bluuebunny/crossref_metadata_2025 huggingface dataset:
The neuronal pathology of schizophrenia: molecules and mechanisms
Authors: Reynolds G.P. , Harte M.K.
Published: March 2007

There is an accumulation of evidence for abnormalities in schizophrenia of both the major neurotransmitter systems of the brain – those of GABA (γ-aminobutyric acid) and glutamate. Initial studies have found deficits in the putative neuronal marker, N-acetylaspartate, in a number of brain regions in schizophrenia. The animal models have provided some interesting correlates and discrepancies with these findings. The deficit in inhibitory interneurons within structures implicated in schizophrenic symptomatology may well have direct functional relevance, and can be induced by animal models of the disease such as subchronic phencyclidine administration or social isolation. Their association with these animal models suggests an environmental involvement. A loss of glutamatergic function in schizophrenia is supported by decreases in markers for the neuronal glutamate transporter in striatal structures that receive cortical glutamatergic projections. Deficits in the VGluT1 (vesicular glutamate transporter-1) in both striatal and hippocampal regions support this observation, and the association of VGluT1 density with a genetic risk factor for schizophrenia points to genetic influences on these glutamatergic deficits. Further studies differentiating neuronal loss from diminished activity and improved models allowing us to determine the temporal and causal relationships between GABAergic and glutamatergic deficits will lead to a better understanding of the processes underlying the neuronal pathology of schizophrenia.
A microleakage study of ceramic laminate veneers by autoradiography: effect of incisal edge preparation
Authors: Hekimoǧlu C. , Anil N. , Yalçin E.
Published: March 2007

summary  The purpose of this study was to evaluate the microleakage characteristics of laminate veneers with different incisal edge preparation. Two groups of 20 extracted human maxillary central incisors were used for fabricating laminate veneers. The cervical margin of all veneers were placed 1 mm above the cementoenamel junction. The incisal finish line of 20 teeth was placed at the incisal edge (window type preparation). The incisal finish line of the other 20 teeth was placed linguoincisally (incisal edge overlapped type preparation). All veneers were fabricated according to the manufacturer's instructions with vacuum fired porcelain and cemented with dual‐cure resin cement. The autoradiographic method was used for determination of microleakages. Microleakages at the interface of the laminate veneer and tooth were determined according to the scale described in the manuscript. Mc Nemar test was used for comparison of microleakages at cervical margins. Microleakage grades at other areas were compared in percentage. In the two preparation types the cervical microleakages were of similar degree. The incisal microleakages in the overlapped laminate veneers were greater than in the window type veneers. In conclusion, the window preparation type was more effective in terms of prevention of microleakage at the incisal margin than the overlapped type laminates.
Effects of occlusal load on cervical lesions
Authors: Litonjua L. A. , Bush P. J. , Andreana S. , Tobias T. S. , Cohen R. E.
Published: March 2007

summary  Toothbrush abrasion has been considered to cause cervical lesions. However, some investigators have proposed that occlusal loading factors direct tensile stresses at the cervical area, resulting in wedge‐shaped abfraction defects. The purpose of this study is to investigate the role of axial and non‐axial load on the development of cervical lesions. Matched paired premolars, extracted for orthodontic purposes, were used in a custom‐fabricated toothbrushing apparatus. A periodontal sulcus width of 0ḃ1 mm with 1 mm gingival recession was simulated with denture base resin. In phase 1, eight matched premolar pairs were subjected to 80 h (1ḃ4 million strokes) of brushing and 300 g of toothbrush force. Toothpaste slurry was applied continuously through the toothbrush. One specimen in each pair was subjected to 250 h and 45 kg of continuous axial load, while the other unloaded tooth served as a negative control. In phase 2, 10 matched premolar pairs were subjected to the same conditions; however, the experimental teeth were subjected to 250 h and 45 kg of intermittent non‐axial load, directed at a 45° angle to the buccal cusp. Rubber impressions were made of the cervical lesions, then trimmed, weighed, and compared to determine the amount of tooth material lost. When teeth were loaded axially, there was significantly less tooth material loss (P < 0ḃ02); however, when teeth were loaded non‐axially, there was no significant difference (P =0ḃ80) when compared with controls. Optical and scanning electron microscopy did not reveal any significant differences in the morphology between pairs. Our data suggest that the application of occlusal load may not necessarily play a significant role in the progression of cervical tooth wear commonly referred to as abfraction.
The development of a new index for measurement of incisal/occlusal tooth wear
Authors: Hooper S. M. , Meredith N. , Jagger D. C.
Published: March 2007

summary  A number of indices have been developed for the measurement of tooth surface loss but they have not achieved universal acceptance. The aim of this study was to develop a new index suitable for the monitoring of incisal/occlusal tooth wear on serial study models. The new index recorded incisal/cuspal wear for individual teeth. Each tooth was scored on a six‐point scale ranging from 0–5. Six assessors evaluated the index and it was applied to baseline and sequential models taken after 20 years. The study demonstrated the value of maintaining long‐term dental records in the form of study models for monitoring progressive tooth wear.
Comparison of deep bite and open bite cases: normative data for condylar positions, paths and radiographic appearances
Authors: Ari‐Demirkaya A. , Biren S. , Özkan H. , Küçükkeleş N.
Published: March 2007

summary  To compare normal overbite, deep bite and open bite cases with clinically healthy temporomandibular joints (TMJ) regarding the difference between condylar positions in centric relation (CR) and habitual or centric occlusion (CO), condylar paths and radiographic findings of condylar appearance in order to establish normative data. Three study groups of normal overbite, deep bite and open bite cases consisted each of 30 subjects with no detectable clinical signs of temporomandibular disorder. The CR–CO differences and axiographic tracings were recorded using the School Artikulator of Mack (SAM®) diagnostic system. Condylar shape was evaluated on panoramic radiographs. The CR–CO differences were greater in the vertical plane in open bite cases, and direction of movements from CR to CO showed great variability. Open bite cases had significantly shorter condylar paths. Radiographic findings exhibited that 23% of the total sample showed evidence of erosion and 83% evidence of flattening of condyles. The erosion rates were higher in the open bite group, but flattening was seen more often in the deep bite group. Results of this study showed that open bite cases show larger vertical CR–CO slides and, shorter protrusion paths than normal and deep overbite cases. The radiographic appearance of condyles in non‐patients may also differ significantly according to vertical incisor guidance type. Deep bite cases demonstrated a higher incidence of condylar flattening. This study indicates that the clinician should be paying special attention to the TMJ status of open bite patients.
Scales of Eden: Conservation and Pristine Devastation on Bikini Atoll
Authors: Davis Jeffrey Sasha
Published: March 2007

Landscapes are often discursively constructed as wildernesses through an erasure of the histories of people in the landscape. Current representations of Bikini Atoll in the Marshall Islands as an Edenic wilderness are no different. What is unusual about conceptualizations of Bikini Atoll as a pristine wilderness is that it is the site of a recent history of colonial appropriation and massive landscape transformation through nuclear-weapons testing. Although people both outside and within the Bikinian community regularly represent the atoll as a kind of paradise, there are strong differences of opinion regarding what the future uses of the atoll should be. This is because there is a sharp division between representations of the atoll as a pristine wilderness with visually pleasing landscapes and seascapes that need to be preserved and locally produced representations of the atoll as an Eden with an abundance of useable natural resources.
Maintaining the Environmental–Racial Order in Northern New Mexico
Authors: Wilmsen Carl
Published: March 2007

The environmental–racial order in northern New Mexico is maintained through a process of racial triangulation in which Anglos, Native Americans, and Hispanos are valued relative to one another along axes of environmental stewardship and victimization (Kim C J, 1999, “The racial triangulation of Asian Americans” Politics and Society 27 105–138). Both axes involve the juxtaposing of three long-standing images: (1) Spanish injustices to the Indians; (2) the inability of Mexicans to manage their land properly; and (3) Indians being preeminent environmental stewards. In contrast to Kim's formulation of racial triangulation, however, the axes also involve imagery that contradicts these images: the debauched, poverty-stricken Indian; and European culture as a despoiler of the environment. Also in contrast to Kim's formulation, racial triangulation can involve the creation of new identities. In the 1960s Hispano activists began claiming to be heirs to a hybrid culture that included elements of both Native American and Spanish cultures. While this claim to hybridity enabled the creation of new oppositional discourses, the reconciling of contradictory imagery by historicizing the discourses and by other means undermines the new Hispano oppositional discourses as well as Hispano identity itself. Racial triangulation is thus a fluid and contested process in which identity formation and the interchange between predominant and oppositional discourses are constitutive of power relations. Contradictory imagery in the discourse facilitates the maintenance of the environmental–racial order, even as it enables subordinates to challenge their racialized positions and to effect change in the distribution of material wealth, rights, and privileges.
Keeping a Beat in the Dark: Narratives of Regional Identity in Basil Bunting's Briggflatts
Authors: Tomaney John
Published: March 2007

This paper is about narratives of regional identity. In it I look at how they are formed and at the complex (and at times contradictory) cultural and political uses to which they are put. I examine the poetry of Basil Bunting, in particular his sonata Briggflatts as an example of a narrative of regional identity. Bunting's life and poetry are used to cast light on many of the important themes that can be identified in the literature on regionalism including the uses of history in identity formation, issues of landscape and language, and issues of universalism versus particularism in social–political practice. I draw on Bunting's subtle, complex, and pluralistic sense of his Northumbrian home-world to challenge those advocates of the ‘relational region’ who see places as simply the local articulation of global flows and who present any concern with local culture and identity as atavistic and archaic. I suggest that, by focusing on the enduring importance of dwelling, Bunting's poetry demonstrates the progressive potential of regional narratives while avoiding recourse to a crude metaphysics of scale. I show how poetry is a means of developing narratives of local and regional identity in ways which transcend the dichotomies with which social scientists in general—and geographers in particular—perennially struggle.
Where Eagles Dare: An Ethno-Fable with Personal Landfill
Authors: Krupar Shiloh R
Published: March 2007

“Where eagles dare” is an ethno-fable about the conversion of the toxic Rocky Mountain Arsenal to wildlife nature preserve, supplemented by an academic and personal subsurface guide that considers Arsenal remediation beneath the surface.
Multi- and Unisensory Visual Flash Illusions
Authors: Courtney Jon R , Motes Michael A , Hubbard Timothy L
Published: March 2007

The role of stimulus structure in multisensory and unisensory interactions was examined. When a flash (17 ms) was accompanied by multiple tones (each 7 ms, SOA < 100 ms) multiple flashes were reported, and this effect has been suggested to reflect the role of stimulus continuity in multisensory interactions. In experiments 1 and 2 we examined if stimulus continuity would affect concurrently presented stimuli. When a relatively longer flash (317 ms) was accompanied by multiple tones (each 7 ms), observers reported perceiving multiple flashes. In experiment 3 we tested whether a flash presented near fixation would induce an illusory flash further in the periphery. One flash (17 ms) presented 5° below fixation was reported as multiple flashes if presented with two flashes (each 17 ms, SOA = 100 ms) 2° above fixation. The extent to which these data support a phenomenological continuity principle and whether this principle applies to unisensory perception is discussed.
Irradiation, Border Location, and the Shifted-Chessboard Pattern
Authors: Westheimer Gerald
Published: March 2007

The position of a black – white border is perceived somewhat towards the black side of its physical location. New measurements were performed of the magnitude of this effect for foveal vision in the normal observer and it was found to be about 0.4 min of arc at medium photopic luminances. The border shift can be accounted for by postulating that the retinal light spread caused by the optics of the eye is subjected to a compressive nonlinearity of light intensity (Naka — Rushton equation). Such irradiation-induced apparent enlargement of the white elements does not fully account for the shifted-chessboard illusion. When an additional stage of center — surround (DoG) transformation is introduced, a hypothetical excitation distribution can be generated, whose contours, at the appropriate scale, can outline quite well the seen shape deviations from rectangularity of the illusion. Contributing to the final percept, in addition to the light-spread, compressive nonlinearity, and center — surround reorganization, which would be retinal in origin, there are some cortical stages: the generation of the experience of sharp, straight borders and pointed corners, the emergence of a monotonic slope of the demarcation lines made of ‘saw-tooth’ position and angle shifts, and, finally, when all the retinal effects have been nulled out, a Zöllner kind of orientation deviation, due to offset pattern elements acting as tilted virtual contours.
Role of the chromobox protein CBX7 in lymphomagenesis
Authors: Scott Clare L. , Gil Jésus , Hernando Eva , Teruya-Feldstein Julie , Narita Masako , Martínez Dolores , Visakorpi Tapio , Mu David , Cordon-Cardo Carlos , Peters Gordon , Beach David , Lowe Scott W.
Published: March 2007

Chromobox 7 (CBX7) is a chromobox family protein and a component of the Polycomb repressive complex 1 (PRC1) that extends the lifespan of cultured epithelial cells and can act independently of BMI-1 to repress the
INK4a/ARF
tumor suppressor locus. To determine whether CBX7 might be oncogenic, we examined its expression pattern in a range of normal human tissues and tumor samples. CBX7 was expressed at high levels in germinal center lymphocytes and germinal center-derived follicular lymphomas, where elevated expression correlated with high c-Myc expression and a more advanced tumor grade. By targeting Cbx7 expression to the lymphoid compartment in mice, we showed that Cbx7 can initiate T cell lymphomagenesis and cooperate with c-Myc to produce highly aggressive B cell lymphomas. Furthermore, Cbx7 repressed transcription from the
Ink4a/Arf
locus and acted epistatically to the Arf-p53 pathway during tumorigenesis. These data identify CBX7 as a chromobox protein causally linked to cancer development and may help explain the low frequency of
INK4a/ARF
mutations observed in human follicular lymphoma.
Design Rules: Industrial Research and Epistemic Merit
Authors: Wilholt Torsten
Published: March 2007

A common complaint against the increasing privatization of research is that research that is conducted with the immediate purpose of producing applicable knowledge will not yield knowledge as valuable as that generated in more curiosity-driven, academic settings. In this paper, I make this concern precise and reconstruct the rationale behind it. Subsequently, I examine the case of industry research on the giant magnetoresistance effect in the 1990s as a characteristic example of research undertaken under considerable pressure to produce applicable results. The example permits one to arrive at a more optimistic assessment of the epistemic merits of private, application-driven research. I attempt to specify the conditions that, in this case, advanced the production of interesting and reliable knowledge.
Pathogens in Early-Onset and Late-Onset Intensive Care Unit–Acquired Pneumonia
Authors: Verhamme K. M. C. , De Coster W. , De Roo L. , De Beenhouwer H. , Nollet G. , Verbeke J. , Demeyer I. , Jordens P.
Published: March 2007

Objectives.

To compare the type of pathogens isolated from patients with early-onset intensive care unit (ICU)-acquired pneumonia with those isolated from patients with late-onset ICU-acquired pneumonia and to study risk factors for the isolation of pathogens that are potentially resistant to multiple drugs.

Design.

Prospective cohort study.

Setting.

Patients admitted to the ICU of a 677-bed, university-affiliated teaching hospital in Belgium during 1997-2002.

Methods.

ICU-acquired pneumonia was defined as a case of pneumonia that occurred 2 days or more after admission to the ICU in combination with a positive results of radiologic analysis, clinical signs and symptoms, and a positive culture result. All cases of pneumonia were categorized as either early onset (within 7 days after admission) and late onset (7 days or more after admission), with or without previous antibiotic treatment, and the corresponding pathogens were analyzed. Risk factors for the isolation of pathogens potentially resistant to multiple drugs (ie, Pseudomonas aeruginosa, Serratia marcescens, Enterobacter species, Morganella morganii, methicillin-resistant Stapylococcus aureus, Citrobacter species, Acinetobacter species, Burkholderia species, extended-spectrum β-lactamase–producing pathogens, and Stenotrophomonas maltophilia) were analyzed using logistic regression analysis.

Results.

A total of 4,200 patients stayed at the ICU for 2 or more days, 298 of whom developed ICU-acquired pneumonia, for an overall incidence of 13 cases (95% confidence interval [CI], 11-14 cases) per 1,000 ICU-days. Pathogens potentially resistant to multiple drugs were isolated from 52% of patients with early-onset pneumonia. Risk factors for the isolation of these pathogens were greater age and previous receipt of antibiotic prophylaxis (adjusted odds ratio [aOR], 4.6 [95% CI, 1.6-13.0]) or antibiotic therapy (aOR, 8.2 [95% CI, 2.8-23.8]). The length of ICU admission and hospital stay were weaker risk factors for the isolation of these pathogens.

Conclusions.

Pathogens potentially resistant to multiple drugs were isolated in 52% of cases of early-onset ICU-acquired pneumonia. Previous antibiotic use (both prophylactic and therapeutic) is the main risk factor for the isolation of these pathogens.
Validation of Surveillance in the Intensive Care Unit Component of the German Nosocomial Infections Surveillance System
Authors: Zuschneid I. , Geffers C. , Sohr D. , Kohlhase C. , Schumacher M. , Rüden H. , Gastmeier P.
Published: March 2007

A validation study was performed for the intensive care unit component of the German nosocomial infections surveillance system (Krankenhaus Infektions Surveillance System [KISS]). A total of 286 reported infections and 1,195 medical records with no reported infection from 20 randomly selected KISS intensive care units were reviewed by trained physicians. The mean sensitivity was 66% (median, 81%), and the mean specificity was 99.4% (median, 99.6%).
Efficacy of Infection Control Strategies to Reduce Transmission of Vancomycin-Resistant Enterococci in a Tertiary Care Hospital in Korea: A 4-Year Follow-Up Study
Authors: YoonChang Sung Won , Peck Kyong Ran , Kim Og Son , Lee Jang Ho , Lee Nam Yong , Oh Won Sup , Song Jae-Hoon
Published: March 2007

To determine the effectiveness of infection control strategies to reduce transmission of vancomycin-resistant enterococci (VRE), a cohort study was performed in a university hospital. Contact precautions alone were not effective in reducing transmission of VRE. Strict isolation of affected patients in private rooms, in addition to use of contact precautions, showed a significantly improved reduction in the transmission of VRE.
Nosocomial Bacteremia in Children: A 15-Year Experience at a General Hospital in Mexico
Authors: Pérez-González Luis Fernando , Ruiz-González Juana María , Noyola Daniel E.
Published: March 2007

Objective.

To describe the incidence and etiology of nosocomial bloodstream infections in children at a general hospital.

Design.

Review of nosocomial bloodstream infections detected in children during 1991-2005. Data were prospectively gathered through active surveillance. Annual rates of infection were compared.

Setting.

A public general hospital in San Luis Potosi, Mexico.

Patients.

Children younger than 15 years of age admitted to pediatric wards and subjected to prospective surveillance for nosocomial infection.

Interventions.

Measures instituted to decrease the incidence of hospital-acquired infection during the 15-year study period included establishing active surveillance for hospital-acquired infection, reinforcing compliance with handwashing recommendations, decreasing the degree of crowding on wards, establishing guidelines for the management of intravenous catheters and solutions, preparing parenteral nutrition and intravenous solutions under a laminar air-flow hood, and increasing nursing personnel.

Results.

There were 868 nosocomial bloodstream infections detected in 29,273 subjects (overall rate, 2.94 episodes per 100 discharges). Infection rates were greatest among children admitted to the neonatal intensive care unit and lowest for those admitted to the school-age ward and the infectious diseases ward. There was a significant decrease in rates of nosocomial bacteremia in all of the wards. The organisms isolated most commonly were Klebsiella pneumoniae, Candida species, and coagulase-negative staphylococci. Mortality rates were higher for children with a gram-negative bacterial bloodstream infection (45.2%) and lower for children with a gram-positive bacterial infection (19.2%).

Conclusions.

Rates of nosocomial bloodstream infection decreased over the past 15 years at our hospital but continue to cause significant mortality. Continuing efforts to decrease the frequency of and mortality due to bloodstream infection are warranted.
Use of the National Noscomial Infection Surveillance System Risk Index for Prediction of Mortality: Results of a 6-Year Postdischarge Follow-Up Study
Authors: Palma Silvia , Cosano Antonio , Gómez-Ortega Antonio , Mariscal Marcial , Moreno-Montesinos Jose Martin , Martínez-Gallego Gabriel , Medina-Cuadros Marcelino , Delgado-Rodriguez Miguel
Published: March 2007

A positive linear trend (P<.001) between the National Noscomial Infection Surveillance system (NNIS) risk index and mortality was observed in 2,848 general surgery patients followed up 6 years after discharge. In stratified analyses, the NNIS risk index predicted mortality in patients with chronic disease (P = .007, by test for trend) but not in the remaining patients.
Resource Consumption in the Infection Control Management of Pertussis Exposure Among Healthcare Workers in Pediatrics
Authors: Daskalaki Irini , Hennessey Patricia , Hubler Robin , Long Sarah S.
Published: March 2007

Objective.

To assess consumption of resources in the infection control management of healthcare workers (HCWs) exposed to pertussis and to assess avoidability of exposure.

Setting.

Tertiary care children's medical center.

Methods.

Analysis of the extent of and reasons for HCW exposure to pertussis during contact with children with the disease, whether exposures were avoidable (because of the failure to recognize a case or to order or adhere to isolation precautions) or unavoidable (because the case was not recognizable or because another diagnosis was confirmed), and the cost of implementing exposure management.

Interventions.

Interventions consisted of an investigation of every HCW encounter with any patient who was confirmed later to have pertussis from the time of hospital admission of the patient, use of azithromycin as postexposure prophylaxis (PEP) for exposed HCWs, performance of 21-day surveillance for cough illness, testing of symptomatic exposed HCWs for Bordetella pertussis, and enhanced preexposure education of HCWs.

Results.

From September 2003 through April 2005, pertussis was confirmed in 28 patients (median age, 62 days); 24 patients were admitted. For 11 patients, pertussis was suspected, appropriate precautions were taken, and no HCW was exposed. Inadequate precautions for 17 patients led to 355 HCW exposures. The median number of HCWs exposed per exposing patient was 9 (range, 1-86 HCWs; first quartile mean, 2; fourth quartile mean, 61). Exposure was definitely avoidable for only 61 (17%) of 355 HCWs and was probably unavoidable for 294 HCWs (83%). The cost of 20-month infection control management of HCWs exposed to pertussis was $69,770. The entire cohort of HCWs involved in direct patient care at the facility could be immunized for approximately $60,000.

Conclusions.

Exposure of HCWs to pertussis during contact with children who have the disease is largely unavoidable, and management of this exposure is resource intensive. Universal preexposure vaccination of HCWs is a better utilization of resources than is case-based postexposure management.
Risk Factors for Neonatal Methicillin-ResistantStaphylococcus aureusInfection in a Well-Infant Nursery
Authors: Nguyen Dao M. , Bancroft Elizabeth , Mascola Laurene , Guevara Ramon , Yasuda Lori
Published: March 2007

Objective.

To determine risk factors for neonatal methicillin-resistantStaphylococcus aureus(MRSA) skin and soft-tissue infection in a well-infant nursery.

Design.

Case-control studies.

Setting.

A well-infant nursery in a nonteaching, community hospital.

Methods.

Case infants were newborns in the nursery who were born in the period November 2003 through June 2004 and had onset of MRSA skin and soft-tissue infection within 21 days after discharge from the nursery. Site inspections were conducted. Control infants were randomly selected male infants in the nursery during the outbreak periods. MRSA isolates were characterized with pulsed-field gel electrophoresis.

Results.

Eleven case infants were identified in 2 outbreaks: outbreak 1 occurred from November 18 through December 24, 2003, and outbreak 2 occurred from May 26 through June 5, 2004. All were full-term male infants with pustular-vesicular lesions in the groin. Inspection revealed uncovered circumcision equipment, multiple-dose lidocaine vials, and inadequate hand hygiene practices. In outbreak 1, case infants (n= 6) had a significantly higher mean length of stay than control infants (3.7 vs 2.5 days;P= .01). In outbreak 2, case infants (n= 5) were more likely to have been circumcised in the nursery (OR, undefined [95% CI, 1.7 to undefined]) and to have received lidocaine injections (OR, undefined [95% CI, 2.6 to undefined]). Controlling for length of stay, case infants were more likely to have been circumcised in the nursery (OR, 12.2 [95% CI, 1.5 to undefined]). Pulsed-field gel electrophoresis showed that 7 available isolates were indistinguishable from a community-associated MRSA strain (USA300-0114).

Conclusions.

Newborns in well-infant nurseries are at risk for nosocomial infection with community-associated MRSA strains. Reducing length of stay, improving circumcision and hand hygiene practices, and eliminating use of multiple-dose lidocaine vials should decrease transmission of community-associated MRSA strains in nurseries.
Development of a Surveillance System for Methicillin-ResistantStaphylococcus aureusin German Hospitals
Authors: Chaberny Iris F. , Sohr Dorit , Rüden Henning , Gastmeier Petra
Published: March 2007

Objective.

To determine the appropriate method to calculate the rate of methicillin-resistantStaphylococcus aureus(MRSA) infection and colonization (hereafter, MRSA rates) for interhospital comparisons, such that the large number of patients who are already MRSA positive on admission is taken into account.

Design.

A prospective, multicenter, hospital-based surveillance of MRSA-positive case patients from January through December 2004.

Setting.

Data from 31 hospitals participating in the German national nosocomial infections surveillance system (KISS) were recorded during routine surveillance by the infection control team at each hospital.

Results.

Data for 4,215 MRSA-positive case patients were evaluated. From this data, the following values were calculated. The median incidence density was 0.71 MRSA-positive case patients per 1,000 patient-days, and the median nosocomial incidence density was 0.27 patients with nosocomial MRSA infection or colonization per 1,000 patient-days (95% CI, 0.18-0.34). The median average daily MRSA burden was 1.13 MRSA patient-days per 100 patient-days (95% CI, 0.86-1.51), with the average daily MRSA burden defined as the total number of MRSA patient-days divided by the total number of patient-days times 100. The median MRSA-days–associated nosocomial MRSA infection and colonization rate, which describes the MRSA infection risk for other patients in hospitals housing large numbers of MRSA-positive patients and/or many patients who were MRSA positive on admission, was 23.1 cases of nosocomial MRSA infection and colonization per 1,000 MRSA patient-days (95% CI, 17.4-28.6). The values were also calculated for various MRSA screening levels.

Conclusions.

The MRSA-days–associated nosocomial MRSA rate allows investigators to assess the extent of MRSA colonization and infection at each hospital, taking into account cases that have been imported from other hospitals, as well as from the community. This information provides an appropriate incentive for hospitals to introduce further infection control measures.
Recommendations to Resolve Inconsistent Guidelines for the Reprocessing of Sheathed and Unsheathed Rigid Laryngoscopes
Authors: Muscarella Lawrence F.
Published: March 2007

Neither a consensus statement nor a formal set of step-by-step guidelines for reprocessing rigid laryngoscopes have been published or endorsed by professional organizations. Several published guidelines, standards, and clinical reports were reviewed to evaluate the risk of nosocomial infection associated with the use of rigid laryngoscopes, to determine their minimum reprocessing requirements. This review found that the recommendations of some guidelines and standards for reprocessing rigid laryngoscopes are incomplete, inadequate, and inconsistent with one another, and that current practices for reprocessing rigid laryngoscopes are reported to be inadequate and lack standardization. It is recommended that a consensus statement be developed that standardizes the reprocessing of rigid laryngoscopes and requires cleaning followed by high-level disinfection (or sterilization) and drying of the rigid laryngoscope's blade and handle to prevent nosocomial infection, regardless of whether a protective barrier or sheath is used during the procedure.
Risk Factors and Outcomes of Influenza A (H3N2) Pneumonia in an Area Where Avian Influenza (H5N1) Is Endemic
Authors: Apisarnthanarak Anucha , Puthavathana Pilaipan , Mundy Linda M.
Published: March 2007

We conducted a cohort study to identify the risks and outcomes of influenza A (H3N2) pneumonia. Of the 145 patients studied, 10 (7%) had influenza A pneumonia. Logistic regression identified multiple comorbidities (P<.001) and diarrhea at the initial presentation (P = .001) as associated risks. Infection with influenza A (P = .01) and receipt of inadequate antimicrobial therapy (P = .005) were predictors of mortality.
Multiple Translational Isoforms Give Functional Specificity to Serum- and Glucocorticoid-induced Kinase 1
Authors: Arteaga Maria Francisca , Alvarez de la Rosa Diego , Alvarez Jose A. , Canessa Cecilia M.
Published: March 2007

Serum- and glucocorticoid-induced kinase 1 is a ubiquitous kinase that regulates diverse processes such as ion transport and cell survival. We report that a single SGK1 mRNA produces isoforms with different N-termini owing to alternative translation initiation. The long isoforms, 49 and 47 kDa, are the most abundant, localize to the ER membrane, exhibit rapid turnover, their expression is decreased by ER stress, activate the epithelial sodium channel (ENaC) and translocate FoxO3a transcriptional factors from the nucleus to the cytoplasm. The short isoforms, 45 and 42 kDa, localize to the cytoplasm and nucleus, exhibit long half-life and phosphorylate glycogen synthase kinase-3β. The data indicate that activation of Sgk1 in different cellular compartments is key to providing functional specificity to Sgk1 signaling pathways. We conclude that the distinct properties and functional specialization of Sgk1 given by the N-terminus confer versatility of function while maintaining the same core kinase domain.
Prospective evaluation of the new chromogenic medium CandiSelect 4 for differentiation and presumptive identification of the major pathogenic Candida species
Authors: Sendid Boualem , François Nadine , Standaert Annie , Dehecq Eric , Zerimech Farid , Camus Daniel , Poulain Daniel
Published: March 2007

The rapid identification of pathogenic yeasts is a crucial step in ensuring that effective antifungal treatment is started as early as possible. CandiSelect 4 (CS4; Bio-Rad) is a new chromogenic medium for the isolation of fungi, the direct identification of Candida albicans and the presumptive identification of the major pathogenic Candida species. The performance of CS4 was compared with that of another chromogenic medium, CHROMagar Candida (CA; Becton Dickinson). For primary cultures, 502 of the 1549 (32 %) samples were culture-positive. A total of 542 yeasts were isolated including 465 monomicrobial and 37 mixed cultures: 392 C. albicans, 60 Candida glabrata, 25 Candida tropicalis, 12 Candida krusei and 53 other Candida species. The percentage of C. albicans isolates that could be identified directly after 24, 48 and 72 h culture was 31.6, 82.9 and 92.1 %, respectively, for CS4, and 32.9, 82.9 and 91.1 % for CA. The presumptive identification of C. glabrata, C. tropicalis and C. krusei was evaluated after 48 h incubation. The percentage of strains with morphologically typical colonies was 80, 68 and 84.6 %, respectively, for CS4 compared with 75, 76 and 76.9 % for CA. For pure subcultures, from 24 h, all isolates of C. albicans (n=21) were directly identifiable on the two chromogenic media CA and CS4. At 48 h, the proportion of typical strains observed on the two chromogenic media was identical for C. glabrata (85 %) and C. krusei (100 %). A slight difference in favour of CS4 was observed for C. tropicalis (100 vs 95 %). CS4 also allowed the growth of several other fungi. CS4 can be recommended as a primary isolation medium for the identification of C. albicans, and for the rapid and effective differentiation of the major pathogenic Candida species.
Epidemiological shift in the prevalence of pertussis in Taiwan: implications for pertussis vaccination
Authors: Lin Yu-Chi , Yao Shu-Man , Yan Jer-Jea , Chen Ying-Yan , Chiang Chuen-Sheue , Wu Ho-Sheng , Li Shu-Ying
Published: March 2007

In Taiwan, routine pertussis immunization has been implemented for more than 40 years and a low incidence of pertussis was maintained until an 80-fold increase in cases occurred in 1992. The unexpected increase emphasized the significance of pertussis. This study evaluated a total of 2452 reported cases of pertussis during 1993–2004 and surveillance data on incidence, age distribution and seasonality. The highest morbidity was in infants aged <1 year, and upward trends in the incidence of pertussis were significant for infants aged <1 year and adolescents aged 10–14 years. The highest mean number of cases was observed in August and upward trends were in colder months. This study indicates that the epidemiology of pertussis may have been changed by waning immunity in Taiwan. Increased surveillance activities, especially in older age groups, and additional booster doses of acellular pertussis vaccine for children aged 6–8 years and adolescents/young adults aged 15–20 years are necessary to control and prevent pertussis.
Effects of oregano, carvacrol and thymol on Staphylococcus aureus and Staphylococcus epidermidis biofilms
Authors: Nostro Antonia , Roccaro Andrea Sudano , Bisignano Giuseppe , Marino Andreana , Cannatelli Maria A. , Pizzimenti Francesco C. , Cioni Pier Luigi , Procopio Francesca , Blanco Anna Rita
Published: March 2007

The aim of this study was to evaluate the effect of oregano essential oil, carvacrol and thymol on biofilm-grown Staphylococcus aureus and Staphylococcus epidermidis strains, as well as the effects of the oils on biofilm formation. For most of the S. aureus (n=6) and S. epidermidis (n=6) strains tested, the biofilm inhibitory concentration (0.125–0.500 %, v/v, for oregano, and 0.031–0.125 %, v/v, for carvacrol and thymol) and biofilm eradication concentration (0.25–1.0 %, v/v, for oregano and 0.125–0.500 %, v/v, for carvacrol and thymol) values were twofold or fourfold greater than the concentration required to inhibit planktonic growth. Subinhibitory concentrations of the oils attenuated biofilm formation of S. aureus and S. epidermidis strains on polystyrene microtitre plates.
Effect of deletion of the lpxM gene on virulence and vaccine potential of Yersinia pestis in mice
Authors: Anisimov Andrey P. , Shaikhutdinova Rima Z. , Pan'kina Lyudmila N. , Feodorova Valentina A. , Savostina Elena P. , Bystrova Ol'ga V. , Lindner Buko , Mokrievich Aleksandr N. , Bakhteeva Irina V. , Titareva Galina M. , Dentovskaya Svetlana V. , Kocharova Nina A. , Senchenkova Sof'ya N. , Holst Otto , Devdariani Zurab L. , Popov Yuriy A. , Pier Gerald B. , Knirel Yuriy A.
Published: March 2007

Yersinia pestisundergoes an obligate flea–rodent–flea enzootic life cycle. The rapidly fatal properties ofY. pestisare responsible for the organism's sustained survival in natural plague foci. Lipopolysaccharide (LPS) plays several roles inY. pestispathogenesis, prominent among them being resistance to host immune effectors and induction of a septic-shock state during the terminal phases of infection. LPS is acylated with 4–6 fatty acids, the number varying with growth temperature and affecting the molecule's toxic properties.Y. pestismutants were constructed with a deletion insertion in thelpxMgene in both virulent and attenuated strains, preventing the organisms from synthesizing the most toxic hexa-acylated lipid A molecule when grown at 25 °C. The virulence and/or protective potency of pathogenic and attenuatedY. pestisΔlpxMmutants were then examined in a mouse model. The ΔlpxMmutation in a virulent strain led to no change in the LD50value compared to that of the parental strain, while the ΔlpxMmutation in attenuated strains led to a modest 2.5–16-fold reduction in virulence. LPS preparations containing fully hexa-acylated lipid A were ten times more toxic in actinomycin D-treated mice then preparations lacking this lipid A isoform, although this was not significant (P>0.05). The ΔlpxMmutation in vaccine strain EV caused a significant increase in its protective potency. These studies suggest there is little impact from lipid A modifications on the virulence ofY. pestisstrains but there are potential improvements in the protective properties in attenuated vaccine strains.
Evaluation of T-cell responses to peptides with MHC class I-binding motifs derived from PE_PGRS 33 protein of Mycobacterium tuberculosis
Authors: Chaitra M. G. , Shaila M. S. , Nayak R.
Published: March 2007

The PE and PPE proteins ofMycobacterium tuberculosisform a source of antigenic variation among different strains ofM. tuberculosis. One of the PE_PGRS proteins, Rv1818c, plays a role in the pathogenesis of mycobacterial infection and specifically influences host-cell responses to tuberculosis infection. Although little is known about these two classes of protein, an immunoinformatics approach has indicated the possibility of their participation in eliciting a major histocompatibility complex (MHC) class I-mediated immune response against tuberculosis, as peptides derived from Rv1818c are predicted to bind to MHC class I molecules with high affinity. In the present work, a DNA vaccine was constructed encoding the full-length Rv1818c protein ofM. tuberculosisand its immunogenicity was analysed in BALB/c mice. Immunization with Rv1818c DNA induced a strong CD8+cytotoxic lymphocyte and Th1-type response, with high levels of gamma interferon (IFN-γ) and low levels of interleukin-4. Two nonameric peptides (Peptide6–14and Peptide385–393) from Rv1818c were identified by their ability to induce the production of IFN-γby CD8+T cells in mice immunized with Rv1818c DNA. An epitope-specific response was demonstrated by the lysis of peptide-pulsed antigen-presenting cells, release of cytotoxic granules and IFN-γproduction. These peptides bound with high affinity to MHC H-2Kdand showed low dissociation rates of peptide–MHC complexes. These results could form the basis for testing the identified T-cell epitopes of PE_PGRS proteins in the induction of protective immunity againstM. tuberculosischallenge in the mouse model.
Comparison of four chromogenic media for culture-based screening of meticillin-resistant Staphylococcus aureus
Authors: Cherkaoui Abdessalam , Renzi Gesuele , François Patrice , Schrenzel Jacques
Published: March 2007

Meticillin-resistant Staphylococcus aureus (MRSA) are responsible for nosocomial and community-acquired infections. Detection of MRSA is of utmost importance for the adaptation of infection control and therapeutic strategies. To date, selective agar plates constitute the standard routine method for reliable detection of this worldwide infectious problem. The performance of four different chromogenic media was evaluated in this study for MRSA detection and identification on >240 consecutive swab samples. The results indicate that primary plating on MRSASelect or MRSA ID is more sensitive than screening with oxacillin-based culture media. In addition, the utilization of cefoxitin- or cephamycin-containing plates reduces significantly the number of required confirmatory tests. Several selective agar plates allowing the identification of S. aureus are commercially available. However, their respective performances under real conditions of utilization are heterogeneous, underlining the absence of a gold standard medium for MRSA screening.
Evaluation of a chromogenic agar (MRSASelect) for the detection of meticillin-resistant Staphylococcus aureus with clinical samples in The Netherlands
Authors: van Loo I. H. M. , van Dijk S. , Verbakel-Schelle I. , Buiting A. G. M.
Published: March 2007

A novel chromogenic medium for the detection of meticillin-resistant Staphylococcus aureus (MRSA), MRSASelect (Bio-Rad), was evaluated with clinical samples in a public health laboratory in The Netherlands. In total, 3000 samples were tested in the period January to March 2005, including 972 nose, 972 throat, 968 perineum, and 88 wound or urine samples. Presumptive MRSA colonies appeared pink/mauve on the MRSASelect medium. The performance of MRSASelect medium was compared with the routine screening method. Evaluation of the colony morphology showed that all confirmed MRSA isolates grew as pink/mauve colonies. None of the white colonies were MRSA strains. The number of false-positive pink/mauve colonies increased after prolonged incubation from 20 to 48 h. The specificity decreased from 92 % after 20 h incubation to 89 % after 48 h incubation. In total 70 MRSA strains were isolated, 55 of which were detected by the MRSASelect medium and 55 were detected by the routine screening method. Sensitivity was 78.6 % for both test procedures, and specificities were 99.5 and 100 %, respectively for the MRSASelect medium and the routine screening method. The addition of an enrichment broth to the MRSASelect medium increased the number of MRSA strains detected by 12 %. In total, 18 patients were MRSA positive, 4 of these were detected by the MRSASelect medium only and 1 was detected by the routine screening method only. Sensitivity on patient level was 94.4 and 77.8 % for the MRSASelect medium and the routine screening method, respectively, while specificities were 99.7 and 99.0 %.
A novel mitochondrial matrix serine/threonine protein phosphatase regulates the mitochondria permeability transition pore and is essential for cellular survival and development
Authors: Lu Gang , Ren Shuxun , Korge Paavo , Choi Jayoung , Dong Yuan , Weiss James , Koehler Carla , Chen Jau-nian , Wang Yibin
Published: March 2007

Mitochondria play a central role in the regulation of programmed cell death signaling. Here, we report the finding of a mitochondrial matrix-targeted protein phosphatase 2C family member (PP2Cm) that regulates mitochondrial membrane permeability transition pore (MPTP) opening and is essential for cell survival, embryonic development, and cardiac function. PP2Cm is highly conserved among vertebrates, with the highest expression levels detected in the heart and brain. Small hairpin RNA (shRNA)-mediated knockdown of PP2Cm resulted in cell death associated with loss of mitochondrial membrane potential in cultured cardiac mycoytes and an induction of hepatocyte apoptosis in vivo. PP2Cm-deficient mitochondria showed elevated susceptibility to calcium-induced MPTP opening, whereas mitochondrial oxidative phosphorylation activities were not affected. Finally, inactivation of PP2Cm in developing zebrafish embryos caused abnormal cardiac and neural development as well as heart failure associated with induced apoptosis. These data suggest that PP2Cm is a novel mitochondrial protein phosphatase that has a critical function in cell death and survival, and may play a role in regulating the MPTP opening.
Ubiquitylation of histone H2B controls RNA polymerase II transcription elongation independently of histone H3 methylation
Authors: Tanny Jason C. , Erdjument-Bromage Hediye , Tempst Paul , Allis C. David
Published: March 2007

Transcription by RNA polymerase II (polII) is accompanied by dramatic changes in chromatin structure. Numerous enzymatic activities contribute to these changes, including ATP-dependent nucleosome remodeling enzymes and histone modifying enzymes. Recent studies in budding yeast document a histone modification pathway associated with polII transcription, whereby ubiquitylation of histone H2B leads to methylation of histone H3 on specific lysine residues. Although this series of events appears to be highly conserved among eukaryotes, its mechanistic function in transcription is unknown. Here we document a significant functional divergence between ubiquitylation of H2B and methylation of Lys 4 on histone H3 in the fission yeastSchizosaccharomyces pombe. Loss of H2B ubiquitylation results in defects in cell growth, septation, and nuclear structure, phenotypes not observed in cells lacking H3 Lys 4 methylation. Consistent with these results, gene expression microarray analysis reveals a greater role for H2B ubiquitylation in gene regulation than for H3 Lys 4 methylation. Chromatin immunoprecipitation (ChIP) experiments demonstrate that loss of H2B ubiquitylation alters the distribution of polII and histones in gene coding regions. We propose that ubiquitylation of H2B impacts transcription elongation and nuclear architecture through its effects on chromatin dynamics.