The women's heart health programme: a pilot trial of sex-specific cardiovascular management.

BACKGROUND: There is increasing knowledge of sex-specific differences in cardiovascular disease and recognition of sex disparities in management. In our study, we investigated whether a cardiovascular programme tailored to the specific needs of women could lead to improved outcomes. METHODS: We randomised 100 female patients to receive cardiology follow-up with the conventional sex-neutral cardiac programme (control), or the sex-tailored Women's Heart Health Programme (intervention). The intervention group was managed by an all-women multidisciplinary team and received culture-centred health intervention workshops, designed through in-depth interviews with the participants. The primary outcome was cardiovascular risk factor improvement at 1 year. Secondary outcomes include cardiovascular event rates, quality of life scores, and self-reported improvement in knowledge, attitudes, intentions and practices. Generalised structural equation model analysis was used to determine if the intervention group had better outcomes at alpha level 0.1. RESULTS: The mean age was 67.3 ± 12.7 years, with an ethnic distribution of 70% Chinese, 18% Malays, and 12% Indians. The majority of these patients had no formal or primary level of education (63%), and were mostly unemployed (78%). Patients in intervention group had better control of diabetes mellitus (lower HbA1c of 0.63% [CI 0.21-1.04], p = 0.015) and lower body-mass-index (0.74 kg/m2 [CI 0.02-1.46], p = 0.092) at 1 year, but there was no significant difference in blood pressure or lipid control. Overall, there was a trend towards better risk factor control, 31.6% of intervention group versus 26.5% of control group achieved improvement in at least 1 CV risk factor control to target range. There was no significant difference in incidence of cardiovascular events, quality of life, or domains in knowledge, attitudes, intention and practices. CONCLUSION: This pilot study is the first of its kind evaluating a new model of care for women with heart disease. The potential to improve outcomes needs to be studied in a larger trial with longer follow up. TRIAL REGISTRATION: This trial was prospectively registered clinicaltrials.gov on 6 May 2013. Trial Number: 2013/00088. Identifier: NCT02017470.

Health Meanings among Foreign Domestic Workers in Singapore: A Culture-Centered Approach.

Economic migration is integral to processes of globalization, with large numbers of the global poor moving across borders in search of employment in the face of structural adjustment programs and large-scale displacement of the poor from traditional forms of livelihood. One such group are foreign domestic workers (FDWs). In this culture-centered study, we listen to the voices of FDWs in Singapore to understand the key meanings of health held by this group of migrant workers as they negotiate living and working in Singapore. Through the representation of FDW voices at sites where they have previously been excluded, we hope to co-create participatory spaces in national discourse so that policies and interventions can be developed to address the health needs of FDWs. The results represented in this essay are part of a larger project engaging the CCA to foster communicative platforms for structural transformation.

Mapping niche-specific two-component system requirements in uropathogenic Escherichia coli.

Sensory systems allow pathogens to differentiate between different niches and respond to stimuli within them. A major mechanism through which bacteria sense and respond to stimuli in their surroundings is two-component systems (TCSs). TCSs allow for the detection of multiple stimuli to lead to a highly controlled and rapid change in gene expression. Here, we provide a comprehensive list of TCSs important for the pathogenesis of uropathogenic Escherichia coli (UPEC). UPEC accounts for >75% of urinary tract infections (UTIs) worldwide. UTIs are most prevalent among people assigned female at birth, with the vagina becoming colonized by UPEC in addition to the gut and the bladder. In the bladder, adherence to the urothelium triggers E. coli invasion of bladder cells and an intracellular pathogenic cascade. Intracellular E. coli are safely hidden from host neutrophils, competition from the microbiota, and antibiotics that kill extracellular E. coli. To survive in these intimately connected, yet physiologically diverse niches E. coli must rapidly coordinate metabolic and virulence systems in response to the distinct stimuli encountered in each environment. We hypothesized that specific TCSs allow UPEC to sense these diverse environments encountered during infection with built-in redundant safeguards. Here, we created a library of isogenic TCS deletion mutants that we leveraged to map distinct TCS contributions to infection. We identify-for the first time-a comprehensive panel of UPEC TCSs that are critical for infection of the genitourinary tract and report that the TCSs mediating colonization of the bladder, kidneys, or vagina are distinct.IMPORTANCEWhile two-component system (TCS) signaling has been investigated at depth in model strains of Escherichia coli, there have been no studies to elucidate-at a systems level-which TCSs are important during infection by pathogenic Escherichia coli. Here, we report the generation of a markerless TCS deletion library in a uropathogenic E. coli (UPEC) isolate that can be leveraged for dissecting the role of TCS signaling in different aspects of pathogenesis. We use this library to demonstrate, for the first time in UPEC, that niche-specific colonization is guided by distinct TCS groups.

Isolation and adoptive transfer of innate lymphoid cells 2 to a recipient mouse model of PDAC.

Innate lymphoid cells 2 (ILC2) play a significant role in the tumorigenesis of pancreatic ductal adenocarcinoma (PDAC). An important aspect of ILC2-mediated tumorigenesis is the expansion of the resident ILC2 and simultaneous recruitment of the peripheral ILC2. Here, we describe a protocol for isolation, enrichment, and DiD labeling of ILC2 for in vivo tracking of ILC2s in the mouse. Further, we describe steps for the adoptive transfer of ILC2 to a recipient mouse model of PDAC. For complete details on the use and execution of this protocol, please refer to Alam et al. (2022).

Fungal ablation and transplantation of specific fungal species into PDAC tumor-bearing mice.

Intratumor and gut mycobiome is linked to pancreatic ductal adenocarcinoma (PDAC) tumorigenesis; however, an optimal approach to culture and transplant fungus into mouse for in vivo studies is missing. This protocol describes culture steps of Alternaria alternata and Malassezia globosa and their subsequent transplantation into a PDAC mouse model via oral gavage. The utilization of the fungal culture method will allow for consistent growth and expansion of specific fungal species for downstream processing. For complete details on the use and execution of this protocol, please refer to Alam et al. (2022).

Using Genetics to Evaluate the Success of a Feral Cat (Felis catus) Control Program in North-Western Australia.

The feral cat has been implicated in the decline and extinction of many species worldwide and a range of strategies have been devised for its control. A five-year control program using the aerial broadcast of toxic Eradicat® baits was undertaken at Fortescue Marsh in the Pilbara region of north-western Australia, for the protection of biodiversity in this important wetland area. This program has been shown to have had a significant detrimental effect on cats in this landscape, but the long-term impact is difficult to ascertain. We assessed population genetics across three cohorts of feral cats sampled as part of the control program. We also compared cat populations in natural habitats and around human infrastructure. A key challenge in any study of wild animal populations is small sample sizes and feral cats are particularly difficult to capture and sample. The results of this study superficially appear to suggest promising trends but were limited by sample size and many were not statistically significant. We find that the use of genetic techniques to monitor the impact of invasive species control programs is potentially useful, but ensuring adequate sample sizes over a long enough time-frame will be critical to the success of such studies.

Fluorescence Multiplexing with Spectral Imaging and Combinatorics.

Ultraviolet-to-infrared fluorescence is a versatile and accessible assay modality but is notoriously hard to multiplex due to overlap of wide emission spectra. We present an approach for fluorescence called multiplexing using spectral imaging and combinatorics (MuSIC). MuSIC consists of creating new independent probes from covalently linked combinations of individual fluorophores, leveraging the wide palette of currently available probes with the mathematical power of combinatorics. Probe levels in a mixture can be inferred from spectral emission scanning data. Theory and simulations suggest MuSIC can increase fluorescence multiplexing ∼4-5 fold using currently available dyes and measurement tools. Experimental proof-of-principle demonstrates robust demultiplexing of nine solution-based probes using ∼25% of the available excitation wavelength window (380-480 nm), consistent with theory. The increasing prevalence of white lasers, angle filter-based wavelength scanning, and large, sensitive multianode photomultiplier tubes make acquisition of such MuSIC-compatible data sets increasingly attainable.

Evaluating the efficacy of a landscape scale feral cat control program using camera traps and occupancy models.

The impact of introduced predators is a major factor limiting survivorship and recruitment of many native Australian species. In particular, the feral cat and red fox have been implicated in range reductions and population declines of many conservation dependent species across Australia, including ground-nesting birds and small to medium-sized mammals. The impact of predation by feral cats since their introduction some 200 years ago has altered the structure of native fauna communities and led to the development of landscape-scale threat abatement via baiting programs with the feral cat bait, Eradicat. Demonstrating the effectiveness of broad-scale programs is essential for managers to fine tune delivery and timing of baiting. Efficacy of feral cat baiting at the Fortescue Marsh in the Pilbara, Western Australia was tested using camera traps and occupancy models. There was a significant decrease in probability of site occupancy in baited sites in each of the five years of this study, demonstrating both the effectiveness of aerial baiting for landscape-scale removal of feral cats, and the validity of camera trap monitoring techniques for detecting changes in feral cat occupancy during a five-year baiting program.

Do As I Say: Using Communication Role-Plays to Assess Sexual Assertiveness Following an Intervention.

Sexual risk reduction interventions are often ineffective for women who drink alcohol. The present study examines whether an alcohol-related sexual risk reduction intervention successfully trains women to increase assertive communication behaviors and decrease aggressive communication behaviors. Women demonstrated their communication skills during interactive role-plays with male role-play partners. Young, unmarried, and nonpregnant African American women (N = 228, ages 18-24) reporting unprotected vaginal or anal sex and greater than three alcoholic drinks in the past 90 days were randomly assigned to a control, a sexual risk reduction, or a sexual and alcohol risk reduction (NLITEN) condition. Women in the NLITEN condition significantly increased assertive communication behavior compared to women in the control condition, yet use of aggressive communicative behaviors was unchanged. These data suggest assertive communication training is an efficacious component of a sexual and alcohol risk reduction intervention. Public health practitioners and health educators may benefit from group motivational enhancement therapy (GMET) training and adding a GMET module to existing sexual health risk reduction interventions. Future research should examine GMET's efficacy in combination with other evidence-based interventions within other populations and examine talking over and interrupting one's sexual partner as an assertive communication behavior within sexual health contexts.