Myrica cerifera, a Medicinal Plant of the Lumbee Tribe, has Antibacterial and Nematicidal Properties.

Currently threatening the world of medicine is a growing number of antibiotic-resistant diseases. More specifically, bacteria and nematodes have gained resistance to many of the world's leading antibiotics and nematicides, respectively, making infections more difficult to treat. Subsequently, these parasitic organisms are able to continue damaging crops and other living organisms like humans without strong interference. To help people and the environment, the development of new and novel antibiotics is vital. Previous research suggests that phytochemicals are a potential solution that will not only help inhibit bacterial growth but also reduce nematode survival. We hypothesized that Myrica cerifera, a plant often used by the Lumbee tribe to treat illness, possesses antibacterial and nematicidal properties. To answer our hypothesis, we began by collecting plant specimens to extract material for biological assays and to subsequently isolate and elucidate the structures of active components. The extract was evaluated for antibacterial properties with an agar diffusion assay and then nematicidal properties using Caenorhabditis elegans. M. cerifera extract was added onto an agar lawn at various doses, and the nematodes' lifespans were scored. The findings of this study show that extracts of this plant, more commonly referred to as 'wax myrtle', do significantly decrease the lifespan of C. elegans and increase the zone of inhibition for Staphylococcus epidermidis and Staphylococcus aureus. In addition, two compounds were isolated and characterized through chemical extraction, chromatographic separation, and spectroscopic analysis. These compounds could potentially be used to treat bacterial and nematode infections.

COVID-19 Vaccine Intent Among Health Care Professionals of Queen Elizabeth Hospital, Barbados.

INTRODUCTION: Due to increased exposure risk and the potential impact of COVID-19 infection, health care professionals (HCP) are a target group for COVID-19 vaccination. This study aimed to examine the acceptability of COVID-19 vaccines among HCP at the Queen Elizabeth Hospital, Barbados. DESIGN AND METHODS: A cross-sectional survey of HCP was conducted between February 14 and 27, 2021 using an online questionnaire. The questionnaire included demographic information, knowledge of novel coronavirus, intention to accept the COVID-19 vaccination, vaccine literacy (VL), and perceptions and attitudes regarding COVID-19 vaccines. Mean VL scores were calculated. The relationship between socio-demographic variables and vaccine intent was assessed using a multivariable logistic regression model. RESULTS: Of 343 HCPs, 55.1% indicated they would accept the COVID-19 vaccine if it were available; 44.9% expressed hesitancy towards the COVID-19 vaccine. We assessed the impact of socio-demographic factors and previous vaccine behavior on vaccine intent; after adjustment of the multivariable logistic regression model, non-Barbadian nationality and previous flu vaccine uptake were statistically significant predictors of reported intent to take the COVID-19 vaccine. Persons who indicated that they would take the vaccine had a higher mean vaccine literacy score [3.46 95% CI (3.40, 3.52)] than those who were not ready to take the vaccine immediately [3.23 95% CI (3.15, 3.30)]. VL scores were higher among the 29.5% of HCPs who believed vaccines should be mandatory. CONCLUSION: This study highlighted vaccine hesitancy among HCPs in the sole public tertiary hospital of Barbados. As HCP perceptions may help or hinder the campaign to promote vaccine uptake in Barbados, vaccine promotion programs targeting HCPs are needed to ensure the success of the country's COVID-19 vaccination drive.

The electrophysiological response to polarization-modulated patterned visual stimuli.

Recent reports indicate that the subjective ability of humans to discriminate between polarization E-vector orientations approaches that of many invertebrates. Here, we show that polarization-modulated patterned stimuli generate an objectively recordable electrophysiological response in humans with normal vision. We investigated visual evoked potential (VEP) and electroretinographic (ERG) responses to checkerboard patterns defined solely by their polarization E-vector orientation alternating between ± 45°. Correcting for multiple comparisons, paired-samples t-tests were conducted to assess the significance of post-stimulus deflections from baseline measures of noise. Using standard check pattern sizes for clinical electrophysiology, and a pattern-reversal protocol, participants showed a VEP response to polarization-modulated patterns (PolVEP) with a prominent and consistent positive component near 150 ms (p < 0.01), followed by more variable negative components near 200 ms and 300 ms. The effect was unrecordable with visible wavelengths >550 nm. Further, pseudo-depolarization negated the responses, while control studies provided confirmatory evidence that the PolVEP response was not the product of luminance artefacts. Polarization-modulated patterns did not elicit a recordable ERG response. The possible origins of the PolVEP signals, and the absence of recordable ERG signals, are discussed. We conclude that evoked cortical responses to polarization-modulated patterns provide an objective measure of foveal function, suitable for both humans and non-human primates with equivalent macular anatomy.

Reservoirs of resistance: polymyxin resistance in veterinary-associated companion animal isolates of Pseudomonas aeruginosa.

BACKGROUND: Pseudomonas aeruginosa is an opportunistic pathogen and a major cause of infections. Widespread resistance in human infections are increasing the use of last resort antimicrobials such as polymyxins. However, these have been used for decades in veterinary medicine. Companion animals are an understudied source of antimicrobial resistant P. aeruginosa isolates. This study evaluated the susceptibility of P. aeruginosa veterinary isolates to polymyxins to determine whether the veterinary niche represents a potential reservoir of resistance genes for pathogenic bacteria in both animals and humans. METHODS AND RESULTS: Clinical P. aeruginosa isolates (n=24) from UK companion animals were compared for antimicrobial susceptibility to a panel of human-associated isolates (n=37). Minimum inhibitory concentration (MIC) values for polymyxin B and colistin in the companion animals was significantly higher than in human isolates (P=0.033 and P=0.013, respectively). Genotyping revealed that the veterinary isolates were spread throughout the P. aeruginosa population, with shared array types from human infections such as keratitis and respiratory infections, suggesting the potential for zoonotic transmission. Whole genome sequencing revealed mutations in genes associated with polymyxin resistance and other antimicrobial resistance-related genes. CONCLUSION: The high levels of resistance to polymyxin shown here, along with genetic similarities between some human and animal isolates, together suggest a need for sustained surveillance of this veterinary niche as a potential reservoir for resistant, clinically relevant bacteria in both animals and humans.

Adsorption of nitrogen-containing compounds on hydroxylated α-quartz surfaces.

Adsorption energies of various nitrogen-containing compounds (specifically, 2,4,6-trinitrotoluene (TNT), 2,4-dinitrotoluene (DNT), 2,4-dinitroanisole (DNAn), and 3-nitro-1,2,4-triazole-5-one (NTO)) on the hydroxylated (001) and (100) α-quartz surfaces are computed. Different density functionals are utilized and both periodic as well as cluster approaches are applied. From the adsorption energies, partition coefficients on the considered α-quartz surfaces are derived. While TNT and DNT are preferably adsorbed on the (001) surface of α-quartz, NTO is rather located on both α-quartz surfaces.

New insights into genetic predisposition and novel therapeutic targets for nonalcoholic fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease in the United States affecting 80-100 million Americans. NAFLD encompasses a spectrum of diseases ranging from excess liver fat (nonalcoholic fatty liver or NAFL), to necro-inflammation (nonalcoholic steatohepatitis or NASH), to fibrosis/ cirrhosis, and malignant transformation (hepatocellular carcinoma). Susceptibility to NAFLD is highly variable and it remains unclear why some patients with NAFLD exhibit NASH, whereas patients with known risk factors have NAFL only. The reasons for this variability can be a partially attributed to differences in genetic background. In the last decade, there have been multiple genome wide association studies, which have enriched our understanding of the genetic basis of NAFLD. The I148M PNPLA3 (patatin-like phospholipase domain-containing protein 3) variant has been identified as the major common genetic determinant of NAFLD. Variants with moderate effect size like TM6SF2, MBOAT7 and GCKR have also been shown to have a significant contribution. New research has uncovered major pathways leading to disease development and progression; therefore, multiple medications are being developed and tested for the treatment of advanced NAFLD. These agents target metabolic mechanisms as well as inflammation and fibrosis pathways. Several randomized clinical trials (RCTs) are evaluating the efficacy of these novel agents on histological improvement of disease severity and decreasing liver-related outcomes. FDA-approved medications for NASH and NASH-related fibrosis are expected by 2020.

Leadership Development Programs at Academic Health Centers: Results of a National Survey.

PURPOSE: To identify the prevalence and characteristics of faculty leadership development programs (LDPs) offered by North American academic health centers (AHCs) and to uncover gaps in leadership training. METHOD: Faculty development/affairs deans of the 161 Association of American Medical Colleges member schools were surveyed in 2015 on their approach to faculty leadership training. For AHCs delivering their own training, the survey included questions about LDP participants, objectives, curriculum, delivery, resources, and evaluation. The literature on leadership and leadership development was used to develop a taxonomy of leadership competencies, which formed the basis of the survey questions related to program content. Survey results were analyzed with descriptive statistics and chi-square analysis for categorical data. RESULTS: Of the 94 respondents (response rate 58%), 93 provided some form of leadership training and 61 provided a formal internal faculty LDP. Content was variable and rarely based on a specific leadership competency model. Although programs described innovative approaches to learning, lectures and case discussions were the predominant approaches. Evaluation beyond participant satisfaction was uncommon. CONCLUSIONS: Faculty LDPs were common, with some programs describing elements informed by the leadership literature. However, nationally programs can improve by basing content on a leadership competency model, incorporating multiple approaches to teaching, and implementing more rigorous program evaluation.

Systems Thinking and Systems-Based Practice Across the Health Professions: An Inquiry Into Definitions, Teaching Practices, and Assessment.

Phenomenon: Systems thinking is the cornerstone of systems-based practice (SBP) and a core competency in medicine and health sciences. Literature regarding how to teach or apply systems thinking in practice is limited. This study aimed to understand how educators in medicine, physical therapy, physician assistant, nursing, and speech-language pathology education programs teach and assess systems thinking and SBP. APPROACH: Twenty-six educators from seven different degree programs across the five professions were interviewed and program descriptions and relevant course syllabi were reviewed. Qualitative analysis was iterative and incorporated inductive and deductive methods as well as a constant comparison of units of data to identify patterns and themes. FINDINGS: Six themes were identified: 1) participants described systems thinking as ranging across four major levels of healthcare (i.e., patient, care team, organization, and external environment); 2) participants associated systems thinking with a wide range of activities across the curriculum including quality improvement, Inter-professional education (IPE), error mitigation, and advocacy; 3) the need for healthcare professionals to understand systems thinking was primarily externally driven; 4) participants perceived that learning systems thinking occurred mainly informally and experientially rather than through formal didactic instruction; 5) participants characterized systems thinking content as interspersed across the curriculum and described a variety of strategies for teaching and assessing it; 6) participants indicated a structured framework and inter-professional approach may enhance teaching and assessment of systems thinking. Insights: Systems thinking means different things to different health professionals. Teaching and assessing systems thinking across the health professions will require further training and practice. Tools, techniques, taxonomies and expertise outside of healthcare may be used to enhance the teaching, assessment, and application of systems thinking and SBP to clinical practice; however, these would need to be adapted and refined for use in healthcare.

Retention Characteristics of a pH Tunable Water Stationary Phase in Supercritical Fluid Chromatography.

The retention characteristics of a novel pH tunable water stationary phase are presented. The method utilizes a change in mobile phase from N2 to CO2 to acidify the water phase in situ and control the ionization and elution of organic acids. With N2 present the phase pH > 5.4 and the acids are ionized and strongly retained. Conversely, with CO2 present the pH < 3.8 and the acids are neutralized and can elute. This effect is reasonably independent of time. For example, at 80°C hexanoic acid readily elutes from a 10 m column after switching to CO2 at any point over a 1 h period. Beyond this, however, some broadening and peak erosion is noted. Acids are also retained on 10 and 2 m columns similarly, since their elution primarily depends upon the change in stationary phase pH. Altering the CO2 solubility in the water phase alone (i.e., through changing system temperature and pressure without using N2) also produces similar changes in stationary phase acidity. However, this approach yields greater system noise and instability. The N2/CO2 switching mode is used to analyze organic acids in various samples and is found to provide high selectivity for them over other matrix components. Therefore, this approach can potentially simplify the analysis of such acids in complex samples.

Experimental and computational study of membrane affinity for selected energetic compounds.

The affinity of various energetic compounds for a biological membrane was investigated using experimental and computational techniques. We measured octanol-water (log(Kow)) and liposome-water (log(Klipw)) partition coefficients for the following chemicals: trinitrotoluene (TNT), 2,4-dinitrotoluene (2,4-DNT), 2,6-dinitrotoluene (2,6-DNT), 2,4-dinitroanisole (DNAN), 2methoxy-5-nitrophenol (2M5NP), 2,4,6-trinitrobenzene (TNB), and 2,4-dinitrophenol (2,4-DNP). In order to determine log(Klipw) experimentally, we used artificial solid supported lipid liposomes produced under trade mark TRANSIL. Log(Kow) value were predicted with several program packages including the COSMOthermX software. Log(Klipw) were estimated with COSMOmic as implemented in the COSMOthermX program package. In order to verify accuracy of our experimentally obtained results, we performed basic statistical analysis of data taken from the literature. We concluded that compounds considered in this study possess a moderate ability to penetrate into membranes. Comparison of both coefficients has shown that in general, the log(Kow) values are slightly smaller than log(Klipw).

Theoretical predictions of thermodynamic parameters of adsorption of nitrogen containing environmental contaminants on kaolinite.

In this study thermodynamic parameters of adsorption of nitrogen containing environmental contaminants (NCCs, 2,4,6, trinitrotoluene (TNT), 2,4-dinitrotoluene (DNT), 2,4-dinitroanisole (DNAN), and 3-one-1,2,4-triazol-5-one (NTO)) interacting with the tetrahedral and octahedral surfaces of kaolinite were predicted. Adsorption complexes were investigated using a density functional theory and both periodic and cluster approach. The complexes, modeled using the periodic boundary conditions approach, were fully optimized at the BLYP-D2 level to obtain the structures and adsorption energies. The relaxed kaolinite-NCCs structures were used to prepare cluster models to calculate thermodynamic parameters and partition coefficients at the M06-2X-D3 and BLYP-D2 levels from the gas phase. The entropy effect on the Gibbs free energies of adsorption of NCCS on kaolinite was also studied and compared with available experimental data. The results showed that in all calculated models, the NCCs molecules are physisorbed and they favor a parallel orientation toward both kaolinite surfaces. It was found that all calculated NCCs compounds are more stable on the octahedral than on the tetrahedral surface of kaolinite. The Gibbs free energies and partition coefficients were also predicted for interactions of NCCs with Na-kaolinite from aqueous solution. Calculations revealed adsorption of NCCs is effective from the gas phase on both cation free kaolinite surfaces and on Na-kaolinite from aqueous solution at room temperature. Theoretical data were validated against experimental results, and the reasons for small differences between calculated and measured partition coefficients are discussed.

Theoretical study of adsorption of nitrogen-containing environmental contaminants on kaolinite surfaces.

The adsorption of nitrogen-containing compounds (NCCs) including 2,4,6-trinitrotoluene (TNT), 2,4-dinitrotoluene (DNT), 2,4-dinitroanisole (DNAN), and 3-nitro-1,2,4-triazol-5-one (NTO) on kaolinite surfaces was investigated. The M06-2X and M06-2X-D3 density functionals were applied with the cluster approximation. Several different positions of NCCs relative to the adsorption sites of kaolinite were examined, including NCCs in perpendicular and parallel orientation toward both surface models of kaolinite. The binding between the target molecules and kaolinite surfaces was analyzed and bond energies were calculated applying the atoms in molecules (AIM) method. All NCCs were found to prefer a parallel orientation toward both kaolinite surfaces, and were bound more strongly to the octahedral than to the tetrahedral site. TNT exhibited the strongest interaction with the octahedral surface and DNAN with the tetrahedral surface of kaolinite. Hydrogen bonding was shown to be the dominant non-covalent interaction for NCCs interacting with the octahedral surface of kaolinite with a small stabilizing effect of dispersion interactions. In the case of adsorption on the tetrahedral surface, kaolonite-NCC binding was shown to be governed by the balance between hydrogen bonds and dispersion forces. The presence of water as a solvent leads to a significant decrease in the adsorption strength for all studied NCCs interacting with both kaolinite surfaces.

Influence of carbon and metal oxide nanomaterials on aqueous concentrations of the munition constituents cyclotrimethylenetrinitramine (RDX) and tungsten.

There is an increasing likelihood of interactions between nanomaterials and munitions constituents in the environment resulting from the use of nanomaterials as additives to energetic formulations and potential contact in waste streams from production facilities and runoff from training ranges. The purpose of the present research was to determine the ability of nano-aluminum oxide (Al(2)O(3)) and multiwalled carbon nanotubes (MWCNTs) to adsorb the munitions constituents cyclotrimethylenetrinitramine (RDX) and tungsten (W) from aqueous solution as a first step in determining the long-term exposure, transport, and bioavailability implications of such interactions. The results indicate significant adsorption of RDX by MWCNTs and of W by nano-Al(2)O(3) (but not between W and MWCNT or RDX and nano-Al(2)O(3)). Kinetic sorption and desorption investigations indicated that the most sorption occurs nearly instantaneously (<5 min), with a relatively slower, secondary binding leading to statistically significant but relatively smaller increases in adsorption over 30 d. The RDX sorption that occurred during the initial interaction was irreversible, with long-term, reversible sorption likely the result of a secondary interaction; as interaction time increased, however, the portion of W irreversibly sorbed onto nano-Al(2)O(3) also increased. The present study shows that strong interactions between some munitions constituents and nanomaterials following environmental release are likely. Time-dependent binding has implications for the bioavailability, migration, transport, and fate of munitions constituents in the environment.

Practical responses to confidentiality dilemmas in elite sport medicine.

AIM: To examine the ethical challenges of upholding patient confidentiality in sports medicine and the practical responses of clinicians to these challenges. METHOD: Questionnaire survey and follow-up semi-structured interviews with the members of the British Olympic Association's Medical Committee and Physiotherapy Forum. RESULTS: Clinicians identified three contextual factors that influenced issues related to patient confidentiality in sports medicine: the use of confidentiality waivers; the facilities available for treatment; and the cultural norms of elite sport. They further identified interpersonal strategies used to lessen or eradicate conflicts, including emphasising the benefits and avoidance of disbenefits for athletes and the potential negative consequences for others. CONCLUSIONS: Aspects of clinicians' practice environment should be designed to enable compliance with the highest levels of ethical conduct. Professional associations should establish guidelines for clinicians' interpersonal conduct in dealing with confidentiality issues and consider their provision of ethics-based continuous professional development. They should also petition for the establishment of athletes' codes of conduct which identify a context-relevant understanding of 'serious harm' and how that might impact on information disclosure.

Mineral-organic interfacial processes: potential roles in the origins of life.

Life is believed to have originated on Earth ∼4.4-3.5 Ga ago, via processes in which organic compounds supplied by the environment self-organized, in some geochemical environmental niches, into systems capable of replication with hereditary mutation. This process is generally supposed to have occurred in an aqueous environment and, likely, in the presence of minerals. Mineral surfaces present rich opportunities for heterogeneous catalysis and concentration which may have significantly altered and directed the process of prebiotic organic complexification leading to life. We review here general concepts in prebiotic mineral-organic interfacial processes, as well as recent advances in the study of mineral surface-organic interactions of potential relevance to understanding the origin of life.

Molecular simulations of adsorption of RDX and TATP on IRMOF-1(Be).

The influence of different sorption sites of isoreticular metal-organic frameworks (IRMOFs) on interactions with explosive molecules is investigated. Different connector effects are taken into account by choosing IRMOF-1(Be) (IRMOF-1 with Zn replaced by Be), and two high explosive molecules: 1,3,5-trinitro-s-triazine (RDX) and triacetone triperoxide (TATP). The key interaction features (structural, electronic and energetic) of selected contaminants were analyzed by means of density functional calculations. The interaction of RDX and TATP with different IRMOF-1(Be) fragments is studied. The results show that physisorption is favored and occurs due to hydrogen bonding, which involves the C-H groups of both molecules and the carbonyl oxygen atoms of IRMOF-1(Be). Additional stabilization of RDX and TATP arises from weak electrostatic interactions. Interaction with IRMOF-1(Be) fragments leads to polarization of the target molecules. Of the molecular configurations we have studied, the Be-O-C cluster connected with six benzene linkers (1,4-benzenedicarboxylate, BDC), possesses the highest binding energy for the studied explosives (-16.4 kcal mol(-1) for RDX and -12.9 kcal mol(-1) for TATP). The main difference was discovered to be in the preferable adsorption site for adsorbates (RDX above the small and TATP placed above the big cage). Based on these results, IRMOF-1 can be suggested as an effective material for storage and also for separation of similar explosives. Hydration destabilizes most of the studied adsorption systems by 1-3 kcal mol(-1) but it leads to the same trend in the binding strength as found for the non-hydrated complexes.

Professional relations in sport healthcare: workplace responses to organisational change.

This article examines the impact of organisational changes in UK elite sport on the professional relations among and between different healthcare providers. The article describes the processes by which demand for elite sport healthcare has increased in the UK. It further charts the subsequent response within medicine and physiotherapy and, in particular, the institutionalisation of sport-specific sub-disciplines through the introduction of specialist qualifications. Drawing on semi-structured interviews with 14 doctors and 14 physiotherapists, the article argues that organisational changes have led to intra-professional tensions within both professional groups but in qualitatively different forms reflecting the organisational traditions and professional identities of the respective disciplines. Organisational changes promoting multi-disciplinary healthcare teams have also fostered an environment conducive to high levels of inter-professional cooperation though significant elements of inter-professional conflict remain. This study illustrates how intra-professional relations are affected by specialisation, how legitimation discourses are used by different professions, and how intra- and inter-professional conflict and cooperation should be seen as highly interdependent processes.

An implementation case study. Implementation of the Indian Health Service's Resource and Patient Management System Electronic Health Record in the ambulatory care setting at the Phoenix Indian Medical Center.

The Phoenix Indian Medical Center (PIMC) has successfully implemented the Resource and Patient Management System Electronic Health Record (RPMS-EHR) in its Ambulatory Care departments. One-hundred and twenty-six providers use the system for essentially all elements of documentation, ordering, and coding. Implementation of one function at a time, in one clinical area at a time, allowed for focused training and support. Strong departmental leadership and the development of 'super-users' were key elements. Detailed assessments of each clinic prior to implementation were vital, resulting in optimal workstation utilization and a greater understanding of each clinic's unique flow. Each phase saw an increasing reluctance to revert to old paper processes. The success of this implementation has placed pressure on the remainder of the hospital to implement the RPMS-EHR, and has given the informatics team an increased awareness of what resources are required to achieve this result.