A central line care maintenance bundle for the prevention of central line–associated bloodstream infection in non–intensive care unit settings

OBJECTIVE: To evaluate a central line care maintenance bundle to reduce central line-associated bloodstream infection (CLABSI) in non-ICU settings. DESIGN: Before-after trial with 12 month follow-up period. SETTING: 1250-bed teaching hospital. PARTICIPANTS: Patients with central lines on eight general medicine wards. Four wards received the intervention and four served as controls. INTERVENTION: A multifaceted catheter care maintenance bundle consisting of educational programs for nurses, update of hospital policies, visual aids, a competency assessment, process monitoring, regular progress reports, and consolidation of supplies necessary for catheter maintenance. RESULTS: Data were collected for 25,542 catheter-days including 43 CLABSI (rate = 1.68 per 1,000 CL-days) and 4,012 catheter dressing observations. Following the intervention, a 2.5% monthly decrease in the CLABSI incidence density was observed on intervention floors, but this was not statistically significant (95% confidence interval (CI); −5.3 – 0.4). On control floors, there was a smaller, but marginally significant decrease in CLABSI incidence during the study (change in monthly rate = −1.1%; 95% CI, −2.1 - −0.1). Implementation of the bundle was associated with improvement in catheter dressing compliance on intervention wards (78.8% compliance pre-intervention vs. 87.9% during intervention/follow-up; p<0.001) but improvement was also observed on control wards (84.9% compliance pre-intervention vs. 90.9% during intervention/follow-up; P = .001). CONCLUSIONS: A multi-faceted program to improve catheter care was associated with improvement in catheter dressing care, but no change in CLABSI rates. Additional study is needed to determine strategies to prevent CLABSI in non-ICU patients

Creating the Capacity to Screen Deaf Women for Perinatal Depression [poster]

There are approximately 1 million Deaf women in the U.S. who depend on American Sign Language (ASL) for communication. Although Deaf women become pregnant and enter motherhood at rates similar to hearing women, Deaf women attend fewer prenatal appointments, receive less information from their physicians, are less satisfied with physician concern and quality of communication, and are less satisfied with their prenatal care. These barriers persist after childbirth, leaving Deaf mothers with little professional support for struggles with postnatal healthcare, breastfeeding, and childcare. Combined with pre-existing mental health disparities observed among members of the Deaf community, such barriers leave Deaf women especially vulnerable to development or exacerbation of depression during the perinatal period (i.e., during pregnancy or within one year postpartum). Expert groups recommend depression screening as a standard of perinatal care - the first critical step to direct women to treatment. Yet, available screening tools are not accessible to Deaf women due to documented low levels of English literacy and health literacy. It is, therefore, critical to develop and validate tools to screen for depression among Deaf perinatal women so they may access the same standard of care as other perinatal women. To address these barriers, our team is conducting a one-year, community-engaged pilot study to develop and perform preliminary psychometric analyses on an ASL translation of the Edinburgh Postnatal Depression Scale (EPDS). During the poster session, we will outline our unique community-engaged research methods, as well as exhibit the first draft of the ASL EPDS

Parent-Child Dynamics and Emerging Adult Religiosity: Attachment, Parental Beliefs, and Faith Support

Parental religiosity has been shown to predict child and adolescent religiosity, but the role of parents in emerging adult religiosity is largely unknown. We explored associations among emerging adult religiosity, perceived parental religiosity, perceived similarity to mother\u27s and father\u27s religious beliefs, parental faith support, and parental attachment. Participants were 481 alumni of two Christian colleges and completed surveys online. Emerging adult religiosity (measured by Christian orthodoxy and intrinsic religiosity) was high and similar to parents\u27 religiosity. Perceived similarity to parents\u27 religious beliefs, faith support, and attachment to fathers predicted emerging adult religiosity. However, parental religiosity alone was a weak predictor and functioned as a negative suppressor variable when combined with similarity to parents\u27 beliefs and faith support. Findings underscore the importance of parental support and parent-child relationship dynamics more than the level of parental religiosity and point to possible unique roles for mothers and fathers in emerging adult religiosity

Recruitment of p300/CBP in p53-Dependent Signal Pathways

AbstractThe products of the p53 and CBP/p300 genes have been individually implicated in control of cell growth and regulation of transcription. p53 is known to act as a positive and negative regulator of gene expression. Here we show that p53, in both wild-type and mutant conformation, forms a specific protein complex with p300. However, in its wild-type but not mutant conformation, p53 inhibits a promoter containing the DNA-binding sequences for the transcription factor AP1, in a p300-dependent manner. p300 stimulates the transcriptional activity of p53 on p53-regulated promoters, and it enhances the responsiveness to a physiological upstream modulator of p53 function, ionizing radiation. A dominant negative form of p300 prevents transcriptional activation by p53, and it counteracts p53-mediated G1 arrest and apoptosis. The data implicate p300 as an important component of p53-signaling, thus providing new insight into the mechanisms of cellular proliferation

Fitness, PA, Perceived Competence, Parental Support, and Literacy Outcomes in the REACH After-School Sports Program

The purpose of this study was to assess the effectiveness of the REACH program in increasing physical activity (PA) levels, cardiorespiratory fitness, perceived competence, self-efficacy, parental support, and literacy across a year-long after-school PA intervention. Participants (N = 78) were students who volunteered from after-school program at either one of the two intervention schools or the control schools. Data are presented from two time points: Baseline (Aug/Sep 2017), and Post (end of the school year in May 2018). Data consisted of PA levels measured by PAC-Q, PACER test, Harter’s Perceived Competence questionnaire, parental support, and literacy tests. School differences in post-intervention scores were found in three (parental support, literacy, PACER) of seven intervention-related measures. Most notably parental support was higher in intervention schools over the control and PACER scores were higher in one intervention school than the control. The results demonstrate that data collection methods may need to be reconsidered in diverse low-income schools. The dramatic amount of missing data and lack of student effort points to students perhaps being overwhelmed with standardized tests and performing tasks for researchers. This leads to a dilemma in data collection in after-school programs in low-income schools: researchers need data to understand what is happening but how are students being served by the data collection process? Researchers should consider new approaches to collect data in low-income urban after-school programs to limit loss of data and to make the data collection meaningful to student participants

New Measure to Screen Deaf Women for Perinatal Depression

Approximately 1 million women in the U.S. have profound hearing loss and use American Sign Language (ASL) as their primary language. Many providers are unfamiliar with the unique linguistic and cultural needs of the Deaf community, therefore Deaf women experience major obstacles to receiving effective physical and mental healthcare. For example, failure to provide ASL interpreters or translations from written English is a common communication barrier that prevents Deaf women from receiving health-related treatment and information. In 2017, Drs. Melissa Anderson, Kelly Wolf Craig, and Nancy Byatt were awarded a 1-year pilot project grant for their Creating the Capacity to Screen Deaf Women for Perinatal Depression project. The primary goal of this project was to translate the Edinburgh Postnatal Depression Scale (EPDS) from written English to American Sign Language (ASL). Using the new ASL EPDS, the team aimed to recruit 50 Deaf perinatal women from across the United States to conduct depression screening interviews. This brief describes the study, its results and future plans

Degradation of biological macromolecules supports uncultured microbial populations in Guaymas Basin hydrothermal sediments

© The Author(s), 2021. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Castro, S. P., Borton, M. A., Regan, K., de Angelis, I. H., Wrighton, K. C., Teske, A. P., Strous, M., & Ruff, S. E. Degradation of biological macromolecules supports uncultured microbial populations in Guaymas Basin hydrothermal sediments. Isme Journal. (2021), https://doi.org/10.1038/s41396-021-01026-5.Hydrothermal sediments contain large numbers of uncultured heterotrophic microbial lineages. Here, we amended Guaymas Basin sediments with proteins, polysaccharides, nucleic acids or lipids under different redox conditions and cultivated heterotrophic thermophiles with the genomic potential for macromolecule degradation. We reconstructed 20 metagenome-assembled genomes (MAGs) of uncultured lineages affiliating with known archaeal and bacterial phyla, including endospore-forming Bacilli and candidate phylum Marinisomatota. One Marinisomatota MAG had 35 different glycoside hydrolases often in multiple copies, seven extracellular CAZymes, six polysaccharide lyases, and multiple sugar transporters. This population has the potential to degrade a broad spectrum of polysaccharides including chitin, cellulose, pectin, alginate, chondroitin, and carrageenan. We also describe thermophiles affiliating with the genera Thermosyntropha, Thermovirga, and Kosmotoga with the capability to make a living on nucleic acids, lipids, or multiple macromolecule classes, respectively. Several populations seemed to lack extracellular enzyme machinery and thus likely scavenged oligo- or monomers (e.g., MAGs affiliating with Archaeoglobus) or metabolic products like hydrogen (e.g., MAGs affiliating with Thermodesulfobacterium or Desulforudaceae). The growth of methanogens or the production of methane was not observed in any condition, indicating that the tested macromolecules are not degraded into substrates for methanogenesis in hydrothermal sediments. We provide new insights into the niches, and genomes of microorganisms that actively degrade abundant necromass macromolecules under oxic, sulfate-reducing, and fermentative thermophilic conditions. These findings improve our understanding of the carbon flow across trophic levels and indicate how primary produced biomass sustains complex and productive ecosystems.We are grateful to the captain and crew of the R/V Atlantis AT37-06 as well as the crew of the human occupied vehicle Alvin for their tireless support. Sampling at Guaymas Basin was supported by NSF (OCE-1357238)

Recent advances in the application of stable isotope ratio analysis in forensic chemistry

This review paper updates the previous literature in relation to the continued and developing use of stable isotope ratio analysis in samples which are relevant to forensic science. Recent advances in the analysis of drug samples, explosive materials, and samples derived from human and animal samples are discussed. The paper also aims to put the use of isotope ratio mass spectrometry into a forensic context and discuss its evidential potential

Toll-Like Receptor 2 Signaling Protects Mice from Tumor Development in a Mouse Model of Colitis-Induced Cancer

Inflammatory bowel disease (IBD) is a disorder of chronic inflammation with increased susceptibility to colorectal cancer. The etiology of IBD is unclear but thought to result from a dysregulated adaptive and innate immune response to microbial products in a genetically susceptible host. Toll-like receptor (TLR) signaling induced by intestinal commensal bacteria plays a crucial role in maintaining intestinal homeostasis, innate immunity and the enhancement of intestinal epithelial cell (IEC) integrity. However, the role of TLR2 in the development of colorectal cancer has not been studied. We utilized the AOM-DSS model for colitis-associated colorectal cancer (CAC) in wild type (WT) and TLR2−/− mice. Colons harvested from WT and TLR2−/− mice were used for histopathology, immunohistochemistry, immunofluorescence and cytokine analysis. Mice deficient in TLR2 developed significantly more and larger colorectal tumors than their WT controls. We provide evidence that colonic epithelium of TLR2−/− mice have altered immune responses and dysregulated proliferation under steady-state conditions and during colitis, which lead to inflammatory growth signals and predisposition to accelerated neoplastic growth. At the earliest time-points assessed, TLR2−/− colons exhibited a significant increase in aberrant crypt foci (ACF), resulting in tumors that developed earlier and grew larger. In addition, the intestinal microenvironment revealed significantly higher levels of IL-6 and IL-17A concomitant with increased phospho-STAT3 within ACF. These observations indicate that in colitis, TLR2 plays a protective role against the development of CAC

Barriers to ideal outcomes after pediatric liver transplantation

Long‐term survival for children who undergo LT is now the rule rather than the exception. However, a focus on the outcome of patient or graft survival rates alone provides an incomplete and limited view of life for patients who undergo LT as an infant, child, or teen. The paradigm has now appropriately shifted to opportunities focused on our overarching goals of “surviving and thriving” with long‐term allograft health, freedom of complications from long‐term immunosuppression, self‐reported well‐being, and global functional health. Experts within the liver transplant community highlight clinical gaps and potential barriers at each of the pretransplant, intra‐operative, early‐, medium‐, and long‐term post‐transplant stages toward these broader mandates. Strategies including clinical research, innovation, and quality improvement targeting both traditional as well as PRO are outlined and, if successfully leveraged and conducted, would improve outcomes for recipients of pediatric LT.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151257/1/petr13537.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151257/2/petr13537_am.pd