Association between psychosocial factors and satisfaction with communication in family members of intensive care unit patients during COVID-19 pandemic: An exploratory cross-sectional study.

OBJECTIVE: To investigate the relationship between satisfaction with communication and perceived stress, depressive symptoms and perceived social support among family members of critically ill. RESEARCH METHODOLOGY/DESIGN: Exploratory, cross-sectional study was conducted. SETTING: Private teaching hospital in Santiago, Chile. MAIN OUTCOMES MEASURES: Family members of critically ill patients with 3-7 days of stay and respiratory support were approached. Questionnaires were used to assess satisfaction with communication (Family Satisfaction in the Intensive Care Unit-24), perceived stress (Perceived Stress Scale-10), depressive symptoms (Patient Health Questionnaire-9) and perceived social support (Medical Outcomes Study Social Support Survey). The relationship between satisfaction with communication and relevant variables was investigated using bivariate analyses and a beta regression. RESULTS: The study included 42 family members, with 71.4% being female and 52.4% having prior critical care experience. There was a positive correlation between perceived stress and depressive symptoms (r = 0.32, p = 0.039). According to the beta regression, perceived social support (B; 95% confidence interval, 0.44 [1.05-2.29]) and the number of calls with unit staff (0.17 [1.06-1.32]) were positively associated with satisfaction with communication but negatively with college education (-1.86 [0.04-0.64]) and perceived stress (-0.07 [0.87-0.99]). CONCLUSION: Psychosocial factors, such as higher educational level, perceived stress and perceived social support, can influence family members' evaluation of communication with staff. Current communication practices in acute care settings should be adapted to family members' psychosocial context to improve their satisfaction with the communication process. IMPLICATIONS FOR CLINICAL PRACTICE: Critical care professionals must be aware of the influence of family member-related factors on the quality and effectiveness of the communication process. Psychosocial features of the family members are likely to impact their satisfaction with communication and should be assessed on admission and during their stay to assist clinicians to adjust and improve their communication practices.

Community-based participatory research to guide adoption of culturally responsive trauma-informed HIV care throughout Nashville, Tennessee.

Background: Psychological trauma is a highly prevalent driver of poor health among people with HIV (PWH) in the Southern United States (U.S.). Trauma-informed care (TIC) has potential to advance national Ending the HIV Epidemic (EHE) goals, but formative research is needed to tailor TIC implementation to complex and interdependent HIV networks. Methods: We applied a community-based participatory research (CBPR) approach to iteratively engage personnel from high volume HIV care institutions in Nashville, Tennessee. Current practices and potential implementation determinants were identified through participatory process mapping (PM) and key informant interviews. The Consolidated Framework for Implementation Research (CFIR) was applied to deductively code interview data. Personnel attending a dissemination summit developed a network-wide implementation plan. Results: Data were collected with personnel from five institutions (e.g., community-based organizations, primary care clinics, public health department), for PM (n=48), interviews (n=35), and the summit (n=17). Results suggest there are limited trauma screenings, assessments, and services across the network. Relevant Characteristics of Individuals included a trauma-sensitive workforce committed to continuous learning and TIC adoption. Relevant Inner Setting Factors were networks and communications, with strong tension for change, high compatibility with TIC, and need for advancing cultural responsiveness. Relevant Outer Setting Factors included patient needs and resources and cosmopolitanism, with need for better leveraged mental health services. Relevant Process domains were champions and leadership, with need to diversify championship among leaders. Relevant Intervention Characteristics included relative advantage and complexity, with need for personnel wellness initiatives and increased engagement with the community as service designers. Four recommendations included development of shared communication systems, personnel wellness campaigns, routine evaluations to inform practices, and culturally responsive care initiatives. Conclusion: Modifiable TIC determinants were identified, and a community-created implementation plan was developed to guide adoption. Future research will focus on city-wide implementation and strengthening pre-implementation research in other settings.

Calidad microbiológica del agua del lago volcánico Quilotoa. Cotopaxi-Ecuador / Microbiological quality of the water of the Quilotoa volcanic lake. Cotopaxi Ecuador

INTRODUCCIÓN: el agua de los lagos volcánicos no es estéril, en ella se ha adaptado a través de milenios una microbiota con diversas capacidades metabólicas. La diversidad microbiana de los lagos volcánicos en Ecuador ha sido poco estudiada y aún se desconoce su abundancia y riqueza. OBJETIVO: el objetivo del presente estudio fue conocer la calidad microbiológica del agua del lago Quilotoa, situado en la Provincia de Cotopaxi-Ecuador. MATERIALES Y METODOS: se realizaron dos muestreos durante el año 2019, recolectando un total 32 muestras. La calidad microbiológica se cuantifico utilizando la técnica de filtración por membrana en agar R2A para bacterias heterótrofas, agar eosina azul de metileno para coliformes, agar manitol salado para Staphylococcus, agar cetrimide para Pseudomonas y agar Sabouraud con cloranfenicol para hongos. RESULTADOS: los resultados promedios fueron para bacterias heterótrofas de 2,00 x 102 UFC/mL; Pseudomonas 7,00x 10 UFC/mL, Staphylococcus 3,80 x 10 UFC/mL y hongos 1,40 x 10 UFC/mL. No se detectó la presencia de bacterias coliformes. CONCLUSIONES: los grupos microbianos presentes en bajo número son indicativos de una microbiota característica adaptada a las condiciones fisicoquímicas de este lago. Se concluye que se trata de un lago con una población microbiana escasa lo que indicaría una buena calidad microbiológica.

INTRODUCTION: the water of volcanic lakes is not sterile, native microbiota shows different metabolic capabilities established over millennia. The microbial diversity of volcanic lakes in Ecuador have been little studied and their abundance and richness are still unknown. OBJECTIVE: the objective of this study was to know the microbiological quality of water of Lake Quilotoa, located in the Province of Cotopaxi-Ecuador. MATERIALS AND METHODS: two samplings were carried out during 2019, collecting a total of 32 samples. Microbiological quality was quantified using the membrane filtration technique on R2A agar for heterotrophic bacteria, eosin blue methylene agar for coliforms, salty mannitol agar for Staphylococcus, cetrimide agar for Pseudomonas and Sabouraud agar with chloramphenicol for fungi. RESULTS: the average results were for heterotrophic bacteria 2.00 x 102 CFU/mL, Pseudomonas 7.00 x 10 CFU/mL, Staphylococcus 3.80 x 10 CFU/mL and fungi 1.40 x 10 CFU/mL. The presence of coliform was not detected. CONCLUSIONS: the microbial groups present in low numbers are indicative of a characteristic microbiota adapted to the physicochemical conditions of this lake. It is concluded that it is a lake with a few microbial populations, which might indicate a good microbiological quality.

Tuning Crystal Structures of Iron-Based Metal-Organic Frameworks for Drug Delivery Applications.

Iron-based metal-organic frameworks (Fe-MOFs) have emerged as promising candidates for drug delivery applications due to their low toxicity, structural flexibility, and safe biodegradation in a physiological environment. Here, we studied two types of Fe-MOFs: MIL-53 and MIL-88B, for in vitro drug loading and releasing of ibuprofen as a model drug. Both Fe-MOFs are based on the same iron clusters and organic ligands but form different crystal structures as a result of two different nucleation pathways. The MIL-53 structure demonstrates one-dimensional channels, while MIL-88B exhibits a three-dimensional cage structure. Our studies show that MIL-53 adsorbs more ibuprofen (37.0 wt %) compared to MIL-88B (19.5 wt %). A controlled drug release was observed in both materials with a slower elution pattern in the case of the ibuprofen-encapsulated MIL-88B. This indicates that a complex cage structure of MIL-88 is beneficial to control the rate of drug release. A linear correlation was found between cumulative drug release and the degree of material degradation, suggesting the biodegradation of Fe-MILs as the main drug elution mechanism. The cytotoxicity of MIL-88B was evaluated in vitro with NIH-3T3 Swiss mouse fibroblasts, and it shows that MIL-88B has no adverse effects on cell viability up to 0.1 mg/mL. This low toxicity was attributed to the morphology of MIL-88B nanocrystals. The very low toxicity and controlled drug release behavior of Fe-MIL-88B suggest that better materials for drug-delivery applications can be created by controlling not only the composition but also the crystal structure and nanoparticle morphology of the material.

Conjugation of Paclitaxel to Hybrid Peptide Carrier and Biological Evaluation in Jurkat and A549 Cancer Cell Lines.

Paclitaxel (PTX) is one of the most potent cancer drugs; however, its low solubility and strong systemic side effects limit its clinical applications. To overcome these issues, new drug formulations and chemical modifications have been proposed. In this study, we present conjugation of PTX to hybrid collagen-cell penetrating peptide (COL-CPP) carriers. The peptide carrier is highly soluble and utilizes a unique stabilization strategy: folding into a triple helix. Here, we report the formation of PTX-COL-CPP prodrug that has similar drug potency as free PTX when tested in Jurkat (human T lymphocyte of acute T cell leukemia) cells but not in A549 (human epithelial of lung carcinoma) cells. Confocal images and flow cytometry show that this behavior originates from lower cellular uptake of COL-CPP and endosomal entrapment of the prodrug in A549, but not in Jurkat cells.

MRI signal hyperintensities and treatment remission of geriatric depression.

BACKGROUND: White matter abnormalities may interfere with limbic-cortical balance and contribute to chronic depressive syndromes in the elderly. This study sought to clarify the relationship of SH to treatment response. We hypothesized that patients who failed to remit during a 12-week controlled treatment trial of escitalopram would exhibit greater SH burden than patients who remitted. METHODS: The participants were 42 non-demented individuals with non-psychotic major depression and 25 elderly comparison subjects. After a 2-week single blind placebo period, subjects who still had a Hamilton Depression Rating Scale (HDRS) of 18 or greater received escitalopram 10mg daily for 12 weeks. Remission was defined as a HDRS score of 7 or below for 2 consecutive weeks. FLAIR sequences were acquired on a 1.5 T scanner and total SH were quantified using a semi-automated thresholding method. RESULTS: The patient sample consisted of 22 depressed patients who achieved remission during the study and 20 depressed patients who remained symptomatic. ANCOVA, with age and gender as covariates, revealed that depressed subjects had greater total SH burden relative to non-depressed controls. Furthermore, patients who failed to remit following escitalopram treatment had significantly greater SH burden than both patients who remitted and elderly comparison subjects, whereas SH burden did not differ between depressed patients who remitted and elderly comparison subjects. LIMITATIONS: Patients were treated with a fixed dose of antidepressants and the index of SH is an overall measure that does not permit examination of the relationship of regional SH to treatment remission. DISCUSSION: SH may contribute to a "disconnection state" both conferring vulnerability to and perpetuating late-life depression.

Anterior cingulate cortical volumes and treatment remission of geriatric depression.

BACKGROUND: Structural abnormalities of the anterior cingulate cortex (ACC) may interfere with the interaction of cortical and limbic networks involved in emotional regulation and contribute to chronic depressive syndromes in the elderly. This study examined the relationship of regional anterior cingulate cortical volumes with treatment remission of elderly depressed patients. We hypothesized that patients who failed to remit during a 12-week controlled treatment trial of escitalopram would exhibit smaller anterior cingulate gray matter volumes than patients who remitted. METHODS: The participants were 41 non-demented individuals with non-psychotic major depression. After a 2-week single-blind placebo period, subjects who still had a Hamilton Depression Rating Scale (HDRS) of 18 or greater received escitalopram 10 mg daily for 12 weeks. Remission was defined as a HDRS score of 7 or below for at least 2 consecutive weeks. The patient sample consisted of 22 depressed patients who achieved remission during the study and 19 depressed patients who remained symptomatic. High-resolution magnetization-prepared rapidly acquired gradient echo (MPRAGE) sequences were acquired on a 1.5 T scanner and regional ACC volumes were manually outlined (dorsal, rostral, anterior subgenual, and posterior subgenual). RESULTS: Repeated measure analyses revealed that patients who failed to remit following escitalopram treatment had smaller dorsal and rostral anterior cingulate gray matter volumes than patients who remitted, whereas subgenual cortical volumes did not differ between the groups. CONCLUSIONS: Structural abnormalities of the dorsal and rostral anterior cingulate may perpetuate late-life depression.

High-risk HPV types in lesions of the uterine cervix of female commercial sex workers in the Philippines.

In order to prevent cervical cancer, vaccines against human papilloma virus types 16 (HPV-16) and 18 (HPV-18) have been implemented worldwide. However, the HPV types that cause cancer can differ according to geographical area and ethnicity. In this new era of the HPV vaccine, it is important to elucidate the prevalent HPV types in each area. Therefore, the prevalence of HPV infection and cervical abnormalities among 369 female commercial sex workers in the Philippines were examined. HPV L1 gene was amplified by polymerase chain reaction (PCR) using modified GP5+/6+ primers, and genotyping was performed by sequencing cloned PCR products. HPV DNA was detected in 211 (57.2%) women, among whom 46 HPV types were identified. HPV-52 was most common and multiple-type infection was observed in 44.5%. Among 56 women with abnormal cervical cytology (low- and high-grade squamous intraepithelial lesions and adenocarcinoma in situ), HPV-52 was most common (23.2%), followed by HPV-16 (19.6%), -58 (10.7%), and -67 (10.7%). Only 27% of these women were positive for HPV-16 and -18. Multivariate analysis revealed that HPV-16, -39, -52, -67, and -82 were significantly associated with abnormal cytology. Repeated analysis of HPV-52 single-positive samples using the original GP5+/6+ PCR primers produced negative results in 57% of cases, suggesting that the prevalence of HPV-52 infection may have been underestimated in previous studies, and the current vaccines may not be sufficient for preventing infection and the development of premalignant lesions of the cervix in women in the Philippines.