Extending the biosynthetic repertoires of cyanobacteria and chloroplasts.

Chloroplasts in plants and algae and photosynthetic microorganisms such as cyanobacteria are emerging hosts for sustainable production of valuable biochemicals, using only inorganic nutrients, water, CO2 and light as inputs. In the past decade, many bioengineering efforts have focused on metabolic engineering and synthetic biology in the chloroplast or in cyanobacteria for the production of fuels, chemicals and complex, high-value bioactive molecules. Biosynthesis of all these compounds can be performed in photosynthetic organelles/organisms by heterologous expression of the appropriate pathways, but this requires optimization of carbon flux and reducing power, and a thorough understanding of regulatory pathways. Secretion or storage of the compounds produced can be exploited for the isolation or confinement of the desired compounds. In this review, we explore the use of chloroplasts and cyanobacteria as biosynthetic compartments and hosts, and we estimate the levels of production to be expected from photosynthetic hosts in light of the fraction of electrons and carbon that can potentially be diverted from photosynthesis. The supply of reducing power, in the form of electrons derived from the photosynthetic light reactions, appears to be non-limiting, but redirection of the fixed carbon via precursor molecules presents a challenge. We also discuss the available synthetic biology tools and the need to expand the molecular toolbox to facilitate cellular reprogramming for increased production yields in both cyanobacteria and chloroplasts.

Tat proteins as novel thylakoid membrane anchors organize a biosynthetic pathway in chloroplasts and increase product yield 5-fold.

Photosynthesis drives the production of ATP and NADPH, and acts as a source of carbon for primary metabolism. NADPH is also used in the production of many natural bioactive compounds. These are usually synthesized in low quantities and are often difficult to produce by chemical synthesis due to their complex structures. Some of the crucial enzymes catalyzing their biosynthesis are the cytochromes P450 (P450s) situated in the endoplasmic reticulum (ER), powered by electron transfers from NADPH. Dhurrin is a cyanogenic glucoside and its biosynthesis involves a dynamic metabolon formed by two P450s, a UDP-glucosyltransferase (UGT) and a P450 oxidoreductase (POR). Its biosynthetic pathway has been relocated to the chloroplast where ferredoxin, reduced through the photosynthetic electron transport chain, serves as an efficient electron donor to the P450s, bypassing the involvement of POR. Nevertheless, translocation of the pathway from the ER to the chloroplast creates other difficulties, such as the loss of metabolon formation and intermediate diversion into other metabolic pathways. We show here that co-localization of these enzymes in the thylakoid membrane leads to a significant increase in product formation, with a concomitant decrease in off-pathway intermediates. This was achieved by exchanging the membrane anchors of the dhurrin pathway enzymes to components of the Twin-arginine translocation pathway, TatB and TatC, which have self-assembly properties. Consequently, we show 5-fold increased titers of dhurrin and a decrease in the amounts of intermediates and side products in Nicotiana benthamiana. Further, results suggest that targeting the UGT to the membrane is a key factor to achieve efficient substrate channeling.

A One-Size-Fits-All HIV Prevention and Education Approach?: Interpreting Divergent HIV Risk Perceptions Between African American and East African Immigrant Women in Washington, DC Using the Proximate-Determinants Conceptual Framework.

BACKGROUND: To date, there are very few comparative US studies and none in DC that distinguish between US-born and foreign-born black women to examine and compare their perceptions of HIV risk. This qualitative study, therefore, analyzes African American and East African women's perceptions of HIV risk in the Washington DC Metropolitan area, which has the highest AIDS rate in the United States. METHODS: Forty in-depth, semistructured interviews and 10 cognitive interviews were conducted among a sample of 25 African American women and 25 East African born women between October 2012 and March 2013 to examine perceptions regarding HIV risk. The in-depth semistructured interviews were preceded by the cognitive interviews and accompanying survey. Study protocol was reviewed and approved by the American University Institutional Review Board. RESULTS: Adopting Boerma and Weir's Proximate Determinants conceptual framework to interpret the data, the results of the study demonstrate that African American and East African immigrant women have divergent perceptions of HIV risk. Although African American women ascribe HIV risk to individual-level behaviors and choices such as unprotected sex, East African women attribute HIV risk to conditions of poverty and survival. CONCLUSIONS: Study findings suggest that addressing HIV prevention and education among black women in DC will require distinct and targeted strategies that are culturally and community-centered to resonate with these different audiences.

How religiosity shapes health perceptions and behaviors of Latina immigrants: is it an enabling or prohibitive factor?

The study examines how religiosity shapes the health perceptions and health-related behaviors of 50 Latina immigrants from El Salvador, Guatemala, Mexico and Bolivia. Between May and August 2011, focus groups were conducted with participants representing each country of origin. Qualitative content analysis was the analytic strategy adopted in the study. The meta-theme, Religiosity Contributes to Positive Perceptions of Health and Health-Promoting Behaviors, is associated with six emerging themes: (1) Religiosity promotes a sense of personal responsibility for one's health; (2) Religiosity promotes a holistic view of health; (3) Religiosity promotes the view that health is a priority; (4) Religiosity promotes the view that health enables one to perform necessary tasks; (5) Religiosity promotes health-seeking behavior; and (6) Religiosity provides intrinsic health benefits. Findings do not follow the clear-cut dichotomy of the health locus of control model and challenge simplified notions that Latinas hold a purely external health locus of control toward their health and health care. Latinas rely on both God and themselves in managing their health and engaging in health-promoting actions, which are prompted in large part by their religiosity. Implications for culturally appropriate health communication and interventions are discussed.

Attitudes, perceptions and behaviours towards HIV testing among African-American and East African immigrant women in Washington, DC: implications for targeted HIV testing promotion and communication strategies.

OBJECTIVES: The objective of the study was to examine and compare the HIV testing attitudes, perceptions and behaviours between African-American and East African immigrant women in the Washington, DC metropolitan area. METHODS: Adopting an inductive, qualitative methodological approach, we conducted a total of 40 in-depth, semistructured interviews between October 2012 and March 2013. Qualitative thematic analysis was used to analyse the data. RESULTS: Overall, African-American women held more favourable views towards HIV testing than East African immigrant women. Very few East African immigrant women sought HIV testing intentionally. The majority of East African participants were tested inadvertently, while others tested for immigration-related or employment-related purposes. There were many barriers that impede women from seeking an HIV test including negative assumptions (eg, "Getting an HIV test implies that I am HIV positive"), negative emotions (eg, "Fear of being diagnosed with HIV and what this will mean for me") and potential negative reactions from partner or others (eg, "Getting an HIV test can signal distrust, disrespect, or infidelity"). There were nuances in how each group articulated some of these barriers and East African women expressed unique concerns that originated from experiences in their home countries. CONCLUSIONS: The study shed light into the complexity of factors that constrain women from presenting themselves voluntarily for an HIV test and highlighted the nuances between African-American and East African perceptions. Implications of findings for effective targeted HIV screening promotion and communication strategies among these groups of women are discussed.

The level of acceptance of spanish medical students of the transplantation of solid organs from animals: a stratified and multicentre study.

INTRODUCTION: Research into the transplantation of solid organs from animals (xenotransplantation) is generating interest and curiosity given that this could be a way of resolving the shortage in transplant organs. However, the fact is that currently xenotransplantation is far from becoming a clinical practice. OBJECTIVE: To analyse the attitude of medical students from Spanish universities towards the donation of organs from animals and to determine the factors affecting their attitudes. TYPE OF STUDY: A sociological, interdisciplinary, observational and multicentre study in Spain. STUDY POPULATION: Students enrolled on the medical degree in Spain (n = 34 000). SAMPLE SIZE: A sample of 9598 students (a confidence level of 99% and precision of ± 1%) stratified by geographical area and academic year. Instrument of measurement: A validated questionnaire of attitude towards organ xenotransplantation (PCID-XenoTx RIOS) which was self-administered and completed anonymously. RESULTS: A completion rate of 95.7% (n = 9275) was obtained. If the results of xenotransplantation were as good as in human donation, 81% (n = 7491) would be in favour, 3% (n = 308) against and 16% (n = 1476) undecided. The following variables affected this attitude: sex (P < 0.001); academic year (P < 0.001); discussion of transplantation with one's family (P < 0.001) and friends (P < 0.001); the opinion of one's partner (P < 0.001); the respondent's attitude towards organ donation (P < 0.001); religion (P < 0.001); and participation in altruistic activities (P < 0.001). The following variables persisted in the multivariate analysis: (1) being a female (OR = 1.794; P < 0.001); (2) academic year (OR = 2.487; P < 0.001); (3) having spoken about the issue with one's family (OR = 1.200; P = 0.019); (4) the favourable opinion of one's partner (OR = 1.526; P = 0.028); (5) an attitude in favour of donation (OR = 2.087; P < 0.001); (6) being an atheist/agnostic, (OR = 2.5; P < 0.001); and (7) a belief that one's religion is in favour of transplantation (OR = 1.317; P = 0.005). CONCLUSIONS: Spanish medical students have a favourable attitude towards xenotransplantation. This willingness and interest could be a decisive platform for the development and strengthening of research, both for centres with a pre-clinical xenotransplantation programme and new healthcare centres.

"Getting tested is almost like going to the Salem witch trials": discordant discourses between Western public health messages and sociocultural expectations surrounding HIV testing among East African immigrant women.

Washington, DC, has the highest AIDS diagnosis rate in the USA, and Black women are disproportionately affected. Although HIV testing is the first entryway into vital treatment services, evidence reveals that foreign-born blacks have a lower rate of recent HIV testing than US-born blacks. To date, however, there are no studies that examine the culture-specific perceptions of HIV testing among East African immigrant women (who comprise a large share of Black Africans in DC) to better understand their potential barriers to testing. Adopting the PEN-3 cultural model as our theoretical framework, the main objective of this study was to examine East African women's HIV testing perceptions and partner communication norms. Between October 2012 and March 2013, trained interviewers conducted a total of 25 interviews with East African women in the Washington, DC, metropolitan area. For triangulation purposes, data collection consisted of both in-depth, semi-structured interviews and cognitive interviews, in which participants were administered a quantitative survey and assessed on how they interpreted items. Qualitative thematic analysis revealed a systematic pattern of discordant responses across participants. While they were aware of messages related to Western public health discourse surrounding HIV testing (e.g., Everyone should get tested for HIV; One should talk to one's spouse about HIV testing), divergent sociocultural expectations rooted in cultural and religious beliefs prevailed (e.g., Getting an HIV test brings shame to the person who got tested and to one's family; it implies one is engaging in immoral behavior; One should not talk with one's spouse about HIV testing; doing so breaks cultural norms). Implications of using a culture-centered model to examine the role of sociocultural expectations in HIV prevention research and to develop culturally responsive prevention strategies are discussed.

Examining breast cancer screening barriers among Central American and Mexican immigrant women: fatalistic beliefs or structural factors?

Researchers have examined "cancer fatalism" (the belief that cancer is predetermined, beyond individual control, and necessarily fatal) as a major barrier to breast cancer screening among Latinas. The authors examine perceptions of breast cancer, its causes, and experiences with screening among Salvadoran, Guatemalan, Mexican, and Bolivian immigrant women in Washington, DC. Two salient themes emerged: (a) perceptions of breast cancer causes and breast cancer screening; and (b) structural factors are the real barriers to breast cancer screening. Findings demonstrate participants' awareness and motivation to get screened and elucidate structural barriers that are obscured by the discourse of fatalism and hinder breast cancer screening.

Designing audience-centered interactive voice response messages to promote cancer screenings among low-income Latinas.

INTRODUCTION: Cancer screening rates among Latinas are suboptimal. The objective of this study was to explore how Latinas perceive cancer screening and the use and design of interactive voice response (IVR) messages to prompt scheduling of 1 or more needed screenings. METHODS: Seven focus groups were conducted with Latina community health center patients (n = 40) in need of 1 or more cancer screenings: 5 groups were of women in need of 1 cancer screening (breast, cervical, or colorectal), and 2 groups were of women in need of multiple screenings. A bilingual researcher conducted all focus groups in Spanish using a semistructured guide. Focus groups were recorded, transcribed, and translated into English for analysis. Emergent themes were identified by using thematic content analysis. RESULTS: Participants were familiar with cancer screening and viewed it positively, although barriers to screening were identified (unaware overdue for screening, lack of physician referral, lack of insurance or insufficient insurance coverage, embarrassment or fear of screening procedures, fear of screening outcomes). Women needing multiple screenings voiced more concern about screening procedures, whereas women in need of a single screening expressed greater worry about the screening outcome. Participants were receptive to receiving IVR messages and believed that culturally appropriate messages that specified needed screenings while emphasizing the benefit of preventive screening would motivate them to schedule needed screenings. CONCLUSION: Participants' receptiveness to IVR messages suggests that these messages may be an acceptable strategy to promote cancer screening among underserved Latina patients. Additional research is needed to determine the effectiveness of IVR messages in promoting completion of cancer screening.

"You know that we travel a lot": Mobility narratives among female sex workers living with HIV in Tanzania and the Dominican Republic.

Female sex workers (FSW) are highly mobile, which may result in reduced access to and use of health services and increased risk for poor health outcomes, particularly for those living with HIV. Mobility includes spatial, temporal, and social elements that are not fully captured by quantitative measures. We conducted two rounds of in-depth interviews with FSW living with HIV in Iringa, Tanzania (n = 20), and Santo Domingo, Dominican Republic (n = 20), to describe mobility experiences and compare mobility narratives across settings. We integrated a thematic analysis of all interviews with a narrative analysis of a subset of 10 information-rich interviews (five in each country) with women who had recently traveled, for sex work or another reason, outside of their hometown. Across narratives, FSW living with HIV traveled locally or to seasonal destinations, for short and long periods. Social factors influencing mobility included economic drivers; risk of arrest, harassment, or violence; anonymity and/or familiarity; social relationships; and clients' mobility. Spatial, temporal, and social factors intersected in unique ways in FSW's mobility experiences, yet distinct mobility typologies were evident across settings and destinations. Together, mobility narratives of FSW living with HIV can inform quantitative research on mobility typologies in Tanzania, the Dominican Republic, and elsewhere. With the potential for economic circumstances, climate change, and other emergencies to increase people's mobility around the world, researchers and practitioners can learn from the lived experiences of FSW to inform whether and how to tailor and improve the accessibility of HIV care and treatment interventions based on spatial, temporal, and social characteristics of mobility.

Identification of cross-reactive IgE-binding proteins from Philippine allergenic grass pollen extracts.

Background: Respiratory allergies are one of the most common allergic diseases that affect Filipinos. Grass pollen accounts for the majority of the outdoor allergens triggering these respiratory allergies. Cross-reactivity among the Philippine grass pollen grains has not been extensively studied. Objective: This study aims to investigate the cross-reactivity of our local grasses and identify the cross-reactive allergens. Methods: Grass pollen grains were collected and processed into crude allergenic extracts. The IgE-reactivity of these crude allergenic pollen extracts was studied using sera from patients who tested positive for the mentioned extracts. The proteins from the immunoblots of cross-reactive pollen allergen extracts were sequenced and identified. Results: Allergenic pollen proteins were identified as cross-reactive among the grass pollen extracts. Four of these have not been listed yet as grass allergens in the World Health Organization/International Union of Immunological Societies allergen nomenclature database. Conclusion: Local grass pollen allergens are cross-reactive with probable new allergens identified.

Skin assessment in congenital untreated isolated GH deficiency.

PURPOSE: The separation between the inside and outside through the skin was fundamental for the evolution of prevertebrates, which grow through extrapituitary circuits, to vertebrates, which grow through the somatotrophic axis, namely pituitary growth hormone (GH). and circulating IGF1.Individuals with untreated isolated growth hormone (GH) deficiency (IGHD) due to a mutation in the GH-releasing hormone receptor (GHRH) gene, residing in Itabaianinha, Brazil, are vulnerable to skin cancer and have reduced sweating. However other aspects of their skin physiology are still unknown. Our objectives were to evaluate the number of skin cancers, skin aging, and functional aspects of the skin in this IGHD cohort. METHODS: Twenty-six IGHD individuals and 26 controls matched by age, sex, ethnicity, and occupation were submitted to a biochemical, dermatological and a functional skin assessment by the Multi Probe Adapter Cutometer® MPA 580. RESULTS: There was no difference in the number of skin cancers and in the degrees of photodamage between the groups. The melanin content in the forearm was similar between the groups but was lower in the buttocks (p = 0.005), as well as skin resistance (p < 0.0001) and elasticity (p = 0.003), lower in the IGHD. There was no difference in hydration and sebum content between the two groups. CONCLUSION: IGHD is apparently associated with a neutral profile in terms of skin cancer and photodamage, with similar melanin on the forearm and lower buttocks, lower skin resistance and elasticity, with hydration and sebum similar to controls.

Cross-border health care utilization among the Hispanic population in the United States: implications for closing the health care access gap.

OBJECTIVES: To examine predictors of health care service utilization in Mexico or any other country in Latin America among the U.S. Hispanic population. METHODS: This study used data from the 2007 Pew Hispanic Healthcare Survey, a nationally representative survey of 4013 Hispanic adults. Using the Behavioral Model of Health Service Use (BMHSU) model, we examined three levels of predictive factors: (1) predisposing characteristics (e.g., language proficiency), (2) enabling resources (e.g., health insurance status), and (3) need (e.g., self-perceived health status). Multivariate logistic regression analyses were conducted to predict odds of seeking health care services in Mexico or any other country in Latin America. RESULTS: As hypothesized, lack of continuous health insurance coverage, perceived lack of quality health care, and low English proficiency increased the likelihood of seeking health care in Mexico or any other Latin American country among US Hispanic adults. Self-reported health status and usual source of care, however, were not significant predictors. CONCLUSIONS: Hispanic immigrants face critical access gaps to health care in the United States. Implications for closing the access gap for this population are discussed within the context of health care system reform and immigration reform in the United States.

The impact of mass media health communication on health decision-making and medical advice-seeking behavior of u.s. Hispanic population.

Mass media health communication has enormous potential to drastically alter how health-related information is disseminated and obtained by different populations. However, there is little evidence regarding the influence of media channels on health decision-making and medical advice-seeking behaviors among the Hispanic population. The Pew 2007 Hispanic Healthcare Survey was used to test the hypothesis that the amount of mass media health communication (i.e., quantity of media-based health information received) is more likely to influence Hispanic adults' health decision-making and medical advice-seeking behavior compared to health literacy and language proficiency variables. Results indicated that quantity of media-based health information is positively associated with health decision-making and medical advice-seeking behavior above and beyond the influence of health literacy and English and Spanish language proficiency. In a context where physician-patient dynamics are increasingly shifting from a passive patient role model to a more active patient role model, media-based health information can serve as an influential cue to action, prompting Hispanic individuals to make certain health-related decisions and to seek more health advice and information from a health provider. Study implications are discussed.

HPV vaccine decision-making and acceptance: does religion play a role?

We conducted a web-based survey among 476 white, Black, and Hispanic parents or caregivers with daughter(s) between the ages of 9-17 to better understand how religion influences HPV vaccine acceptance. Catholic parents were more likely than nonaffiliated parents to have already vaccinated their daughters (vs. being undecided) (OR = 3.26, 95% CI = 1.06, 10.06). Parents with frequent attendance at religious services were more likely than parents who do not attend services to have decided against vaccination (vs. being undecided) (OR = 2.92, 95% CI = 1.25, 6.84). Directions for research and implications for interventions are addressed.

[The daily life of men who lives with chronic venous ulcer: phenomenological study]. / O cotidiano do homem que convive com a úlcera venosa crônica: estudo fenomenológico.

The chronic venous leg ulcer is the major therapeutic problem of lower limb injuries, which can trigger changes in the daily life of the person affected by it. This study aimed to understand the daily life of men who lives with chronic venous ulcers. A phenomenological study was conducted with eight men, who were interviewed during June and July of 2001. The study asked questions related to: "Restrictions in social life" and "Recovering the skin integrity and restart the activities affected by the wound". The answers revealed that men with these ulcers have social implications in the areas of productivity and sexuality. This leads to restrictions in everyday life with loss in performance of socially established roles for men, leading to anxiety for his return at full performance of his social role. The findings suggest significant experiential aspects that may guide professionals in the planning and implementation of health actions aimed to treat these patients.

[Elderly women: revealing their experiences and care needs]. / Mulheres idosas: desvelando suas vivências e necessidades de cuidado.

This qualitative study used a social phenomenology approach to elucidate the experiences, care needs and expectations of the elderly women. Nine elderly women were interviewed between February and May 2011 using a semi-structured questionnaire. The elderly women referred to their physical, mental, and social limitations. They valued ​​the preservation of their autonomy in daily activities and in self-care and considered their families to be a fundamental support. They had expectations of remaining healthy, pursuing leisure activities, and having improved access to healthcare information and treatment. The absence of prospects at this stage of life was related to the loss of significant people and the loss of health. The results of this study reveal important aspects of the experiences of elderly women and encourage further research and improvement in teaching, clinical practice and management policies in relation to the needs of these women.

[The social phenomenology of Alfred Schütz and its contribution for the nursing]. / A fenomenologia social de Alfred Schütz e sua contribuição para a enfermagem.

Nursing care can be considered a social action that is set in the everyday world, where intersubjective relations are established and must be valued by the nurse in the different contexts in which it acts. It is a theoretical study which aimed to highlight the main concepts of the social phenomenology of Alfred Schütz's and its contribution to Nursing as a knowledge and professional practice field. The following questions guided this study: what is the understanding of caring in Nursing from the perspective of the social phenomenology of Alfred Schütz's? How to apply Alfred Schütz's theoretical concepts in the action of caring in Nursing? The theoretical concepts of the social phenomenology and their interface with Nursing were delimited. By incorporating the concepts of the t theory of social action developed by Alfred Schütz into Nursing, this study allows nurses to value and apply the aspects highlighted by this theoretical framework within healthcare, education and scientific research.

The impact of social capital and social environmental factors on mental health and flourishing: the experiences of asylum-seekers in France.

BACKGROUND: There is growing interest on how social capital and related social environmental factors impact overall population health and well-being. The nature of asylum-seekers' social environment alters once they migrate to a new context and these changes influence their mental health and well-being. However, there is limited scholarship on how these social environmental factors impact the mental health, well-being, and capacity to flourish of asylum-seekers. METHODS: The aim of the study, therefore, was to examine how specific social environmental factors-social networks, social support, and social cohesion at various levels (micro, meso, and macro)-influence the mental health, well-being, and capacity to flourish of asylum-seekers in France. In collaboration with a community-based organization, we used a qualitative research design to conduct 120 semi-structured interviews with asylum-seekers in France. RESULTS: The emerging salient themes depicted how the asylum-seekers' usual informal social networks comprised of family and friends had been disrupted since they migrated to France, which impacted their mental health and well-being. Conversely, staying connected with their informal transnational social networks via social media and developing ties with new local informal and formal social networks allowed them to receive different forms of social support, and buffered some of the negative mental health consequences. However, the lack of social cohesion due to a lack of belonging, marginalization, and current harmful migration-related policies impeded asylum-seekers' capacity to flourish. CONCLUSION: While social support derived from social networks buffered some negative impacts on mental health and well-being, the overall lack of social cohesion ultimately impeded asylum-seekers' capacity to flourish within their host communities, which was further exacerbated by harmful migration policies of exclusion within France. Introducing more inclusive policies related to the governance of migration and an intersectoral approach that views health in all policies is key to promoting social cohesion and flourishing among asylum-seekers in France.

Examining the Role of Quality of Institutionalized Healthcare on Maternal Mortality in the Dominican Republic.

The main study objective was to determine the extent to which the quality of institutionalized healthcare, sociodemographic factors of obstetric patients, and institutional factors affect maternal mortality in the Dominican Republic. COM-Poisson distribution and the Pearson correlation coefficient were used to determine the relationship of predictor factors (i.e., hospital bed rate, vaginal birth rate, teenage mother birth rate, single mother birth rate, unemployment rate, infant mortality rate, and sex of child rate) in influencing maternal mortality rate. The factors hospital bed rate, teenage mother birth rate, and unemployment rate were not correlated with maternal mortality. Maternal mortality increased as vaginal birth rates and infant death rates increased whereas it decreased as single mother birth rates increased. Further research to explore alternate response variables, such as maternal near-misses or severe maternal morbidity is warranted. Additionally, the link found between infant death and maternal mortality presents an opportunity for collaboration among medical specialists to develop multi-faceted solutions to combat adverse maternal and infant health outcomes in the DR.