C-TERMINALLY ENCODED PEPTIDE (CEP) and cytokinin hormone signaling intersect to promote shallow lateral root angles.

Root system architecture (RSA) influences the acquisition of heterogeneously dispersed soil nutrients. Cytokinin and C-TERMINALLY ENCODED PEPTIDE (CEP) hormones affect RSA, in part by controlling the angle of lateral root (LR) growth. Both hormone pathways converge on CEP DOWNSTREAM 1 (CEPD1) and CEPD2 to control primary root growth; however, a role for CEPDs in controlling the growth angle of LRs is unknown. Using phenotyping combined with genetic and grafting approaches, we show that CEP hormone-mediated shallower LR growth requires cytokinin biosynthesis and perception in roots via ARABIDOPSIS HISTIDINE KINASE 2 (AHK2) and AHK3. Consistently, cytokinin biosynthesis and ahk2,3 mutants phenocopied the steeper root phenotype of cep receptor 1 (cepr1) mutants on agar plates, and CEPR1 was required for trans-Zeatin (tZ)-type cytokinin-mediated shallower LR growth. In addition, the cepd1,2 mutant was less sensitive to CEP and tZ, and showed basally steeper LRs on agar plates. Cytokinin and CEP pathway mutants were grown in rhizoboxes to define the role of these pathways in controlling RSA. Only cytokinin receptor mutants and cepd1,2 partially phenocopied the steeper-rooted phenotype of cepr1 mutants. These results show that CEP and cytokinin signaling intersect to promote shallower LR growth, but additional components contribute to the cepr1 phenotype in soil.

Mpox Knowledge, Attitudes, and Practices Among Persons Presenting for JYNNEOS Vaccination-District of Columbia, August to October 2022.

BACKGROUND: More than 30,000 mpox cases have been confirmed in the United States since May 2022. Mpox cases have disproportionally occurred among adult gay, bisexual, and other men who have sex with men; transgender persons; and Black and Hispanic/Latino persons. We examined knowledge, attitudes, and practices regarding mpox vaccination among adults presenting for vaccination to inform prevention efforts. METHODS: We collected mixed-methods data from a convenience sample of adults presenting for JYNNEOS vaccination at 3 DC Health mpox vaccine clinics during August-October 2022. Survey and interview topics included knowledge about mpox symptoms and vaccine protection, beliefs about vaccine access, and trusted sources of information. RESULTS: In total, 352 participants completed self-administered surveys and 62 participants completed an in-depth interview. Three main themes emerged from survey and interview data. First, most participants had a general understanding about mpox, but gaps remained in comprehensive understanding about mpox symptoms, modes of transmission, vaccine protection, personal risk, and vaccine dosing strategies. Second, participants had high trust in public health agencies. Third, participants wanted more equitable and less stigmatizing access to mpox vaccine services. CONCLUSIONS: Nonstigmatizing, inclusive, and clear communication from trusted sources, including public health agencies, is needed to address mpox knowledge gaps and increase vaccine access and uptake in affected communities. Mpox outreach efforts should continue innovative approaches, including person-level risk assessment tools, to address community needs.

CEP hormones at the nexus of nutrient acquisition and allocation, root development, and plant-microbe interactions.

A growing understanding is emerging of the roles of peptide hormones in local and long-distance signalling that coordinates plant growth and development as well as responses to the environment. C-TERMINALLY ENCODED PEPTIDE (CEP) signalling triggered by its interaction with CEP RECEPTOR 1 (CEPR1) is known to play roles in systemic nitrogen (N) demand signalling, legume nodulation, and root system architecture. Recent research provides further insight into how CEP signalling operates, which involves diverse downstream targets and interactions with other hormone pathways. Additionally, there is emerging evidence of CEP signalling playing roles in N allocation, root responses to carbon levels, the uptake of other soil nutrients such as phosphorus and sulfur, root responses to arbuscular mycorrhizal fungi, plant immunity, and reproductive development. These findings suggest that CEP signalling more broadly coordinates growth across the whole plant in response to diverse environmental cues. Moreover, CEP signalling and function appear to be conserved in angiosperms. We review recent advances in CEP biology with a focus on soil nutrient uptake, root system architecture and organogenesis, and roles in plant-microbe interactions. Furthermore, we address knowledge gaps and future directions in this research field.

CEP peptide and cytokinin pathways converge on CEPD glutaredoxins to inhibit root growth.

C-TERMINALLY ENCODED PEPTIDE (CEP) and cytokinin hormones act over short and long distances to control plant responses to environmental cues. CEP and cytokinin pathway mutants share phenotypes, however, it is not known if these pathways intersect. We show that CEP and cytokinin signalling converge on CEP DOWNSTREAM (CEPD) glutaredoxins to inhibit primary root growth. CEP inhibition of root growth was impaired in mutants defective in trans-zeatin (tZ)-type cytokinin biosynthesis, transport, perception, and output. Concordantly, mutants affected in CEP RECEPTOR 1 showed reduced root growth inhibition in response to tZ, and altered levels of tZ-type cytokinins. Grafting and organ-specific hormone treatments showed that tZ-mediated root growth inhibition involved CEPD activity in roots. By contrast, root growth inhibition by CEP depended on shoot CEPD function. The results demonstrate that CEP and cytokinin pathways intersect, and utilise signalling circuits in separate organs involving common glutaredoxin genes to coordinate root growth.

Automated Sexual History and Self-Collection of Extragenital Chlamydia and Gonorrhea Improve Detection of Bacterial Sexually Transmitted Infections in People with HIV.

With consistently rising rates of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) since 2014, the need for increased screening, testing, and treatment of bacterial sexually transmitted infections (STIs) in people at risk is clear. In this study, people with HIV were asked to complete a comprehensive audio computer-assisted self-interview sexual history at routine clinic-based laboratory visits every 3-6 months. The sexual health screening resulted in an automated summary of recommended bacterial STI tests. Self-collection of recommended extragenital CT/GC specimens was implemented to decrease the need for a provider to collect the specimen(s) and to give more control to the client. In total, extragenital CT/GC testing returned a 7.3% (n = 11) test positivity for CT and/or GC, with the highest test positivity of 14% (n = 7) among rectal swabs and 4% (n = 4) for pharyngeal swabs. Urogenital testing for combined CT/GC returned a 4.8% (n = 11) test positivity. All participants with extragenital CT/GC who underwent simultaneous urine testing returned discordant laboratory results, with urine collected at the same clinic visit resulting as negative. In addition, 7 of 11 (63.6%) of the positive extragenital GC/CT cases were asymptomatic. Therefore, extragenital site-specific testing was essential in appropriately diagnosing and treating CT and GC among participants. When extragenital STI testing was recommended, participants needing extragenital CT/GC specimens primarily chose self-collection after a brief demonstration. Error rates between self- versus provider-collected samples did not differ, and participants provided positive feedback on the intervention and self-collection process in satisfaction surveys taken at the end of each visit.

A new method to visualize CEP hormone-CEP receptor interactions in vascular tissue in vivo.

C-TERMINALLY ENCODED PEPTIDEs (CEPs) control diverse responses in plants including root development, root system architecture, nitrogen demand signalling, and nutrient allocation that influences yield, and there is evidence that different ligands impart different phenotypic responses. Thus, there is a need for a simple method that identifies bona fide CEP hormone-receptor pairings in vivo and examines whether different CEP family peptides bind the same receptor. We used formaldehyde or photoactivation to cross-link fluorescently tagged group 1 or group 2 CEPs to receptors in semi-purified Medicago truncatula or Arabidopsis thaliana leaf vascular tissues to verify that COMPACT ROOT ARCHITECTURE 2 (CRA2) is the Medicago CEP receptor, and to investigate whether sequence diversity within the CEP family influences receptor binding. Formaldehyde cross-linked the fluorescein isothiocyanate (FITC)-tagged Medicago group 1 CEP (MtCEP1) to wild-type Medicago or Arabidopsis vascular tissue cells, but not to the CEP receptor mutants, cra2 or cepr1. Binding competition showed that unlabelled MtCEP1 displaces FITC-MtCEP1 from CRA2. In contrast, the group 2 CEP, FITC-AtCEP14, bound to vascular tissue independently of CEPR1 or CRA2, and AtCEP14 did not complete with FITC-MtCEP1 to bind CEP receptors. The binding of a photoactivatable FITC-MtCEP1 to the periphery of Medicago vascular cells suggested that CRA2 localizes to the plasma membrane. We separated and visualized a fluorescent 105 kDa protein corresponding to the photo-cross-linked FITC-MtCEP1-CRA2 complex using SDS-PAGE. Mass spectrometry identified CRA2-specific peptides in this protein band. The results indicate that FITC-MtCEP1 binds to CRA2, MtCRA2 and AtCEPR1 are functionally equivalent, and the binding specificities of group 1 and group 2 CEPs are distinct. Using formaldehyde or photoactivated cross-linking of biologically active, fluorescently tagged ligands may find wider utility by identifying CEP-CEP receptor pairings in diverse plants.

Evaluation of the time to desensitization of the larynx of cats following topical lidocaine application.

OBJECTIVES: The objective of this study was to evaluate the time to decreased reactivity of the arytenoid cartilages in cats after application of topical lidocaine. METHODS: One hundred and ten mixed-breed cats were randomly assigned to one of five groups based on the time between application of lidocaine and stimulation of the larynx: 5 (T5), 15 (T15), 30 (T30), 45 (T45) or 60 (T60) s. Cats were premedicated with dexmedetomidine, ketamine and buprenorphine. Anesthesia was induced with propofol to effect. Lidocaine 2% (2 mg/kg) was applied topically to the vocal cords using a catheter attached to a syringe under direct laryngoscopy. After lidocaine application, the designated time elapsed and the vocal cords were stimulated with the patient end of an endotracheal tube. Severity of reaction was reported as none, mild, moderate or severe. All cats were intubated after the reactivity score was recorded. Anesthesia was maintained with isoflurane and 100% oxygen while cats were spayed or castrated. Cats were monitored in recovery for signs of respiratory complications and pain. RESULTS: There was a significant difference in overall reactivity score between T5 and T45 (P = 0.0038). Also, there was a significant difference in the number of cats with no reaction compared with cats with any reaction between T5 and T30 (P = 0.03), as well as between T5 and T45 (P = 0.0028). No cat had a severe reactivity score at T45 or T60. All cats were successfully intubated. There were no complications during intubation, maintenance of anesthesia or recovery. CONCLUSIONS AND RELEVANCE: As the lowest overall reactivity score occurred at T45, it is recommended to wait at least 45 s after application of topical lidocaine before attempting tracheal intubation.

The Peptide Hormone Receptor CEPR1 Functions in the Reproductive Tissue to Control Seed Size and Yield.

The interaction of C-TERMINALLY ENCODED PEPTIDES (CEPs) with CEP RECEPTOR1 (CEPR1) controls root growth and development, as well as nitrate uptake, but has no known role in determining yield. We used physiological, microscopic, molecular, and grafting approaches to demonstrate a reproductive tissue-specific role for CEPR1 in controlling yield and seed size. Independent Arabidopsis (Arabidopsis thaliana) cepr1 null mutants showed disproportionately large reductions in yield and seed size relative to their decreased vegetative growth. These yield defects correlated with compromised reproductive development predominantly in female tissues, as well as chlorosis, and the accumulation of anthocyanins in cepr1 reproductive tissues. The thinning of competing reproductive organs to improve source-to-sink ratios in cepr1, along with reciprocal bolt-grafting experiments, demonstrated that CEPR1 acts locally in the reproductive bolt to control yield and seed size. CEPR1 is expressed throughout the vasculature of reproductive organs, including in the chalazal seed coat, but not in other seed tissues. This expression pattern implies that CEPR1 controls yield and seed size from the maternal tissue. The complementation of cepr1 mutants with transgenic CEPR1 rescued the yield and other phenotypes. Transcriptional analyses of cepr1 bolts showed alterations in the expression levels of several genes of the CEP-CEPR1 and nitrogen homeostasis pathways. This transcriptional profile was consistent with cepr1 bolts being nitrogen deficient and with a reproductive tissue-specific function for CEP-CEPR1 signaling. The results reveal a local role for CEPR1 in the maternal reproductive tissue in determining seed size and yield, likely via the control of nitrogen delivery to the reproductive sinks.

CEP receptor signalling controls root system architecture in Arabidopsis and Medicago.

Root system architecture (RSA) influences the effectiveness of resources acquisition from soils but the genetic networks that control RSA remain largely unclear. We used rhizoboxes, X-ray computed tomography, grafting, auxin transport measurements and hormone quantification to demonstrate that Arabidopsis and Medicago CEP (C-TERMINALLY ENCODED PEPTIDE)-CEP RECEPTOR signalling controls RSA, the gravitropic set-point angle (GSA) of lateral roots (LRs), auxin levels and auxin transport. We showed that soil-grown Arabidopsis and Medicago CEP receptor mutants have a narrower RSA, which results from a steeper LR GSA. Grafting showed that CEPR1 in the shoot controls GSA. CEP receptor mutants exhibited an increase in rootward auxin transport and elevated shoot auxin levels. Consistently, the application of auxin to wild-type shoots induced a steeper GSA and auxin transport inhibitors counteracted the CEP receptor mutant's steep GSA phenotype. Concordantly, CEP peptides increased GSA and inhibited rootward auxin transport in wild-type but not in CEP receptor mutants. The results indicated that CEP-CEP receptor-dependent signalling outputs in Arabidopsis and Medicago control overall RSA, LR GSA, shoot auxin levels and rootward auxin transport. We propose that manipulating CEP signalling strength or CEP receptor downstream targets may provide means to alter RSA.

CEP3 levels affect starvation-related growth responses of the primary root.

CEPs (C-TERMINALLY ENCODED PEPTIDEs) inhibit Arabidopsis primary root growth by unknown mechanisms. We investigated how CEP3 levels control primary root growth. CEP3 peptide application decreased cell division, S-phase cell number, root meristematic cell number, and meristem zone (MZ) size in a dose- and CEP RECEPTOR1-dependent manner. Grafting showed that CEP3-dependent growth inhibition requires root and shoot CEPR1. CEP3 induced mitotic quiescence in MZ cells significantly faster than that induced by nutrient limitation alone. CEP3 also inhibited the restoration of S-phase to mitotically quiescence cells by nutrient resupply without quantitatively reducing TARGET OF RAPAMYCIN (TOR) kinase activity. In contrast, cep3-1 had an increased meristem size and S-phase cell number under nitrogen (N)-limited conditions, but not under N-sufficient conditions. Furthermore, cep3-1 meristematic cells remained in S-phase longer than wild-type cells during a sustained carbon (C) and N limitation. RNA sequencing showed that CEP3 peptide down-regulated genes involved in S-phase entry, cell wall and ribosome biogenesis, DNA replication, and meristem expansion, and up-regulated genes involved in catabolic processes and proteins and peptides that negatively control meristem expansion and root growth. Many of these genes were reciprocally regulated in cep3-1. The results suggest that raising CEP3 induces starvation-related responses that curtail primary root growth under severe nutrient limitation.

CEP-CEPR1 signalling inhibits the sucrose-dependent enhancement of lateral root growth.

Lateral root (LR) proliferation is a major determinant of soil nutrient uptake. How resource allocation controls the extent of LR growth remains unresolved. We used genetic, physiological, transcriptomic, and grafting approaches to define a role for C-TERMINALLY ENCODED PEPTIDE RECEPTOR 1 (CEPR1) in controlling sucrose-dependent LR growth. CEPR1 inhibited LR growth in response to applied sucrose, other metabolizable sugars, and elevated light intensity. Pathways through CEPR1 restricted LR growth by reducing LR meristem size and the length of mature LR cells. RNA-sequencing of wild-type (WT) and cepr1-1 roots with or without sucrose treatment revealed an intersection of CEP-CEPR1 signalling with the sucrose transcriptional response. Sucrose up-regulated several CEP genes, supporting a specific role for CEP-CEPR1 in the response to sucrose. Moreover, genes with basally perturbed expression in cepr1-1 overlap with WT sucrose-responsive genes significantly. We found that exogenous CEP inhibited LR growth via CEPR1 by reducing LR meristem size and mature cell length. This result is consistent with CEP-CEPR1 acting to curtail the extent of sucrose-dependent LR growth. Reciprocal grafting indicates that LR growth inhibition requires CEPR1 in both the roots and shoots. Our results reveal a new role for CEP-CEPR1 signalling in controlling LR growth in response to sucrose.

Perceived water insecurity among adults from urban and peri-urban Haiti: A qualitative study.

Water and sanitation services are fundamental in preventing the spread of waterborne and hygiene-related diseases. However, in developing countries, such as Haiti, access to clean water continues to pose major challenges despite efforts to improve quality and reduce distance. With Léogâne being the epicenter of the earthquake in Haiti in 2010, there were dozens of interventions aimed to improve access to clean water, specifically well construction and use of water treatment strategies. Using the socioecological framework, this study collected qualitative data to supplement a household water insecurity experiences (HWISE) survey in order to fully understand the narratives around water in Léogâne (urban) and its neighboring commune Gressier (peri-urban). The inclusion criteria for this study was that the participant must be a resident of either site, at least 18 years or older, and a female. Only females were included in this study so that researchers could better understand how perceived water insecurity impacts reproductive health, specifically gynecological infections. This cross-sectional study yielded 61 total in-depth interviews using a semi-structured open ended questionnaire to allow participants the ability to elaborate. Results suggest that there are common misconceptions about water and reproductive health specifically that engaging in sexual intercourse in saltwater will not result in pregnancy. Relevant narratives among the two communes included water acquisition, use of water, and bathing practices, among several others. Through understanding the local Haitian perspective and practices that surround water insecurity, we can better tailor public health interventions to improve access to water, female hygiene practices, and ultimately lower and prevent disease transmission.

Perceptions of water insecurity from urban and peri-urban Haiti: A quantitative analysis.

Safe drinking water access has continued to be a growing issue in Haiti. Water accessibility, availability, and quality can have severe implications on health and safety, with those in urban areas often having more access. Key differences relating to water accessibility can be seen between the urban and peri-urban areas of Haiti. One major objective of this research is to examine the disparities between the two areas and determine limiting and enabling factors that are contributing to the perceived access to clean water. A cross-cultural household water insecurity experiences (HWISE) survey (n = 499) was distributed to determine barriers and accessibility to sufficient water quality and quantity at the household level. This paper explores the relationship between water insecurity between two urban and peri-urban communes in Haiti using this data. Fisher's Exact and Kruskal-Wallis tests were used to identify significant differences between strata, and logistic regression was used to determine significant associations with water security outcomes. Results indicated there were differences in both the costs and the sources of drinking and non-drinking water between urban and peri-urban Haiti. Certain demographic and behavioral characteristics were associated with increased water insecurity, including a household size greater than five and experiencing injury during collection.

Knowledge that Acts: Evaluating the Outcomes of a Knowledge Brokering Intervention in Western Australia's Ningaloo Region.

Knowledge exchange involves a suite of strategies used to bridge the divides between research, policy and practice. The literature is increasingly focused on the notion that knowledge generated by research is more useful when there is significant interaction and knowledge sharing between researchers and research recipients (i.e., stakeholders). This is exemplified by increasing calls for the use of knowledge brokers to facilitate interaction and flow of information between scientists and stakeholder groups, and the integration of scientific and local knowledge. However, most of the environmental management literature focuses on explicit forms of knowledge, leaving unmeasured the tacit relational and reflective forms of knowledge that lead people to change their behaviour. In addition, despite the high transaction costs of knowledge brokering and related stakeholder engagement, there is little research on its effectiveness. We apply Park's Manag Learn 30(2), 141-157 (1999); Knowledge and Participatory Research, London: SAGE Publications (2006) tri-partite knowledge typology as a basis for evaluating the effectiveness of knowledge brokering in the context of a large multi-agency research programme in Australia's Ningaloo coastal region, and for testing the assumption that higher levels of interaction between scientists and stakeholders lead to improved knowledge exchange. While the knowledge brokering intervention substantively increased relational networks between scientists and stakeholders, it did not generate anticipated increases in stakeholder knowledge or research application, indicating that more prolonged stakeholder engagement was required, and/or that there was a flaw in the assumptions underpinning our conceptual framework.

Preoperative skin antiseptics for preventing surgical site infections: what to do?

BACKGROUND: Safe and effective patient preoperative skin antisepsis is recommended to prevent surgical site infections (SSIs), reduce patient morbidity, and reduce systemic costs. However, there is lack of consensus among best practice recommendations regarding the optimal skin antiseptic solution and method of application. METHODS: In 2010 and 2011 the health technology appraisal committee of the Surgery Operational Clinical Network (SOCN), of Alberta Health Services (AHS), conducted an environmental scan to determine the current preoperative skin antisepsis in Alberta, reviewed key publications and existing guidelines, and requested a systematic review from the Canadian Agency for Drugs and Technologies in Health (CADTH). Using this information, and an established protocol for evidence-informed recommendations, the health technology appraisal committee made recommendations that were, in 2012, reviewed and endorsed by the SOCN executive and the AHS-Infection Prevention and Control (IPC) group. RESULTS: The environmental scan revealed practice variation in the types of antiseptic solutions and application methods being used in the 18 Alberta hospitals surveyed. The systematic review suggested that preoperative antiseptic showering reduces skin flora but the effect on SSI rates was inconclusive. While the review found no conclusive evidence to recommend an optimal antiseptic solution or application method, the results of two large randomized controlled trials suggest that chlorhexidine in 70% alcohol is more effective than povidone iodine in the prevention of SSIs. These results and the recommendations from Safer Healthcare Now!, a program of the Canadian Patient Safety Institute (CPSI), were used to inform the recommendations for AHS. These recommendations included abandoning preoperative showering with antiseptics except for special cases (high-risk surgeries such as sternotomies and implants as recommended by IPC) and standardizing skin antiseptic application methods and solution to chlorhexidine (CHG) in 70% alcohol. The exception would be procedures involving the ear, eye, mouth, mucous membranes, neural tissue, infants and emergent trauma cases where povidine iodine should be used. CONCLUSION: Using the best available evidence it was recommended that AHS standardize surgical skin antisepsis to 2% CHG in 70% alcohol as the preferred antiseptic and povidone iodine, as an alternative when CHG is contraindicated, to reduce SSIs, practice variation, and health care costs. Further research is required to determine the optimal skin antiseptic solution to reduce SSIs.

"Measurement Monday": one facility's approach to standardizing skin impairment documentation.

Accurate, timely wound assessment and documentation is fundamental to nursing practice. A 2005 retrospective chart audit (N = 54) at a rural, 238-bed tertiary care facility in Northeastern Pennsylvania (average daily census 175 to 180) found that complete wound assessment documentation (including measurements) was lacking in 59% of patient charts. The purpose of this quality improvement initiative, led by the Wound Ostomy Continence Nurse (WOCN), was to evaluate and improve nursing assessment and documentation of impaired skin (pressure ulcers, skin tears, open surgical wounds, diabetic ulcers, and venous stasis ulcers). A review of the literature confirmed the importance of consistency, which led to the hospital-wide implementation of education programs and "Measurement Monday." Using AHCPR guidelines of care for pressure ulcers and beginning in January 2006 all wounds were assessed and measured every Monday and the proportion of incomplete charts declined to 38%. Following addition of a wound documentation tool in 2007, the proportion of incomplete records was 14.8%. This quality improvement initiative improved the quality and consistency of wound assessment/measurement and documentation.