Piloting Home Produce Delivery to Improve Food Security, Budget, and Diet in Families with Children: A Mixed-Methods Study.

BACKGROUND: Few children in food insecure (FI) households meet dietary recommendations for fruit and vegetables ("produce"). Barriers include affordability, accessibility, and desirability. Home produce delivery may reduce FI, increase produce consumption, and decrease budget tradeoffs. OBJECTIVE: Evaluate the acceptability and potential impact of delivering produce through home visiting programs on FI, diet, and budget tradeoffs. METHODS: In this prospective pre/post mixed methods study, 51 parents engaged in home visiting programs were enrolled. Participants completed pre- and post-program surveys on FI (18-item Food Security Scale), produce consumption, and budget tradeoffs. Pre- and post-surveys were compared using McNemar's test and weighted kappas. Interview guides were based on Social Cognitive Theory and a previously published framework. Interviews were conducted in English or Spanish; thematic analysis was completed. RESULTS: Twenty-nine (56.9%) participants completed both surveys. Most were female (96.3%) and Hispanic (79.3%) (Table 1). Food security improved in the post-period, with more participants reporting high food security (pre: 6.9%, post: 31.0%) and fewer reporting very low food security (pre: 20.7%, post: 6.9%, p<0.01) (Table 2). Budgetary tradeoffs decreased in the post-program period (pre: 71.4%, post: 48.1%, p=0.03). Fifteen participants were interviewed. Themes included 1) saved money, 2) increased fruit and vegetable consumption, and 3) interest in future participation. CONCLUSION: This pilot study found that an intervention for delivery of produce through home visiting programs was acceptable to participants and resulted in potential improvements in FI and household budgets. This supports future studies to further explore the impact of this novel intervention. WHAT'S NEW: In this prospective mixed-methods pilot, home delivered produce was acceptable and feasible with potentially improved food security and household budgets; evidence of potential change in produce consumption was mixed. Changes in budget tradeoffs is a novel outcome in food programs.

Microbially Mediated Rubber Recycling to Facilitate the Valorization of Scrap Tires.

The recycling of scrap tire rubber requires high levels of energy, which poses challenges to its proper valorization. The application of rubber in construction requires significant mechanical and/or chemical treatment of scrap rubber to compatiblize it with the surrounding matrix. These methods are energy-consuming and costly and may lead to environmental concerns associated with chemical leachates. Furthermore, recent methods usually call for single-size rubber particles or a narrow rubber particle size distribution; this, in turn, adds to the pre-processing cost. Here, we used microbial etching (e.g., microbial metabolism) to modify the surface of rubber particles of varying sizes. Specifically, we subjected rubber particles with diameters of 1.18 mm and 0.6 mm to incubation in flask bioreactors containing a mineral medium with thiosulfate and acetate and inoculated them with a microbial culture from waste-activated sludge. The near-stoichiometric oxidation of thiosulfate to sulfate was observed in the bioreactors. Most notably, two of the most potent rubber-degrading bacteria (Gordonia and Nocardia) were found to be significantly enriched in the medium. In the absence of added thiosulfate in the medium, sulfate production, likely from the desulfurization of the rubber, was also observed. Microbial etching increased the surface polarity of rubber particles, enhancing their interactions with bitumen. This was evidenced by an 82% reduction in rubber-bitumen separation when 1.18 mm microbially etched rubber was used. The study outcomes provide supporting evidence for a rubber recycling method that is environmentally friendly and has a low cost, promoting pavement sustainability and resource conservation.

High Efficacy Two-Stage Metal Treatment Incorporating Basic Oxygen Furnace Slag and Microbiological Sulfate Reduction.

Lignocellulosic sulfate-reducing biochemical reactors (SRBRs) can be implemented as passive treatment for mining-influenced water (MIW) mitigating the potentially deleterious effects of MIW acidic pH, and high concentrations of metal(loid)s and SO42-. In this study, a novel two-stage treatment for MIW was designed, where basic oxygen furnace slag (slag stage) and microbial SO42- reduction (SRBR stage) were incorporated in series. The SRBRs contained spent brewing grains or sugarcane bagasse as sources of lignocellulose. The slag reactor removed >99% of the metal(loid) concentration present in the MIW (130 ± 40 mg L-1) and increased MIW pH from 2.6 ± 0.2 to 12 ± 0.3. The alkaline effluent pH of the slag reactor was mitigated by remixing slag effluent with acidic MIW before SRBR treatment. The SRBR stage removed the bulk of SO42- from MIW, additional metal(loid)s, and yielded a circumneutral effluent pH. Cadmium, copper, and zinc showed high removal rates in SRBRs (≥96%) and likely precipitated as sulfide minerals. The microbial communities developed in SRBRs were enriched in hydrolytic, fermentative, and sulfate-reducing taxa. However, the SRBRs developed distinct community compositions due to the different lignocellulose sources employed. Overall, this study underscores the potential of a two-stage treatment employing steel slag and SRBRs for full-scale implementation at mining sites.

Let's Talk About Antibiotics: a randomised trial of two interventions to reduce antibiotic misuse.

BACKGROUND: Children with acute respiratory tract infections (ARTIs) receive ≈11.4 million unnecessary antibiotic prescriptions annually. A noted contributor is inadequate parent-clinician communication, however, efforts to reduce overprescribing have only indirectly targeted communication or been impractical. OBJECTIVES: Compare two feasible (higher vs lower intensity) interventions for enhancing parent-clinician communication on the rate of inappropriate antibiotic prescribing. DESIGN: Multisite, parallel group, cluster randomised comparative effectiveness trial. Data collected between March 2017 and March 2019. SETTING: Academic and private practice outpatient clinics. PARTICIPANTS: Clinicians (n=41, 85% of eligible approached) and 1599 parent-child dyads (ages 1-5 years with ARTI symptoms, 71% of eligible approached). INTERVENTIONS: All clinicians received 20 min ARTI diagnosis and treatment education. Higher intensity clinicians received an additional 50 min communication skills training. All parents viewed a 90 second antibiotic education video. MAIN OUTCOMES AND MEASURES: Inappropriate antibiotic treatment was assessed via blinded medical record review by study clinicians and a priori defined as prescriptions for the wrong diagnosis or use of the wrong agent. Secondary outcomes were revisits, adverse drug reactions (both assessed 2 weeks after the visit) and parent ratings of provider communication, shared decision-making and visit satisfaction (assessed at end of the visit on Likert-type scales). RESULTS: Most clinicians completed the study (n=38, 93%), were doctors (n=25, 66%), female (n=30, 78%) and averaged 8 years in practice. All parent-child dyad provided data for the main outcome (n=855 (54%) male, n=1043 (53%) <2 years). Inappropriate antibiotic prescribing was similar among patients who consulted with a higher intensity (54/696, 7.8%) versus a lower intensity (85/904, 9.4%) clinician. A generalised linear mixed effect regression model (adjusted for the two-stage nested design, clinician type, clinic setting and clinician experience) revealed that the odds of receiving inappropriate antibiotic treatment did not significantly vary by group (AOR 0.99, 95% CI: 0.52 to 1.89, p=0.98). Secondary outcomes of revisits and adverse reactions did not vary between arms, and parent ratings of satisfaction with quality of parent-provider communication (5/5), shared decision making (9/10) and visit satisfaction (5/5) were similarly high in both arms. CONCLUSIONS AND RELEVANCE: Rate of inappropriate prescribing was low in both arms. Clinician education coupled with parent education may be sufficient to yield low inappropriate antibiotic prescribing rates. The absence of a significant difference between groups indicates that communication principles previously thought to drive inappropriate prescribing may need to be re-examined or may not have as much of an impact in practices where prescribing has improved in recent years. TRIAL REGISTRATION NUMBER: NCT03037112.

Biodegradation of petroleum hydrocarbons in a weathered, unsaturated soil is inhibited by peroxide oxidants.

Field-weathered crude oil-containing soils have a residual concentration of hydrocarbons with complex chemical structure, low solubility, and high viscosity, often poorly amenable to microbial degradation. Hydrogen peroxide (H2O2)-based oxidation can generate oxygenated compounds that are smaller and/or more soluble and thus increase petroleum hydrocarbon biodegradability. In this study, we assessed the efficacy of H2O2-based oxidation under unsaturated soil conditions to promote biodegradation in a field-contaminated and weathered soil containing high concentrations of total petroleum hydrocarbons (25200 mg TPH kg-1) and total organic carbon (80900 mg TOC kg-1). Microcosms amended with three doses of 48 g H2O2 kg-1 soil (unactivated or Fe2+-activated) or 24 g sodium percarbonate kg-1 soil and nutrients did not show substantial TPH changes during the experiment. However, 7.6-41.8% of the TOC concentration was removed. Furthermore, production of DOC was enhanced and highest in the microcosms with oxidants, with approximately 20-40-fold DOC increase by the end of incubation. In the absence of oxidants, biostimulation led to > 50% TPH removal in 42 days. Oxidants limited TPH biodegradation by diminishing the viable concentration of microorganisms, altering the composition of the soil microbial communities, and/or creating inhibitory conditions in soil. Study's findings underscore the importance of soil characteristics and petroleum hydrocarbon properties and inform on potential limitations of combined H2O2 oxidation and biodegradation in weathered soils.

Serological evidence of Anaplasma spp., Borrelia burgdorferi and Ehrlichia canis in dogs from the Republic of Korea by rapid diagnostic test kits.

BACKGROUND: Emergent and re-emergent canine tick-borne infections are attracting increasing attention worldwide. The rise in pet ownership and the close relationship between dogs and their owners are the most concerning factors because dogs may act as competent reservoirs for human tick-transmitted infectious agents. OBJECTIVES: This study contributes to the epidemiological surveillance of canine tick-transmitted infections with zoonotic risk in the Republic of Korea (ROK) by investigating the seroprevalence of the pathogens, Anaplasma spp., Borrelia burgdorferi, and Ehrlichia canis. METHODS: Four hundred and thirty whole blood samples from domestic dogs were collected in seven metropolitan cities and nine provinces in the ROK and tested using SensPERT Ab test kits (VetAll Laboratories®) to detect seroreactive animals. RESULTS: The seroprevalence rates identified were 9.8% (42/430) for Anaplasma spp., 2.8% (12/430) for B. burgdorferi, and 1.4% (6/430) for E. canis. The risk factors evaluated in this study that could be associated with the development of a humoral immune response, such as sex, age, and history of tick exposure, were similar. There was only one exception for dogs seroreactive to Anaplasma spp., where the risk factor "tick exposure" was statistically significant (p = 0.047). CONCLUSIONS: This serological survey exhibited the widespread presence of Anaplasma spp., B. burgdorferi, and E. canis throughout the ROK. Hence, dogs may play a key role as the sentinel animals of multiple zoonotic infectious agents in the country.

Continuous-mode acclimation and operation of lignocellulosic sulfate-reducing bioreactors for enhanced metal immobilization from acidic mining-influenced water.

Lignocellulosic sulfate-reducing bioreactors are an inexpensive passive approach for treatment of mining-influenced water (MIW). Typically, microbial community acclimation to MIW involves bioreactor batch-mode operation to initiate lignocellulose hydrolysis and fermentation and provide electron donors for sulfate-reducing bacteria. However, batch-mode operation could significantly prolong bioreactor start-up times (up to several months) and select for slow-growing microorganisms. In this study we assessed the feasibility of bioreactor continuous-mode acclimation to MIW (pH 2.5, 6.5 mM SO42-, 18 metal(loid)s) as an alternate start-up method. Results showed that bioreactors with spent brewing grains and sugarcane bagasse achieved acclimation in continuous mode at hydraulic retention times (HRTs) of 7-12-d within 16-22 days. During continuous-mode acclimation, extensive SO42- reduction (80 ± 20% -91 ± 3%) and > 98% metal(loid) removal was observed. Operation at a 3-d HRT further yielded a metal(loid) removal of 97.5 ± 1.3 -98.8 ± 0.9% until the end of operation. Sulfate-reducing microorganisms were detected closer to the influent in the spent brewing grains bioreactors, and closer to the effluent in the sugarcane bagasse bioreactors, giving insight as to where SO42- reduction was occurring. Results strongly support that a careful selection of lignocellulose and bioreactor operating parameters can bypass typical batch-mode acclimation, shortening bioreactor start-up times and promoting effective MIW metal(loid) immobilization and treatment.

Designing an Adaptive Adolescent Physical Activity and Nutrition Intervention for COVID-19-Related Health Challenges: Formative Research Study.

BACKGROUND: With rates of childhood obesity continually increasing, effective physical activity and nutrition interventions are needed. Formative research is used to tailor interventions to different cultural and geographic contexts and can be vital in adapting intervention strategies in the face of significant disruptive circumstances (like COVID-19). OBJECTIVE: We conducted formative research via in-person and web-based focus groups among middle schoolers and parents to better understand the facilitators and barriers to physical activity and fruit and vegetable consumption and to inform the design of a large intervention for a low-income, urban setting in the US Midwest. METHODS: We conducted 2 phases of qualitative focus groups with parents (n=20) and 6th-9th grade middle schoolers (n=23). Phase 1 was conducted prior to the COVID-19 pandemic in late 2019, and phase 2 was conducted during the COVID-19 pandemic in the summer of 2020. Focus groups were transcribed and thematically coded using the Dedoose software. RESULTS: The main facilitators of physical activity prior to the pandemic included the opportunity to have fun, peer influence, competition (for some), and incentives, while the main barriers to physical activity were time constraints and social discomfort. The main facilitators of eating fruits and vegetables included parental influence, preparation technique, and convenience, while barriers included dislike of vegetables, time constraints, and preparation or freshness. During the pandemic, facilitators of physical activity remained the same, while additional barriers to physical activity such as lack of motivation and limited time spent outside of the home were reported. For fruit and vegetable consumption, both facilitators and barriers remained the same for both time periods. Additionally, for some participants, the pandemic offered an opportunity to offer more fruits and vegetables to middle schoolers throughout the day. CONCLUSIONS: Some themes identified were common to those reported in previous studies, such as peer influence on physical activity and parental influence on fruit and vegetable consumption. Novel themes such as lack of motivation to be active and limited time outside the home helped improve intervention adaptation, specifically during the COVID-19 pandemic. The continuity of formative research after a major unexpected change in the intervention context can be essential in targeting areas of an intervention that can be retained and those that need to be adjusted.

Demographic Characteristics Among Members of Patient Family Advisory Councils at a Pediatric Health System.

Patient Family Advisory Councils (PFACs) are groups of patients, families, and clinical health system leaders collaborating to improve the quality, safety, and experience of care. Best practices encourage PFAC membership to reflect the diversity of the communities served. A cross-sectional survey was conducted from September 2019 to January 2020 collecting demographic characteristics of the members of a pediatric health system's 17 PFACs. Of the 93 respondents (71.5%), notable inequities were racial (4.8% adult PFAC members vs. 17.4% patients were Black) and financial (adult PFAC median annual income was >$100,000 compared to the community median $77,589). The governing family advisory board used this information to codesign interventions to achieve the ideal state of inclusive excellence by identifying barriers for participation for the Black community, recruiting and retaining diverse board members, and continuous monitoring to maintain a diverse board representation.

Co-Infection with Anaplasma Species and Novel Genetic Variants Detected in Cattle and Goats in the Republic of Korea.

Anaplasmosis, a tick-borne disease with multiple reservoirs, has been evolving in its pathogenesis, increasing domestic ruminants susceptibility to simultaneous infections with multiple pathogens. However, there is limited information regarding anaplasmosis in domestic ruminants in the Republic of Korea (ROK). We aimed to evaluate the role of Korean cattle and goats in Anaplasma infection maintenance. Polymerase chain reaction was performed to investigate the prevalence and genetic diversity of Anaplasma spp. from 686 whole blood samples collected from different ROK provinces. Anaplasma infection was mostly caused by A. phagocytophilum (21.1%) in cattle, and A. bovis (7.3%) in goats. Co-infection cases were found in cattle: A. bovis and A. phagocytophilum (16.7%), and in goats: A. bovis and A. capra (1.0%). Notably, a triple co-infection with A. bovis, A. phagocytophilum, and A. capra was found in one cow. Phylogenetic analysis revealed novel variants of the A. phagocytophilum 16S rRNA and A. capra gltA genes. This research contributes to the ratification of cattle as a potential reservoir of A. capra and demonstrates Anaplasma co-infection types in Korean domestic ruminants. As anaplasmosis is a zoonotic disease, our study could be crucial in making important decisions for public health.

Beyond clinical food prescriptions and mobile markets: parent views on the role of a healthcare institution in increasing healthy eating in food insecure families.

BACKGROUND: Children in food-insecure families face increased barriers to meeting recommendations for fruit and vegetable consumption. Hospitals and pediatric healthcare institutions have attempted to alleviate food-insecurity through various internal programs like food prescriptions, yet little evidence for these programs exist. Consistent with a patient-centered perspective, we sought to develop a comprehensive understanding of barriers to fruit and vegetable consumption and a parent-driven agenda for healthcare system action. METHODS: We conducted six qualitative focus group discussions (four in English, two in Spanish) with 29 parents and caregivers of patients who had screened positive for food-insecurity during visits to a large pediatric healthcare system in a midwestern U.S. city. Our iterative analysis process consisted of audio-recording, transcribing and coding discussions, aiming to produce a) a conceptual framework of barriers to fruit and vegetable consumption and b) a synthesis of participant programmatic suggestions for their healthcare system. RESULTS: Participants were 90% female, 38% Black/African American and 41% Hispanic/Latino. Barriers to fruit and vegetable consumption in their families fell into three intersecting themes: affordability, accessibility and desirability. Participant-generated intervention recommendations were multilevel, suggesting healthcare systems focus not only on clinic and community-based action, but also advocacy for broader policies that alleviate barriers to acquiring healthy foods. CONCLUSION: Parents envision an expanded role for healthcare systems in ensuring their children benefit from a healthy diet. Findings offer critical insight on why clinic-driven programs aimed to address healthy eating may have failed and healthcare organizations may more effectively intervene by adopting a multilevel strategy.

Reductions in Parent Interest in Receiving Antibiotics following a 90-Second Video Intervention in Outpatient Pediatric Clinics.

OBJECTIVES: To assess the impact of a 90-second animated video on parents' interest in receiving an antibiotic for their child. STUDY DESIGN: This pre-post test study enrolled English and Spanish speaking parents (n = 1051) of children ages 1-5 years presenting with acute respiratory tract infection symptoms. Before meeting with their provider, parents rated their interest in receiving an antibiotic for their child, answered 6 true/false antibiotic knowledge questions, viewed the video, and then rated their antibiotic interest again. Parents rated their interest in receiving an antibiotic using a visual analogue scale ranging from 0 to 100, with 0 being "I definitely do not want an antibiotic," 50 "Neutral," and 100 "I absolutely want an antibiotic." RESULTS: Parents were 84% female, with a mean age of 32 ± 6.0, 26.0% had a high school education or less, 15% were black, and 19% were Hispanic. After watching the video, parents' average antibiotic interest ratings decreased by 10 points (mean, 57.0 ± 20 to M ± 21; P < .0001). Among parents with the highest initial antibiotic interest ratings (≥60), even greater decreases were observed (83.0 ± 12.0 to 63.4 ± 22; P < .0001) with more than one-half (52%) rating their interest in the low or neutral ranges after watching the video. CONCLUSIONS: A 90-second video can decrease parents' interest in receiving antibiotics, especially among those with higher baseline interest. This scalable intervention could be used in a variety of settings to reduce parents' interest in receiving antibiotics. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03037112.

Enhancing biodegradation of C16-alkyl quaternary ammonium compounds using an oxygen-based membrane biofilm reactor.

Quaternary ammonium compounds (QACs) (e.g., hexadecyltrimethyl-ammonium bromide, CTAB) are emerging contaminants with widespread use as surfactants and disinfectants. Because the initial step of QAC biodegradation is mono-oxygenation, QAC degraders require O2, but normal aeration leads to serious foaming. Here, we developed and tested an oxygen-based membrane biofilm reactor (O2-MBfR) that delivers O2 by diffusion through the walls of hollow-membranes to a biofilm accumulating on the outer surface of membranes. The O2-MBfR sustained QAC biodegradation even with high and toxic QAC input concentrations, up to 400 mg/L CTAB. Bubbleless O2 transfer completely eliminated foaming, and biofilm accumulation helped the QAC biodegraders resist toxicity. Pseudomonas, Achromobacter, Stenotrophomonas, and members of the Xanthomonadaceae family were dominant in the biofilm communities degrading CTAB, and their proportions depended on the O2-delivery capacity of the membranes. Bacteria capable of biodegrading QACs often harbor antibiotic resistance genes (ARGs) that help them avoid QAC toxicity. Gene copies of ARGs were detected in biofilms and liquid, but the levels of ARGs were 5- to 35-fold lower in the liquid than in the biofilm. In summary, the O2-MBfR achieved aerobic biodegradation of CTAB with neither foaming nor toxicity, and it also minimized the spread of ARGs.

Integrated consensus genetic and physical maps of flax (Linum usitatissimum L.).

Three linkage maps of flax (Linum usitatissimum L.) were constructed from populations CDC Bethune/Macbeth, E1747/Viking and SP2047/UGG5-5 containing between 385 and 469 mapped markers each. The first consensus map of flax was constructed incorporating 770 markers based on 371 shared markers including 114 that were shared by all three populations and 257 shared between any two populations. The 15 linkage group map corresponds to the haploid number of chromosomes of this species. The marker order of the consensus map was largely collinear in all three individual maps but a few local inversions and marker rearrangements spanning short intervals were observed. Segregation distortion was present in all linkage groups which contained 1-52 markers displaying non-Mendelian segregation. The total length of the consensus genetic map is 1,551 cM with a mean marker density of 2.0 cM. A total of 670 markers were anchored to 204 of the 416 fingerprinted contigs of the physical map corresponding to ~274 Mb or 74 % of the estimated flax genome size of 370 Mb. This high resolution consensus map will be a resource for comparative genomics, genome organization, evolution studies and anchoring of the whole genome shotgun sequence.

Simple sequence repeat marker development from bacterial artificial chromosome end sequences and expressed sequence tags of flax (Linum usitatissimum L.).

Flax is an important oilseed crop in North America and is mostly grown as a fibre crop in Europe. As a self-pollinated diploid with a small estimated genome size of ~370 Mb, flax is well suited for fast progress in genomics. In the last few years, important genetic resources have been developed for this crop. Here, we describe the assessment and comparative analyses of 1,506 putative simple sequence repeats (SSRs) of which, 1,164 were derived from BAC-end sequences (BESs) and 342 from expressed sequence tags (ESTs). The SSRs were assessed on a panel of 16 flax accessions with 673 (58 %) and 145 (42 %) primer pairs being polymorphic in the BESs and ESTs, respectively. With 818 novel polymorphic SSR primer pairs reported in this study, the repertoire of available SSRs in flax has more than doubled from the combined total of 508 of all previous reports. Among nucleotide motifs, trinucleotides were the most abundant irrespective of the class, but dinucleotides were the most polymorphic. SSR length was also positively correlated with polymorphism. Two dinucleotide (AT/TA and AG/GA) and two trinucleotide (AAT/ATA/TAA and GAA/AGA/AAG) motifs and their iterations, different from those reported in many other crops, accounted for more than half of all the SSRs and were also more polymorphic (63.4 %) than the rest of the markers (42.7 %). This improved resource promises to be useful in genetic, quantitative trait loci (QTL) and association mapping as well as for anchoring the physical/genetic map with the whole genome shotgun reference sequence of flax.