Comparing external ventricular drains-related ventriculitis surveillance definitions

OBJECTIVETo evaluate the agreement between the current National Healthcare Safety Network (NHSN) definition for ventriculitis and others found in the literature among patients with an external ventricular drain (EVD)DESIGNRetrospective cohort study from January 2009 to December 2014SETTINGNeurology and neurosurgery intensive care unit of a large tertiary-care centerPATIENTSPatients with an EVD were included. Patients with an infection prior to EVD placement or a permanent ventricular shunt were excluded.METHODSWe reviewed the charts of patients with positive cerebrospinal fluid (CSF) cultures and/or abnormal CSF results while they had an EVD in place and applied various ventriculitis definitions.RESULTSWe identified 48 patients with a total of 52 cases of ventriculitis (41 CSF culture-positive cases and 11 cases based on abnormal CSF test results) using the NHSN definition. The most common organisms causing ventriculitis were gram-positive commensals (79.2%); however, 45% showed growth of only 1 colony on 1 piece of media. Approximately 60% of the ventriculitis cases by the NHSN definition met the Honda criteria, approximately 56% met the Gozal criteria, and 23% met Citerio’s definition. Cases defined using Honda versus Gozal definitions had a moderate agreement (κ=0.528; P&lt;.05) whereas comparisons of Honda versus Citerio definitions (κ=0.338; P&lt;.05) and Citerio versus Gozal definitions (κ=0.384; P&lt;.05) had only fair agreements.CONCLUSIONSThe agreement between published ventriculostomy-associated infection (VAI) definitions in this cohort was moderate to fair. A VAI surveillance definition that better defines contaminants is needed for more homogenous application of surveillance definitions between institutions and better comparison of rates.Infect Control Hosp Epidemiol 2017;38:574–579</jats:sec

Sumoylation in plants : mechanistic insights and its role in drought stress

Post-translational modification by SUMO is an essential process that has a major role in the regulation of plant development and stress responses. Such diverse biological functions are accompanied by functional diversification among the SUMO conjugation machinery components and regulatory mechanisms that has just started to be identified in plants. In this review, we focus on the current knowledge of the SUMO conjugation system in plants in terms of components, substrate specificity, cognate interactions, enzyme activity, and subcellular localization. In addition, we analyze existing data on the role of SUMOylation in plant drought tolerance in model plants and crop species, paying attention to the genetic approaches used to stimulate or inhibit endogenous SUMO conjugation. The role in drought tolerance of potential SUMO targets identified in proteomic analyses is also discussed. Overall, the complexity of SUMOylation and the multiple genetic and environmental factors that are integrated to confer drought tolerance highlight the need for significant efforts to understand the interplay between SUMO and drought

Proposal and preliminary design for a high speed civil transport aircraft. Swift: A high speed civil transport for the year 2000

To meet the needs of the growing passenger traffic market in light of an aging subsonic fleet, a new breed of aircraft must be developed. The Swift is an aircraft that will economically meet these needs by the year 2000. Swift is a 246 passenger, Mach 2.5, luxury airliner. It has been designed to provide the benefit of comfortable, high speed transportation in a safe manner with minimal environmental impact. This report will discuss the features of the Swift aircraft and establish a solid, foundation for this supersonic transport of tomorrow

Knowledge, Behavior and Attitudes Concerning STI Prevention among Out-of-School Youth in the Philippines

The purpose of this study is to determine the current knowledge, behavior and attitude toward STI prevention among out-of-school youth in the Philippines. Anonymous self-administered questionnaires were distributed separately to 28 out-of-school youth (15 male, 12 female, one unspecified). The mean age of the subjects was 18.0 ± 3.0 years, with an overall age range of 15 to 24 years. The female respondents were younger than the male respondents on average. The out-of-school youth obtained information on STIs mainly from the media, and had fewer information sources than in-school students. Although the out-of-school youth had insufficient knowledge of STIs compared to the students, they were fairly knowledgeable about cervical cancer. They were also more sexually active than the students. The out-of-school youth consulted their parents on STI prevention, but received insufficient knowledge on STI prevention from just this source. It was concluded that out-of-school youth could constitute a high risk demographic for STIs, and health education may be essential to help them protect themselves from STIs

Poverty Reduction Initiatives at the Universidad de Santa Isabel: Vincentian Seeds of Hope

Following its mission to be an agent of social transformation, the Universidad de Santa Isabel in the Phillipines has many initiatives for poverty reduction. The USI Saint Louise de Marillac Alternative College has a Social Entrepreneurship degree that teaches business and entrepreneurial skills along with social responsibility and Vincentian values. Tuition is based on a sliding scale, and the program also helps graduates establish their businesses. USI has a savings program for personnel and students. It also pays interest and makes loans, including loans for housing that have helped many people out of homelessness after natural disasters. Scholarships are also offered through the university. Among many others, there are projects that provide education in citizenship and social advocacy, help communities start their own businesses, and encourage different university departments and sectors to unite in community extension activities

Significado de la anemia en las diferentes etapas de la vida

Overview: Anemia is very common in primary care consultations and pediatrics, and IDA is the cause of 50% of all cases of anemia. Methodology: Literature review and documentary descriptive analysis of the pathogenesis of iron-deficiency anemia, the basic diagnostic tests to study IDA and the significance of such using a specific time period in the documentary search and inclusion criteria that takes into account factors that are analyzed in the study: Ideas about the metabolism of iron. Ideas about hematopoiesis. Laboratory diagnosis and classification of anemia. Clinical features of iron deficiency anemia. Causes of iron deficiency. Results and conclusion: The staged documentary study covers the publications on the pathogenesis of iron deficiency anemia, the basic diagnostic tests to study the IDA and the significance of such, and it shows how important this data is for professional nursing in the area of primary care and pediatrics, to identify it and act accordingly.Resumen: La anemia presenta una elevada prevalencia en las consultas de atención primaria y pediatría, y la ADH representa el 50% de todos los casos de anemia. Metodología: Revisión bibliográfica y análisis descriptivo documental sobre etiopatogenia de la anemia ferropénica, las pruebas diagnósticas básicas para el estudio de la ADH  y su significado, utilizando una temporalidad determinada en la búsqueda documental y criterios de inclusión atendiendo a las dimensiones que se analizan en el estudio: Nociones acerca del metabolismo del hierro. Nociones acerca de la hematopoyesis. Diagnóstico por el laboratorio y clasificación de las anemias. Clínica de la anemia ferropénica. Causas de la deficiencia de hierro. Resultados y conclusión: EL estudio documental efectuado nos presenta la existencia de publicaciones con contenidos sobre etiopatogenia de la anemia ferropénica, las pruebas diagnósticas básicas para el estudio de la ADH  y su significado, evidenciando la importancia de este contenido para el profesional de enfermería en el área de la atención primaria y pediatría

Cost-utility of a walking programme for moderately depressed, obese, or overweight elderly women in primary care: a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>There is a considerable public health burden due to physical inactivity, because it is a major independent risk factor for several diseases (e.g., type 2 diabetes, cardiovascular disease, moderate mood disorders neurotic diseases such as depression, etc.). This study assesses the cost utility of the adding a supervised walking programme to the standard "best primary care" for overweight, moderately obese, or moderately depressed elderly women.</p> <p>Methods</p> <p>One-hundred six participants were randomly assigned to an interventional group (n = 55) or a control group (n = 51). The intervention consisted of an invitation, from a general practitioner, to participate in a 6-month walking-based, supervised exercise program with three 50-minute sessions per week. The main outcome measures were the healthcare costs from the Health System perspective and quality adjusted life years (QALYs) using EuroQol (EQ-5D.)</p> <p>Results</p> <p>Of the patients invited to participate in the program, 79% were successfully recruited, and 86% of the participants in the exercise group completed the programme. Over 6 months, the mean treatment cost per patient in the exercise group was €41 more than "best care". The mean incremental QALY of intervention was 0.132 (95% CI: 0.104–0.286). Each extra QALY gained by the exercise programme relative to best care cost €311 (95% CI, €143–€394). The cost effectiveness acceptability curves showed a 90% probability that the addition of the walking programme is the best strategy if the ceiling of inversion is €350/QALY.</p> <p>Conclusion</p> <p>The invitation strategy and exercise programme resulted in a high rate of participation and is a feasible and cost-effective addition to best care. The programme is a cost-effective resource for helping patients to increase their physical activity, according to the recommendations of general practitioners. Moreover, the present study could help decision makers enhance the preventive role of primary care and optimize health care resources.</p> <p>Trial Registration</p> <p>[ISRCTN98931797]</p

Listening to Silence: An Insight into the Lives of the Deaf in Baguio City

Oftentimes, people describe the Deaf as unfortunate and pitiful. However, this is clearly not how they view themselves. This study’s objective is to bring awareness to the lives and struggles of the Deaf community as well as see how others, namely parents and students, perceive them in the present. To achieve this, 3 research questions were formulated: “What are the special skills and abilities of the Deaf?”, “How do Deaf individuals want to be treated by the general population?”, and “How do people feel about their interactions with the Deaf?” By using an inductive thematic analysis, this phenomenological qualitative study concluded that the Deaf excel in the area of arts (culinary, visual, and performing) and sports. This could be linked to a gain connected to Cross-Modal Neuroplasticity. The Deaf also explained that they do not want to be “fixed.” They simply want to be accepted and treated fairly. Still, they would appreciate it if others physically assist them in activities that are difficult for them due to their impairment. As for the perception of others, it was shown that parents of the Deaf had larger numbers of pessimistic initial reactions than hearing students. Stress levels are higher for parents as they have to consider the communication, financial support, and the upbringing of their Deaf children. It is worthwhile to note that other respondents viewed the Deaf as abled, skilled, and talented in certain fields. They were familiar and comfortable around the Deaf as they accepted them for who they are

Citrus psorosis virus 24K protein inhibits the processing of miRNA precursors by interacting with components of the biogenesis machinery

[EN] Sweet orange (Citrus sinensis) is one of the most important fruit crops worldwide. Virus infections in this crop can interfere with cellular processes, causing dramatic economic losses. By performing RT-qPCR analyses, we demonstrated that citrus psorosis virus (CPsV)-infected orange plants exhibited higher levels of unprocessed microRNA (miRNA) precursors than healthy plants. This result correlated with the reported reduction of mature miRNAs species. The protein 24K, the CPsV suppressor of RNA silencing (VSR), interacts with miRNA precursors in vivo. Thus, this protein becomes a candidate responsible for the increased accumulation of unprocessed miRNAs. We analyzed 24K RNA-binding and protein-protein interaction domains and described patterns of its subcellular localization. We also showed that 24K colocalizes within nuclear D-bodies with the miRNA biogenesis proteins DICER-LIKE 1 (DCL1), HYPONASTIC LEAVES 1 (HYL1), and SERRATE (SE). According to the results of bimolecular fluorescence complementation and co-immunoprecipitation assays, the 24K protein interacts with HYL1 and SE. Thus, 24K may inhibit miRNA processing in CPsV-infected citrus plants by direct interaction with the miRNA processing complex. This work contributes to the understanding of how a virus can alter the regulatory mechanisms of the host, particularly miRNA biogenesis and function.Agencia Nacional de Promocion de la Investigacion, el Desarrollo Tecnologico y la Innovacion (Agencia I+D+i) PICT 2017-1233 Carina A. Reyes. Agencia Nacional de Promocion de la Investigacion, el Desarrollo Tecnologico y la Innovacion (Agencia I+D+i) PICT 2018-1264 Maria L. Garcia. Agencia Nacional de Promocion de la Investigacion, el Desarrollo Tecnologico y la Innovacion (Agencia I+D+i) PICT 2020-01925 Carina A. Reyes. Proyecto de Cooperacion Cientifica para el Desarrollo (Ministerio de Economia, Industria y Competitividad) COOPA20191 Carina A. Reyes y Carmen Hernandez.Marmisolle, FE.; Borniego, MB.; Cambiagno, DA.; Gonzalo, L.; García, ML.; Manavella, PA.; Hernández Fort, C.... (2024). Citrus psorosis virus 24K protein inhibits the processing of miRNA precursors by interacting with components of the biogenesis machinery. Microbiology Spectrum. 12(7). https://doi.org/10.1128/spectrum.03513-2312

Individualized decision aid for diverse women with lupus nephritis (IDEA-WON): A randomized controlled trial.

BackgroundTreatment decision-making regarding immunosuppressive therapy is challenging for individuals with lupus. We assessed the effectiveness of a decision aid for immunosuppressive therapy in lupus nephritis.Methods and findingsIn a United States multicenter, open-label, randomized controlled trial (RCT), adult women with lupus nephritis, mostly from racial/ethnic minority backgrounds with low socioeconomic status (SES), seen in in- or outpatient settings, were randomized to an individualized, culturally tailored, computerized decision aid versus American College of Rheumatology (ACR) lupus pamphlet (1:1 ratio), using computer-generated randomization. We hypothesized that the co-primary outcomes of decisional conflict and informed choice regarding immunosuppressive medications would improve more in the decision aid group. Of 301 randomized women, 298 were analyzed; 47% were African-American, 26% Hispanic, and 15% white. Mean age (standard deviation [SD]) was 37 (12) years, 57% had annual income of &lt;$40,000, and 36% had a high school education or less. Compared with the provision of the ACR lupus pamphlet (n = 147), participants randomized to the decision aid (n = 151) had (1) a clinically meaningful and statistically significant reduction in decisional conflict, 21.8 (standard error [SE], 2.5) versus 12.7 (SE, 2.0; p = 0.005) and (2) no difference in informed choice in the main analysis, 41% versus 31% (p = 0.08), but clinically meaningful and statistically significant difference in sensitivity analysis (net values for immunosuppressives positive [in favor] versus negative [against]), 50% versus 35% (p = 0.006). Unresolved decisional conflict was lower in the decision aid versus pamphlet groups, 22% versus 44% (p &lt; 0.001). Significantly more patients in the decision aid versus pamphlet group rated information to be excellent for understanding lupus nephritis (49% versus 33%), risk factors (43% versus 27%), medication options (50% versus 33%; p ≤ 0.003 for all); and the ease of use of materials was higher in the decision aid versus pamphlet groups (51% versus 38%; p = 0.006). Key study limitations were the exclusion of men, short follow-up, and the lack of clinical outcomes, including medication adherence.ConclusionsAn individualized decision aid was more effective than usual care in reducing decisional conflict for choice of immunosuppressive medications in women with lupus nephritis.Trial registrationClinicaltrials.gov, NCT02319525