bluuebunny/crossref_metadata_2025 huggingface dataset:
Paper of note in
Science
Authors: Gough Nancy R.
Published: February 2016

This week’s article features a paper describing how some proteins can be produced when general protein translation is suppressed.
Suicidal sacrificial bacteria
Authors: VanHook Annalisa M.
Published: February 2016

A quorum-sensing factor induces autolysis in
Pseudomonas
to promote biofilm formation.
Toxic TRPA1 activity degrades myelin
Authors: Gough Nancy R.
Published: February 2016

Proton-mediated activation of TRPA1 channels in oligodendrocytes during ischemia damages myelin.
Untargeted Metabolomics To Ascertain Antibiotic Modes of Action
Authors: Vincent Isabel M. , Ehmann David E. , Mills Scott D. , Perros Manos , Barrett Michael P.
Published: February 2016

Deciphering the mode of action (MOA) of new antibiotics discovered through phenotypic screening is of increasing importance. Metabolomics offers a potentially rapid and cost-effective means of identifying modes of action of drugs whose effects are mediated through changes in metabolism. Metabolomics techniques also collect data on off-target effects and drug modifications. Here, we present data from an untargeted liquid chromatography-mass spectrometry approach to identify the modes of action of eight compounds: 1-[3-fluoro-4-(5-methyl-2,4-dioxo-pyrimidin-1-yl)phenyl]-3-[2-(trifluoromethyl)phenyl]urea (AZ1), 2-(cyclobutylmethoxy)-5′-deoxyadenosine, triclosan, fosmidomycin, CHIR-090, carbonyl cyanide
m
-chlorophenylhydrazone (CCCP), 5-chloro-2-(methylsulfonyl)-
N
-(1,3-thiazol-2-yl)-4-pyrimidinecarboxamide (AZ7), and ceftazidime. Data analysts were blind to the compound identities but managed to identify the target as thymidylate kinase for AZ1, isoprenoid biosynthesis for fosmidomycin, acyl-transferase for CHIR-090, and DNA metabolism for 2-(cyclobutylmethoxy)-5′-deoxyadenosine. Changes to cell wall metabolites were seen in ceftazidime treatments, although other changes, presumably relating to off-target effects, dominated spectral outputs in the untargeted approach. Drugs which do not work through metabolic pathways, such as the proton carrier CCCP, have no discernible impact on the metabolome. The untargeted metabolomics approach also revealed modifications to two compounds, namely, fosmidomycin and AZ7. An untreated control was also analyzed, and changes to the metabolome were seen over 4 h, highlighting the necessity for careful controls in these types of studies. Metabolomics is a useful tool in the analysis of drug modes of action and can complement other technologies already in use.
Population Structure Analysis of Carbapenem-Resistant Acinetobacter baumannii Clinical Isolates from Brazil Reveals Predominance of Clonal Complexes 1, 15, and 79
Authors: Camargo Carlos Henrique , Tiba Monique Ribeiro , Saes Marta Regina , Vasconcellos Francielli Mahnic de , Santos Luis Fernando dos , Romero Eliete Caló , Garcia Doroti de Oliveira
Published: February 2016

The population structure of 71 carbapenem-resistant
Acinetobacter baumannii
clinical isolates from several hospitals in Brazil was investigated by ApaI pulsed-field gel electrophoresis,
bla
OXA-51
-like subtyping, and multilocus sequence typing (Institute Pasteur scheme). In addition to the predominance of strains carrying
bla
OXA-23
, we detected the presence of
bla
OXA-72
and
bla
OXA-231
. We observed a predominance of clonal complex 1 (CC1), CC15, and CC79 and representative strains of the worldwide-disseminated international clone I.
Global Urine Metabolomics in Patients Treated with First-Line Tuberculosis Drugs and Identification of a Novel Metabolite of Ethambutol
Authors: Das Mrinal Kumar , Arya Rakesh , Debnath Sanjita , Debnath Rahul , Lodh Anindita , Bishwal Subasa Chandra , Das Anjan , Nanda Ranjan Kumar
Published: February 2016

Population level variation of drug metabolism phenotype (DMP) has great implications in treatment outcome, drug-related side effects, and resistance development. In this study, we used a gas chromatography-time of flight-mass spectrometry (GC-TOF-MS)-based untargeted urine metabolomics approach to understand the DMP of a tuberculosis (TB) patient cohort (
n
= 20) from Tripura, a state in the northeastern part of India. Urine samples collected at different postdose time points (2 h, 6 h, 12 h, 24 h, 36 h, and 48 h) from these newly diagnosed TB patients receiving first-line anti-TB drugs were analyzed, and we have successfully detected three of the four first-line drugs,
viz
., isoniazid (INH), ethambutol (ETB), and pyrazinamide (PZA). The majority of their known metabolites, acetyl-isoniazid (AcINH), isonicotinic acid (INA), isonicotinuric acid (INTA), 2,2′-(ethylenediimino)-dibutyric acid (EDBA), 5-hydroxypyrazinamide (5OH-PZA), pyrazinoic acid (POA), and 5-hydroxypyrazinoic acid (5OH-POA), were also detected. Analyzing the variation in abundances of drugs and their known metabolites and calculating the metabolic ratios in these samples, we offer comprehensive DMP information on this small patient cohort that represents Tripura, India. The majority (75%) of these patients are found to be slow acetylators of INH. The average metabolic ratios of POA/PZA and 5OH-POA/POA are 3.16 ± 3.03 and 6.09 ± 6.15, respectively. Employing correlation analysis of the metabolomics metadata and a manual prediction of drug catabolism, we have proposed 2-aminobutyric acid (AABA) as a novel metabolite of ETB. These observations indicate the usefulness of GC-MS-based metabolomics to characterize the DMP at a population level and also to identify novel drug metabolites.
Role of the Stringent Stress Response in the Antibiotic Resistance Phenotype of Methicillin-Resistant Staphylococcus aureus
Authors: Aedo Sandra , Tomasz Alexander
Published: February 2016

Resistance to beta-lactam antibiotics in methicillin-resistant
Staphylococcus aureus
(MRSA) requires the presence of an acquired genetic determinant,
mecA
or
mecC
, which encode penicillin-binding protein PBP2A or PBP2A′, respectively. Although all MRSA strains share a mechanism of resistance, the phenotypic expression of beta-lactam resistance shows considerable strain-to-strain variation. The stringent stress response, a stress response that results from nutrient limitation, was shown to play a key role in determining the resistance level of an MRSA strain. In the present study, we validated the impact of the stringent stress response on transcription and translation of
mecA
in the MRSA clinical isolate strain N315, which also carries known regulatory genes (
mecI/mecR1
/
mecR2
and
blaI/blaR1
) for
mecA
transcription. We showed that the impact of the stringent stress response on the resistance level may be restricted to beta-lactam resistance based on a “foreign” determinant such as
mecA
, as opposed to resistance based on mutations in the native
S. aureus
determinant
pbpB
(encoding PBP2). Our observations demonstrate that high-level resistance mediated by the stringent stress response follows the current model of beta-lactam resistance in which the native PBP2 protein is also essential for expression of the resistance phenotype. We also show that the
Staphylococcus sciuri pbpD
gene (also called
mecAI
), the putative evolutionary precursor of
mecA
, confers oxacillin resistance in an
S. aureus
strain, generating a heterogeneous phenotype that can be converted to high and homogenous resistance by induction of the stringent stress response in the bacteria.
The Recombinant Bacteriophage Endolysin HY-133 Exhibits
In Vitro
Activity against Different African Clonal Lineages of the Staphylococcus aureus Complex, Including Staphylococcus schweitzeri
Authors: Idelevich Evgeny A. , Schaumburg Frieder , Knaack Dennis , Scherzinger Anna S. , Mutter Wolfgang , Peters Georg , Peschel Andreas , Becker Karsten
Published: February 2016

HY-133 is a recombinant bacteriophage endolysin with bactericidal activity against
Staphylococcus aureus
. Here, HY-133 showed
in vitro
activity against major African methicillin-susceptible and methicillin-resistant
S. aureus
lineages and ceftaroline/ceftobiprole- and borderline oxacillin-resistant isolates. HY-133 was also active against
Staphylococcus schweitzeri
, a recently described species of the
S. aureus
complex. The activity of HY-133 on the tested isolates (MIC
50
, 0.25 μg/ml; MIC
90
, 0.5 μg/ml; range, 0.125 to 0.5 μg/ml) was independent of the species and strain background or antibiotic resistance.
Complement Activation by Giardia duodenalis Parasites through the Lectin Pathway Contributes to Mast Cell Responses and Parasite Control
Authors: Li Erqiu , Tako Ernest A. , Singer Steven M.
Published: February 2016

Infection withGiardia duodenalisis one of the most common causes of diarrheal disease in the world. While numerous studies have identified important contributions of adaptive immune responses to parasite control, much less work has examined innate immunity and its connections to the adaptive response during this infection. We explored the role of complement in immunity toGiardiausing mice deficient in mannose-binding lectin (Mbl2) or complement factor 3a receptor (C3aR). Both strains exhibited delayed clearance of parasites and a reduced ability to recruit mast cells in the intestinal submucosa. C3aR-deficient mice had normal production of antiparasite IgA, butex vivoT cell recall responses were impaired. These data suggest that complement is a key factor in the innate recognition ofGiardiaand that recruitment of mast cells and activation of T cell immunity through C3a are important for parasite control.
Short-Stalked Prosthecomicrobium hirschii Cells Have a Caulobacter-Like Cell Cycle
Authors: Williams Michelle , Hoffman Michelle D. , Daniel Jeremy J. , Madren Seth M. , Dhroso Andi , Korkin Dmitry , Givan Scott A. , Jacobson Stephen C. , Brown Pamela J. B.
Published: February 2016

The dimorphic alphaproteobacteriumProsthecomicrobium hirschiihas both short-stalked and long-stalked morphotypes. Notably, these morphologies do not arise from transitions in a cell cycle. Instead, the maternal cell morphology is typically reproduced in daughter cells, which results in microcolonies of a single cell type. In this work, we further characterized the short-stalked cells and found that these cells have aCaulobacter-like life cycle in which cell division leads to the generation of two morphologically distinct daughter cells. Using a microfluidic device and total internal reflection fluorescence (TIRF) microscopy, we observed that motile short-stalked cells attach to a surface by means of a polar adhesin. Cells attached at their poles elongate and ultimately release motile daughter cells. Robust biofilm growth occurs in the microfluidic device, enabling the collection of synchronous motile cells and downstream analysis of cell growth and attachment. Analysis of a draftP. hirschiigenome sequence indicates the presence of CtrA-dependent cell cycle regulation. This characterization ofP. hirschiiwill enable future studies on the mechanisms underlying complex morphologies and polymorphic cell cycles.

IMPORTANCEBacterial cell shape plays a critical role in regulating important behaviors, such as attachment to surfaces, motility, predation, and cellular differentiation; however, most studies on these behaviors focus on bacteria with relatively simple morphologies, such as rods and spheres. Notably, complex morphologies abound throughout the bacteria, with striking examples, such asP. hirschii, found within the stalkedAlphaproteobacteria.P. hirschiiis an outstanding candidate for studies of complex morphology generation and polymorphic cell cycles. Here, the cell cycle and genome ofP. hirschiiare characterized. This work sets the stage for future studies of the impact of complex cell shapes on bacterial behaviors.
Lanthanide-Dependent Regulation of Methanol Oxidation Systems in Methylobacterium extorquens AM1 and Their Contribution to Methanol Growth
Authors: Vu Huong N. , Subuyuj Gabriel A. , Vijayakumar Srividhya , Good Nathan M. , Martinez-Gomez N. Cecilia , Skovran Elizabeth
Published: February 2016

Methylobacterium extorquens
AM1 has two distinct types of methanol dehydrogenase (MeDH) enzymes that catalyze the oxidation of methanol to formaldehyde. MxaFI-MeDH requires pyrroloquinoline quinone (PQQ) and Ca in its active site, while XoxF-MeDH requires PQQ and lanthanides, such as Ce and La. Using MeDH mutant strains to conduct growth analysis and MeDH activity assays, we demonstrate that
M. extorquens
AM1 has at least one additional lanthanide-dependent methanol oxidation system contributing to methanol growth. Additionally, the abilities of different lanthanides to support growth were tested and strongly suggest that both XoxF and the unknown methanol oxidation system are able to use La, Ce, Pr, Nd, and, to some extent, Sm. Further, growth analysis using increasing La concentrations showed that maximum growth rate and yield were achieved at and above 1 μM La, while concentrations as low as 2.5 nM allowed growth at a reduced rate. Contrary to published data, we show that addition of exogenous lanthanides results in differential expression from the
xox1
and
mxa
promoters, upregulating genes in the
xox1
operon and repressing genes in the
mxa
operon. Using transcriptional reporter fusions, intermediate expression from both the
mxa
and
xox1
promoters was detected when 50 to 100 nM La was added to the growth medium, suggesting that a condition may exist under which
M. extorquens
AM1 is able to utilize both enzymes simultaneously. Together, these results suggest that
M. extorquens
AM1 actively senses and responds to lanthanide availability, preferentially utilizing the lanthanide-dependent MeDHs when possible.

IMPORTANCE
The biological role of lanthanides is a nascent field of study with tremendous potential to impact many areas in biology. Our studies demonstrate that there is at least one additional lanthanide-dependent methanol oxidation system, distinct from the MxaFI and XoxF MeDHs, that may aid in classifying additional environmental organisms as methylotrophs. Further, our data suggest that
M. extorquens
AM1 has a mechanism to regulate which MeDH is transcribed, depending on the presence or absence of lanthanides. While the mechanism controlling differential regulation is not yet understood, further research into how methylotrophs obtain and use lanthanides will facilitate their cultivation in the laboratory and their use as a biomining and biorecycling strategy for recovery of these commercially valuable rare-earth elements.
l-Hydroxyproline andd-Proline Catabolism in Sinorhizobium meliloti
Authors: Chen Siyun , White Catharine E. , diCenzo George C. , Zhang Ye , Stogios Peter J. , Savchenko Alexei , Finan Turlough M.
Published: February 2016

Sinorhizobium melilotiforms N2-fixing root nodules on alfalfa, and as a free-living bacterium, it can grow on a very broad range of substrates, includingl-proline and several related compounds, such as proline betaine,trans-4-hydroxy-l-proline (trans-4-l-Hyp), andcis-4-hydroxy-d-proline (cis-4-d-Hyp). Fourteenhypgenes are induced upon growth ofS. melilotiontrans-4-l-Hyp, and of those,hypMNPQencodes an ABC-typetrans-4-l-Hyp transporter andhypREencodes an epimerase that convertstrans-4-l-Hyp tocis-4-d-Hyp in the bacterial cytoplasm. Here, we present evidence that the HypO, HypD, and HypH proteins catalyze the remaining steps in whichcis-4-d-Hyp is converted to α-ketoglutarate. The HypO protein functions as ad-amino acid dehydrogenase, convertingcis-4-d-Hyp to Δ1-pyrroline-4-hydroxy-2-carboxylate, which is deaminated by HypD to α-ketoglutarate semialdehyde and then converted to α-ketoglutarate by HypH. The crystal structure of HypD revealed it to be a member of theN-acetylneuraminate lyase subfamily of the (α/β)8protein family and is consistent with the known enzymatic mechanism for other members of the group. It was also shown thatS. melilotican catabolized-proline as both a carbon and a nitrogen source, thatd-proline can complementl-proline auxotrophy, and that the catabolism ofd-proline is dependent on thehypcluster. Transport ofd-proline involves the HypMNPQ transporter, following whichd-proline is converted to Δ1-pyrroline-2-carboxylate (P2C) largely via HypO. The P2C is converted tol-proline through the NADPH-dependent reduction of P2C by the previously uncharacterized HypS protein. Thus, overall, we have now completed detailed genetic and/or biochemical characterization of 9 of the 14hypgenes.

IMPORTANCEHydroxyproline is abundant in proteins in animal and plant tissues and serves as a carbon and a nitrogen source for bacteria in diverse environments, including the rhizosphere, compost, and the mammalian gut. While the main biochemical features of bacterial hydroxyproline catabolism were elucidated in the 1960s, the genetic and molecular details have only recently been determined. Elucidating the genetics of hydroxyproline catabolism will aid in the annotation of these genes in other genomes and metagenomic libraries. This will facilitate an improved understanding of the importance of this pathway and may assist in determining the prevalence of hydroxyproline in a particular environment.
Hanging on by a thread: a rare case of secondary pseudoainhum
Authors: Arkush Leo , De Silva Bernadette , Gordon David
Published: February 2016

Pseudoainhum is a rare and poorly characterised phenomenon involving autoamputation of a digit associated with an identifiable or related disease process. We describe the case of a 19-year-old man with long-standing neurodisability, sensorineural hearing loss and severe keratoderma, presenting with painless rapidly-progressing autoamputation of his left little toe. Genetic analysis thus far has been inconclusive. The toe appeared to be hanging on by a thread, with no clinical signs of infection. Radiographs showed lysis with complete resorption of the proximal phalynx. Routine blood tests found an isolated neutropenia with normal C reactive protein and biochemistry. We report an unusual case of a young adult with a history of chronic neurological and dermatological problems presenting with secondary pseudoainhum and provide a valuable addition to the limited literature describing this rare condition.
Ruptured subcapsular liver haematoma following mechanically-assisted cardiopulmonary resuscitation
Authors: Joseph John R , Freundlich Robert Edward , Abir Mahshid
Published: February 2016

A 64-year-old man with a history of ascending aortic surgery and pulmonary embolus presented with shortness of breath. He rapidly decompensated, prompting intubation, after which he lost pulses. Manual resuscitation was initiated immediately, with subsequent use of a LUCAS-2 mechanical compression device. The patient was given bolus thrombolytic therapy and regained pulses after 7 min of CPR. Compressions were reinitiated with the LUCAS-2 twice more during resuscitation over the subsequent hour for brief episodes of PEA. After confirmation of massive pulmonary embolism on CT, the patient underwent interventional radiology-guided ultrasonic catheter placement with local thrombolytic therapy and experienced immediate improvement in oxygenation. He later developed abdominal compartment syndrome, despite cessation of thrombolytic and anticoagulation therapy. Bedside exploratory abdominal laparotomy revealed a ruptured subcapsular haematoma of the liver. The patient's haemodynamics improved following surgery and he was extubated 11 days postarrest with intact neurological function.
Process of determining the value of belief about jinn possession and whether or not they are a result of mental illness
Authors: Guthrie Elspeth , Abraham Seri , Nawaz Shahzada
Published: February 2016

We present the case of a 28-year-old Afghan woman who presented perinatally with concerns of being possessed by jinns. She was noted to have third person auditory hallucinations, delusions of control and somatic passivity. She was diagnosed with schizophrenia and was treated with antipsychotic medications with a positive outcome. Her husband also believed that his wife was possessed and believed that her jinns talked through his wife on occasions. He did not experience any psychotic symptoms himself. In the Muslim faith, beliefs about jinns are widely held by people with and without any signs of mental illness. We feel that the patient's interpretation of her symptoms was influenced by her and her husband's religious and cultural beliefs, leading to a delay in receiving appropriate treatment. Awareness among mental health professionals about widely held religious and cultural beliefs will enhance the assessment, diagnosis and treatment of similar presentations.
Supporting breastfeeding In Local Communities (SILC) in Victoria, Australia: a cluster randomised controlled trial
Authors: McLachlan Helen L , Forster Della A , Amir Lisa H , Cullinane Meabh , Shafiei Touran , Watson Lyndsey F , Ridgway Lael , Cramer Rhian L , Small Rhonda
Published: February 2016

Objectives

Breastfeeding has significant health benefits for mothers and infants. Despite recommendations from the WHO, by 6 months of age 40% of Australian infants are receiving no breast milk. Increased early postpartum breastfeeding support may improve breastfeeding maintenance. 2 community-based interventions to increase breastfeeding duration in local government areas (LGAs) in Victoria, Australia, were implemented and evaluated.

Design

3-arm cluster randomised trial.

Setting

LGAs in Victoria, Australia.

Participants

LGAs across Victoria with breastfeeding initiation rates below the state average and > 450 births/year were eligible for inclusion. The LGA was the unit of randomisation, and maternal and child health centres in the LGAs comprised the clusters.

Interventions

Early home-based breastfeeding support by a maternal and child health nurse (home visit, HV) with or without access to a community-based breastfeeding drop-in centre (HV+drop-in).

Main outcome measures

The proportion of infants receiving ‘any’ breast milk at 3, 4 and 6 months (women's self-report).

Findings

4 LGAs were randomised to the comparison arm and provided usual care (n=41 clusters; n=2414 women); 3 to HV (n=32 clusters; n=2281 women); and 3 to HV+drop-in (n=26 clusters; 2344 women). There was no difference in breastfeeding at 4 months in either HV (adjusted OR 1.04; 95% CI 0.84 to 1.29) or HV+drop-in (adjusted OR 0.92; 95% CI 0.78 to 1.08) compared with the comparison arm, no difference at 3 or 6 months, nor in any LGA in breastfeeding before and after the intervention. Some issues were experienced with intervention protocol fidelity.

Conclusions

Early home-based and community-based support proved difficult to implement. Interventions to increase breastfeeding in complex community settings require sufficient time and partnership building for successful implementation. We cannot conclude that additional community-based support is ineffective in improving breastfeeding maintenance given the level of adherence to the planned protocol.

Trial registration number

ACTRN12611000898954; Results.
Association of chronic insomnia symptoms and recurrent extreme sleep duration over 10 years with well-being in older adults: a cohort study
Authors: Abell Jessica G , Shipley Martin J , Ferrie Jane E , Kivimäki Mika , Kumari Meena
Published: February 2016

Objectives

The extent to which aspects of sleep affect well-being in the long-term remains unclear. This longitudinal study examines the association between chronic insomnia symptoms, recurrent sleep duration and well-being at older ages.

Setting

A prospective cohort of UK civil servants (the Whitehall II study).

Participants

4491 women and men (25.2% women) with sleep measured 3 times over 10 years and well-being once at age 55–79 years. Insomnia symptoms and sleep duration were assessed through self-reports in 1997–1999, 2003–2004 and 2007–2009.

Primary outcome measures

Indicators of well-being, measured in 2007–2009, were the Control, Autonomy, Self-realisation and Pleasure measure (CASP-19) of overall well-being (range 0–57) and the physical and mental well-being component scores (range 0–100) of the Short Form Health Survey (SF-36).

Results

In maximally adjusted analyses, chronic insomnia symptoms were associated with poorer overall well-being (difference between insomnia at 3 assessments vs none −7.0 (SE=0.4) p<0.001), mental well-being (difference −6.9 (SE=0.4), p<0.001) and physical well-being (difference −2.8 (SE=0.4), p<0.001) independently of the other sleep measures. There was a suggestion of a dose–response pattern in these associations. In addition, recurrent short sleep (difference between ≤5 h sleep reported at 3 assessments vs none −1.7 (SE=0.7), p<0.05) and recurrent long sleep (difference between >9 h reported at 2 or 3 assessments vs none −3.5 (SE=0.9), p<0.001) were associated with poorer physical well-being.

Conclusions

We conclude that in older people, chronic insomnia symptoms are negatively associated with all aspects of well-being, whereas recurrent long and short sleep is only associated with reduced physical well-being.
Preferences for engagement in health technology assessment decision-making: a nominal group technique with members of the public
Authors: Wortley Sally , Tong Allison , Howard Kirsten
Published: February 2016

Objective

To identify characteristics (factors) about health technology assessment (HTA) decisions that are important to the public in determining whether public engagement should be undertaken and the reasons for these choices.

Design

Focus groups using a nominal group technique to identify and rank factors relevant to public engagement in HTA decision-making. Thematic analysis was also undertaken to describe reasons underpinning participants’ choices and rankings.

Setting

Members of the Australian general public.

Participants

58 people, aged 19–71 years participated in 6 focus groups.

Results

24 factors were identified by participants that were considered important in determining whether public engagement should be undertaken. These factors were individually ranked and grouped into 4 themes to interpret preferences for engagement. Members of the public were more likely to think public engagement was needed when trade-offs between benefits and costs were required to determine ‘value’, uncertainties in the evidence were present, and family members and/or carers were impacted. The role of public engagement was also seen as important if the existent system lacked transparency and did not provide a voice for patients, particularly for conditions less known in the community.

Conclusions

Members of the public considered value, impact, uncertainty, equity and transparency in determining when engagement should be undertaken. This indicates that the public's preferences on when to undertake engagement relate to both the content of the HTA itself as well as the processes in place to support HTA decision-making. By understanding these preferences, decision-makers can work towards more effective, meaningful public engagement by involving the public in issues that are important to them and/or improving the processes around decision-making.
ADding negative pRESSure to improve healING (the DRESSING trial): a RCT protocol
Authors: Gillespie Brigid M , Webster Joan , Ellwood David , Stapleton Helen , Whitty Jennifer A , Thalib Lukman , Cullum Nicky , Mahomed Kassam , Chaboyer Wendy
Published: February 2016

Introduction

Obese women are more likely to develop a surgical site infection (SSI) following caesarean section (CS) than non-obese women. Negative pressure wound therapy (NPWT) is increasingly being used to reduce SSI with limited evidence for its effectiveness.

Objectives

To determine the clinical and cost-effectiveness of using NPWT in obese women having elective and semiurgent CS.

Methods and analysis

A multisite, superiority parallel pragmatic randomised controlled trial with an economic evaluation. Women with a body mass index (BMI) of ≥30, booked for elective and semiurgent CS at 4 Australian acute care hospitals will be targeted. A total of 2090 women will be enrolled. A centralised randomisation service will be used with participants block randomised to either NPWT or standard surgical dressings in a 1:1 ratio, stratified by hospital. The primary outcome is SSI; secondary outcomes include type of SSI, length of stay, readmission, wound complications and health-related quality of life. Economic outcomes include direct healthcare costs and cost-effectiveness, which will be evaluated using incremental cost per quality-adjusted life year gained. Data will be collected at baseline, and participants followed up on the second postoperative day and weekly from the day of surgery for 4 weeks. Outcome assessors will be masked to allocation. The primary statistical analysis will be based on intention-to-treat.

Ethics and dissemination

Ethics approval has been obtained from the ethics committees of the participating hospitals and universities. The findings of the trial will be disseminated through peer-reviewed journals, national and international conference presentations.

Trial registration number

ACTRN12615000286549; Pre-results.
Hybrid simulation compared to manikin alone in teaching pelvic examinations: a randomised control trial
Authors: Manley Kristyn , Edwards Sian , Mears Jane , Siassakos Dimitrios
Published: February 2016

Introduction

Performing a pelvic examination is a core skill for all medical undergraduates. The use of hybrid simulation, manikin with patient actress, to attain technical and communication skills competencies and to improve the quality of care we offer women, has not been compared to other teaching methods before. Outcome measures were technical skills, communication skills and confidence in completing a pelvic examination.

Methods

A cluster randomised control trial was conducted over an academic year. Forty-eight medical students who completed an 8-week obstetrics and gynaecology attachment were recruited. Clusters were randomly assigned for initial training on hybrid or manikin only models and attended an end of attachment Objective Structured Clinical Assessment.

Results

Outcome data were received for 43/48 students (89.5%). Following the objectively structured clinical examination, the hybrid trained cohort had higher technical scores (mean 23 (95% CI 20.1 to 25.8) vs 16.7 (CI 14.7 to 18.6); mean difference 6.3, CI 3.0 to 9.6) and communication skills scores (mean 22.6 (CI 21.2 to 23.8) vs 15.9 (CI 14.4 to 17.3); mean difference 6.7, CI 4.8 to 8.5) compared to the manikin only trained participants. Confidence in undertaking future pelvic examinations were similar in the control and intervention groups; (p=0.10, r=0.18).

Conclusions

This study demonstrates the value of hybrid simulation compared to manikins alone in improving the short-term acquisition of competence in simulated pelvic examinations at an undergraduate level. Future research should focus on whether hybrid models lead to long-term acquisition of skill and comparison of these models with other innovative methods such as clinical teaching associates.
Association of diethylhexyl phthalate with obesity-related markers and body mass change from birth to 3 months of age
Authors: Kim Jin Hee , Park Hyunkyung , Lee Jangwoo , Cho Geumjoon , Choi Sooran , Choi Gyuyeon , Kim Su Young , Eun So-Hee , Suh Eunsook , Kim Sung Koo , Kim Hai-Joong , Kim Gun-Ha , Lee Jeong Jae , Kim Young Don , Eom Soyong , Kim Seunghyo , Moon Hyo-Bang , Park Jeongim , Choi Kyungho , Kim Sungjoo , Kim Sungkyoon
Published: February 2016

Background

Several studies have suggested potential links of phthalates to obesity in children and adults. Limited evidence, however, has been available for the relations between diethylhexyl phthalate (DEHP) and obesity-related markers or body mass change in early life.

Methods

128 healthy pregnant women were recruited and, after delivery, their newborns’ first urine and umbilical cord blood samples were collected. We measured urinary levels of two DEHP metabolites, mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP). We also measured the levels of leptin, total cholesterol and triglyceride (TG) in cord serum, and used them along with weight, length, head circumference and ponderal index (PI, 100 g/cm3) at birth, as obesity-related markers, and estimated the relations between DEHP metabolites and obesity-related markers using generalised linear models. For the evaluation of body mass increase by early life DEHP exposure, body mass index (BMI) z-score change during 3 months after birth by DEHP metabolites in the first urine samples of the newborns were evaluated using logistic regression.

Results

DEHP exposure was associated with decrease of PI and increase of TG (PI, β=−0.11, p=0.070 and TG, β=0.14, p=0.027), especially for boys (PI, β=−0.13, p=0.021; and TG, β=0.19, p=0.025). Moreover, DEHP exposure was positively associated with body mass increase during 3 months after birth (change of BMI z-scores, OR=4.35, p=0.025).

Conclusions

Our findings suggest that DEHP exposure may affect body mass change in early life through changes of obesity-related markers.
Longer procedural times are independently associated with symptomatic intracranial hemorrhage in patients with large vessel occlusion stroke undergoing thrombectomy
Authors: Kass-Hout Tareq , Kass-Hout Omar , Sun Chung-Huan Johnny , Kass-Hout Taha A , Nogueira Raul , Gupta Rishi
Published: February 2016

Background

Time to reperfusion is an essential factor in determination of outcomes in acute ischemic stroke (AIS).

Objective

To establish the effect of the procedural time on the clinical outcomes of patients with AIS.

Methods

Data from all consecutive patients who underwent mechanical thrombectomy between September 2010 and July 2012 were analysed retrospectively. The variable of interest was procedural time (defined as time from groin puncture to final recanalization time). Outcome measures included the rates of symptomatic intracranial hemorrhage (sICH, defined as any parenchymal hematoma—eg, PH-1/PH-2), final infarct volume, 90-day mortality, and independent functional outcomes (modified Rankin Scale 0–2) at 90 days.

Results

The cohort included 242 patients with a mean age of 65.5±14.2 and median baseline National Institutes of Health Stroke Scale score 20. 51% of the patients were female. The mean procedure time was significantly shorter in patients with a good outcome (86.7 vs 73.1 min, respectively, p=0.0228). Patients with SICH had significantly higher mean procedure time than patients without SICH (79.67 vs 104.5 min, respectively; p=0.0319), which remained significant when controlling for the previous factors (OR=0.974, 95% CI 0.957 to 0.991). No correlation was found between the volume of infarction and the procedure time (r=0.10996, p=0.0984). No association was seen between procedure time and 90-day mortality (77.8 vs 88.2 min in survivals vs deaths, respectively; p=0.0958).

Conclusions

Our data support an association between the risk of SICH and a longer procedure time, but no association between procedural times and the final infarction volume or long-term functional outcomes was found.
Social Role Participation Questionnaire for patients with ankylosing spondylitis: translation into Dutch, reliability and construct validity
Authors: van Genderen Simon , Plasqui Guy , Lacaille Diane , Arends Suzanne , van Gaalen Floris , van der Heijde Désirée , Heuft Liesbeth , Keszei András , Luime Jolanda , Spoorenberg Anneke , Landewé Robert , Gignac Monique , Boonen Annelies
Published: February 2016

Objective

The Social Role Participation Questionnaire (SRPQ) assesses the influence of health on participation in 11 specific and one general participation role across 4 participation dimensions: ‘importance’, ‘satisfaction with time’, ‘satisfaction with performance’ and ‘physical difficulty’. This study aimed to translate the SRPQ into Dutch, and assess the clinimetric properties and aspects of its validity among patients with ankylosing spondylitis (AS).

Methods

Translation was performed using the dual panel approach. For each participation dimension, internal consistency, test-retest reliability (n=31), and construct validity were assessed in 246 patients with AS.

Results

The translation required only minor adaptations. Cronbach αs were α≥0.7. A strong correlation was present between satisfaction with ‘time’ and ‘performance’(r=0.85). Test-retest reliability was satisfactory (κ=0.79–0.95). Correlations with participation domains of the Short-Form Health Survey 36 (SF-36), the WHO Disease Assessment Score II, and generic as well as disease-specific health outcomes (Physical and Mental component scale of the SF-36, Satisfaction With Life Scale, Bath Ankylosing Spondylitis Disease Index (BASDAI), Bath Ankylosing Spondylitis Functioning Index (BASFI)) were at least moderate (r=−0.41 to 0.75) for all dimensions except for ‘role importance’ where correlations were weak (r≤40). Discriminative ability across 5 self-reported health states was good for all dimensions (p<0.01). The ‘general participation’ role showed similar reliability and validity for each dimension, as the average of the all 11 roles.

Conclusions

The Dutch version of the SRPQ is available to help understand social role participation of patients with AS. The dimension ‘role importance’ measures a distinct aspect of participation. The general participation item was a good global measure of participation.
Paleoenvironment of the Quilchena flora, British Columbia, during the Early Eocene Climatic Optimum
Authors: Mathewes Rolf W. , Greenwood David R. , Archibald S. Bruce
Published: February 2016

The Quilchena fossil locality is dated (51.5 ± 0.4 Ma) to the Early Eocene Climatic Optimum, and this locality is reconstructed as the warmest and wettest of the Early Eocene upland sites from the Okanagan Highlands of British Columbia and northern Washington State. Mean annual temperature (MAT) is estimated from leaf margin analysis, using 55 dicot morphotypes, as 16.2 ± 2.1 °C/14.6 ± 4.8 °C. Using bioclimatic analysis of 45 nearest living relatives, a moist mesothermal climate is indicated (MAT 12.7–16.6 °C; cold month mean temperature (CMMT) 3.5–7.9 °C; mean annual precipitation (MAP) 103–157 cm/year. Leaf size analysis estimates MAP at 121 ± 39 cm/year. Estimates from the climate leaf analysis multivariate program corroborate these results, although with a slightly cooler MAT (13.3 ± 2.1 °C). Plants that support an interpretation of warm winters with minimal or no frost include Azolla, Glyptostrobus, Taxodium, Keteleeria, Pseudolarix, Eucommia, Dipteronia, Hovenia, Ternstroemia, and others. These thermophilous elements occur together with temperate genera such as Alnus, Betula, Ulmus, Calocedrus, and Fraxinus. Palynological assemblages at Quilchena are dominated by bisaccate conifers and Cupressaceae. Common angiosperms include Ulmus type, triporates, Pterocarya, and Alnus. Insect fossils at Quilchena that today inhabit tropical and subtropical regions also support warm and equable climate without significant frost, and include obligate palm-feeding beetles (Pachymerina), which indicate CMMT perhaps as high as 8 °C. These are found together with temperate aphids, wasps, giant lacewings, brown lacewings, and a panorpoid scorpionfly, supporting an interpretation of equable climatic conditions during the Early Eocene Climatic Optimum.
Growth rate and abundance of common fishes is negatively related to dissolved organic carbon concentration in lakes
Authors: Benoît Pierre-Olivier , Beisner Beatrix E. , Solomon Christopher T.
Published: February 2016

Dissolved organic carbon (DOC) can limit food web productivity in lakes, potentially imposing resource limitation on fishes. We asked whether the abundance or early growth rate of three fish species was negatively related to DOC in 59 lakes in southern Quebec, Canada, where DOC concentrations ranged from 4 to 16 mg·L−1 for lakes containing walleye (Sander vitreum) and yellow perch (Perca flavescens) and from 2.6 to 9 mg·L−1 for lakes containing lake trout (Salvelinus namaycush). Estimates of abundance and growth rate were more precise for walleye and lake trout than for yellow perch because of differences in sample size. Abundance was negatively related to DOC for walleye and perhaps also for lake trout and yellow perch. Early growth rate was negatively related to DOC for walleye and lake trout, but not for yellow perch. These results support a growing body of literature suggesting that the productivity of fish populations may be negatively related to DOC concentrations in lakes.
Diversity in yeast–mycelium dimorphism response of the Dutch elm disease pathogens: the inoculum size effect
Authors: Wedge Marie-Ève , Naruzawa Erika Sayuri , Nigg Martha , Bernier Louis
Published: February 2016

Dutch elm disease (DED) is caused by the dimorphic fungi Ophiostoma ulmi, Ophiostoma novo-ulmi, and Ophiostoma himal-ulmi. A cell population density-dependent phenomenon related to quorum sensing was previously shown to affect the reversible transition from yeast-like to mycelial growth in liquid shake cultures of O. novo-ulmi NRRL 6404. Since the response to external stimuli often varies among DED fungal strains, we evaluated the effect of inoculum size on 8 strains of the 3 species of DED agents by determining the proportion of yeast and mycelium produced at different spore inoculum concentrations in defined liquid shake medium. The results show that not all DED fungi strains respond similarly to inoculum size effect, since variations were observed among strains. It is thus possible that the different strains belonging to phylogenetically close species use different signalling molecules or molecular signalling pathways to regulate their growth mode via quorum-sensing mechanisms.
MARKETING CAPABILITY, COMPETITIVE STRATEGIES AND PERFORMANCE OF MICRO AND SMALL FAMILY BUSINESSES IN GHANA
Authors: AGYAPONG AHMED , OSEI HANNAH VIVIAN , AKOMEA SAMUEL YAW
Published: February 2016

The study examines the mediating role of competitive strategies (cost leadership and differentiation) in the marketing capability-performance relationship using data from 264 micro and small family firms in Ghana. The bootstrap method for exploring mediating relationships was used to examine the hypotheses. The findings indicate that although differentiation influence performance, cost leadership does not influence performance after controlling for firm age and firm size. However, marketing capability significantly influence performance. The findings further revealed that marketing capabilities do not have any indirect relationship on performance through cost leadership. However, the results indicated that marketing capability influenced firm performance through differentiation strategy. The findings indicate the need to implement both competitive strategy and marketing capability to enhance performance of micro and small family businesses.
Selective octabromination of tetraarylporphyrins based on meso-substituent identity: Structural and electrochemical studies
Authors: Commins Patrick J. , Hill Jonathan P. , Matsushita Yoshitaka , Webre Whitney A. , Labuta Jan , Ariga Katsuhiko , D’Souza Francis
Published: February 2016

Synthesis and isolation of selectively brominated tetraarylporphyrin derivatives is reported. Treatment with bromine of meso-5,10,15,20-tetrakis(3,4,5-trimethoxyphenyl)porphyrin (1) or meso-5,10,15,20-tetrakis(3,5-di-[Formula: see text]-butyl-4-hydroxyphenyl)porphinatocopper(II) (2-Cu) yields products octabrominated at the 2,6-positions of meso-aryl substituents [5,10,15,20-tetrakis(2,6-dibromo-3,4,5-trimethoxyphenyl)porphyrin, [Formula: see text]Br81] or macrocyclic [Formula: see text]-positions. The latter of these ([Formula: see text]-brominated) was identified as the oxoporphyrinogen 2,3,7,8,12,13,17,18-octabromo-5,10,15,20- tetrakis(3,5-di-[Formula: see text]-butyl-4-oxo-cyclohexa-2,5-dienylidene)porphyrinogen 3 obtained due to the adventitious oxidation and demetalation of 2-Cu, which could be alkylated at its macrocyclic nitrogen atoms yielding N[Formula: see text],N[Formula: see text],N[Formula: see text],N[Formula: see text]-tetrakis(4-bromobenzyl)-2,3,7,8,12,13,17,18-octabromo-5,10,15,20-tetrakis(3,5-di-[Formula: see text]-butyl-4-oxo-cyclo hexa-2,5-dienylidene)porphyrinogen 4. The former compound [Formula: see text]Br81 was complexed with Zn(II) ([Formula: see text]Br81-Zn) or Cu(II) ([Formula: see text]Br81-Cu) and could also be subjected to further bromination yielding 2,3,7,8,12,13,17,18-octabromo-5,10,15,20-tetrakis(2,6-dibromo-3,4,5-trimethoxyphenyl)porphyrin, Br[Formula: see text]1. The effect on the electrochemical properties of the 2,6-bromophenyl-substituted porphyrin compounds over the more highly brominated products was assessed.
Effect of polyfluorination on self-assembling and electronic properties of thioalkyl-porphyrazines
Authors: Belviso Sandra , Cammarota Francesca , Rossano Rocco , Lelj Francesco
Published: February 2016

The novel polyfluorinated thioalkyl-porfirazine 2,3,7,8,12,13,17,18-octakis(1,1,1,2,2,-3,3,4,4-nonafluorohexylthio)-5,10,15,20-21H,23H-porfirazine was synthesized to investigate the fluorine effect on self-aggregation, electrochemical, and spectral properties of this class of tetrapyrrole macrocycles. This compound showed an ordered and quite thermally stable columnar discotic mesophase, never seen in non-fluorinated symmetrically substituted “free-base” thioalkyl-porphyrazines, revealing a significant effect of fluorine on molecular self-assembling properties. An important effect of fluorination was also observed on the spectral and electrochemical properties of the molecule, giving rise to a hypsochromic shift in the 400–700 nm range of UV-vis absorption spectrum and to a marked cathodic shift of the reduction potentials in respect to the non-fluorinated analogs. DFT and TDDFT calculations has been undertaken to elucidate the origin of the observed behavior. Interestingly, HOMO, LUMO, and band-gap values together with its mesomorphic properties make this compound a promising material for organic photovoltaics.
Isolated Intracranial Rosai-Dorfman Disease
Authors: Taufiq Md. , Khair Abul , Begum Ferdousy , Akhter Shabnam , Shamim Farooq Md. , Kamal Mohammed
Published: February 2016

Background. Rosai-Dorfman disease (RDD) is a benign histiocytic proliferative disorder of unknown etiology. This rare condition commonly causes massive cervical lymphadenopathy. Intracranial RDD without any nodal involvement is extremely rare.Case Report. A young Bangladeshi male complained of bilateral complete blindness with left sided deafness for about three years. There was no lymphadenopathy. MRI and CT scan of brain suggested an inflammatory/neoplastic (?meningioma) lesion located at left parasellar region which extended frontally to encircle both optic nerves and also to left prepontine area. Histopathologically the lesion was diagnosed as RDD. The patient was treated with steroid and significant clinical improvement observed.Conclusion. The prognosis of intracranial RDD is not poor. It can be treated with surgery with or without corticosteroids, chemotherapy, and so forth. But as the condition is extremely rare and often misdiagnosed, the clinician, radiologist, and histopathologist should have a suspicion in their mind about the possibility of RDD.