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Background. By 2023, 1,080,000 cases of COVID-19 have been reported in Harris County. Systemic inequity and vaccine hesitancy have contributed to COVID-19 disparities. Community Health Workers provide health education and instrumental support to alleviate health disparities among vulnerable communities. We conducted an analysis of Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis in June 2022 among a broad coalition of Community Health Work stakeholders to better understand the local landscape in the context of the COVID-19 pandemic. Methods. We recruited 33 community health workers and industry stakeholders in Harris County, Texas, to participate in the SWOT analysis. Participants were asked to describe their opinions on the SWOT facing the Community Health Work landscape and then rank the outcomes of the analysis to prioritize action. Results. A total of 19 themes were identified. Weaknesses included lack of respect and resources for Community Health Workers and poor coordination and capacity among the workforce infrastructure. Limited funding and lack of appreciation for Community Health Workers were deemed important threats. Diversity and community connection were critical strengths, and strong education, training, and raising awareness for community health work were considered opportunities to overcome identified weaknesses and threats. Discussion. Increased funding, greater coordination, greater respect, and amplified training can improve capacity for Community Health Workers and, therefore, improve public health outcomes for respiratory illness and viral infections such as COVID-19. This analysis helps fill an important research gap on the topic Community Health Workers responding to public health crises with racially disparate outcomes.
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All vertebrates possess a daily rhythm, encompassing a comprehensive set of physiological, cognitive, and behavioral patterns that manifest throughout a 24-hour period. The aim of this study was to compare the effect of crude protein (CP) levels in the diet on the daily rhythm of urea in serum (US) and saliva in alpacas and sheep. Ten alpacas and ten sheep, adult, clinically healthy males, were used; they were maintained in natural light conditions and fed ad libitum with two levels of CP (16 and 7%). Blood and saliva samples were taken every 4 h for 48 h. A two-way ANOVA was conducted to analyze the parameters, including adjusted mean rhythm (MESOR), amplitude, and acrophase. It was found that both US and saliva urea exhibited circadian rhythms with a peak during the midday (10:59 - 12:16 h). The MESOR with low CP diets was higher (P < 0.05) in alpacas. The MESOR of urea levels in saliva was greater (P < 0.05) at the highest level of CP in the diet, with no differences between alpacas and sheep (P > 0.05). The amplitude was greater (P < 0.05) in alpacas and at the high level of CP compared to the low level of CP in the diet. Our findings reveal that both serum and saliva urea levels in alpacas and sheep follow a daily rhythm and the MESOR of US was higher in alpacas when they consume food with low CP content, and this difference disappears when CP levels are increased in the diet.
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Abstract Background: Functional neuroimaging studies may aid to our understanding of the pathophysiology of the takotsubo cardiomyopathy. Objective: The aim of the study was to review the available evidence of brain functional connectivity in takotsubo cardiomyopathy patients. Methods: This was a systematic review. We searched MEDLINE, LILACS, Ovid (Cochrane), Scopus, and Science Direct for studies conducting functional magnetic resonance imaging (fMRI) in takotsubo patients. After reviewing title/abstract and full text, we selected relevant studies, extracted methodological characteristics, and their main findings, and assessed their risk of bias with the Newcastle-Ottawa scale. We present a narrative review. Results: We included five case-control studies from 600 registries. The risk of bias was low; comparability was the main issue. Resting-state fMRI findings suggest significant differences for the hippocampus, the Insula, the amygdala, and the para-hippocampal gyrus. Task fMRI findings suggest significant differences for the Insula, the superior occipital gyrus, and the amygdala. Studies were heterogeneous about the laterality and directionality of these differences. Conclusion: Brain connectivity alterations involving elements relevant for autonomic control like the Insula and the Amygdala provide evidence in favor of the role of functional networks in the neurocardiology of stress-related cardiomyopathies. However, it is not possible to determine if this role is causal or consequential.
Resumen Antecedentes: Los estudios de neuroimagen funcional podrían ayudar a clarificar la fisiopatología de la miocardiopatía de takotsubo. Objetivo: Revisar la evidencia disponible sobre conectividad funcional cerebral en pacientes con cardiomiopatía de takotsubo. Métodos: Revisión sistemática. Se buscaron en MEDLINE, LILACS, Ovid (Cochrane), Scopus, y ScienceDirect estudios de imagen por resonancia magnética funcional (IRMf) en pacientes con cardiomiopatía de takotsubo. Tras revisar títulos, resúmenes y textos completos se seleccionaron los estudios relevantes, se extrajeron sus características metodológicas y resultados principales, y se valoró su riesgo de sesgo mediante la escala Newcastle-Ottawa. Se presenta revisión narrativa de los resultados. Resultados: Se incluyeron cinco estudios de casos y controles de entre 600 registros. El riesgo de sesgo fue bajo, la comparabilidad fue la principal limitante. Los estudios de IRMf en estado de reposo sugieren diferencias significativas en el Hipocampo, la Ínsula, la Amígdala y el Giro parahipocampal. Los estudios de IRMf bajo paradigma sugieren diferencias en la Ínsula, el Giro occipital superior y en la Amígdala. Los estudios fueron heterogéneos respecto a la lateralización y direccion de estas diferencias. Conclusión: Alteraciones en la conectividad cerebral de zonas relevantes para el control autonómico como la ínsula y la Amígdala provén evidencia a favor del rol de redes funcionales en la neurocardiología de miocardiopatías relacionadas con el estrés. Sin embargo, aún no es posible determinar si esto obedece a un rol causal o consecuencial.
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The prevalence and antimicrobial resistance of Salmonella serotypes on beef carcasses from four small abattoirs in Jalisco State, Mexico, were investigated during a 10-month period. Following U.S. Department of Agriculture Food Safety and Inspection Service protocols, Salmonella was isolated from 78 (15.4%) beef carcasses (n = 505) after the final carcass water wash. Isolation frequency differed by establishment (P < 0.05) and was higher (P < 0.05) during the wet season (May through September) for all establishments. Thirteen Salmonella serotypes and four serogroups (partially serotyped isolates) were identified. The most prevalent were Salmonella enterica Give (24.4%), Salmonella Typhimurium (17.9%), and Salmonella Group B (14.1%). Antimicrobial susceptibility was tested against 11 drugs, and results indicated that 46.2% of the isolates were resistant to tetracycline, 42.3% were resistant to streptomycin, 23.1% were resistant to chloramphenicol, 21.8% were resistant to trimethoprim-sulfamethoxazole, and 19.2% were resistant to gentamicin. No resistance to ceftriaxone or ciprofloxacin was observed, and 33% of the isolates were resistant to three or more antimicrobials. Although Salmonella Give was the most prevalent serotype, 95% of the isolates of this serotype were susceptible to all antimicrobials tested. Antimicrobial resistance was more common in Salmonella Typhimurium, and 93% (13 of 14) of the isolates of this serotype were resistant to at least five antimicrobials. The frequency of multidrug-resistant Salmonella isolates differed among establishments (P < 0.05) and may be related to the origin of the cattle presented for harvesting. These findings highlight the need for control measures to reduce Salmonella prevalence on beef carcasses in small abattoirs in Mexico and for strategies to ensure the cautious use of antimicrobials in animal production to prevent and control the spread of antimicrobial-resistant foodborne pathogens.