bluuebunny/crossref_metadata_2025 huggingface dataset:
Occurrence of Pepper Mild Mottle Virus in Drinking Water Sources in Japan
Authors: Haramoto Eiji , Kitajima Masaaki , Kishida Naohiro , Konno Yoshiaki , Katayama Hiroyuki , Asami Mari , Akiba Michihiro
Published: September 2013

Pepper mild mottle virus (PMMoV) is a plant virus that has been recently proposed as a potential indicator of human fecal contamination of environmental waters; however, information on its geographical occurrence in surface water is still limited. We aimed to determine the seasonal and geographic occurrence of PMMoV in drinking water sources all over Japan. Between July 2008 and February 2011, 184 source water samples were collected from 30 drinking water treatment plants (DWTPs); viruses from 1 to 2 liters of each sample were concentrated by using an electronegative membrane, followed by RNA extraction and reverse transcription. Using quantitative PCR, PMMoV was detected in 140 (76%) samples, with a concentration ranging from 2.03 × 10
3
to 2.90 × 10
6
copies/liter. At least one of the samples from 27 DWTPs (
n
= 4 or 8) was positive for PMMoV; samples from 10 of these DWTPs were always contaminated. There was a significant difference in the occurrence of PMMoV among geographical regions but not a seasonal difference. PMMoV was frequently detected in samples that were negative for human enteric virus or
Escherichia coli
. A phylogenetic analysis based on the partial nucleotide sequences of the PMMoV coat protein gene in 12 water samples from 9 DWTPs indicated that there are genetically diverse PMMoV strains present in drinking water sources in Japan. To our knowledge, this is the first study to demonstrate the occurrence of PMMoV in environmental waters across wide geographical regions.
An Efficient Method Using Gluconacetobacter europaeus To Reduce an Unfavorable Flavor Compound, Acetoin, in Rice Vinegar Production
Authors: Akasaka Naoki , Sakoda Hisao , Hidese Ryota , Ishii Yuri , Fujiwara Shinsuke
Published: September 2013

Gluconacetobacter europaeus
, one of the microorganisms most commonly used for vinegar production, produces the unfavorable flavor compound acetoin. Since acetoin reduction is important for rice vinegar production, a genetic approach was attempted to reduce acetoin produced by
G. europaeus
KGMA0119 using specific gene knockout without introducing exogenous antibiotic resistance genes. A uracil-auxotrophic mutant with deletion of the orotate phosphoribosyltransferase gene (
pyrE
) was first isolated by positive selection using 5-fluoroorotic acid. The
pyrE
disruptant designated KGMA0704 (Δ
pyrE
) showed 5-fluoroorotic acid resistance. KGMA0704 and the
pyrE
gene were used for further gene disruption experiments as a host cell and a selectable marker, respectively. Targeted disruption of
aldC
or
als
, which encodes α-acetolactate decarboxylase or α-acetolactate synthase, was attempted in KGMA0704. The disruption of these genes was expected to result in a decrease in acetoin levels. A disruption vector harboring the
pyrE
marker within the targeted gene was constructed for double-crossover recombination. The cells of KGMA0704 were transformed with the exogenous DNA using electroporation, and genotypic analyses of the transformants revealed the unique occurrence of targeted
aldC
or
als
gene disruption. The
aldC
disruptant KGMA4004 and the
als
disruptant KGMA5315 were cultivated, and the amount of acetoin was monitored. The acetoin level in KGMA4004 culture was significantly reduced to 0.009% (wt/vol) compared with KGMA0119 (0.042% [wt/vol]), whereas that of KGMA5315 was not affected (0.037% [wt/vol]). This indicates that
aldC
disruption is critical for acetoin reduction.
G. europaeus
KGMA4004 has clear application potential in the production of rice vinegar with less unfavorable flavor.
Impact of Logging and Forest Conversion to Oil Palm Plantations on Soil Bacterial Communities in Borneo
Authors: Lee-Cruz Larisa , Edwards David P. , Tripathi Binu M. , Adams Jonathan M.
Published: September 2013

Tropical forests are being rapidly altered by logging and cleared for agriculture. Understanding the effects of these land use changes on soil bacteria, which constitute a large proportion of total biodiversity and perform important ecosystem functions, is a major conservation frontier. Here we studied the effects of logging history and forest conversion to oil palm plantations in Sabah, Borneo, on the soil bacterial community. We used paired-end Illumina sequencing of the 16S rRNA gene, V3 region, to compare the bacterial communities in primary, once-logged, and twice-logged forest and land converted to oil palm plantations. Bacteria were grouped into operational taxonomic units (OTUs) at the 97% similarity level, and OTU richness and local-scale α-diversity showed no difference between the various forest types and oil palm plantations. Focusing on the turnover of bacteria across space, true β-diversity was higher in oil palm plantation soil than in forest soil, whereas community dissimilarity-based metrics of β-diversity were only marginally different between habitats, suggesting that at large scales, oil palm plantation soil could have higher overall γ-diversity than forest soil, driven by a slightly more heterogeneous community across space. Clearance of primary and logged forest for oil palm plantations did, however, significantly impact the composition of soil bacterial communities, reflecting in part the loss of some forest bacteria, whereas primary and logged forests did not differ in composition. Overall, our results suggest that the soil bacteria of tropical forest are to some extent resilient or resistant to logging but that the impacts of forest conversion to oil palm plantations are more severe.
Dynamics of the Saccharomyces cerevisiae Transcriptome during Bread Dough Fermentation
Authors: Aslankoohi Elham , Zhu Bo , Rezaei Mohammad Naser , Voordeckers Karin , De Maeyer Dries , Marchal Kathleen , Dornez Emmie , Courtin Christophe M. , Verstrepen Kevin J.
Published: September 2013

The behavior of yeast cells during industrial processes such as the production of beer, wine, and bioethanol has been extensively studied. In contrast, our knowledge about yeast physiology during solid-state processes, such as bread dough, cheese, or cocoa fermentation, remains limited. We investigated changes in the transcriptomes of three genetically distinctSaccharomyces cerevisiaestrains during bread dough fermentation. Our results show that regardless of the genetic background, all three strains exhibit similar changes in expression patterns. At the onset of fermentation, expression of glucose-regulated genes changes dramatically, and the osmotic stress response is activated. The middle fermentation phase is characterized by the induction of genes involved in amino acid metabolism. Finally, at the latest time point, cells suffer from nutrient depletion and activate pathways associated with starvation and stress responses. Further analysis shows that genes regulated by the high-osmolarity glycerol (HOG) pathway, the major pathway involved in the response to osmotic stress and glycerol homeostasis, are among the most differentially expressed genes at the onset of fermentation. More importantly, deletion ofHOG1and other genes of this pathway significantly reduces the fermentation capacity. Together, our results demonstrate that cells embedded in a solid matrix such as bread dough suffer severe osmotic stress and that a proper induction of the HOG pathway is critical for optimal fermentation.
Development of a Tetracycline-Inducible Gene Expression System for the Study of Helicobacter pylori Pathogenesis
Authors: Debowski Aleksandra W. , Verbrugghe Phebe , Sehnal Miriam , Marshall Barry James , Benghezal Mohammed
Published: September 2013

Deletion mutants and animal models have been instrumental in the study of
Helicobacter pylori
pathogenesis. Conditional mutants, however, would enable the study of the temporal gene requirement during
H. pylori
colonization and chronic infection. To achieve this goal, we adapted the
Escherichia coli
Tn
10
-derived tetracycline-inducible expression system for use in
H. pylori
. The
ureA
promoter was modified by inserting one or two
tet
operators to generate tetracycline-responsive promoters, named
uPtetO
, and these promoters were then fused to the reporter
gfp
mut2 and inserted into different loci. The expression of the tetracycline repressor (
tetR
) was placed under the control of one of three promoters and inserted into the chromosome. Conditional expression of green fluorescent protein (GFP) in strains harboring
tetR
and
uPtetO-GFP
was characterized by measuring GFP activity and by immunoblotting. The two
tet
-responsive
uPtetO
promoters differ in strength, and induction of these promoters was inducer concentration and time dependent, with maximum expression achieved after induction for 8 to 16 h. Furthermore, the chromosomal location of the
uPtetO-GFP
construct and the nature of the promoter driving expression of
tetR
influenced the strength of the
uPtetO
promoters upon induction. Integration of
uPtetO-GFP
and
tetR
constructs at different genomic loci was stable
in vivo
and did not affect colonization. Finally, we demonstrate tetracycline-dependent induction of GFP expression
in vivo
during chronic infection. These results open new experimental avenues for dissecting
H. pylori
pathogenesis using animal models and for testing the roles of specific genes in colonization of, adaptation to, and persistence in the host.
Evidence of Intraflagellar Transport and Apical Complex Formation in a Free-Living Relative of the Apicomplexa
Authors: Portman Neil , Foster Christie , Walker Giselle , Šlapeta Jan
Published: September 2013

Since its first description,
Chromera velia
has attracted keen interest as the closest free-living relative of parasitic Apicomplexa. The life cycle of this unicellular alga is complex and involves a motile biflagellate form. Flagella are thought to be formed in the cytoplasm, a rare phenomenon shared with
Plasmodium
in which the canonical mode of flagellar assembly, intraflagellar transport, is dispensed with. Here we demonstrate the expression of intraflagellar transport components in
C. velia
, answering the question of whether this organism has the potential to assemble flagella via the canonical route. We have developed and characterized a culturing protocol that favors the generation of flagellate forms. From this, we have determined a marked shift in the mode of daughter cell production from two to four daughter cells per division as a function of time after passage. We conduct an ultrastructural examination of the
C. velia
flagellate form by using serial TEM and show that flagellar biogenesis in
C. velia
occurs prior to cytokinesis. We demonstrate a close association of the flagellar apparatus with a complex system of apical structures, including a micropore, a conoid, and a complex endomembrane system reminiscent of the apical complex of parasitic apicomplexans. Recent work has begun to elucidate the possible flagellar origins of the apical complex, and we show that in
C. velia
these structures are contemporaneous within a single cell and share multiple connections. We propose that
C. velia
therefore represents a vital piece in the puzzle of the origins of the apical complex.
Cerebral Blood Flow and Apoptosis-Associated Factor with Electroacupuncture in a Traumatic Brain Injury Rat Model
Authors: Chuang Chih Hsiang , Hsu Yao Chin , Wang Che Chuan , Hu ChoYa , Kuo Jinn Rung
Published: September 2013

Objective

Electroacupuncture (EA) has been widely used for treatment of stroke, but there is little information on the effect of EA on the neuroprotective function in traumatic brain injury (TBI). The aim of the present study was to investigate the protective effects and mechanisms of EA treatment in a TBI rat model.

Methods

Male Sprague–Dawley rats were randomly divided into four groups: sham operation, TBI control, TBI+EA treated for 30 min or TBI+EA treated for 60 min. The animals were treated with EA immediately after TBI. The EA was applied at acupuncture points GV20, GV26, LI4 and KI1 with a dense-dispersed wave, frequencies of 0.2 and 1 Hz, and amplitude of 1 mA for 30 or 60 min. Regional blood flow, cell infarction volume, extent of neuronal apoptosis, expression of cell apoptosis-associated factor transforming growth-interacting factor (TGIF) were studied, and functional outcome was assessed by running speed test. All tests except regional blood flow were performed 72 h after TBI onset.

Results

Immediately after TBI, compared with the TBI control groups, the regional blood flow was significantly increased by EA treatment for 60 min. Compared with the TBI controls 72 h after TBI, the TBI-induced run speed impairment, infarction volume, neuronal apoptosis and apoptosis-associated TGIF expression were significantly improved by EA treatment.

Conclusions

The treatment of TBI in the acute stage with EA for 60 min could increase the regional blood flow and attenuate the levels of TGIF in the injured cortex, might lead to a decrease in neuronal apoptosis and cell infarction volume, and might represent one mechanism by which functional recovery may occur.
Body composition in sport: a comparison of a novel ultrasound imaging technique to measure subcutaneous fat tissue compared with skinfold measurement
Authors: Müller Wolfram , Horn Martin , Fürhapter-Rieger Alfred , Kainz Philipp , Kröpfl Julia M , Maughan Ronald J , Ahammer Helmut
Published: September 2013

Background

Extremely low weight and rapid changes in weight and body composition have become major concerns in many sports, but sufficiently accurate field methods for body composition assessment in athletes are missing. This study aimed to explore the use of ultrasound methods for assessment of body fat content in athletes.

Methods

19 female athletes (stature: 1.67(±0.06) m, weight: 59.6(±7.6) kg; age: 19.5(±3.3) years) were investigated by three observers using a novel ultrasound method for thickness measurement of uncompressed subcutaneous adipose tissue and of embedded structures. Two observers also measured skinfold thickness at eight International Society for the Advancement of Kinanthrometry (ISAK) sites; mean skinfold values were compared to mean subcutaneous adipose tissue thicknesses measured by ultrasound. Interobserver reliability of imaging and evaluation obtained by this ultrasound technique: intraclass correlation coefficient ICC=0.968 (95% CI 0.957 to 0.977); evaluation of given images: ICC=0.997 (0.993 to 0.999).

Results

Skinfold compared to ultrasound thickness showed that compressibility of subcutaneous adipose tissue depends largely on the site and the person: regression slopes ranged from 0.61 (biceps) to 1.59 (thigh) and CIs were large. Limits of agreement ranged from 2.6 to 8.6 mm. Regression lines did not intercept the skinfold axis at zero because of the skin thickness being included in the skinfold. The four ISAK trunk sites caused ultrasound imaging problems in 13 of 152 sites (8 ISAK sites, 19 athletes).

Conclusions

The ultrasound method allows measurement ofuncompressedsubcutaneous adipose tissue thickness with an accuracy of 0.1–0.5 mm, depending on the probe frequency. Compressibility of the skinfold depends on the anatomical site, and skin thickness varies by a factor of two. This inevitably limits the skinfold methods for body fat estimation. Ultrasound accuracy for subcutaneous adipose tissue measurement is limited by the plasticity of fat and furrowed tissue borders. Comparative US measurements show that skinfold measurements do not allow accurate assessment of subcutaneous adipose tissue thickness.
Current hydration guidelines are erroneous: dehydration does not impair exercise performance in the heat
Authors: Wall Bradley A , Watson Greig , Peiffer Jeremiah J , Abbiss Chris R , Siegel Rodney , Laursen Paul B
Published: September 2013

Background

Laboratory studies that support the hydration guidelines of leading governing bodies have shown that dehydration to only −2% of body mass can lead to increase in body temperature and heart rate during exercise, and decrease in performance. These studies, however, have been conducted in relatively windless environments (ie, wind speed <12.9 km/h), without participants being blinded to their hydration status.

Aim

To investigate the effect of blinded hydration status on cycling time-trial performance in the heat with ecologically valid facing wind speed conditions.

Methods

During three experimental trials, 10 cyclists were dehydrated to −3% body mass by performing 2 h of submaximal exercise (walking and cycling) in the heat, before being reinfused with saline to replace 100%, 33% or 0% of fluid losses, leaving them 0%, −2% or −3% hypohydrated, respectively. Participants then completed a 25 km time trial in the heat (33°C, 40% relative humidity; wind speed 32 km/h) during which their starting hydration status was maintained by infusing saline at a rate equal to their sweat rate. The treatment was participant-blinded and the order was randomised. Completion time, power output, heart rate, rectal temperature and perceptual variables were measured.

Results

While rectal temperature was higher beyond 17 km of the time trial in the −3% vs 0% conditions (38.9±0.3°C vs 38.6±0.3°C; p<0.05), no other differences between trials were shown.

Conclusion

When well-trained cyclists performed a 25 km cycling time trial under ecologically valid conditions and were blinded to their hydration status, performance, physiological and perceptual variables were not different between trials. These data do not support the residing basis behind many of the current hydration guidelines.
Position statement on youth resistance training: the 2014 International Consensus
Authors: Lloyd Rhodri S , Faigenbaum Avery D , Stone Michael H , Oliver Jon L , Jeffreys Ian , Moody Jeremy A , Brewer Clive , Pierce Kyle C , McCambridge Teri M , Howard Rick , Herrington Lee , Hainline Brian , Micheli Lyle J , Jaques Rod , Kraemer William J , McBride Michael G , Best Thomas M , Chu Donald A , Alvar Brent A , Myer Gregory D
Published: September 2013

The current manuscript has been adapted from the official position statement of the UK Strength and Conditioning Association on youth resistance training. It has subsequently been reviewed and endorsed by leading professional organisations within the fields of sports medicine, exercise science and paediatrics. The authorship team for this article was selected from the fields of paediatric exercise science, paediatric medicine, physical education, strength and conditioning and sports medicine.
The role of International Sport Federations in the protection of the athlete's health and promotion of sport for health of the general population
Authors: Mountjoy Margo , Junge Astrid
Published: September 2013

Objective

To determine the priorities and activities of International Sport Federations (IFs) with respect to the promotion of health in their sport and for the general population.

Methods

All 35 IFs participating in Olympic Games in 2014 or in 2016 were asked to rate the importance of 10 indicated topics, and to report their programmes, guidelines or research activities on 16 health-related topics using an online questionnaire (response rate 97%).

Results

On average, the ‘fight against doping’ had the highest priority followed by ‘health of their elite athlete’ and ‘image as a safe sport’. The topics with the lowest importance ratings were ‘health of their recreational athlete’, ‘increasing the number of recreational athletes’ and ‘health of the general population’. All except one IF reported to have health-related programmes/guidelines/research activities; most IFs had 7 or 8 of the listed activities. Eight IFs (23.5%) stated to have activities for ‘prevention of chronic diseases in the general population’ but only FIFA and FINA reported related projects.

Conclusions

IFs aimed to protect the health of their elite athletes through a variety of activities, however the health and number of their recreational athletes was of low importance for them. Thus, IFs are missing an important opportunity to increase the popularity of their sport, and to contribute to the health of the general population by encouraging physical activity through their sport. FIFA’s ‘Football for Health’ and FINA’s ‘Swim for All’ projects could serve as role models.
Interaction between air pollution exposure and genes in relation to levels of inflammatory markers and risk of myocardial infarction
Authors: Panasevich Sviatlana , Leander Karin , Ljungman Petter , Bellander Tom , de Faire Ulf , Pershagen Göran , Nyberg Fredrik
Published: September 2013

Objectives

Air pollution exposure induces cardiovascular effects, possibly via systemic inflammation and coagulation misbalance. Genetic variation may determine individual susceptibility. Our aim was to investigate effect modification by inflammation (Interleukin6 (IL6),tumour necrosis factor-α (TNF-α)) and coagulation (fibrinogen Bβ,plasminogen activator inhibitor-1(PAI-1)) gene variants on the effect of long-term or short-term air pollution exposure on both blood marker levels and non-fatal myocardial infarction (MI) risk.

Design

Population-based case–control study with a nested case-crossover study. Gene-environment interactions for short-term and long-term air pollution on blood marker levels were studied in population controls, for long-term exposure on MI risk using case–control design, and for short-term exposure on MI onset using case-crossover design.

Setting

The Stockholm Heart Epidemiology Programme (SHEEP) conducted in 1992–1994 in Stockholm, Sweden. Spatial modelling was used to assess long-term (up to 30 years retrospectively) air pollution exposure to traffic-NO2and heating-SO2emissions at home addresses. Urban background NO2, SO2, PM10and O3measurements were used to estimate short-term (up to 5 days) air pollution exposure.

Participants

1192 MI cases and 1506 population controls aged 45–70 years.

Outcomes

The levels of blood markers of inflammation (IL-6, TNF-α) and coagulation (fibrinogen, PAI-1) and MI risk.

Results

We observed gene–environment interaction for severalIL6andTNFSNPs in relation to inflammation blood marker levels. One-year traffic-NO2exposure was associated with higher IL-6 levels with each additionalIL6-174C allele, and 1-year heating-SO2exposure with higher levels of TNF-α inTNF-308AA homozygotes versus −308G carriers. Short-term air pollution exposure also interacted withIL6andTNFin relation to marker levels. The risk of MI followed the effect on blood markers in each genotype group.

Conclusions

Genetic variants inIL6andTNFmay modify effects of long-term and short-term air pollution exposure on inflammatory marker levels and MI risk.
Can use of healthcare services among 15–16-year-olds predict an increased level of high school dropout? A longitudinal community study
Authors: Homlong Lisbeth , Rosvold Elin O , Haavet Ole R
Published: September 2013

Objectives

To study associations between healthcare seeking in 15–16-year-olds and high school dropout 5 years later.

Design

Longitudinal community study.

Setting

Data from a comprehensive youth health survey conducted in 2000–2004, linked to data from national registries up to 2010.

Participants

13 964 10th grade secondary school students in six Norwegian counties.

Main outcome measure

Logistic regression was used to compute ORs for high school dropout.

Results

The total proportion of students not completing high school 5 years after registering was 29% (girls 24%, boys 34%). Frequent attenders to school health services and youth health clinics at age 15–16 years had a higher dropout rate (37/48% and 45/71%), compared with those with no or moderate use. Adolescents referred to mental health services were also more likely to drop out (47/62%). Boys with moderate use of a general practitioner (GP) had a lower dropout rate (30%). A multiple logistic regression analysis, in which we adjusted for selected health indicators and sociodemographic background variables, revealed that seeking help from the youth health clinic and consulting mental health services, were associated with increased level of high school dropout 5 years later. Frequent attenders (≥4 contacts) had the highest odds of dropping out. Yet, boys who saw a GP and girls attending the school health services regularly over the previous year were less likely than their peers to drop out from high school.

Conclusions

Adolescents who seek help at certain healthcare services can be at risk of dropping out of high school later. Health workers should pay particular attention to frequent attenders and offer follow-up when needed. However, boys who attended a GP regularly were more likely to continue to high school graduation, which may indicate a protective effect of having a regular and stable relationship with a GP.
Comparison of strategies to reduce meticillin-resistantStaphylococcus aureusrates in surgical patients: a controlled multicentre intervention trial
Authors: Lee Andie S , Cooper Ben S , Malhotra-Kumar Surbhi , Chalfine Annie , Daikos George L , Fankhauser Carolina , Carevic Biljana , Lemmen Sebastian , Martínez José Antonio , Masuet-Aumatell Cristina , Pan Angelo , Phillips Gabby , Rubinovitch Bina , Goossens Herman , Brun-Buisson Christian , Harbarth Stephan ,   for the MOSAR WP4 Study Group
Published: September 2013

Objective

To compare the effect of two strategies (enhanced hand hygiene vs meticillin-resistantStaphylococcus aureus(MRSA) screening and decolonisation) alone and in combination on MRSA rates in surgical wards.

Design

Prospective, controlled, interventional cohort study, with 6-month baseline, 12-month intervention and 6-month washout phases.

Setting

33 surgical wards of 10 hospitals in nine countries in Europe and Israel.

Participants

All patients admitted to the enrolled wards for more than 24 h.

Interventions

The two strategies compared were (1) enhanced hand hygiene promotion and (2) universal MRSA screening with contact precautions and decolonisation (intranasal mupirocin and chlorhexidine bathing) of MRSA carriers. Four hospitals were assigned to each intervention and two hospitals combined both strategies, using targeted MRSA screening.

Outcome measures

Monthly rates of MRSA clinical cultures per 100 susceptible patients (primary outcome) and MRSA infections per 100 admissions (secondary outcome). Planned subgroup analysis for clean surgery wards was performed.

Results

After adjusting for clustering and potential confounders, neither strategy when used alone was associated with significant changes in MRSA rates. Combining both strategies was associated with a reduction in the rate of MRSA clinical cultures of 12% per month (adjusted incidence rate ratios (aIRR) 0.88, 95% CI 0.79 to 0.98). In clean surgery wards, strategy 2 (MRSA screening, contact precautions and decolonisation) was associated with decreasing rates of MRSA clinical cultures (15% monthly decrease, aIRR 0.85, 95% CI 0.74 to 0.97) and MRSA infections (17% monthly decrease, aIRR 0.83, 95% CI 0.69 to 0.99).

Conclusions

In surgical wards with relatively low MRSA prevalence, a combination of enhanced standard and MRSA-specific infection control approaches was required to reduce MRSA rates. Implementation of single interventions was not effective, except in clean surgery wards where MRSA screening coupled with contact precautions and decolonisation was associated with significant reductions in MRSA clinical culture and infection rates.

Trial registration

clinicaltrials.gov identifier:NCT00685867
Suicide-related events in young people following prescription of SSRIs and other antidepressants: a self-controlled case series analysis
Authors: Wijlaars Linda P M M , Nazareth Irwin , Whitaker Heather J , Evans Stephen J W , Petersen Irene
Published: September 2013

Objectives

We aimed to examine the temporal association between selective serotonin reuptake inhibitors (SSRI) and tricyclic antidepressant (TCA) prescriptions and suicide-related events in children and adolescents.

Design

Self-controlled case series.

Setting

Electronic health records were used from 479 general practices in The Health Improvement Network (THIN) UK primary care database from 1995 to 2009.

Participants

81 young people aged 10–18 years with a record of completed suicide, 1496 who attempted suicide, 1178 with suicidal ideation and 2361 with intentional self-harm.

Main outcome measures

Incidence Rate Ratios (IRRs) for completed and attempted suicide, suicidal ideation and intentional self-harm.

Results

For non-fatal suicide-related behaviour, IRRs were similar for the time the person was prescribed either SSRIs or TCAs: IRRs increased during pre-exposure, peaked on prescription day, were stable up to the fourth prescription-week, and decreased after the prescriptions were stopped. For both types of antidepressants, IRRs were lower or similar to pre-exposure levels during the period of prescription. For SSRIs, there was an increase in the IRR for completed suicide on the day of prescription (N=5; IRR=42.5, 95% CI 4.5 to 403.4), and during the fourth week of SSRI prescription (N=2; IRR=11.3, 95% CI 1.1 to 115.6).

Conclusions

We found that a very small number of young people were prescribed antidepressants and that there was an absence of a sustained increase in rates of suicide-related events in this group. There were no systematic differences between the association of TCAs and SSRIs and the incidence risk ratios for attempted suicide, suicidal ideation or intentional self-harm and, apart from the day of prescription, rates did not exceed pre-exposure levels. The pattern of IRR for suicide for SSRIs was similar to that found in non-fatal suicide-related events. Our results warrant a re-evaluation of the current prescription of SSRIs in young people. We recommend the creation of a pragmatic registry for active pharmacovigilance.
Risk factors for persistence of livestock-associated MRSA and environmental exposure in veal calf farmers and their family members: an observational longitudinal study
Authors: Dorado-García Alejandro , Bos Marian EH , Graveland Haitske , Van Cleef Brigitte AGL , Verstappen Koen M , Kluytmans Jan AJW , Wagenaar Jaap A , Heederik Dick JJ
Published: September 2013

Objectives

Livestock-associated methicillin-resistantStaphylococcus aureus(LA-MRSA) emergence is a major public health concern. This study was aimed at assessing risk factors for persistently carrying MRSA in veal calf farmers and their family members. We also evaluate the dynamics of MRSA environmental load during the veal-calf production cycle.

Design

Observational, longitudinal, repeated cross-sectional study.

Setting

52 veal calf farms in the Netherlands.

Participants

From the end of 2010 to the end of 2011, a total of 211 farmers, family members and employees were included in the study.

Primary outcome and secondary outcome measures

Nasal swabs were taken from participants on days 0, 4, 7 and week 12. A persistent MRSA carrier was defined as a person positive for MRSA on days 0, 4 and 7. Participants filled in an extensive questionnaire to identify potential risk factors and confounders. For estimation of MRSA prevalence in calves and environmental contamination, animal nasal swabs and Electrostatic Dust Collectors were taken on day 0 and week 12.

Results

The presence of potential animal reservoirs (free-ranging farm cats and sheep) and the level of contact with veal calves was positively associated with persistent MRSA carriage. Interestingly, at the end of the study (week 12), there was a twofold rise in animal prevalence and a significantly higher MRSA environmental load in the stables was found on farms with MRSA carriers.

Conclusions

This study supports the hypothesis that environmental contamination with MRSA plays a role in the acquisition of MRSA in farmers and their household members and suggests that other animal species should also be targeted to implement effective control strategies.
Ten years of asthma admissions to adult critical care units in England and Wales
Authors: Gibbison Ben , Griggs Kathryn , Mukherjee Mome , Sheikh Aziz
Published: September 2013

Objectives

To describe the patient demographics, outcomes and trends of admissions with acute severe asthma admitted to adult critical care units in England and Wales.

Design

10-year, retrospective analysis of a national audit database.

Setting

Secondary care: adult, general critical care units in the UK.

Participants

830 808 admissions to adult, general critical care units.

Primary and secondary outcome measures

Demographic data including age and sex, whether the patient was invasively ventilated or not, length of stay (LOS; both in the critical care unit and acute hospital), survival (both critical care unit and acute hospital) and time trends across the 10-year period.

Results

Over the 10-year period, there were 11 948 (1.4% of total) admissions with asthma to adult critical care units in England and Wales. Among them 67.5% were female and 32.5% were male (RR F:M 2.1; 95% CI 2.0 to 2.1). Median LOS in the critical care unit was 1.8 days (IQR 0.9–3.8). Median LOS in the acute hospital was 7 days (IQR 4–14). Critical care unit survival rate was 95.5%. Survival at discharge from hospital was 93.3%. There was an increase in admissions to adult critical care units by an average of 4.7% (95% CI 2.8 to 6.7)/year.

Conclusions

Acute asthma represents a modest burden of work for adult critical care units in England and Wales. Demographic patterns for admission to critical care unit mirror those of severe asthma in the general adult community. The number of critical care admissions with asthma are rising, although we were unable to discern whether this represents a true increase in the incidence of acute asthma or asthma severity.
A survey of TB knowledge among medical students in Southwest China: is the information reaching the target?
Authors: Zhao Ying , Ehiri John , Li Daikun , Luo Xingneng , Li Ying
Published: September 2013

Objectives

Tuberculosis (TB) control in schools is a concern in low-income and middle-income countries with high TB burdens. TB knowledge is recognised as important for TB control in China, which has one of the highest TB prevalence in the world. Accordingly, National TB Control Guideline in China emphasised TB-health education in schools as one of the core strategies for improving TB knowledge among the population. It was important to assess the level of TB knowledge in schools following 5-year implementation of the guideline, to determine whether the information was reaching the targets.

Design

A cross-sectional study.

Methods and study setting

This survey assessed TB knowledge and access to TB-health information by questionnaire survey with 1486 undergraduates from two medical universities in Southwest China.

Results

Overall, the students had inadequate TB knowledge. Only 24.1%, 27.2% and 34.1% of the students had knowledge of TB symptoms of cough/blood-tinged sputum, their local TB dispensaries and free TB treatment policy, respectively. Very few (14.5%) had heard about the Directly Observed Therapy Short Course (DOTS), and only about half (54%) had ever accessed TB-health education information. Exposure to health education messages was significantly associated with increased knowledge of the five core TB knowledge as follows: classic TB symptoms of cough/blood-tinged sputum (OR (95% CI) 0.5(0.4 to 0.7)), TB modes of transmission (OR (95% CI) 0.4(0.3 to 0.5)), curability of TB (OR (95% CI) 0.6(0.5 to 0.7)), location and services provided by TB local dispensaries (OR (95% CI) 0.6(0.5 to 0.8)) and the national free TB treatment policy (OR (95% CI) 0.7(0.5 to 0.8)).

Conclusions

The findings pose the question of whether it is time for a rethink of the current national and global approach to TB-health education/promotion which favours promotion of awareness on World TB Days rather than regular community sensitisation efforts.
Safety during night shifts: a cross-sectional survey of junior doctors’ preparation and practice
Authors: Jackson Emma J , Moreton Adam
Published: September 2013

Objectives

We aimed to determine whether junior doctors and trusts in the region make use of published evidence relating to best practice during night shift work that can safeguard alertness, reduce fatigue and limit mistakes. We surveyed junior doctors’ preparation for and practice during night shifts, and the working and living conditions offered by hospitals for junior doctors carrying out night duties.

Design

Cross-sectional survey.

Setting

An anonymous online questionnaire was sent to junior doctors training within Health Education North West from 13 December 2012 to 14 February 2013.

Participants

32% (16/42) of trusts within Health Education North West sent the survey to 2139 junior doctor email addresses; 24.5% (524/2139) entered data into the survey.

Results

91.6% of surveyed junior doctors worked night shifts. Prior to starting night shifts, 65% do not have a ‘prophylactic’ afternoon nap. At work, half (49%) can access a room with a reclining chair while 24% have a room with a bed. 37% ‘never’ achieve a ‘natural break’ on night shift; 53% ‘never’ achieve the recommended 20–45 min nap. 91% of respondents were unaware of the duration of sleep inertia that can affect alertness upon waking. When converting between day/night shifts, 2% use light lamps and 6% use non-benzodiazepine sedatives. Principal themes from free text analysis were feeling lethargic or unwell during night shifts, concern for patient and personal safety and inability to rest or take breaks.

Conclusions

The trainees surveyed find night shifts difficult, yet do not/are unable to implement evidence-based recommendations to limit fatigue. Results suggest those surveyed experience a lack of rest facilities within their place of work and a demanding workload. The results may indicate the need to increase awareness of the potential benefits associated with different interventions that can help mitigate the fatigue associated with rotating shift work.
Asthma related to cleaning agents: a clinical insight
Authors: Vandenplas Olivier , D'Alpaos Vinciane , Evrard Geneviève , Jamart Jacques , Thimpont Joel , Huaux François , Renauld Jean-Christophe
Published: September 2013

Objective

To determine the agents causing asthmatic reactions during specific inhalation challenges (SICs) in workers with cleaning-related asthma symptoms and to assess the pattern of bronchial responses in order to identify the mechanisms involved in cleaning-related asthma.

Design

A retrospective case series analysis.

Setting

The study included all participants who completed an SIC procedure with the cleaning/disinfection products suspected of causing work-related asthma over the period 1992–2011 in a tertiary centre, which is the single specialised centre of the French-speaking part of Belgium where all participants with work-related asthma are referred to for SIC.

Results

The review identified 44 participants who completed an SIC with cleaning/disinfection agents. Challenge exposure to the suspected cleaning agents elicited a ≥20% fall in forced expiratory volume in 1 s (FEV1) in 17 (39%) participants. The cleaning products that induced a positive SIC contained quaternary ammonium compounds (n=10), glutaraldehyde (n=3), both of these agents (n=1) and ethanolamines (n=2). Positive SICs were associated with a significant decrease in the median (IQR) value of the provocative concentration of histamine causing a 20% fall in FEV1(PC20) from 1.4 (0.2–4.2) mg/mL at baseline to 0.5 (0.4–3.0) mg/mL after the challenge and a significant increase in sputum eosinophils from 1.8 (0.8–7.2)% at baseline to 10.0 (4.1–15.9)% 7 h after the challenge exposure while these parameters did not significantly change in participants with a negative SIC. Overall, 11 of 17 participants with positive SICs showed greater than threefold decrease in postchallenge histamine PC20value, a >2% increase in sputum eosinophils, or both of these outcomes.

Conclusions

These data indicate that a substantial proportion of workers who experience asthma symptoms related to cleaning materials show a pattern of bronchial reaction consistent with sensitiser-induced occupational asthma. The results also suggest that quaternary ammonium compounds are the principal cause of sensitiser-induced occupational asthma among cleaners.
Cortical β-amyloid levels and neurocognitive performance after cardiac surgery
Authors: Klinger Rebecca Y , James Olga G , Wong Terence Z , Newman Mark F , Doraiswamy P Murali , Mathew Joseph P
Published: September 2013

Introduction

Neurological and neurocognitive dysfunction occurs frequently in the large number of increasingly elderly patients undergoing cardiac surgery every year. Perioperative cognitive deficits have been shown to persist after discharge and up to several years after surgery. More importantly, perioperative cognitive decline is predictive of long-term cognitive dysfunction, reduced quality of life and increased mortality. The proposed mechanisms to explain the cognitive decline associated with cardiac surgery include the neurotoxic accumulation of β-amyloid. This study will be the first to provide molecular imaging to assess the relationship between neocortical β-amyloid deposition and postoperative cognitive dysfunction.

Methods and analysis

40 patients providing informed consent for participation in this Institutional Review Board-approved study and undergoing cardiac (coronary artery bypass graft (CABG), valve or CABG+valve) surgery with cardiopulmonary bypass will be enrolled based on defined inclusion and exclusion criteria. At 6 weeks after surgery, participants will undergo18F-florbetapir positron emission tomography imaging to assess neocortical β-amyloid burden along with a standard neurocognitive battery and blood testing for apolipoprotein E ε-4 genotype.

Results

The results will be compared to those of 40 elderly controls and 40 elderly patients with mild cognitive impairment who have previously completed18F-florbetapir imaging.

Ethics and dissemination

This study has been approved by the Duke University Institutional Review Board. The results will provide novel mechanistic insights into postoperative cognitive dysfunction that will inform future studies into potential treatments or preventative therapies of long-term cognitive decline after cardiac surgery.
The Smoking MUMS (Maternal Use of Medications and Safety) Study: protocol for a population-based cohort study using linked administrative data
Authors: Havard Alys , Jorm Louisa R , Preen David , Daube Michael , Kemp Anna , Einarsdóttir Kristjana , Randall Deborah , Tran Duong Thuy
Published: September 2013

Introduction

Approximately 14% of Australian women smoke during pregnancy. Although the risk of adverse outcomes is reduced by smoking cessation, less than 35% of Australian women quit smoking spontaneously during pregnancy. Evidence for the efficacy of bupropion, varenicline or nicotine replacement therapy as smoking cessation aids in the non-pregnant population suggest that pharmacotherapy for smoking cessation is worth exploring in women of childbearing age. Currently, little is known about the utilisation, effectiveness and safety of pharmacotherapies for smoking cessation during pregnancy; neither the extent to which they are used prior to pregnancy nor whether their use has changed in response to related policy reforms. The Smoking MUMS (Maternal Use of Medications and Safety) Study will explore these issues using linked person-level data for a population-based cohort of Australian mothers.

Methods and analysis

The cohort will be assembled by linking administrative health records for all women who gave birth in New South Wales or Western Australia since 2003 and their children, including records relating to childbirth, use of pharmaceuticals, hospital admissions, emergency department presentations and deaths. These longitudinal linked data will be used to identify utilisation of smoking cessation pharmacotherapies during and between pregnancies and to explore the associated smoking cessation rates and maternal and child health outcomes. Subgroup and temporal analyses will identify potential differences between population groups including indigenous mothers and social security recipients and track changes associated with policy reforms that have made alternative smoking cessation pharmacotherapies available.

Ethics and dissemination

Ethical approval has been obtained for this study. To enhance the translation of the project's findings into policy and practice, policy and clinical stakeholders will be engaged through a reference group and a policy forum will be held. Outputs from the project will include scientific papers and summary reports designed for policy audiences.
A population-based case–control study on social factors and risk of testicular germ cell tumours
Authors: Schmeisser Nils , Conway David I , Stang Andreas , Jahn Ingeborg , Stegmaier Christa , Baumgardt-Elms Cornelia , Jöckel Karl-Heinz , Behrens Thomas , Ahrens Wolfgang
Published: September 2013

Objectives

Incidence rates for testicular cancer have risen over the last few decades. Findings of an association between the risk of testicular cancer and social factors are controversial. The association of testicular cancer and different indicators of social factors were examined in this study.

Design

Case–control study.

Setting

Population-based multicentre study in four German regions (city states Bremen and Hamburg, the Saarland region and the city of Essen).

Participants

The study included 797 control participants and 266 participants newly diagnosed with testicular cancer of which 167 cases were classified as seminoma and 99 as non-seminoma. The age of study participants ranged from 15 to 69 years.

Methods

Social position was classified by educational attainment level, posteducational training, occupational sectors according to Erikson-Goldthorpe-Portocarrero (EGP) and the socioeconomic status (SES) on the basis of the International SocioEconomic Index of occupational status (ISEI). ORs and corresponding 95% CIs (95% CIs) were calculated for the whole study sample and for seminoma and non-seminoma separately.

Results

Testicular cancer risk was modestly increased among participants with an apprenticeship (OR=1.7 (95% CI 1.0 to 2.8)) or a university degree (OR=1.6 (95% CI 0.9 to 2.8)) relative to those whose education was limited to school. Analysis of occupational sectors revealed an excess risk for farmers and farm-related occupations. No clear trend was observed for the analyses according to the ISEI-scale.

Conclusions

Social factors based on occupational measures were not a risk factor for testicular cancer in this study. The elevated risk in farmers and farm-related occupations warrants further research including analysis of occupational exposures.