Using Cognitive Interviewing to Design Interventions for Implementation in Oncology Settings.

BACKGROUND: Implementation of effective interventions into clinical practice is slow, in large part, because researchers do not sufficiently attend to the realities of nurses who implement interventions. OBJECTIVES: The aim of the study was to provide an exemplar of how cognitive interviewing-an important and underused method for developing nursing research-can be used to design survey items and assess multilevel implementation factors. METHODS: We utilized the Consolidated Framework for Implementation Research to create a survey to assess factors that influence how oncology nurses deliver physical activity interventions. Two rounds of cognitive interviews were conducted with five purposively selected oncology nurses to assess survey items' clarity and effectiveness at eliciting desired information. We used a cognitive interviewing coding scheme to code data and revise unclear items. Participants completed the revised survey online and underwent a second interview to provide additional feedback. RESULTS: Seven important changes were made to the survey: how to assess nurses' perceptions of other nurses' beliefs and practices; language to capture data relating to nursing leadership and administration; increased detail to assess factors related to nurses' workplaces; language related to capturing factors related to policy; language to capture data related to equity, disparities, and cultural tailoring; terms replacement with language used by nurses; and strategy to capture data about nurses' knowledge of national physical activity recommendations for cancer survivors. DISCUSSION: Cognitive interviewing can be applied to develop survey items that capture real-world experiences and perspectives of practicing nurses. This is an essential step in developing nursing interventions that are ready to be implemented and increasing the uptake of evidence-based nursing care. Cognitive interviewing can be used across nursing settings, populations, and interventions to develop understandings of attitudes, attributes, characteristics, and perceptions for a variety of nursing interventions.

Differential Effects of Two Widely Used Solvents, DMSO and Ethanol, on the Growth and Recovery of Trypanosoma cruzi Epimastigotes in Culture.

Trypanosoma cruzi is the etiological agent of Chagas disease. Epimastigote forms of T. cruzi can be readily cultured in axenic conditions. Ethanol and dimethyl sulfoxide (DMSO) are commonly used solvents employed as vehicles for hydrophobic compounds. In order to produce a reference plot of solvent dependent growth inhibition for T. cruzi research, the growth of epimastigotes was analyzed in the presence of different concentrations of ethanol (0.1-4.0%) and DMSO (0.5-7.5%). The ability of the parasites to resume growth after removal of these solvents was also examined. As expected, both ethanol and DMSO produced a dose-dependent inhibition of cellular growth. Parasites could recover normal growth after 9 days in up to 2% ethanol or 5% DMSO. Since DMSO was better tolerated than ethanol, it is thus recommended to prefer DMSO over ethanol in the case of a similar solubility of a given compound.

Systems biology study of mucopolysaccharidosis using a human metabolic reconstruction network.

Mucopolysaccharidosis (MPS) is a group of lysosomal storage diseases (LSD), characterized by the deficiency of a lysosomal enzyme responsible for the degradation of glycosaminoglycans (GAG). This deficiency leads to the lysosomal accumulation of partially degraded GAG. Nevertheless, deficiency of a single lysosomal enzyme has been associated with impairment in other cell mechanism, such as apoptosis and redox balance. Although GAG analysis represents the main biomarker for MPS diagnosis, it has several limitations that can lead to a misdiagnosis, whereby the identification of new biomarkers represents an important issue for MPS. In this study, we used a system biology approach, through the use of a genome-scale human metabolic reconstruction to understand the effect of metabolism alterations in cell homeostasis and to identify potential new biomarkers in MPS. In-silico MPS models were generated by silencing of MPS-related enzymes, and were analyzed through a flux balance and variability analysis. We found that MPS models used approximately 2286 reactions to satisfy the objective function. Impaired reactions were mainly involved in cellular respiration, mitochondrial process, amino acid and lipid metabolism, and ion exchange. Metabolic changes were similar for MPS I and II, and MPS III A to C; while the remaining MPS showed unique metabolic profiles. Eight and thirteen potential high-confidence biomarkers were identified for MPS IVB and VII, respectively, which were associated with the secondary pathologic process of LSD. In vivo evaluation of predicted intermediate confidence biomarkers (ß-hexosaminidase and ß-glucoronidase) for MPS IVA and VI correlated with the in-silico prediction. These results show the potential of a computational human metabolic reconstruction to understand the molecular mechanisms this group of diseases, which can be used to identify new biomarkers for MPS.

Characterization of Affective Behaviors and Motor Functions in Mice With a Striatal-Specific Deletion of Bmal1 and Per2.

The expression of circadian clock genes, either centrally or in the periphery, has been shown to play an integral role in the control of behavior. Brain region-specific downregulation of clock genes revealed behavioral phenotypes associated with neuropsychiatric disorders and neurodegenerative disease. The specific function of the clock genes as well as the underlying mechanisms that contribute to the observed phenotypes, however, are not yet fully understood. We assessed anxiety- and depressive-like behavior and motor functions in male and female mice with a conditional ablation of Bmal1 or Per2 from medium spiny neurons (MSNs) of the striatum as well as mice lacking one copy of Gpr88. Whereas the conditional knockout of Bmal1 and Per2 had mild effects on affective behaviors, a pronounced effect on motor functions was found in Bmal1 knockout mice. Subsequent investigation revealed an attenuated response of Bmal1 knockout mice to dopamine receptor type 1 agonist treatment, independently of the expression of targets of the dopamine signaling pathway or mitochondrial respiration in MSNs. The study thus suggests a potential interaction of Bmal1 within the direct dopamine signaling pathway, which may provide the link to a shared, MSN-dependent mechanism regulating affective behavior and motor function in mice.

Multimorbidity Profiles and Infection Severity in COVID-19 Population Using Network Analysis in the Andalusian Health Population Database.

Identifying the population at risk of COVID-19 infection severity is a priority for clinicians and health systems. Most studies to date have only focused on the effect of specific disorders on infection severity, without considering that patients usually present multiple chronic diseases and that these conditions tend to group together in the form of multimorbidity patterns. In this large-scale epidemiological study, including primary and hospital care information of 166,242 patients with confirmed COVID-19 infection from the Spanish region of Andalusia, we applied network analysis to identify multimorbidity profiles and analyze their impact on the risk of hospitalization and mortality. Our results showed that multimorbidity was a risk factor for COVID-19 severity and that this risk increased with the morbidity burden. Individuals with advanced cardio-metabolic profiles frequently presented the highest infection severity risk in both sexes. The pattern with the highest severity associated in men was present in almost 28.7% of those aged ≥ 80 years and included associations between cardiovascular, respiratory, and metabolic diseases; age-adjusted odds ratio (OR) 95% confidence interval (1.71 (1.44-2.02)). In women, similar patterns were also associated the most with infection severity, in 7% of 65-79-year-olds (1.44 (1.34-1.54)) and in 29% of ≥80-year-olds (1.35 (1.18-1.53)). Patients with mental health patterns also showed one of the highest risks of COVID-19 severity, especially in women. These findings strongly recommend the implementation of personalized approaches to patients with multimorbidity and SARS-CoV-2 infection, especially in the population with high morbidity burden.

Potential distribution in Colombia of the introduced fish Pangasianodon hypophthalmus (Siluriformes: Pangasiidae) and implications for endangered native fish / Distribución potencial en Colombia del pez introducido Pangasianodon hypophthalmus (Siluriformes: Pangasiidae) e implicaciones para los peces nativos en peligro de extinción

Abstract Introduction: One of the significant threats to aquatic ecosystems is introducing non-native species in natural environments. This represents one of the principal causes of biodiversity loss in the world. Pangasianodon hypophthalmus is an introduced species in Colombia that shares life characteristics and habitat with endangered native species, such as Ageneiosus pardalis, Sorubim cuspicaudus, and Pseudoplatystoma magdaleniatum. However, its distribution is little-known, and scientists have barely explored the effects on the native fauna. Objectives: To evaluate the P. hypophthalmus invasive potential in some of the Colombian basins, which drain into the Caribbean Sea. Methods: Using records available in various databases, we performed a niche conservatism analysis between the native and introduced records of P. hypophthalmus using the R package Ecospat. Subsequently, we modeled the potential invasion area of P. hypophthalmus and the distribution areas of three native species, performing ecological niche modeling (ENM) using the Maxent algorithm. Finally, we calculated a geographic niche overlap between the non-native and native species. Results: The Ecospat spatial analysis indicated that P. hypophthalmus retains some environmental niche attributes through space. For this reason, we can use ENM as an approximation to its range of distribution in the invaded area. Our results using ENM demonstrated that the four species analyzed prefer low and slightly rocky regions; therefore, the geographical overlap of the three native species' ecological niches and the introduced species exceed 80 %. Conclusions: There are adequate conditions in the study basins to fully establish the species P. hypophthalmus, representing a high risk for aquatic ecosystems and native ichthyofauna. Knowledge of the potential distribution areas is essential to implement control of the species.

Resumen Introducción: Una de las amenazas importantes para los ecosistemas acuáticos es la introducción de las especies no nativas en ambientes naturales. Esto representa una de las principales causas de pérdida de biodiversidad en el mundo. Pangasianodon hypophthalmus es una especie introducida en Colombia que comparte características de vida y hábitat con especies nativas en peligro de extinción como: Ageneiosus pardalis, Sorubim cuspicaudus y Pseudoplatystoma magdaleniatum. Sin embargo, poco se conoce de su distribución y los efectos en la fauna nativa han sido poco explorados. Objetivo: Evaluar el potencial invasivo de P. hypophthalmus en algunas de las cuencas colombianas que desembocan en el Mar Caribe. Métodos: Utilizando registros disponibles en varias bases de datos, realizamos un análisis de conservadurismo de nicho entre los registros nativos e introducidos de P. hypophthalmus usando el paquete de R Ecospat. Posteriormente, modelamos el área potencial de invasión de P. hypophthalmus y las áreas de distribución de tres especies nativas realizando modelos de nicho ecológico (MNE) utilizando el algoritmo de Maxent. Finalmente, calculamos una superposición de nicho geográfico entre las especies nativas y no nativas. Resultados: El análisis espacial de Ecospat indica que P. hypophthalmus conserva algunos atributos del nicho ambiental a través del espacio. Por esta razón, podemos usar los MNE como una aproximación a su rango de distribución en el área invadida. Nuestros resultados usando MNE demostraron que las cuatro especies analizadas prefieren regiones bajas y ligeramente rocosas; por ello, la superposición geográfica de los nichos ecológicos de las tres especies nativas y la especie introducidas superan el 80 %. Conclusiones: Existen condiciones adecuadas en las cuencas de estudio para el establecimiento completo de la especie P. hypophthalmus, lo que representa un alto riesgo para los ecosistemas acuáticos y la ictiofauna nativa. El conocimiento de las áreas de distribución potencial es fundamental para implementar controles sobre la especie.

The stabilization of housekeeping transcripts in Trypanosoma cruzi epimastigotes evidences a global regulation of RNA decay during stationary phase.

The relative steady state concentration of mRNAs of four housekeeping single-copy type Trypanosoma cruzi genes (actin, triosephosphate isomerase, trypanothion reductase and the ribosomal protein S4) was analyzed throughout the growth curve. A distinguishable pattern was observed with maximal levels occurring at the logarithmic phase of growth and minimum levels occurring at the stationary phase. The half-lives of all analyzed messenger RNAs, and also of three molecular species of immature ribosomal RNAs were increased in cells isolated from stationary phase. These results suggest the occurrence of a novel global regulation mechanism that might protect transcripts from degradation in stationary epimastigotes, probably as a strategy to perpetuate through this quiescent stage.

[Blastocystis sp. frequency and sources among children from 0 to 5 years of age attending public day care centers in Calarcá, Colombia]. / Frecuencia y fuentes de Blastocystis sp. en niños de 0 a 5 años de edad atendidos en hogares infantiles públicos de la zona urbana de Calarcá, Colombia.

INTRODUCTION: There are no reports of the potential sources of Blastocystis sp . in Colombia. OBJECTIVES: To estimate the frequency of Blastocystis sp . and explore possible associations among infection, clinical manifestations and environmental sources. MATERIALS AND METHODS: A descriptive study was conducted; a representative sample was calculated from a population of 1,993 children less than 5 years old of the lowest socioeconomic levels (1 and 2) attending day care centers in Calarcá, Colombia. The calculated sample size was 275 children, who were selected randomly in 10 % of the centers. Stool testing, questionnaires and sampling to identify the parasite in feces, nails, pets and environmental sources, were performed. Fresh preparations were made with 1% iodine solution, and a concentration technique with formalin-ether was used. Prevalence and odd ratios were estimated; the chi-square test was utilized for qualitative variables, and Student's t for the quantitative ones. RESULTS: The prevalence of infection in children was of 57.5%. A statistically significant association was found between the Blastocystis sp . positive stool tests and the presence of the parasite in containers of sugar cane beverage (OR=1.70; 95% CI: 1.05-2.79), wood or ground floors (OR=3.43; 95% CI: 1.12-10.48) and in foods other than bottled milk (OR=3.23; 95% CI: 1.41-4.41). A non-significant high prevalence was found in nails (OR=1.62; 95% CI: 0.99-2.67), as well as a significantly higher prevalence of diarrhea (OR=1.95; 95% CI: 0.99-2.77) in children with Blastocystis sp . (45%) as compared with those without the parasite (33%; p<0.05). CONCLUSIONS: Blastocystis sp . showed a significant association with diarrhea symptoms in children 0 to 5 years old and was widely distributed in the environment and in water. It is necessary to determine if there are specific hosts with pathogenic potential through molecular techniques.

Frecuencia y fuentes de Blastocystis sp . en niños de 0 a 5 años de edad atendidos en hogares infantiles públicos de la zona urbana de Calarcá, Colombia / Blastocystis sp . frequency and sources among children from 0 to 5 years of age attending public day care centers in Calarcá, Colombia

Introducción. No se han descrito las fuentes potenciales de infección por Blastocystis sp . en Colombia. Objetivos. Estimar la frecuencia de Blastocystis sp . y explorar posibles asociaciones entre la infección, las manifestaciones clínicas y algunas fuentes ambientales. Materiales y métodos. Se llevó a cabo un estudio descriptivo con una población de 1.993 menores de 5 años (lactantes y preescolares) de estratos socioeconómicos 1 y 2, atendidos en hogares infantiles de Calarcá, Colombia. Se calculó una muestra de 275 y se seleccionó aleatoriamente a los participantes en 10 % de los hogares infantiles. Se practicaron exámenes coprológicos y encuestas y se tomaron muestras para la identificación del parásito en heces, uñas, animales domésticos y algunas fuentes ambientales. Se hicieron preparaciones en fresco con lugol al 1 % y se utilizó una técnica de concentración con formol-éter. Se estimaron prevalencias y razones de momios; para las variables cualitativas se utilizó el test de ji al cuadrado y, para las cuantitativas, la prueba t de Student. Resultados. La prevalencia de infección en los niños fue de 57,5 %. Hubo asociación estadísticamente significativa entre la presencia del parásito en heces y su hallazgo en recipientes de agua de panela (OR=1,70; IC 95% 1,05-2,79), en los pisos de madera o de tierra en la vivienda (OR=3,43; IC 95% 1,12-10,48), y en alimentos diferentes a la leche en el tetero (OR=3,23; IC 95% 1,41-4,41); y se encontró una prevalencia alta sin asociación en muestras de uñas (OR=1,62; IC 95% 0,99-2,67). La diarrea fue más frecuente en niños con Blastocystis sp. (45 %) que en aquellos sin el parásito (33 %) (OR: 1,95; IC 95% 0,99-2,77) (p<0,05). Conclusiones. Blastocystis sp . se asoció significativamente con síntomas de diarrea en los niños menores de 5 años y se encontró distribuido ampliamente en el ambiente y en el agua. Se requeriría determinar si hay huéspedes específicos para genotipos patógenos por medio de técnicas moleculares.

Introduction: There are no reports of the potential sources of Blastocystis sp . in Colombia. Objectives: To estimate the frequency of Blastocystis sp . and explore possible associations among infection, clinical manifestations and environmental sources. Materials and methods: A descriptive study was conducted; a representative sample was calculated from a population of 1,993 children less than 5 years old of the lowest socioeconomic levels (1 and 2) attending day care centers in Calarcá, Colombia. The calculated sample size was 275 children, who were selected randomly in 10 % of the centers. Stool testing, questionnaires and sampling to identify the parasite in feces, nails, pets and environmental sources, were performed. Fresh preparations were made with 1% iodine solution, and a concentration technique with formalin-ether was used. Prevalence and odd ratios were estimated; the chi-square test was utilized for qualitative variables, and Student´s t for the quantitative ones. Results: The prevalence of infection in children was of 57.5%. A statistically significant association was found between the Blastocystis sp . positive stool tests and the presence of the parasite in containers of sugar cane beverage (OR=1.70; 95% CI: 1.05-2.79), wood or ground floors (OR=3.43; 95% CI: 1.12-10.48) and in foods other than bottled milk (OR=3.23; 95% CI: 1.41-4.41) . A non-significant high prevalence was found in nails (OR=1.62; 95% CI: 0.99-2.67), as well as a significantly higher prevalence of diarrhea (OR=1.95; 95% CI: 0.99-2.77) in children with Blastocystis sp . (45%) as compared with those without the parasite (33%; p<0.05). Conclusions: Blastocystis sp . showed a significant association with diarrhea symptoms in children 0 to 5 years old and was widely distributed in the environment and in water. It is necessary to determine if there are specific hosts with pathogenic potential through molecular techniques.

Trypanosoma cruzi: allelic comparisons of the actin genes and analysis of their transcripts.

Two allelic genomic fragments containing actin genes from Trypanosoma cruzi were isolated and characterized. One allele comprises two complete tandem repeats of a sequence encoding an actin gene. In the other, only one actin gene is found. Each one of these three gene copies encode for a complete and identical potential protein of 376 amino acids which is 93% similar with its homolog from Trypanosoma brucei. Northern hybridizations of both total and polysomal RNA from epimastigotes demonstrated the presence of an actin polyadenylated mRNA of about 1.6 kb. Actin transcripts processing sites were determined by 5(')- and 3(')-RACE. The obtained sequence data demonstrates that actin genes from both alleles are expressed. The stability of actin mRNA was found to be similar to the one exhibited by the ribosomal protein S4 mRNA as an internal reference. A time course analysis of cultured epimastigotes showed a novel behaviour in which actin mRNA steady state concentration peaks during the transition from the logarithmic to the stationary phase of growth.