Human Resources

Nonprofit organizations must have a sound understanding of human resources management in order to effectively accomplish their mission. This training manual provides users of all experience levels with the fundamentals they need to build a successful human resources strategy for operating a nonprofit support organization for AIDS advocacy, prevention and treatment

Measuring the microbiome of chronic wounds with use of a topical antimicrobial dressing – A feasibility study

<div><p>Background</p><p>Polymicrobial communities colonize all wounds, and biofilms are hypothesized to be a key link to the chronic state and stalled healing. Molecular methods offer greater insight when studying microbial ecology in chronic wounds, as only a small fraction of wound bacteria are cultured by currently available methods and studies have shown little agreement between culture and molecular based approaches. Some interventions, like dressings with oxidized silver, are reported to help the stalled wounds move to a normal healing trajectory but the underlying mechanisms are difficult to measure. One hypothesis is that the use of topical antimicrobial dressings targets the wound microbiome and reduces bioburden.</p><p>Objectives</p><p>Our objective was to determine if culture-independent molecular methods could be used to identify the microbial composition in chronic wounds, and measure the microbiome over time when a topical antimicrobial dressing is used to reduce bioburden.</p><p>Methods</p><p>Patients with chronic wounds defined as >6 weeks in duration and not taking systemic antibiotics were recruited to participate. A wound contact layer containing silver oxynitrate was applied immediately after routine sharp debridement material was collected and swabs of the wound bed taken. Next-generation sequencing of the bacterial 16S rRNA gene in each specimen was used to measure the microbiome.</p><p>Results</p><p>Distinct bacterial communities were observed between swab and debridement samples, highlighting spatial differences and the importance of sampling consistency. The microbial communities appeared to be similar between different diabetes statuses, but different among the three wound categories included.</p><p>Conclusions</p><p>Culture-independent methods can be applied to measure the microbiome of chronic wounds even when a topical antimicrobial dressing is applied to the wound.</p></div

Overview of the bacterial communities between diabetes status and among wound types in pre-treated samples (V1 samples).

<p>(A) Plots for swab samples. The Y axis represents the percentage of the OTUs being observed among the total reads. (B) Plots for debridement samples. Y axis represents the percentage of the OTUs being observed among the total reads.</p

Comparison of alpha diversity in treated (V2-V6) samples.

<p>Comparison of alpha diversity in treated (V2-V6) samples.</p

PCoA clustering, common/unique bacterial OTUs at species level, and differentially abundant bacterial OTUs between diabetes status and among wound types in post-treatment samples (V2-V6 samples).

<p>(A) Plots for swab samples. Venn diagrams suggest that diabetic status-associated and wound type-associated OTUs exist in swab samples. Differentially abundant OTUs are listed in the bar chart. (B) Plots for debridement samples. Venn diagrams suggest that diabetic status-associated and wound type-associated OTUs exist in debridement samples. Differentially abundant OTUs are listed in the bar chart.</p

Anthropometric and biochemical parameters showing significant correlations with serum A-FABP and NT-proBNP at baseline.

<p><i>β</i>, Standardized regression coefficients.</p>†<p>Pearson correlation analyses were performed.</p><p>*A multiple stepwise regression analysis was performed. Variables included in the original model are age, gender, waist circumference, BMI, and LDL-c.</p>#<p>A multiple stepwise regression analysis was performed. Variables included in the original model are age, gender, SBP, TG, HDL-c, LDL-c, FPG, HbA1c, HOMA-IR, and AIR.</p

Bacterial relative abundance (>1% abundance in all samples) plots for three patient timelines.

<p>Plots are split by debridement samples (top panel) and swab samples (bottom panel). Wound locations are as follows: P10 (post-surgical abdomen, non-F/L wound), P8 (venous leg ulcer), P9 (diabetic foot ulcer). Debridement samples were not taken on visit 2.</p

DataSheet1.PDF

<p>Background: Cancer remains a leading cause of death and constitutes an enormous burden on society worldwide. The association between the human telomerase reverse transcriptase (TERT) gene variant rs2736098 polymorphisms and cancer predisposition remain inconclusive.</p><p>Objective and methods: Databases including Pubmed and Embase were systematically searched from inception to September 15, 2017 to retrieve studies investigating the association between the TERT variant rs2736098 polymorphisms and cancer risk in accordance with previously determined exclusion and inclusion criteria. The pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were evaluated using random or fixed effects models.</p><p>Results: Thirty-one case-control studies from 29 articles with 15,837 cases and 19,263 controls were screened out after a systematic search. Pooled analysis demonstrated that the TERT variant rs2736098 G > A polymorphism was significantly correlated with cancer risk in all populations (A vs. G: OR = 1.134, 95% CI = 1.051–1.224, P = 0.001; AA vs. GG: OR = 1.280, 95% CI = 1.087–1.508, P = 0.003; GA vs. GG: OR = 1.125, 95% CI = 1.020–1.240, P = 0.018; GA/AA vs. GG: OR = 1.159, 95% CI = 1.047–1.283, P = 0.004). In the subgroup analysis based on cancer type, the TERT rs2736098 with the A allele was 1.299 times more frequent than that with the G allele (OR = 1.299, 95% CI = 1.216–1.386) under the allelic genetic model in lung cancer, and 1.152 times (OR = 1.152, 95% CI = 1.032–1.286) that in bladder cancer.</p><p>Conclusions: This meta-analysis demonstrated significant correlations between the TERT variant rs2736098 polymorphisms and cancer susceptibility. The A allele in the rs2736098 G > A polymorphism contributes to susceptibility in many types of cancer, especially lung cancer and bladder cancer.</p

Patient demographics and wound characteristics at baseline (T = 0) and the end of study (T = 4).

<p>Patient demographics and wound characteristics at baseline (T = 0) and the end of study (T = 4).</p

Comparison of median wound score (median BWAT ± IQR) between diabetes status and among wound types before and after treatment.

<p>Median wound score ratio = visit 6/visit 1 ± IQR, Median wound score change = visit 6—visit 1 ± IQR.</p