bluuebunny/crossref_metadata_2025 huggingface dataset:
Kodecytes: modifying the surface of red blood cells
Authors: Henry Stephen
Published: February 2020

There are few routine techniques available to modify the antigenic surface of red blood cells (RBC). Primarily, modification techniques involve antigen destruction with enzymes or denaturing chemicals. In contrast, very few antigen additive technologies exist. One antigen additive technology involves the passive insertion of Function‐Spacer‐Lipid constructs (Kode Technology) into the cell membrane. Kode constructs can label any cell (creating kodecytes) with controlled levels of almost any small molecule, including blood group carbohydrate and peptide antigens. They have been used to modify RBCs with a variety of ABH, Lewis and related antigens to study the specificity of monoclonal and polyclonal antibodies. Although kodecytes with carbohydrate epitopes have been extensively evaluated, those with peptide antigens also exist and some can be prepared with cross‐reactive bacterially related peptide antigens, to create IgG‐reactive kodecytes. These so‐called ASKGkodecytes can mimic all serological IgG reactions and are particularly suited for teaching and training. Recently kodecytes have also been used to quantify ABH antibody levels without the requirement for plasma dilution, and in this review the probable mechanism of action is explained. In general, kodecytes allow for the controlled antigen modification of RBCs and have the ability to make almost unlimited quantities of antigen rare or unusual RBCs from common resources. Not only are kodecytes useful research tools to study RBCs in vitro and in vivo but they also have the potential to create standardized diagnostics, quality control systems, advanced serological teaching panels and novel research tools.
Effects of Economic Growth, Trade Openness, and Urbanization on Carbon Dioxide Emissions in Ghana, 1960 to 2014
Authors: Boateng Forster Kwame
Published: February 2020

This paper examines the effects of per capita gross domestic product (GDP), trade openness, and urbanization on the total carbon dioxide emissions of Ghana using time-series annual data from 1960 to 2014. The 55-year period, from 1960 to 2014, covered economic transformation of Ghana from a low-income agrarian country to a lower-middle income country. The analysis used the autoregressive distributed lag method of co-integration. The results showed that per capita GDP, trade openness, and urbanization all significantly influenced both long-run and short-run levels of carbon dioxide emissions in Ghana. However, increased trade openness led to reduced total emissions, while rising per capita GDP and increased urbanization both increased total emissions albeit at different intensity levels.
Dos aproximaciones al cuerpo y el territorio como escenarios de lo político y del mantener la vida
Authors: Cortés Severino Catalina
Published: February 2020

La invitación de este numero a pensar y reflexionar sobre establecer vínculos con diferentes sistemas de vida quiero desarrollarla a partir de una aproximación a ciertas prácticas culturales y acciones cotidianas de cuidado que se configuran desde lo frágil y crean tejidos de solidaridad para habitar el mundo y mantener la vida. Este argumento lo desarrollaré a través de dos etnografías que realicé en años anteriores y que hoy quiero releerlas y repensarlas desde dichas problemáticas. El primer trabajo de campo es el resultado de un proceso de acercamiento audiovisual y etnográfico a dos movimientos sociales: la Comunidad de Paz de San José de Apartado y la Organización de Mujeres Wayuu Munsurat. El segundo trabajo es una aproximación a los procesos que emergieron de las reclamaciones y demandas comunes por parte de las mujeres que lideraron la toma de tierras en los 80 en el barrio San Martin de Porres/Bogotá. Las preguntas que me han acompañado a lo largo de estas investigación tienen que ver con ¿Cómo estas etnografías nos empujan a repensar y cuestionar lo que estamos entendiendo por lo político desde el cuidado y sus posibilidades de reparar y crear vínculos diferentes entre territorios y cuerpos? y ¿Porqué es necesario tener un acercamiento al cuidado y su relacionalidad con mantener el cuerpo y los territorios? Las acciones y coaliciones creadas y generadas por estas mujeres desde la vulnerabilidad tenían como principal objetivo mantenerse y sobrevivir, es decir, reparar los tejidos vitales. Y es precisamente esto lo que me interesa de sobremanera, el indagar en esa articulación entre el cuidado-como la necesidad de mantener la vida- y lo político- como forma de apropiarse del mundo y de reformular la existencia.
Numerical simulation of flow over stationary and rotating golf ball on Cartesian grid
Authors: Go Gwangsoo , Ahn Hyung Taek , Gu Gibeom , Kim Min Ah
Published: February 2020

Wake patterns behind a golf ball with and without back-spin (ωD/2U=0.1 where ω is the angular velocity, D is the diameter of the golf ball, and U is the freestream velocity) were investigated at ReD=1.1×105. To simulate wake regions, the in-house Cartesian mesh-based incompressible flow solver, namely ULSAN3D-Cart, was utilized. Navier-Stokes equations for incompressible flows are solved by the standard projection method with the unconditionally stable semi-Lagrangian scheme. The pressure Poisson equation is solved by the geometric multigrid method. The computational domain was set to [−4D,28D]×[−8D,8D]2. The number of grid cells was set to 4,096×2,0482(≅17.2×109). By using hybrid MPI/OpenMP parallelization, this large-scale flow was simulated on the KISTI Nurion supercomputer. For the flow simulation, total 32,768 cores of Intel Xeon Phi 7250 processors are utilized. For the visualization of the wake field, in-situ parallel processing was conducted on the Nurion machine using 17,408 CPU cores utilizing the open-source visualization software, Paraview. By the comparison of the stationary and the back-spinning golf balls, the differences in the wake patterns are clearly observable. For the stationary case, wake stretches in a symmetric manner with respect to the horizontal center line. On the other hands, for the back-spinning case, the wake bends downward direction, which indicates the generation of the upward lift.
Torrefaction of Agricultural Residues: Effect of Temperature and Residence Time on the Process Products Properties
Authors: Jagodzińska Katarzyna , Czerep Michał , Kudlek Edyta , Wnukowski Mateusz , Pronobis Marek , Yang Weihong
Published: February 2020

To date, few studies on the potential utilization of agricultural residue torrefaction products have been performed. Thus, torrefaction product characterization aimed at its potential utilization was performed. Wheat–barley straw pellets and wheat–rye chaff were used in the study. The impact of the torrefaction temperature (280–320 °C) on polycyclic aromatic hydrocarbons (PAHs) content in the biochar and noncondensable gas (noncondensables) composition was investigated. The impact of the torrefaction time (30–75 min) on the composition of the condensable volatiles (condensables) and their toxicity were also studied. The torrefaction process was performed in a batch-scale reactor. The PAH contents were measured using high-performance liquid chromatography (HPLC), and the noncondensables composition was measured online using a gas analyzer and then gas chromatograph with flame ionization detector (GC-FID). The condensables composition and main compound quantification were determined and quantified using gas chromatography–mass spectrometry (GC/MS). Three toxicity tests, for saltwater bacteria (Microtox® bioassay), freshwater crustaceans (Daphtoxkit F magna®), and vascular plants (Lemna sp. growth inhibition test), were performed for the condensables. The PAHs content in the biochar, regardless of the torrefaction temperature, allows them to be used in agriculture. The produced torgas shall be co-combusted with full-caloric fuel because of its low calorific value. Toxic compounds (furans and phenols) were identified in the condensable samples, and regardless of the processing time, the condensables were classified as highly toxic. Therefore, they can be used either as pesticides or as an anaerobic digestion substrate after their detoxification.
High temperature microstructure evolution and thermal shock resistance of plasma sprayed Al2O3-ZrO2-CeO2 coatings
Authors: Zhao Ce-ce , Sun Xiao-wen , Wang Xing-yu , Yang Yong , Zhang Chen , Wang Yan-wei , Ma Yu-duo , Cui Yu-hang , Wang Lei , Dong Yan-chun , Wang You
Published: February 2020

Al2O3-ZrO2-CeO2 composite coatings were prepared by plasma spraying Al2O3-ZrO2 composite powders with and without CeO2 addition. The microstructure and properties of the Al2O3-ZrO2-CeO2 coatings at high temperature and thermal shock resistance were investigated. The results show that an amorphous phase was formed in the plasma sprayed Al2O3-ZrO2 and Al2O3-ZrO2-CeO2 coatings. The Al2O3-ZrO2 coating consisted mainly of t-ZrO2, α-Al2O3, and γ-Al2O3. The Al2O3-ZrO2-CeO2 coating consisted mainly of t-ZrO2, α-Al2O3, γ-Al2O3, and CeO2. The Al2O3-ZrO2-CeO2 coating was more uniform and denser than the Al2O3-ZrO2 coating. The results after heat treatment showed that the two coatings were stable at 800 °C. With the increase of temperature, the coatings underwent phase transformation at high temperature (1000 and 1200 °C). At 1000 °C, the amorphous phase was obviously reduced, and the amorphous phase was crystallized to form nanocrystals. When the heat treatment temperature was raised to 1200 °C, the intensity of the diffraction peaks of t-ZrO2 and α-Al2O3 increased, the amorphous phase was completely crystallized, and γ-Al2O3 was transformed into α-Al2O3. The porosity of the two coatings decreased and the hardness increased after heat treatment. The thermal shock resistance of the coatings on the TC4 titanium alloy substrate was better than that on the Q235 steel substrate. The thermal shock resistance of the Al2O3-ZrO2-CeO2 coating was better than that of the Al2O3-ZrO2 coating.
Identifying cues for tone-in-noise detection using decision variable correlation in the budgerigar (Melopsittacus undulatus)
Authors: Henry Kenneth S. , Amburgey Kassidy N. , Abrams Kristina S. , Carney Laurel H.
Published: February 2020

Previous studies evaluated cues for masked tone detection using reproducible noise waveforms. Human results founded on this approach suggest that tone detection is based on combined energy and envelope (ENV) cues, but detection cues in nonhuman species are less clear. Decision variable correlation (DVC) was used to evaluate tone-in-noise detection cues in the budgerigar, an avian species with human-like behavioral sensitivity to many complex sounds. DVC quantifies a model's ability to predict trial-by-trial variance in behavioral responses. Budgerigars were behaviorally conditioned to detect 500-Hz tones in wideband (WB; 100–3000 Hz) and narrowband (NB; 452–552 Hz) noise. Behavioral responses were obtained using a single-interval, two-alternative discrimination task and two-down, one-up adaptive tracking procedures. Tone-detection thresholds in WB noise were higher than human thresholds, putatively due to broader peripheral frequency tuning, whereas NB thresholds were within ∼1 dB of human results. Budgerigar average hit and false-alarm rates across noise waveforms were consistent, highly correlated across subjects, and correlated to human results. Trial-by-trial behavioral results in NB noise were best explained by a model combining energy and ENV cues. In contrast, WB results were better predicted by ENV-based or multiple-channel energy detector models. These results suggest that budgerigars and humans use similar cues for tone-in-noise detection.
Diminished Plantar Cutaneous Sensation in Patients With Chronic Ankle Instability: A Critically Appraised Topic
Authors: Jones Christina , Kosik Kyle B. , Gribble Phillip , Hoch Matthew C.
Published: February 2020

Clinical Question: Do individuals with chronic ankle instability have diminished plantar cutaneous sensation compared to ankle sprain copers or individuals with no history of ankle sprain? Clinical Bottom Line: Patients with chronic ankle instability have diminished plantar cutaneous sensation compared to healthy controls with no history of ankle sprain and ankle sprain copers.
Neuromuscular Control Training Does Not Improve Gait Biomechanics in Those With Chronic Ankle Instability: A Critically Appraised Topic
Authors: Migel Kimmery , Wikstrom Erik
Published: February 2020

Introduction/Clinical Scenario: Ankle sprains are highly common within the population and can lead to chronic ankle instability (CAI). Individuals with CAI have both functional and mechanical impairments, which are thought to contribute to maladaptive gait biomechanics. Neuromuscular control and balance training are frequently incorporated into rehabilitation programs, however the effect of balance training on gait biomechanics remains unknown. Focused Clinical Question: Does balance or neuromuscular training improve gait biomechanics in individuals with CAI? Summary of Key Findings: Three studies assessed 4–6 weeks of progressive neuromuscular control training and found no improvements in gait biomechanics. One study found a worsening of eversion position at midstance upon program completion. However, when training was augmented with destabilizing shoes, improvements in dorsiflexion were noted. Clinical Bottom Line: Cumulative findings suggest that neuromuscular control training does not improve gait biomechanics in those with CAI. However, augmentation of programs may be beneficial. Strength of Recommendation: There is high-quality evidence(Grade B) that balance training does not alter gait biomechanics in patients with CAI.
Field-Derived Power–Duration Variables to Predict Cycling Time-Trial Performance
Authors: Nimmerichter Alfred , Prinz Bernhard , Gumpenberger Matthias , Heider Sebastian , Wirth Klaus
Published: February 2020

Purpose: To evaluate the predictive validity of critical power (CP) and the work above CP (W′) on cycling performance (mean power during a 20-min time trial; TT20). Methods: On 3 separate days, 10 male cyclists completed a TT20 and 3 CP and W′ prediction trials of 1, 4, and 10 min and 2, 7, and 12 min in field conditions. CP and W′ were modeled across combinations of these prediction trials with the hyperbolic, linear work/time, and linear power inverse-time (INV) models. The agreement and the uncertainty between the predicted and actual TT20 were assessed with 95% limits of agreement and a probabilistic approach, respectively. Results: Differences between the predicted and actual TT20 were “trivial” for most of the models if the 1-min trial was not included. Including the 1-min trial in the INV and linear work/time models “possibly” to “very likely” overestimated TT20. The INV model provided the smallest total error (ie, best individual fit; 6%) for all cyclists (305 [33] W; 19.6 [3.6] kJ). TT20 predicted from the best individual fit-derived CP, and W′ was strongly correlated with actual TT20 (317 [33] W; r = .975; P < .001). The bias and 95% limits of agreement were 4 (7) W (−11 to 19 W). Conclusions: Field-derived CP and W′ accurately predicted cycling performance in the field. The INV model was most accurate to predict TT20 (1.3% [2.4%]). Adding a 1-min-prediction trial resulted in large total errors, so it should not be included in the models.
Validation of Aztreonam-Avibactam Susceptibility Testing Using Digitally Dispensed Custom Panels
Authors: Ransom Eric , Bhatnagar Amelia , Patel Jean B. , Machado Maria-Jose , Boyd Sandra , Reese Natashia , Lutgring Joseph D. , Lonsway David , Anderson Karen , Brown Allison C. , Elkins Christopher A. , Rasheed J. Kamile , Karlsson Maria
Published: February 2020

Aztreonam-avibactam is a combination antimicrobial agent with activity against carbapenemase-producing
Enterobacteriaceae
(CPE) with metallo-β-lactamases (MβLs). Although aztreonam-avibactam is not yet approved by the U.S. Food and Drug Administration (FDA), clinicians can administer this combination by using two FDA-approved drugs: aztreonam and ceftazidime-avibactam. This combination of drugs is recommended by multiple experts for treatment of serious infections caused by MβL-producing CPE.
Molecular Determinants of Substrate Selectivity of a Pneumococcal Rgg-Regulated Peptidase-Containing ABC Transporter
Authors: Wang Charles Y. , Medlin Jennifer S. , Nguyen Don R. , Disbennett W. Miguel , Dawid Suzanne
Published: February 2020

The export of peptides from the cell is a fundamental process carried out by all bacteria. One method of bacterial peptide export relies on a family of transporters called peptidase-containing ABC transporters (PCATs). PCATs export so-called GG peptides which carry out diverse functions, including cell-to-cell communication and interbacterial competition. In this work, we describe a PCAT-encoding genetic locus,
rtg
, in the pathogen
Streptococcus pneumoniae
(pneumococcus). The
rtg
locus is linked to increased competitive fitness advantage in a mouse model of nasopharyngeal colonization. We also describe how the
rtg
PCAT preferentially secretes a set of coregulated GG peptides but not GG peptides secreted by other pneumococcal PCATs. These findings illuminate a relatively understudied part of PCAT biology: how these transporters discriminate between different subsets of GG peptides. Ultimately, expanding our knowledge of PCATs will advance our understanding of the many microbial processes dependent on these transporters.
Identification of Fis1 Interactors in Toxoplasma gondii Reveals a Novel Protein Required for Peripheral Distribution of the Mitochondrion
Authors: Jacobs Kylie , Charvat Robert , Arrizabalaga Gustavo
Published: February 2020

Toxoplasma gondiiis an opportunistic pathogen that can cause devastating tissue damage in the immunocompromised and congenitally infected. Current therapies are not effective against all life stages of the parasite, and many cause toxic effects. The single mitochondrion of this parasite is a validated drug target, and it changes its shape throughout its life cycle. When the parasite is inside a cell, the mitochondrion adopts a lasso shape that lies in close proximity to the pellicle. The functional significance of this morphology is not understood and the proteins involved are currently not known. We have identified a protein that is required for proper mitochondrial positioning at the periphery and that likely plays a role in tethering this organelle. Loss of this protein results in dramatic changes to the mitochondrial morphology and significant parasite division and propagation defects. Our results give important insight into the molecular mechanisms regulating mitochondrial morphology.
EspM Is a Conserved Transcription Factor That Regulates Gene Expression in Response to the ESX-1 System
Authors: Sanchez Kevin G. , Ferrell Micah J. , Chirakos Alexandra E. , Nicholson Kathleen R. , Abramovitch Robert B. , Champion Matthew M. , Champion Patricia A.
Published: February 2020

Mycobacterial pathogens use the ESX-1 system to transport protein substrates that mediate essential interactions with the host during infection. We previously demonstrated that in addition to transporting proteins, the ESX-1 secretion system regulates gene expression. Here, we identify a conserved transcription factor that regulates gene expression in response to the ESX-1 system. We demonstrate that this transcription factor is functionally conserved in
M. marinum
, a pathogen of ectothermic animals;
M. tuberculosis
, the human-pathogenic species that causes tuberculosis; and
M. smegmatis
, a nonpathogenic mycobacterial species. These findings provide the first mechanistic insight into how the ESX-1 system elicits a transcriptional response, a function of this protein transport system that was previously unknown.
Novel Cassette Assay To Quantify the Outer Membrane Permeability of Five β-Lactams Simultaneously in Carbapenem-ResistantKlebsiella pneumoniaeandEnterobacter cloacae
Authors: Kim Tae Hwan , Tao Xun , Moya Bartolome , Jiao Yuanyuan , Basso Kari B. , Zhou Jieqiang , Lang Yinzhi , Sutaria Dhruvitkumar S. , Zavascki Alexandre P. , Barth Afonso L. , Reeve Stephanie M. , Schweizer Herbert P. , Deveson Lucas Deanna , Boyce John D. , Bonomo Robert A. , Lee Richard E. , Shin Beom Soo , Louie Arnold , Drusano George L. , Bulitta Jürgen B.
Published: February 2020

Antimicrobial resistance is causing a global human health crisis and is affecting all antibiotic classes. While β-lactams have been commonly used against susceptible isolates ofKlebsiella pneumoniaeandEnterobacter cloacae, carbapenem-resistant isolates are spreading worldwide and pose substantial clinical challenges. Rapid penetration of β-lactams leads to high drug concentrations at their periplasmic target sites, allowing β-lactams to more completely inactivate their target receptors. Despite this, there are limited tangible data on the permeability of β-lactams through the outer membranes of many Gram-negative pathogens. This study presents a novel, cassette assay, which can simultaneously characterize the permeability of five β-lactams in multidrug-resistant clinical isolates. We show that carbapenems, and especially imipenem, penetrate the outer membrane ofK. pneumoniaeandE. cloacaesubstantially faster than noncarbapenem β-lactams. The ability to efficiently characterize the outer membrane permeability is critical to optimize the use of β-lactams and combat carbapenem-resistant isolates.
Plasmids Shaped the Recent Emergence of the Major Nosocomial Pathogen Enterococcus faecium
Authors: Arredondo-Alonso S. , Top J. , McNally A. , Puranen S. , Pesonen M. , Pensar J. , Marttinen P. , Braat J. C. , Rogers M. R. C. , van Schaik W. , Kaski S. , Willems R. J. L. , Corander J. , Schürch A. C.
Published: February 2020

Enterococcus faeciumis one of the most frequent nosocomial pathogens of hospital-acquired infections.E. faeciumhas gained resistance against most commonly available antibiotics, most notably, against ampicillin, gentamicin, and vancomycin, which renders infections difficult to treat. Many antibiotic resistance traits, in particular, vancomycin resistance, can be encoded in autonomous and extrachromosomal elements called plasmids. These sequences can be disseminated to other isolates by horizontal gene transfer and confer novel mechanisms to source specificity. In our study, we elucidated the total plasmid content, referred to as the plasmidome, of 1,644E. faeciumisolates by using short- and long-read whole-genome technologies with the combination of a machine-learning classifier. This was fundamental to investigate the full collection of plasmid sequences present in our collection (pan-plasmidome) and to observe the potential transfer of plasmid sequences betweenE. faeciumhosts. We observed thatE. faeciumisolates from hospitalized patients carried a larger number of plasmid sequences compared to that from other sources, and they elucidated different configurations of plasmidome populations in the hospital environment. We assessed the contribution of different genomic components and observed that plasmid sequences have the highest contribution to source specificity. Our study suggests thatE. faeciumplasmids are regulated by complex ecological constraints rather than physical interaction between hosts.
Genome Dynamics of Vibrio cholerae Isolates Linked to Seasonal Outbreaks of Cholera in Dhaka, Bangladesh
Authors: Baddam Ramani , Sarker Nishat , Ahmed Dilruba , Mazumder Razib , Abdullah Ahmed , Morshed Rayhan , Hussain Arif , Begum Suraiya , Shahrin Lubaba , Khan Azharul Islam , Islam Md Sirajul , Ahmed Tahmeed , Alam Munirul , Clemens John D. , Ahmed Niyaz
Published: February 2020

The switching of serotype from Ogawa to Inaba and back to Ogawa has been observed temporally in
Vibrio cholerae
O1, which is responsible for endemic cholera in Bangladesh. The serospecificity is key for effective intervention and for preventing cholera, a deadly disease that continues to cause significant morbidity and mortality worldwide. In the present study, WGS of
V. cholerae
allowed us to better understand the factors associated with the serotype switching events observed during 2015 to 2018. Genomic data analysis of strains isolated during this interval highlighted variations in the genes
ctxB
,
tcpA
, and
rtxA
and also identified significant differences in the genetic content of the mobilome, which included key elements such as SXT ICE, VSP-II, and PLE. Our results indicate that selective forces such as antibiotic resistance and phage resistance might contribute to the clonal expansion and predominance of a particular
V. cholerae
serotype responsible for an outbreak.
Gliotoxin, a Known Virulence Factor in the Major Human Pathogen Aspergillus fumigatus, Is Also Biosynthesized by Its Nonpathogenic Relative
Aspergillus fischeri
Authors: Knowles Sonja L. , Mead Matthew E. , Silva Lilian Pereira , Raja Huzefa A. , Steenwyk Jacob L. , Goldman Gustavo H. , Oberlies Nicholas H. , Rokas Antonis
Published: February 2020

Aspergillus fumigatus
is a major opportunistic fungal pathogen of humans, but most of its close relatives are nonpathogenic. Why is that so? This important, yet largely unanswered, question can be addressed by examining how
A. fumigatus
and its close nonpathogenic relatives are similar or different with respect to virulence-associated traits. We investigated whether
Aspergillus fischeri
, a nonpathogenic close relative of
A. fumigatus
, can produce gliotoxin, a mycotoxin known to contribute to
A. fumigatus
virulence. We discovered that the nonpathogenic
A. fischeri
produces gliotoxin under the same conditions as those of the major pathogen
A. fumigatus
. However, we also discovered that, in contrast to what has previously been observed in
A. fumigatus
, the loss of secondary metabolite production in
A. fischeri
does not alter its virulence. Our results are consistent with the “cards of virulence” model of opportunistic fungal disease, in which the ability to cause disease stems from the combination (“hand”) of virulence factors (“cards”) but not from individual factors
per se
.
Dynamics of the Physicochemical Characteristics, Microbiota, and Metabolic Functions of Soybean Meal and Corn Mixed Substrates during Two-Stage Solid-State Fermentation
Authors: Wang Cheng , Shi Changyou , Su Weifa , Jin Mingliang , Xu Bocheng , Hao Lihong , Zhang Yu , Lu Zeqing , Wang Fengqin , Wang Yizhen , Du Huahua
Published: February 2020

Solid-state fermentation (SSF) plays pivotal roles not only in human food but also farm animal diets. Soybean meal (SBM) and corn account for approximately 70% of the global feed consumption. However, the nutritional value of conventional SBM and corn mixed substrates (MS) is limited by antinutritional factors, causing substantial economic loss in livestock production. Although emerging studies have reported that SSF can improve the nutritional value of SBM-based substrates, the dynamic changes in the physicochemical features, microbiota, and metabolic functions of MS during SSF remain poorly understood, limiting further investigation. To provide insights into the dynamics of the physicochemical characteristics and the complex microbiome during the two-stage SSF of MS, multiple physicochemical analyses combined with high-throughput sequencing were applied here. These novel insights shed light on the complex changes that occur in the nutrition and microbiome during two-stage SSF of MS and are of great value for industrial feed-based practices and metabolomic research on SSF ecosystems.
A Gene Cluster That Encodes Histone Deacetylase Inhibitors Contributes to Bacterial Persistence and Antibiotic Tolerance in Burkholderia thailandensis
Authors: Micheva-Viteva Sofiya N. , Shakya Migun , Adikari Samantha H. , Gleasner Cheryl D. , Velappan Nileena , Mourant Judith R. , Chain Patrick S. G. , Hong-Geller Elizabeth
Published: February 2020

The discovery of antibiotics such as penicillin and streptomycin marked a historic milestone in the 1940s and heralded a new era of antimicrobial therapy as the modern standard for medical treatment. Yet, even in those early days of discovery, it was noted that a small subset of cells (∼1 in 10
5
) survived antibiotic treatment and continued to persist, leading to recurrence of chronic infection. These persisters are phenotypic variants that have modified their physiology to survive environmental stress. In this study, we have performed three transcriptomic screens to identify persistence genes that are common between three different stressor conditions. In particular, we identified genes that function in the synthesis of secondary metabolites, small molecules, and complex lipids, which are likely required to maintain the persistence state. Targeting universal persistence genes can lead to the development of clinically relevant antipersistence therapeutics for infectious disease management.
Human Skin, Oral, and Gut Microbiomes Predict Chronological Age
Authors: Huang Shi , Haiminen Niina , Carrieri Anna-Paola , Hu Rebecca , Jiang Lingjing , Parida Laxmi , Russell Baylee , Allaband Celeste , Zarrinpar Amir , Vázquez-Baeza Yoshiki , Belda-Ferre Pedro , Zhou Hongwei , Kim Ho-Cheol , Swafford Austin D. , Knight Rob , Xu Zhenjiang Zech
Published: February 2020

Considerable evidence suggests that the gut microbiome changes with age or even accelerates aging in adults. Whether the age-related changes in the gut microbiome are more or less prominent than those for other body sites and whether predictions can be made about a person’s age from a microbiome sample remain unknown. We therefore combined several large studies from different countries to determine which body site’s microbiome could most accurately predict age. We found that the skin was the best, on average yielding predictions within 4 years of chronological age. This study sets the stage for future research on the role of the microbiome in accelerating or decelerating the aging process and in the susceptibility for age-related diseases.
The Remarkable Dual-Level Diversity of Prokaryotic Flagellins
Authors: Hu Dalong , Reeves Peter R.
Published: February 2020

Bacterial and archaeal flagellins are remarkable in having a shared region with variation in housekeeping proteins and a region with extreme diversity, perhaps greater than for any other protein. Analysis of the 113,285 available full-gene sequences of flagellin genes from published bacterial and archaeal sequences revealed the nature and enormous extent of flagellin diversity. There were 35,898 unique amino acid sequences that were resolved into 187 clusters. Analysis of the
Escherichia coli
and
Salmonella enterica
flagellins revealed that the variation occurs at two levels. The first is the division of the variable regions into sequence forms that are so divergent that there is no meaningful alignment even within species, and these corresponded to the
E. coli
or
S. enterica
H-antigen groups. The second level is variation within these groups, which is extensive in both species. Shared sequence would allow PCR of the variable regions and thus strain-level analysis of microbiome DNA.
Successful pregnancy in a liver transplant patient of Budd-Chiari syndrome
Authors: Sohail Rubina , Bashir Alia , Safdar Zara , Noreen Asifa
Published: February 2020

In recent years, the number of patients undergoing liver transplant has increased. Successful transplant has resulted in better quality of life and improved fertility in younger women. This is a case study a 31-year-old woman, who had history of Budd-Chiari syndrome and underwent liver transplantation in 2014 with uneventful postoperative course. She was clinically stable on tablet tacrolimus and coumarin with no episode of allograft rejection since transplantation. The patient conceived spontaneously, after 4 years of transplant and during pregnancy, she was managed by multidisciplinary team. During the initial period, the graft and pregnancy continued without complications. However, at 33 weeks, the patient presented with sluggish fetal movements, amniotic fluid index of 3.4 and SD ratio of 3.31 for which she underwent caesarean section. She delivered a healthy female baby of 1.4 kg. This case study concludes that vigilant monitoring of fetal growth is pivotal for optimal fetal outcome.
First reported case of lead-related infective endocarditis secondary to Capnocytophaga canimorsus: ‘Dog Scratch’ endocarditis
Authors: Squire Gareth , Hetherington Simon
Published: February 2020

A 76-year-old woman presented with a 6-week history of malaise, night sweats and recurrent fever. She had a background of dilated cardiomyopathy for which she had a cardiac resynchronisation device in situ. She had several hospital admissions across this time with differing diagnoses offered. She received multiple courses of antibiotics with short-term symptom resolution. Blood cultures grew Gram-negative rods and samples were sent to a specialist centre for subtype analysis. A transthoracic echocardiogram revealed thickening of the distal right ventricular lead. A transoesophageal echocardiogram demonstrated a clearer vegetation on this lead. It transpired that she had been scratched by her dog a fortnight before symptom onset. The causal bacterium was reported asCapnocytophaga canimorsus, a bacterium that exists almost exclusively in the saliva and claws of dogs and cats. She received an extended course of antibiotics with eventual removal of the infected device.
The influence of distance and quality on utilisation of birthing services at health facilities in Eastern Region, Ghana
Authors: Dotse-Gborgbortsi Winfred , Dwomoh Duah , Alegana Victor , Hill Allan , Tatem Andrew J , Wright Jim
Published: February 2020

Objectives

Skilled birth attendance is the single most important intervention to reduce maternal mortality. However, studies have not used routinely collected health service birth data at named health facilities to understand the influence of distance and quality of care on childbirth service utilisation. Thus, this paper aims to quantify the influence of distance and quality of healthcare on utilisation of birthing services using routine health data in Eastern Region, Ghana.

Methods

We used a spatial interaction model (a model that predicts movement from one place to another) drawing on routine birth data, emergency obstetric care surveys, gridded estimates of number of pregnancies and health facility location. We compared travel distances by sociodemographic characteristics and mapped movement patterns.

Results

A kilometre increase in distance significantly reduced the prevalence rate of the number of women giving birth in health facilities by 6.7%. Although quality care increased the number of women giving birth in health facilities, its association was insignificant. Women travelled further than expected to give birth at facilities, on average journeying 4.7 km beyond the nearest facility with a recorded birth. Women in rural areas travelled 4 km more than urban women to reach a hospital. We also observed that 56% of women bypassed the nearest hospital to their community.

Conclusion

This analysis provides substantial opportunities for health planners and managers to understand further patterns of skilled birth service utilisation, and demonstrates the value of routine health data. Also, it provides evidence-based information for improving maternal health service provision by targeting specific communities and health facilities.
Supporting workforce practice change: protocol for a pilot study of a motivational interviewing virtual client software tool for health professionals
Authors: Oster Candice , Schoo Adrian , Litt John , Morello Andrea , Leibbrandt Richard , Antonello Christopher , Powers David , Lange Belinda , Maeder Anthony , Lawn Sharon
Published: February 2020

Introduction

Motivating behavioural change during client consultations is of crucial importance across all health professions to address the growing burden of chronic conditions. Yet health professionals often lack the skills and confidence to use evidence-based counselling interventions to support clients’ behavioural change and mobilise clients’ resources and self-efficacy for change to address their long-term needs.

Aims

This pre–post pilot study will develop a motivational interviewing (MI) virtual client training tool for health professionals and test the effectiveness of the educational content and usability of the virtual client interaction.

Methods and analysis

Postgraduate students across a range of health disciplines will be recruited. Data assessing attitudes towards preventive healthcare will be collected using a modified version of the Preventive Medicine Attitudes and Activities Questionnaire. Conversations with the virtual client will be analysed using the Motivational Interviewing Treatment Integrity code to assess changes in MI skills. The System Usability Scale will be used to assess the usability of the virtual client training tool.

Ethics and dissemination

This protocol was approved by the Flinders University Social and Behavioural Research Ethics Committee in May 2019. The results of the pilot study will inform the development of an avatar-based mobile application consisting of MI teaching and interactions with a generic virtual client that can be easily adapted to multiple scenarios.
Exploring the association of the discharge medicines review with patient hospital readmissions through national routine data linkage in Wales: a retrospective cohort study
Authors: Mantzourani Efi , Nazar Hamde , Phibben Catherine , Pang Jessica , John Gareth , Evans Andrew , Thomas Helen , Way Cheryl , Hodson Karen
Published: February 2020

Objective

To evaluate the association of the discharge medicines review (DMR) community pharmacy service with hospital readmissions through linking National Health Service data sets.

Design

Retrospective cohort study.

Setting

All hospitals and 703 community pharmacies across Wales.

Participants

Inpatients meeting the referral criteria for a community pharmacy DMR.

Interventions

Information related to the patient’s medication and hospital stay is provided to the community pharmacists on discharge from hospital, who undertake a two-part service involving medicines reconciliation and a medicine use review. To investigate the association of this DMR service with hospital readmission, a data linking process was undertaken across six national databases.

Primary outcome

Rate of hospital readmission within 90 days for patients with and without a DMR part 1 started.

Secondary outcome

Strength of association of age decile, sex, deprivation decile, diagnostic grouping and DMR type (started or not started) with reduction in readmission within 90 days.

Results

1923 patients were referred for a DMR over a 13-month period (February 2017–April 2018). Provision of DMR was found to be the most significant attributing factor to reducing likelihood of 90-day readmission using χ2 testing and classification methods. Cox regression survival analysis demonstrated that those receiving the intervention had a lower hospital readmission rate at 40 days (p<0.000, HR: 0.59739, CI 0.5043 to 0.7076).

Conclusions

DMR after a hospital discharge is associated with a reduction in risk of hospital readmission within 40 days. Linking data across disparate national data records is feasible but requires a complex processual architecture. There is a significant value for integrated informatics to improve continuity and coherency of care, and also to facilitate service optimisation, evaluation and evidenced-based practice.
Weight perceptions in older adults: findings from the English Longitudinal Study of Ageing
Authors: Jackson Sarah E , Smith Lee , Steptoe Andrew
Published: February 2020

Objectives

To explore weight perceptions in a large, nationally representative sample of older adults, and the extent to which they differ according to age and perceived health status.

Setting

England.

Participants

5240 men and women (≥50 years old) participating in the English Longitudinal Study of Ageing (2016/2017).

Main outcome measures

Weight perception was self-reported as too heavy, too light or about right.

Results

The majority of older adults endorsed a weight perception that matched their (objectively measured) body mass index (BMI) classification. However, 1 in 10 (9.9%) older adults classified by BMI as normal weight (18.5–24.9 kg/m2) felt too light, with women at the upper end of the older age spectrum (OR=1.04, 95% CI 1.01 to 1.09), and men (OR=3.70, 95% CI 1.88 to 7.28) and women (OR=2.61, 95% CI 1.27 to 5.35) in poorer health more likely to do so. Almost half (44.8%) of older adults classified as overweight (25–29.9 kg/m2) and 1 in 10 (10.3%) classified as obese (≥30 kg/m2) felt about the right weight, with this observed more frequently among men and women at the upper end of the older age spectrum (OR range 1.04–1.06).

Conclusion

Older adults’ perceptions of their own weight generally correspond with traditional BMI cut-offs for normal weight, overweight and obesity. However, a substantial minority ‘underestimate’ their weight status, with those at the upper end of the age spectrum and those in poorer health more likely to do so.
Comparison of autologous osteoperiosteal cylinder and osteochondral graft transplantation in the treatment of large cystic osteochondral lesions of the talus (OLTs): a protocol for a non-inferiority randomised controlled trial
Authors: Deng En , Shi Weili , Jiang Yanfang , Guo Qinwei
Published: February 2020

Introduction

Large cystic osteochondral lesions of the talus (OLTs) have been shown to have inferior clinical outcomes after reparative techniques such as bone marrow stimulation. Autologous osteochondral transplantation has been viewed as an alternative choice for treating these lesions, but donor-site morbidity has limited its application. Excellent clinical outcomes have been shown in repairing these types of lesions with autologous osteoperiosteal grafts, and these outcomes are achieved at a low cost and without donor-site morbidity in the normal knee joint. This will be the first randomised controlled trial to compare the two surgical techniques, and recommendations for the treatment of patients with large cystic OLTs will be provided.

Methods and analysis

A non-inferiority randomised controlled trial will be conducted. A total of 70 participants with clinically diagnosed large cystic OLTs will be randomly allocated to either the experimental group or the control group at a ratio of 1:1. The experimental group will be treated with autologous osteoperiosteal cylinder graft transplantation, while the control group will be treated with autologous osteochondral transplantation. The primary outcome measure will be the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score and the Short Form 12 (SF-12) questionnaire. Secondary outcome measures will include the secondary arthroscopy International Cartilage Repair Society score, the Magnetic Resonance Observation of Cartilage Repair Tissue score, the Tegner activity level score, the visual analogue scale, routine X-rays, CT and complications. These parameters will be evaluated preoperatively, as well as at 3, 6, 12, 24, 36 and 60 months postoperatively. In this trial, we hypothesised that both procedures offer good results for the treatment of patients with large cystic OLTs, and occurrence of donor-site morbidity in autologous osteoperiosteal cylinder graft transplantation group is less than that in autologous osteochondral transplantation group.

Ethics and dissemination

The current study was approved by the board of research ethics of Peking University Third Hospital Medical Science Research Ethics Committee. The results of this study will be presented at national and international conferences and published in peer-reviewed journals.

Trial registration number

NCT03347877.
Can network science reveal structure in a complex healthcare system? A network analysis using data from emergency surgical services
Authors: Kohler Katharina , Ercole Ari
Published: February 2020

Introduction

Hospitals are complex systems and optimising their function is critical to the provision of high quality, cost effective healthcare. Metrics of performance have to date focused on the performance of individual elements rather than the whole system. Manipulation of individual elements of a complex system without an integrative understanding of its function is undesirable and may lead to counterintuitive outcomes and a holistic metric of hospital function might help design more efficient services.

Objectives

We aimed to use network analysis to characterise the structure of the system of perioperative care for emergency surgical admissions in our tertiary care hospital.

Design

We constructed a weighted directional network representation of the emergency surgical services using patient location data from electronic health records.

Setting

A single-centre tertiary care hospital in the UK.

Participants

We selected data from the retrospective electronic health record data of all unplanned admissions with a surgical intervention during their stay during a 3.5-year period, which resulted in a set of 16 500 individual admissions.

Methods

We then constructed and analysed the structure of this network using established methods from network science such as degree distribution, betweenness centrality and small-world characteristics.

Results

The analysis showed the service to be a complex system with scale-free, small-world network properties. We also identified such potential hubs and bottlenecks in the system.

Conclusions

Our holistic, system-wide description of a hospital service may provide tools to inform service improvement initiatives and gives us insights into the architecture of a complex system of care. The implications for the structure and resilience of the service is that while being robust in general, the system may be vulnerable to outages at specific key nodes.