Chromium propionate in turkeys: effect on performance and animal safety.

Two hundred eighty-eight male Nicholas Large White turkey poults were used to determine the effect of supplementing turkeys with chromium propionate (Cr Prop) from 1 to 84 d of age on performance and animal safety. Treatments consisted of Cr prop supplemented to provide 0, 0.2, or 1.0 mg Cr/kg diet. One mg of supplemental Cr is 5 times (x) the minimal concentration of Cr Prop that enhanced insulin sensitivity in turkeys. Each treatment consisted of 8 floor pens with 12 poults per pen. Turkeys were individually weighed initially, and at the end of the starter 1 (d 21), starter 2 (d 42), grower 1 (d 63), and grower 2 phase (d 84). On d 85, blood was collected from the wing vein in heparinized tubes from 2 turkeys per pen for plasma chemistry measurements. A separate blood sample was collected from the same turkeys in tubes containing K2EDTA for hematology measurements. Turkey performance was not affected by treatment during the starter 1 phase. Gain was greater (P = 0.024) and feed/gain lower (P = 0.030) for turkeys supplemented with Cr compared with controls during the starter 2 phase. Over the entire 84-d study turkeys supplemented with Cr had greater (P = 0.005) ADG and tended (P = 0.074) to gain more efficiently than controls. Gain (P = 0.180) and feed/gain (P = 0.511) of turkeys supplemented with 0.2 mg Cr/kg did not differ from those receiving 1.0 mg Cr/kg over the entire 84-d study. Feed intake was not affected by treatment. Body weights of turkeys supplemented with Cr were heavier (P = 0.005) than controls by d 84. Chromium supplementation did not affect hematological measurements and had minimal effect on plasma chemistry variables. Results of this study indicates that Cr Prop supplementation can improve turkey performance, and is safe when supplemented to turkey diets at 5x the minimal concentration that enhanced insulin sensitivity.

Celiac disease seroprevalence in subjects with dyspeptic symptoms. A study on a Mexican population.

INTRODUCTION AND AIMS: Celiac disease (CD) is an autoimmune enteropathy that develops in genetically susceptible individuals. The typical gastrointestinal manifestation is diarrhea but symptoms of dyspepsia, such as epigastric pain, nausea, or satiety, can sometimes appear. Previous studies have reported that the prevalence of CD in patients with dyspepsia can be as high as 7%. The aim of the present study was to evaluate CD seroprevalence in subjects with dyspeptic symptoms and a control group in a Mexican population. MATERIAL AND METHODS: A case-control study was conducted on blood donors that answered the PAGI-SYM questionnaire for dyspepsia and in whom IgA antibodies to tissue transglutaminase 2 (IgA anti-tTG2) and IgG antibodies to deamidated gliadin peptide (IgG anti-DGP) were determined. CD seroprevalence in subjects with dyspeptic symptoms and in asymptomatic subjects was compared. RESULTS: A total of 427 subjects (76.3% men), with a mean patient age of 34 years (range of 18-65 years) were included. Of those participants, 87 (20.3%) had symptoms of dyspepsia (group A) and 340 (79.6%) were asymptomatic (group B). Antibodies were positive in one (1.15%) of the group A subjects (1/87, 95% CI 0.2-6 %), whereas they were positive in 4 (1.18%) of the group B subjects (4/340, 95% CI 0.4-2.9%, p = 0.59). CONCLUSIONS: CD seroprevalence in the study population with dyspeptic symptoms (1%) was not different from that of the control population. Thus, CD screening in Mexican patients with dyspepsia is not justified.

Causas de exclusión de donantes renales vivos en el servicio de trasplante de un hospital de tercer nivel del noroeste de México

Objetivo: Identificar las causas de exclusión de los donantes renales vivos en un centro hospitalario de tercer nivel en el noroeste de México. Materiales y métodos: Estudio de tipo observacional, transversal, descriptivo, retrospectivo. Se realizó la evaluación de los expedientes clínicos de los candidatos vivos para donación renal, que abarcó el periodo comprendido entre el 1 de enero de 2019 y el 31 de diciembre de 2021. Resultados: De los 30 expedientes seleccionados, solo se eligieron 2 (6,6 %) donadores, es decir, existió un índice de rechazo de 28 (93,3 %) de los potenciales candidatos. La edad promedio fue de 40,7 años; al dividirlos en grupos de edad, se observó que el 7,44 % fueron ≤39 años; el 5,31 %, ≥50 años; y el 4,25 %, de 40 a 49 años. Dentro de las principales patologías que originaron el rechazo del donador vivo se encuentran las enfermedades crónicas, como afección renal desconocida, obesidad, diabetes mellitus, hipertensión arterial sistémica y cardiopatías, que representaron el 60,7 %. El deseo de donar es más frecuente entre consanguíneos que en no consanguíneos. En el caso de los consanguíneos, es decir, hermanos, padres, hijos, tíos, etc., el 64,2 % fue rechazado; en los no consanguíneos, el 34,7 %, que incluía a esposos y amigos. Conclusiones: Los resultados obtenidos sobre el índice de masa corporal (IMC) mostraron que el sobrepeso y la obesidad fueron las principales causas de exclusión, circunstancia que es particular en nuestro país respecto a su perfil epidemiológico. La cantidad de donantes vivos en nuestro centro se redujo porque la mayor parte de la población no es sana, padece obesidad y ello repercute al momento de presentarse como candidato a donante.

Objective: To identify the causes for exclusion of living kidney donors at a third-level hospital in northwestern Mexico. Materials and methods: An observational, cross-sectional, descriptive and retrospective study, in which the medical records of candidates for living kidney donation were evaluated from January 1, 2019 to December 31, 2021. Results: Out of the 30 selected records, only 6.6 % (2) were chosen as donors, i.e., the rejection rate of the potential candidates was 93.3 % (28). The average age was 40.7 years; when divided into age groups, it was observed that 7.44 % were ≤ 39 years, 5.31 % were ≥ 50 years and 4.25 % were in the 40-49 age range. The main pathologies that caused the rejection of living donors were chronic diseases such as unknown renal disease, obesity, diabetes mellitus, systemic hypertension and heart diseases, which accounted for 60.7 %. The desire to donate was more frequent among blood relatives than non-blood relatives. In the case of blood relatives, i.e., siblings, parents, children, uncles, aunts, etc., 64.2 % were rejected, while 34.7 % of non-blood relatives, including spouses and friends, were rejected. Conclusions: Based on the body mass index (BMI), the results showed that overweight and obesity were the main causes of exclusion, a situation that is consistent with the Mexican epidemiological profile. The number of living donors at our center has been reduced because most of the population is not healthy and has obesity, which affects the willingness to be a candidate for living kidney donation.

Performance and processing yield comparisons of Large White male turkeys by genetic lines, sources, and seasonal rearing.

Large White male turkey genetic lines (GL) comparison in performance and processing yields under the same conditions are rare in the literature. Two rearing experiments (EXP) were conducted to accomplish 2 objectives. The first objective was to test the effects of poult source and genetic lines on performance and processing yields. The second objective was to extract season and growth patterns when comparing both EXP common treatments. In EXP 1, male poults from 5 different sources were randomly assigned to 48 concrete: litter-covered floor pens. In EXP 2, male poults from 7 different genetic lines were randomly assigned to 48 concrete: litter-covered floor pens. For both EXP, the experimental design was a completely randomized block design with a one-factor arrangement. Both EXP were placed in the same house with the same management and nutrition in two separate seasons of the same year. Bird performance and carcass processing yield were analyzed in SAS 9.4 or JMP 15.1 in a mixed model. In EXP 1 no significant difference in BW or processing yield was observed. However, a similar GL from a commercial hatchery had an improved feed conversion ratio (FCR) over the same GL sourced directly from the genetic company hatchery. In EXP 2, statistical differences were observed in performance and breast meat yield depending on the GL. A season effect was observed when comparing the two EXP. Birds raised in the fall season had a 2 kg BW increase, on average, over their spring counterparts. This difference in BW can also be observed in a statistically higher breast meat yield by the birds raised in the fall over the ones raised in the spring. In conclusion, a comparison between GL resulted in effects due to genetic line, poult source, and rearing season on bird performance and carcass yield.

Impact of Cadmium Mediated by Tobacco Use in Musculoskeletal Diseases.

Tobacco use has a negative impact on health due to its relationship with the development of high-mortality diseases, such as pulmonary cancer. However, the effect of cadmium (Cd), present in tobacco smoke, on the development of joint diseases has been scarcely studied. The objective of this review is to discuss the evidence regarding the mechanisms by which Cd exposure, through tobacco smoke, may lead to the development of osteoarthritis (OA), osteoporosis (OP), and rheumatoid arthritis (RA). There's evidence suggesting a string association between moderate to severe OA development and tobacco use, and that a higher blood concentration of Cd can trigger oxidative stress (OS) and inflammation, favoring cartilage loss. At the bone level, the Cd that is inhaled through tobacco smoke affects bone mineral density, resulting in OP mediated by a decrease in the antioxidant enzymes, which favors the bone resorption process. In RA, tobacco use promotes the citrullination process through Cd exposure and increases OS and inflammation. Understanding how tobacco use can increase the damage at the articular level mediated by a toxic metal, i.e., Cd, is important. Finally, we propose prevention, control, and treatment strategies for frequently disabling diseases, such as OA, OP, and RA to reduce its prevalence in the population.

Effect of methionine chelated Zn and Mn and corn particle size on Large White male turkey live performance and carcass yields.

Most turkey research has been conducted with a regular corn particle size set through phase-feeding programs. This study's first objective was to determine the effect of increasing corn particle size through the feed phases on performance, processing yield, and feed milling energy usage in Large White commercial male turkey production. Zinc (Zn) and manganese (Mn) are essential microminerals for animals' healthy growth. The source in which these elements are supplied to the bird will determine their bioavailability, effect on bird growth, and subsequent environmental impact. This study's second objective was to measure both inorganic and chelated Zn and Mn sources on turkey performance, turkey carcass processing yields, and subsequent litter residues. Twelve hundred Nicolas Select male poults were randomly assigned to 48 concrete; litter-covered floor pens. The experimental design was a completely randomized block design with a 2 × 2 factorial arrangement of 2 sources of minerals (organic blend vs. inorganic) formulated to match breeder recommendations and 2 types of corn mean particle size (coarse corn [1,000-3,500 µm] vs. fine corn [276 µm]). The ASABE S319.4 standard was used to measure corn mean particle size. Bird performance, carcass processing yield, litter content of Zn and Mn, and pellet mill energy consumption were analyzed in SAS 9.4 in a mixed model. There was a reduction of pellet mill energy usage of 36% when coarse corn was added post-pelleting. Birds fed increasing coarse corn mean particle size were 250 g lighter on average in body weight (BW) than birds fed a constant control mean particle size. No difference was found in feed intake (FI) or feed conversion ratio (FCR). Birds fed methionine chelated Zn and Mn blended with inorganic mineral sources were 250 g heavier on average than birds fed only an inorganic source of minerals. In addition, feeding an organic blend of Zn and Mn resulted in greater breast meat yield. Litter from birds fed the control corn mean particle size, and inorganic minerals had a higher concentration of Zn in the litter but were not different when the chelated Zn/Mn were fed. In conclusion, increasing the corn mean particle size and adding it post pellet could save money during feed milling; however, birds might have a slightly lower BW. A combination of inorganic and chelated Zn and Mn may improve performance and increase total breast meat yields.

Effect of pellet quality and biochar litter amendment on male turkey performance.

Bedding (litter) is essential to poultry performance and health and can have an environmental impact after use in the poultry facility such as a soil amendment or as an alternative energy source. Pine shavings are the most common bedding used for turkey production. However, the increase in its price and its increasing scarcity in some areas have created new research opportunities for reusing litter as bedding. Improvement in feed pellet quality has been reported to improve poultry performance. However, the reports for turkeys are limited and dated. This study's objective was to determine how the improvement of feed pellet quality and the use of biochar added to a combination of used turkey brooder house litter and Miscanthus grass as bedding affects turkey performance, small intestine morphology, and ammonia production. Nicolas Select (Aviagen Turkeys, Lewisburg, WV) male poults (816) were randomly assigned to 48 concrete litter floor pens on the day of hatch. The experiment used a completely randomized block design with a 2 × 4 factorial arrangement of treatments: 2 levels of fines in the feed and 4 bedding treatments. The bedding treatments were a constant level of used turkey brooder house litter combined with a varying combination of biochar and Miscanthus grass. Turkey's body weight (BW), body weight gain (BWG), feed intake (FI), and feed conversion ratio (FCR) were determined. Differences in treatment means were considered to be statistically significant at P ≤ 0.05 using a mixed model in SAS 9.4. Turkeys fed the feed with improved pellet quality had a higher BW from 3 to 17 wk (17.0 ± 0.1 kg) than turkeys fed an increased abundance of fines (16.72 ± 0.1 kg). Turkeys fed feed with increased pellet quality had a lower FI (45.6 vs. 48.1 ± 0.4 kg) and improved FCR (2.20 vs. 2.31 ± 0.01) from 0 to 20 wk. Litter treatment with 20% biochar resulted in higher BW at 20 wk (20.91 ± 0.16 kg) because of increased BWG at 11 wk over the rest of the biochar levels (3.7 ± 0.1 kg). Strategies to reduce the abundance of fines in feed through feed formulation, feed manufacturing, feed transport, and in-house feed management should be considered to increase male turkeys' performance. There may be opportunities to use biochar as a litter amendment to improve turkey health and performance.

Effect of feed form, soybean meal protein content, and Rovabio Advance on poult live performance to 3 wk of age.

Based on research reports, feed characteristics can increase poult growth via several factors. Two rearing experiments (EXP) were conducted to test the effects of feed form and ingredient quality in turkey poults. Bird performance and the duodenum, jejunum, ileum, and cecum morphology were observed in both EXP. Poults were reared in battery cages (48 cages in EXP 1 and 72 cages in EXP 2). Four dietary treatments with differing feed form and function factors were evaluated in EXP 1. A completely randomized block design with a 2 × 2 × 2 factorial arrangement of treatments consisting of 2 levels of fines, 2 soybean meal (SBM) sources, and 2 levels of an enzyme cocktail (Rovabio Advance) was tested in EXP 2. Poult BW, BW gain (BWG), feed intake (FI), and feed conversion ratio (FCR) were determined in both EXP. Apparent metabolizable energy corrected for nitrogen (AMEn) was determined in EXP 2. Differences were considered to be statistically significant at P ≤ 0.05. Feeding increased feed crumble particle size with fewer fines in the starter feed resulted in an increased BWG accompanied by an increased FI. Reduced feed fines reduced AMEn when the dietary enzyme cocktail was not present. The feed formulation with 60% CP SBM resulted in a lower FI and an improved FCR. The enzyme cocktail interacted synergistically with screening and fed SBM source factors on the AMEn and FCR. It was concluded that both the feed form and quality, as used in this study, affect poult performance.

Effect of cadmium on the viability on monolayer cultures of synoviocytes, chondrocytes, and Hoffa: A preliminary study.

Osteoarthritis (OA) is the gradual loss of articular cartilage and involves several tissues, such as the synovial membrane, meniscus, ligaments, and adipose tissue known as Hoffa fat pad. There are largely unexplored factors that lead to OA development, such as the impact of exposure to heavy metals like cadmium (Cd) on the viability of cells in the knee joint tissue. The objective of this report was to identify the cell type with the highest susceptibility to Cd toxicity with respect to cell viability and death. Our findings showed that a concentration as low as 3 µM cadmium chloride for 12 h affects the viability of synovial cells, and a concentration of 10 µM affects Hoffa cells. Our results suggest that Cd can affect the viability of synovial and chondral cells primarily. In contrast, Hoffa cells were less susceptible, likely because Cd favors the production of pro-inflammatory cytokines before triggering their death as part of its damage mechanism at the articular level.

Mapping of host-parasite-microbiome interactions reveals metabolic determinants of tropism and tolerance in Chagas disease.

Chagas disease (CD) is a parasitic disease caused by Trypanosoma cruzi protozoa, presenting with cardiomyopathy, megaesophagus, and/or megacolon. To determine the mechanisms of gastrointestinal (GI) CD tissue tropism, we systematically characterized the spatial localization of infection-induced metabolic and microbiome alterations, in a mouse model of CD. Notably, the impact of the transition between acute and persistent infection differed between tissue sites, with sustained large-scale effects of infection in the esophagus and large intestine, providing a potential mechanism for the tropism of CD within the GI tract. Infection affected acylcarnitine metabolism; carnitine supplementation prevented acute-stage CD mortality without affecting parasite burden by mitigating infection-induced metabolic disturbances and reducing cardiac strain. Overall, results identified a previously-unknown mechanism of disease tolerance in CD, with potential for new therapeutic regimen development. More broadly, results highlight the potential of spatially resolved metabolomics to provide insight into disease pathogenesis and infectious disease drug development.

Effect of cadmium on the concentration of essential metals in a human chondrocyte micromass culture.

BACKGROUND: An essential element imbalance in the joint might favor gradual degeneration of the articular cartilage. It has been reported that cadmium (Cd) plays an antagonistic role with regards to the presence of essential elements, such as zinc (Zn), iron (Fe), and manganese (Mn), which may favor the development of disabling diseases, like osteoarthritis (OA) and osteoporosis. METHODS: 3D cultures of human chondrocytes were phenotyped with the Western blot technique and structurally evaluated with histological staining. The samples were exposed to 1, 5, and 10 µM of CdCl2 for 12 h, with a non-exposed culture as control. The concentration of Cd, Fe, Mn, Zn, chromium (Cr), and nickel (Ni) was quantified through plasma mass spectrometry (ICP-MS). The data were analyzed with a Kruskal Wallis test, a Kendall's Tau test and Spearman's correlation coefficient with the Stata program, version 14. RESULTS: Our results suggest that Cd exposure affects the structure of micromass cultures and plays an antagonistic role on the concentration of essential metals, such as Zn, Ni, Fe, Mn, and Cr. CONCLUSION: Cd exposure may be a risk factor for developing joint diseases like OA, as it can interfere with cartilage absorption of other essential elements that maintain cartilage homeostasis.

The effect of hybrid zinc oxide/graphene oxide (ZnO/GO) nano-catalysts on the photocatalytic degradation of simazine.

The photocatalytic degradation of simazine (SIM) was investigated using zinc oxide/graphene oxide (ZnO/GO) composite materials under visible light irradiation. The reaction kinetics was studied to optimize the reaction parameters for efficient degradation of SIM. Batch studies were performed to investigate the effects of initial reaction pH, the loading of the ZnO onto GO, and mass of catalyst on the removal of SIM from aqueous solution. A pH of 2 was determined to be the optimal reaction pH for the different ZnO-loaded GO catalysts. In addition, a mass of 40 mg of catalyst in the reaction was observed to be the most effective for the catalysts synthesized using 20 and 30 mmol of Zn2+ ions; whereas a mass of 10 mg was most effective for the ZnO/GO composite material synthesized using 10 mmol Zn2+ ions. The reaction was observed to follow a second-order kinetics for the degradation process. Furthermore, the synthesized ZnO/GO composite catalysts resulted in higher reaction rates than those observed for pure ZnO. The 30 mmol ZnO/GO composite expressed a rate of SIM degradation ten times greater than the rate observed for pure ZnO, and sixty-two times greater than the rate of photolysis. In addition, the catalyst cycling exhibited a constant photocatalytic activity for the ZnO/GO composite over three reaction cycles without the need of a conditioning cycle.

Toxicity of cadmium in musculoskeletal diseases.

Epidemiological studies have reported that exposure to toxic metals like cadmium (Cd) may promote the development of musculoskeletal diseases, such as osteoporosis, rheumatoid arthritis (RA), and osteoarthritis (OA), among others. The objective of this review is to summarize the molecular mechanisms of inflammation and oxidative stress activated by Cd at the bone level, particularly in osteoporosis, RA, and OA. Cadmium can increase bone resorption, affect the activity of osteoclasts and calcium (Ca) absorption, and impair kidney function, which favors the development of osteoporosis. In the case of RA, Cd interferes with the activity of antioxidant proteins, like superoxide dismutase (SOD) and catalase (CAT). It also promotes an inflammatory state, inducing the process of citrullination, which affects the proteins of immune response. On the other hand, accumulation of Cd in the tissues and blood of smokers has been related to the development of some musculoskeletal diseases. Therefore, knowing the negative impact of Cd toxicity at the articular level can help understand the damage mechanisms it produces, leading to the development of such diseases.

Removal of Cu2+ and Ni2+ from Aqueous Solution using SnO2 Nanomaterial effect of: pH, Time, Temperature, interfering cations.

Tin oxide, SnO2, nanomaterial was synthesized and tested for the removal of Cu2+ and Ni2+ ions from aqueous solutions. Various parameters for the binding were investigated in batch studied, which included pH, time, temperature, and interferences. In addition, isotherm studied were performed to determine the maximum binding capacity for both Cu2+ and Ni2+ ions. The optimal binding pH determined from the effects of pH were to be at pH 5 for both the Cu2+ and Ni2+ ions. The isotherm studies were performed at temperatures of 4°C, 25 °C, and 45 °C for both the Cu2+ and Ni2+ ions and were found to follow the Langmuir isotherm model. The binding capacities for the Cu2+ ions were 2.63 mg/g, 2.95 mg/g and 3.27 mg/g at the aforementioned temperatures, respectively. Whereas the binding capacities for Ni2+ were 0.79 mg/g, 1.07 mg/g, and 1.46 mg/g at the respective temperatures. The determined thermodynamic parameters for the binding showed that the binding processes for the reactions were endothermic, as the ΔG was observed to decrease with decreasing temperatures. As well the ΔH was 28.73 kJ/mol for Cu2+ (III) and 13.37 kJ/mol for Ni2+. The ΔS was observed to be 92.65 J/mol for Cu2+ and 54.53 J/mol for Ni2+. The free energy of adsorption for the Cu2+ was determined to be 13.99 kJ/mol and the activation energy for the binding of Ni2+ was determined to be 8.09 KJ/mol. The activation energy data indicate that the reaction was occurring through chemisorption.

Resistive switching control for conductive Si-nanocrystals embedded in Si/SiO2 multilayers.

In this paper, we report on the enhanced control of resistive switching in multilayer Si/SiO2 structures, which permit the formation of Si nanocrystals with a typical size of 5.88 nm and overall good shape homogeneity. The deposition of a different number of Si and SiO2 bilayers (6, 8 and 10) allowed control of SET/RESET voltages in negative bias ranges 4.5-10 V and 6.3-13 V for six- and ten-bilayer devices, respectively. The corresponding resistance ratio between ON/OFF states varied in the ranges 107-105 for the aforementioned number of bilayers. Based on the result of XPS measurements, we suggest that the resistive switching in the studied system occurs due to the formation and annihilation of Si-Si and Si-O bonds, which serve as conductive pathways and isolating material, respectively.

Estimating intratumoral heterogeneity from spatiotemporal data.

Glioblastoma multiforme (GBM) is a malignant brain cancer with a tendency to both migrate and proliferate. We propose modeling GBM with heterogeneity in cell phenotypes using a random differential equation version of the reaction-diffusion equation, where the parameters describing diffusion (D) and proliferation ([Formula: see text]) are random variables. We investigate the ability to perform the inverse problem to recover the probability distributions of D and [Formula: see text] using the Prohorov metric, for a variety of probability distribution functions. We test the ability to perform the inverse problem for noisy synthetic data. We then examine the predicted effect of treatment, specifically, chemotherapy, when assuming such a heterogeneous population and compare with predictions from a homogeneous cell population model.

THE PROHOROV METRIC FRAMEWORK AND AGGREGATE DATA INVERSE PROBLEMS FOR RANDOM PDEs.

We consider nonparametric estimation of probability measures for parameters in problems where only aggregate (population level) data are available. We summarize an existing computational method for the estimation problem which has been developed over the past several decades [24, 5, 12, 28, 16]. Theoretical results are presented which establish the existence and consistency of very general (ordinary, generalized and other) least squares estimates and estimators for the measure estimation problem with specific application to random PDEs.

Innovative approach to the design and evaluation of treatment adherence interventions for drug-resistant TB.

BACKGROUND: Drug-resistant tuberculosis (DR-TB) treatment is expensive, lengthy, and can cause severe side effects. Patients face socio-economic, psychosocial, and systemic barriers to adherence; poor adherence results in poor treatment outcomes. OBJECTIVE: To estimate the effects of the components of the information-motivation-behavioral skills model on DR-TB treatment adherence. DESIGN: We recruited 326 adults receiving DR-TB treatment and 86 of their health care service providers from 40 health centers in Lima, Peru. The main outcome was adherence (i.e., the proportion of prescribed doses taken by a patient). Exposure measures were adherence information, motivation, and behavioral skills; loss to follow-up during previous TB treatment(s); providers' work engagement; and patient-perceived support from his/her social network. RESULTS: Structural equation modeling revealed that adherence information and motivation had positive effects on adherence, but only if mediated through behavioral skills (ß = 0.02, P < 0.01 and ß = 0.07, P < 0.001, respectively). Behavioral skills had a direct positive effect on adherence (ß = 0.27, P < 0.001). Loss to follow-up during previous treatment had a direct negative effect, providers' work engagement had a direct positive effect, and perceived support had indirect positive effects on adherence. The model's overall R2 was 0.76. CONCLUSION: The components of the information-motivation-behavioral skills model were associated with adherence and could be used to design, monitor, and evaluate interventions targeting adherence to DR-TB treatment.

Effectiveness and Adoption of a Drawing-to-Learn Study Tool for Recall and Problem Solving: Minute Sketches with Folded Lists.

Drawing by learners can be an effective way to develop memory and generate visual models for higher-order skills in biology, but students are often reluctant to adopt drawing as a study method. We designed a nonclassroom intervention that instructed introductory biology college students in a drawing method, minute sketches in folded lists (MSFL), and allowed them to self-assess their recall and problem solving, first in a simple recall task involving non-European alphabets and later using unfamiliar biology content. In two preliminary ex situ experiments, students had greater recall on the simple learning task, non-European alphabets with associated phonetic sounds, using MSFL in comparison with a preferred method, visual review (VR). In the intervention, students studying using MSFL and VR had ∼50-80% greater recall of content studied with MSFL and, in a subset of trials, better performance on problem-solving tasks on biology content. Eight months after beginning the intervention, participants had shifted self-reported use of drawing from 2% to 20% of study time. For a small subset of participants, MSFL had become a preferred study method, and 70% of participants reported continued use of MSFL. This brief, low-cost intervention resulted in enduring changes in study behavior.