bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel Group of Leaderless Multipeptide Bacteriocins from Gram-Positive Bacteria
Authors: Ovchinnikov Kirill V. , Chi Hai , Mehmeti Ibrahim , Holo Helge , Nes Ingolf F. , Diep Dzung B.
Published: June 2016

From raw milk we found 10
Lactococcus garvieae
isolates that produce a new broad-spectrum bacteriocin. Though the isolates were obtained from different farms, they turned out to possess identical inhibitory spectra, fermentation profiles of sugars, and repetitive sequence-based PCR (rep-PCR) DNA patterns, indicating that they produce the same bacteriocin. One of the isolates (
L. garvieae
KS1546) was chosen for further assessment. Purification and peptide sequencing combined with genome sequencing revealed that the antimicrobial activity was due to a bacteriocin unit composed of three similar peptides of 32 to 34 amino acids. The three peptides are produced without leader sequences, and their genes are located next to each other in an operon-like structure, adjacent to the genes normally involved in bacteriocin transport (ABC transporter) and self-immunity. The bacteriocin, termed garvicin KS (GarKS), showed sequence homology to four multipeptide bacteriocins in databases: the known staphylococcal aureocin A70, consisting of four peptides, and three unannotated putative multipeptide bacteriocins produced by
Bacillus cereus
. All these multipeptide bacteriocin loci show conserved genetic organization, including being located adjacent to conserved genetic determinants (Cro/cI and integrase) which are normally associated with mobile genetic elements or genome rearrangements. The antimicrobial activity of all multipeptide bacteriocins was confirmed with synthetic peptides, and all were shown to have broad antimicrobial spectra, with GarKS being the most active of them. The inhibitory spectrum of GarKS includes important pathogens belonging to the genera
Staphylococcus
,
Bacillus
,
Listeria
, and
Enterococcus
.

IMPORTANCE
Bacterial resistance to antibiotics is a very serious global problem. There are no new antibiotics with novel antimicrobial mechanisms in clinical trials. Bacteriocins use antimicrobial mechanisms different from those of antibiotics and can kill antibiotic-resistant bacteria, but the number of bacteriocins with very broad antimicrobial spectra is very small. In this study, we have found and purified a novel three-peptide bacteriocin, garvicin KS. By homology search, we were able to find one known and three novel sequence-related bacteriocins consisting of 3 or 4 peptides. None of the peptides has modified amino acids in its sequence. Thus, the activity of all bacteriocins was confirmed with chemically synthesized peptides. All of them, especially garvicin KS, have very broad antibacterial spectra, thus representing a great potential in antimicrobial applications in the food industry and medicine.
Nonnodulating Bradyrhizobium spp. Modulate the Benefits of Legume-Rhizobium Mutualism
Authors: Gano-Cohen Kelsey A. , Stokes Peter J. , Blanton Mia A. , Wendlandt Camille E. , Hollowell Amanda C. , Regus John U. , Kim Deborah , Patel Seema , Pahua Victor J. , Sachs Joel L.
Published: June 2016

Rhizobia are best known for nodulating legume roots and fixing atmospheric nitrogen for the host in exchange for photosynthates. However, the majority of the diverse strains of rhizobia do not form nodules on legumes, often because they lack key loci that are needed to induce nodulation. Nonnodulating rhizobia are robust heterotrophs that can persist in bulk soil, thrive in the rhizosphere, or colonize roots as endophytes, but their role in the legume-rhizobium mutualism remains unclear. Here, we investigated the effects of nonnodulating strains on the native
Acmispon-Bradyrhizobium
mutualism. To examine the effects on both host performance and symbiont fitness, we performed clonal inoculations of diverse nonnodulating
Bradyrhizobium
strains on
Acmispon strigosus
hosts and also coinoculated hosts with mixtures of sympatric nodulating and nonnodulating strains. In isolation, nonnodulating
Bradyrhizobium
strains did not affect plant performance. In most cases, coinoculation of nodulating and nonnodulating strains reduced host performance compared to that of hosts inoculated with only a symbiotic strain. However, coinoculation increased host performance only under one extreme experimental treatment. Nearly all estimates of nodulating strain fitness were reduced in the presence of nonnodulating strains. We discovered that nonnodulating strains were consistently capable of coinfecting legume nodules in the presence of nodulating strains but that the fitness effects of coinfection for hosts and symbionts were negligible. Our data suggest that nonnodulating strains most often attenuate the
Acmispon-Bradyrhizobium
mutualism and that this occurs via competitive interactions at the root-soil interface as opposed to
in planta
.

IMPORTANCE
Rhizobia are soil bacteria best known for their capacity to form root nodules on legume plants and enhance plant growth through nitrogen fixation. Yet, most rhizobia in soil do not have this capacity, and their effects on this symbiosis are poorly understood. We investigated the effects of diverse nonnodulating rhizobia on a native legume-rhizobium symbiosis. Nonnodulating strains did not affect plant growth in isolation. However, compared to inoculations with symbiotic rhizobia, coinoculations of symbiotic and nonnodulating strains often reduced plant and symbiont fitness. Coinoculation increased host performance only under one extreme treatment. Nonnodulating strains also invaded nodule interiors in the presence of nodulating strains, but this did not affect the fitness of either partner. Our data suggest that nonnodulating strains may be important competitors at the root-soil interface and that their capacity to attenuate this symbiosis should be considered in efforts to use rhizobia as biofertilizers.
Algicidal Activity of Streptomyces eurocidicus JXJ-0089 Metabolites and Their Effects on Microcystis Physiology
Authors: Zhang Bing-Huo , Ding Zhang-Gui , Li Han-Quan , Mou Xiao-Zhen , Zhang Yu-Qin , Yang Jian-Yuan , Zhou En-Min , Li Wen-Jun
Published: June 2016

Copper sulfate (CuSO
4
) has been widely used as an algicide to control harmful cyanobacterial blooms (CyanoHABs) in freshwater lakes. However, there are increasing concerns about this application, due mainly to the general toxicity of CuSO
4
to other aquatic species and its long-term persistence in the environment. This study reported the isolation and characterization of two natural algicidal compounds, i.e., tryptamine and tryptoline, from
Streptomyces
eurocidicus
JXJ-0089. At a concentration of 5 μg/ml, both compounds showed higher algicidal efficiencies than CuSO
4
on
Microcystis
sp. FACHB-905 and some other harmful cyanobacterial strains. Tryptamine and tryptoline treatments induced a degradation of chlorophyll and cell walls of cyanobacteria. These two compounds also significantly increased the intracellular oxidant content, i.e., superoxide anion radical (O
2
−
) and malondialdehyde (MDA), but reduced the activity of intracellular reductants, i.e., superoxide dismutase (SOD), of cyanobacteria. Moreover, tryptamine and tryptoline treatments significantly altered the internal and external contents of microcystin-LR (MC-LR), a common cyanotoxin. Like CuSO
4
, tryptamine and tryptoline led to releases of intracellular MC-LR from
Microcystis
, but with lower rates than CuSO
4
. Tryptamine and tryptoline (5 μg/ml) in cyanobacterial cultures were completely degraded within 8 days, while CuSO
4
persisted for months. Overall, our results suggest that tryptamine and tryptoline could potentially serve as more efficient and environmentally friendly alternative algicides than CuSO
4
in controlling harmful cyanobacterial blooms.

IMPORTANCE
Cyanobacterial harmful algal blooms (CyanoHABs) in aquatic environments have become a worldwide problem. Numerous efforts have been made to seek means to prevent, control, and mitigate CyanoHABs. Copper sulfate (CuSO
4
), was once a common algicide to treat and control CyanoHABs. However, its application has become limited due to concerns about its general toxicity to other aquatic species and its long-term persistence in the environment. There is a great need for algicides with higher specificity and low environmental impacts. This study reports the isolation and characterization of two natural algicidal compounds from a streptomycete strain,
Streptomyces eurocidicus
JXJ-0089. Our results suggest that the identified algicides could potentially serve as more efficient and environmentally friendly alternative algicides than CuSO
4
in controlling harmful cyanobacterial blooms.
Tracking Human Adenovirus Inactivation by Gamma Radiation under Different Environmental Conditions
Authors: Pimenta Andreia I. , Guerreiro Duarte , Madureira Joana , Margaça Fernanda M. A. , Cabo Verde Sandra
Published: June 2016

Adenovirus is the most prevalent enteric virus in waters worldwide due to its environmental stability, which leads to public health concerns. Mitigation strategies are therefore required. The aim of this study was to assess the inactivation of human adenovirus type 5 (HAdV-5) by gamma radiation in aqueous environments. Various substrates with different organic loads, including domestic wastewater, were inoculated with HAdV-5 either individually or in a viral pool (with murine norovirus type 1 [MNV-1]) and were irradiated in a Cobalt-60 irradiator at several gamma radiation doses (0.9 to 10.8 kGy). The infectivity of viral particles, before and after irradiation, was tested by plaque assay using A549 cells. D
10
values (dose required to inactivate 90% of a population or the dose of irradiation needed to produce a 1 log
10
reduction in the population) were estimated for each substrate based on virus infectivity inactivation exponential kinetics. The capability of two detection methods, nested PCR and enzyme-linked immunosorbent assay (ELISA), to track inactivated viral particles was also assessed. After irradiation at 3.5 kGy, a reduction of the HAdV-5 titer of 4 log PFU/ml on substrates with lower organic loads was obtained, but in highly organic matrixes, the virus titer reduction was only 1 log PFU/ml. The D
10
values of HAdV-5 in high organic substrates were significantly higher than in water suspensions. The obtained results point out some discrepancies between nested PCR, ELISA, and plaque assay on the assessments of HAdV-5 inactivation. These results suggest that the inactivation of HAdV-5 by gamma radiation, in aqueous environments, is significantly affected by substrate composition. This study highlights the virucidal potential of gamma radiation that may be used as a disinfection treatment for sustainable water supplies.

IMPORTANCE
Human adenovirus (HAdV) is the most prevalent of the enteric viruses in environmental waters worldwide. The purposes of this study are to provide new insights on the inactivation of enteric virus by gamma irradiation and to introduce new concepts and reinforce the benefits and utility of radiation technologies as disinfection processes. This may be an effective tool to guarantee the reduction of viral pathogens and to contribute to public health and sustainable water supplies.
Cell Surface Glycoside Hydrolases of Streptococcus gordonii Promote Growth in Saliva
Authors: Yang Jinghua , Zhou Yuan , Zhang Luxia , Shah Nehal , Jin Cheng , Palmer Robert J. , Cisar John O.
Published: June 2016

The growth of the oral commensal
Streptococcus gordonii
in saliva may depend on a number of glycoside hydrolases (GHs), including three cell wall-anchored proteins that are homologs of pneumococcal β-galactosidase (BgaA), β-
N
-acetylglucosaminidase (StrH), and endo-β-
N
-acetylglucosaminidase D (EndoD). In the present study, we introduced unmarked in-frame deletions into the corresponding genes of
S. gordonii
DL1, verified the presence (or absence) of the encoded proteins on the resulting mutant strains, and compared these strains with wild-type strain DL1 for growth and glycan foraging in saliva. The overnight growth of wild-type DL1 was reduced 3- to 10-fold by the deletion of any one or two genes and approximately 20-fold by the deletion of all three genes. The only notable change in the salivary proteome associated with this reduction of growth was a downward shift in the apparent molecular masses of basic proline-rich glycoproteins (PRG), which was accompanied by the loss of lectin binding sites for galactose-specific
Erythrina cristagalli
agglutinin (ECA) and mannose-specific
Galanthus nivalis
agglutinin (GNA). The binding of ECA to PRG was also abolished in saliva cultures of mutants that expressed cell surface BgaA alone or together with either StrH or EndoD. However, the subsequent loss of GNA binding was seen only in saliva cocultures of different mutants that together expressed all three cell surface GHs. The findings indicate that the growth of
S. gordonii
DL1 in saliva depends to a significant extent on the sequential actions of first BgaA and then StrH and EndoD on N-linked glycans of PRG.

IMPORTANCE
The ability of oral bacteria to grow on salivary glycoproteins is critical for dental plaque biofilm development. Little is known, however, about how specific salivary components are attacked and utilized by different members of the biofilm community, such as
Streptococcus gordonii. Streptococcus gordonii
DL1 has three cell wall-anchored glycoside hydrolases that are predicted to act on host glycans. In the present study, we introduced unmarked in-frame deletions in the corresponding genes, verified the presence (or absence) of encoded proteins on the resulting mutant strains, and compared these strains with wild-type DL1 for growth and glycan foraging in saliva. The results indicate that the growth of
S. gordonii
DL1 depends to a significant extent on sequential action of these cell surface GHs on N-linked glycans of basic proline-rich salivary glycoproteins, which appears to be an essential first step in salivary glycan foraging.
The Glycoside Hydrolase Family 8 Reducing-End Xylose-Releasing Exo-oligoxylanase Rex8A from Paenibacillus barcinonensis BP-23 Is Active on Branched Xylooligosaccharides
Authors: Valenzuela Susana V. , Lopez Sergi , Biely Peter , Sanz-Aparicio Julia , Pastor F. I. Javier
Published: June 2016

A GH8 family enzyme involved in xylan depolymerization has been characterized. The enzyme, Rex8A, is a reducing-end xylose-releasing exo-oligoxylanase (Rex) that efficiently hydrolyzes xylooligosaccharides and shows minor activity on polymeric xylan. Rex8A hydrolyzes xylooligomers of 3 to 6 xylose units to xylose and xylobiose in long-term incubations. Kinetic constants of Rex8A were determined on xylotriose, showing a

K
m

of 1.64 ± 0.03 mM and a
k
cat
value of 118.8 s
−1
. Besides linear xylooligosaccharides, the enzyme hydrolyzed decorated xylooligomers. The catalytic activity on branched xylooligosaccharides, i.e., the release of xylose from the reducing end, is a newly described trait of xylose-releasing exo-oligoxylanases, as the exo-activity on these substrates has not been reported for the few of these enzymes characterized to date. Modeling of the three-dimensional (3D) structure of Rex8A shows an (α/α)
6
barrel fold where the loops connecting the α-helices contour the active site. These loops, which show high sequence diversity among GH8 enzymes, shape a catalytic cleft with a −2 subsite that can accommodate methyl-glucuronic acid decorations. The hydrolytic ability of Rex8A on branched oligomers can be crucial for the complete depolymerization of highly substituted xylans, which is indispensable to accomplish biomass deconstruction and to generate efficient catalysts.

IMPORTANCE
A GH8 family enzyme involved in xylan depolymerization has been characterized. The Rex8A enzyme from
Paenibacillus barcinonensis
is involved in depolymerization of glucuronoxylan, a major component of the lignocellulosic substrates. The study shows that Rex8A is a reducing-end xylose-releasing exo-oligoxylanase that efficiently hydrolyzes xylose from neutral and acidic xylooligosaccharides generated by the action of other xylanases also secreted by the strain. The activity of a Rex enzyme on branched xylooligosaccharides has not been described to date. This report provides original and useful information on the properties of a new example of the rarely studied Rex enzymes. Depolymerization of highly substituted xylans is crucial for biomass valorization as a platform for generation of biofuels, chemicals, and solvents.
Biodegradative Activities of Selected Environmental Fungi on a Polyester Polyurethane Varnish and Polyether Polyurethane Foams
Authors: Álvarez-Barragán Joyce , Domínguez-Malfavón Lilianha , Vargas-Suárez Martín , González-Hernández Ricardo , Aguilar-Osorio Guillermo , Loza-Tavera Herminia
Published: June 2016

Polyurethane (PU) is widely used in many aspects of modern life because of its versatility and resistance. However, PU waste disposal generates large problems, since it is slowly degraded, there are limited recycling processes, and its destruction may generate toxic compounds. In this work, we isolated fungal strains able to grow in mineral medium with a polyester PU (PS-PU; Impranil DLN) or a polyether PU (PE-PU; Poly Lack) varnish as the only carbon source. Of the eight best Impranil-degrading strains, the six best degraders belonged to the
Cladosporium cladosporioides
complex, including the species
C. pseudocladosporioides
,
C. tenuissimum
,
C. asperulatum
, and
C. montecillanum
, and the two others were identified as
Aspergillus fumigatus
and
Penicillium
chrysogenum
. The best Impranil degrader,
C. pseudocladosporioides
strain T1.PL.1, degraded up to 87% after 14 days of incubation. Fourier transform infrared (FTIR) spectroscopy analysis of Impranil degradation by this strain showed a loss of carbonyl groups (1,729 cm
−1
) and N—H bonds (1,540 and 1,261 cm
−1
), and gas chromatography-mass spectrometry (GC-MS) analysis showed a decrease in ester compounds and increase in alcohols and hexane diisocyanate, indicating the hydrolysis of ester and urethane bonds. Extracellular esterase and low urease, but not protease activities were detected at 7 and 14 days of culture in Impranil. The best eight Impranil-degrading fungi were also able to degrade solid foams of the highly recalcitrant PE-PU type to different extents, with the highest levels generating up to 65% of dry-weight losses not previously reported. Scanning electron microscopy (SEM) analysis of fungus-treated foams showed melted and thinner cell wall structures than the non-fungus-treated ones, demonstrating fungal biodegradative action on PE-PU.

IMPORTANCE
Polyurethane waste disposal has become a serious problem. In this work, fungal strains able to efficiently degrade different types of polyurethanes are reported, and their biodegradative activity was studied by different experimental approaches. Varnish biodegradation analyses showed that fungi were able to break down the polymer in some of their precursors, offering the possibility that they may be recovered and used for new polyurethane synthesis. Also, the levels of degradation of solid polyether polyurethane foams reported in this work have never been observed previously. Isolation of efficient polyurethane-degrading microorganisms and delving into the mechanisms they used to degrade the polymer provide the basis for the development of biotechnological processes for polyurethane biodegradation and recycling.
Effects of High-Pressure Treatment on Spores of Clostridium Species
Authors: Doona Christopher J. , Feeherry Florence E. , Setlow Barbara , Wang Shiwei , Li William , Nichols Frank C. , Talukdar Prabhat K. , Sarker Mahfuzur R. , Li Yong-Qing , Shen Aimee , Setlow Peter
Published: June 2016

This work analyzes the high-pressure (HP) germination of spores of the food-borne pathogen
Clostridium perfringens
(with inner membrane [IM] germinant receptors [GRs]) and the opportunistic pathogen
Clostridium difficile
(with no IM GRs), which has growing implications as an emerging food safety threat. In contrast to those of spores of
Bacillus
species, mechanisms of HP germination of clostridial spores have not been well studied. HP treatments trigger
Bacillus
spore germination through spores' IM GRs at ∼150 MPa or through SpoVA channels for release of spores' dipicolinic acid (DPA) at ≥400 MPa, and DPA-less spores have lower wet heat resistance than dormant spores. We found that
C. difficile
spores exhibited no germination events upon 150-MPa treatment and were not heat sensitized. In contrast, 150-MPa-treated unactivated
C. perfringens
spores released DPA and became heat sensitive, although most spores did not complete germination by fully rehydrating the spore core, but this treatment of heat-activated spores led to almost complete germination and greater heat sensitization. Spores of both clostridial organisms released DPA during 550-MPa treatment, but
C. difficile
spores did not complete germination and remained heat resistant. Heat-activated 550-MPa-HP-treated
C. perfringens
spores germinated almost completely and became heat sensitive. However, unactivated 550-MPa-treated
C. perfringens
spores did not germinate completely and were less heat sensitive than spores that completed germination. Since
C. difficile
and
C. perfringens
spores use different mechanisms for sensing germinants, our results may allow refinement of HP methods for their inactivation in foods and other applications and may guide the development of commercially sterile low-acid foods.

IMPORTANCE
Spores of various clostridial organisms cause human disease, sometimes due to food contamination by spores. Because of these spores' resistance to normal decontamination regimens, there is continued interest in ways to kill spores without compromising food quality. High hydrostatic pressure (HP) under appropriate conditions can inactivate bacterial spores. With growing use of HP for food pasteurization, advancement of HP for commercial production of sterile low-acid foods requires understanding of mechanisms of spores' interactions with HP. While much is known about HP germination and inactivation of spores of
Bacillus
species, how HP germinates and inactivates clostridial spores is less well understood. In this work we have tried to remedy this information deficit by examining germination of spores of
Clostridium difficile
and
Clostridium perfringens
by several HP and temperature levels. The results may give insight that could facilitate more efficient methods for spore eradication in food sterilization or pasteurization, biodecontamination, and health care.
Effect of exercise training on liver function in adults who are overweight or exhibit fatty liver disease: a systematic review and meta-analysis
Authors: Smart N A , King N , McFarlane J R , Graham P L , Dieberg G
Published: June 2016

Objective

Exercise training has been shown to have beneficial effects on liver function in adults overweight or with fatty liver disease. To establish which exercise programme characteristics were likely to elicit optimal improvements.

Design

Systematic review and meta-analysis of randomised, controlled trials.

Data sources

PubMed, CINAHL and Cochrane controlled trials registry searched (1966 to 2 October 2015).

Eligibility criteria for selecting studies

Exercise intervention, with or without dietary intervention, versus usual care in adults undertaking, exercise training, who were overweight, obese or exhibited fatty liver disease (non-alcoholic fatty liver disease or non-alcoholic steatohepatitis).

Results

We included 21 randomised controlled trials, totalling 1530 participants. Exercise intervention studies with total exercise programme workload >10 000 kcal produced significant improvements in intrahepatic fat, −3.46% (95% CI −5.20% to −1.73%), p<0.0001, I2=73%; effect size (standardised mean difference, SMD) −1.77 (−3.11 to −0.42), p=0.01, I2=77%. When data from only exercise studies were pooled, there was a reduction in fasting free fatty acids (FFAs) −74.15 µmol/L (95% CI −118.47 to −29.84), p=0.001, I2=67% with a large effect size (SMD) −0.94 (−1.36 to −0.52), p<0.0001, I2=0%. When data from only exercise studies were pooled, there was a significant reduction in insulin MD −1.88 UL (95% CI −3.43 to −0.34), p=0.02, I2=31%. The liver enzymes, alanine aminotransferase, aspartate aminotransferase and γ-glutamyl transpeptidase, were not significantly altered with exercise.

Conclusions

Exercise training reduces intrahepatic fat and FFAs while increasing cardiorespiratory fitness. An aggregate exercise programme energy expenditure (>10 000 kcal) may be required to promote reductions in intrahepatic fat.
Lost opportunities to prevent early onset type 2 diabetes mellitus after a pregnancy complicated by gestational diabetes
Authors: Bernstein Judith A , McCloskey Lois , Gebel Christina M , Iverson Ronald E , Lee-Parritz Aviva
Published: June 2016

Objectives

Gestational diabetes mellitus (GDM) greatly increases the risk of developing diabetes in the decade after delivery, but few women receive appropriately timed postpartum glucose testing (PPGT) or a referral to primary care (PC) for continued monitoring. This qualitative study was designed to identify barriers and facilitators to testing and referral from patient and providers' perspectives.

Methods

We interviewed patients and clinicians in depth about knowledge, values, priorities, challenges, and recommendations for increasing PPGT rates and PC linkage. Interviews were coded with NVIVO data analysis software, and analyzed using an implementation science framework.

Results

Women reported motivation to address GDM for the health of the fetus. Most women did not anticipate future diabetes for themselves, and focused on delivery outcomes rather than future health risks. Patients sought and received reassurance from clinicians, and were unlikely to discuss early onset following GDM or preventive measures. PPGT barriers described by patients included provider not mentioning the test or setting it up, transportation difficulties, work responsibilities, fatigue, concerns about fasting while breastfeeding, and timing of the test after discharge from obstetrics, and no referral to PC for follow-up. Practitioners described limited communication among multiple care providers during pregnancy and delivery, systems issues, and separation of obstetrics from PC.

Conclusions

Patients' barriers to PPGT included low motivation for self-care, structural obstacles, and competing priorities. Providers reported the need to balance risk with reassurance, and identified systems failures related to test timing, limitations of electronic medical record systems (EMR), lack of referrals to PC, and inadequate communication between specialties. Prevention of early onset has great potential for medical cost savings and improvements in quality of life.
Does attractiveness influence condom use intentions in heterosexual men? An experimental study
Authors: Eleftheriou Anastasia , Bullock Seth , Graham Cynthia A , Stone Nicole , Ingham Roger
Published: June 2016

Objectives

Judgements of attractiveness have been shown to influence the character of social interactions. The present study sought to better understand the relationship between perceived attractiveness, perceived sexual health status and condom use intentions in a heterosexual male population.

Setting

The study employed an electronic questionnaire to collect all data, during face-to-face sessions.

Participants

51 heterosexual, English-speaking men aged between 18 and 69 years.

Outcome measures

Men were asked to rate the attractiveness of 20 women on the basis of facial photographs, to estimate the likelihood that each woman had a sexually transmitted infection (STI) and to indicate their willingness to have sex with or without a condom with each woman.

Results

The more attractive a woman was judged to be on average, the more likely participants would be willing to have sex with her (p<0.0001) and the less likely they were to intend to use a condom during sex (p<0.0001). Multivariate analysis revealed that higher condom use intentions towards a particular woman were associated with lower ratings of her attractiveness (p<0.0005), higher ratings of her STI likelihood (p<0.0001), the participant being in an exclusive relationship (p=0.002), having a less satisfactory sex life (p=0.015), lower age (p=0.001), higher number of sexual partners (p=0.001), higher age at first intercourse (p=0.002), higher rates of condomless sex in the last 12 months (p<0.043) and lower confidence in their ability to assess whether or not a woman had an STI (p=0.001). The more attractive a participant judged himself to be, the more he believed that other men like him would engage in condomless sex (p=0.001) and the less likely he was to intend to use a condom himself (p=0.02).

Conclusions

Male perceptions of attractiveness influence their condom use intentions; such risk biases could profitably be discussed during sex education sessions and in condom use promotion interventions.
Impact of integrated upper limb spasticity management including botulinum toxin A on patient-centred goal attainment: rationale and protocol for an international prospective, longitudinal cohort study (ULIS-III)
Authors: Turner-Stokes Lynne , Ashford Stephen , Jacinto Jorge , Maisonobe Pascal , Balcaitiene Jovita , Fheodoroff Klemens
Published: June 2016

Objectives

Describe the rationale and protocol for the Upper Limb International Spasticity (ULIS)-III study, which aims to evaluate the impact of integrated spasticity management, involving multiple botulinum toxin A (BoNT-A) injection cycles and concomitant therapies, on patient-centred goal attainment. Outline novel outcome assessment methods for ULIS-III and report initial evaluation data from goal setting in early stages of the study.

Design

Large international longitudinal cohort study of integrated upper limb spasticity management, including BoNT-A.

Participants and setting

ULIS-III is a 2-year study expected to enrol >1000 participants at 58 study centres across 14 countries.

Interventions

The study design is non-interventional and intended to reflect real-life clinical practice. It will describe injection practices and additional treatment strategies, and record clinical decision-making in a serial approach to long-term spasticity management.

Outcome measures

ULIS-III will use a goal-directed approach to selection of targeted standardised measures to capture the diversity of presentation, goals and outcomes. ULIS-III will implement the Upper Limb Spasticity Index, a battery of assessments including a structured approach to goal attainment scaling (Goal Attainment Scaling—Evaluation of Outcomes for Upper Limb Spasticity tool), alongside a limited set of standardised measures, chosen according to patients' selected goal areas. Concomitant therapy inputs, patient satisfaction with engagement in goal setting, health economic end points and health-related quality of life data will also be captured.

Results of initial evaluation of goal quality

Recruitment started in January 2015. By June 2015, 58 sites had been identified and initial data collected for 79 patients across 13 sites in 3 countries. Goal setting data were quality-checked and centres rated on the basis of function-related and Specific, Measurable, Achievable, Realistic, Timed (SMART) characteristics of goal statements. Overall, 11/13 centres achieved the highest rating (A++).

Conclusions

ULIS-III will provide valuable information regarding treatment of and outcomes from real-life upper limb spasticity management worldwide.

Trial registration number

NCT02454803; Pre-results.
E-DIP: Early Discharge Project. A Model for Throughput and Early Discharge for 1-Day Admissions
Authors: Cho Hyung J , Desai Neil , Florendo Angelita , Marshall Christine , Michalski Jaime , Lee Nathan , Dunn Andrew
Published: June 2016

Short stay admissions that are outside of observation unit models hold challenges for throughput and decreasing length of stay (LOS). In our institution at Mount Sinai Hospital in New York City, United States, we noticed a lack of communication about potential next-day discharges from the day and night admission teams to the inpatient teams. Our hospitalist division started the Early Discharge Initiation Project (E-DIP), a system of flagging and communicating potential discharges to improve this problem. We used a multidisciplinary approach with PDSA cycles, engaging members of all teams involved in this process, including the nocturnists. We utilized a paper list, an EHR notification order, and email communication to relay potential next-day discharges. We created an awareness and educational campaign to reinforce the process and its importance. We then used a text paging system to remind the inpatient teams for early discharge. After the initiation of E-DIP, the average number of 1-day admissions per day increased from 0.9 to 1.6 (78% increase). Percentage of discharge orders before 11AM increased from 28% to 42%. Mean discharge time improved to 28 minutes earlier. E-DIP was successful in increasing 1-day admissions and mean discharge times.
Educational impact of paediatric palliative simulation study days
Authors: Renton Kate , Quinton Hilary , Mayer Anton-Paul Thomas
Published: June 2016

Background

The use of simulation-based medical/nursing teaching is increasingly widespread. Simulation-based teaching offers an immersive learning experience where professionals can practice communication and practical skills in a safe, authentic environment. We designed a paediatric palliative simulation study day primarily aimed at nursing staff who manage these patients in the community/hospice. We believe this is the first of its kind in the UK.

Aims

To establish whether attendance at a paediatric palliative simulation study day improved confidence and knowledge in management of common and/or difficult situations in palliative care.

Method

Health professionals working at local paediatric hospices or in associated specialties to palliative care were invited to attend the free 1-day course. 5 scenarios were developed by experienced health professionals working in paediatric palliative care. On the day, participants were asked to complete a questionnaire to check basic demographic data, confidence levels and knowledge (50 true/false questions). Following participation/observation of 5 scenarios, they again completed the same questionnaire regarding confidence levels and knowledge. Results were analysed with Excel and XLStat using basic demographic data and Wilcoxon signed rank two-tailed test.

Results

57 healthcare workers participated in 5 study days. 81% (n=47) professionals described themselves as working primarily in palliative care. Only 35% (n=20) had previously experienced simulation. Based on confidence questions, attendees felt more confident in managing specific palliative scenarios (p<0.0001). Based on true/false questions prestudy and poststudy day, 86% (n=49) of participants improved their knowledge. The median improvement score for the cohort was 3 (p<0.0001).

Conclusions

The study demonstrated a significant improvement in confidence and knowledge following the simulation course. This supports further time/financial investment in developing this type of study day. Simulation is a useful teaching adjunct in paediatric palliative care. The course also provides a valuable opportunity for professionals to network and discuss/share experiences.
Does simulation have a role in palliative medicine specialty training?
Authors: Walker Lucy N , Russon Lynne
Published: June 2016

Simulation training has been adopted by other industries, particularly aviation, for many years. With patient safety on every agenda, more recently there has been considerable interest and investment in its use for the acute medical specialities. Evidence in palliative medicine, for the use of simulation is mainly limited to advanced communication skills but little is described about its use in developing acute clinical skills. This article describes how in the Yorkshire and Humber Deanery a simulation training day was set up for Palliative Medicine specialty trainees, to assess their knowledge and develop the skills required to deal with acute medical emergencies, as described in the specialty training curriculum for palliative medicine. Scenarios included opioid toxicity, acute left ventricular failure, anaphylaxis, hypoglycaemia and massive haemorrhage. The set up and scenarios are described, along with the mechanisms for delivering feedback. This method of training received positive feedback from trainees and facilitators. The advantages, limitations and potential future role for high-fidelity simulation training for medical trainees and the wider multidisciplinary palliative care team are discussed.
Exploring the relationship between general practice characteristics, and attendance at walk-in centres, minor injuries units and EDs in England 2012/2013: a cross-sectional study
Authors: Tammes Peter , Morris Richard W , Brangan Emer , Checkland Kath , England Helen , Huntley Alyson , Lasserson Daniel , MacKichan Fiona , Salisbury Chris , Wye Lesley , Purdy Sarah
Published: June 2016

Background

For several years, EDs in the UK NHS have faced considerable increases in attendance rates. Walk-in centres (WiCs) and minor injuries units (MIUs) have been suggested as solutions. We aimed to investigate the associations between practice and practice population characteristics with ED attendance rates or combined ED/WiC/MIU attendance, and the associations between WiC/MIU and ED attendance.

Methods

We used general practice-level data including 7462 English practices in 2012/2013 and present adjusted regression coefficients from linear multivariable analysis for relationships between patients' emergency attendance rates and practice characteristics.

Results

Every percentage-point increase in patients reporting inability to make an appointment was associated with an increase in emergency attendance by 0.36 (95% CI 0.06 to 0.66) per 1000 population. Percentage-point increases in patients unable to speak to a general practitioner (GP)/nurse within two workdays and patients able to speak often to their preferred GP were associated with increased emergency attendance/1000 population by 0.23 (95% CI 0.05 to 0.42) and 0.10 (95% CI 0.00 to 0.19), respectively. Practices in areas encompassing several towns (conurbations) had higher attendance than rural practices, as did practices with more non-UK-qualified GPs. Practice population characteristics associated with increased emergency attendance included higher unemployment rates, higher percentage of UK whites and lower male life expectancy, which showed stronger associations than practice characteristics. Furthermore, higher MIU or WiC attendance rates were associated with lower ED attendance rates.

Conclusions

Improving availability of appointments and opportunities to speak a GP/nurse at short notice might reduce ED attendance. Establishing MIUs and WiCs might also reduce ED attendance.
TREVO and Capture LP have equal technical success rates in mechanical thrombectomy of proximal and distal anterior circulation occlusions
Authors: Protto Sara , Pienimäki Juha-Pekka , Seppänen Janne , Matkaselkä Ira , Ollikainen Jyrki , Numminen Heikki , Sillanpää Niko
Published: June 2016

Purpose

Mechanical thrombectomy (MT) is a proven method to treat large vessel occlusions in acute anterior circulation stroke. We compared the technical, imaging, and clinical outcomes of MT performed with either TREVO or Capture LP devices.

Methods

There were 42 and 43 patients in the TREVO and Capture LP groups, respectively. Baseline variables, technical outcome (Thrombolysis In Cerebral Infarction, TICI), 24 hours imaging outcome, and 3-month clinical outcome (modified Rankin Scale, mRS) were prospectively recorded. The patients were stratified according to clot location, groups compared, and logistic regression models devised to study the effect of device selection on the clinical outcome.

Results

The technical success rates were equal in both proximal (internal carotid artery and proximal M1 segment) and distal occlusions (distal M1 and M2 segments). The proportion of TICI 2b or 3 was 96% and 87% with TREVO and 87% and 89% with Capture LP (p=0.25 and p=0.80, respectively). Device selection did not significantly predict good clinical outcome (mRS ≤2) in either proximal or distal occlusions. In multivariate analysis, selecting Capture LP borderline significantly increased the odds of an excellent outcome close to sixfold both in proximal and distal occlusions (OR 6.7, 95% CI 0.82 to 53.7, p=0.08 and OR 5.7, 95% CI 0.88 to 37.8, p=0.07, respectively).

Conclusions

TREVO and Capture LP perform equally well in proximal and distal occlusions in the anterior circulation when technical and good clinical outcome are considered. Capture LP may have a small advantage in reaching mRS ≤1 at 3 months. However, this needs to be confirmed in a randomized study.
Intracranial infarcts in two cats with suspected thoracic limb and pulmonary neoplasia
Authors: Tzounos Caitlin , Davies Emma Sian
Published: June 2016

Cerebrovascular accidents (CVAs) or strokes are now widely accepted to occur in cats and dogs and may occur following either intracranial blood vessel rupture (haemorrhagic) or occlusion (ischaemic). Neoplasia is a well‐recognised cause of ischaemic CVAs in human beings and a link between neoplasia and ischaemic CVA has been suggested within veterinary medicine. Two cats presented with acute‐onset, non‐progressive, non‐painful intracranial neurological signs, with historical thoracic limb lameness. MRI findings were consistent with ischaemic CVAs affecting the cerebellum and thalamus in cat 1 and the thalamus in cat 2. Neurological signs of both cats improved initially, although subsequently both cats became increasingly lame and further investigation identified neoplastic disease involving the lungs and at least one thoracic limb. These cases provide further evidence for a potential link between neoplastic disease and ischaemic CVAs. It is recommended that cats presenting with ischaemic CVAs undergo further diagnostic investigation for evidence of neoplasia, metabolic disease and cardiac diseases.
Ovine footrot: new insights into bacterial colonisation
Authors: Maboni G. , Frosth S. , Aspán A. , Tötemeyer S.
Published: June 2016

Ovine footrot is characterised by interdigital dermatitis (ID) and by the separation of the skin and hoof horn (under‐running footrot). Dichelobacter nodosus is the essential pathogen causing footrot; the role of other microorganisms in this disease remains unclear. The aims of this study were (i) to investigate the colonisation of D nodosus, Fusobacterium necrophorum and Treponema species in biopsies from the ovine interdigital skin of healthy, ID and footrot‐affected feet and (ii) to characterise the virulence of D nodosus strains in those biopsies. Postslaughter biopsy samples (n=241) were collected and analysed by real‐time PCR to determine prevalence and load of the different bacterial species. The highest prevalence and load of D nodosus were found on feet with ID. The vast majority of samples contained virulent D nodosus and some samples contained both virulent and benign D nodosus. Notably, the more pathogenic subspecies of F necrophorum was found in samples from UK sheep. Our findings provide further insights into the role bacterial colonisation may play in the early stage of ID and in the progression towards footrot.
Estimating total resisting force in flexible barrier impacted by a granular avalanche using physical and numerical modeling
Authors: Ashwood Wesley , Hungr Oldrich
Published: June 2016

Flexible barriers are a promising tool for protection against extremely rapid landslides such as debris flow and debris avalanches. With landslide impacts of any size, the total force induced within the barrier and transferred to the anchorage is a fundamental question to design. Current practice limits the investigation to flow parameters, neglecting the behavior of the structure, which can vary significantly. This paper describes steps taken to quantify the total force induced within a flexible barrier. It describes laboratory experiments of dry granular flow against rigid and flexible barriers with observations of resisting force and other filling processes that provide an understanding of the behavior and possible flow–structure interaction for larger scale rapid landslides. Results from the experiments suggest that for granular flows with high discharge the current practice sufficiently quantifies the total force, and for those with lower discharge, the total force is better characterized by active lateral earth pressure calculations. Test results were also used to validate an adaptation to an existing depth-integrated numerical model for landslide mobility to quantify the total force. This model was then used to estimate the resisting forces induced within a full-scale flexible barrier impacted by a controlled debris flow.
Leukotriene B4mediates macrophage influx and pulmonary hypertension in bleomycin-induced chronic neonatal lung injury
Authors: Ee Mong Tieng , Kantores Crystal , Ivanovska Julijana , Wong Mathew J. , Jain Amish , Jankov Robert P.
Published: June 2016

Systemically-administered bleomycin causes inflammation, arrested lung growth, and pulmonary hypertension (PHT) in the neonatal rat, similar to human infants with severe bronchopulmonary dysplasia (BPD). Leukotrienes (LTs) are inflammatory lipid mediators produced by multiple cell types in the lung. The major LTs, LTB4and cysteinyl LTs, are suggested to contribute to BPD, but their specific roles remain largely unexplored in experimental models. We hypothesized that LTs are increased in bleomycin-induced BPD-like injury, and that inhibition of LT production would prevent inflammatory cell influx and thereby ameliorate lung injury. Rat pups were exposed to bleomycin (1 mg·kg−1·day−1ip) or vehicle (control) from postnatal days 1–14 and were treated with either zileuton (5-lipoxygenase inhibitor), montelukast (cysteinyl LT1 receptor antagonist), or SC57461A (LTA4 hydrolase inhibitor) 10 mg·kg−1·day−1ip. Bleomycin led to increased lung content of LTB4, but not cysteinyl LTs. Bleomycin-induced increases in tissue neutrophils and macrophages and lung contents of LTB4and tumor necrosis factor-α were all prevented by treatment with zileuton. Treatment with zileuton or SC57461A also prevented the hemodynamic and structural markers of chronic PHT, including raised pulmonary vascular resistance, increased Fulton index, and arterial wall remodeling. However, neither treatment prevented impaired alveolarization or vascular hypoplasia secondary to bleomycin. Treatment with montelukast had no effect on macrophage influx, PHT, or on abnormal lung structure. We conclude that LTB4plays a crucial role in lung inflammation and PHT in experimental BPD. Agents targeting LTB4or LTB4-mediated signaling may have utility in infants at risk of developing BPD-associated PHT.