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Background: Identifying secondary infections in patients receiving extracorporeal membrane oxygenation (ECMO) presents challenges due to the ECMO circuit's influence on traditional signs of infection. Objectives: This study evaluates procalcitonin as a diagnostic marker for secondary infections in patients receiving ECMO with influenza or COVID-19 infection. Design: Single-center retrospective cohort study. Methods: All adult patients receiving veno-venous ECMO with underlying influenza or COVID-19 from November 2017 to October 2021 were included. Patient demographics, time receiving ECMO, culture data, and procalcitonin levels were examined. The first procalcitonin within 3 days of infection was compared to negative workups that were collected at least 10 days from the last positive culture. Furthermore, we compared procalcitonin levels by the type of pathogen and site of infection. Results: In this study, 84 patients with influenza or COVID-19 who received ECMO were included. A total of 276 procalcitonin labs were ordered in this cohort, with 33/92 (36%) of the secondary infections having an associated procalcitonin value. When comparing procalcitonin levels, there was no significant difference between the infection and negative workup groups [1 ng/mL (interquartile ranges, IQR: 0.4-1.2) versus 1.3 (0.5-4.3), p = 0.19]. Using 0.5 ng/mL as the cut-off, the sensitivity of procalcitonin was 67% and the specificity was 30%. In our cohort, the positive predictive value of procalcitonin was 14.5% and the negative predictive value was 84%. There was no difference in procalcitonin by type of organism or site of infection. Procalcitonin levels did not routinely decline even after an infection was identified. Conclusion: While procalcitonin is a proposed potential diagnostic marker for secondary infections in patients receiving ECMO, this single-center study demonstrated low sensitivity and specificity of procalcitonin in identifying secondary infections. Furthermore, there was no association of procalcitonin levels with etiology of infection when one was present. Procalcitonin should be used cautiously in identifying infections in veno-venous ECMO.
BACKGROUND: It is very difficult to determine whether patients receiving ECMO have infections as both vital signs and laboratory markers have not shown good utility. Procalcitonin is a laboratory test sometimes used to identify infections, but its test performance is not known in this population. METHODS: We performed a study of adult patient patients receiving ECMO to determine if there were differences in procalcitonin levels when patients had infections as compared to when they did not have infections. We also looked to see if procalcitonin levels routinely dropped after an infection was diagnosed. RESULTS: Procalcitonin values were no different when patients had an infection as compared to when they did not have an infection. Using standard laboratory cut-offs, the procalcitonin sensitivity was 67%, and specificity was 30%. Procalcitonin levels did not routinely decline even after an infection was identified. CONCLUSIONS: Procalcitonin poorly differentiated patients with infections from those without infections and should be used with caution in patients receiving ECMO.
The utility of procalcitonin for identifying secondary infections in patients with influenza or COVID-19 receiving extracorporeal membrane oxygenation Aim: To determine if procalcitonin performs well as a diagnostic marker in identifying additional infections in adult patients receiving ECMO with influenza or COVID-19.
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Plastic is an important part of today's human daily lifestyle, and it is classified as a "global pollutant" due to its durability. The natural degradation of plastic is extremely slow and will take a hundred years or more. The ultimate destinations of plastics as well as their effects on the ecosystem vary with the type of plastic and the rate of their degradation. In this study, an attempt was made to explain the degradation of low-density polyethylene (LDPE) plastic beads with the help of selected bacterial isolates in both laboratory and field conditions. 16 S rRNA gene sequencing further identified the bacterial isolates as Micrococcus luteus and Bacillus pumilus, obtained from the municipal waste disposal site near Anand, Gujarat, India. The beads were subjected to photolysis and hydrolysis for a predetermined amount of time in addition to biodegradation. After 60 days of treatment with Pseudomonas aeruginosa, Micrococcus luteus, and Bacillus pumilus in both laboratory and field conditions, a significant percentage decrease in the weight of LDPE beads was observed. Pseudomonas aeruginosa was taken as a positive control. Further, the rate of degradation was found to be accelerated in the presence of 10% starch.
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Ecosistema , Polietileno , Humanos , Hidrólisis , Fotólisis , Biodegradación AmbientalRESUMEN
West Nile Virus (WNV) is an arthropod-borne virus that is spread through mosquito vectors. WNV emerged in the US in 1999 and has since become endemic in the US, causing the most domestically acquired arboviral disease in the country. Mosquito surveillance for WNV is useful to monitor arboviral disease burden over time and across different locations. RT-qPCR is the preferred method for WNV surveillance, but these methods are labor-intensive. The Panther Fusion System has an Open Access feature that allows for laboratory-developed tests (LDTs) to run on a fully automated system for nucleic acid extraction, RT-qPCR, and result generation. This study demonstrates the successful optimization of a WNV multiplex LDT (assay targets: ENV and NS1 genes) for high-throughput environmental surveillance testing of mosquito pool homogenates on the Panther Fusion System. Analytical sensitivity of the assay was 186 and 744 copies/PCR reaction for the ENV and NS1 targets, respectively. To assess the performance of this assay, a total of 80 mosquito pools were tested, including 60 previously tested pools and 20 spiked negative mosquito pools. Among the 60 previously tested specimens, the Panther Fusion WNV LDT demonstrated 100% positive and negative agreement with the CDC West Nile RT-qPCR assay. The Panther Fusion WNV LDT also detected all 20 spiked specimens. The Panther Fusion WNV LDT assay was successfully developed and optimized for high throughput testing with similar performance to the previously used CDC West Nile RT-qPCR assay.
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Arbovirus , Culicidae , Fiebre del Nilo Occidental , Virus del Nilo Occidental , Animales , Humanos , Virus del Nilo Occidental/genética , Fiebre del Nilo Occidental/diagnóstico , Mosquitos VectoresRESUMEN
Seizure semiology represents the clinical expression of the activation of the several brain regions comprising an epileptic network. In mesial temporal lobe epilepsy (MTLE), this network includes the insular-opercular-neocortical temporal-hippocampal (IONTH) regions. In this study, we present the case of a patient with pharmacoresistant seizures characterized by nausea, lip-smacking, semipurposeful hand movements, and speechlessness, suggesting dominant hemisphere MTLE, with scalp video-EEG findings and left hippocampal sclerosis on brain MRI confirming the diagnosis. She underwent anterior temporal lobectomy with amygdalohippocampectomy and was seizure-free for 14 years before relapsing. Recurrent seizure semiology was similar to preoperative seizures, that is, consistent with left MTLE, despite the medial temporal lobe missing. Seizures were therefore assumed to arise from remnant portions of the IONTH network-the insula, operculum, and posterolateral temporal neocortex. Reinvestigation including MEG localization of spikes and acute MRI changes following a seizure cluster suggested a left opercular region epilepsy. Our patient thus demonstrated the principle that seizures with mesial temporal characteristics may arise from outside the mesial temporal lobe (MTL). MTLE semiology arises from the activation of a set of structures (the seizure network) associated with the MTL, which can be triggered by foci both within and outside the MTL itself, and indeed even in its absence. However, it is not necessary to resect the entire extended network to bring about extended periods of seizure freedom in patients with refractory MTLE.
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Epilepsia del Lóbulo Frontal , Epilepsia Generalizada , Epilepsia del Lóbulo Temporal , Femenino , Humanos , Convulsiones/diagnóstico por imagen , Convulsiones/cirugía , Lóbulo Temporal/diagnóstico por imagen , Lóbulo Temporal/cirugía , Epilepsia del Lóbulo Temporal/diagnóstico por imagen , Epilepsia del Lóbulo Temporal/cirugía , Hipocampo/diagnóstico por imagen , Hipocampo/cirugía , Daño Encefálico CrónicoRESUMEN
Land use and land cover patterns impact soil properties and negatively affect soil microbial community and related processes. However, the information regarding the influence of urban land use on soil microbial composition and functioning is limited. Here, we investigated the impact of urban land use patterns on soil microbiological parameters by comparing five contrasting anthropogenic land use classes, i.e. agriculture, park, roadside plantation, street green, and bare land. Soil physicochemical properties, basal respiration (BR), microbial biomass carbon (MBC), and enzyme activities were estimated and correlated. The results revealed that soil physicochemical and microbiological properties greatly varied across the five land use classes. Among all the land use types, the roadside plantation had the highest nutrient content, i.e. soil organic carbon (SOC), total nitrogen (TN), and mineral nitrogen (MN) (1.33%, 0.13%, 84.0 mg kg-1, respectively), while the soil functional capacities measured in terms of BR, MBC, microbial quotient (QCO2), soil microbial activity (SMA), and dehydrogenase activity (DHA) (9.90 C µg g-1 h-1, 300 µg g-1, 0.045 µg h-1/ µg MBC, 9.0 µg ml-1, 1.30 TPF g-1 h-1, respectively) were highest in the park. Disturbed street greens were markedly nutrient depleted and apparently exhibited lower microbial activity. Variations in soil BR, MBC, and enzyme activity were revealed to be primarily influenced by soil moisture, available phosphorus, and SOC content. We concluded that the negative impacts of anthropogenic land use soil quality and microbiological functioning can be managed by integrating proper management approaches for various land use classes in urban systems.
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Carbono , Suelo , Monitoreo del Ambiente , Agricultura , NitrógenoRESUMEN
The aim of this study was to isolate and characterize bovine-vaginal probiotics genotypically and phenotypically using in silico and evaluate their in vivo performance in buffaloes with endometritis. For the in vitro isolation and characterization, vaginal swabs were collected from 34 cows and 17 buffaloes, and 709 primary bacterial isolates with probiotic activity were obtained using MRS agar media. Two isolates Lactiplantibacillus plantarum KUGBRC (LPKUGBRC) and Pediococcus pentosaceus GBRCKU (PPGBRCKU) demonstrated optimum in vitro probiotic activities as compared to Lacticaseibacillus rhamnosus GG including, acid production, secretion of fatty acids and exopolysaccharide, cell surface hydrophobicity, self-aggregating and co-aggregating capacity with pathogens, anti-microbial activity and bacteriocin-like compounds against pathogens Escherichia coli and Staphylococcus aureus in cell-free supernatant and absence of hemolytic activity. Their phenotypic capacity was confirmed by analyzing the whole genome sequencing data and identifying genes and pathways associated with probiotic properties. These probiotic isolates have shown no virulence genes were discovered in their genomic study. In vivo study of 92 buffaloes suffering from clinical endometritis with purulent cervico-vaginal mucus (CVM) were randomly allocated 40 × 108 CFU/ml LPKUGBRC and PPGBRCKU and 40 ml Normal saline. The LPKUGBRC reduced the duration between administration of probiotic to induction of healthy estrus significantly. However, no effect was observed on pregnancy rate. These results suggest that LPKUGBRC and PPGBRCKU probiotic bacteria demonstrate probiotic efficiency and adaptability. Further sourced from the same niche as the targeted infection, they offer a distinct advantage in targeting the specific microbial population associated with endometritis. The findings of this study highlight the potential of LPKUGBRC and PPGBRCKU probiotics in treating endometritis and suggest further exploration of their clinical applications.
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BACKGROUND: Propylene glycol (PG) is used in a variety of cosmetics, food and pharmaceuticals. PG is a known sensitizer but also irritating when patch tested (PT). OBJECTIVES: The aims were to investigate the frequency of contact sensitization to PG and to identify cases of allergic contact dermatitis (ACD). METHODS: A retrospective study was performed on patients PT at the Skin Health Institute (SHI), Victoria, Australia to PG 5% pet. and PG 10% aq. between 1 January 2005 and 31 December 2020. RESULTS: In all, 6761 patients were PT to PG and 21 (0.31%) reacted. Of those 21 individuals, 9 (42.9%) had a relevant reaction. 75% of relevant positive reactions were in patients PT to PG 10% aq. The most common source of PG exposure was topical medicaments (77.8% of relevant reactions) and moisturizers, with the largest group being topical corticosteroids. CONCLUSION: Contact sensitization to PG in the patch test population remains uncommon, although it is possible that testing with concentrations of 5%-10% PG did not identify all reactions. Topical corticosteroids were the most important cause. Patients with suspected contact dermatitis to topical corticosteroids should be PT to PG.
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Dermatitis Alérgica por Contacto , Fármacos Dermatológicos , Humanos , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Estudios Retrospectivos , Propilenglicol/efectos adversos , Alérgenos/efectos adversos , Pruebas del Parche/efectos adversos , Victoria/epidemiología , Glucocorticoides/efectos adversosRESUMEN
Understanding heterogeneity in shy or inhibited children's risk for poor socioemotional adjustment can inform intervention targets. The present study considered temperament traits associated with approach and regulation that may alter trajectories away from internalizing behaviors and poor socioemotional competence among shy toddlers. Fifty-five 22-24-month-old children (22 boys) preselected for parent-reported shyness were observed during laboratory tasks designed to measure shyness, activity level, positive affect, and inhibitory control between January 2016 and January 2018. Basal respiratory sinus arrhythmia (RSA) was obtained for a subset of the sample from recordings of cardiac activity as toddlers watched a neutral video. Hierarchical regression analyses predicted internalizing and competence from activity level, positive affect, inhibitory control, and basal RSA, alone and in interaction with shyness, while controlling for child gender. Activity level was positively associated with internalizing behaviors, and inhibitory control and positive affect were negatively associated with internalizing behaviors. Importantly, shyness was associated with more internalizing behaviors among children low in inhibitory control or high in basal RSA, but not among children high in inhibitory control or low in basal RSA. Relations between temperament traits and socioemotional adjustment were specific to internalizing behaviors and did not generalize to competence. The present findings suggest that in toddlerhood positive affect and inhibitory control may serve as protective factors for shy children, lessening risk for internalizing problems, whereas high activity or greater basal RSA may forecast risk. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Emociones , Temperamento , Masculino , Humanos , Timidez , Padres/psicología , FelicidadRESUMEN
Heavy metals beyond their permissible limits are major contaminants and causes of concern due to their persistent nature and health hazards. Several studies validated the utilization of plants as biomonitors and bioaccumulators for heavy metal pollution. Therefore, this study was conducted to examine the proficiency for heavy metal monitoring and mitigation by commonly found plant species in urban areas of Delhi. For this objective, four sites (viz., control, residential, commercial, and industrial) and sixteen usually growing plant species were selected. Four heavy metals, i.e., lead (Pb), cadmium (Cd), copper (Cu), and zinc (Zn), were analysed for soil and dust from each site, and leaf samples from each plant, at all sites, and various other parameters were calculated. Among the four elements, Pb and Cd showed maximum geoaccumulation and contamination at all sites. Pollution load index (PLI) values for both soil and dust indicated that industrial sites (1.78, 2.15) were most contaminated followed by commercial (1.52, 1,87), residential (1.41, 1.67), and control (1.22, 1.37) sites. Concentrations of Pb, Cu, and Zn were found to be highest in Morus alba, while Cd concentrations were found to be highest in Millettia pinnata (L.) Panigrahi. From various analyses, we concluded that commonly found plant species such as Ficus religiosa L., Terminalia arjuna (Roxb. Ex DC.) Wight &Arn., Morus alba L., Prosopis juliflora (Sw.) DC., and M. pinnata proved to be exceptional biomonitors and bioaccumulators for heavy metals in urban areas. Therefore, these plant species are highly recommended for plantation in urban areas for decontamination of the air and soil by mitigating heavy metal pollution.
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Metales Pesados , Contaminantes del Suelo , Cadmio/análisis , Plomo/análisis , Contaminantes del Suelo/análisis , Monitoreo del Ambiente , Metales Pesados/análisis , Plantas , Suelo , Polvo/análisis , Hojas de la Planta/química , IndiaRESUMEN
Background: Kratom (Mitragyna speciosa) use in the United States is becoming increasingly popular and its legal status varies widely from state to state. Multiple reports of adverse events associated with kratom use have ranged from liver injury, seizures, psychiatric disturbance, and rarely death. Methods: This study investigated coroner autopsy reports from Kern County in California for the year 2020 which included qualitative data on substances from blood toxicological reports. Of the 214 opioid-associated accidental overdoses reported, 4 subjects (1.9%) had mitragynine (kratom) exposure on the autopsy report and were included in the study. We reported available demographic information and comorbid substance findings from the associated autopsy reports. Results: All 4 individuals with mitragynine (kratom) toxicology had accidental opioid overdose deaths noted in autopsy reports. Each subject also had toxicology positive for at least one other substance. Fentanyl was found in 3 (75%) of the cases and suspected to be the primary contributor to opioid-related deaths in those cases. However, one fatality was without fentanyl, but instead had tested positive for benzodiazepines, cannabis, and other psychiatric medications. Discussion: The findings of this brief report provide insight into the role that mitragynine (kratom) may have in modulating risk of opioid-related deaths. The combined use of kratom with opioids such as fentanyl appears most likely to increase the risk of a fatal overdose, but it may also occur with other medications such as benzodiazepines and psychiatric medications. It is a serious concern that in the midst of the opioid overdose epidemic there is a growing presence of kratom use in the U.S. population with a largely unregulated status.
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Background: Ultrasound-based transient elastography (TE) is a non-invasive alternative to liver biopsy for the staging of hepatic fibrosis due to various chronic liver diseases. This meta-analysis aims to assess the diagnostic accuracy of TE for detecting liver cirrhosis (F4) and severe fibrosis (F3) in patients with chronic liver diseases, in comparison to the gold standard liver biopsy. Methods: A systematic search was performed using PubMed search engine following Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines from inception to May 2021. The meta-analysis studies evaluating the diagnostic accuracy of TE for severe fibrosis and cirrhosis were identified. We conducted a meta-meta-analysis to generate pooled estimates of the sensitivity, specificity, and diagnostic odds ratios (ORs) for F3 and F4 fibrosis stage. Results: We included five studies with a total of 124 sub-studies and 20,341 patients in our analysis. Three studies have reported the diagnostic accuracy of TE in detecting F3/severe fibrosis stage and found 81.9% pooled sensitivity (95% confidence interval (CI): 79.9-83.7%; P < 0.001) (I2 = 0%), 84.7% pooled specificity (95% CI: 81.3-87.6%) (I2 = 81%; P = 0.02). All five studies reported the diagnostic accuracy of TE in detecting F4/liver cirrhosis stage. We found 84.8% pooled sensitivity (95% CI: 81.4-87.7%) (I2 = 86.4%; P < 0.001), 87.5% pooled specificity (95% CI: 85.4-89.3%) (I2 = 90%; P < 0.001) and pooled diagnostic OR (41.8; 95% CI: 3.9 - 56.5) (I2 = 87%; P < 0.001). Conclusions: Ultrasound-based TE has excellent diagnostic accuracy for identifying cirrhosis and liver fibrosis stages 3. Future studies should focus on estimating the diagnostic accuracy of other fibrosis stages in chronic liver disease patients. This will eventually decrease the risk associated with invasive liver biopsy.
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The transplacental route of vertical transmission of Hepatitis B Virus (HBV) has been known for over a decade. Here we present evidence which suggest HBV can replicate in placenta. Forty-one HBsAg positive and 10 control pregnant women were enrolled in the study after obtaining informed consent. HBV positives were further divided in the High Viral Load (HVL) Group and Low Viral Load (LVL) Group according to INASL guidelines 2018. The Presence of the HBV DNA and expression of NTCP in the placenta was analyzed by qPCR/RT-qPCR and/or immunohistochemistry (IHC). The presence of cccDNA was assessed using Digital Droplet PCR while the presence of pre-genomic (pg) RNA was assessed through qRT-PCR and sequencing. The presence of HBeAg and HBcAg in the placenta was assessed by IHC. Immunostaining of NTCP, HBeAg and HBcAg on trophoblasts along with the presence of total HBV DNA, cccDNA and pgRNA indicated, that these cells are not only susceptible to HBV infection but may also support viral replication. This is further supported by the finding that trophoblasts of the several HBeAg seronegative samples harbored the HBeAg. Although, we did not find any correlation in NTCP expression and viral markers with viral load indicates placental replication may not aping hepatocytes. The presence of the HBV receptor, NTCP along with the presence of cccDNA, pgRNA, and HBeAg in placenta of HBV infected females without circulating HBeAg suggest that placenta act as a replication host.
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Hepatitis B Crónica , Hepatitis B , Femenino , Humanos , Embarazo , Virus de la Hepatitis B/genética , Antígenos e de la Hepatitis B , Antígenos de Superficie de la Hepatitis B , ADN Viral/genética , Mujeres Embarazadas , Antígenos del Núcleo de la Hepatitis B , Receptores de HL , Placenta , Replicación Viral/genética , Biomarcadores , ARNRESUMEN
The rise in urbanization has led to an increase in dust pollution which is hazardous to the health of living beings. The role of roadside plant species in intercepting particulate matter and improving air quality is well reported. Hence, this study was carried out to determine the ability of various plant species to intercept atmospheric dust and withstand the abiotic stress triggered by dust deposition. In the present investigation, three sites (viz., control, commercial, and industrial) differing in anthropogenic activities and vegetation were selected. Sixteen plant species entailing both trees and shrubs that are commonly occurring at all three sites were selected to estimate their dust interception capacity (DIC). The impact of dust pollution on foliage biochemistry and their tolerance in winter and summer seasons were analyzed. Based on biochemical, biological, and socio-economic parameters, air pollution tolerance index (APTI) and anticipated performance index (API) were evaluated. Both dust load and DIC were found to be two times higher in winter than in the summer season. Terminalia arjuna, Ficus benghalensis, and Plumeria alba were the best dust accumulators, while Prosopis juliflora accumulated least. The highest DIC was observed at the industrial site, for Terminalia arjuna (0.025 mg/cm2/d) in winter and Plumeria alba (0.023 mg/cm2/d) in the summer season. Photosynthetic pigments showed a negative correlation with dust load, while pH, ascorbic acid, electrolytic leakage (E.L.), and proline content showed a positive correlation. In the present study, APTI and API values were highest for Ficus religiosa, Ficus benghalensis, Alstonia scholaris, Dalbergia sissoo, and Terminalia arjuna. Such plant species with wide canopy, large and rough leaf surface area with perforated veins are found to be more suitable and, hence, recommended for the development of greenery to improve air quality in urban areas like Delhi.
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Contaminantes Atmosféricos , Contaminación del Aire , Contaminantes Atmosféricos/análisis , Monitoreo del Ambiente , Contaminación del Aire/análisis , Polvo/análisis , Plantas , Material Particulado/análisis , Hojas de la Planta/química , Ácido Ascórbico/análisis , Prolina , IndiaRESUMEN
BACKGROUND: Anticholinergic medications are drugs that block cholinergic transmission, either as their primary therapeutic action or as a secondary effect. Patients with dementia may be particularly sensitive to the central effects of anticholinergic drugs. Anticholinergics also antagonise the effects of the main dementia treatment, cholinesterase inhibitors. Our study aimed to investigate anticholinergic prescribing for dementia patients in UK acute hospitals before and after admission. METHODS: We included 352 patients with dementia from 17 UK hospital sites in 2019. They were all inpatients on surgical, medical or Care of the Elderly wards. Information about each patient's medications were collected using a standardised form, and the anticholinergic drug burden of each patient was calculated with an evidence-based online calculator. Wilcoxon's rank test was used to look at the correlation between two subgroups upon admission and discharge. RESULTS: On admission to hospital, 37.8% of patients had an anticholinergic burden score ≥ 1 and 5.68% ≥3. On discharge, 43.2% of patients with an anticholinergic burden score ≥ 1 and 9.1% ≥3. The increase in scores was statistically significant (p = 0.001). Psychotropics were the most common group of anticholinergic medications prescribed at discharge. Of those patients taking cholinesterase inhibitors, 44.9% were also prescribed anticholinergic medications. CONCLUSIONS: Our cross-sectional, multicentre study found that people with dementia are commonly prescribed anticholinergic medications, even if concurrently taking cholinesterase inhibitors, and are significantly more likely to be discharged from hospital with a higher anticholinergic burden than on admission.
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Inhibidores de la Colinesterasa , Demencia , Anciano , Antagonistas Colinérgicos/efectos adversos , Inhibidores de la Colinesterasa/uso terapéutico , Estudios Transversales , Demencia/inducido químicamente , Demencia/tratamiento farmacológico , Demencia/epidemiología , Hospitales , HumanosRESUMEN
South Asian (SA), including Asian Indian and Pakistani Americans, have a high burden of cardiometabolic risk factors and low levels of physical activity (PA). Increasing PA in the U.S. population is a national priority; however, SA American women and girls experience unique barriers to PA that are not addressed by current promotion efforts. To address this gap, our community-based participatory research partnership developed the South Asians Active Together (SAATH) intervention. This study is a two-arm randomized clinical trial to evaluate the effects, mediators, and implementation of the 18-week SAATH intervention. A total of 160 mother-daughter dyads will be randomized in a 1:1 ratio to the SAATH intervention and control groups. The intervention was designed for mother-daughter dyads and targets individual, interpersonal, and family levels through (1) group exercise classes, (2) mother-daughter discussions, and (3) peer group discussions. The intervention targets the environment level through community partner meetings aimed at creating environment changes to enhance PA opportunities for SA women and girls. The control group will receive PA education materials. We hypothesize that dyads who receive the intervention will have significantly greater increases in moderate- and vigorous-intensity PA (MVPA) from baseline to 4 months, compared to the control group. MVPA will be measured at 12 months in intervention participants to examine if changes are sustained. A process evaluation will use the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. This study will fill knowledge gaps about the effectiveness and implementation of culturally adapted, community-based PA interventions for SA women and girls.
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Asiático , Promoción de la Salud , Ejercicio Físico , Femenino , Promoción de la Salud/métodos , Humanos , Madres , Núcleo Familiar , Ensayos Clínicos Controlados Aleatorios como Asunto , Estados UnidosRESUMEN
Chronic non-specific contamination of the reproductive tract in animals is a major issue during early postpartum, natural coitus, or artificial insemination. Uterine infection is one of the major concerns reducing fertility, production loss, and early culling of the animals. Therefore, the aim of this study was to identify any novel bacterium if present in the uterine environment of Bubalus bubalis causing infections. A strictly anaerobic bacterial strain designated as Paraclostridium bifermentans GBRC was isolated and characterized. Bacterium was found to be Gram positive moderate rod with motility. The optimum growth was observed at 40 ± 2 °C. The pathogenic characteristics of the GBRC strain, such as hemolysis, gelatin hydrolysis, and the production of volatile sulfur compounds, were similar to those seen in the epithelial layer invading pathogenic strains. Assembled genome size was 3.6 MB, with 78 contigs, and a G + C content of 28.10%. Furthermore, the whole genome sequence analysis confirmed the presence of genes encoding virulence factors and provided genomic insights on adaptation of the strain in the uterine environment. Based on the phenotypic and genetic differences with phylogenetic relatives, strain GBRC is proposed to represent a first reported species of the genus Paraclostridium with potential pathogenic character, from the buffalo uterine environment. This study analysis of the GBRC strain serves as a key reference point for the investigation of potential pathogenic strains that may cause endometritis and metritis in bovine.