bluuebunny/crossref_metadata_2025 huggingface dataset:
Sudden Death and Angelman Syndrome
Authors: Herbst Jonathon , Byard Roger W.
Published: August 2011

Abstract:  Angelman syndrome is a condition characterized by developmental delay due to abnormalities in the maternally derived chromosome 15q11‐q13. Typical features include impaired expressive language, an ataxic gait, and seizures. Hyperactivity may result in accidental bruises and abrasions, raising issues of possible inflicted injury. A fascination with water may predispose to drowning. A 5‐year‐old boy with an established diagnosis of Angelman syndrome is reported who died of upper airway obstruction due to massively enlarged tonsils complicating infectious mononucleosis. Assessment of the severity of underlying illness in developmentally delayed children may be difficult due to failure to vocalize worsening symptoms and distress. In addition, signs of upper airway narrowing due to infection in Angelman syndrome may be masked by the sucking and swallowing difficulties that affected individuals may have with drooling and excessive chewing and mouthing behavior.
Context Effects and Observer Bias—Implications for Forensic Odontology
Authors: Page Mark , Taylor Jane , Blenkin Matt
Published: August 2011

Abstract:  Psychologists have long recognized the effects of contextual and extraneous information on decision making. Such information renders the subject susceptible to both motivational and cognitive bias; yet, it is difficult to assess the extent to which these influence forensic odontologists opinions as there have been no studies to date on this subject. This article explores the various types of contextual effects and biasing influences that potentially impact on the analysis of bitemarks in forensic odontology. It appears that the current practice of bitemark analysis is rich in sources of potentially biasing influences. In addition to the fundamental recognition that some form of bias is likely to exist, ways in which these should be minimized include: separation of the collection and analysis phases; limiting the amount of contextual information available to the odontologist responsible for the analysis; and ensuring that evidence that is ambiguous or of poor quality is identified as such prior to analysis.
Does conventional or single port laparoscopically assisted vaginal hysterectomy affect female sexual function?
Authors: LEE JUNG HUN , CHOI JOONG SUB , HONG JIN HWA , JOO KWAN JOONG , KIM BUM YOUNG
Published: August 2011

Objective. To investigate the effects of conventional and single port laparoscopically assisted vaginal hysterectomy (LAVH) on sexual function in premenopausal women. Design. A prospective case‐control study. Setting. University teaching hospital. Population. A total of 95 premenopausal women having LAVH from January 2009 to December 2009. Methods. Comparison of 47 premenopausal women who had single port LAVH using trans‐umbilical GelPort access (SP‐LAVH group) and 48 premenopausal women who had conventional multiport LAVH (conventional LAVH group). Main outcome measures. Evaluation of sexual function was done prior to and six months after surgery using a validated tool, the female sexual function index (FSFI). Results. In terms of women's demographic characteristics and operative results, there was no significant difference between the two study groups, or between pre‐ and postoperative individual domain scores or total female sexual function index in women who underwent either conventional or single port LAVH. Conclusions. Neither conventional nor single port LAVH affects sexual function in premenopausal women. Women can be counseled that this type of surgery is unlikely to alter sexual function.
Recent developments in the clinical use of the levonorgestrel‐releasing intrauterine system
Authors: GEMZELL‐DANIELSSON KRISTINA , INKI PIRJO , HEIKINHEIMO OSKARI
Published: August 2011

This overview focuses on recent developments in the clinical use of the levonorgestrel‐ releasing intrauterine system (LNG‐IUS) on established indications. Recent studies confirm that the LNG‐IUS is safe and equally effective for all age groups of women. All available studies showed that intrauterine contraception is more effective when compared to non‐intrauterine contraceptive methods to prevent repeat abortions. Furthermore, insertion in young nulliparous women is acceptable in the majority of women and associated with high continuation rates. The effectivity of LNG‐IUS appears to be similar in women with chronic medical conditions, including HIV infection or coagulation disorders, and healthy women. More and most importantly, it has no adverse effect on the underlying condition. We also discuss effects of LNG‐IUS on bone mineral density, vaginal flora, cardiovascular risk factors and breast cancer. In treatment of heavy menstrual bleeding, the LNG‐IUS appears to be one of the most effective and cost‐effective methods.
Left upper quadrant approach in gynecologic laparoscopic surgery
Authors: NGU SIEW‐FEI , CHEUNG VINCENT Y. T. , PUN TING‐CHUNG
Published: August 2011

Objective. To review the use of the left upper quadrant approach in benign gynecologic laparoscopic surgery over a nine‐year period. Design. Retrospective review. Setting. University‐affiliated hospital. Population. Women who underwent laparoscopic gynecologic surgery the upper quadrant approach between January 2002 and December 2010. Methods. Medical records were reviewed. Main outcome measures. Demographic data, past surgical histories, indications for surgery and the use of the left upper quadrant approach, intraoperative findings, diagnosis and any complications. Results. 143 patients were identified, accounting for 4.9% of all gynecologic laparoscopic surgery. The indications for using the left upper quadrant approach were: previous open abdominal surgery (113, 79.0%), surgery in the second trimester of pregnancy (16, 11.1%), presence of large pelvic mass (9, 6.2%), previous transverse rectus abdominis myocutaneous flap for breast reconstruction (3, 2.0%), previous periumbilical hernia repair (1, 0.6%) and previous laparoscopic umbilical wound dehiscence (1, 0.6%). In women with previous abdominal surgery, the overall incidence of adhesions between omentum and/or bowel to the anterior abdominal wall in the umbilical region was 58.4%. Twelve (8.3%) patients required conversion to laparotomy. One patient had subcutaneous surgical emphysema over the left upper quadrant entry site. Conclusions. The left upper quadrant approach is an effective, safe and easy technique for peritoneal cavity access in women undergoing laparoscopic gynecologic surgery and should be considered in women with risk factors of periumbilical adhesions and in the presence of a large pelvic mass.
Intracanal dressing and root canal filling materials in tooth replantation: a literature review
Authors: Panzarini Sônia Regina , Trevisan Carolina Lunardelli , Brandini Daniela Atili , Poi Wilson Roberto , Sonoda Celso Koogi , Luvizuto Eloá Rodrigues , dos Santos Cláudia Letícia Vendrame
Published: August 2011

Abstract –  The prognosis of tooth replantation is usually related to the need of endodontic treatment, which has a direct relationship with the occurrence of root resorptions. Several studies have been undertaken in an attempt to prevent, delay, or treat these complications, which are the main causes of loss of replanted teeth. This literature review examines research evidence on intracanal dressings and root canal filling materials used in cases of tooth replantation. A comprehensive search was performed in the Medline/Pubmed, Bireme and Scielo full‐text electronic journal databases to retrieve English‐language articles referring to these topics that had been published between 1964 and 2010. Calcium hydroxide (CH) remains the usually recommended choice as an intracanal medicament in replanted teeth; however, there is evidence to support the initial use of a corticosteroid‐antibiotic combination such as Ledermix paste to control potential early resorption, prior to the introduction of CH where the beneficial effect in the treatment of progressive root resorption has been well proven. Regarding root filling materials, CH‐containing sealers are a good option because of their biological properties. Accurate diagnosis and adequate treatment plan may constitute very complex tasks, particularly in tooth avulsion because several variables are involved. In addition to the technical knowledge and clinical experience directed toward the quality of treatment, patient education may favorably influence the survival of replanted teeth.
Recovering the function and esthetics of fractured teeth using several restorative cosmetic approaches. Three clinical cases
Authors: Anchieta Rodolfo B. , Rocha Eduardo P. , Watanabe Maurício U. , de Almeida Erika O. , Freitas‐Junior Amilcar C. , Martini Ana P. , Barioni Sônia R. P.
Published: August 2011

Abstract –  The teeth most commonly affected by trauma are the maxillary central incisors. The most frequent types of traumatic dental injuries to permanent teeth are enamel fractures, enamel and dentine fractures, and enamel and dentine fractures with pulp involvement. This article describes three clinical cases with different levels of traumatized maxillary incisors and several cosmetic approaches for recovery of the esthetics and the masticatory function, as well as the social/psychological aspects of treatment. All cases involved young adult men. The three clinical cases involve dentin and enamel fractures, dentin and enamel fractures with pulp exposure, and dentin and enamel fractures with pulp exposure associated with root fracture. The cosmetic treatments used to resolve fractures were direct composite resin by layering technique, indirect all‐ceramic restorations (laminate veneer and ceramic crowns over the teeth), and immediate implant after extraction followed by immediate loading (ceramic abutments with ceramic crown over implant). In all three cases, excellent functional and esthetic results were achieved by use of these treatment modalities. The patients were very satisfied with the results.
Leg ulcers associated with Klinefelter's syndrome: a case report and review of the literature
Authors: Shanmugam Victoria K , Tsagaris Katina C , Attinger Christopher E
Published: August 2011

We present the case of a young man with type II diabetes, stage III chronic kidney disease, hypertension, obstructive sleep apnea and diabetes who presented to the Georgetown University Hospital Center for Wound Healing with refractory lower extremity ulcers. Autoimmune work‐up was negative. However, chromosome analysis showed a genetic variant of Klinefelter's syndrome (48 XXYY). Lower extremity ulceration is a recognised complication of Klinefelter's syndrome. The pathogenesis of ulcers in this endocrinopathy is unclear, but associations with abnormalities of fibrinolysis and prothrombotic states are reported. This case emphasises the importance of considering Klinefelter's syndrome in the differential diagnosis of a sterile male patient with non healing lower extremity ulcers.
Major trauma deaths at Perth secondary hospitals
Authors: Fatovich Daniel M , Burrell Maxine , Jacobs Ian G
Published: August 2011

Objective: Some major trauma (Injury Severity Score [ISS] >15) patients transported to a secondary hospital in Perth do not survive. We sought to describe this cohort and assess preventability.

Methods: A cohort study from a previously developed cohort of trauma deaths in Western Australia from 1 July 1997 to 30 June 2006. A preformatted data sheet was used to collect a range of descriptive, time, physiological, and autopsy data. Trauma scores were calculated. Preventability was assessed using three approaches, based on ISS, Trauma Revised Injury Severity Score (TRISS) and individual case review.

Results: There were 74 major trauma deaths, mean age 55.6 ± 26.3 years (range 3–95). Thirty‐seven (50%) were motor vehicle crashes. The mean Revised Trauma Score was 3.84 ± 3.09 (0–7.84), median ISS 31 (interquartile range [IQR] 25–51), median TRISS 0.127 (IQR 0.031–0.772) and median time to death was 80 min (IQR 20 min–10 h 8 min). Severe head and chest injuries were the most common. Almost half (36, 48.6%) were receiving CPR on arrival to the hospital. The crude proportion of potentially preventable deaths, based on ISS, TRISS and case review, were 16.2%, 32.4% and 6.7%, respectively. However, these were predominantly elderly patients and a decision against resuscitation was recorded in 54%.

Conclusions: The proportion of potentially preventable major trauma deaths at Perth secondary hospitals is low. The most notable group were the elderly after falls, and trauma system efforts should be focused on this group. Primary prevention of major trauma represents the biggest opportunity for improvements in trauma survival.
Long‐term quality‐of‐life outcomes in children undergoing adenotonsillectomy for obstructive sleep apnoea: a longitudinal study
Authors: Randhawa P.S. , Cetto R. , Chilvers G. , Georgalas C. , Narula A.A.
Published: August 2011

Clin. Otolaryngol. 2011, 36, 475–481

Objectives:  To assess a cohort of patients who underwent adenotonsillectomy for obstructive sleep apnoea, 4 years after surgery for evidence of continued and long‐term improvement in quality of life. We also sought to compare our results to Child Health Questionnaire scores obtained from our previous study. We also compared our data with a healthy UK children population from normative data available.

Design:  Longitudinal study.

Settings:  University Hospital Tertiary Referral Centre.

Participants:  A 4‐year follow‐up study of 37 children who underwent adenotonsillectomy for obstructive sleep apnoea confirmed on polysomnography. There were 19 boys and 18 girls from our initial cohort. The primary caregiver completed the validated Child Health Questionnaire Parental Form version‐28, 4 years after initial surgery. Our control group consist of 221 healthy children aged 6–18 that were included as ‘normal’ controls in a study looking at children with juvenile arthritis. The children were defined as healthy by a physician and/or after declaration by the parent.

Main outcome measure:  Child Health Questionnaire Parental Form version‐28 scores.

Results:  A total of 33 patients (89%) from our initial cohort were contacted. The mean age was 10.6 (median, 11; range, 5–16). When compared with results obtained 3 months postoperatively, the mean scores were higher in five domains and were statistically significant in three subscales (Role Limitations P < 0.00001; Bodily Pain P < 0.002; and Global Health P < 0.02). There was a significant deterioration in Behaviour subscale (P < 0.0007) in spite of surgery. Compared with controls, 4‐year follow‐up scores were higher in five domains with the Global Health domain (P < 0.0004) being statistically significant. When the 4‐year follow‐up scores were compared with preoperative values, these were higher in all 13 domains with statistically significant improvements in nine domains, indicating that improvements had persisted 4 years after surgery. At 4 years, however, the means scores in many domains remain lower when compared with controls.

Conclusion:  Quality‐of‐life data are an important measure when deciding on a specific clinical intervention. In the short term, quality‐of‐life measures have been shown to improve after adenotonsillectomy for obstructive sleep apnoea. Our study demonstrates that the benefits of surgery are still persistent and the children continue to improve in the long term.
In Vitro and In Vivo Photodynamic Activity of Core‐modified Porphyrin IY69 Using 690 nm Diode Laser
Authors: Paul Bibbin , Rajaputra Pallavi , You Youngjae
Published: August 2011

Core‐modified porphyrins have been explored as the second‐generation photosensitizers due to their excellent photophysical properties. IY69 [(5‐phenyl‐10,15‐bis(4‐carboxylatomethoxyphenyl)‐20‐(2‐thienyl)‐21,23‐dithiaporphyrin] was developed from the structure optimization guided by in vitro phototoxicity, showing potent activity (IC50 = 80 nm, broadband at 5 J cm−2, R3230AC cells). The present study demonstrates in vivo photodynamic therapy (PDT) efficacy of IY69 using a murine tumor model (colon 26 cells on BALB/c mice) and 690 nm diode laser. In vitro phototoxicity of IY69 with the diode laser was compared with that with broadband light against colon 26 cells. Attenuation of the laser light by tissue samples was determined to estimate actual power density at targets. Biodistribution in various organs 24, 48, 72 h after i.p. administration was determined. Even though IY69 phototoxicity with the diode laser was less effective than that with the broadband light, the diode laser was quite effective in vitro (IC50 = 0.1 μm, 10 J cm−2, colon 26 cells). Concentration and light dose‐dependent phototoxicity was observed. A significant light attenuation of 95% and 99% was observed by skin and 3 mm muscle with skin. IY69 PDT showed significant damage on tumor and delay in tumor growth in a dose‐dependent manner.
Physical disturbance to ecological niches created by soil structure alters community composition of methanotrophs
Authors: Kumaresan Deepak , Stralis‐Pavese Nancy , Abell Guy C. J. , Bodrossy Levente , Murrell J. Colin
Published: August 2011

Aggregates of different sizes and stability in soil create a composite of ecological niches differing in terms of physico‐chemical and structural characteristics. The aim of this study was to identify, using DNA‐SIP and mRNA‐based microarray analysis, whether shifts in activity and community composition of methanotrophs occur when ecological niches created by soil structure are physically perturbed. Landfill cover soil was subject to three treatments termed: ‘control’ (minimal structural disruption), ‘sieved’ (sieved soil using 2 mm mesh) and ‘ground’ (grinding using mortar and pestle). ‘Sieved’ and ‘ground’ soil treatments exhibited higher methane oxidation potentials compared with the ‘control’ soil treatment. Analysis of the active community composition revealed an effect of physical disruption on active methanotrophs. Type I methanotrophs were the most active methanotrophs in ‘sieved’ and ‘ground’ soil treatments, whereas both Type I and Type II methanotrophs were active in the ‘control’ soil treatment. The result emphasize that changes to a particular ecological niche may not result in an immediate change to the active bacterial composition and change in composition will depend on the ability of the bacterial communities to respond to the perturbation.
Determinants and frequency of pharmaceutical compounding in pharmacy practice in Palestine
Authors: Zaid Abdel Naser , Al-Ramahi Rowa' , Shahed Qusai , Saleh Belal , Elaraj Josephean
Published: August 2011

Objectives

The aims of this study were to determine the frequency of prescription compounding by community pharmacists, identify factors that influence pharmacists' decisions to provide compounding services, and evaluate physicians' perspectives on prescribing medications that require compounding.

Methods

The study was a cross-sectional survey administered via face-to-face structured interviews with randomly selected community pharmacists and physicians from different areas of the West Bank.

Key findings

Of the 260 community pharmacists who were contacted, 212 agreed to participate in the survey, giving a response rate of 81.5%. Overall, 153 (72.2%) of respondent pharmacists provided compounding services. Compounded prescriptions accounted for 1973 (1.55%) of 126 840 prescriptions dispensed in a typical month. Among the compounders, 112 (73.2%) pharmacists reported that their goal in providing full pharmaceutical care to their patients was the most important motivator. The most frequently reported reason for not providing compounding was ‘I do not receive prescriptions that require compounding’ by 43 out of 59 (72.9%) pharmacists. A total of 179 out of 220 physicians consented to participate in this study giving a response rate of 81.4%. The majority of physicians (142, 79.3%) did not prescribe compounded medicines. The most important reason for their decision to prescribe compounded medicines was the unavailability of the required dosage forms. The most commonly cited reason for not prescribing them was a lack of trust in the quality of the compounded formulations.

Conclusion

While most respondent pharmacists provide a compounding service this represents only a small percentage of the total volume of dispensed prescriptions. Most responding physicians do not prescribe medications that require compounding because they lack trust in the quality of the compounded formulations.
Justice judgements, school failure, and adolescent deviant behaviour
Authors: Sanches Cristina , Gouveia‐Pereira Maria , Carugati Felice
Published: August 2011

Background. The current paper is based on two different approaches. One is the relational model of authority (Tyler & Lind, 1992), which addresses the effects of justice perceptions on the legitimacy of authorities and behavioural compliance. The other is Emler and Reicher's theory (1995, 2005), which explains the involvement of adolescents in delinquency through their relationship with the institutional authorities of society.

Aims. To provide empirical evidence for the linkage of these perspectives, analysing the relationship between justice perceptions about teachers and the involvement of adolescents in deviant behaviour. Our hypotheses are that teachers’ justice is negatively related with deviant behaviour and that this relationship is mediated through the evaluation of institutional authorities, after controlling for school failure.

Sample. Three hundred and ninety adolescents aged between 14 and 17 years.

Methods. Participants completed the following scales: perceptions of justice about teachers, evaluation of institutional authorities, and deviant behaviour. Data were examined through correlation and bootstrap analyses.

Results. Justice judgments about teachers were negatively related with deviant behaviour, and this relationship was partially mediated by the evaluation of institutional authorities, even after controlling for school failure. However, procedural justice revealed a much stronger relationship with deviance, compared to distributive justice.

Conclusions. As predicted, these results suggest that when adolescents perceive school authorities as fair, other institutional authorities are likely to be perceived in a similar way and the more those authorities are positively evaluated, the less often adolescents engage in deviant conduct. Results are discussed according to the theories underlying our hypothesis. Directions for future research are suggested.
Angoff's delta method revisited: Improving DIF detection under small samples
Authors: Magis David , Facon Bruno
Published: August 2011

Most methods for detecting differential item functioning (DIF) are suitable when the sample sizes are sufficiently large to validate the null statistical distributions. There is no guarantee, however, that they will still perform adequately when there are few respondents in the focal group or in both the reference and the focal group. Angoff's delta plot is a potentially useful alternative for small‐sample DIF investigation, but it suffers from an improper DIF flagging criterion. The purpose of this paper is to improve this classification rule under mild statistical assumptions. This improvement yields a modified delta plot with an adjusted DIF flagging criterion for small samples. A simulation study was conducted to compare the modified delta plot with both the classical delta plot approach and the Mantel–Haenszel method. It is concluded that the modified delta plot is consistently less conservative and more powerful than the usual delta plot, and is also less conservative and more powerful than the Mantel–Haenszel method as long as at least one group of respondents is small.
Young children's responses to media representations of intergroup threat and ethnicity
Authors: Durkin Kevin , Nesdale Drew , Dempsey Gemma , McLean Amanda
Published: August 2011

Two studies are reported in which ethnic majority children's reactions to media representations of ethnic minorities are examined. In Study 1, 20 white Scottish 6‐year‐olds viewed short television stories in which white or ethnic minority children were depicted as hostile to the participants’ in‐group (threat present) or not (threat absent). A strong effect of threat on liking was obtained but no effect of ethnicity of target and no interaction. In Study 2, 4‐ and 6‐year‐old white Scottish children viewed PowerPoint displays in which Scottish people were shown only as white (traditional version) or as ethnically diverse (multicultural version). Intergroup threat was manipulated. Again, a strong effect of threat was obtained. However, when threat was absent, participants exposed to the traditional condition liked the white out‐group more than the multi‐ethnic out‐group, while participants exposed to the multicultural condition liked the multi‐ethnic out‐group more than the white out‐group. The results are interpreted as consistent with the predictions of Social Identity Development Theory.
Secondary-Drop-Breakup Simulation Integrated With Fuel-Breakup Simulation Near Injector Outlet
Authors: Ishii Eiji , Ishikawa Masanori , Sukegawa Yoshihiro , Yamada Hiroshi
Published: August 2011

The fuel spray of an injector for automobile engines contains multiscale free surfaces: liquid films formed at the fuel-injector outlet, ligaments generated by liquid-film breakup, and droplets generated from the ligaments within the secondary-drop-breakup region. To simulate these multiscale free surfaces, we developed a method that combines two types of simulation. The liquid-film breakup near the injector outlet was simulated by using a particle method, and the secondary-drop breakup after the liquid-film breakup was simulated by using a discrete droplet model (DDM). The injection conditions of DDM were the distributions of droplet diameters and velocities calculated in the liquid-film-breakup simulation. We applied our method to simulate the spray from a collision-type fuel injector. The simulated liquid-film breakup near the injector outlet and behavior of the secondary-drop breakup qualitatively agreed with measurements. Furthermore, the errors of the mean droplet diameters between the simulations and the measurements were less than 12%. This shows that our method is effective for fuel spray simulation.
Putting computation on a par with experiments and theory in the undergraduate physics curriculum
Authors: Serbanescu Ruxandra M. , Kushner Paul J. , Stanley Sabine
Published: August 2011

Computation is an indispensable tool for physicists, but incorporating computational physics into the undergraduate physics curriculum presents many challenges. How can instructors fit computational physics into already packed curricula, and how can some level of computational proficiency become second nature to today’s physics students? We review how web-based learning resources have been used to integrate computational activities into redesigned lab and lecture courses at the University of Toronto. The methodology of incorporating computation into lecture and laboratory courses at the first and second years is presented.
Tumor Progression Locus 2 Mediates Signal-Induced Increases in Cytoplasmic Calcium and Cell Migration
Authors: Hatziapostolou Maria , Koukos Georgios , Polytarchou Christos , Kottakis Filippos , Serebrennikova Oksana , Kuliopulos Athan , Tsichlis Philip N.
Published: August 2011

The kinase Tpl2 triggers calcium signaling and cell migration downstream of various receptors implicated in cancer and inflammation.
Florigens, Flowering, and 14-3-3 Proteins
Authors: Thompson Heather M.
Published: August 2011

A 14-3-3 protein bridges an interaction between rice florigen and a bZIP-containing transcription factor to activate expression of flowering genes.
Channeling Neuronal Migration
Authors: Adler Elizabeth M.
Published: August 2011

VEGF enhances NMDAR signaling to promote granule cell migration in the developing cerebellum.
Functional Synergy between Antimicrobial Peptoids and Peptides against Gram-Negative Bacteria
Authors: Chongsiriwatana Nathaniel P. , Wetzler Modi , Barron Annelise E.
Published: August 2011

Antimicrobial peptides (AMPs) are integral components of innate immunity and are typically found in combinations in which they can synergize for broader-spectrum or more potent activity. Previously, we reported peptoid mimics of AMPs with potent and selective antimicrobial activity. Using checkerboard assays, we demonstrate that peptoids and AMPs can interact synergistically, with fractional inhibitory concentration indices as low as 0.16. These results strongly suggest that antimicrobial peptoids and peptides are functionally and mechanistically analogous.
Transmission of Dapsone-Resistant Leprosy Detected by Molecular Epidemiological Approaches
Authors: Li Wei , Sakamuri Rama M. , Lyons Danielle E. , Orcullo Florenda M. , Shinde Vidyagouri , Pena Edred Lao Dela , Maghanoy Armi A. , Mallari Irene B. , Tan Esterlina V. , Nath Indira , Brennan Patrick J. , Balagon Marivic , Vissa Varalakshmi
Published: August 2011

Drug resistance surveillance identified six untreated leprosy patients in the Philippines withMycobacterium lepraefolP1mutations which confer dapsone resistance. Five patients share a village of residence; four who carried the mutation, Thr53Val, were also linked byM. lepraevariable-number tandem repeat (VNTR) strain types. In India,folP1mutations were detected in two relapse patients with a history of dapsone treatment. Mutations were not found in the rifampin target generpoB. These findings indicate that dapsone resistance is being transmitted.
Molecular Characterization of Multidrug-Resistant Escherichia coli Isolates from Irish Cattle Farms
Authors: Karczmarczyk Maria , Walsh Ciara , Slowey Rosemarie , Leonard Nola , Fanning Séamus
Published: August 2011

This study describes the genotypic characteristics of a collection of 100 multidrug-resistant (MDR)
Escherichia coli
strains recovered from cattle and the farm environment in Ireland in 2007. The most prevalent antimicrobial resistance identified was to streptomycin (100%), followed by tetracycline (99%), sulfonamides (98%), ampicillin (82%), and neomycin (62%). Resistance was mediated predominantly by
strA-strB
(92%),
tetA
(67%),
sul2
(90%),
bla
TEM
(79%), and
aphA1
(63%) gene markers, respectively. Twenty-seven isolates harbored a class 1 integrase (
intI1
), while
qacE
Δ
1
and
sul1
markers were identified in 25 and 26 isolates, respectively. The variable regions of these integrons contained aminoglycoside, trimethoprim, and β-lactam resistance determinants (
aadA12
,
aadB
-
aadA1
,
bla
OXA-30
-
aadA1
,
dfrA1
-
aadA1
,
dfrA7
). Class 2 integrons were identified less frequently (4%) and contained the gene cassette array
dfrA1-sat1-aadA1
. Resistance to ampicillin, neomycin, streptomycin, sulfonamide, and tetracycline was associated with transferable high-molecular-weight plasmids, as demonstrated by conjugation assays. A panel of virulence markers was screened for by PCR, and genes identified included
vt1
, K5 in 2 isolates,
papC
in 10 isolates, and PAI IV
536
in 37 isolates. MDR commensal
E. coli
isolates from Irish cattle displayed considerable diversity with respect to the genes identified. Our findings highlight the importance of the commensal microflora of food-producing animals as a reservoir of transferable MDR.
Comparative Genomic Analysis of Acinetobacter oleivorans DR1 To Determine Strain-Specific Genomic Regions and Gentisate Biodegradation
Authors: Jung Jaejoon , Madsen Eugene L. , Jeon Che Ok , Park Woojun
Published: August 2011

The comparative genomics of
Acinetobacter oleivorans
DR1 assayed with
A. baylyi
ADP1,
A. calcoaceticus
PHEA-2, and
A. baumannii
ATCC 17978 revealed that the incorporation of phage-related genomic regions and the absence of transposable elements have contributed to the large size (4.15 Mb) of the DR1 genome. A horizontally transferred genomic region and a higher proportion of transcriptional regulator- and signal peptide-coding genes were identified as characteristics of the DR1 genome. Incomplete glucose metabolism, metabolic pathways of aromatic compounds, biofilm formation, antibiotics and metal resistance, and natural competence genes were conserved in four compared genomes. Interestingly, only strain DR1 possesses gentisate 1,2-dioxygenase (
nagI
) and grows on gentisate, whereas other species cannot. Expression of the
nagI
gene was upregulated during gentisate utilization, and four downstream open reading frames (ORFs) were cotranscribed, supporting the notion that gentisate metabolism is a unique characteristic of strain DR1. The genomic analysis of strain DR1 provides additional insights into the function, ecology, and evolution of
Acinetobacter
species.
β-Lactams and Florfenicol Antibiotics Remain Bioactive in Soils while Ciprofloxacin, Neomycin, and Tetracycline Are Neutralized
Authors: Subbiah Murugan , Mitchell Shannon M. , Ullman Jeffrey L. , Call Douglas R.
Published: August 2011

It is generally assumed that antibiotic residues in soils select for antibiotic-resistant bacteria. This assumption was tested by separately adding 10 different antibiotics (≥200 ppm) to three soil-water slurries (silt-loam, sand-loam, and sand; 20% soil [wt/vol]) and incubating mixtures for 24 h at room temperature. The antibiotic activity of the resultant supernatant was assessed by culturing a sensitive
Escherichia coli
strain in the filter-sterilized supernatant augmented with Luria-Bertani broth. We found striking differences in the abilities of supernatants to suppress growth of the indicator
E. coli
. Ampicillin, cephalothin, cefoxitin, ceftiofur, and florfenicol supernatants completely inhibited growth while bacterial growth was uninhibited in the presence of neomycin, tetracycline, and ciprofloxacin supernatants. High-performance liquid chromatography (HPLC) analysis demonstrated that cefoxitin and florfenicol were almost completely retained in the supernatants, whereas tetracycline and ciprofloxacin were mostly removed. Antibiotic dissipation in soil, presumably dominated by adsorption mechanisms, was sufficient to neutralize 200 ppm of tetracycline; this concentration is considerably higher than reported contamination levels. Soil pellets from the tetracycline slurries were resuspended in a minimal volume of medium to maximize the interaction between bacteria and soil particles, but sensitive bacteria were still unaffected by tetracycline (
P
= 0.6). Thus, residual antibiotics in soil do not necessarily exert a selective pressure, and the degree to which the pharmaceutical remains bioactive depends on the antibiotic. Efforts to control antibiotic contamination would be better directed toward compounds that retain biological activity in soils (e.g., cephalosporins and florfenicol) because these are the antibiotics that could exert a selective pressure in the environment.
Aedes aegypti Membrane-Bound Alkaline Phosphatase Expressed in Escherichia coli Retains High-Affinity Binding for Bacillus thuringiensis Cry4Ba Toxin
Authors: Thammasittirong Anon , Dechklar Manasave , Leetachewa Somphob , Pootanakit Kusol , Angsuthanasombat Chanan
Published: August 2011

Glycosylphosphatidylinositol-linked alkaline phosphatase (GPI-ALP) from the epithelial membrane of the larval midgut of
Aedes aegypti
was previously identified as a functional receptor of the
Bacillus thuringiensis
Cry4Ba toxin. Here, heterologous expression in
Escherichia coli
of the cloned ALP, lacking the secretion signal and GPI attachment sequences, and assessment of its binding characteristics were further investigated. The 54-kDa His tag-fused ALP overexpressed as an inclusion body was soluble when phosphate buffer (pH 7.5) was supplemented with 8 M urea. After renaturation in a nickel-nitrilotriacetic acid (Ni-NTA) affinity column, the refolded ALP protein was able to retain its phosphatase activity. This refolded ALP also showed binding to the 65-kDa activated Cry4Ba toxin under nondenaturing (dot blot) conditions. Quantitative binding analysis using a quartz crystal microbalance revealed that the purified ALP immobilized on a gold electrode was bound by the Cry4Ba toxin in a stoichiometry of approximately 1:2 and with high affinity (dissociation constant [
K

d

] of ∼14 nM) which is comparable to that calculated from kinetic parameters (dissociation rate constant [
k
off
]/binding constant [
k
on
]). Altogether, the data presented here of the
E. coli
-expressed ALP from
A. aegypti
retaining high-affinity toxin binding support our notion that glycosylation of this receptor is not required for binding to its counterpart toxin, Cry4Ba.
Differential Regulation of Orthologous Chitinase Genes in Mycoparasitic Trichoderma Species
Authors: Gruber Sabine , Kubicek Christian P. , Seidl-Seiboth Verena
Published: August 2011

Mycoparasitic
Trichoderma
species have expanded numbers of fungal subgroup C chitinases that contain multiple carbohydrate binding modules and could thus be important for fungal cell wall degradation during the mycoparasitic attack. In this study, we analyzed the gene regulation of subgroup C chitinases in the mycoparasite
Trichoderma virens
. In addition to regulation by nutritional stimuli, we found complex expression patterns in different parts of the fungal colony, and also, the mode of cultivation strongly influenced subgroup C chitinase transcript levels. Thus, the regulation of these genes is governed by a combination of colony-internal and -external signals. Our results showed completely different expression profiles of subgroup C chitinase genes in
T. virens
than in a previous study with
T. atroviride
, although both fungi are potent mycoparasites. Only a few subgroup C chitinase orthologues were found in
T. atroviride
and
T. virens
, and even those showed substantially divergent gene expression patterns. Microscopic analysis revealed morphogenetic differences between
T. atroviride
and
T. virens
, which could be connected to differential subgroup C chitinase gene expression. The biological function of fungal subgroup C chitinases therefore might not be as clear-cut as previously anticipated. They could have pleiotropic roles and might be involved in both degradation of exogenous chitinous carbon sources, including other fungal cell walls, and recycling of their own cell walls during hyphal development and colony formation.
Ncb2 Is Involved in Activated Transcription of
CDR1
in Azole-Resistant Clinical Isolates of Candida albicans
Authors: Shukla Shipra , Yadav Vipin , Mukhopadhyay Gauranga , Prasad Rajendra
Published: August 2011

We recently demonstrated that
CDR1
overexpression in azole-resistant isolates of
Candida albicans
is due to its enhanced transcriptional activation and increased mRNA stability. In this study, we provide the first evidence of transcriptional regulation of
CDR1
by Ncb2, the β subunit of NC2, a heterodimeric regulator of transcription. Conditional
NCB2
null mutants displayed decreased susceptibility toward azole and an enhanced transcription of
CDR1
. Interestingly, Ncb2 associated with the
CDR1
promoter under both repression and activation; however, an increase in recruitment was observed under both transient and constitutive activation states. By chromatin immunoprecipitation (ChIP) assay, we showed the preferential recruitment of Ncb2 to the core TATA region under activation (azole-resistant isolate), while under repression (azole-susceptible isolate) it was present at the TATA upstream region. Further, ChIP analysis revealed that Ncb2 binding was not restricted to the
CDR1
gene; instead, it was observed on the promoters of genes coregulated with
CDR1
by the transcription activator Tac1. The
tac1
Δ null mutants, which fail to show the drug-induced transient activation of
CDR1
, also showed no increase in Ncb2 recruitment at the promoter. Taken together, our results show that Ncb2, in conjunction with Tac1, is involved in the transcriptional activation of
CDR1
, opening up new therapeutic possibilities to combat multidrug resistance (MDR) in
C. albicans
.
Cellular Effects and Epistasis among Three Determinants of Adaptation in Experimental Populations of Saccharomyces cerevisiae
Authors: Parreiras Lucas S. , Kohn Linda M. , Anderson James B.
Published: August 2011

Epistatic interactions in which the phenotypic effect of an allele is conditional on its genetic background have been shown to play a central part in various evolutionary processes. In a previous study (J. B. Anderson et al., Curr. Biol. 20:1383-1388, 2010; J. R. Dettman, C. Sirjusingh, L. M. Kohn, and J. B. Anderson, Nature 447:585-588, 2007), beginning with a common ancestor, we identified three determinants of fitness as mutant alleles (each designated with the letter “
e
”) that arose in replicate
Saccharomyces cerevisiae
populations propagated in two different environments, a low-glucose and a high-salt environment. In a low-glucose environment,
MDS3e
and
MKT1e
interacted positively to confer a fitness advantage. Also,
PMA1e
from a high-salt environment interacted negatively with
MKT1e
in a low-glucose environment, an example of a Dobzhansky-Muller incompatibility that confers reproductive isolation. Here we showed that the negative interaction between
PMA1e
and
MKT1e
is mediated by alterations in intracellular pH, while the positive interaction between
MDS3e
and
MKT1e
is mediated by changes in gene expression affecting glucose transporter genes. We specifically addressed the evolutionary significance of the positive interaction by showing that the presence of the
MDS3
mutation is a necessary condition for the spread and fixation of the new mutations at the identical site in
MKT1
. The expected mutations in
MKT1
rose to high frequencies in two of three experimental populations carrying
MDS3e
but not in any of three populations carrying the ancestral allele. These data show how positive and negative epistasis can contribute to adaptation and reproductive isolation.
Ehrlichia chaffeensis TRP120 Interacts with a Diverse Array of Eukaryotic Proteins Involved in Transcription, Signaling, and Cytoskeleton Organization
Authors: Luo Tian , Kuriakose Jeeba A. , Zhu Bing , Wakeel Abdul , McBride Jere W.
Published: August 2011

Ehrlichia chaffeensisis an obligately intracellular bacterium that exhibits tropism for mononuclear phagocytes and survives by evading host cell defense mechanisms. Recently, molecular interactions betweenE. chaffeensis47-kDa tandem repeat (TR) protein (TRP47) and the eukaryotic host cell have been described. In this investigation, yeast (Saccharomyces cerevisiae) two-hybrid analysis demonstrated thatE. chaffeensis-secreted tandem repeat protein 120 (TRP120) interacts with a diverse group of host cell proteins associated with major biological processes, including transcription and regulation, cell signaling, protein trafficking, and actin cytoskeleton organization. Twelve target proteins with the highest frequency of interaction with TRP120 were confirmed by cotransformation in yeast. Host targets, including human immunoglobulin lambda locus (IGL), cytochromecoxidase subunit II (COX2), Golgi-associated gamma adaptin ear-containing ARF binding protein 1 (GGA1), polycomb group ring finger 5 (PCGF5), actin gamma 1 (ACTG1), and unc-13 homolog D (UNC13D;Caenorhabditis elegans), colocalized strongly with TRP120 in HeLa cells and withE. chaffeensisdense-cored morulae and areas adjacent to morulae in the host cytoplasm. The TR domain of TRP120 interacted only with PCGF5, indicating that distinct TRP120 domains contribute to specific host target interactions and that multiple domains are required to reconstitute TRP120 interactions with other host targets. Three previously defined molecular interactions between TRP47 and host proteins, PCGF5, IGLL1, and CAP1, were also associated with TRP120, demonstrating that molecular cross talk occurs betweenEhrlichiaTRPs and host targets. These findings further support the role of TRPs as effectors that reprogram the host cell.
Getting sports injury prevention on to public health agendas – addressing the shortfalls in current information sources
Authors: Finch Caroline F
Published: August 2011

Public health policy is a successful population-level strategy for injury prevention but it is yet to be widely applied to the sports sector. Such policy is generally coordinated by government health departments concerned with the allocation of limited resources to health service delivery and preventive programs for addressing large community health issues. Prioritisation of sports injury prevention (SIP) requires high-quality evidence about the size of the problem and its public health burden; identification of at-risk vulnerable groups; confirmed effective prevention solutions; evidence of intervention cost-effectiveness; and quantification of both financial and policy implications of inaction. This paper argues that the major reason for a lack of sports injury policy by government departments for health or sport to date is a lack of relevant information available for policy makers to make their decisions. Key information gaps evident in Australia are used to highlight this problem. SIP policy does not yet rank highly because, relative to other health/injury issues, there is very little hard evidence to support: claims for its priority ranking, the existence of solutions that can be implemented and which will work, and potential cost-savings to government agencies. Moreover, policy action needs to be integrated across government portfolios, including sport, health and others. Until sports medicine research generates high-quality population-level information of direct relevance and importance to policy makers, especially intervention costing and implementation cost-benefit estimates, and fully engage in policy-informing partnerships, SIP will continue to be left off the public health agenda.
Atraumatic headache in US emergency departments: recent trends in CT/MRI utilisation and factors associated with severe intracranial pathology
Authors: Gilbert John W , Johnson Kevin M , Larkin Gregory L , Moore Christopher L
Published: August 2011

Objectives

To estimate recent trends in CT/MRI utilisation among patients seeking emergency care for atraumatic headache in the USA and to identify factors associated with a diagnosis of significant intracranial pathology (ICP) in these patients.

Design/setting/participants

Data were obtained from the USA National Hospital Ambulatory Medical Care Survey of emergency department (ED) visits between 1998 and 2008. A cohort of atraumatic headache-related visits were identified using preassigned ‘reason-for-visit’ codes. Sample visits were weighted to provide national estimates.

Results

Between 1998 and 2008 the percentage of patients presenting to the ED with atraumatic headache who underwent imaging increased from 12.5% to 31.0% (p<0.01) while the prevalence of ICP among those visits decreased from 10.1% to 3.5% (p<0.05). The length of stay in the ED was 4.6 h (95% CI 4.4 to 4.8) for patients with headache who received imaging compared with 2.7 (95% CI 2.6 to 2.9) for those who did not. Of 18 factors evaluated in patients with headache, 10 were associated with a significantly increased odds of an ICP diagnosis: age ≥50 years, arrival by ambulance, triage immediacy <15 min, systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥100 mm Hg and disturbance in sensation, vision, speech or motor function including neurological weakness.

Conclusions

The use of CT/MRI for evaluation of atraumatic headache increased dramatically in EDs in the USA between 1998 and 2008. The prevalence of ICP among patients who received CT/MRI declined concurrently, suggesting a role for clinical decision support to guide more judicious use of imaging.