bluuebunny/crossref_metadata_2025 huggingface dataset:
An ambulance referral network improves access to emergency obstetric and neonatal care in a district of rural Burundi with high maternal mortality
Authors: Tayler‐Smith K. , Zachariah R. , Manzi M. , Van den Boogaard W. , Nyandwi G. , Reid T. , De Plecker E. , Lambert V. , Nicolai M. , Goetghebuer S. , Christiaens B. , Ndelema B. , Kabangu A. , Manirampa J. , Harries A. D.
Published: May 2013

Objectives

In 2006, Médecins sans Frontières (MSF) established an emergency obstetric and neonatal care (EmONC) referral facility linked to an ambulance referral system for the transfer of women with obstetric complications from peripheral maternity units in Kabezi district, rural Burundi. This study aimed to (i) describe the communication and ambulance service together with the cost; (ii) examine the association between referral times and maternal and early neonatal deaths; and (iii) assess the impact of the referral service on coverage of complicated obstetric cases and caesarean sections.

Methods

Data were collected for the period January to December 2011, using ambulance log books, patient registers and logistics records.

Results

In 2011, there were 1478 ambulance call‐outs. The median referral time (time from maternity calling for an ambulance to the time the patient arrived at the MSF referral facility) was 78 min (interquartile range, 52–130 min). The total annual cost of the referral system (comprising 1.6 ambulances linked with nine maternity units) was € 85 586 (€ 61/obstetric case transferred or € 0.43/capita/year). Referral times exceeding 3 h were associated with a significantly higher risk of early neonatal deaths (OR, 1.9; 95% CI, 1.1–3.2). MSF coverage of complicated obstetric cases and caesarean sections was estimated to be 80% and 92%, respectively.

Conclusion

This study demonstrates that it is possible to implement an effective communication and transport system to ensure access to EmONC and also highlights some of the important operational factors to consider, particularly in relation to minimising referral delays.
Cost‐effectiveness of prospective red blood cell antigen matching to prevent alloimmunization among sickle cell patients
Authors: Kacker Seema , Ness Paul M. , Savage William J. , Frick Kevin D. , Shirey R. Sue , King Karen E. , Tobian Aaron A.R.
Published: May 2013

Background

Sickle cell disease is associated with extensive health care utilization; estimated lifetime costs exceed $460,000 per patient. Approximately 30% of chronically transfused sickle cell patients become alloimmunized to red blood cell antigens, but these patients cannot be identified a priori. Prospective antigen matching can prevent alloimmunization, but is costly and may not benefit most patients.

Study Design and Methods

A Markov‐based model was constructed to compare the health and financial implications of four alternative antigen‐matching strategies for chronically transfused sickle cell patients. The strategies varied by the group of patients receiving matched blood (all patients prophylactically or only patients with a history of alloimmunization [history‐based]), and by the extent of antigen matching (limited to C, E, and K, or extended to 11 antigens). Direct medical costs and alloimmunization events were assessed over 10‐ and 20‐year periods, for a hypothetical cohort of initially transfusion‐naive patients and for a dynamic population.

Results

Within a hypothetical cohort of initially transfusion‐naive patients, implementing prophylactic limited matching for all chronically transfused patients instead of history‐based limited matching is expected to cost an additional $765.56 million over 10 years, but result in 2072 fewer alloimmunization events. Within the same cohort, implementing prospective extensive matching is expected to cost $1.86 billion more than history‐based extensive matching, but result in 2424 fewer alloimmunization events. Averting a single alloimmunization event using prospective matching would cost $369,482 to $769,284. Among a dynamic population over 10 years, prospective limited matching is expected to cost $358.34 million more than history‐based limited matching.

Conclusions

While prospective matching for all transfused patients would reduce alloimmunization, this strategy requires considerable expenditure.
Comparative studies of the spruce tree stand in the Tatrzański National Park
Authors: Staszewski Tomasz , Uziębło Aldona Katarzyna , Kubiesa Piotr , Łukasik Włodzimierz
Published: May 2013

The paper presents the results of an investigation carried out at a permanent plot in spruce stand of the Tatrzański National Park in the years 1998–2006. Concentrations of phytotoxic gases in the air together with the load of acidifying compounds reaching the forest soil were characterized. The forest ecosystem response was evaluated by analysing the chemistry of the needles, changes in health status of trees and floral composition. Neither exceedances of the critical SO2 and NO2 concentration levels in the air nor the critical load of acidity were found. Only ozone concentration level was recognised as a potential threat to the trees. Heavy metal concentrations in spruce needles represented levels concerned as non-hazardous for the health status of the tree stand. The use of the spruce needles as a cumulative bioindicator showed the presence of PAHs with carcinogenic properties in the air. The investigated spruce stand belongs to the slightly damaged class, however in the period of 1998–2004 a deterioration of the spruce trees condition was observed expressed by a diminishing number of health trees. A comparative investigation carried out in the years 2001 and 2006 proved stability of the floral composition at the permanent plot.
Effects of above-limit ground-level ozone concentrations on the health condition of the silver birch (Betula pendula Roth) assimilation apparatus within the period of 2009–2011
Authors: Bednářová Emilie
Published: May 2013

Effects of above-limit ground-level ozone concentrations on the health condition of the silver birch (Betula pendula Roth) assimilation apparatus was monitored using the method of study of changes in epicuticular waxes. These waxes are present on the surface of leaves and protect the plant (and, especially, its assimilation apparatus) against negative environmental effects. Studies were performed in a tree stand of the 2nd age category in altitudes ranging from 600 to 1,050 m in the Ore Mountains (Krušné hory in Czech). It was found out that, as compared with a control stand, the thickness of the wax epicuticular layer decreased with the increasing altitude while concentrations of the ground-level ozone increased. A visible damage of the assimilation apparatus was observed in localities with the highest concentrations of ground-level ozone. Here, not only an overall decrease in the amount of epicuticular waxes was observed but also a degradation of their structure. A statistical analysis of results proved that the loss of epicuticular waxes was significantly dependent on above-limit concentrations of ground-level ozone.
Comparison of soil and seepage water properties in the limed and not-limed spruce forest stands in the Beskydy Mts.
Authors: Drápelová Ida , Kulhavý Jiří
Published: May 2013

The study deals with evaluation of a liming experiment carried out in spruce stands situated near Bílý Kříž in Moravian-Silesian Beskydy Mts. at an altitude of 908 m. Soil type was humo-ferric podzol with mor-moder humus form and low content of nutrients. Soil properties and soil solution composition from two research plots with Picea abies [L.] Karst. monoculture aged 28 in 2006 were compared. One of the plots was limed by dolomitic limestone at a total dose of 9 t ha-1 in the 80s of the 20th century the second plot was a not-limed control. Sampling of sub-surface seepage water was carried out in fortnight intervals on the both plots during 2001–2006. Statistically significant differences between the limed and control plot were found in soil solution concentrations of Ca2+, Mg2+, Na+, K+, NH4+, HPO42-, SO42-, dissolved organic carbon (DOC) and pH. Significant differences were not observed between the plots in NO3- concentrations. Soil samples taken from the both plots in 2003 were analyzed and the results have shown that changes induced by liming could be detected even after 16 year after the last liming event. Increased pH values in the entire soil profile, and changes in the composition of soil sorption complex and increased base saturation in the forest floor horizons were found on the limed plot.
Effect of site conditions and tree species composition on physico-chemical properties of soil environment in the Western Carpathians area
Authors: Vavříček Dušan , Pecháček Jan , Baláž G.
Published: May 2013

The objective of pedological research conducted in the Kněhyně–Čertův mlýn National Nature Reserve was to verify to what extent the properties of the soil environment are influenced by: a) chemistry of soil-forming substrate, b) site conditions, c) species composition of forest stand. The results of this study document that the soil taxonomic units in the area of interest are of podzol character and that the altitudinal soil zonality has not developed there. The total content of basic macrobioelements in soil-forming substrates is not in correlation with their accessible fraction in top genetic horizons of the profile depth. The results of this study also show that lead content reaches a significantly hazardous boundary level at sites of ridge stands in the exposure of northern quadrants. The soil environment under forest stands with prevailing Norway spruce (Picea abies/L./ Karst.) is enriched with C-compounds and active humus in the entire profile more than the soil under stand types with prevailing European beech (Fagus sylvatica). In top horizons of soil Norway spruce influences significantly negatively humus quality (C:N) and also the content of accessible potassium which decreases in humification horizons below the limit of 200 mg∙kg-1.
Review of Heat Transfer Research for Solar Thermochemical Applications
Authors: Lipiński W. , Davidson J. H. , Haussener S. , Klausner J. F. , Mehdizadeh A. M. , Petrasch J. , Steinfeld A. , Venstrom L.
Published: May 2013

This article reviews the progress, challenges and opportunities in heat transfer research as applied to high-temperature thermochemical systems that use high-flux solar irradiation as the source of process heat. Selected pertinent areas such as radiative spectroscopy and tomography-based heat and mass characterization of heterogeneous media, kinetics of high-temperature heterogeneous reactions, heat and mass transfer modeling of solar thermochemical systems, and thermal measurements in high-temperature systems are presented, with brief discussions of their methods and example results from selected applications.
Estrogen Reduces Lipid Content in the Liver Exclusively from Membrane Receptor Signaling
Authors: Pedram Ali , Razandi Mahnaz , O’Mahony Fiona , Harvey Harry , Harvey Brian J. , Levin Ellis R.
Published: May 2013

Membrane-localized estrogen receptor can alter metabolism without translocating to the nucleus.
Understanding the Determinants of Notch Interactions with Its Ligands
Authors: de Celis Jose F.
Published: May 2013

Multiple regulatory events govern Notch interactions and response to its ligands.
Signal Scaffolds
Authors: Ray L. Bryan
Published: May 2013

Scaffolding proteins are active participants in the Wnt and Hippo signaling networks.
Cationic Antimicrobial Peptides and Biogenic Silver Nanoparticles Kill Mycobacteria without Eliciting DNA Damage and Cytotoxicity in Mouse Macrophages
Authors: Mohanty Soumitra , Jena Prajna , Mehta Ranjit , Pati Rashmirekha , Banerjee Birendranath , Patil Satish , Sonawane Avinash
Published: May 2013

With the emergence of multidrug-resistant mycobacterial strains, better therapeutic strategies are required for the successful treatment of the infection. Although antimicrobial peptides (AMPs) and silver nanoparticles (AgNPs) are becoming one of the popular antibacterial agents, their antimycobacterial potential is not fully evaluated. In this study, we synthesized biogenic-silver nanoparticles using bacterial, fungal, and plant biomasses and analyzed their antibacterial activities in combination with AMPs against mycobacteria.
Mycobacterium smegmatis
was found to be more susceptible to AgNPs compared to
M. marinum
. We found that NK-2 showed enhanced killing effect with NP-1 and NP-2 biogenic nanoparticles at a 0.5-ppm concentration, whereas LLKKK-18 showed antibacterial activity only with NP-2 at 0.5-ppm dose against
M. smegmatis
. In case of
M. marinum
NK-2 did not show any additive activity with NP-1 and NP-2 and LLKKK-18 alone completely inhibited the bacterial growth. Both NP-1 and NP-2 also showed increased killing of
M. smegmatis
in combination with the antituberculosis drug rifampin. The sizes and shapes of the AgNPs were determined by transmission electron microscopy and dynamic light scattering. AgNPs showed no cytotoxic or DNA damage effects on macrophages at the mycobactericidal dose, whereas treatment with higher doses of AgNPs caused toxicity and micronuclei formation in cytokinesis blocked cells. Macrophages actively endocytosed fluorescein isothiocyanate-labeled AgNPs resulting in nitric oxide independent intracellular killing of
M. smegmatis
. Apoptosis and cell cycle studies showed that treatment with higher dose of AgNPs arrested macrophages at the G
1
-phase. In summary, our data suggest the combined effect of biogenic-AgNPs and antimicrobial peptides as a promising antimycobacterial template.
Comparative Persistence of Subgroups of F-Specific RNA Phages in River Water
Authors: Yang Yongheng , Griffiths Mansel W.
Published: May 2013

F-specific (F+) RNA phages are widely used as indicators for the presence of fecal contamination and/or enteric viruses in water, and identifying subgroups of F+ RNA phages provides an approach for microbial source tracking. Different survival characteristics of the F+ RNA phage subgroups result in a misinterpretation of their original proportion in water, thus giving misleading information when they are used for microbial source tracking. This study investigated the comparative persistence of subgroups of F+ RNA phages in river water under different conditions. Results suggested that temperature and pH are the major factors affecting the persistence of F+ RNA phages in river water, and organic substances promote phage survival. The comparative persistence patterns of subgroups of F+ RNA phages varied and may bias extrapolation of their initial proportions in surface water. Thus, the characteristics of water should be taken into consideration and the results should be carefully interpreted when F+ RNA phages are used for microbial source tracking.
Mechanism of the Synergistic Inactivation of Escherichia coli by UV-C Light at Mild Temperatures
Authors: Gayï¿½n E. , Maï¿½as P. , ï¿½lvarez I. , Condï¿½n S.
Published: May 2013

UV light only penetrates liquid food surfaces to a very short depth, thereby limiting its industrial application in food pasteurization. One promising alternative is the combination of UV light with mild heat (UV-H), which has been demonstrated to produce a synergistic bactericidal effect. The aim of this article is to elucidate the mechanism of synergistic cellular inactivation resulting from the simultaneous application of UV light and heat. The lethality of UV-H treatments remained constant below ∼45ï¿½C, while lethality increased exponentially as the temperature increased. The percentage of synergism reached a maximum (40.3%) at 55ï¿½C. Neither the flow regimen nor changes in the dose delivered by UV lamps contributed to the observed synergism. UV-H inactivation curves of the parental
Escherichia coli
strain obtained in a caffeic acid selective recovery medium followed a similar profile to those obtained with
uvrA
mutant cells in a nonselective medium. Thermal fluidification of membranes and synergistic lethal effects started around 40 to 45ï¿½C. Chemical membrane fluidification with benzyl alcohol decreased the UV resistance of the parental strain but not that of the
uvrA
mutant. These results suggest that the synergistic lethal effect of UV-H treatments is due to the inhibition of DNA excision repair resulting from the membrane fluidification caused by simultaneous heating.
Regulon Studies and
In Planta
Role of the BraI/R Quorum-Sensing System in the Plant-Beneficial Burkholderia Cluster
Authors: Coutinho Bruna G. , Mitter Birgit , Talbi Chouhra , Sessitsch Angela , Bedmar Eulogio J. , Halliday Nigel , James Euan K. , Cï¿½mara Miguel , Venturi Vittorio
Published: May 2013

The genus
Burkholderia
is composed of functionally diverse species, and it can be divided into several clusters. One of these, designated the plant-beneficial-environmental (PBE)
Burkholderia
cluster, is formed by nonpathogenic species, which in most cases have been found to be associated with plants. It was previously established that members of the PBE group share an
N
-acyl-homoserine lactone (AHL) quorum-sensing (QS) system, designated BraI/R, that produces and responds to 3-oxo-C
14
-HSL (OC14-HSL). Moreover, some of them also possess a second AHL QS system, designated XenI2/R2, producing and responding to 3-hydroxy-C
8
-HSL (OHC8-HSL). In the present study, we performed liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) analysis to determine which AHL molecules are produced by each QS system of this group of bacteria. The results showed that XenI2/R2 is mainly responsible for the production of OHC8-HSL and that the BraI/R system is involved in the production of several different AHLs. This analysis also revealed that
Burkholderia phymatum
STM815 produces greater amounts of AHLs than the other species tested. Further studies showed that the BraR protein of
B. phymatum
is more promiscuous than other BraR proteins, responding equally well to several different AHL molecules, even at low concentrations. Transcriptome studies with
Burkholderia xenovorans
LB400 and
B. phymatum
STM815 revealed that the BraI/R regulon is species specific, with exopolysaccharide production being the only common phenotype regulated by this system in the PBE cluster. In addition, BraI/R was shown not to be important for plant nodulation by
B. phymatum
strains or for endophytic colonization and growth promotion of maize by
B. phytofirmans
PsJN.
Physiological Levels of Glucose Induce Membrane Vesicle Secretion and Affect the Lipid and Protein Composition of Yersinia pestis Cell Surfaces
Authors: Kolodziejek Anna M. , Caplan Allan B. , Bohach Gregory A. , Paszczynski Andrzej J. , Minnich Scott A. , Hovde Carolyn J.
Published: May 2013

Yersinia pestis
grown with physiologic glucose increased cell autoaggregation and deposition of extracellular material, including membrane vesicles. Membranes were characterized, and glucose had significant effects on protein, lipid, and carbohydrate profiles. These effects were independent of temperature and the biofilm-related locus
pgm
and were not observed in
Yersinia pseudotuberculosis
.
A New Large-DNA-Fragment Delivery System Based on Integrase Activity from an Integrative and Conjugative Element
Authors: Miyazaki Ryo , van der Meer Jan Roelof
Published: May 2013

During the past few decades, numerous plasmid vectors have been developed for cloning, gene expression analysis, and genetic engineering. Cloning procedures typically rely on PCR amplification, DNA fragment restriction digestion, recovery, and ligation, but increasingly, procedures are being developed to assemble large synthetic DNAs. In this study, we developed a new gene delivery system using the integrase activity of an integrative and conjugative element (ICE). The advantage of the integrase-based delivery is that it can stably introduce a large DNA fragment (at least 75 kb) into one or more specific sites (the gene for glycine-accepting tRNA) on a target chromosome. Integrase recombination activity in
Escherichia coli
is kept low by using a synthetic hybrid promoter, which, however, is unleashed in the final target host, forcing the integration of the construct. Upon integration, the system is again silenced. Two variants with different genetic features were produced, one in the form of a cloning vector in
E. coli
and the other as a mini-transposable element by which large DNA constructs assembled in
E. coli
can be tagged with the integrase gene. We confirmed that the system could successfully introduce cosmid and bacterial artificial chromosome (BAC) DNAs from
E. coli
into the chromosome of
Pseudomonas putida
in a site-specific manner. The integrase delivery system works in concert with existing vector systems and could thus be a powerful tool for synthetic constructions of new metabolic pathways in a variety of host bacteria.
Increased Lysine Content Is the Main Characteristic of the Soluble Form of the Polyamide Cyanophycin Synthesized by Recombinant Escherichia coli
Authors: Frommeyer Maja , Steinbï¿½chel Alexander
Published: May 2013

Cyanophycin, a polyamide of cyanobacterial or noncyanobacterial origin consisting of aspartate, arginine, and lysine, was synthesized in different recombinant strains of
Escherichia coli
expressing
cphA
from
Synechocystis
sp. strain PCC 6308 or PCC 6803,
Anabaena
sp. strain PCC 7120, or
Acinetobacter calcoaceticus
ADP1. The molar aspartate/arginine/lysine ratio of the water-soluble form isolated from a recombinant strain expressing CphA
6308
was 1:0.5:0.5, with a lysine content higher than any ever described before. The water-insoluble form consisted instead of mainly aspartate and arginine residues and had a lower proportion of lysine, amounting to a maximum of only 5 mol%. It could be confirmed that the synthesis of soluble cyanobacterial granule polypeptide (CGP) is independent of the origin of
cphA
. Soluble CGP isolated from all recombinant strains contained a least 17 mol% lysine. The total CGP portion of cell dry matter synthesized by CphA
6308
from recombinant
E. coli
was about 30% (wt/wt), including 23% (wt/wt) soluble CGP, by using terrific broth complex medium for cultivation at 30ï¿½C for 72 h. Enhanced production of soluble CGP instead of its insoluble form is interesting for further application and makes recombinant
E. coli
more attractive as a suitable source for the production of polyaspartic acid or dipeptides. In addition, a new low-cost, time-saving, effective, and common isolation procedure for mainly soluble CGP, suitable for large-scale application, was established in this study.
Contrasting Results of Culture-Dependent and Molecular Analyses of Mycobacterium avium subsp. paratuberculosis from Wood Bison
Authors: Forde Taya , De Buck Jeroen , Elkin Brett , Kutz Susan , van der Meer Frank , Orsel Karin
Published: May 2013

Reduced to near extinction in the late 1800s, a number of wood bison populations (
Bison bison athabascae
) have been re-established through reintroduction initiatives. Although an invaluable tool for conservation, translocation of animals can spread infectious agents to new areas or expose animals to pathogens in their new environment.
Mycobacterium avium
subsp.
paratuberculosis
, a bacterium that causes chronic enteritis in ruminants, is among the pathogens of potential concern for wood bison management and conservation. In order to inform translocation decisions, our objectives were to determine the
M. avium
subsp.
paratuberculosis
infection status of wood bison herds in Canada and to culture and genetically characterize the infective strain(s). We tested fecal samples from bison (
n
= 267) in nine herds using direct PCR for three
M. avium
subsp.
paratuberculosis
-specific genetic targets with different copy numbers within the
M. avium
subsp.
paratuberculosis
genome. Restriction enzyme analysis (REA) and sequencing of IS
1311
were performed on seven samples from five different herds. We also evaluated a panel of different culture conditions for their ability to support
M. avium
subsp.
paratuberculosis
growth from feces and tissues of direct-PCR-positive animals. Eighty-one fecal samples (30%) tested positive using direct IS
900
PCR, with positive samples from all nine herds; of these, 75% and 21% were also positive using IS
MAP02
and F57, respectively. None of the culture conditions supported the growth of
M. avium
subsp.
paratuberculosis
from PCR-positive samples. IS
1311
REA and sequencing indicate that at least two different
M. avium
subsp.
paratuberculosis
strain types exist in Canadian wood bison. The presence of different
M. avium
subsp.
paratuberculosis
strains among wood bison herds should be considered in the planning of translocations.
Differential Role of Manduca sexta Aminopeptidase-N and Alkaline Phosphatase in the Mode of Action of Cry1Aa, Cry1Ab, and Cry1Ac Toxins from Bacillus thuringiensis
Authors: Flores-Escobar Biviana , Rodríguez-Magadan Hector , Bravo Alejandra , Soberón Mario , Gómez Isabel
Published: May 2013

Aminopeptidase-N (APN1) and alkaline phosphatase (ALP) proteins located in the midgut epithelium of
Manduca sexta
have been implicated as receptors for Cry1Aa, Cry1Ab, and Cry1Ac insecticidal proteins produced by
Bacillus thuringiensis
subsp.
kurstaki
. In this study, we analyzed the roles of ALP and APN1 in the toxicity of these three Cry1A proteins. Ligand blot analysis using brush border membrane vesicles of
M. sexta
showed that Cry1Aa and Cry1Ab bind preferentially to ALP during early instars while binding to APN was observed after the third instar of larval development. Cry1Ac binds to APN throughout all larval development, with no apparent binding to ALP. ALP was cloned from
M. sexta
midgut RNA and expressed in
Escherichia coli
. Surface plasmon resonance binding analysis showed that recombinant ALP binds to Cry1Ac with 16-fold lower affinity than to Cry1Aa or Cry1Ab. Downregulation of APN1 and ALP expression by RNA interference (RNAi) using specific double-stranded RNA correlated with a reduction of transcript and protein levels. Toxicity analysis of the three Cry1A proteins in ALP- or APN1-silenced larvae showed that Cry1Aa relies similarly on both receptor molecules for toxicity. In contrast, RNAi experiments showed that ALP is more important than APN for Cry1Ab toxicity, while Cry1Ac relied principally on APN1. These results indicated that ALP and APN1 have a differential role in the mode of action of Cry1A toxins, suggesting that
B. thuringiensis
subsp.
kurstaki
produces different Cry1A toxins that in conjunction target diverse midgut proteins to exert their insecticidal effect.
Functional Screening of Metagenome and Genome Libraries for Detection of Novel Flavonoid-Modifying Enzymes
Authors: Rabausch U. , Juergensen J. , Ilmberger N. , Böhnke S. , Fischer S. , Schubach B. , Schulte M. , Streit W. R.
Published: May 2013

The functional detection of novel enzymes other than hydrolases from metagenomes is limited since only a very few reliable screening procedures are available that allow the rapid screening of large clone libraries. For the discovery of flavonoid-modifying enzymes in genome and metagenome clone libraries, we have developed a new screening system based on high-performance thin-layer chromatography (HPTLC). This
m
etagenome
e
xtract
t
hin-layer chromatography
a
nalysis (META) allows the rapid detection of glycosyltransferase (GT) and also other flavonoid-modifying activities. The developed screening method is highly sensitive, and an amount of 4 ng of modified flavonoid molecules can be detected. This novel technology was validated against a control library of 1,920 fosmid clones generated from a single
Bacillus cereus
isolate and then used to analyze more than 38,000 clones derived from two different metagenomic preparations. Thereby we identified two novel UDP glycosyltransferase (UGT) genes. The metagenome-derived
gtfC
gene encoded a 52-kDa protein, and the deduced amino acid sequence was weakly similar to sequences of putative UGTs from
Fibrisoma
and
Dyadobacter
. GtfC mediated the transfer of different hexose moieties and exhibited high activities on flavones, flavonols, flavanones, and stilbenes and also accepted isoflavones and chalcones. From the control library we identified a novel macroside glycosyltransferase (MGT) with a calculated molecular mass of 46 kDa. The deduced amino acid sequence was highly similar to sequences of MGTs from
Bacillus thuringiensis
. Recombinant MgtB transferred the sugar residue from UDP-glucose effectively to flavones, flavonols, isoflavones, and flavanones. Moreover, MgtB exhibited high activity on larger flavonoid molecules such as tiliroside.
Benz[
a
]anthracene Biotransformation and Production of Ring Fission Products by
Sphingobium
sp. Strain KK22
Authors: Kunihiro Marie , Ozeki Yasuhiro , Nogi Yuichi , Hamamura Natsuko , Kanaly Robert A.
Published: May 2013

A soil bacterium, designated strain KK22, was isolated from a phenanthrene enrichment culture of a bacterial consortium that grew on diesel fuel, and it was found to biotransform the persistent environmental pollutant and high-molecular-weight polycyclic aromatic hydrocarbon (PAH) benz[
a
]anthracene. Nearly complete sequencing of the 16S rRNA gene of strain KK22 and phylogenetic analysis revealed that this organism is a new member of the genus
Sphingobium
. An 8-day time course study that consisted of whole-culture extractions followed by high-performance liquid chromatography (HPLC) analyses with fluorescence detection showed that 80 to 90% biodegradation of 2.5 mg liter
−1
benz[
a
]anthracene had occurred. Biodegradation assays where benz[
a
]anthracene was supplied in crystalline form (100 mg liter
−1
) confirmed biodegradation and showed that strain KK22 cells precultured on glucose were equally capable of benz[
a
]anthracene biotransformation when precultured on glucose plus phenanthrene. Analyses of organic extracts from benz[
a
]anthracene biodegradation by liquid chromatography negative electrospray ionization tandem mass spectrometry [LC/ESI(−)-MS/MS] revealed 10 products, including two
o
-hydroxypolyaromatic acids and two hydroxy-naphthoic acids. 1-Hydroxy-2- and 2-hydroxy-3-naphthoic acids were unambiguously identified, and this indicated that oxidation of the benz[
a
]anthracene molecule occurred via both the linear kata and angular kata ends of the molecule. Other two- and single-aromatic-ring metabolites were also documented, including 3-(2-carboxyvinyl)naphthalene-2-carboxylic acid and salicylic acid, and the proposed pathways for benz[
a
]anthracene biotransformation by a bacterium were extended.
Manganese and Zinc Regulate Virulence Determinants in Borrelia burgdorferi
Authors: Troxell Bryan , Ye Meiping , Yang Youyun , Carrasco Sebastian E. , Lou Yongliang , Yang X. Frank
Published: May 2013

Borrelia burgdorferi
, the causative agent of Lyme disease, must adapt to two diverse niches, an arthropod vector and a mammalian host. RpoS, an alternative sigma factor, plays a central role in spirochetal adaptation to the mammalian host by governing expression of many genes important for mammalian infection.
B. burgdorferi
is known to be unique in metal utilization, and little is known of the role of biologically available metals in
B. burgdorferi
. Here, we identified two transition metal ions, manganese (Mn
2+
) and zinc (Zn
2+
), that influenced regulation of RpoS. The intracellular Mn
2+
level fluctuated approximately 20-fold under different conditions and inversely correlated with levels of RpoS and the major virulence factor OspC. Furthermore, an increase in intracellular Mn
2+
repressed temperature-dependent induction of RpoS and OspC; this repression was overcome by an excess of Zn
2+
. Conversely, a decrease of intracellular Mn
2+
by deletion of the Mn
2+
transporter gene,
bmtA
, resulted in elevated levels of RpoS and OspC. Mn
2+
affected RpoS through BosR, a Fur family homolog that is required for
rpoS
expression: elevated intracellular Mn
2+
levels greatly reduced the level of BosR protein but not the level of
bosR
mRNA. Thus, Mn
2+
and Zn
2+
appeared to be important in modulation of the RpoS pathway that is essential to the life cycle of the Lyme disease spirochete. This finding supports the emerging notion that transition metals such as Mn
2+
and Zn
2+
play a critical role in regulation of virulence in bacteria.
The MerR-Like Regulator BrlR Confers Biofilm Tolerance by Activating Multidrug Efflux Pumps in Pseudomonas aeruginosa Biofilms
Authors: Liao Julie , Schurr Michael J. , Sauer Karin
Published: May 2013

A defining characteristic of biofilms is antibiotic tolerance that can be up to 1,000-fold greater than that of planktonic cells. In
Pseudomonas aeruginosa
, biofilm tolerance to antimicrobial agents requires the biofilm-specific MerR-type transcriptional regulator BrlR. However, the mechanism by which BrlR mediates biofilm tolerance has not been elucidated. Genome-wide transcriptional profiling indicated that
brlR
was required for maximal expression of genes associated with antibiotic resistance, in particular those encoding the multidrug efflux pumps MexAB-OprM and MexEF-OprN. Chromatin immunoprecipitation (ChIP) analysis revealed a direct regulation of these genes by BrlR, with DNA binding assays confirming BrlR binding to the promoter regions of the
mexAB-oprM
and
mexEF-oprN
operons. Quantitative reverse transcriptase PCR (qRT-PCR) analysis further indicated BrlR to be an activator of
mexAB-oprM
and
mexEF-oprN
gene expression. Moreover, immunoblot analysis confirmed increased MexA abundance in cells overexpressing
brlR
. Inactivation of both efflux pumps rendered biofilms significantly more susceptible to five different classes of antibiotics by affecting MIC but not the recalcitrance of biofilms to killing by bactericidal agents. Overexpression of either efflux pump in a Δ
brlR
strain partly restored tolerance of Δ
brlR
biofilms to antibiotics. Expression of
brlR
in mutant biofilms lacking both efflux pumps partly restored antimicrobial tolerance of biofilms to wild-type levels. Our results indicate that BrlR acts as an activator of multidrug efflux pumps to confer tolerance to
P. aeruginosa
biofilms and to resist the action of antimicrobial agents.
Role of fine needle aspiration cytology in diagnosing filarial arm cysts
Authors: Tandon Nishi , Bansal Cherry , Sharma Richa , Irfan Sumaiya
Published: May 2013

Filariasis is prevalent in tropical and subtropical areas and is endemic in regions of India. Lymphatic filariasis in India is caused mainly by two species of nematodes:Wuchereria bancroftiandBrugia malayi, which invade the human lymphatic system. We report two cases of superficial cystic lesions of the upper limb revealed on fine needle aspiration (FNA) to be clinically unsuspected filariasis. Despite similar aetiologies, both cases revealed variations in aspirate nature, smear morphology and peripheral blood findings. FNA provides definitive diagnosis and is an important tool for diagnosing soft tissue swellings owing to filariasis.
Retropharyngeal cellulitis in adolescence
Authors: Tanaka Kosuke , Inokuchi Ryota , Namai Yoshiyuki , Yahagi Naoki
Published: May 2013

A healthy 10-year-old boy presented with fever and progressively worsening sore throat and dysphagia. Physical examination showed pharyngeal erythema with tender left cervical lymphadenopathy. Radiography revealed 9 mm deep prevertebral soft tissues at the C2 level, and contrast-enhanced CT showed fluid collection with no major ring enhancement in the retropharyngeal space. He was diagnosed with retropharyngeal cellulitis and treated with intravenous antibiotics. Retropharyngeal cellulitis or abscess is a relatively rare infection in adolescents but is more frequent in 2–4-year-old children. Retropharyngeal cellulitis may rapidly extend caudally, with fatal consequences. For adolescents, physicians need to be aware of this clinical entity and carefully evaluate imaging findings even when only the mild pharyngeal physical findings are noted.
Coronary stent stenosis in acute myocardial infarction
Authors: Bacci Marcelo Rodrigues , Santos Janaina Aparecida Boide , Nogueira Leonardo Fernando Ferrari
Published: May 2013

Acute myocardial infarction (AMI) represents one of the major mortality causes in the world. Treatment of AMI is widely known; however, in developing countries some medications are not so easily available yet. We present a case of a 49-year-old black male patient who suffered an AMI and 2 weeks after stent angioplasty evolved to a new ischaemic episode with a stent thrombosis. The patient did not use the prescribed medications.
Urinary incontinence in physically active women and female athletes
Authors: Goldstick Orly , Constantini Naama
Published: May 2013

A literature review was performed on the topic of urinary incontinence during physical activity and sports. This paper reviews the prevalence, risk factors, pathophysiology and treatment modalities of urinary incontinence in physically active women and female athletes. Urinary incontinence affects women of all ages, including top female athletes, but is often under-reported. The highest prevalence of urinary incontinence is reported in those participating in high impact sports. Pelvic floor muscle training is considered the first-line treatment, although more research is needed to determine optimal treatment protocols for exercising women and athletes. Trainers, coaches and other athletes’ caregivers should be educated and made aware of the need for proper urogynaecological assessment.
Which is the most useful patient-reported outcome in femoroacetabular impingement? Test–retest reliability of six questionnaires
Authors: Hinman Rana S , Dobson Fiona , Takla Amir , O'Donnell John , Bennell Kim L
Published: May 2013

Background/aims

The most reliable patient-reported outcomes (PROs) for people with femoroacetabular impingement (FAI) is unknown because there have been no direct comparisons of questionnaires. Thus, the aim was to evaluate the test–retest reliability of six existing PROs in a single cohort of young active people with hip/groin pain consistent with a clinical diagnosis of FAI.

Methods

Young adults with clinical FAI completed six PRO questionnaires on two occasions, 1–2 weeks apart. The PROs were modified Harris Hip Score, Hip dysfunction and Osteoarthritis Score, Hip Outcome Score, Non-Arthritic Hip Score, International Hip Outcome Tool, Copenhagen Hip and Groin Outcome Score.

Results

30 young adults (mean age 24 years, SD 4 years, range 18–30 years; 15 men) with stable symptoms participated. Intraclass correlation coefficient(3,1)values ranged from 0.73 to 0.93 (95% CI 0.38 to 0.98) indicating that most questionnaires reached minimal reliability benchmarks. Measurement error at the individual level was quite large for most questionnaires (minimal detectable change (MDC95) 12.4–35.6, 95% CI 8.7 to 54.0). In contrast, measurement error at the group level was quite small for most questionnaires (MDC952.2–7.3, 95% CI 1.6 to 11).

Conclusions

The majority of the questionnaires were reliable and precise enough for use at the group level. Samples of only 23–30 individuals were required to achieve acceptable measurement variation at the group level. Further direct comparisons of these questionnaires are required to assess other measurement properties such as validity, responsiveness and meaningful change in young people with FAI.
Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete
Authors: Cools Ann M J , Struyf Filip , De Mey Kristof , Maenhout Annelies , Castelein Birgit , Cagnie Barbara
Published: May 2013

The scapula functions as a bridge between the shoulder complex and the cervical spine and plays a very important role in providing both mobility and stability of the neck/shoulder region. The association between abnormal scapular positions and motions and glenohumeral joint pathology has been well established in the literature, whereas studies investigating the relationship between neck pain and scapular dysfunction have only recently begun to emerge. Although several authors have emphasised the relevance of restoring normal scapular kinematics through exercise and manual therapy techniques, overall scapular rehabilitation guidelines decent for both patients with shoulder pain as well as patients with neck problems are lacking. The purpose of this paper is to provide a science-based clinical reasoning algorithm with practical guidelines for the rehabilitation of scapular dyskinesis in patients with chronic complaints in the upper quadrant.
A double-blind, randomised, placebo-controlled trial of oral midazolam plus oral ketamine for sedation of children during laceration repair
Authors: Barkan Shiri , Breitbart Rachelle , Brenner-Zada Galit , Feldon Michal , Assa Amit , Toledano Michal , Berkovitch Sofia , Shavit Itai , Kozer Eran
Published: May 2013

Objectives

To compare the efficacy of oral midazolam alone with a combination of oral midazolam and ketamine in children requiring laceration repair.

Design

A randomised, double-blind, placebo-controlled study.

Setting

Paediatric emergency department.

Participants

Children 1–10 years of age with lacerations requiring sedation.

Interventions

Using a computer-generated sequence, children were randomly assigned in blocks of four to one of two groups: oral midazolam (0.5 mg/kg) plus oral placebo and oral midazolam (0.5 mg/kg) plus oral ketamine (5 mg/kg). The allocation sequence was kept by the pharmacy staff, and the investigators were blinded to randomisation until statistical analysis of the study was completed.

Main outcome measures

Visual Analogue Scale (VAS) assessment by a parent and Sedation Score assessment by an investigator.

Results

60 children were recruited; 29 were assigned for treatment with midazolam and 31 for the combination of midazolam and ketamine. There were no differences in basic demographics and wound characteristics between the groups. VAS assessment by a parent was 4.5±3.3 mm in the midazolam+ketamine group versus 4.4±2.7 mm in the midazolam alone group (mean difference 0.1, CI −1.9 to 1.71). Sedation Score during procedure was lower in the midazolam+ketamine group (mean difference 1.14, 95% CI 0.67 to 1.6). Intravenous sedation was required in two (6%) of the children in the midazolam+ketamine group, and in eight (27%) in the midazolam alone group. p=0.039. No clinically significant adverse effects were documented in either group.

Conclusions

No difference was found in pain assessment during local anaesthetic injection between the group treated with midazolam and ketamine, and the group treated with midazolam alone. The combination of oral midazolam and ketamine led to deeper sedation than midazolam alone, with less children requiring intravenous sedation.

Clinical trial registration

The trial was registered in www.clinicaltrials.gov asNCT01470157.
Parental anxiety and affecting factors in acute paediatric blunt head injury
Authors: Serinken M , Kocyigit A , Karcioglu O , Sengül C , Hatipoğlu C , Elicabuk H
Published: May 2013

Objective

This study is designed to investigate the factors affecting parental anxiety regarding their children with head injury in the emergency department (ED).

Materials and methods

This prospective observational study enrolled all consecutive paediatric patients admitted to the university-based ED with the presenting chief complaint of paediatric blunt head injury (PBHI). The parents were asked to respond to the 10-item questionnaire during both presentation and discharge. Anxiety and persuasion scores of the parents were calculated and magnitudes of the decreases in anxiety and persuasion scores were analysed with respect to sociodemographic and clinical variables.

Results

The study sample included 341 patients admitted to the ED. The anxiety and persuasion scores of mothers and fathers were not significantly different from each other on presentation while the extent of decrease in anxiety scores of mothers were significantly smaller than that of the fathers (p=0.003). The parents’ education levels had significant impact on anxiety and persuasion scores recorded on presentation. The anxiety and persuasion scores were inversely related to education levels of the parents on presentation (p=0.002 and p=0.000, respectively). In addition, lower education levels were found to be associated with a greater decrease in anxiety and persuasion scores. Neurosurgical consultation also affected the magnitude of the decrease in anxiety and persuasion scores of the parents. The changes in the scores were affected negatively by the parents’ age.

Conclusions

Radiological investigations had no significant impact on the decrease in anxiety and persuasion scores of the parents by themselves, while neurosurgical consultation had significant impact on them. Emergency physicians should tailor their strategy to institute effective communication with the parents of children to cut down unnecessary investigations in PBHI.
Systemic antibiotics after incision and drainage of simple abscesses: a meta-analysis
Authors: Singer Adam J , Thode Henry C
Published: May 2013

Background

Over the last decade, there has been a significant increase in the number of cutaneous abscesses. While there is general agreement that abscesses should be treated with incision and drainage, it is unclear whether systemic antibiotics should be routinely prescribed.

Objective

To evaluate whether systemic antibiotics, when compared with a placebo, improve cure rates in patients with simple abscesses after incision and drainage.

Methods Design

Systematic review and meta-analysis using RevMan5.

Patients and settings

Children and adults with simple abscesses treated in outpatient clinics or emergency departments.

Data sources

Cochrane Central, Medline, Embase and bibliographies.

Outcome measures

Percentage of patients with complete resolution of abscess without the need for recurrent incision and drainage, additional antibiotics, or hospital admission within 7–10 days of treatment.

Results

We included four trials, consisting of 589 patients in total (428 adults and 161 children). Patients were randomised to one of three antibiotics (cephridine (27), cephalexin (82), or trimethoprim sulfamethoxazole (161)) or to placebo (285), with 34 lost to follow-up or having incomplete data. When given in addition to incision and drainage, systemic antibiotics did not significantly improve the percentage of patients with complete resolution of their abscesses 7–10 days after treatment (88.1% vs 86.0%; OR 1.17 (95% CI 0.70 to 1.95)).

Conclusions

When given in addition to incision and drainage, systemic antibiotics do not significantly improve the percentage of patients with complete resolution of their abscesses.
Neuroendocrine tumours—challenges in the diagnosis and classification of pulmonary neuroendocrine tumours
Authors: den Bakker M A , Thunnissen F B J M
Published: May 2013

Pulmonary neuroendocrine (NE) proliferations are a diverse group of disorders which share distinct cytological, architectural and biosynthetic features. Tumours composed of NE cells are dispersed among different tumour categories in the WHO classification of tumours and as such do not conform to a singular group with regards to treatment and prognosis. This is reflected by the highly variable behaviour of NE proliferations, ranging from asymptomatic, for instance in diffuse idiopathic pulmonary NE cell hyperplasia and tumourlets, to highly malignant cancers such as small cell lung cancer and large cell NE carcinoma. In this review NE proliferations are described as distinct entities ranging from low grade lesions to high grade cancers. The differential diagnoses are considered with each of the entries. Finally, mention is made of tumours which may show some NE features.