extraction form, one reviewer (SH), extracted the relevant information from the methods and/or results sections of the trials. RESULTS: Measures of a change of health practitioner behaviour were the most common, with 88.8% of trials using these as outcome measures. Measures that assessed change at a patient level, either actual measures of change or surrogate measures of change, were used in 28.8% and 36.7% of studies (respectively). Health practitioners' knowledge and attitudes were assessed in 22.8% of the studies and changes at an organisational level were assessed in 17.6%. CONCLUSION: Most trials of interventions aimed at changing clinical practice measured the effect of the intervention at the level of the practitioner, i.e. did the practitioner change what they do, or has their knowledge of and/or attitude toward that practice changed? Less than one-third of the trials measured, whether or not any change in practice, resulted in a change in the ultimate end-point of patient health status

    “Do you think your main partner has other sex partners?” A simple question provides insight into sexual risk in Jamaica

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    To estimate the association between a simple measure of sexual partner concurrency and sexually transmitted infection (STI) we conducted a cross-sectional population-based household survey (n=1795) and targeted surveys of people at venues where people meet sexual partners (n=1580) to ask about sexual behavior. Persons interviewed at venues were tested for HIV, gonorrhoea, chlamydia, gonorrhea, and trichomoniasis. We compared the association between STI and reporting a partner had other partners. More women than men reported their main partner had other partners. Thirteen percent of all women in the population-based survey and 14.4% in the targeted survey reported having one partner in the past 12 months and that partner had additional partners. STI prevalence was significantly associated with reporting a partner had other partners (36.8% vs 30.2%; prevalence ratio [PR]1.2; 95% CI 1.1,1.4). Construction of complete sexual networks is costly and not routinely feasible. We recommend adding a question to cross-sectional surveys used to monitor sexual behavior about whether the respondent believes his or her partner has other sexual partners. Although subject to bias, the question was useful in Jamaica to identify a group of women with only one sexual partner at increased risk of infection

    Cognitive Diversity in a Healthy Aging Cohort: Cross-Domain Cognition in the Cam-CAN Project.

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    Objective: Studies of "healthy" cognitive aging often focus on a limited set of measures that decline with age. The current study argues that defining and supporting healthy cognition requires understanding diverse cognitive performance across the lifespan. Method: Data from the Cambridge Centre for Aging and Neuroscience (Cam-CAN) cohort was examined across a range of cognitive domains. Performance was related to lifestyle including education, social engagement, and enrichment activities. Results: Results indicate variable relationships between cognition and age (positive, negative, or no relationship). Principal components analysis indicated maintained cognitive diversity across the adult lifespan, and that cognition-lifestyle relationships differed by age and domain. Discussion: Our findings support a view of normal cognitive aging as a lifelong developmental process with diverse relationships between cognition, lifestyle, and age. This reinforces the need for large-scale studies of cognitive aging to include a wider range of both ages and cognitive tasks.The Cambridge Centre for Aging and Neuroscience (Cam-CAN) research was supported by the Biotechnology and Biological Sciences Research Council (grant number BB/H008217/1)

    "Now he walks and walks, as if he didn't have a home where he could eat": food, healing, and hunger in Quechua narratives of madness

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    In the Quechua-speaking peasant communities of southern Peru, mental disorder is understood less as individualized pathology and more as a disturbance in family and social relationships. For many Andeans, food and feeding are ontologically fundamental to such relationships. This paper uses data from interviews and participant observation in a rural province of Cuzco to explore the significance of food and hunger in local discussions of madness. Carers’ narratives, explanatory models, and theories of healing all draw heavily from idioms of food sharing and consumption in making sense of affliction, and these concepts structure understandings of madness that differ significantly from those assumed by formal mental health services. Greater awareness of the salience of these themes could strengthen the input of psychiatric and psychological care with this population and enhance knowledge of the alternative treatments that they use. Moreover, this case provides lessons for the global mental health movement on the importance of openness to the ways in which indigenous cultures may construct health, madness, and sociality. Such local meanings should be considered by mental health workers delivering services in order to provide care that can adjust to the alternative ontologies of sufferers and carers

    Adipose tissue macrophage heterogeneity and the role of Tim4⁺ macrophages in lipid homeostasis

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    Resident macrophages are essential for the maintenance of tissue homeostasis as they participate in clearance of apoptotic cells and tissue remodelling and repair. In recent years, there has been an increased interest in the study of adipose tissue macrophages (ATMs). In lean individuals, ATMs are important for the control of insulin sensitivity, thermogenesis, angiogenesis and adipose tissue development. In obesity, the number and phenotype of ATMs is altered, and is associated with chronic low grade systemic and local inflammation. These “pro-inflammatory” changes are postulated to contribute to the manifestation of metabolic syndrome. These findings have suggested that the pool of ATMs is heterogeneous and may change, especially during obesity. To date, the characterisation of ATMs has been limited largely to the F4/80/CD11b markers, however the hypothesis of this thesis is that ATMs have distinct phenotype and function that could influence, in different ways, tissue homeostasis. This thesis aims to characterise and phenotype ATM subsets in order to better understand their potential specific role in the tissue. During the course of this research, a novel population of Tim4+ resident ATMs were identified. An additional aim of this thesis was to elucidate their role in adipose tissue homeostasis. Partial bone marrow chimeras were used to identify macrophage origin. The main AT depots were shielded from irradiation and a donor BM was injected intravenously. After 8 weeks, the origin of macrophages was analysed using flow cytometry. Tim4, a phosphatidylserine receptor mediating phagocytosis of apoptotic cells and a marker found on resident macrophages in other tissues, was used for the first time in adipose tissue. Four subsets of ATMs were identified: F4/80highCD11c-Tim4+, F4/80highCD11c- Tim4-; F4/80lowCD11c+Tim4-; F4/80lowCD11c-Tim4-. Interestingly, this newly described F4/80highTim4+ ATM subset showed the lowest non-host chimerism compared to the other ATMs, suggesting this is a main self-replenishing resident ATM population. To study the impact of obesity on ATM turnover, partial chimeric mice were fed HFD for 8 weeks. This increased the number of macrophages in AT. However, the different subsets of ATMs were differentially affected by the diet. Indeed, only a small proportion of Tim4+ ATMs derived from the bone marrow. In contrast, replenishment of the 3 other subsets was almost fully dependent on the arrival of monocyte-derived cells from the bone marrow. TIMD4, the gene encoding for Tim4, has been highlighted in genetic studies as being linked with dyslipidaemia. This suggests that Tim4+ ATMs might play a role in lipid homeostasis. Further characterisation of Tim4 ATMs demonstrated that these Tim4+ ATMs are highly charged in neutral lipid, and also have an increased lysosomal activity (shown by lysotracker staining) compared to the other ATM subsets. Using blocking anti-Tim4 antibodies in vivo, I found that Tim4 contributed markedly to free fatty acid (FFA) release into the plasma after short-term and long term HFD feeding. In addition, in vitro and in vivo experiments demonstrated that Tim4 could be required for the uptake of neutral lipids and their integration into lysosomes for degradation, though this seems to be dependent on the nature of the lipid. Collectively, these results indicate that Tim4 plays a crucial role in the control of lipid trafficking under conditions when dietary lipid is in excess. Tim4 allows uptake of lipids by Tim4+ ATMs and subsequent release of FFA into the circulation. Finally, the presence of Tim4+ lipid laden ATMs was demonstrated in the human omentum. This finding may lead to the discovery of new targets to improve metabolic health in obese patients. This work stresses the importance of resident ATM population in body lipid homeostasis as they could be involved in coping with lipid availability in the body and influence the amount of FFA in the plasma

    Recommendations for a core outcome set for measuring standing balance in adult populations: a consensus-based approach

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    Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice.To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults.A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria.The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS.Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations.Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate.The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally

    Accessing routinely collected health data to improve clinical trials: recent experience of access.

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    BACKGROUND: Routinely collected electronic health records (EHRs) have the potential to enhance randomised controlled trials (RCTs) by facilitating recruitment and follow-up. Despite this, current EHR use is minimal in UK RCTs, in part due to ongoing concerns about the utility (reliability, completeness, accuracy) and accessibility of the data. The aim of this manuscript is to document the process, timelines and challenges of the application process to help improve the service both for the applicants and data holders. METHODS: This is a qualitative paper providing a descriptive narrative from one UK clinical trials unit (MRC CTU at UCL) on the experience of two trial teams' application process to access data from three large English national datasets: National Cancer Registration and Analysis Service (NCRAS), National Institute for Cardiovascular Outcomes Research (NICOR) and NHS Digital to establish themes for discussion. The underpinning reason for applying for the data was to compare EHRs with data collected through case report forms in two RCTs, Add-Aspirin (ISRCTN 74358648) and PATCH (ISRCTN 70406718). RESULTS: The Add-Aspirin trial, which had a pre-planned embedded sub-study to assess EHR, received data from NCRAS 13 months after the first application. In the PATCH trial, the decision to request data was made whilst the trial was recruiting. The study received data after 8 months from NICOR and 15 months for NHS Digital following final application submission. This concluded in May 2020. Prior to application submission, significant time and effort was needed particularly in relation to the PATCH trial where negotiations over consent and data linkage took many years. CONCLUSIONS: Our experience demonstrates that data access can be a prolonged and complex process. This is compounded if multiple data sources are required for the same project. This needs to be factored in when planning to use EHR within RCTs and is best considered prior to conception of the trial. Data holders and researchers are endeavouring to simplify and streamline the application process so that the potential of EHR can be realised for clinical trials
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