Observations on the transmission of Dientamoeba fragilis and the cyst life cycle stage.

Little is known about the life cycle and mode of transmission of Dientamoeba fragilis. Recently it was suggested that fecal­oral transmission of cysts may play a role in the transmission of D. fragilis. In order to establish an infection, D. fragilis is required to remain viable when exposed to the pH of the stomach. In this study, we investigated the ability of cultured trophozoites to withstand the extremes of pH. We provide evidence that trophozoites of D. fragilis are vulnerable to highly acidic conditions. We also investigated further the ultrastructure of D. fragilis cysts obtained from mice and rats by transmission electron microscopy. These studies of cysts showed a clear cyst wall surrounding an encysted parasite. The cyst wall was double layered with an outer fibrillar layer and an inner layer enclosing the parasite. Hydrogenosomes, endoplasmic reticulum and nuclei were present in the cysts. Pelta-axostyle structures, costa and axonemes were identifiable and internal flagellar axonemes were present. This study therefore provides additional novel details and knowledge of the ultrastructure of the cyst stage of D. fragilis.

EHR Smart Phrases Used as Enrollment Mechanism in Diabetes Self-Management Support Programs: Preliminary Outcomes.

ABSTRACT: Diabetes in the United States is increasing rapidly. Innovative strategies are needed for diabetes prevention and self-management. This study assessed the usability, acceptability, and awareness of an electronic health record (EHR) tool for referring patients to a community-based diabetes self-management support program. Mixed-methods approaches were used, using EHR data and key informant interviews to assess the implementation of this quality improvement (QI) process intervention. The implementation of a smart phrase tool within the EHR led to a substantial increase in referrals (773) to the Health Extension for Diabetes (HED) program. Clinical health care professionals have actively used the referral mechanism; they reported using smart phrases to increase efficiency in patient care. Lack of training and program awareness was identified as a barrier to adoption. Awareness of the HED program and .HEDREF smart phrase was limited, but improved with targeted QI and training interventions. The .HEDREF smart phrase demonstrated effectiveness in increasing patient referrals to the HED program, highlighting the potential of EHR tools to streamline documentation and promote patient engagement in diabetes self-management. Future research should focus on broader health care contexts, patient perspectives, and integration of technology for optimal patient outcomes.

Mobile Medication Adherence Platform for Buprenorphine (MAP4BUP): A Phase I feasibility, usability and efficacy pilot randomized clinical trial.

BACKGROUND/AIM: Poor medication adherence is one of the main barriers to the long-term efficacy of buprenorphine/naloxone (BUP/NAL). The aims of this pilot investigation were to examine if a Bluetooth-enabled pill cap and mobile application is a feasible, usable tool for increasing BUP/NAL adherence among people with an opioid use disorder. METHODS: This pilot randomized clinical trial (RCT; total n = 41) lasted 12 weeks and was conducted in two office-based BUP/NAL provider locations in Spokane, WA and Coeur d'Alene, ID from January 2020 to September of 2021 with an 11-month gap due to COVID-19. Patients receiving BUP/NAL who consented to participate were randomized to receive the pill cap device (PLY group; n = 19) or a service as usual (SAU group; n = 22) group that included an identical but inactive cap for their bottle. The PLY group received reminders via text and voice, and the support of a "helper" (e.g., friend) to monitor pill cap openings. RESULTS: Most participants in PLY group found the device both feasible (92.86 %) and usable (78.57 %). Most participants liked using the device (92.86 %) and were satisfied with the device (85.71 %). While not statistically different from one another, medication adherence per the Medication Possession Ratio was 75 % in the SAU group and 84 % in the PLY group. Pill cap openings were significantly higher in the PLY group with an average of 91.8 openings versus the SAU group's average of 56.7 (p < 0.05). CONCLUSION: The devices was feasible, usable, and patients had high levels of satisfaction. The device was associated with increased pill openings.

Research Methods Used in Evidence-Based Design: An Analysis of Five Years of Research Articles From the HERD Journal.

OBJECTIVE: This study aims to analyze research methodologies from 157 research articles published in this journal in the last five years (2016-2020). BACKGROUND: Health environments research is comprised of research covering many topics and from various disciplines worldwide. No systematic study exists to uncover themes in evidence-based design (EBD) research concerning the types of research published, people engaged in research, and the research methods employed. Understanding the nature of health environment research performed can help researchers, practitioners, and students situate their work within an EBD research structure. METHODS: Case study research was used to analyze 157 articles published in the Health Environments Research & Design Journal devoted to EBD and research. Secondary data were extracted to capture research methods from health environments studies and then analyzed to identify themes. The design and outcome categories were structured around and the Center for Health Design's (CHD) Knowledge Repository with origins to Ulrich et al.'s Evidence-Based Design Framework. RESULTS: Findings are reported on categories commonly found in empirical research articles: (i) key words, (ii) disciplines from authors, (iii) settings studied, (iv) populations studied or sampled, (v) research approach and study design, (vi) research strategies, (vii) data collection methods, (viii) data analysis procedures, (ix) design categories and variables, and (x) outcome categories and variables. CONCLUSIONS: The analyses highlighted the research methods most frequently used in health environments research. Findings revealed several inconsistencies across articles on key words and the framing of research methodologies. Results suggest that there should be a consistent and overarching research taxonomy with a set of acceptable terms for effective literature searches.

Oral pre-treatment with thiocyanate (SCN-) protects against myocardial ischaemia-reperfusion injury in rats.

Despite improvements in revascularization after a myocardial infarction, coronary disease remains a major contributor to global mortality. Neutrophil infiltration and activation contributes to tissue damage, via the release of myeloperoxidase (MPO) and formation of the damaging oxidant hypochlorous acid. We hypothesized that elevation of thiocyanate ions (SCN-), a competitive MPO substrate, would modulate tissue damage. Oral dosing of rats with SCN-, before acute ischemia-reperfusion injury (30 min occlusion, 24 h or 4 week recovery), significantly reduced the infarct size as a percentage of the total reperfused area (54% versus 74%), and increased the salvageable area (46% versus 26%) as determined by MRI imaging. No difference was observed in fractional shortening, but supplementation resulted in both left-ventricle end diastolic and left-ventricle end systolic areas returning to control levels, as determined by echocardiography. Supplementation also decreased antibody recognition of HOCl-damaged myocardial proteins. SCN- supplementation did not modulate serum markers of damage/inflammation (ANP, BNP, galectin-3, CRP), but returned metabolomic abnormalities (reductions in histidine, creatine and leucine by 0.83-, 0.84- and 0.89-fold, respectively), determined by NMR, to control levels. These data indicate that elevated levels of the MPO substrate SCN-, which can be readily modulated by dietary means, can protect against acute ischemia-reperfusion injury.

Hyperglycaemia and oxidative stress upregulate HSP60 & HSP70 expression in HeLa cells.

Heat Shock Proteins 60 & 70 (HSP60 & HSP70) are intracellular protein that has been shown to be present at elevated levels in systemic circulation in Type 2 Diabetes mellitus (T2DM) patients. Conditions that lead to its secretion, and the mechanism of its translocation from cells, have not yet been defined. The aim of this study was to determine if specific cell stressors associated with T2DM, namely hyperglycaemia and oxidative stress, result in the upregulation of HSP60 in human cells in vitro. Human HeLa cells were grown in media supplemented with 100 mM glucose, 200 µM hydrogen peroxide (H2O2), and 50 µM sodium azide. Initially, the effect of these treatments on cell growth rate was examined, with each treatment significantly inhibiting growth rate. LDH and MTT assays were also used to successfully demonstrate that these treatments do not significantly increase cell lysis, but do significantly impair mitochondrial dehydrogenase activity. To confirm this mitochondria specific form of inhibition, DCFDA assay were used to investigate any increases in intracellular reactive oxygen species (ROS) generation. All three treatments resulted in significantly increased ROS generation, with greater ROS production occurring with a greater exposure time. Interestingly, when the protein levels of HSP60 and HSP70 were measured after 3 and 7 days of exposure of the HeLa cells to 100 mM glucose, 200 µM H2O2, and 50 µM sodium azide significant induction of these two molecular stress proteins were observed ranging from 2.43-5.08 fold compared to untreated control cells.