- AKR1D1 is a novel regulator of metabolic phenotype in human hepatocytes and is dysregulated in non-alcoholic fatty liver disease. [Journal Article]
- MMetabolism 2019 Jul 19; :153947
- CONCLUSIONS: Genetic manipulation of AKR1D1 regulates the metabolic phenotype of human hepatoma cell lines, driving steatosis and inflammation. Taken together, the observation that AKR1D1 mRNA is down-regulated with advancing NAFLD suggests that it may have a crucial role in the pathogenesis and progression of the disease.
- The dynamics between limited-term and lifelong coinfecting bacterial parasites in wild rodent hosts. [Journal Article]
- JEJ Exp Biol 2019 Jul 08
- Interactions between coinfecting parasites1 may take various forms, either direct or indirect, facilitative or competitive, and may be mediated by either bottom-up or top-down mechanisms. While each …
Interactions between coinfecting parasites1 may take various forms, either direct or indirect, facilitative or competitive, and may be mediated by either bottom-up or top-down mechanisms. While each form of interaction leads to different evolutionary and ecological outcomes, it is challenging to tease them apart throughout the infection period. To establish the first step towards a mechanistic understanding of the interactions between coinfecting limited-term bacterial parasites and lifelong bacterial parasites, we studied the coinfection ofBartonella sp. (limited-term) and Mycoplasma sp. (lifelong), which commonly co-occur in wild rodents. We infected Bartonella and Mycoplasma-free rodents with each species, and simultaneously with both, and quantified the infection dynamics and host responses. Bartonella benefited from the interaction; its infection load decreased more slowly in coinfected rodents than in rodents infected with Bartonella alone. There were no indications for bottom-up effects, but coinfected rodents experienced various changes, depending on the infection stage, in their body mass, stress levels, and activity pattern, which may further affect bacterial replication and transmission. Interestingly, the infection dynamics and changes in the average coinfected rodent traits were more similar to the chronic effects of Mycoplasma infection, whereas coinfection uniquely impaired the host's physiological and behavioral stability. These results suggest that parasites with distinct life history strategies may interact, and their interaction may be asymmetric, non-additive, multifaceted, and dynamic through time. Since multiple, sometimes contrasting, forms of interactions are simultaneously at play and their relative importance alternates throughout the course of infection, the overall outcome may change under different ecological conditions.1"Parasite" is used throughout the article in its broad definition as an organism that lives in or on an organism of another species (its host) and benefits by consuming parts of the host resources or components. It damages the host but is rarely lethal in the short term. This term includes herein viruses, bacteria, protozoa, helminths, ectoparasites, and other blood-sucking organisms.
- Evidence for a cardiac metabolic switch in patients with Hodgkin's lymphoma. [Journal Article]
- EHESC Heart Fail 2019 Jul 06
- CONCLUSIONS: Our data provide evidence for metabolic alterations in patients with Hodgkin's lymphoma related to cardiac glucose uptake in humans. This effect was independent from skeletal muscle metabolism.
- Prevention and Recovery Care Services in Australia: Developing a State-Wide Typology of a Subacute Residential Mental Health Service Model. [Journal Article]
- FPFront Psychiatry 2019; 10:383
- CONCLUSIONS: Although PARC services were broadly similar, their identified differences suggest there is variable model implementation across Victoria sufficient to generate a PARC service typology. This typology may prove important for interpreting differences in outcomes experienced by consumers and carers using PARC services, when applied in our analyses of service effectiveness. The value of conducting service mapping and typology studies is underscored. Further research to characterize subacute residential services, including recovery-promoting features of the built environment, is warranted.
- Older people's mental health in rural areas: Converting policy into service development, service access and a sustainable workforce. [Journal Article]
- AJAust J Rural Health 2019 Jun 24
- This paper describes the older people's mental health workforce development, policy development and implementation process and quantifies the rural service delivery and access impacts over a 15-year …
This paper describes the older people's mental health workforce development, policy development and implementation process and quantifies the rural service delivery and access impacts over a 15-year period in New South Wales. It highlights the factors that are considered to be critical to successful rural service development such as commitment to funding parity, investment in strong local service leadership, and development of innovative, locally adapted rural service models. Building on these foundations, the Older People's Mental Health Program in New South Wales was able to address key challenges relating to service access in rural health and develop new, sustainable specialist older people's mental health service networks. A sustained focus on policy and implementation which explicitly supports rural older people's mental health service enhancement, and development of evidence-based models of care, has significantly improved access to specialist mental health care for older people in rural areas. It has delivered 23 new rural older people's mental health community teams and a 440% increase in the number of people accessing these teams. It has also doubled the number of acute inpatient units and established new specialist mental health-residential aged care partnership services in rural New South Wales. It has resulted in increased access to services for the "older old," while not diminishing older people's rates of access to general adult mental health services. It has also supported innovative, sustainable rural service models such as "hub and spoke" models and step-up step-down inpatient services that build on existing health and hospital infrastructure and link geographically dispersed specialist clinicians and services together in rural service delivery.
- The evacuation of two rural hospitals following a tsunami warning: What happened next. [Journal Article]
- JBJ Bus Contin Emer Plan 2019 Jan 01; 12(4):316-330
- This paper describes the lessons gained and actions taken following the evacuation of two small rural hospitals following a tsunami warning. These evacuations were unique in that the normal protocol …
This paper describes the lessons gained and actions taken following the evacuation of two small rural hospitals following a tsunami warning. These evacuations were unique in that the normal protocol to transfer within the health system was not feasible due to their geographical isolation. The after action review process provided valuable insight to all stakeholders, who entered into discussions to ensure procedures, supplies, equipment and arrangements would be put in place to support the safe and effective evacuation of patients in the event of a future emergency. A key component of this process was the after action report, which captured key lessons learned and actionable items pertaining to five areas: evacuation locations, equipment and supplies, hospital unit/department evacuation plans, site evacuation plans, and exercising and validating plans. Following this format, each lesson is broken down into steps taken to achieve these goals, outlining best practices and lived experiences or highlighting gaps where further research is required and step-by-step guidance that can be adapted by emergency managers within the field of healthcare. Through this, pertinent strategies and considerations involved in the planning and execution in the evacuation of rural hospitals are also offered.
- Source attribution of Campylobacter jejuni shows variable importance of chicken and ruminants reservoirs in non-invasive and invasive French clinical isolates. [Journal Article]
- SRSci Rep 2019 May 30; 9(1):8098
- Campylobacter jejuni is the most common cause of bacterial gastroenteritis worldwide. Mainly isolated from stool samples, C. jejuni can also become invasive. C. jejuni belongs to the commensal microb…
Campylobacter jejuni is the most common cause of bacterial gastroenteritis worldwide. Mainly isolated from stool samples, C. jejuni can also become invasive. C. jejuni belongs to the commensal microbiota of a number of hosts, and infection by this bacterium can sometimes be traced back to exposure to a specific source. Here we genome sequenced 200 clinical isolates (2010-2016) and analyzed them with 701 isolate genomes from human infection, chicken, ruminants and the environment to examine the relative contribution of different reservoirs to non-invasive and invasive infection in France. Host-segregating genetic markers that can discriminate C. jejuni source were used with STRUCTURE software to probabilistically attribute the source of clinical strains. A self-attribution correction step, based upon the accuracy of source apportionment within each potential reservoir, improved attribution accuracy of clinical strains and suggested an important role for ruminant reservoirs in non-invasive infection and a potentially increased contribution of chicken as a source of invasive isolates. Structured sampling of Campylobacter in the clinic and from potential reservoirs provided evidence for variation in the contribution of different infection sources over time and an important role for non-poultry reservoirs in France. This provides a basis for ongoing genomic epidemiology surveillance and targeted interventions.
- Clinical Opioid Withdrawal Scale (COWS): Implementation and Outcomes. [Journal Article]
- CCCrit Care Nurs Q 2019 Jul/Sep; 42(3):222-226
- The opioid crisis has shown evidence worldwide and locally. There was no protocol to detect opioid withdrawal at this organization. The purpose of this project was to develop a nursing-driven opioid …
The opioid crisis has shown evidence worldwide and locally. There was no protocol to detect opioid withdrawal at this organization. The purpose of this project was to develop a nursing-driven opioid withdrawal management tool using the validated Clinical Opioid Withdrawal Scale (COWS) to address an increase in opioid-addicted patients. Evidence-based practice change was executed using the San Diego 8A's method for adult trauma step-down patients experiencing opioid withdrawal with the COWS tool affecting frequency of nursing attempts at managing opioid withdrawal over an 8-week period. Training was provided to 45 nurses on COWS use in opioid-positive patients exhibiting withdrawal symptoms. Nurses were tested and retested to establish reliability. Nursing management included communication with MDs, safe opioid use education, social work consultation, use of nonopioid pain relief, or other symptomatic medication management. Nursing withdrawal management: pre-COWS = 25%; post-COWS = 96%. There was a statistically significant increase in the percentage of patients evaluated correctly following COWS initiation (n = 28, χ = 29, P < .0001, 95% CI, 47.71-83.74). Data were collected on a matched cohort of symptomatic toxicology-positive patients before and after change (n = 28 pre-COWS and n = 28 post-COWS). Use of the COWS tool with corresponding interventions by trauma nurses is feasible and results in improved withdrawal management.
- CE: Understanding the Complications of Sickle Cell Disease. [Journal Article]
- AJAm J Nurs 2019; 119(6):26-35
- : Sickle cell disease (SCD) is an autosomal recessive genetic condition that alters the shape and function of the hemoglobin molecule in red blood cells. While the overall survival rate among childre…
: Sickle cell disease (SCD) is an autosomal recessive genetic condition that alters the shape and function of the hemoglobin molecule in red blood cells. While the overall survival rate among children with SCD has improved in recent years, pediatric rates of hospitalization, ED use, and mortality from complications of SCD remain high. Among patients ages 18 and older, hospital admission and ED usage are even greater-and the median age at death of people with SCD is considerably lower than that of the general population. Nurses who care for patients with SCD have an opportunity to improve health outcomes and quality of life for these patients by recognizing the major SCD-associated complications and providing patients and their caregivers with appropriate educational information. The authors discuss the genetic, hematologic, and clinical features of SCD and describe the major associated health complications. In addition, they review the nursing implications of each complication and provide online links to resources for clinicians, patients, and caregivers.
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- Genetic Polymorphisms Affecting IDO1 or IDO2 Activity Differently Associate With Aspergillosis in Humans. [Journal Article]
- FIFront Immunol 2019; 10:890
- Aspergillus is the causative agent of human diseases ranging from asthma to invasive infection. Genetic and environmental factors are crucial in regulating the interaction between the host and Asperg…
Aspergillus is the causative agent of human diseases ranging from asthma to invasive infection. Genetic and environmental factors are crucial in regulating the interaction between the host and Aspergillus. The role played by the enzyme indoleamine 2,3-dioxygenase 1 (IDO1), which catalyzes the first and rate-limiting step of tryptophan catabolism along the kynurenine pathway, is increasingly being recognized, but whether and how genetic variation of IDO1 influences the risk of aspergillosis in susceptible patients is incompletely understood. In addition, whether the closely related protein IDO2 plays a similar role remains unexplored. In the present study, we performed genetic association studies in two different cohorts of susceptible patients [cystic fibrosis (CF) patients and recipients of hematopoietic stem cell transplantation (HSCT)], and identified IDO1 polymorphisms that associate with the risk of infection in both cohorts. By using human bronchial epithelial cells and PBMC from CF and HSCT patients, respectively, we could show that the IDO1 polymorphisms appeared to down-modulate IDO1 expression and function in response to IFNγ or Aspergillus conidia, and to associate with an increased inflammatory response. In contrast, IDO2 polymorphisms, including variants known to profoundly affect protein expression and function, were differently associated with the risk of aspergillosis in the two cohorts of patients as no association was found in CF patients as opposed to recipients of HSCT. By resorting to a murine model of bone marrow transplantation, we could show that the absence of IDO2 more severely affected fungal burden and lung pathology upon infection with Aspergillus as compared to IDO1, and this effect appeared to be linked to a deficit in the antifungal effector phagocytic activity. Thus, our study confirms and extends the role of IDO1 in the response to Aspergillus, and shed light on the possible involvement of IDO2 in specific clinical settings.