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Spirulina is an edible cyanobacterium that increasingly gaining recognition for it untapped potential in the biomanufacturing of pharmaceuticals. Despite the rapidly accumulating information on extracellular vesicles (EVs) from most other bacteria, nothing is known about Spirulina extracellular vesicles (SPEVs). This study reports the successful isolation, characterization and visualization of SPEVs for the first time and it further investigates the potential therapeutic benefits of SPEVs using a mouse model. SPEVs were isolated using ultracentrifugation and size‐exclusion‐chromatography. Cryo‐Transmission Electron Microscopy revealed pleomorphic outer‐membrane‐vesicles and outer‐inner‐membrane‐vesicles displaying diverse shapes, sizes and corona densities. To assess short‐ and long‐term immune responses, mice were injected intraperitoneally with SPEVs, which demonstrated a significant increase in neutrophils and M1 macrophages at the injection site, indicating a pro‐inflammatory effect induced by SPEVs without clinical signs of toxicity or hypersensitivity. Furthermore, SPEVs demonstrated potent adjuvanticity by enhancing antigen‐specific IgG responses in mice by over 100‐fold compared to an unadjuvanted model vaccine antigen. Mass‐spectrometry identified 54 proteins within SPEVs, including three protein superfamily members linked to the observed pro‐inflammatory effects. Our findings highlight the potential of SPEVs as a new class of vaccine adjuvant and warrant additional studies to further characterize the nature of the immune response. [ABSTRACT FROM AUTHOR]

It is my belief that a prevailing colonial mentality in higher education dance spaces, as it relates to jazz dance, is responsible for the lack of serious engagement and appropriate regard. This article makes the argument for the decolonization of higher education spaces, advocating for fuller engagement with the jazz genre and positioning it to better shape and influence the minds and bodies of burgeoning dance professionals.

Navigating the healthcare conundrum in the Blue Zone of Loma Linda, California, requires understanding the unique factors that make this region stand out in terms of health and longevity. But more important is understanding the healthcare system sustaining the Blue Zone in Loma Linda, California. In an era marked by soaring healthcare costs and diminishing reimbursement rates, hospitals and physicians face an unprecedented challenge: providing excellent patient care while maintaining financial sustainability. This leadership perspective publication paper delves into the multifaceted struggles encountered by healthcare and hospital leaders, exploring the root causes, implications, and potential solutions for this complex issue. As we examine the evolving healthcare landscape, we aim to shed light on the critical need for innovative approaches to sustain the future of healthcare excellence in one of the five original Blue Zones. [ABSTRACT FROM AUTHOR]

Background: Mansonella perstans is among the most neglected of the neglected tropical diseases and is believed to cause more human infections than any other filarial pathogen in Africa. Based largely upon assumptions of limited infection-associated morbidity, this pathogen remains understudied, and many basic questions pertaining to its pathogenicity, distribution, prevalence, and vector-host relationships remain unanswered. However, in recent years, mounting evidence of the potential for increased Mansonella infection-associated disease has sparked a renewal in research interest. This, in turn, has produced a need for improved diagnostics, capable of providing more accurate pictures of infection prevalence, pathogen distribution, and vector-host interactions. Methodology/Principal findings: Utilizing a previously described pipeline for the discovery of optimal molecular diagnostic targets, we identified a repetitive DNA sequence, and developed a corresponding assay, which allows for the sensitive and species-specific identification of M. perstans in human blood samples. Testing also demonstrated the ability to utilize this assay for the detection of M. perstans in field-collected mosquito samples. When testing both sample types, our repeat-targeting index assay outperformed a ribosomal sequence-targeting reference assay, facilitating the identification of additional M. perstans-positive samples falsely characterized as "negative" using the less sensitive detection method. Conclusions/Significance: Through the development of an assay based upon the systematic identification of an optimal DNA target sequence, our novel diagnostic assay will provide programmatic efforts with a sensitive and specific testing platform that is capable of accurately mapping M. perstans infection and determining prevalence. Furthermore, with the added ability to identify the presence of M. perstans in mosquito samples, this assay will help to define our knowledge of the relationships that exist between this pathogen and the various geographically relevant mosquito species, which have been surmised to represent potential secondary vectors under certain conditions. Detection of M. perstans in mosquitoes will also demonstrate proof-of-concept for the mosquito-based monitoring of filarial pathogens not vectored primarily by mosquitoes, an approach expanding opportunities for integrated surveillance. Author summary: Infection with Mansonella perstans remains exceedingly common in many of the world's tropical and sub-tropical regions. However, M. perstans is largely understudied due to the long-held belief that this pathogen is of little clinical significance. However, in recent years, many within the research community have begun to advocate for the increased study of this pathogen, pointing to evidence of mansonellosis-associated disease morbidity, the potential for Mansonella spp. to confound diagnostic testing for other pathogens, and the possibility for co-infections with M. perstans to impact disease progression and treatment outcomes for other infections. As a result of this growing appreciation of the importance of M. perstans, there exists a need for improved diagnostic options, capable of providing researchers with the tools required to accurately and effectively map infection, explore the pathogen-vector relationship, and determine pathogen prevalence. In response to these needs, we have developed a novel real-time PCR assay targeting a highly repetitive DNA sequence within the M. perstans genome. This index assay outperformed a ribosomal-sequence targeting reference assay when comparatively testing both human blood and field-collected mosquito samples. As such, this assay will provide researchers with an improved tool for the identification of M. perstans as part of various operational research efforts. [ABSTRACT FROM AUTHOR]

Abstract Background Although training and education have long been accepted as integral to disaster preparedness, many currently taught practices are neither evidence-based nor standardized. The need for effective evidence-based disaster training of healthcare staff at all levels, including the development of standards and guidelines for training in the multi-disciplinary health response to major events, has been designated by the disaster response community as a high priority. We describe the application of systematic evidence-based consensus building methods to derive educational competencies and objectives in criteria-based preparedness and response relevant to all hospital healthcare workers. Methods The conceptual development of cross-cutting competencies incorporated current evidence through a systematic consensus building process with the following steps: (1) review of peer-reviewed literature on relevant content areas and educational theory; (2) structured review of existing competencies, national level courses and published training objectives; (3) synthesis of new cross-cutting competencies; (4) expert panel review; (5) refinement of new competencies and; (6) development of testable terminal objectives for each competency using similar processes covering requisite knowledge, attitudes, and skills. Results Seven cross-cutting competencies were developed: (1) Recognize a potential critical event and implement initial actions; (2) Apply the principles of critical event management; (3) Demonstrate critical event safety principles; (4) Understand the institutional emergency operations plan; (5) Demonstrate effective critical event communications; (6) Understand the incident command system and your role in it; (7) Demonstrate the knowledge and skills needed to fulfill your role during a critical event. For each of the cross-cutting competencies, comprehensive terminal objectives are described. Conclusion Cross-cutting competencies and objectives developed through a systematic evidence-based consensus building approach may serve as a foundation for future hospital healthcare worker training and education in disaster preparedness and response.

Aim: The study aimed to establish the views of a range of stakeholders about their experiences of the newly implemented nursing associate role in England and its potential to contribute to patient care. Background: Second‐level nursing roles are increasingly used internationally within the healthcare workforce. In response to registered nurse workforce deficits, a new nursing associate role has been introduced in England to augment care provided by registered nurses and enable career progression of support workers. Design: Qualitative descriptive design. Methods: Semi‐structured interviews and a focus group were conducted with a range of healthcare professionals in a large inner city acute secondary care healthcare organisation in England. Interviews were guided by the Consolidated Framework for Implementation Research and analysed using Framework Analysis. The study was reported according to COREQ guidelines. Results: 33 healthcare professionals were interviewed—directors of nursing, ward managers, nursing associates and multidisciplinary team members. Participants perceived the role was broadly adaptable to different healthcare settings and provided a positive professional development mechanism for healthcare support workers. Managers felt training commitments made implementing the role complex and costly. Participants argued the role had limitations, particularly with intravenous medicine management. Implementation was impeded by rapid pace and consequent lack of clear communication and planning. Conclusions: The nursing associate role was perceived as an inclusive pathway into nursing but with limitations when working with high‐acuity patients. Further evaluation is needed to investigate how the role has embedded over time. Relevance to clinical practice: The role should be seen as both a stepping stone into registered nursing positions and valued as part of the nursing workforce. Consideration must be given to how the role can be safely implemented in different settings. Findings have relevance to healthcare leaders internationally, who continue to work in a climate of economic pressure and staffing shortages. [ABSTRACT FROM AUTHOR]

We describe the development of an innovative program to support physician vitality. We provide the context and process of program delivery which includes a number of experimental support programs. We discuss a model for intervention and methods used to enhance physician resilience, support work-life balance, and change the culture to one that explicitly addresses the physician's biopsychosocial-spiritual needs. Recommendations are given for marriage and family therapists (MFTs) who wish to develop similar support programs for healthcare providers. Video Abstract. [ABSTRACT FROM AUTHOR]

Acute myocardial infarction (AMI) is extremely rare in children, and unlike the adult disease, the etiology of the infarction is rarely due to atherosclerotic coronary disease. This unique reported case involved a 15-year-old boy with severe chest pain who presented with an ST-segment-elevation myocardial infarction secondary to in situ thrombus formation in the left anterior descending (LAD) coronary artery. The initial electrocardiogram (ECG) had a Q-wave pattern in V6 and ST depression in the inferior leads with ST-segment elevation in reciprocal leads. The cardiac enzymes and routine labs showed evidence of myocardial damage. The boy was urgently taken to the cardiac catheterization laboratory for percutaneous coronary intervention, where complete occlusion of the LAD was found and successfully stented. Eventually, a peripheral blood smear showed pancytopenia with 38 % hypergranular blast-like cells consistent with acute myeloid leukemia (AML), and chemotherapy with all-transretinoic acid was implemented. This first pediatric case report of an AML-associated AMI emphasizes the benefit resulting from expedient reperfusion of the ischemic myocardium by quick reestablishment of coronary perfusion. It also emphasizes the limitations of existing noninvasive technologies in detecting myocardial viability. [ABSTRACT FROM AUTHOR]

Purpose - The general population relies on the healthcare system for needed care during disasters. Unfortunately, the system is already operating at capacity. Healthcare facilities must develop plans to accommodate the surge of patients generated during disasters. The purpose of this paper is to examine a concept for providing independent, technologically advanced medical surge capacity via a Convertible Use Rapidly Expandable (CURE) Center. Design/methodology/approach - To develop this concept, a site was chosen to work through a scenario involving a large earthquake. Although the study-affiliated hospital was built with then state-of-the-art technologies, there is still concern for its continued functioning should a large earthquake occur. Working within these parameters, the planning team applied the concepts to a specific educational complex. Because this complex was in the initial building stages, required attributes could be incorporated, making the concept a potential reality. Challenges with operations, communications, and technologies were identified and addressed in the context of planning for delivery of quality healthcare. Findings - The process highlighted several requirements. Planning must include community leaders, enhanced by agencies or individuals experienced in disaster response. Analyzing regional threats in the context of available resources comes first, and reaching a consensus on the scope of operation is required. This leads to an operational plan, and in turn to understanding the needs for a specific site. Use of computer modeling and virtual deployment of the center indicates where additional planning is needed. Originality/value - Previous strategies for increasing surge capacity rely on continued availability of hospital resources, alternative care sites with minimal medical capability, or, costly hospital expansions. Development of a site-specific CURE Center can allow communities to provide fiscally responsible solutions for sustained medical care during disasters. [ABSTRACT FROM AUTHOR]

Background: Although training and education have long been accepted as integral to disaster preparedness, many currently taught practices are neither evidence-based nor standardized. The need for effective evidence-based disaster training of healthcare staff at all levels, including the development of standards and guidelines for training in the multi-disciplinary health response to major events, has been designated by the disaster response community as a high priority. We describe the application of systematic evidence-based consensus building methods to derive educational competencies and objectives in criteria-based preparedness and response relevant to all hospital healthcare workers. Methods: The conceptual development of cross-cutting competencies incorporated current evidence through a systematic consensus building process with the following steps: (1) review of peer-reviewed literature on relevant content areas and educational theory; (2) structured review of existing competencies, national level courses and published training objectives; (3) synthesis of new cross-cutting competencies; (4) expert panel review; (5) refinement of new competencies and; (6) development of testable terminal objectives for each competency using similar processes covering requisite knowledge, attitudes, and skills. Results: Seven cross-cutting competencies were developed: (1) Recognize a potential critical event and implement initial actions; (2) Apply the principles of critical event management; (3) Demonstrate critical event safety principles; (4) Understand the institutional emergency operations plan; (5) Demonstrate effective critical event communications; (6) Understand the incident command system and your role in it; (7) Demonstrate the knowledge and skills needed to fulfill your role during a critical event. For each of the cross-cutting competencies, comprehensive terminal objectives are described. Conclusion: Cross-cutting competencies and objectives developed through a systematic evidence-based consensus building approach may serve as a foundation for future hospital healthcare worker training and education in disaster preparedness and response. [ABSTRACT FROM AUTHOR]

Provides information on the clinical syndrome called traveller's diarrhea. Epidemiology; Etiology; Evaluation; Treatment; Prevention.

Results from previous research on everyday problem solving involving Caucasians suggests that it may be a useful concept in studying cognitive aging in African Americans . The purpose of this investigation was to examine : (1) the factor structure of an everyday problem solving in a sample of African Americans , (2) the internal consistency of everyday problem solving in a sample of African Americans , and (3) the relation ship of problem solving to demographic factors, physical functioning, and measures of fluid ability. The sample included subjects recruited from Baltimore , MD . The sample consisted of 249 community dwelling African - American adults with a mean age of 67 . 8 years (SD = 8.47). Variables included the Everyday Problem Solving Test (EPT), gender , age , education , physical functioning , and inductive reasoning . Everyday problem solving as a latent construct was confirmed and the split half reliability was high (.89). As in previous research , inductive reasoning and physical functioning were related to everyday problem solving abilities . We also found that certain domains of the EPT are more influ enced by demographic factors than others . Our finding suggest that the Everyday Problems Test is appropriate for use with African American samples . [ABSTRACT FROM AUTHOR]

Discusses the importance of an individual difference approach in studying the ethnic diversity of an aging population. Cross-cultural research on aged minority populations; Designs and strategies for studying individual differences; Need to understand the heterogeneity represented within a given ethnic group to know the differences between various ethnic and racial groups.

The Salas y Gómez and Nazca ridges are two seamount chains of volcanic origin, which include over 110 seamounts that collectively stretch across over 2,900 km in the southeastern Pacific. Ecosystems in this region are isolated by the Atacama Trench, the Humboldt Current System, and an extreme oxygen minimum zone. This isolation has produced a unique biodiversity that is marked by one of the highest levels of marine endemism on Earth. These areas also provide important habitats and ecological stepping stones for whales, sea turtles, corals, and a multitude of other ecologically important species, including 82 species that are threatened or endangered. Recent explorations in this region have documented one of the deepest light-dependent marine ecosystems on Earth, as well as numerous species that are new to science. Waters surrounding the Salas y Gómez and Nazca ridges are mostly located in areas beyond national jurisdiction (ABNJ), with smaller portions located in the national waters of Chile and Peru. Within this region, Chile has already protected all the ridge features that fall within its jurisdiction, and Peru is evaluating a proposal that would protect the seafloor that falls within its national waters. However, all of the ABNJ in the region, which cover over 73% of the Salas y Gómez and Nazca ridges, are unprotected and under threat from a variety of stressors, including climate change, plastic pollution, overfishing, and potential deep-sea mining in the future. Importantly, fishing and other commercial activities are at low levels in international waters of this region, so there is a time-sensitive opportunity to protect its unique natural and cultural resources before they are degraded. This study provides a synthesis of the relevant science that has been conducted on the Salas y Gómez and Nazca ridges, and discusses the opportunities and challenges for protecting this unique region via existing sectoral organizations and through the emerging international agreement on biodiversity beyond national jurisdiction (BBNJ). Given its exceptional natural and cultural significance, the Salas y Gómez and Nazca ridges should be comprehensively protected from exploitation, pollution and other anthropogenic threats using the best available conservation measures. [ABSTRACT FROM AUTHOR]

The article offers information on food insecurity is consistently associated with negative health outcomes, and health systems are increasingly interested in addressing the social determinants of health, including food access within the clinical space. Topics include the food pharmacy has helpful for patients currently experiencing very low food security.