ABSTRACT
A growing increase in the number of serious infections caused by multidrug resistant bacteria (MDR) is challenging our society. Despite efforts to discover novel therapeutic options, few antibiotics targeting MDR have been approved by the Food and Drug Administration (FDA). Lactic acid bacteria have emerged as a promising therapeutic alternative due to their demonstrated ability to combat MDR pathogens in vitro. Our previous co-culture studies showed Lacticaseibacillus rhamnosus CRL 2244 as having a potent killing effect against carbapenem-resistant Acinetobacter baumannii (CRAB) strains. Here we report that cell-free conditioned media (CFCM) samples obtained from Lcb. rhamnosus CRL 2244 cultures incubated at different times display antimicrobial activity against 43 different pathogens, including CRAB, methicillin-resistant Staphylococcus aureus (MRSA) and carbapenemase Klebsiella pneumoniae (KPC)-positive strains. Furthermore, transwell and ultrafiltration analyses together with physical and chemical/biochemical tests showed that Lcb. rhamnosus CRL 2244 secretes a <3 kDa metabolite(s) whose antimicrobial activity is not significantly impaired by mild changes in pH, temperature and various enzymatic treatments. Furthermore, sensitivity and time-kill assays showed that the bactericidal activity of the Lcb. rhamnosus CRL 2244 metabolite(s) enhances the activity of some current FDA approved antibiotics. We hypothesize that this observation could be due to the effects of Lcb. rhamnosus CRL 2244 metabolite(s) on cell morphology and the enhanced transcriptional expression of genes coding for the phenylacetate (PAA) and histidine catabolic Hut pathways, metal acquisition and biofilm formation, all of which are associated with bacterial virulence. Interestingly, the extracellular presence of Lcb. rhamnosus CRL 2244 induced the transcription of the gene coding for the CidA/LgrA protein, which is involved in programmed cell death in some bacteria. Overall, the findings presented in this report underscore the promising potential of the compound(s) released by Lcb. rhamnosus CRL2244 as an alternative and/or complementary option to treat infections caused by A. baumannii as well as other MDR bacterial pathogens.
Subject(s)
Anti-Bacterial Agents , Drug Resistance, Multiple, Bacterial , Lacticaseibacillus rhamnosus , Lacticaseibacillus rhamnosus/metabolism , Lacticaseibacillus rhamnosus/genetics , Anti-Bacterial Agents/pharmacology , Drug Resistance, Multiple, Bacterial/drug effects , Microbial Sensitivity Tests , Acinetobacter baumannii/drug effects , Drug Synergism , Methicillin-Resistant Staphylococcus aureus/drug effects , Culture Media, Conditioned/pharmacology , Bacterial Proteins/metabolism , Bacterial Proteins/geneticsABSTRACT
TP53 gene disruption, including 17p13 deletion [del(17p)] and/or TP53 mutations, is a negative prognostic biomarker in chronic lymphocytic leukemia (CLL) associated with disease progression, treatment failure and shorter survival. Germline variants in p53 signaling pathway genes could also lead to p53 dysfunction, but their involvement in CLL has not been thoroughly evaluated. The aim of this study was to determine the association of TP53, MDM2 and NQO1 gene variability with clinical and genetic data of CLL patients. Individual genotype and haplotype data of CLL patients were compared with clinical prognostic factors, cytogenetic and molecular cytogenetic findings as well as IGHV and TP53 mutational status. The study included 116 CLL patients and 161 healthy blood donors. TP53 (rs1042522, rs59758982, rs1625895), NQO1 (rs1800566) and MDM2 (rs2279744, rs150550023) variants were genotyped using different PCR approaches. Analysis of genotype frequencies revealed no association with the risk of CLL. TP53 rs1042522, rs1625895 and MDM2 rs2279744 variants were significantly associated with abnormal karyotype and the presence of del(17p). Similarly, these two TP53 variants were associated with TP53 disruption. Moreover, TP53 C-A-nondel and G-A-del haplotypes (rs1042522-rs1625895-rs59758982) were associated with an increased likelihood of carrying del(17p) and TP53 disruptions. MDM2 T-nondel haplotype (rs2279744-rs150550023) was found to be a low risk factor for del(17p) (OR = 0.32; CI: 0.12-0.82; p = 0.02) and TP53 disruptions (OR = 0.41; CI: 0.18-0.95; p = 0.04). Our findings suggest that TP53 and MDM2 variants may modulate the risk to have chromosome alterations and TP53 disruptions, particularly del(17p). To our knowledge this is the first study of several germline variants in p53 pathway genes in Argentine patients with CLL.
ABSTRACT
Three-dimensional printing in the field of additive manufacturing shows potential for customized medicines and solving gaps in paediatric formulations. Despite successful clinical trials, 3D printing use in pharmaceutical point-of-care is limited by regulatory loopholes and a lack of Pharmacopoeia guidelines to ensure quality. Semi-solid extrusion is a 3D printing technology that stands out for its versatility, but understanding the fluid dynamics of the semi-solid mass is critical. The aim of this research is to look into the advantages of instrumenting a 3D printer with a semi-solid extrusion motor-driven printhead, which is able to record the printing pressure over time, for in situ characterization of the semi-solid mass and quality evaluation of dosage forms. Four formulations using hydrochlorothiazide as the active pharmaceutical ingredient and several excipients were used. Their flow properties were studied at different printing speeds and temperatures using traditional techniques (rheometer and Texture Analyzer) and the proposed semi-solid extrusion motor-driven printhead incorporated into a printing platform. In addition, the influence of printing speed in the printing process was also evaluated by the study of printing pressure and printlet quality. The results demonstrated the similarities between the use of a Texture Analyzer and the semi-solid extrusion motor-driven. However, the latter enables temperature selection and printing speed in accordance with the printing process which are critical printing parameters. In addition, due to the incorporation of a sensor, it was possible to conclude, for the first time, that there is a link between changes in essential printing parameters like printing speed or formulations and variations in printing pressure and printlet quality attributes such as the energy require to obtain a single dosage unit, weight or diameter. This breakthrough holds a lot of potential for assuring the quality of 3D printing dosage forms and paving the way for their future incorporation into point-of-care settings.
ABSTRACT
We report here a draft genome assembly of Lacticaseibacillus rhamnosus CRL 2244, recovered from wastewater in Argentina. The genome has a size of 2,898,100 bp, with G + C content of 46.73%. Comparative analysis reveals that its closest relative is L. rhamnosus 1.0320 (GCF_006151905.1), with an average nucleotide identity of 97.46%.
ABSTRACT
Record-breaking levels of asylum seeking by families with young children continue at the United States/Mexico border, particularly the Rio Grande Valley sector. In this Commentary, our aim is to increase awareness by providing child and adolescent mental health care providers with an update on current migrant conditions, bringing to light issues of family separation previously highlighted in the Journal.1 For context, our international group has collected data, via 3 large-scale studies funded by the National Institutes of Health, from more than 600 Latinx immigrants seeking asylum at the US/Mexico border in the last 4 years, during which levels of violence, climate disruption, and poverty in the Northern Triangle of Central America (ie, El Salvador, Guatemala, and Honduras) and Mexico have propelled high and sustained levels of asylum seeking in the United States. We contribute expertise in clinical psychology, Latinx psychology, attachment disruption, and public health, as well as this front-row perspective.
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Objetivo: evaluar el efecto preliminar del Aprendizaje Basado en Problemas en habilidades de Gestión del Cuidado. Método: cuasiexperimental pretest-postest, con alumnos de la carrera de Licenciatura en Enfermería de una institución educativa. Muestra de 29 alumnos (Grupo Experimental) y 74 (Grupo Control). El Grupo Experimental solucionó cuatro escenarios bajo el método de Aprendizaje Basado en Problemas con los 7 pasos propuestos por la Universidad de McMaster, en un programa de Gestión del Cuidado en modalidad a distancia. El instrumento autoinformado evaluó las habilidades de Gestión del Cuidado pretesty postesten ambos grupos. Se obtuvieron valores medios y se realizó estadística descriptiva e inferencial (t de Student, t pareada, regresión lineal). Resultados: el Grupo Experimental obtuvo puntuaciones más elevadas en habilidades analíticas, de acción y globales que el Grupo Control (p<0,05). No se registraron diferencias en las habilidades interpersonales ni en el uso de la información. El Grupo Control no presentó diferencias significativas antes y después de la enseñanza habitual, mientras que en el Grupo Experimental sí se reportaron diferencias (p<0,05). Conclusión: a pesar de que existe poca evidencia en el desarrollo de habilidades de Gestión del Cuidado en Enfermería, el presente estudio demuestra que el Aprendizaje Basado en Problemas es un método efectivo y significativo en educación a distancia.
Objective: to assess the preliminary effect of Problem-Based Learning on Care Management skills. Method: a quasi-experimental pre- and post-test conducted with students attending the Bachelor's Degree in Nursing offered by an educational institution. The sample was comprised by 29 (Experimental Group) and 74 (Control Group) students. The Experimental Group solved four scenarios under the Problem-Based Learning method with the 7 steps proposed by McMaster University, in a Care Management program in distance mode. The self-reporting instrument assessed the pre- and post-test Care Management skills in both groups. Mean values were obtained and descriptive and inferential statistics were performed (Student's t, paired t, linear regression). Results: the Experimental Group obtained higher scores in analytical, action-related and global skills than the Control Group (p<0.05). No differences were recorded in interpersonal skills or in use of the information. The Control presented no significant differences before and after usual teaching, whereas differences were in fact reported in the Experimental Group (p<0.05). Conclusion: despite the fact that there is little evidence on the development of Nursing Care Management skills, the current study shows that Problem-Based Learning is an effective and significant method in remote education.
Objetivo: avaliar o efeito preliminar da Aprendizagem Baseada em Problemas nas habilidades de Gestão do Cuidado. Método: pré e pós-teste quase experimental, realizado com alunos do curso de Bacharelado em Enfermagem de uma instituição de ensino. A amostra foi composta por 29 (Grupo Experimental) e 74 (Grupo Controle). O Grupo Experimental resolveu quatro cenários sob o método de Aprendizagem Baseada em Problemas com os 7 passos propostos pela McMaster University, em um programa de Gestão do Cuidado na modalidade à distância. O instrumento de autorrelato avaliou as habilidades de Gestão do Cuidado pré e pós-teste em ambos os grupos. Valores médios foram obtidos e estatísticas descritivas e inferenciais foram realizadas (t de Student, t pareado, regressão linear). Resultados: o Grupo Experimental obteve escores mais elevados em habilidades analíticas, de ação e globais do que o Grupo Controle (p<0,05). Não foram registradas diferenças nas habilidades interpessoais ou no uso da informação. O Grupo Controle não apresentou diferenças significativas antes e depois do ensino usual, enquanto as diferenças foram de fato relatadas no Grupo Experimental (p<0,05). Conclusão: apesar de haver poucas evidências sobre o desenvolvimento de habilidades de Gestão do Cuidado de Enfermagem, o presente estudo mostra que a Aprendizagem Baseada em Problemas é um método eficaz e significativo na educação à distância.
Subject(s)
Humans , Students, Nursing , Universities , Problem-Based Learning/methods , Education, Nursing, Baccalaureate , Educational Measurement , Non-Randomized Controlled Trials as TopicABSTRACT
Introduction. Lateral flow test (LFTs) have been used as an alternative to reverse transcription quantitative PCR (RT-qPCR) in point-of-care testing. Despite their benefits, the sensitivity of LFTs may be low and is affected by several factors. We have previously reported the feasibility of using direct lysis of individual or pools of saliva samples from symptomatic and asymptomatic patients as a source of viral genomes for detection by RT-qPCR.Hypothesis. Direct lysed saliva is more sensitive than antigen tests to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in samples from children.Aim. Our goals here were to valuate the specificity and sensitivity of the PanBio COVID-19 antigen rapid test device (Ag-RTD) compared with RT-qPCR of direct lysed saliva.Methodology. We evaluated the performance of the PanBio COVID-19 Ag-RTD in comparison to RT-qPCR direct lysed saliva from paired samples of 256 symptomatic and 242 asymptomatic paediatric patients.Results. Overall, although there were no differences in the specificity (96.6%), we found a lower sensitivity (64.3%) of the PanBio Ag-test RTD compared to saliva in both symptomatic and asymptomatic patients. In addition, the sensitivity of PanBio was not correlated with the viral load present in the samples.Conclusion. Our data highlight the benefits of using RT-qPCR and saliva samples for SARS-CoV-2 detection, particularly in paediatric patients.
Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Child , SARS-CoV-2/genetics , COVID-19 Testing , Saliva , COVID-19/diagnosis , Polymerase Chain Reaction , Sensitivity and SpecificityABSTRACT
OBJECTIVE: More than 550 million people speak Spanish and, yet, psychometric data on psychological instruments in Spanish lags. Given evidence of significant traumatic exposure and distress among Spanish speakers, the aim of the current study was to examine the factor structure of the Impact of Events Scale-Revised (IES-R), in a large sample of Spanish-speaking adults. METHOD: Participants (n = 725) were university students living in Latin America (M = 21.02; SD = 3.12). Most were born in Mexico (77.6%) and the next largest subgroup was from Ecuador (18.9%). Respondents completed the 22-item IES-R. RESULTS: The IES-R mean score was 20.08 (SD = 21.34) and 26.6% of the sample met the cutoff score for clinically significant symptoms. Regarding factor structure, eight different factor structures that have demonstrated a good fit in the extant literature were examined. The one-factor model demonstrated an acceptable fit, χ²(209) = 839.13, p < .0001; root-mean-square error (RMSEA) = 0.06, 95% confidence interval (CI) [0.06, 0.07]; comparative fit index (CFI) = 0.91, Tucker-Lewis index (TLI) = 0.90. The two-factor model demonstrated good fit, χ²(208) = 746.70, p < .0001; RMSEA = 0.06, 95% CI [0.05, 0.06]; CFI = 0.92, TLI = 0.91, and nested model comparisons of the two-factor and one-factor models using the chi-square difference test supported the two-factor model. CONCLUSIONS: The most parsimonious of the multifactor models, a two-factor model with Avoidance symptoms as one factor and Intrusions and Hyperarousal combined into a second may be of greatest use for this particular version of the IES-R. The current research demonstrates strong psychometric support for Intrusion/Hyperarousal and Avoidance subscales when measuring traumatic stress in Spanish speakers and underscores the need for culturally and contextually sensitive assessment in this population, in which posttraumatic stress is prevalent. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
ABSTRACT
Carbapenem-resistant Acinetobacter baumannii (CRAB) is a recognized nosocomial pathogen with limited antibiotic treatment options. Lactic acid bacteria (LAB) constitute a promising therapeutic alternative. Here we studied the antibacterial properties of a collection of LAB strains using phenotypic and transcriptomic analysis against A. baumannii clinical strains. One strain, Lacticaseibacillus rhamnosus CRL 2244, demonstrated a potent inhibitory capacity on A. baumannii with a significant killing activity. Scanning electron microscopy images showed changes in the morphology of A. baumannii with an increased formation of outer membrane vesicles. Significant changes in the expression levels of a wide variety of genes were also observed. Interestingly, most of the modified genes were involved in a metabolic pathway known to be associated with the survival of A. baumannii. The paa operon, Hut system, and fatty acid degradation were some of the pathways that were induced. The analysis reveals the impact of Lcb. rhamnosus CRL 2244 on A. baumannii response, resulting in bacterial stress and subsequent cell death. These findings highlight the antibacterial properties of Lcb. rhamnosus CRL 2244 and its potential as an alternative or complementary strategy for treating infections. Further exploration and development of LAB as a treatment option could provide valuable alternatives for combating CRAB infections.
Subject(s)
Acinetobacter baumannii , Lacticaseibacillus rhamnosus , Lactobacillales , Acinetobacter baumannii/genetics , Lacticaseibacillus , Anti-Bacterial Agents/pharmacology , Cell Death , Carbapenems/pharmacologyABSTRACT
Carbapenem-resistant Acinetobacter baumannii (CRAB) is a recognized nosocomial pathogen with limited antibiotic treatment options. Lactic acid bacteria (LAB) constitute a promising therapeutic alternative. Here we studied the antibacterial properties of a collection of LAB strains using phenotypic and transcriptomic analysis against A. baumannii clinical strains. One strain, Lacticaseibacillus rhamnosus CRL 2244, demonstrated a potent inhibitory capacity on A. baumannii with a significant killing activity. Scanning electron microscopy images showed changes in the morphology of A. baumannii with an increased formation of outer membrane vesicles. Significant changes in the expression levels of a wide variety of genes were also observed. Interestingly, most of the modified genes were involved in a metabolic pathway known to be associated with the survival of A. baumannii . The paa operon, Hut system, and fatty acid degradation were some of the pathways that were induced. The analysis reveals the impact of Lcb. rhamnosus CRL 2244 on A. baumannii response, resulting in bacterial stress and subsequent cell death. These findings highlight the antibacterial properties of Lcb. rhamnosus CRL 2244 and its potential as an alternative or complementary strategy for treating infections. Further exploration and development of LAB as a treatment option could provide valuable alternatives for combating CRAB infections.
ABSTRACT
3D printing technology can be used to develop individualized medicines in hospitals and pharmacies, allowing a high degree of personalization and the possibility to adjust the dose of the API based on the quantity of material extruded. The main goal of incorporating this technology is to have a stock of API-load print cartridges that could be used at different storage times and for different patients. However, it is necessary to study the extrudability, stability, and buildability of these print cartridges during storage time. A paste-like formulation containing hydrochlorothiazide as a model drug was prepared and distributed in five print cartridges, each of which was studied for different storage times (0 h-72 h) and conditions, for repeated use on different days. For each print cartridge, an extrudability analysis was performed, and subsequently, 100 unit forms of 10 mg hydrochlorothiazide were printed. Finally, various dosage units containing different doses were printed, taking into account the optimized printing parameters based on the results of the extrudability analysis carried out previously. An appropriate methodology for the rapid development of appropriate SSE 3DP inks for pediatrics was established and evaluated. The extrudability analysis and several parameters allowed the detection of changes in the mechanical behavior of the printing inks, the pressure interval of the steady flow, and the selection of the volume of ink to be extruded to obtain each of the required doses. The print cartridges were stable for up to 72 h after processing, and orodispersible printlets containing 6 mg to 24 mg of hydrochlorothiazide can be produced using the same print cartridge and during the same printing process with guaranteed content and chemical stability. The proposed workflow for the development of new printing inks containing APIs will allow the optimization of feedstock material and human resources in pharmacy or hospital pharmacy services, thus speeding up their development and reducing costs.
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BACKGROUND: Black cisgender and transgender women are disproportionately affected by the HIV epidemic compared to women of other racial and ethnic identities. Twelve demonstration sites across the United States are adapting, implementing and evaluating a comprehensive bundle of two or more evidence informed interventions to improve health and outcomes and quality of life for Black women with HIV. METHODS: Guided by Greenhalgh's Conceptual Model of Diffusion of Innovations in Health Service Organizations and Proctor's model for use of implementation strategies and evaluating implementation, service and client outcomes, this mixed methods study documents outcomes at the client, organization, and system level. Participant eligibility for the bundled interventions includes: individuals who are 18 years or older, identify as Black or African-American, identify as cisgender or transgender female and have a diagnosis of HIV. Qualitative data are collected systematically through a series of annual site visits and a standardized monthly call form to assess the barriers and facilitators to the implementation process and the key determinants impacting the intervention uptake and implementation strategies. Quantitative data collection for the implementation, service and client outcomes is conducted through a pre-post prospective study to examine the impact on Black women's health and well-being. Implementation outcomes include: the reach to Black women with HIV, adoption of interventions across the sites and their community; the fidelity to the components of the bundled interventions; the costs of the intervention; and the sustainability of the intervention in the organization and community. Primary service and client outcomes are improved linkage to and retention in HIV care and treatment, increased and sustained viral suppression, improved quality of life and resilience, and stigma reduction. DISCUSSION: The study protocol presented is specifically designed to advance the evidence for adopting culturally responsive and relevant care into clinic and public health settings to improve the health and well-being for Black women with HIV. In addition the study may advance the implementation science field by furthering what is known about the ways in which bundled interventions can address barriers to care and facilitate the uptake of organizational practices to improve health.
Subject(s)
HIV Infections , Implementation Science , Humans , Female , United States , Prospective Studies , Quality of Life , Women's Health , HIV Infections/epidemiologyABSTRACT
OBJECTIVES: To explore the impact of COVID-19 on the implementation of bundled interventions to improve the engagement and retention of Black women in HIV care. METHODS: Pre-implementation interviews conducted between January and April 202 L with 12 demonstration sites implementing bundled interventions for Black women with HIV. Directed content analysis was employed to examine the site interview transcripts. RESULTS: The pandemic intensified barriers to care and harmful social conditions. However, COVID-19 also forced pivots in health care and social service delivery and some of these changes benefited Black women living with HIV. CONCLUSIONS: The continuation of policies that support the material needs of Black women with HIV and ease access to care is critical. Racial capitalism impedes the enactment of these policies and thus threatens public health.
Subject(s)
COVID-19 , HIV Infections , Female , Humans , Black People , COVID-19/epidemiology , Delivery of Health Care , Policy , Black or African American , Public HealthABSTRACT
INTRODUCTION: Peritoneal dialysis (PD) guidelines recommend a 14-day break-in period after catheter placement, yet this period could be shortened with new insertion techniques. METHODS: We conducted a prospective cohort study to compare percutaneous vs. surgical catheter insertion in a newly established PD program. The break-in period was intentionally shortened to <24 h to start PD almost immediately. RESULTS: We included 223 subjects who underwent percutaneous (34%) or surgical (66%) catheter placement. Compared to the surgical group, the percutaneous group had a higher proportion of early dialysis initiation within 24 h (97% vs. 8%, p < 0.001), similar successful initiation rates (87% vs. 92%, p = 0.34), and shorter lengths of stay (12 [9-18] vs. 18 [14-22] days, p < 0.001). Percutaneous insertion increased the likelihood of successful PD initiation within 24 h (OR 74, 95% CI 31-182), without increasing major complications. CONCLUSION: Percutaneous placement could represent a cost-effective and efficient technique to shorten break-in periods.
Subject(s)
Peritoneal Dialysis , Humans , Cohort Studies , Prospective Studies , Peritoneal Dialysis/methods , Catheterization/methods , Catheters, IndwellingABSTRACT
OBJECTIVE: to assess the preliminary effect of Problem-Based Learning on Care Management skills. METHOD: a quasi-experimental pre- and post-test conducted with students attending the Bachelor's Degree in Nursing offered by an educational institution. The sample was comprised by 29 (Experimental Group) and 74 (Control Group) students. The Experimental Group solved four scenarios under the Problem-Based Learning method with the 7 steps proposed by McMaster University, in a Care Management program in distance mode. The self-reporting instrument assessed the pre- and post-test Care Management skills in both groups. Mean values were obtained and descriptive and inferential statistics were performed (Student's t, paired t, linear regression). RESULTS: the Experimental Group obtained higher scores in analytical, action-related and global skills than the Control Group (p<0.05). No differences were recorded in interpersonal skills or in use of the information. The Control presented no significant differences before and after usual teaching, whereas differences were in fact reported in the Experimental Group (p<0.05). CONCLUSION: despite the fact that there is little evidence on the development of Nursing Care Management skills, the current study shows that Problem-Based Learning is an effective and significant method in remote education.
Subject(s)
Education, Nursing, Baccalaureate , Students, Nursing , Humans , Problem-Based Learning/methods , Educational Measurement , UniversitiesABSTRACT
OBJECTIVES: This study aimed to characterize 5 approaches that have been developed in research on patients and health coverage, which reveal information from the perspective of patients: (1) access to healthcare, (2) therapeutic trajectories, (3) social participation in decision making on health coverage, (4) tacit knowledge, and (5) communities of practice. METHODS: This is a narrative literature review, based on searches performed in PubMed/MEDLINE and Web of Science, between August and December 2021. A total of 45 scientific articles were selected for analysis, which were complemented by a gray literature search that provided 6 additional manuscripts. RESULTS: Improving access to health services requires an understanding of the meaning of the concept of access from the users themselves. The patient trajectory approach contributes by emphasizing that the focus of analysis must adopt the patient's perspective, given that it provides valuable information for the decision making on health coverage. In addition, the role that social participation has in the process to grant trust and legitimacy is described. Tacit knowledge makes explicit the importance of revealing it as a source of information that adds value to the decision-making process. Finally, communities of practice are described as spaces where new ways of experiencing the disease originate, as well as ways of relating to the health system and its actors. CONCLUSIONS: The article raises the relevance that various social actors know these approaches, as well as strategies to integrate them into the assessment processes in terms of health coverage.
ABSTRACT
The potential for suboptimal psychometric performance of reverse-coded items may be particularly pronounced when scales are translated and administered in Spanish with these problems exacerbated in youth respondents. This is a significant concern, given the rapid rise in Hispanic-American and Spanish-speaking individuals in the US and their rightful, growing representation in psychological research and clinical care. The aim of this study was to examine the psychometric performance of reverse-coded items across four Spanish-speaking samples spanning developmental stages including youth, college students, and parents (N = 1,084; Adolescents n = 107; M = 19.79; SD = 2.09; 41.1% female; Caregivers n = 58; M = 40.79; SD = 7.94; 60.3% female; Spanish-speaking adults in the US n = 157; M = 33.4; SD = 9.5; 68.8% female; and College students living in Latin America n = 783; M = 21.04; SD = 3.13; 69.2% female) and four scales (Big Five Inventory; Strengths and Difficulties Questionnaire; Difficulties in Emotion Regulation Scale; Beck Hopelessness Scale); we expected reverse-coded items would demonstrate inadequate item-total correlations and their inclusion would compromise scale internal consistency. Hypotheses were supported with evidence of poor psychometric performance for at least two reverse-coded items on each instrument, such that un-reversing the items improved their item-total correlations. Across every instrument, alpha was either improved by excluding reverse-coded items or by including them in an un-reversed fashion and, overall, there was a moderate, negative effect of reverse-coded items on scale alphas. In growing consensus with previous authors, we recommend that reverse-coded items not be included in Spanish scales.
ABSTRACT
Cefiderocol (CFDC) is a novel chlorocatechol-substituted siderophore antibiotic approved to treat complicated urinary tract infections (cUTI) and hospital-acquired and ventilator-acquired pneumonia (HAP/VAP). Previous work determined that albumin-rich human fluids increase the minimum inhibitory concentration (MICs) of Acinetobacter baumannii against CFDC and reduce the expression of genes related to iron uptake systems. This latter effect may contribute to the need for higher concentrations of CFDC to inhibit growth. The presence of human urine (HU), which contains low albumin concentrations, did not modify MIC values of two carbapenem-resistant A. baumannii. Levels of resistance to CFDC were not modified by HU in strain AMA40 but were reduced in strain AB5075. Expanding the studies to other carbapenem-resistant A. baumannii isolates showed that the presence of HU resulted in unmodified or reduced MIC of CDFC values. The expression of piuA, pirA, bauA, and bfnH determined by qRT-PCR was enhanced in A. baumannii AMA40 and AB5075 by the presence of HU in the culture medium. All four tested genes code for functions related to recognition and transport of ferric-siderophore complexes. The effect of HU on expression of pbp1, pbp3, blaOXA-51-like, blaADC, and blaNDM-1, genes associated with resistance to ß-lactams, as well as genes coding for efflux pumps and porins was variable, showing dependence with the strain analyzed. We conclude that the lack of significant concentrations of albumin and free iron in HU makes this fluid behave differently from others we tested. Unlike other albumin rich fluids, the presence of HU does not impact the antibacterial activity of CFDC when tested against A. baumannii.
Subject(s)
Acinetobacter baumannii , Albumins/pharmacology , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Carbapenems/pharmacology , Cephalosporins , Humans , Iron/pharmacology , Microbial Sensitivity Tests , Siderophores , beta-Lactamases/genetics , CefiderocolABSTRACT
Young adults and racial/ethnic minorities report the worst mental health outcomes during the COVID19 pandemic, according to the Center for Disease Control (2020). The objectives of this study were (1) to identify common mental health symptoms among Latin American, US Hispanic, and Spanish college students, and (2) to identify clinical features predictive of higher post-traumatic stress symptoms (PTSS) among this population. The study sample included 1,113 college students from the USA, Mexico, Chile, Ecuador, and Spain who completed an online survey containing demographic questions and mental health screeners. Findings revealed higher scores of depression, suicidality, and PTSS compared to pre-pandemic levels and current scores by non-Spanish speaking college students; however, less than 5% of participants endorsed clinical levels of anxiety. After controlling for demographic profiles and sociocultural values, clinical symptoms of depression, loneliness, perceived stress, anxiety, and coping strategies explained 62% of the PTSS variance. Age, history of mental illness, perceived social support, and familism were not significant predictors. This sample of college students revealed higher mental health symptoms during the COVID-19 pandemic. The high prevalence of PTSS highlights the need to develop pragmatic, cost-effective, and culturally sensitive prevention and intervention strategies to mitigate these symptoms. Implications for college administrators and clinicians are discussed.