Building the Kingdom: A Supervision Training Program in Pastoral Care and Homiletics

We believe deeply in the importance of supervision for all ministers and would call supervision an essential ministry of and for the ecclesia. With this in mind, we created a certificate program in supervision that would foster lifelong learning and best practices in ministry. In writing this article, we hope to share our work with the larger community and invite conversation regarding the training and practice of supervision for pastoral ministry and preaching

COMPARING GC×GC-TOFMS-BASED METABOLOMIC PROFILING AND WOOD ANATOMY FOR FORENSIC IDENTIFICATION OF FIVE MELIACEAE (MAHOGANY) SPECIES

Illegal logging and associated trade have increased worldwide. Such environmental crimes represent a major threat to forest ecosystems and society, causing distortions in market prices, economic instability, ecological deterioration, and poverty. To prevent illegal imports of forest products, there is a need to develop wood identification methods for identifying tree species regulated by the Convention on International Trade in Species of Wild Fauna andFlora in Trade (CITES) and other look-alike species. In this exploratory study, we applied metabolomic profiling of five species (Swietenia mahagoni, Swietenia macrophylla, Cedrela odorata, Khaya ivorensis, and Toona ciliata) using two-dimensional gas chromatog- raphy combined with time-of-flight mass spectrometry (GC3GC-TOFMS). We also performed qualitative, quantitative (based on the measurement of vessel area, tangential vessel lumina diameter,vessel element length, ray height, and ray width), and machine-vision aided (XyloTron) wood anatomy on a subsample of wood specimens to explore thepotential and limits of each approach. Fifty dried xylaria wood specimens were ground, extracted with methanol, and subsequently analyzed by GC3GC-TOFMS. In this study, the four genera could easily be identified using qualitative wood anatomy and chemical profiling. At the spe- cies level, Swietenia macrophylla and Swietenia mahagoni specimens were found to share many major metabolites and could only be differentiated after feature selection guided by cluster resolution (FS-CR) and visualization using Principal Component Analysis (PCA). Expectedly, specimens from the two Swiete- nia spp. could not be distinguished based on qualitative wood anatomy. However, significant differences in quantitative anatomical features were obtained for these two species. Excluding T. ciliata that was not included in the reference database of end grain images at the time of testing (2021), the XyloTron could successfully identify the majority of the specimens to the right genus and 50% of the specimens to the right species. The machine-vision tool was particularly successful at identifying Cedrela odorata samples, where all samples were correctly identified. Despite the limited number of specimens available for thisstudy, our preliminary results indicate that GC3GC-TOFMS-based metabolomic profiles could be used as comple- mentary method to differentiate CITES-regulated wood specimens at the genus and species levels.

A study on trypsin, Aspergillus flavus and Bacillus sp. protease inhibitory activity in Cassia tora (L.) syn Senna tora (L.) Roxb. seed extract

<p>Abstract</p> <p>Background</p> <p>Proteases play an important role in virulence of many human, plant and insect pathogens. The proteinaceous protease inhibitors of plant origin have been reported widely from many plant species. The inhibitors may potentially be used for multiple therapeutic applications in viral, bacterial, fungal diseases and physiological disorders. In traditional Indian medicine system, <it>Cassia tora </it>(<it>Senna tora</it>) is reportedly effective in treatment of skin and gastrointestinal disorders. The present study explores the protease inhibitory activity of the above plant seeds against trypsin, <it>Aspergillus flavus </it>and <it>Bacillus </it>sp. proteases.</p> <p>Methods</p> <p>The crushed seeds of <it>Cassia tora </it>were washed thoroughly with acetone and hexane for depigmentation and defatting. The proteins were fractionated by ammonium sulphate (0-30, 30-60, 60-90%) followed by dialysis and size exclusion chromatography (SEC). The inhibitory potential of crude seed extract and most active dialyzed fraction against trypsin and proteases was established by spot test using unprocessed x-ray film and casein digestion methods, respectively. Electrophoretic analysis of most active fraction (30-60%) and SEC elutes were carried employing Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and Gelatin SDS-PAGE. Inhibition of fungal spore germination was studied in the presence of dialyzed active inhibitor fraction. Standard deviation (SD) and ANOVA were employed as statistical tools.</p> <p>Results</p> <p>The crude seeds' extract displayed strong antitryptic, bacterial and fungal protease inhibitory activity on x-ray film. The seed protein fraction 30-60% was found most active for trypsin inhibition in caseinolytic assay (P < 0.001). The inhibition of caseinolytic activity of the proteases increased with increasing ratio of seed extract. The residual activity of trypsin, <it>Aspergillus flavus </it>and <it>Bacillus </it>sp. proteases remained only 4, 7 and 3.1%, respectively when proteases were incubated with 3 mg ml^-1seed protein extract for 60 min. The inhibitory activity was evident in gelatin SDS-PAGE where a major band (~17-19 kD) of protease inhibitor (PI) was detected in dialyzed and SEC elute. The conidial germination of <it>Aspergillus flavus </it>was moderately inhibited (30%) by the dialyzed seed extract.</p> <p>Conclusions</p> <p><it>Cassia tora </it>seed extract has strong protease inhibitory activity against trypsin, <it>Aspergillus flavus </it>and <it>Bacillus </it>sp. proteases. The inhibitor in <it>Cassia tora </it>may attenuate microbial proteases and also might be used as phytoprotecting agent.</p

A Unique Regulator Contributes to Quorum Sensing and Virulence in Burkholderia cenocepacia

Burkholderia cenocepacia causes chronic and life-threatening respiratory infections in immunocompromized people. The B. cenocepacia N-acyl-homoserine lactone (AHL)-dependent quorum sensing system relies on the production of AHLs by the synthases CepI and CciI while CepR, CciR and CepR2 control expression of many genes important for pathogenesis. Downstream from, and co-transcribed with cepI, lies BCAM1871 encoding a hypothetical protein that was uncharacterized prior to this study. Orthologs of B. cenocepacia BCAM1871 are uniquely found in Burkholderia spp and are conserved in their genomic locations in pathogenic Burkholderia. We observed significant effects on AHL activity upon mutation or overexpression of BCAM1871, although these effects were more subtle than those observed for CepI indicating BCAM1871 acts as an enhancer of AHL activity. Transcription of cepI, cepR and cciIR was significantly reduced in the BCAM1871 mutant. Swimming and swarming motilities as well as transcription of fliC, encoding flagellin, were significantly reduced in the BCAM1871 mutant. Protease activity and transcription of zmpA and zmpB, encoding extracellular zinc metalloproteases, were undetectable in the BCAM1871 mutant indicating a more significant effect of mutating BCAM1871 than cepI. Exogenous addition of OHL restored cepI, cepR and fliC transcription but had no effect on motility, protease activity or zmpA or zmpB transcription suggesting AHL-independent effects. The BCAM1871 mutant exhibited significantly reduced virulence in rat chronic respiratory and nematode infection models. Gene expression and phenotypic assays as well as vertebrate and invertebrate infection models showed that BCAM1871 significantly contributes to pathogenesis in B. cenocepacia

A genome-wide CRISPR screen identifies a restricted set of HIV host dependency factors

Host proteins are essential for HIV entry and replication and can be important nonviral therapeutic targets. Large-scale RNA interference (RNAi)-based screens have identified nearly a thousand candidate host factors, but there is little agreement among studies and few factors have been validated. Here we demonstrate that a genome-wide CRISPR-based screen identifies host factors in a physiologically relevant cell system. We identify five factors, including the HIV co-receptors CD4 and CCR5, that are required for HIV infection yet are dispensable for cellular proliferation and viability. Tyrosylprotein sulfotransferase 2 (TPST2) and solute carrier family 35 member B2 (SLC35B2) function in a common pathway to sulfate CCR5 on extracellular tyrosine residues, facilitating CCR5 recognition by the HIV envelope. Activated leukocyte cell adhesion molecule (ALCAM) mediates cell aggregation, which is required for cell-to-cell HIV transmission. We validated these pathways in primary human CD4 + T cells through Cas9-mediated knockout and antibody blockade. Our findings indicate that HIV infection and replication rely on a limited set of host-dispensable genes and suggest that these pathways can be studied for therapeutic intervention

An evidence-based approach to the use of telehealth in long-term health conditions: development of an intervention and evaluation through pragmatic randomised controlled trials in patients with depression or raised cardiovascular risk

Background: Health services internationally are exploring the potential of telehealth to support the management of the growing number of people with long-term conditions (LTCs). Aim: To develop, implement and evaluate new care programmes for patients with LTCs, focusing on two common LTCs as exemplars: depression or high cardiovascular disease (CVD) risk. Methods Development: We synthesised quantitative and qualitative evidence on the effectiveness of telehealth for LTCs, conducted a qualitative study based on interviews with patients and staff and undertook a postal survey to explore which patients are interested in different forms of telehealth. Based on these studies we developed a conceptual model [TElehealth in CHronic disease (TECH) model] as a framework for the development and evaluation of the Healthlines Service for patients with LTCs. Implementation: The Healthlines Service consisted of regular telephone calls to participants from health information advisors, supporting them to make behaviour change and to use tailored online resources. Advisors sought to optimise participants’ medication and to improve adherence. Evaluation: The Healthlines Service was evaluated with linked pragmatic randomised controlled trials comparing the Healthlines Service plus usual care with usual care alone, with nested process and economic evaluations. Participants were adults with depression or raised CVD risk recruited from 43 general practices in three areas of England. The primary outcome was response to treatment and the secondary outcomes included anxiety (depression trial), individual risk factors (CVD risk trial), self-management skills, medication adherence, perceptions of support, access to health care and satisfaction with treatment. Trial results Depression trial: In total, 609 participants were randomised and the retention rate was 86%. Response to treatment [Patient Health Questionnaire 9-items (PHQ-9) reduction of ≥ 5 points and score of < 10 after 4 months] was higher in the intervention group (27%, 68/255) than in the control group (19%, 50/270) [odds ratio 1.7, 95% confidence interval (CI) 1.1 to 2.5; p = 0.02]. Anxiety also improved. Intervention participants reported better access to health support, greater satisfaction with treatment and small improvements in self-management, but not improved medication adherence. CVD risk trial: In total, 641 participants were randomised and the retention rate was 91%. Response to treatment (maintenance of/reduction in QRISK®2 score after 12 months) was higher in the intervention group (50%, 148/295) than in the control group (43%, 124/291), which does not exclude a null effect (odds ratio 1.3, 95% CI 1.0 to 1.9; p = 0.08). The intervention was associated with small improvements in blood pressure and weight, but not smoking or cholesterol. Intervention participants were more likely to adhere to medication, reported better access to health support and greater satisfaction with treatment, but few improvements in self-management. The Healthlines Service was likely to be cost-effective for CVD risk, particularly if the benefits are sustained, but not for depression. The intervention was implemented largely as planned, although initial delays and later disruption to delivery because of the closure of NHS Direct may have adversely affected participant engagement. Conclusion: The Healthlines Service, designed using an evidence-based conceptual model, provided modest health benefits and participants valued the better access to care and extra support provided. This service was cost-effective for CVD risk but not depression. These findings of small benefits at extra cost are consistent with previous pragmatic research on the implementation of comprehensive telehealth programmes for LTCs

Mobile Applications and Wearables for Chronic Respiratory Disease Monitoring

Mobile health (mHealth) has tremendous potential to benefit patients, providers, and the entire healthcare system. Benefits for patients to adopt mHealth include more effective access to health providers, reduced costs of care, and better health control. For physicians and the healthcare system, reasons to embrace mHealth are enhanced health outcomes, facilitated access to patients for care, and decreased time required for administrative tasks. Currently, some mobile apps and wearables dedicated to respiratory health provide medical education and messaging services, enable diary logs, aid with disease self-management, and include educational games. Major challenges for mHealth to be widely adopted include lack of studies demonstrating effectiveness, limited access to technology by all patients, decreased adoption over time, high costs, and data privacy concerns

A systematic review of the impact of mindfulness on the well-being of healthcare professionals

Objectives: Among efforts to improve the wellbeing of healthcare professionals are initiatives based around mindfulness meditation. To understand the value of such initiatives, we conducted a systematic review of empirical studies pertaining to mindfulness in healthcare professionals. Design: Databases were reviewed from the start of records to January 2016. Eligibility criteria included empirical analyses of mindfulness and wellbeing outcomes acquired in relation to practice. 81 papers met the eligibility criteria, consisting of a total 3,805 participants. Studies were principally examined for outcomes such as burnout, distress, anxiety, depression and stress. Results: Mindfulness was generally associated with positive outcomes in relation to most measures (although results were more equivocal with respect to some outcomes, most notably burnout). Conclusion: Overall, mindfulness does appear to improve the wellbeing of healthcare professionals. However, the quality of the studies was inconsistent, so further research is needed, particularly high-quality randomised control trials