Specifically targeting antimicrobial peptides for inhibition of Candidatus Liberibacter asiaticus.

AIMS: Huanglongbing (citrus greening) is a plant disease putatively caused by the unculturable Gram-negative bacterium Candidatus Liberibacter asiaticus (CLas), and it has caused severe damage to citrus plantations worldwide. There are no definitive treatments for this disease, and conventional disease control techniques have shown limited efficacy. This work presents an in silico evaluation of using specifically targeting anti-microbial peptides (STAMPs) consisting of a targeting segment and an antimicrobial segment to inhibit citrus greening by inhibiting the BamA protein of CLas, which is an outer membrane protein crucial for bacterial viability. METHODS AND RESULTS: Initially, a set of peptides with a high affinity toward BamA protein were screened and evaluated via molecular docking and molecular dynamics simulations and were verified in vitro via bio-layer interferometry (BLI). In silico studies and BLI experiments indicated that two peptides, HASP2 and HASP3, showed stable binding to BamA. Protein structures for STAMPs were created by fusing known anti-microbial peptides (AMPs) with the selected short peptides. The binding of STAMPs to BamA was assessed using molecular docking and binding energy calculations. The attachment of high-affinity short peptides significantly reduced the free energy of binding for AMPs, suggesting that it would make it easier for the STAMPs to bind to BamA. Efficacy testing in vitro using a closely related CLas surrogate bacterium showed that STAMPs had greater inhibitory activity than AMP alone. CONCLUSIONS: In silico and in vitro results indicate that the STAMPs can inhibit CLas surrogate Rhizobium grahamii more effectively compared to AMPs, suggesting that STAMPs can achieve better inhibition of CLas, potentially via enhancing the site specificity of AMPs.

Inhibition of a conserved bacterial dual-specificity phosphatase confers plant tolerance to Candidatus Liberibacter spp.

"Candidatus Liberibacter spp." are insect-vectored, fastidious, and vascular-limited phytopathogens. They are the presumptive causal agents of potato zebra chip, tomato vein clearing, and the devastating citrus greening disease worldwide. There is an urgent need to develop new strategies to control them. In this study, we characterized a dual-specificity serine/tyrosine phosphatase (STP) that is well conserved among thirty-three geographically diverse "Candidatus Liberibacter spp." and strains that infect multiple Solanaceaea and citrus spp. The STP is expressed in infected plant tissues, localized at the plant cytosol and plasma membrane, and interferes with plant cell death responses. We employed an in silico target-based molecular modeling and ligand screen to identify two small molecules with high binding affinity to STP. Efficacy studies demonstrated that the two molecules can inhibit "Candidatus Liberibacter spp." but not unrelated pathogens and confer plant disease tolerance. The inhibitors and strategies are promising means to control "Candidatus Liberibacter spp."

Examining suicide risk in sexual and gender minority youth: A descriptive observational study on depressive symptoms, social support and self-esteem.

AIM: To understand the factors that contribute to the risk of suicide among lesbian, gay, bisexual, transgender, queer, intersex and asexual (sexual minorities) youth. BACKGROUND: The increase in the likelihood of suicide has made it an urgent issue in public health, particularly among young people, where it now ranks as the fourth leading cause of death. This issue becomes even more significant when focusing on sexual minorities. METHODS: A cross-sectional study was performed in targeted young individuals (15-29 years). Several variables were assessed, including suicide risk, self-esteem, presence and severity of depressive symptoms, perceived social support and self-reported levels of anxiety and depression. RESULTS: Statistically significant disparities were observed in suicide risk, presence of depressive symptoms and self-reported levels of anxiety and depression, all of which were more pronounced in sexual minority youth compared to heterosexual cisgender individuals. Likewise, statistically significant differences were noted concerning self-esteem and family support, both of which were lower in sexual minority youth. CONCLUSION: This study has identified risk factors, such as anxiety, depression and limited social support, as well as protective factors, like higher self-esteem and self-concept. Understanding and addressing all these factors are essential in reducing the elevated rates of suicide among sexual minority youth. Consequently, evidence-based interventions such as Gender and Sexuality Alliances, which empower and create safe spaces for sexual minority youth, possess substantial potential for effectively addressing this issue. IMPLICATIONS FOR THE PROFESSION: Given sexual minorities vulnerability, healthcare pros, especially nurses, must grasp suicide risk factors. They can help by educating, offering care, assessing risk and fighting stigma. This guarantees safety and access to mental health services for at-risk individuals from sexual minorities. REPORTING METHOD: The reporting follows the STROBE checklist. PATIENT CONTRIBUTION: People who were invited to participate voluntarily completed a range of questionnaires.

Analysis of different gamification-based teaching resources for physiotherapy students: a comparative study.

BACKGROUND: For health professionals, gamification is a new teaching method that has achieved an important role in recent years, with excellent results in learning and knowledge acquisition. Thus, the objective of this study was to analyze the gaming experience through different gamification resources in the classroom with physiotherapy students. METHODS: A comparative study on gamification-based teaching resources was carried out during the first semester of the 2021-2022 academic year. A total of 33 physiotherapy students participated in this study. After the theoretical topics were taught, the participants were invited to participate in different gamification resources such as Kahoot!, Physiotherapy Party and Escape Room. The gaming experience with the different gamification resources was measured with the GAMEX scale. RESULTS: The Physiotherapy Party showed a higher score in relation to the enjoyment dimension compared to the Kahoot! and Escape Room (p = 0.004). The Escape Room presented higher scores in absorption, creative thinking, activation and dominance compared to Kahoot! and Physiotherapy Party (p < 0.005). CONCLUSIONS: Gamification resources promote enjoyment and creativity in the students in the classroom. The use of new teaching methods based on gamification, such as Escape Room as Physiotherapy Party should be considered as first choice in the use of gamification resources due to the benefits they bring to students.

Characteristics and management of patients with SARS-CoV2 infection admitted to pediatric intensive care units: Data analysis of the Spanish national multicenter registry.

INTRODUCTION: The purpose of this study is to describe the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) disease characteristics and management in children admitted to the pediatric intensive care units (PICU). METHODS: The present study was based on a national multicentric prospective registry including PICU patients with SARS-CoV2 infection or symptoms of multisystem inflammatory syndrome in children (MIS-C). RESULTS: A total of 298 patients were admitted to 41 different Spanish PICUs. A total of 76% of them were previously healthy. The most frequent manifestation was MIS-C (69.8%). On admission, 59.4% of patients did not have respiratory distress, and only 17.4% needed conventional mechanical ventilation (MV). The need for MV was associated with age (incidence rate ratios [IRR] 1.21, p < .012), pediatric sequential organ failure assessment score (p-SOFA) Score (IRR 1.12, p = .001), and need for transfusion (IRR 4.5, p < .004) in MIS-C patients, and with vasoactive drug use (IRR 2.73, p = .022) and the diagnosis of acute respiratory distress syndrome (IRR 2.83, p = .018) in patients admitted for other reasons. During the first day of admission, 56% of patients met shock criteria and 50.7% needed vasoactive drugs. In MIS-C patients, their use was associated with higher p-SOFA score (IRR 1.06, p < .001) and with the diagnosis of shock (IRR 5.78, p < .001). In patients without MIS-C, it was associated with higher p-SOFA score (IRR 1.05, p = .022). The mortality rate was 3%, being lower in MIS-C patients compared to patients admitted for other reasons (0.5% vs. 9.4%, p < .001). It was also lower in previously healthy patients compared to patients with previous comorbidities (0.9% vs. 9.7%, p < .001). CONCLUSIONS: Severe SARS-CoV2 infection is uncommon in the pediatric population. In our series, respiratory distress was rare, being MIS-C the most frequent cause of PICU admission related to SARS-CoV2. In most cases, the course of the disease was mild except in children with previous diseases.

Influence of Shift Work on The Health of Nursing Professionals.

Shift work is increasingly common in health services, subjecting healthcare professionals to work schedules that can alter circadian rhythms and eating habits with consequent repercussions for the intestinal homeostasis. The objective of this study was to describe the relationship of rotating work shifts with the intestinal health, sleep quality, and emotional dimension of nursing professionals. In March and May 2019, an observational and comparative study was conducted among 380 nursing professionals from different Spanish cities and divided into fixed shift (n = 159) and rotating shift (n = 221). To carry out the present work, the variables measured were gastrointestinal symptoms, stool consistency and shape, anxiety, depression, sleep, as well as stress and work environment. Nurses with rotating shifts reported more abdominal pain and symptoms of depersonalization, as well as worse sleep efficiency and worse nursing practice environment. In addition, overall scores of the Gastrointestinal Symptom Rating Scale and Hospital Anxiety and Depression Scale were found to be significantly worse in nurses with these shifts. Rotating shift work by nursing staff may be associated with the occurrence of gastrointestinal and anxiety-related symptoms. These findings, together with the presence of negative and insensitive attitudes towards patients by nurses on rotating shifts, should be considered to maintain the quality of healthcare.

Effect of gut microbiota modulation on sleep: a systematic review and meta-analysis of clinical trials.

CONTEXT: A bidirectional relationship between gut microbiota (GM) and circadian rhythms has been proposed. OBJECTIVE: The aim of this study was to analyze the efficacy of probiotic or prebiotic intervention on sleep quality and quantity. DATA SOURCES: A systematic review and meta-analysis were conducted using the databases PubMed (MEDLINE), Embase, CINAHL, and Web of Science. Only randomized clinical trials written in English or Spanish were considered. DATA EXTRACTION: The initial search resulted in 219 articles. Following the removal of duplicates and consideration of the selection criteria, 25 articles were selected for the systematic review and 18 articles for the meta-analysis. DATA ANALYSIS: Microbiota modulation was not demonstrated to be associated with significant improvement in sleep quality in the present meta-analysis (P = 0.31). In terms of sleep duration, the meta-analysis found no improvement due to GM modulation (P = 0.43). CONCLUSION: The results of this meta-analysis indicate that there is still insufficient evidence to support the relationship between GM modulation and improved sleep quality. While several studies assume that including probiotics in the diet will undoubtedly improve sleep quality, more research is needed to fully understand this phenomenon. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021245118.

Environmental pesticide exposure and the risk of irritable bowel syndrome: A case-control study.

The agricultural model in southern Spain is highly productive, mainly due to the intensive cultivation under plastic. Despite strict pesticide regulation, human exposure to pesticides in the environment has been connected to an increase in diseases such as celiac disease. Certain pesticides have also been associated to the disruption of the intestinal microbiota, which has been tied to the development of irritable bowel syndrome (IBS). A case-control study was conducted in Andalusia, south Spain, to assess the prevalence and risk of IBS related to pesticide exposure. This research found a high prevalence of IBS in Andalusia between 2000 and 2021 in areas with high pesticide exposure using agronomic criteria. Furthermore, the odds ratio for IBS was significantly higher in the population with high pesticide exposure. This study suggests that pesticides may be involved in IBS, whereas more research is needed to determine the role of pesticides in IBS symptomatology.

A nursing socio-environmental approach for acute pesticide poisoning: A qualitative focus group study.

AIM: To explore the experiences and perceptions of final-year nursing students in assessing and managing acute pesticide poisoning using a socio-environmental care approach in a primary health care simulation-based scenario. DESIGN: A qualitative descriptive study was conducted using focus groups. METHODS: Twelve focus groups were held, with 114 fourth-year nursing students. The study was carried out from September to November 2021. To grant an in-depth analysis of the collected data, a thematic analysis was used. RESULTS: After our data analysis, three main themes emerged: (i) experiences of an acute pesticide poisoning case in a simulation-based scenario; (ii) environmental health nursing competencies for a culturally competent practice and (iii) social factors in prevention strategies. CONCLUSIONS: Using a socio-environmental care approach with a primary care simulation-based poisoning case can provide a realistic public health clinical experience for local problems and prepare the context for the development of global citizenship values, as well as offer numerous opportunities to facilitate transformative learning, including Sustainable Development Goals (SDGs) into local nursing clinical practice. IMPACT: Nurse managers, policymakers and educators must collaborate together to broaden their reach in teaching the role of the environment and social determinants of health through evidence-based care models, as well as actively contributing to the achievement of the SDGs to promote "glocal" competencies among nursing professionals.

Deficiency of Parkinson's Related Protein DJ-1 Alters Cdk5 Signalling and Induces Neuronal Death by Aberrant Cell Cycle Re-entry.

DJ-1 is a multifunctional protein involved in Parkinson disease (PD) that can act as antioxidant, molecular chaperone, protease, glyoxalase, and transcriptional regulator. However, the exact mechanism by which DJ-1 dysfunction contributes to development of Parkinson's disease remains elusive. Here, using a comparative proteomic analysis between wild-type cortical neurons and neurons lacking DJ-1 (data available via ProteomeXchange, identifier PXD029351), we show that this protein is involved in cell cycle checkpoints disruption. We detect increased amount of p-tau and α-synuclein proteins, altered phosphoinositide-3-kinase/protein kinase B (PI3K/AKT) and mitogen-activated protein kinase (MAPK) signalling pathways, and deregulation of cyclin-dependent kinase 5 (Cdk5). Cdk5 is normally involved in dendritic growth, axon formation, and the establishment of synapses, but can also contribute to cell cycle progression in pathological conditions. In addition, we observed a decrease in proteasomal activity, probably due to tau phosphorylation that can also lead to activation of mitogenic signalling pathways. Taken together, our findings indicate, for the first time, that aborted cell cycle re-entry could be at the onset of DJ-1-associated PD. Therefore, new approaches targeting cell cycle re-entry can be envisaged to improve current therapeutic strategies.

Experiences with obstetric violence among healthcare professionals and students in Spain: A constructivist grounded theory study.

BACKGROUND: Obstetric violence appears to be a worldwide concern and is defined as a type of gender-based violence perpetrated by health professionals. This violence undermines and harms women's autonomy. In Spain, 38.3 % of women have identified themselves as victims of this type of violence. AIM: To explore current information and knowledge about obstetric violence within the Spanish healthcare context, as well as to develop a theoretical model to explain the concept of obstetric violence, based on the experiences of healthcare professionals (midwives, registered nurses, gynaecologists and paediatricians) and nursing students. METHODS: A constructivist grounded theory study was conducted at Jaume I University in Spain between May and July 2021, including concurrent data collection and interpretation through constant comparison analysis. An inductive analysis was carried out using the ATLAS.ti 9.0 software to organise and analyse the data. RESULTS: Twenty in-depth interviews were conducted, which revealed that healthcare professionals and students considered obstetric violence a violation of human rights and a serious public health issue. The interviews allowed them to describe certain characteristics and propose preventive strategies. Three main categories were identified from the data analysis: (i) characteristics of obstetric violence in the daily routine, (ii) defining the problem of obstetric violence and (iii) strategies for addressing obstetric violence. Participants identified obstetric violence as structural gender-based violence and emphasised the importance of understanding its characteristics. Our results indicate how participants' experiences influence their process of connecting new information to prior knowledge, and they provide a connection to specific micro- and macro-level strategic plans. DISCUSSION: Despite the lack of consensus, this study resonates with the established principles of women and childbirth care, but also generates a new theoretical model for healthcare students and professionals to identify and manage obstetric violence based on contextual factors. The term 'obstetric violence' offers a distinct contribution to the growing awareness of violence against women, helps to regulate it through national policy and legislation, and involves both structural and interpersonal gender-based abuse, rather than assigning blame only to care providers. CONCLUSIONS: Obstetric violence is the most accurate term to describe disrespect and mistreatment as forms of interpersonal and structural violence that contribute to gender and social inequality, and the definition of this term contributes to the ongoing awareness of violence against women, which may help to regulate it through national policy and legislation.

Evaluation of Candidatus Liberibacter Asiaticus Efflux Pump Inhibition by Antimicrobial Peptides.

Citrus greening, also known as Huanglongbing (HLB), is caused by the unculturable bacterium Candidatus Liberibacter spp. (e.g., CLas), and has caused a devastating decline in citrus production in many areas of the world. As of yet, there are no definitive treatments for controlling the disease. Antimicrobial peptides (AMPs) that have the potential to block secretion-dependent effector proteins at the outer-membrane domains were screened in silico. Predictions of drug-receptor interactions were built using multiple in silico techniques, including molecular docking analysis, molecular dynamics, molecular mechanics generalized Born surface area analysis, and principal component analysis. The efflux pump TolC of the Type 1 secretion system interacted with natural bacteriocin plantaricin JLA-9, blocking the ß barrel. The trajectory-based principal component analysis revealed the possible binding mechanism of the peptides. Furthermore, in vitro assays using two closely related culturable surrogates of CLas (Liberibacter crescens and Rhizobium spp.) showed that Plantaricin JLA-9 and two other screened AMPs inhibited bacterial growth and caused mortality. The findings contribute to designing effective therapies to manage plant diseases associated with Candidatus Liberibacter spp.

Plant-based expression platforms to produce high-value metabolites and proteins.

Plant-based heterologous expression systems can be leveraged to produce high-value therapeutics, industrially important proteins, metabolites, and bioproducts. The production can be scaled up, free from pathogen contamination, and offer post-translational modifications to synthesize complex proteins. With advancements in molecular techniques, transgenics, CRISPR/Cas9 system, plant cell, tissue, and organ culture, significant progress has been made to increase the expression of recombinant proteins and important metabolites in plants. Methods are also available to stabilize RNA transcripts, optimize protein translation, engineer proteins for their stability, and target proteins to subcellular locations best suited for their accumulation. This mini-review focuses on recent advancements to enhance the production of high-value metabolites and proteins necessary for therapeutic applications using plants as bio-factories.

Root cause analysis for understanding patient safety incidents in nursing student placements: A qualitative content analysis.

AIM: to explore nursing students' experiences with the use of RCA technique in patient safety-related incidents during clinical placements. A secondary descriptive qualitative content analysis BACKGROUND: Patient safety education for nursing students is an international priority. While early detection and intervention strategies, such as the root cause analysis technique, have been found to be effective for near misses and errors, little is known about how these strategies facilitate nursing students understand how patient safety incidents happen. DESIGN: A secondary qualitative content analysis was conducted as part of a larger patient safety research project. METHODS: Data were collected from nursing students at [Hidden for blinding purposes]. This study included 108 third-year undergraduate nursing students enroled in the Care Management in the Socio-Health Care Settings for the academic years 2017-2018 and 2018-2019. During hospital clinical placements, nursing students were asked to do a coursework describing a patient safety incident and using the root cause analysis technique for its analysis. A content analysis was used to provide an in-depth analysis of the collected data. RESULTS: Two main themes were identified after the data analysis process: (i) patient safety incident as learning events: highlights how these incidents were turned into learning opportunities and how the root cause analysis guided them in identifying and addressing critical incidents to prevent similar situations in the future; and (ii) strategies for improving patient safety culture: depicts how nursing students realised that following protocols and evidence-based practice reduces incidents related to patient safety and the value of reporting errors in avoiding and minimising the recurrence of similar mistakes. CONCLUSIONS: The root cause analysis technique is a versatile and flexible learning resource for nursing students that can help them understand complex patient safety incidents while also fostering critical and problem-solving thinking, teamwork and systematic communication.

A versatile Agrobacterium-based plant transformation system for genetic engineering of diverse citrus cultivars.

Developing an efficient transformation system is vital in genetically engineering recalcitrant crops, particularly trees. Here, we outline an Agrobacterium tumefaciens-based stable plant transformation methodology for citrus genetic engineering. The process was optimized to suit the requirements of fourteen citrus varieties by establishing appropriate infection, co-cultivation, selection, and culture media conditions. The procedure includes transforming seedling-derived epicotyl segments with an A. tumefaciens strain, then selecting and regenerating transformed tissues. Transgenic shoots were further identified by a visual reporter (e.g., ß-glucuronidase) and confirmed by Northern and Southern blot analysis. Transgene integrations among the transgenic lines ranged between one to four. The methodology can yield transformation efficiencies of up to 11%, and transgenic plants can be recovered as early as six months, depending on the variety. In addition, we show that incorporating A. tumefaciens helper virulence genes (virG and virE), spermidine, and lipoic acid in the resuspension buffer before transformation improved the transformation efficiency of specific recalcitrant cultivars, presumably by enhancing T-DNA integration and alleviating oxidative stress on the explant tissues. In conclusion, the optimized methodology can be utilized to engineer diverse recalcitrant citrus varieties towards trait improvement or functional genetics applications.

Exploring the microaggression experiences of LGBTQ+ community for a culturally safe care: A descriptive qualitative study.

BACKGROUND: Microaggressions, stigma and minority stress still occur among sexual and gender minorities on an individual, interpersonal, and structural level. Cultural immersion may therefore be an effective strategy in order to find potential healthcare approaches and foster more comprehensive, critical, intersectional, and inclusive care practices. OBJECTIVE: The aim of this study was to develop insight into the experiences of LGBTQ+ community members to obtain in-depth perceptions of microaggressions and an understanding of their healthcare needs to provide a culturally safe and sensitive care. DESIGN: A qualitative descriptive study was conducted between September to November 2021. SETTINGS: This study was conducted at the University of Almeria with LGBTQ+ community members. PARTICIPANTS: Twenty-one LGBTQ+ individual participated in this study, aged between 18 and 56 years old. METHODS: Participants were recruited using a purposive sampling. Responses from semi-structured interviews were studied using a thematic analysis. Methods and findings are reported in line with Standards for Reporting Qualitative Research recommendations. RESULTS: Three themes emerged from the qualitative analysis: (i) experiences to understand the impact of a heteronormative society, (ii) perceptions of engaging with health education and promotion, and (iii) healthcare access, use and experiences within the LGTBQ+ community. CONCLUSIONS: This study yields findings about the difficulties that LGBTQ+ community members face in the healthcare system in order to ensure equal care for vulnerable communities and integrate a culturally safe care approach into nursing practice. Certain microaffirmation strategies against social determinants of health such as school-based nursing strategies can help to raise awareness and knowledge among heterosexual peers and reduce cultural invisibility, microaggressions, stigma and minority stress. In order to provide culturally safe care, educators might also explore the inclusion of gender and sexual minority care content in both in-faculty education and ongoing continuing education for nurse practitioners.

Evolution of the Public-Health Response to COVID-19 Pandemic in Spain: A Descriptive Qualitative Study.

The capacity of hospitals and primary care centres has, rightfully, been at the centre of public and political debate on resource availability and control measures during the outbreak of COVID-19 and lockdown. Thus, the aim of this study is to describe the public and professional perceptions towards the evolution of the COVID-19 public-health response, in order to analyse and learn lessons for future health policies in similar situations in the future. A descriptive qualitative study was conducted through 41 in-depth interviews between January and June 2021. Twenty-one healthcare professionals and twenty service users participated in our study. The participants were recruited using purposive sampling. After our data analysis, three main themes emerged: (i) experiences during an unprecedented public health threat: the impact and challenges of early control measures, and outcomes for the public image of nursing; (ii) overcoming the impact of the outbreak on the healthcare system: professional coping strategies in the context of the pandemic, and institutional considerations in hospitals and primary care; and (iii) the efficiency of resource management during the outbreak: perceptions of professionals and healthcare users. Health providers and service users demand structural and organisational changes, as well as resource-optimisation strategies for front-line workers. Nurses need to be involved in decision making in order to provide evidence-based guidelines and ensure well-resourced and supported care practice.

Experiences and perceptions of final-year nursing students of using a chatbot in a simulated emergency situation: A qualitative study.

AIM: The aim of this study is to explore the experiences and perceptions of final-year nursing students on the acceptability and feasibility of using a chatbot for clinical decision-making and patient safety. BACKGROUND: The effective and inclusive use of new technologies such as conversational agents or chatbots could support nurses in increasing evidence-based care and decreasing low-quality services. METHODS: A descriptive qualitative study was used through focus group interviews. The data analysis was conducted using a thematic analysis. RESULTS: This study included 114 participants. After our data analysis, two main themes emerged: (i) experiences in the use of a chatbot service for clinical decision-making and and (ii) integrating conversational agents into the organizational safety culture. CONCLUSIONS: The findings of our study provide preliminary support for the acceptability and feasibility of adopting SafeBot, a chatbot for clinical decision-making and patient safety. Our results revealed substantial recommendations for refining navigation, layout and content, as well as useful insights to support its acceptance in real nursing practice. IMPLICATIONS FOR NURSING MANAGEMENT: Leaders and managers may well see artificial intelligence-based conversational agents like SafeBot as a potential solution in modern nursing practice for effective problem-solving resolution, innovative staffing and nursing care delivery models at the bedside and criteria for measuring and ensure quality and patient safety.