bluuebunny/crossref_metadata_2025 huggingface dataset:
Flowers of Bienertia cycloptera and Suaeda aralocaspica (Chenopodiaceae) complete the life cycle performing single-cell C4 photosynthesis
Authors: Boyd Christine N. , Franceschi Vincent R. , Chuong Simon D. X. , Akhani Hossein , Kiirats Olavi , Smith Monica , Edwards Gerald E.
Published: April 2007

Leaves and cotyledons of the terrestrial C4 plants, Bienertia cycloptera Bunge ex Boiss. and Suaeda aralocaspica (Bunge) Freitag & Schütze (Chenopodiaceae), accomplish C4 photosynthesis within individual chlorenchyma cells: each species having a unique means of intracellular spatial partitioning of biochemistry and organelles. In this study the chlorenchyma tissue in flowers and stems of these species was investigated. Flowers have an outer whorl of green tepals with a layer of chlorenchyma cells, which are located on the abaxial side, exposed to the atmosphere. Anatomical, immunocytochemical, western blots and starch analyses show that the chlorenchyma cells in tepals are specialised for performance of single-cell C4 photosynthesis like that in leaves. In the tepals of B. cycloptera, chlorenchyma cells have a distinctive central cytoplasmic compartment, with chloroplasts which contain Rubisco, separated by cytoplasmic channels from a peripheral chloroplast-containing compartment, with phosphoenolpyruvate carboxylase (PEPC) distributed throughout the cytoplasm. In the tepals of S. aralocaspica, chlorenchyma cells have chloroplasts polarised towards opposite ends of the cells. Rubisco is found in chloroplasts towards the proximal end of the cell and PEPC is found throughout the cytoplasm. Also, green stems of B. cycloptera have a single layer of the specialised C4 type chlorenchyma cells beneath the epidermis, and in stems of S. aralocaspica, chlorenchyma cells are scattered throughout the cortical tissue with chloroplasts around their periphery, typical of C3 type chlorenchyma. During reproductive development, green flowers become very conspicuous, and their photosynthesis is suggested to be important in completion of the life cycle of these single-cell C4 functioning species.
Hydration of Cuphea seeds containing crystallised triacylglycerols
Authors: Volk Gayle M. , Crane Jennifer , Caspersen Ann M. , Kovach David , Gardner Candice , Walters Christina
Published: April 2007

Seeds that exhibit intermediate storage behaviour seem to die under conventional –18°C storage conditions. Cuphea wrightii A. Gray, C. laminuligera Koehne, C. carthagenensis (Jacq.) J.F. Macbr. and C. aequipetala Cav are considered sensitive to low temperature storage. The seeds of these species have triacylglycerols (TAG) that are crystalline at –18°C and melt when the seeds are warmed to >35°C. In contrast, seeds of tolerant species, C. lanceolata W.T. Aiton and C. hookeriana Walp., have TAG that crystallise at temperatures below –18°C and are fluid at 22°C. Cuphea seeds imbided while TAG are crystalline fail to germinate and exhibit visual damage. However, germination proceeded normally when dry seeds were warmed adequately to melt any crystalline TAG before imbibition. Reduced germination and cellular disruption including loss of lipid body compartmentation and fragmented protein bodies develop in seeds with crystalline TAG equilibrated to >0.1 g H2O g–1 DW. This damage cannot be reversed, even when seeds are dried before the damage can be visually detected. Results from this work reveal that the seeds of some species with intermediate type physiologies can be successfully placed into conventional –18 and –80°C storage facilities.
Viewpoint: Concept of redesigning proteins by manipulating calcium/calmodulin-binding domains to engineer plants with altered traits
Authors: Yang Tianbao , Du Liqun , Poovaiah B. W.
Published: April 2007

The importance of calcium and calcium-binding proteins such as calmodulin in plant growth and development as well as plant response to environmental stimuli has been recognised for some time. However, it is only recently that the underlying mechanisms have begun to be unravelled. A variety of intracellular calcium signatures have been observed in response to various stimuli. However, how these changes induce downstream actions and how one can manipulate these events to alter plant response is an area of major interest. Here we discuss the recent advances on three intriguing calcium/calmodulin-regulated proteins: a calcium/calmodulin-regulated metabolic enzyme (DWF1); a chimeric calcium/calmodulin-dependent protein kinase (CCaMK); and a family of calcium/calmodulin-regulated transcription factors (AtSRs or CAMTAs). These proteins play critical roles in plant growth, plant : microbe interactions and plant response to multiple environmental signals. The identification and manipulation of calcium-binding and calmodulin-binding sites in these proteins have provided direct evidence for the role of calcium-binding and calmodulin-binding to the proteins, as well as providing new ways to rebuild the proteins and engineer plants to obtain desired traits.
The genome of
Syntrophus aciditrophicus
: Life at the thermodynamic limit of microbial growth
Authors: McInerney Michael J. , Rohlin Lars , Mouttaki Housna , Kim UnMi , Krupp Rebecca S. , Rios-Hernandez Luis , Sieber Jessica , Struchtemeyer Christopher G. , Bhattacharyya Anamitra , Campbell John W. , Gunsalus Robert P.
Published: April 2007

Biochemically, the syntrophic bacteria constitute the missing link in our understanding of anaerobic flow of carbon in the biosphere. The completed genome sequence of
Syntrophus aciditrophicus
SB, a model fatty acid- and aromatic acid-degrading syntrophic bacterium, provides a glimpse of the composition and architecture of the electron transfer and energy-transducing systems needed to exist on marginal energy economies of a syntrophic lifestyle. The genome contains 3,179,300 base pairs and 3,169 genes where 1,618 genes were assigned putative functions. Metabolic reconstruction of the gene inventory revealed that most biosynthetic pathways of a typical Gram-negative microbe were present. A distinctive feature of syntrophic metabolism is the need for reverse electron transport; the presence of a unique Rnf-type ion-translocating electron transfer complex, menaquinone, and membrane-bound Fe-S proteins with associated heterodisulfide reductase domains suggests mechanisms to accomplish this task. Previously undescribed approaches to degrade fatty and aromatic acids, including multiple AMP-forming CoA ligases and acyl-CoA synthetases seem to be present as ways to form and dissipate ion gradients by using a sodium-based energy strategy. Thus,
S. aciditrophicus
, although nutritionally self-sufficient, seems to be a syntrophic specialist with limited fermentative and respiratory metabolism. Genomic analysis confirms the
S. aciditrophicus
metabolic and regulatory commitment to a nonconventional mode of life compared with our prevailing understanding of microbiology.
Systematic discovery of regulatory motifs in conserved regions of the human genome, including thousands of CTCF insulator sites
Authors: Xie Xiaohui , Mikkelsen Tarjei S. , Gnirke Andreas , Lindblad-Toh Kerstin , Kellis Manolis , Lander Eric S.
Published: April 2007

Conserved noncoding elements (CNEs) constitute the majority of sequences under purifying selection in the human genome, yet their function remains largely unknown. Experimental evidence suggests that many of these elements play regulatory roles, but little is known about regulatory motifs contained within them. Here we describe a systematic approach to discover and characterize regulatory motifs within mammalian CNEs by searching for long motifs (12–22 nt) with significant enrichment in CNEs and studying their biochemical and genomic properties. Our analysis identifies 233 long motifs (LMs), matching a total of ≈60,000 conserved instances across the human genome. These motifs include 16 previously known regulatory elements, such as the histone 3′-UTR motif and the neuron-restrictive silencer element, as well as striking examples of novel functional elements. The most highly enriched motif (LM1) corresponds to the X-box motif known from yeast and nematode. We show that it is bound by the RFX1 protein and identify thousands of conserved motif instances, suggesting a broad role for the RFX family in gene regulation. A second group of motifs (LM2*) does not match any previously known motif. We demonstrate by biochemical and computational methods that it defines a binding site for the CTCF protein, which is involved in insulator function to limit the spread of gene activation. We identify nearly 15,000 conserved sites that likely serve as insulators, and we show that nearby genes separated by predicted CTCF sites show markedly reduced correlation in gene expression. These sites may thus partition the human genome into domains of expression.
Patterning of frontal cortex subdivisions by Fgf17
Authors: Cholfin Jeremy A. , Rubenstein John L. R.
Published: April 2007

The frontal cortex (FC) is the seat of higher cognition. The genetic mechanisms that control formation of the functionally distinct subdivisions of the FC are unknown. Using a set of gene expression markers that distinguish subdivisions of the newborn mouse FC, we show that loss of
Fgf17
selectively reduces the size of the dorsal FC whereas ventral/orbital FC appears normal. These changes are complemented by a rostral shift of sensory cortical areas. Thus,
Fgf17
functions similar to
Fgf8
in patterning the overall neocortical map but has a more selective role in regulating the properties of the dorsal but not ventral FC.
Streptococcal Meningitis Following Myelogram Procedures
Authors: Hsu Jennifer , Jensen Bette , Arduino Matthew , Bergeron Toni , Fox Teresa , Gum Greg , Pischke Vera , Potts David , Townes John , Srinivasan Arjun
Published: April 2007

In September of 2004, we investigated 7 cases of post-myelography meningitis. Streptococcal species were recovered from blood or cerebrospinal fluid in all cases. Our findings suggest that droplet transmission of the oral flora of the clinician performing the procedure was the most likely source of these infections. The Centers for Disease Control and Prevention recommends the use of face masks by those performing myelograms.
Evaluation of Antimicrobial Therapy Orders Circumventing an Antimicrobial Stewardship Program: Investigating the Strategy of “Stealth Dosing”
Authors: LaRosa Lori Ann , Fishman Neil O. , Lautenbach Ebbing , Koppel Ross J. , Morales Knashawn H. , Linkin Darren R.
Published: April 2007

Objective.

Prior-approval antimicrobial stewardship programs (ASPs) improve patient outcomes and decrease antimicrobial resistance. These benefits would be limited if physicians circumvented ASP efforts. We evaluated whether prescribers wait until after the prior-approval period to order restricted antimicrobial therapy that is in conflict with guidelines or unnecessary.

Design.

A cross-sectional study design and a retrospective cohort study design.

Setting.

A tertiary care, academic medical center with a prior-approval ASP that was active between 8 AM and 10 PM.

Methods.

We evaluated whether there was an increase in the proportion of orders for antimicrobial therapy that involve restricted (vs nonrestricted) antimicrobials during the first hour that the ASP is inactive (ie, the first hour that prior approval is not required), compared with the remainder of the day. We also evaluated whether restricted antimicrobial therapy ordered during this first hour is less likely to be continued when the ASP becomes active the next day, compared with that ordered during the preceding hour.

Results.

A greater proportion of the antimicrobial therapy orders placed between 10:00 PM and 10:59 PM were for restricted agents, compared with orders placed during other periods (57.0% vs 49.9%; P = .02). Surgical patients for whom antimicrobial therapy orders were placed between 10:00 PM and 10:59 PM were less likely to have that antimicrobial therapy continued, compared with patients whose therapy was ordered between 9:00 PM and 9:59 PM (60.0% vs 98.1%; P <.001). Nonsurgical patients whose therapy orders were placed between 10:00PM and 10:59 PM were also less likely to have the ordered antimicrobial therapy continued, compared with patients whose therapy was ordered between 9:00 PM and 9:59 PM (70.8% vs 84.2%; P = .01).

Conclusion.

Physicians avoid having to obtain prior approval for therapy involving restricted antimicrobials by waiting until restrictions are no longer active to place orders. Compared with restricted antimicrobial therapy ordered when the ASP is active, these courses of therapy are less often continued by the ASP, suggesting that they are more likely to be in conflict with guidelines or unnecessary.
A Neonatal Specialist With Recurrent Methicillin-Resistant Staphylococcus aureus (MRSA) Carriage Implicated in the Transmission of MRSA to Newborns
Authors: Méan M. , Mallaret M. R. , Andrini P , Recule C. , Debillon T. , Pavese P. , Croizé J.
Published: April 2007

This study reports an investigation of outbreaks of methicillin-resistantStaphylococcus aureus(MRSA) infection and colonization involving 17 newborns in the neonatal unit of a teaching hospital. A neonatal specialist colonized with MRSA that eventually became mupirocin-resistant was implicated as a recurrent source of transmission of MRSA to newborns.
Device-Associated Nosocomial Infection Rates in Intensive Care Units in Greece
Authors: Dima Sofia , Kritsotakis Evangelos I. , Roumbelaki Maria , Metalidis Simeon , Karabinis Andreas , Maguina Nina , Klouva Fyllis , Levidiotou Stamatina , Zakynthinos Epaminondas , Kioumis John , Gikas Achilleas
Published: April 2007

Site-specific, risk-adjusted incidence rates of intensive care unit (ICU)-acquired infections were obtained through standardized surveillance in 8 ICUs in Greece. High rates were observed for central line-associated bloodstream infection (12.1 infections per 1,000 device-days) and ventilator-associated pneumonia (12.5 infections per 1,000 device-days). Gram-negative microorganisms accounted for 60.4% of the isolates recovered, and Acinetobacter species were predominant. To reduce infection rates in Greek ICUs, comprehensive infection control programs are required.
Central Venous Catheter–Related Streptomyces Septic Thrombosis
Authors: Ghanem Ghazi , Adachi Javier , Han Xiang-Yang , Raad Issam
Published: April 2007

Streptomycesspecies are part of the actinomycetes group. They have rarely been reported as a cause of invasive infection. We report a case of catheter-relatedStreptomycesbacteremia complicated by severe sepsis and septic thrombosis. We also present a brief review of the literature onStreptomycesbacteremia.
Pseudo-outbreak of Acinetobacter Iwoffii Infection in a Tertiary Care Center in Thailand
Authors: Apisarnthanarak Anucha , Kiratisin Pattarachai , Thongphubeth Kanokporn , Yuakyen Chananart , Mundy Linda M.
Published: April 2007

We describe a pseudo-outbreak ofAcinetobacter Iwoffiiinfection that was recognized early. The pseudo-outbreak involved 16 patients and occurred 3.5 months after the GNS-506 Vitek automated system was introduced in the microbiology laboratory. Prompt confirmation of incomplete use of the automated system's algorithm as the point source of the misidentifiedA. Iwoffiiclinical isolates averted a full outbreak investigation and excess use of infection control resources.
Infectivity of Hepatitis C Virus in Plasma After Drying and Storing at Room Temperature
Authors: Kamili Saleem , Krawczynski Kris , McCaustland Karen , Li Xiaofang , Alter Miriam J.
Published: April 2007

Objective.

To determine effect of environmental exposure on the survival and infectivity of hepatitis C virus (HCV).

Methods.

Three aliquots of chimpanzee plasma containing HCV and proven infectious HCV inoculum were dried and stored at room temperature, 1 aliquot for 16 hours, 1 for 4 days, and 1 for 7 days. A chimpanzee (CH247) was sequentially inoculated intravenously with each of these experimental inocula, beginning with the material stored for 7 days. Each inoculation was separated by at least 18 weeks of follow-up to monitor for infection. The concentration of HCV RNA was measured and quasi species were sequenced for each experimental inoculum and in serum samples from CH247.

Results.

Evidence of HCV infection developed in CH247 only after inoculation with the material stored for 16 hours. No infection occurred after inoculation with the material stored for 7 days or 4 days. Compared with the original infectious chimpanzee plasma, the concentration of HCV RNA was 1 log lower in all 3 experimental inocula. The same predominant sequences were found in similar proportions in the original chimpanzee plasma and in the experimental inocula, as well as in serum samples from CH247.

Conclusion.

HCV in plasma can survive drying and environmental exposure to room temperature for at least 16 hours, which supports the results of recent epidemiologic investigations that implicated blood-contaminated inanimate surfaces, objects, and/or devices as reservoirs for patient-to-patient transmission of HCV. Healthcare professionals in all settings should review their aseptic techniques and infection control practices to ensure that they are being performed in a manner that prevents cross-contamination from such reservoirs.
Political Versus Epidemiological Correctness
Authors: Farr Barry M.
Published: April 2007

In the March issue of the journal, the Joint SHEA and APIC Task Force indicates that the Society for Healthcare Epidemiology of America (SHEA) and the Association for Professionals in Infection Control and Epidemiology (APIC) support the use of active detection and isolation (ADI) for controlling nosocomial infections due to methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) “in appropriate circumstances, as recommended in previously published guidelines”1(p250) (those published by SHEA and the Healthcare Infection Control Practices Advisory Committee [HICPAC]), but that SHEA and APIC oppose the use of legislation for mandating any infection control approach, including this one as tried in 2006 in Illinois and Maryland.

Both supporters and opponents of controlling MRSA and VRE with ADI probably will agree that legislation is not the optimal way to control nosocomial infections in general, but this position statement undoubtedly will please the latter more than it does the former because the SHEA/APIC Task Force argues that ADI is not ready for routine use throughout all healthcare facilities, directly opposing the position of the original SHEA guideline. As an author of that SHEA guideline, I would like to comment. First, the new position seems politically correct (since most infection control professionals have not yet bothered using ADI to control MRSA and VRE), but many of the planks of the SHEA/APIC Task Force position statement are misleading.
Hospital “Self-Prophylaxis” Strategies for Efficient Protection of the Workforce in the Face of Infectious Disease Threats
Authors: Xiong Wei , Hollingsworth Eric , Muckstadt Jack , Vorenkamp Jaclyn Van Lieu , Lazar Eliot J. , Cagliuso Nicholas V. , Hupert Nathaniel
Published: April 2007

Hospital preparedness for nosocomial or community-wide outbreaks of communicable disease includes the capability for rapid, self-reliant administration of prophylaxis to its workforce, with the goal of minimal disruption of patient care, here called hospital “self-prophylaxis.” We created a new discrete-event simulation model of a hypothetical hospital wing to compare the operational charateristics of standard single-line, “first-come, first-served” dispensing clinics with those of 2 staff management strategies that can dramatically reduce staff waiting time while centralizing dispensing around existing pharmacy-distribution points.
Incidence of Catheter-Related Bloodstream Infection Among Patients With a Needleless, Mechanical Valve–Based Intravenous Connector in an Australian Hematology-Oncology Unit
Authors: Field Kathryn , McFarlane Caroline , Cheng Allen C. , Hughes Andrew J. , Jacobs Elly , Styles Kaylene , Low Jillian , Stow Peter , Campbell Philip , Athan Eugene
Published: April 2007

There are few Australian data on the incidence of catheter-associated bloodstream infection (BSI) among patients in hematology-oncology units. We found an increase in catheter-associated BSI rates coincident with the introduction of a mechanical valve connector (2.6 infections vs 5.8 infections per 1,000 catheter-days; incidence rate ratio, 2.2; P = .031).
Effect of a Chlorhexidine Mouthwash on the Risk of Postextraction Bacteremia
Authors: Tomás I. , Álvarez M. , Limeres J. , Tomás M. , Medina J. , Otero J. L. , Diz P.
Published: April 2007

Objective.

To investigate the prevalence, duration, and etiology of bacteremia following dental extractions performed after a single administration of Chlorhexidine mouthwash.

Design and Setting.

A randomized, controlled trial performed in a university hospital.

Methods.

A series of 106 patients with mental and behavioral disabilities who underwent dental extractions under general anesthesia were randomly assigned to a control group or Chlorhexidine group. The exclusion criteria applied were use of antibiotics in the previous 3 months, use of oral antiseptics, any type of congenital or acquired immunodeficiency, and disease that predisposes the patient to infections or bleeding. The Chlorhexidine group had 0.2% Chlorhexidine mouthwash administered for 30 seconds before any dental manipulation. Blood samples were collected at baseline, 30 seconds, 15 minutes, and 1 hour after the dental extractions. Subculture and further identification of the isolated bacteria were performed by conventional microbiological techniques.

Results.

The prevalence of bacteremia after dental extraction in the control and Chlorhexidine groups were 96% and 79%, respectively, at 30 seconds (P = .008), 64% and 30% at 15 minutes (P <.001), and 20% and 2% at 1 hour (P = .005). The most frequently identified bacteria were Streptococcus species in both the control and Chlorhexidine groups (64% and 68%, respectively), particularly viridans group streptococci.

Conclusion.

We recommend the routine use of a 0.2% Chlorhexidine mouthwash before dental extractions to reduce the risk of postextraction bacteremia.
Introduction: The Emergence Of Christian Identity
Authors: Lieu Judith
Published: April 2007

How can we imagine what the sense of being ‘a Christian’ might have conveyed? We only have texts to guide us. Indeed, despite low levels of literacy, early Christianity can be viewed as a textual construct as can also Judaism and other self-understandings in the Graeco-Roman world. This allows identity and its analysis, although a modern concept, to be creatively applied to the ancient world, including early Christianity. To do so will provoke new perspectives on familiar questions concerning the rise of Christianity, its relationship with Judaism within the context of the Graeco-Roman world, and whether it is possible to speak of the essence of Christianity.
Made Not Born: Conclusions
Authors: Lieu Judith
Published: April 2007

Both continuities and discontinuities mark the strong thrust towards the creation of identity in early Christian writings, although we may not always be able to move directly from these to actual social experience. This, and distinguishing between individuals and conceptualized systems, complicates any simple model of the origins and character of early Christianity, or of the relationship between Judaism and Christianity, Jews and Christians. Yet, two themes emerge if it is possible to speak about a continuity of Christian identity: the ability to tell a story, although stories will always compete, and the creation of ‘the other’, which in the modern world may demand a respect for diversity and for their integrity.
A peptide mimetic of the mycobacterial mannosylated lipoarabinomannan: characterization and potential applications
Authors: Barenholz Ayelet , Hovav Avi-Hai , Fishman Yolanta , Rahav Galia , Gershoni Jonathan M. , Bercovier Hervé
Published: April 2007

Mannosylated lipoarabinomannan (ManLAM), a complex lipoglycan, is a major component ofMycobacterium tuberculosis, the agent of tuberculosis (TB), and is an antigen used for serological diagnosis of TB. Screening random phage-display peptide libraries with anti-ManLAM mAb CS40 for peptide epitope mimics (mimotopes) led to the isolation of a panel of peptides. One of these peptides (B11) was characterized as a ManLAM mimotope: it bound the anti-ManLAM CS40 mAb and competed with ManLAM for antibody binding. Mice immunized with keyhole limpet haemocyanin-conjugated B11 peptide in a proper adjuvant developed antibodies that recognized ManLAM. Competition experiments demonstrated that the B11 peptide inhibited binding of mAb CS40 to ManLAM in a concentration-dependent manner. The data indicated that the affinity of CS40 mAb to B11 (KD1.33×10−8) is higher than its affinity to ManLAM (KD3.00×10−7). The sera of TB patients, as well as the sera of mice experimentally infected withM. tuberculosis, contained significant levels of antibodies that recognized both the B11 peptide and ManLAM. The specificity and sensitivity of the ELISA B11-based test were similar to those of the ELISA ManLAM-based test, indicating that the B11 antigen could be a good substitute for ManLAM serology for the diagnosis of TB.
Genetically similar isolates of Klebsiella pneumoniae serotype K1 causing liver abscesses in three continents
Authors: Turton Jane F. , Englender Hilary , Gabriel Samantha N. , Turton Sarah E. , Kaufmann Mary E. , Pitt Tyrone L.
Published: April 2007

ThemagAgene was sought in hypermucoviscous isolates ofKlebsiellaspp., theKlebsiellaK serotype reference strains and in isolates of the K1 serotype ofKlebsiella pneumoniaefrom the UK, Hong Kong, Israel, Taiwan and Australia. Only K1 isolates were PCR positive formagA; this gene was found in all such isolates tested. Hypermucoviscosity was not confined tomagApositive isolates, nor was it found in allmagApositive isolates. Comparison ofXbaI PFGE profiles revealed that most (19/23) of themagApositive isolates clustered within 72 % similarity, with a further subcluster of isolates, from three different continents, clustering within >80 %. All of the 16 isolates tested within the main cluster had the same sequence type (ST 23) by multilocus sequence typing, with the exception of one isolate, which had a single nucleotide difference at one of the seven loci. This study indicates that a genotype strongly associated with highly invasive disease in Taiwan, where large numbers of cases have been reported, is geographically very widespread.
A novel serovar of Shigella dysenteriae from patients with diarrhoea in Bangladesh
Authors: Talukder Kaisar A. , Mondol Abdus S. , Islam M. Aminul , Islam Zhahirul , Dutta Dilip K. , Khajanchi Bijay K. , Azmi Ishrat J. , Hossain M. A. , Rahman M. , Cheasty Thomas , Cravioto Alejandro , Nair G. B. , Sack David A.
Published: April 2007

Every year, around 3 % of isolates from patients with diarrhoea at Dhaka Hospital, ICDDR,B, are identified as Shigella-like organisms (SLOs) based on their activity in biochemical tests. These isolates do not react with any of the current Shigella antisera including all existing and provisional serotypes. Among these SLOs, a unique cluster of seven isolates with an identical plasmid profile was found and these isolates were further characterized by phenotypic and genotypic techniques. All were nonlactose fermenters, with an identical biochemical pattern typical of Shigella dysenteriae. They were classified as invasive since they harboured the 140 MDa invasive plasmid, were able to bind Congo red, produced keratoconjunctivitis in the guinea pig eye, and were positive by PCR for the ipaH gene and Shigella enterotoxin 2 [ShET-2] gene. All isolates were resistant to ampicillin, tetracycline and sulfamethoxazole–trimethoprim but were susceptible to mecillinam, nalidixic acid, ceftriaxone and ciprofloxacin. Six of the isolates were identical in DNA pattern by PFGE with the seventh exhibiting a closely related pattern; both patterns were distinguishable from all other Shigella and Escherichia coli patterns. An antiserum prepared against one of the isolates reacted with all isolates and did not cross-react with other Shigella and E. coli serotype reference strains. It is therefore proposed that these isolates represent a new provisional serovar of S. dysenteriae, type strain KIVI 162.
The dominance of pandemic serovars of Vibrio parahaemolyticus in expatriates and sporadic cases of diarrhoea in Thailand, and a new emergent serovar (O3 : K46) with pandemic traits
Authors: Serichantalergs Oralak , Bhuiyan Nurul Amin , Nair Gopinath Balakrish , Chivaratanond Orapan , Srijan Apichai , Bodhidatta Ladaporn , Anuras Sinn , Mason Carl J.
Published: April 2007

Vibrio parahaemolyticus is a major cause of gastroenteritis worldwide. A total of 95 V. parahaemolyticus isolates belonging to 23 different serovars were identified in a case–control study of expatriates and Thai adults from 2001 to 2002 in Thailand. Fifty-two per cent of isolates (49/95) were resistant to ampicillin and sulfisoxazole, but all isolates were susceptible to ciprofloxacin and trimethoprim–sulfamethoxazole, two antibiotics commonly used to treat traveller’s diarrhoea. All isolates were positive for the species-specific toxR gene, and 91 and 5 were positive for the thermostable direct haemolysin (tdh) gene and the tdh-related (trh) gene, respectively. Sixty-five isolates were assigned to the pandemic group of V. parahaemolyticus by a group-specific PCR and the presence of the orf8 gene. The pandemic isolates belonged to three recognized serovars (O3 : K6, O1 : K25, O1 : KUT) and a new serovar, O3 : K46. This new serovar harboured pandemic traits. PFGE analysis revealed that all pandemic isolates including serovar O3 : K46 were closely related and clearly distinct from the non-pandemic isolates. In summary, three well-known serovars of pandemic V. parahaemolyticus isolates were identified as a major cause of diarrhoea in Thailand and a new V. parahaemolyticus isolate, serovar O3 : K46, with pandemic traits was detected.
Enhancement of salivary IgA response to a DNA vaccine against Streptococcus mutans wall-associated protein A in mice by plasmid-based adjuvants
Authors: Han Thomas K. , Dao My Lien
Published: April 2007

A specific salivary IgA (sIgA) response was obtained in mice by intranasal immunization with a naked DNA vaccine consisting of theStreptococcus mutanswall-associated protein A gene (wapA) inserted into the mammalian expression vector pcDNA3.1/V5/His-TOPO. In the present study, the vaccine, referred to as pcDNA-wapA, was administered with or without the cationic lipid DMRIE-C. No mucosal response was observed in mice immunized with the vaccine alone, whereas a weak and temporal sIgA response was obtained when the vaccine was mixed with DMRIE-C. To investigate the use of pcDNA containing the interleukin 5 (IL-5) gene (pcDNA-il-5) or the cholera toxin B gene (pcDNA-ctb) as genetic adjuvants, these constructs were used in co-immunization studies. The enhancement effect was transient with pcDNA-il-5, but longer lasting with pcDNA-ctb, thus supporting the use of the latter as a genetic adjuvant to DNA vaccine.
Bacteria-associated haemophagocytic syndrome and septic pulmonary embolism caused by Burkholderia cepacia complex in a woman with chronic granulomatous disease
Authors: Hisano Michi , Sugawara Kana , Tatsuzawa Osamu , Kitagawa Michihiro , Murashima Atsuko , Yamaguchi Koushi
Published: April 2007

Chronic granulomatous disease (CGD) is a primary immunodeficiency characterized by recurrent infections with certain types of bacteria and fungi. Presented herein is the case of a 29 year old woman with CGD who suffered from bacteria-associated haemophagocytic syndrome and a septic pulmonary embolism following a uterine infection and sepsis, caused by Burkholderia cepacia complex.
Differential Haematological Effects of Tick‐borne Fever in Sheep and Goats
Authors: Gokce H. I. , Woldehiwet Z.
Published: April 2007

Tick‐borne fever (TBF) is a rickettsial disease of domestic and wild ruminants in temperate climates. It is characterized by high fever and severe leukopenia. In the present study, the possible difference in the severity of disease in sheep and goats was investigated by inoculating one group of eight goats and one group of eight sheep with the Old Sourhope (OS) strain of Ehrlichia (Cytoecetes) phagocytophila. All sheep and goats experimentally infected with E. phagocytophila reacted with fever and rickettsiaemia, but there were significant differences between goats and sheep in the severity of clinical disease, the duration and magnitude of fever, the magnitude of rickettsiaemia and the patterns of reduction in the number of total leucocytes. Sheep reacted with fever significantly earlier than goats and the febrile period lasted for a significantly longer period. In contrast, the magnitude of rickettsiaemia was significantly higher in goats than in sheep. Infection with TBF was characterized by a transient increase in the number of neutrophils, which was quickly followed by an acute reduction in the number of lymphocytes and a prolonged reduction in the number of neutrophils in both sheep and goats. In both groups of animals, infection with TBF was also characterized by significant reductions in the total number of red blood cells (RBCs), thrombocytes and packed cell volume (PCV) and the concentration of haemoglobin (Hb). However, the mean corpuscular volume (MCV) and mean corpuscular Hb (MCH) were significantly increased in sheep only.
Penicillin sensitivity among hospital nurses without a history of penicillin allergy
Authors: Cetinkaya Feyzullah , Ozturk Ali Osman , Kutluk Gunsel , Erdem Ela
Published: April 2007

Title. Penicillin sensitivity among hospital nurses without a history of penicillin allergy

Aim.  This paper reports a study to document the prevalence of penicillin sensitivity among nurses who had no previous history of sensitivity and worked in an inner city hospital in Turkey.

Background.  Frequent and prolonged exposure to any drug including penicillin may increase the risk of hypersensitivity to these drugs. Local administration of drugs increases the likelihood of sensitization. Nurses are the main group of healthcare workers who prepare and administer antibiotics to patients, so they may be at highest risk for sensitization. Skin testing with major and minor determinants of penicillin has proved useful for identifying penicillin‐specific IgE antibodies in sensitized individuals.

Method.  Skin prick tests were performed with benzyl penicilloyl polylysine (PPL) and a mixture of minor antigenic determinants (MDM) solution with 83 nurses who had been handling beta‐lactam antibiotics. The study was conducted in 2004.

Findings.  Ten nurses (12%) had positive skin reactions to penicillin antigens. Six were sensitive to PPL (7·2%) and four were sensitive to MDM (4·8%).

Conclusion.  Occult sensitization to beta‐lactam antibiotics, without symptoms, may develop in hospital nurses. It is possible that these healthcare workers might be at increased risk of hypersensitivity reactions should they be exposed to beta‐lactams, administered for therapeutic purposes. Further research is needed to explore this important issue.
Aggressive behaviour on acute psychiatric wards: prevalence, severity and management
Authors: Foster Chloe , Bowers Len , Nijman Henk
Published: April 2007

Title. Aggressive behaviour on acute psychiatric wards: prevalence, severity and management

Aim.  This paper reports a study to investigate the nature and prevalence of inpatient aggressive behaviour directed at staff and other patients and, in the case of patient self‐harm, the methods used by nursing staff to manage this.

Background.  Aggressive behaviour poses a threat to the physical and psychological health of psychiatric nursing staff. The fear that results from working in a climate of potential danger can also have a damaging impact on patient care.

Methods.  Nursing staff on five acute inpatient wards in one hospital in the United Kingdom collected data on aggressive incidents using the Staff Observation Aggression Scale – Revised during a 10 month period from June 2001 to April 2002.

Results.  There were 254 incidents of aggression recorded. Staff were most commonly targeted and were involved in 57·1% of incidents. The most frequent provocation of the aggression was the patient being denied something such as leave from the ward (29·5% of incidents). The most frequent means used by patients was verbal aggression (60% of incidents), the most frequent outcome for the victim was feeling threatened (59% of incidents), and verbal interventions were used most frequently to manage the aggressive behaviour (43·7%). Despite many incidents involving verbal aggression in both staff‐ and patient‐targeted aggression, 35·9% of incidents involving staff and 25% of incidents involving other patients resulted in seclusion.

Conclusion.  It is estimated that in a 12 month period at the hospital in this study a nurse would have a one in 10 chance per year of receiving any kind of injury as a result of patient aggression. Despite the predominance of verbal over physical aggression, the fear generated from working in such an environment and a difficulty in understanding the causes of patient aggression may motivate staff to manage aggressive incidents with physical methods such as seclusion and restraint on a frequent basis.
Influence of task properties and subjectivity on consistency of triage: a simulation study
Authors: Gerdtz M. F. , Bucknall T. K.
Published: April 2007

Title. Influence of task properties and subjectivity on consistency of triage: a simulation study

Aim. This paper reports a study to determine nurses’ levels of agreement using a standard 5‐point triage scale and to explore the influence of task properties and subjectivity on decision‐making consistency.

Background. Triage scales are used to define time‐to‐treatment in hospital emergency departments. Studies of the inter‐rater reliability of these scales using paper‐based simulation methods report varying levels of consistency. Understanding how various components of the decision task and individual perceptions of the case influence agreement is critical to the development of strategies to improve consistency of triage.

Method. Simulations were constructed from naturalistic observation, cue types and frequencies were classified. Data collection was conducted in 2002, and the final response rate was 41·3%. Participants were asked to allocate an urgency code for 12 scenarios using the Australasian Triage Scale, and provide estimates of case complexity, levels of certainty and available information. Data were analysed descriptively, agreement between raters was calculated using kappa. The influence of task properties and participants’ subjective estimates of case complexity, levels of certainty and available information on agreement were explored using a general linear model.

Findings. Agreement among raters varied from moderate to poor (κ = 0·18–0·64). Participants’ subjective estimates of levels of available information were found to influence consistency of triage by statistically significant amounts (F5·68; ≤0·01).

Conclusions. Strategies employed to optimize consistency of triage should focus on improving the quality of the simulations that are used. In particular, attention should be paid to the development of interactive simulations that will accommodate individual differences in information‐seeking behaviour.
Effects of nursing interventions within an integrated care pathway for patients with hip fracture
Authors: Olsson Lars‐Eric , Karlsson Jón , Ekman Inger
Published: April 2007

Title. Effects of nursing interventions within an integrated care pathway for patients with hip fracture

Aim.  This paper reports a study to evaluate the contribution of nursing care within an integrated care pathway for patients with hip fracture.

Background.  There is growing interest in quality assurance in health care. Integrated care pathways are a method to achieve this goal, and are a multi‐professional team approach where the requirement for nurses to work effectively within the team is important. However, the nurses’ role and contribution within the team have not been well described.

Method.  A quasi‐experimental, prospective study comparing an intervention group with a comparison group was carried out. One hundred and twelve independently living patients, aged 65 years or older and admitted to a Swedish hospital with a hip fracture, were consecutively selected. Pathological fracture and severe intellectual impairment (Pfeiffer's test <3 points) served as exclusion criteria. The intervention was designed to focus on patients’ motivation and their prerequisites for rehabilitation and was based on the concept of transition. The main outcome measure was the number of patients restored to preoperative activities of daily living levels in 2003–2004.

Findings.  In the intervention group 21% were restored to activities of daily living to level A (independent) at discharge, whereas only 5% in the comparison group were restored to this level. No patients in the intervention group, admitted as independent, remained at activities of daily living level F (dependent), whereas 16% remained at level F in the comparison group (P = 0·003).

Conclusion.  When admitting older patients with a hip fracture, it is important to acquire good knowledge about each patient and their prerequisites and to offer them accelerated rehabilitation in accordance with their individual ability. By monitoring process indicators during the transition, serious deviations from the care plan can be avoided.
Predictive factors for lymph node metastasis and endoscopic treatment strategies for undifferentiated early gastric cancer
Authors: Ye Byong D , Kim Sang G , Lee Jong Y , Kim Joo S , Yang Han‐Kwang , Kim Woo H , Jung Hyun C , Lee Kuhn U , Song In S
Published: April 2007

Background and Aim:  Although more than 80% of undifferentiated early gastric cancers (EGC) are not associated with lymph node metastasis, endoscopic mucosal resection is not generally accepted as a means of curative treatment because of an abundance of conflicting data concerning clinicopathological characteristics and prognoses. The aim of this study was to define a subgroup of undifferentiated EGC that could be cured by endoscopic treatment without the risk of lymph node metastasis.

Method:  A total of 591 patients surgically resected for undifferentiated EGC between January 1999 and March 2005 were reviewed. Associations between various clinicopathological factors and the presence of lymph node metastasis were analyzed to identify the risk factors of lymph node metastasis.

Results:  Lymph node metastasis was found in 79 patients (13.4%). By multivariate logistic regression analysis, a tumor diameter 2.5 cm or larger, invasion into the middle third of the submucosal layer or deeper, and lymphatic involvement were identified as independent risk factors of lymph node metastasis (P < 0.001, respectively). Lymph node metastasis was not found in any patient with undifferentiated EGC smaller than 2.5 cm confined to the mucosa or upper third of the submucosal layer without lymphatic involvement.

Conclusions:  Undifferentiated intramucosal EGC smaller than 2.5 cm without lymphatic involvement was not associated with lymph node metastasis. Thus, we propose in this circumstance that endoscopic mucosal resection could be considered a definitive treatment without compromising the possibility of cure.
Antifibrotic activity of rofecoxib in vivo is associated with reduced portal hypertension in rats with carbon tetrachloride‐induced liver injury
Authors: Tu Chuan‐Tao , Guo Jin‐Sheng , Wang Manner , Wang Ji‐Yao
Published: April 2007

Background and Aim:  Upregulation of cyclooxygenase‐2 (COX‐2), an inducible enzyme that is actively involved in inflammation and wound healing, has been found in cirrhotic livers. The aim of this study was to investigate the effects of selective inhibition of COX‐2 on the development of liver cirrhosis and portal hypertension in rats.

Methods:  Liver cirrhosis was induced by carbon tetrachloride (CCl4) in Sprague‐Dawley rats. Rofecoxib, a highly selective COX‐2 inhibitor, was orally administered to rats at a dose of 10 mg/kg/day. Portal pressure was measured at 8 weeks post CCl4 administration with the catheterization method followed by the harvesting of liver samples. Liver histopathology was analyzed with hematoxylin and eosin and Masson's trichrome staining. The activated, alpha smooth muscle actin (α‐SMA) positive hepatic stellate cells (HSCs) and the protein levels of collagen types I, III, IV, as well as laminin and two fibrogenic mediators, vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF) in the livers, were detected with immunohistochemical staining and western blot methods, respectively. The level of hepatic thromboxane B2 (TXB2), a potent vasoconstrictive substance derived from COX, was measured with enzyme immunoassay.

Results:  Oral administration of rofecoxib decreased portal pressure in rats that were treated with CCl4 for 8 weeks. This was associated with a marked reduction in collagen accumulation and TXB2 level in the rat livers. In addition, rofecoxib administration was found to reduce the number of activated HSCs and to downregulate hepatic protein levels of three detected types of collagen, laminin, VEGF and CTGF in CCl4‐treated rats.

Conclusions:  COX‐2 is involved in the fibrogenesis of livers and the formation of portal hypertension in CCl4‐treated rats. Selective inhibition of COX‐2 by rofecoxib reduces portal hypertension and this is associated with antifibrotic activity as well as a reduction of COX‐2‐derived vasoactive substance.
Ulcerative colitis in China: Retrospective analysis of 3100 hospitalized patients
Authors: Wang Yufang , Ouyang Qin ,   APDW 2004 Chinese IBD working group
Published: April 2007

Background and Aims:  This retrospective study analyzed the clinical characteristics of hospitalized patients with ulcerative colitis (UC) in China.

Methods:  A total of 3100 hospitalized patients with UC admitted to 23 hospitals in China from 1990 to 2003 were retrospectively investigated and their clinical characteristics were analyzed.

Results:  A male/female ratio of 1.34/1.00 was found in the 3100 patients, who had an average age of 44 ± 15.1 years at diagnosis. Of the patients, 2972 (95.9%) had active UC. Active UC was mild in 35.4% of the 2972 patients, moderate in 42.9% and severe in 21.7%. Of the 2726 patients with a description of their lesion extent, 14.8% had proctitis, 26.4% had proctosigmoiditis, 25.0% had left‐sided colitis, 6.3% had extensive colitis, 25.8% had pancolitis and 1.7% had regional colitis. The predominant complaints of the patients with UC were bloody diarrhea (48.2%), abdominal pain (67.3%) and mucus stools (58.4%). Among these patients, 13.6% had extraintestinal manifestations and 9.6% had related complications. A differential diagnosis was difficult to make, as there were 19 varieties of the disease; infectious enterocolitis had a misdiagnosis rate of 22.9% before admission. The main medications for UC in China were aminosalicylates (66.8%) and steroids (42.8%). Only 94 (3%) of the patients required colectomy and only 19 (0.6%) died of UC.

Conclusions:  Compared with UC in Western countries, ulcerative colitis in China has some differences in clinical characteristics. Therefore, a further population‐based epidemiological study is required to determine the prevalence and incidence rates of UC in China.