A qualitative analysis of post-hoc interviews with multilevel participants of a randomized controlled trial of a community-based intervention.

INTRODUCTION: Community-based health interventions often demonstrate efficacy in clinical trial settings but fail to be implemented in the real-world. We sought to identify the key operational and contextual elements of the Los Angeles Barbershop Blood Pressure Study (LABBPS), an objectively successful community-based health intervention primed for real-world implementation. LABBPS was a cluster randomized control trial that paired the barbers of Black-owned barbershops with clinical pharmacists to manage uncontrolled hypertension in Black male patrons, demonstrating a substantial 21.6 mmHg reduction in systolic blood pressure. Despite this success, the LABBPS intervention has not expanded beyond the original clinical trial setting. The aim of this study was to determine the facilitating and limiting factors to expansion of the LABBPS intervention. METHODS: We undertook a qualitative assessment of semi-structured interviews with study participants performed after trial completion. Interviews included a total of 31 participants including 20 (6%) of the 319 LABBPS program participants ("patrons"), 10 (19%) barbers, and one (50%) clinical pharmacist. The semi-structured interviews were focused on perceptions of the medical system, study intervention, and influence of social factors on health. RESULTS: Several common themes emerged from thematic analysis of interview responses including: importance of care provided in a convenient and safe environment, individual responsibility for health and health-related behaviors, and engagement of trusted community members. In particular, patrons reported that receiving the intervention from their barber in a familiar environment positively influenced the formation of relationships with clinical pharmacists around shared efforts to improve medication adherence and healthy habits. All interviewee groups identified the trust diad, comprising the familiar environment and respected community member, as instrumental in increasing health-related behaviors to a degree not usually achieved by traditional healthcare providers. DISCUSSION: In conclusion, participants of an objectively successful community-based intervention trial consistently identified key features that could facilitate wider implementation and efficacy: social trust relationships, soliciting insights of trust bearers, and consistent engagement in a familiar community setting. These findings can help to inform the design and operations of future community-based studies and programs aiming to achieve a broad and sustainable impact.

Results From La Vida Buena (The Good Life): A Quasi-Experimental Intervention of a Community Health Worker-Led Family-Based Childhood Obesity Program for Latino Children 5-8 Years of Age on the U.S.-Mexico Border.

OBJECTIVE: To evaluate the effectiveness of the 8-week, community health worker (CHW)-led La Vida Buena childhood obesity program among Latino children 5 to 8 years old in a rural county along the U.S.-Mexico border. METHODS: This quasi-experimental study used a community-based participatory research approach to compare the effectiveness of the La Vida Buena (The Good Life) curriculum as compared with a single educational session. We took anthropomorphic measures and administered parent-reported nutrition and physical activity surveys at baseline, 3 months, and 6 months. The study took place between 2017 and 2020 in Santa Cruz County, Arizona. RESULTS: Change in body mass index (BMI) z-score was negligible for both groups. The parent-reported behavior indicated a shift toward healthier family behaviors and environment in the intervention group. IMPLICATIONS FOR PRACTICE: This study adds to the growing literature of CHW-led childhood obesity interventions. The engagement of the CHWs in all aspects of the intervention helped to facilitate important behavior changes. Future interventions should emphasize health and wellness rather than BMI z-score and include community, socioeconomic, and systems-level interventions to promote healthy environments.

High methylmercury uptake by green algae in Lake Titicaca: Potential implications for remediation.

Anthropogenic pressure in the high altitude lakes such as Titicaca and Uru (Bolivia) may favor the production of methylmercury (MeHg) known to accumulate in trophic chains. Periphyton associated with emerged aquatic plants (totoras) from the lake shores accumulates and demethylates MeHg providing a potential cost-effective water treatment technique. In this laboratory study, we measured the MeHg uptake kinetics of a consortium of green algae isolated from Lake Titicaca totora's periphyton. The most abundant algal consortium, composed of Oedogonium spp., Chlorella spp., Scenedesmus spp., was exposed to rising MeHg concentrations (from 5 to 200 ng·L-1) to assess their maximum potential capacity for MeHg accumulation. Various algal biomass concentrations were tested to choose the optimal one. Results provided a net MeHg uptake rate by this algal consortium of 2.38 amol ng-1·h-1·nM-1 (the total uptake was 2863 ng MeHg·g-1) for an initial concentration of 200 ng MeHg·L-1 with an algal biomass concentration of 0.02 g·L-1. This initial MeHg concentration is 1000 times higher than the one measured in the eutrophic Cohana Bay of Lake Titicaca, which shows the high accumulation potential of these green algae. Our data suggest that periphyton has a high potential for the treatment of Hg contaminated waters in constructing wetlands in the Andean Altiplano.

Juvenile â€Å“idiopathic†arthritis (JIA) as a manifestation of food allergy. Case study.

Studies linking type of diet and juvenile idiopathic arthritis (JIA) have variable results and are inconsistent. This case shows an evolution which fulfilled the criteria of JIA, but was diagnosed as food allergy. Case: A seven-year old boy had fever, arthralgia, general malaise, headaches, abdominal pain and rashes. These symptoms were diagnosed as fever of unknown origin (FUO) and probable JIA. There was a stabbing pain in the right iliac fossa. An upper and lower endoscopy were performed and nodular ileocolitis was detected. A hypoallergenic diet was prescribed, in addition to mesalazine and oral corticosteroids. The patient was asymptomatic for 2.5 months and then relapsed with all symptoms after consuming dairy. This JIA case shows the diagnostic phases of food allergy: improvement and recurrence of symptoms with the reintroduction of the allergen (oral challenge=gold standard of food allergy). There is evidence that supports the existence of a gut-joint axis, where the luminal content triggers a series of immunologically mediated reactions that can cause systemic diseases such as J other connective tissue diseases. This case report adds reasonable evidence in support of food allergy as a cause of JIA.

Juvenile "idiopathic" arthritis (JIA) as a manifestation of food allergy. Case Study / Alergia alimentaria artritis reumatoidea juvenil. Reporte de un caso

ABSTRACT Studies linking type of diet and juvenile idiopathic arthritis (JIA) have variable results and are inconsistent. This case shows an evolution which fulfilled the criteria of JIA, but was diagnosed as food allergy. Case: A seven-year old boy had fever, arthralgia, general malaise, headaches, abdominal pain and rashes. These symptoms were diagnosed as fever of unknown origin (FUO) and probable JIA. There was a stabbing pain in the right iliac fossa. An upper and lower endoscopy were performed and nodular ileocolitis was detected. A hypoallergenic diet was prescribed, in addition to mesalazine and oral corticosteroids. The patient was asymptomatic for 2.5 months and then relapsed with all symptoms after consuming dairy. This JIA case shows the diagnostic phases of food allergy: improvement and recurrence of symptoms with the reintroduction of the allergen (oral challenge=gold standard of food allergy). There is evidence that supports the existence of a gut-joint axis, where the luminal content triggers a series of immunologically mediated reactions that can cause systemic diseases such as JIA and other connective tissue diseases. This case report adds reasonable evidence in support of food allergy as a cause of JIA.

RESUMEN Los estudios que relacionan el tipo de dieta y la artritis idiopática juvenil (AIJ) tienen resultados variables y son inconsistentes. Este caso muestra una evolución que cumplió con los criterios de AIJ, pero fue diagnosticada como alergia alimentaria. Caso: Un niño de siete años tenía fiebre, artralgia, malestar general, dolores de cabeza, dolor abdominal y erupciones cutáneas. Estos síntomas fueron diagnosticados como fiebre de origen desconocido (FUO) y probable AIJ. Hubo un dolor punzante en la fosa ilíaca derecha. Se realizó una endoscopia superior e inferior y se detectó ileocolitis nodular. Se prescribió una dieta hipoalergénica, además de mesalazina y corticosteroides orales. El paciente estuvo asintomático durante 2,5 meses y luego recayó con todos los síntomas después de consumir lácteos. Este caso de AIJ muestra las fases diagnósticas de la alergia alimentaria: mejora y recurrencia de los síntomas con la reintroducción del alergeno (desafío oral = estándar de oro de alergia alimentaria). Existe evidencia que respalda la existencia de un eje de la articulación intestinal, donde el contenido luminal desencadena una serie de reacciones inmunológicamente mediadas que pueden causar enfermedades sistémicas como la AIJ y otras enfermedades del tejido conectivo. Este informe del caso agrega evidencia razonable en apoyo de la alergia a los alimentos como causa de AIJ.

Adsorption of cadmium by a high-capacity adsorbent composed of silicate-titanate nanotubes embedded in hydrogel chitosan beads.

In this study, we developed a nanoparticle-based mesoporous composite that consisted of silicate-titanate nanotubes (STNTs) supported in hydrogel chitosan beads (STNTs-Ch beads) and was studied for Cd2+ adsorption. By using Fourier-transform infrared spectroscopy, transmission and scanning electron microscopy coupled to an energy-dispersive X-ray spectrometer, we could determine that the hollow STNTs were highly dispersed in the walls of the hollow beads. The dispersion was attributed to the effect of pH when the composite was prepared and we observed a non-interaction between STNTs and chitosan. The adsorption studies of Cd2+ showed that the kinetic rate (k 2) increased 3-fold and that the diffusion rate (K d) increased 2-fold after the embedment. Moreover, the maximum capacity of adsorption of STNTs-Ch beads was 2.3 times higher than that of STNTs alone. The treatment of a synthetic Cd2+ solution and a real leachate in continuous mode showed two phases in which it was observed higher removed fractions of transition metal ions (Cd2+, Co2+, Ni2+, Zn2+ and Cu2+) and the post-transition metal ion Pb2+, in comparison to the removed fractions of alkali and alkali-earth metal ions (Ca2+, K+, Mg2+). The composite was successfully reused four times when adsorbing Cd2+, saving three times the needed amounts of TiO2, SiO2 and chitosan for the production of the material. This composite was produced in a simple way and shows the potential for wastewater treatment.

Polymorphs of the antiviral drug ganciclovir.

Ganciclovir (GCV; systematic name: 2-amino-9-{[(1,3-dihydroxypropan-2-yl)oxy]methyl}-6,9-dihydro-1H-purin-6-one), C9H13N5O4, an antiviral drug for treating cytomegalovirus infections, has two known polymorphs (Forms I and II), but only the structure of the metastable Form II has been reported [Kawamura & Hirayama (2009). X-ray Struct. Anal. Online, 25, 51-52]. We describe a successful preparation of GCV Form I and its crystal structure. GCV is an achiral molecule in the sense that its individual conformers, which are generally chiral objects, undergo fast interconversion in the liquid state and cannot be isolated. In the crystalline state, GCV exists as two inversion-related conformers in Form I and as a single chiral conformer in Form II. This situation is similar to that observed for glycine, also an achiral molecule, whose α-polymorph contains two inversion-related conformers, while the γ-polymorph contains a single conformer that is chiral. The hydrogen bonds are exclusively intermolecular in Form I, but both inter- and intramolecular in Form II, which accounts for the different molecular conformations in the two polymorphs.

Tratamiento de periodontitis en pacientes con artritis reumatoidea: Una revisión sistemática de ensayos clínicos controlados / Treatment of periodontitis in patients with rheumatoid arthritis: A systematic review of clinical trials

Objetivos: Evaluar el efecto del tratamiento periodontal sobre la artritis reumatoide. Material y Métodos: Se realizó una búsqueda electrónica de ensayos clínicos publicados desde junio de 2009 hasta junio de 2014 en PUBMED, Cochrane y manual en las revistas de Periodoncia con más alto factor de impacto según el ISI web of science: Journal of Clinical Periodontology, Journal of Periodontology, Journal of Periodontal Research y The international Journal of Periodontics and Restorative Dentistry. La búsqueda fue realizada por dos operadores calibrados de manera independiente. Resultados: Se encontraron cuatro artículos del tipo ensayos clínicos, tres randomizados y uno controlado. El tratamiento periodontal redujo los signos y síntomas de la artritis reumatoidea mediante la valoración de marcadores séricos. La evaluación del riesgo de sesgo de los artículos incluídos fue alto. Conclusiones: Aparentemente la terapia periodontal aunada a la terapia sistémica de la artritis reumatoidea mejora el estado sistémico del paciente.

Objectives: To evaluate the effect of periodontal treatment on rheumatoid arthritis. Material and Methods: An electronic search was realized in PubMed, The Cochrane Library and manual search of the most important journals of Periodontology with the highest impact factor according to the ISI web of science: Journal of Clinical Periodontology, Journal of Periodontology, Journal of Periodontal Research and The International Journal of Periodontics and Restorative Dentistry. The search was performed by two operators independently calibrated. Results: We found four clinical trials, three of them were randomized and one was controlled. The periodontal treatment reduced the signs and symptoms of rheumatoid arthritis by assessing serum markers. Assessment of risk of bias of included articles was high. Conclusions: Apparently periodontal therapy combined with systemic therapy of rheumatoid arthritis improve patient status.

Caracterização do estado sólido de ganciclovir / Solid state characterization of ganciclovir

O presente trabalho teve como objetivo o estudo do estado sólido do ganciclovir (GCV) e suas diferentes formas polimórficas. O GCV é um fármaco antiviral útil no tratamento de infecções por citomegalovírus (CMV). Embora seja um fármaco amplamente usado, poucos estudos têm sido realizados sobre seu estado sólido. Atualmente, o GCV é conhecido por apresentar quatro formas cristalinas, duas anidras (Forma I e II) e duas hidratas (III e IV). Neste trabalho, nós reportamos a solução da estrutura cristalográfica da Forma I do GCV, que foi encontrado durante o screening de cristalização do fármaco, em que nove ensaios de cristalização (GCV-1, GCV-A, GCV-B, GCV-C, GCV-D, GCV-E, GCV-F, GCV-G e GCV-H) foram realizados e os materiais resultantes foram caracterizados por Difratometria de raios X (DRX), análise térmica (DTA/TG) e Hot Stage Microscopy. De todas as cristalizações realizadas foram obtidas quatro formas sólidas, denominadas como Forma I (GCV-1, GCV-B e GCV-H), Forma III (GCV-C, GCV-D, GCV-F e GCV-G), Forma IV (GCV-A) e Forma V (GCV-E). Esta última está sendo descrita pela primeira vez na literatura e indica a presença de outra forma hidratada de GCV. As Formas I, III e IV corresponderam a forma anidra e as duas formas hidratadas do fármaco, respectivamente. Além disso, foi evidenciado por experimentos de conversão de slurry e análise térmica que o cristalizado de GCV-1 (Forma I) foi o mais estável entre os materiais obtidos, e este deu origem ao monocristal da Forma I de GCV, estrutura cristalina anidra do fármaco. Neste trabalho, pela primeira vez, a estrutura cristalina deste composto foi definida por cristalografia de raios X de monocristal. A análise estrutural mostrou que a Forma I do fármaco cristaliza no grupo espacial monoclínico P21/c e está composta por quatro moléculas de GCV na sua unidade assimétrica. Cada molécula está unida intermolecularmente por ligações de hidrogênio, que dão lugar à formação de cadeias infinitas e estas por sua vez se arranjam de maneira a formar uma estrutura tridimensional.

This presented work aims to study the solid state of ganciclovir (GCV) and its different polymorphic forms. GCV is an antiviral drug useful in the treatment of cytomegalovirus (CMV) infections. Although it is a widely-used drug, few studies have been conducted on its solid state. Currently, GCV is known to have four crystalline forms, two anhydrous (Form I and II) and two hydrates (III and IV). In this investigation, we report a successful preparation of GCV Form I and its crystallographic structure, which was found during the crystallization of the drug, in which nine crystallization tests (GCV-1, GCV-A, GCV-B, GCV- D, GCV-E, GCV-F, GCV-G and GCV-H) were performed and the resulting materials were characterized by X-ray diffractometry (XRD), thermal analysis (DTA/TG) and Hot Stage Microscopy. Of all the crystallizations performed, four solid forms were obtained, denoted as Form I (GCV-1, GCV-B and GCV- H), Form III (GCV-C, GCV-D, GCV-F and GCV-G), Form IV (GCV-A) and Form V (GCV-E). The latter is being described for the first time in the literature and indicates the presence of another hydrated form of GCV. Forms I, III and IV corresponded to the anhydrous form and the two hydrated forms of the drug, respectively. In addition, it was evident by both the slurry conversion and the thermal analysis methods that the GCV-1 crystallized (Form I) was indeed the most stable amongst the materials obtained. This gave rise to GCV Form I monocrystal, anhydrous crystalline structure of the drug. The compound was characterized by monocrystal X-ray crystallography. The structural analysis showed that Form I of the drug crystallized in the monoclinic system space group P21/c is composed of four molecules of GCV in its asymmetric unit. Each molecule is linked intermolecularly by hydrogen bonds, which give rise to the formation of infinite chains arranged in a way that form a three-dimensional structure.

The Selective Estrogen Receptor Modulator Raloxifene Inhibits Neutrophil Extracellular Trap Formation.

Raloxifene is a selective estrogen receptor modulator typically prescribed for the prevention/treatment of osteoporosis in postmenopausal women. Although raloxifene is known to have anti-inflammatory properties, its effects on human neutrophils, the primary phagocytic leukocytes of the immune system, remain poorly understood. Here, through a screen of pharmacologically active small molecules, we find that raloxifene prevents neutrophil cell death in response to the classical activator phorbol 12-myristate 13-acetate (PMA), a compound known to induce formation of DNA-based neutrophil extracellular traps (NETs). Inhibition of PMA-induced NET production by raloxifene was confirmed using quantitative and imaging-based assays. Human neutrophils from both male and female donors express the nuclear estrogen receptors ERα and ERß, known targets of raloxifene. Similar to raloxifene, selective antagonists of these receptors inhibit PMA-induced NET production. Furthermore, raloxifene inhibited PMA-induced ERK phosphorylation, but not reactive oxygen species production, pathways known to be key modulators of NET production. Finally, we found that raloxifene inhibited PMA-induced, NET-based killing of the leading human bacterial pathogen, methicillin-resistant Staphylococcus aureus. Our results reveal that raloxifene is a potent modulator of neutrophil function and NET production.

Arsenic adsorption by iron-aluminium hydroxide coated onto macroporous supports: Insights from X-ray absorption spectroscopy and comparison with granular ferric hydroxides.

This paper evaluates the arsenic adsorption characteristics of a macroporous polymer coated with coprecipitated iron-aluminium hydroxides (MHCMP). The MHCMP adsorbent-composite fits best with a pseudo-second order model for As(III) and a pseudo-first order kinetic model for As(V). The MHCMP shows a maximum adsorption capacity of 82.3 and 49.6 mg As/g adsorbent for As(III) and As(V) ions respectively, and adsorption followed the Langmuir model. Extended X-ray absorption fine structure showed that binding of As(III) ions were confirmed to take place on the iron hydroxides coated on the MHCMP, whereas for As(V) ions the binding specificity could not be attributed to one particular metal hydroxide. As(III) formed a bidentate mononuclear complex with Fe sites, whereas As(V) indicated on a bidentate binuclear complex with Al sites or monodentate with Fe sites on the adsorbent. The column experiments were run in a well water spiked with a low concentration of As(III) (100 µg/L) and a commercially available adsorbent (GEH(®)102) based on granular iron-hydroxide was used for comparison. It was found that the MHCMP was able to treat 7 times more volume of well water as compared to GEH(®)102, maintaining the threshold concentration of less than 10 µg As/L, indicating that the MHCMP is a superior adsorbent.

Low Third-Trimester Serum Levels of Lamivudine/Zidovudine and Lopinavir/Ritonavir in an HIV-Infected Pregnant Woman with Gastric Bypass.

Pharmacokinetics of lamivudine (3TC)/zidovudine (ZDV) and lopinavir/ritonavir (LPV/r) are described in a gravid 27-year-old HIV-infected woman with gastric bypass. Blood levels were obtained for these medications at time points 0 (predose) and 1, 2, 4, 6, 8, and 12 hours postdose. For these times, the levels (µg/mL) of 3TC were 0.0801, 0.69, 0.339, 0.237, 0.202, 0.108, and 0.0461; the levels of ZDV were 0.0153, 0.433, 0.0717, 0.0481, 0.0107, 0.0214, and 0.00864; the levels of lopinavir (LPV) were 2.45, 2.64, 1.95, 2.78, 3.83, 3.20, and 1.92; and the levels of ritonavir (RTV) were 0.09, 0.10, 0.07, 0.11, 0.15, 0.15, and 0.06. These data suggest that gastric bypass affected these antiretroviral drug levels. A functional, intact small bowel is responsible for absorption of these medications.

Vitamin D Metabolites Inhibit Hepatitis C Virus and Modulate Cellular Gene Expression.

BACKGROUND AND AIMS: Previous studies suggest that low serum 25-hydroxyvitamin D [25(OH) D] levels are associated with reduced responsiveness to interferon and ribavirin therapy. We investigated the impact of vitamin D metabolites on HCV and cellular gene expression in cultured hepatoma cells. METHODS: HCV Replicon cell lines stably expressing luciferase reporter constructs (genotype 1b and 2a replicon) or JC1-Luc2a were incubated in the presence of vitamin D2, vitamin D3 or 1,25-dihydroxyvitamin D3 (1,25(OH)2D3). Presence of HCV was quantified by a luciferase reporter assay and immunoblot of the Core protein. Synergy of interferon-alpha A/D (IFN-α) and 1,25(OH)2D3 was evaluated using the Chou-Talalay method. Cellular gene expression by microarray analysis using Illumina Bead Chips and real-time quantitative PCR. RESULTS: Vitamin D2, D3 and 1,25(OH)2D3 each demonstrated anti-HCV activity at low micro molar concentrations. In vitro conversion from D3 to 25(OH)D3 was shown by LC/MS/MS. Combination indices of 1,25(OH)2D3 and IFN-α demonstrated a synergistic effect (0.23-0.46) and significantly reduced core expression by immunoblot. Differentially expressed genes were identified between Huh7.5.1 cells in the presence and absence of 1,25(OH)2D3 and HCV. Genes involved with classical effects of vitamin D metabolism and excretion were activated, along with genes linked to autophagy such as G-protein coupled receptor 37 (GPR37) and Hypoxia-inducible factor 1-alpha (HIF1a). Additionally, additive effects of 1,25(OH)2D3 and IFN-α were seen on mRNA expression of chemokine motif ligand 20 (CCL20). CONCLUSIONS: This study shows that vitamin D reduces HCV protein production in cell culture synergistically with IFN-α. Vitamin D also activates gene expression independently and additively with IFN-α and this may explain its ability to aid in the clearance of HCV in vivo.

Effect of lithium salts on lactate dehydrogenase, adenylate kinase, and 1-phosphofructokinase activities.

Inhibitions of 30 nM rabbit muscle 1-phosphofructokinase (PFK-1) by lithium, potassium, and sodium salts showed inhibition or not depending upon the anion present. Generally, potassium salts were more potent inhibitors than sodium salts; the extent of inhibition by lithium salts also varied with the anion. Li(2)CO(3) was a relatively potent inhibitor of PFK-1 but LiCl and lithium acetate were not. Our results suggest that extents of inhibition by monovalent salts were due to both cations and anions, and the latter needs to be considered before inhibition can be credited to the cation. An explanation for monovalent salt inhibitions is proffered involving interactions of both cations and anions at negative and positive sites of PFK-1 that affect enzyme activity. Our studies suggest that lithium cations per se are not inhibitors: the inhibitors are the lithium salts, and we suggest that in vitro studies involving the effects of monovalent salts on enzymes should involve more than one anion.

Estrategias de prevención del Mobbing o presión laboral tendenciosa en la Corporación Boliviana de Televisión de la Ciudad de La Paz

Se desarrolla el análisis de la influencia que tiene el acoso psicológico en el trabajo que es una forma de violencia psicológica y verbal que se emprende contra varones o mujeres en el ambiente laboral, sobre el clima laboral...