bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rifabutin Acts in Synergy and Is Bactericidal with Frontline Mycobacterium abscessus Antibiotics Clarithromycin and Tigecycline, Suggesting a Potent Treatment Combination
Authors: Pryjma Mark , Burian Ján , Thompson Charles J. 
Published: May 2018

ABSTRACT

Mycobacterium abscessus
is a rapidly emerging mycobacterial pathogen causing dangerous pulmonary infections. Because these bacteria are intrinsically multidrug resistant, treatment options are limited and have questionable efficacy. The current treatment regimen relies on a combination of antibiotics, including clarithromycin paired with amikacin and either imipenem or cefoxitin. Tigecycline may be added when triple therapy is ineffective. We initially screened a library containing the majority of clinically available antibiotics for anti-
M. abscessus
activity. The screen identified rifabutin, which was then investigated for its interactions with
M. abscessus
antibiotics used in drug regimens. Combination of rifabutin with either clarithromycin or tigecycline generated synergistic anti-
M. abscessus
activity, dropping the rifabutin MIC below concentrations found in the lung. Importantly, these combinations generated bactericidal activity. The triple combination of clarithromycin, tigecycline, and rifabutin was also synergistic, and clinically relevant concentrations had a sterilizing effect on
M. abscessus
cultures. We suggest that combinations including rifabutin should be further investigated for treatment of
M. abscessus
pulmonary infections.
Bacterial Silver Resistance Gained by Cooperative Interspecies Redox Behavior
Authors: Muller Michael 
Published: May 2018

ABSTRACT

Silver has emerged as an important therapeutic option for wound infections in recent years due to its broad-spectrum antimicrobial activity. The silver cation (Ag
+
), but not the bulk metal (Ag
0
), is highly toxic for most microorganisms, although resistance due to genetic modification or horizontal gene transfer does occur.
Pseudomonas aeruginosa
, however, achieves silver resistance by producing the redox-active metabolite pyocyanin that reduces Ag
+
to nontoxic Ag
0
. Pyocyanin also possesses broad-spectrum antimicrobial activity. Many microbial species reduce pyocyanin, which reduces molecular oxygen to antimicrobial hydrogen peroxide. In this study, it was hypothesized that both Ag
+
and oxygen would act as competing terminal electron acceptors for pyocyanin, thus acting as a universal microbial protectant from Ag
+
while avoiding hydrogen peroxide formation.
Escherichia coli
and
Staphylococcus aureus
efficiently reduced pyocyanin and generated hydrogen peroxide, while Ag
+
markedly reduced the amount of hydrogen peroxide produced. Although unable to reduce directly Ag
+
to Ag
0
on their own,
E. coli
and
S. aureus
did so when pyocyanin was present, resulting in increased survival when exposed to Ag
+
. Coincubation experiments with either
E. coli
or
S. aureus
with
P. aeruginosa
demonstrated increased survival for those species to Ag
+
, but only if pyocyanin was present. These data demonstrate that microorganisms that display no intrinsic silver resistance may survive and proliferate under potentially toxic conditions, provided their environment contains a suitable redox-active metabolite-producing bacterium. Chronic wounds are often polymicrobial in nature, with pyocyanin-producing
P. aeruginosa
bacteria frequently being present; therefore, redox-based silver resistance may compromise treatment efforts.
The State of the Union Is Strong: a Review of ASM's 6th Conference on Cell-Cell Communication in Bacteria
Authors: Brown Sam P. , Blackwell Helen E. , Hammer Brian K. 
Published: May 2018

ABSTRACT
The 6th American Society for Microbiology Conference on Cell-Cell Communication in Bacteria convened from 16 to 19 October 2017 in Athens, GA. In this minireview, we highlight some of the research presented at that meeting that addresses central questions emerging in the field, including the following questions. How are cell-cell communication circuits designed to generate responses? Where are bacteria communicating? Finally, why are bacteria engaging in such behaviors?
Activation of Bacterial Histidine Kinases: Insights into the Kinetics of the
cis
Autophosphorylation Mechanism
Authors: Sankhe Gaurav D. , Dixit Narendra M. , Saini Deepak K. 
Published: May 2018

Two-component systems consisting of an input-sensing histidine kinase (HK) and an output-generating response regulator (RR) are one of the key apparatuses utilized by bacteria for adapting to the extracellular milieu. HK autophosphorylation is shown to occur primarily in
trans
(intermolecular) and more recently shown to occur in
cis
(intramolecular). Although the catalysis of HK activation remains universal, the reaction scheme for evaluation of the kinetic parameter differs between these designs and
cis
mode largely remains unexplored. We combined experimental and theoretical approach to unravel two-step mechanism of activation of three
cis
mode HKs of
M. tuberculosis
. The new mathematical model yields best-fit parameters to estimate the rates of HK-ATP association and HK autophosphorylation.
TosR-Mediated Regulation of Adhesins and Biofilm Formation in Uropathogenic Escherichia coli
Authors: Luterbach Courtney L. , Forsyth Valerie S. , Engstrom Michael D. , Mobley Harry L. T. 
Published: May 2018

Uropathogenic
E. coli
strains cause the majority of UTIs, which are the second most common bacterial infection in humans. During a UTI, bacteria adhere to cells within the urinary tract, using a number of different fimbrial and nonfimbrial adhesins. Biofilms can also develop on the surfaces of catheters, resulting in complications such as blockage. In this work, we further characterized the regulator TosR, which links both adhesin production and biofilm formation and likely plays a crucial function during UTI and disseminated infection.
Systematic review of rehabilitation intervention outcomes of adult and paediatric patients with infectious encephalitis
Authors: Christie Shanice , Chan Vincy , Mollayeva Tatyana , Colantonio Angela 
Published: May 2018

ObjectiveAlthough a range of rehabilitation interventions have been applied to restore function after infectious encephalitis, there is a lack of literature summarising the benefits of these interventions. This systematic review aims to synthesise current scientific knowledge on outcome measures following rehabilitative interventions among children and adults with infectious encephalitis, with a specific focus on the influence of the age, sex, baseline status and intervention type.Search strategyFive scholarly databases (MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials), three sources of grey literature (Google, Google Scholar and Grey Matters) and reference lists of included publications were systematically searched. Literature published before 15 December 2017 and focused on patients with infectious encephalitis in any rehabilitation setting were included. Quality assessment was completed using the Downs and Black rating scale.ResultsOf the 12 737 reference titles screened, 20 studies were included in this review. All of the studies had sample sizes of less than 25 patients and received a score of less than 15 out of 31 points on the Downs and Black rating scale. Findings showed a variety of interventions has been applied to alleviate sequelae from infectious encephalitis, including using cognitive therapy (nine studies), behavioural therapy (five studies), physical therapy (two studies) or two or more therapies (four studies). There was inconclusive evidence on the effect of sex, age and baseline functional abilities on outcomes. Due to clinical and methodological heterogeneity between studies, meta-analyses were not performed.ConclusionEvidence suggests the potential for a beneficial effect of rehabilitation interventions in patients with infectious encephalitis. Future research is required to identify all effect modifiers and to determine the effect of time in the natural course of recovery. An enhanced set of known effect modifiers will support the process of future evaluation of a client-centred rehabilitation intervention.Trial registration numberCRD42015029217.
Balance and mobility training at home usingWii Fitin children with cerebral palsy: a feasibility study
Authors: Chiu Hsiu-Ching , Ada Louise , Lee Shin-Da 
Published: May 2018

ObjectivesTo investigate whether balance and mobility training at home usingWii Fitis feasible and can provide clinical benefits.DesignSingle-group, pre–post intervention study.SettingParticipants’ home.Participants20 children with cerebral palsy (6–12 years).InterventionParticipants undertook 8 weeks of home-basedWii Fittraining in addition to usual care.Main measuresFeasibility was determined by adherence, performance, acceptability and safety. Clinical outcomes were strength, balance, mobility and participation measured at baseline (preintervention) and 8 weeks (postintervention).ResultsThe training was feasible with 99% of training completed; performance on all games improved; parents understood the training (4/5), it did not interfere in life (3.8/5), was challenging (3.9/5) and would recommend it (3.9/5); and there were no injurious falls. Strength increased in dorsiflexors (Mean Difference (MD) 2.2 N m, 95% CI 1.1 to 3.2, p<0.001), plantarflexors (MD 2.2 N m, 95% CI 1.3 to 3.1, p<0.001) and quadriceps (MD 7.8 N m, 95% CI 5.2 to 10.5, p<0.001). Preferred walking speed increased (MD 0.25 m/s, 95% CI 0.09 to 0.41, p<0.01), fast speed increased (MD 0.24 m/s, 95% CI 0.13 to 0.35, p<0.001) and distance over 6 min increased (MD 28 m, 95% CI 10 to 45, p<0.01). Independence in participation increased (MD 1.4 out of 40, 95% CI 0.0 to 2.8, p=0.04).ConclusionsBalance and mobility training at home usingWii Fitwas feasible and safe and has the potential to improve strength and mobility, suggesting that a randomised trial is warranted.Trial registration numberACTRN12616001362482.
Individual, maternal and household risk factors for anaemia among young children in sub-Saharan Africa: a cross-sectional study
Authors: Moschovis Peter P , Wiens Matthew O , Arlington Lauren , Antsygina Olga , Hayden Douglas , Dzik Walter , Kiwanuka Julius P , Christiani David C , Hibberd Patricia L 
Published: May 2018

ObjectiveAnaemia affects the majority of children in sub-Saharan Africa (SSA). Previous studies of risk factors for anaemia have been limited by sample size, geography and the association of many risk factors with poverty. In order to measure the relative impact of individual, maternal and household risk factors for anaemia in young children, we analysed data from all SSA countries that performed haemoglobin (Hb) testing in the Demographic and Health Surveys.Design and settingThis cross-sectional study pooled household-level data from the most recent Demographic and Health Surveys conducted in 27 SSA between 2008 and 2014.Participants96 804 children age 6–59 months.ResultsThe prevalence of childhood anaemia (defined as Hb <11 g/dL) across the region was 59.9%, ranging from 23.7% in Rwanda to 87.9% in Burkina Faso. In multivariable regression models, older age, female sex, greater wealth, fewer household members, greater height-for-age, older maternal age, higher maternal body mass index, current maternal pregnancy and higher maternal Hb, and absence of recent fever were associated with higher Hb in tested children. Demographic, socioeconomic factors, family structure, water/sanitation, growth, maternal health and recent illnesses were significantly associated with the presence of childhood anaemia. These risk factor groups explain a significant fraction of anaemia (ranging from 1.0% to 16.7%) at the population level.ConclusionsThe findings from our analysis of risk factors for anaemia in SSA underscore the importance of family and socioeconomic context in childhood anaemia. These data highlight the need for integrated programmes that address the multifactorial nature of childhood anaemia.
Quest for certainty regarding early discharge in paediatric low-risk febrile neutropenia: a multicentre qualitative focus group discussion study involving patients, parents and healthcare professionals in the UK
Authors: Morgan Jessica E , Phillips Bob , Stewart Lesley A , Atkin Karl 
Published: May 2018

ObjectivesA systematic review of paediatric low-risk febrile neutropenia found that outpatient care is safe, with low rates of treatment failure. However, this review, and a subsequent meta-ethnography, suggested that early discharge of these patients may not be acceptable to key stakeholders. This study aimed to explore experiences and perceptions of patients, parents and healthcare professionals involved in paediatric febrile neutropenia care in the UK.SettingThree different centres within the UK, purposively selected from a national survey on the basis of differences in their service structure and febrile neutropenia management.ParticipantsThirty-two participants were included in eight focus group discussions.Primary outcomesExperiences and perceptions of paediatric febrile neutropenia care, including possible future reductions in therapy.ResultsParticipants described a quest for certainty, in which they attempted to balance the uncertainty involved in understanding, expressing and negotiating risk with the illusion of certainty provided by strict protocols. Participants assessed risk using both formal and informal stratification tools, overlaid with emotional reactions to risk and experiences of risk within other situations. The benefits of certainty provided by protocols were counterbalanced by frustration at their strict constraints. The perceived benefits and harms of previous inpatient care informed participants’ appraisals of future treatment strategies.ConclusionsThis study highlighted the previously underestimated harms of admission for febrile neutropenia and the paternalistic nature of decision making, along with the frustrations and challenges for all parties involved in febrile neutropenia care. It demonstrates how the same statistics, generated by systematic reviews, can be used by key stakeholders to interpret risk differently, and how families in particular can view the harms of therapeutic options as different from the outcomes used within the literature. It justifies a reassessment of current treatment strategies for these children and further exploration of the potential to introduce shared decision making.
Protocol for an economic evaluation of WHO STOPS childhood obesity stepped-wedge cluster randomised controlled trial
Authors: Sweeney Rohan , Moodie Marj , Nguyen Phuong , Fraser Penny , Bolton Kristy , Brown Andrew , Marks Jennifer , Crooks Nic , Strugnell Claudia , Bell Colin , Millar Lynne , Orellana Liliana , Allender Steven 
Published: May 2018

IntroductionPrevention of overweight and obesity in childhood is a priority because of associated acute and chronic conditions in childhood and later in life, which place significant burden on health systems. Evidence suggests prevention should engage a range of actions and actors and target multiple levels. The Whole of Systems Trial Of PreventionStrategies for childhood obesity (WHO STOPS) will evaluate the outcomes of a novel systems-based intervention that aims to engage whole communities in a locally led multifaceted response. This paper describes the planned economic evaluation of WHO STOPS and examines the methodological challenges for economic evaluation of a complex systems-based intervention.Methods and analysisEconomic evaluation alongside a stepped-wedge cluster randomised controlled trial in regional and rural communities in Victoria, Australia. Cost-effectiveness and cost–utility analyses will provide estimates of the incremental cost (in $A) per body mass index unit saved and quality adjusted life year gained. A Markov cohort model will be employed to estimate healthcare cost savings and benefits over the life course of children. The dollar value of community resources harnessed for the community-led response will be estimated. Probabilistic uncertainty analyses will be undertaken to test sensitivity of results to plausible variations in all trial-based and modelled variables. WHO STOPS will also be assessed against other implementation considerations (such as sustainability and acceptability to communities and other stakeholders).Ethics and disseminationThe trial is registered by the Australian New Zealand Clinical Trials Registry (ACTRN12616000980437). Full ethics clearances have been received for all methods described below: Deakin University’s Human Research Ethics Committee 2014-279, Deakin University’s Human Ethics Advisory Group-Health (HEAG-H) HEAG-H 194_2014, HEAG-H 17 2015, HEAG-H 155_2014, HEAG-H 197_2016, HEAG-H 118_2017, the Victorian Department of Education and Training 2015_002622 and the Catholic Archdiocese of Ballarat. Trial findings (including economic evaluation) will be published in peer-reviewed journals and presented at international conferences. Collected data and analyses will be made available in accordance with journal policies and study ethics approvals. Results will be presented to relevant government authorities with an interest in cost-effectiveness of these types of interventions.Trial registration numberACTRN12616000980437; Pre-results.
Postnatal depression and intimate partner violence: a nationwide clinic-based cross-sectional study in Malaysia
Authors: Ahmad Noor Ani , Silim Umi Adzlin , Rosman Azriman , Mohamed Majdah , Chan Ying Ying , Mohd Kasim Noraida , Yusof Muslimah , Abd Razak Mohamad Aznuddin , Omar Maisarah , Abdul Aziz Fazly Azry , Jamaluddin Rasidah , Ismail Fatanah , Ibrahim Nurashikin , Aris Tahir 
Published: May 2018

IntroductionAn estimated 13% of women in the postnatal period suffer from postnatal depression (PND) worldwide. In addition to underprivileged women, women who are exposed to violence are at higher risk of PND. This study aimed to investigate the relationship between intimate partner violence (IPV) and PND in Malaysia.MethodsThis survey was conducted as a nationwide cross-sectional study using a cluster sampling design. Probable PND was assessed using a self-administered Edinburgh Postnatal Depression Scale (EPDS). Demographic profiles and IPV were assessed using a locally validated WHO Multicountry Study on Women’s Health and Life Events Questionnaire that was administered in a face-to-face interview. An EPDS total score of 12 or more and/or a positive tendency to self-harm were used to define PND.ResultsOut of 6669 women, 5727 respondents were successfully interviewed with a response rate of 85.9%. The prevalence of probable PND was 4.4% (95% CI 2.9 to 6.7). The overall prevalence of IPV was 4.9% (95% CI 3.8 to 6.4). Among the women in this group, 3.7% (95% CI 2.7 to 5.0), 2.6% (95% CI 1.9 to 3.5) and 1.2% (95% CI 0.9 to 1.7) experienced emotional, physical and sexual violence, respectively. Logistic regression analysis revealed that women who were exposed to IPV were at 2.3 times the risk for probable PND, with an adjusted OR (aOR) of 2.34 (95% CI 1.12 to 4.87). Other factors for PND were reported emotional violence (aOR 3.79, 95% CI 1.93 to 7.45), unplanned pregnancy (aOR 3.32, 95% CI 2.35 to 4.69), lack of family support during confinement (aOR 1.79, 95% CI 1.12 to 2.87), partner’s use of alcohol (aOR 1.59, 95% CI 1.07 to 2.35) or being from a household with a low income (aOR 2.99; 95% CI 1.63 to 5.49).ConclusionsExposure to IPV was significantly associated with probable PND. Healthcare personnel should be trained to detect and manage both problems. An appropriate referral system and support should be made available.
Compliance with current VTE prophylaxis guidelines and risk factors linked to complications of VTE prophylaxis in medical inpatients: a prospective cohort study in a Spanish internal medicine department
Authors: Novo-Veleiro Ignacio , Alvela-Suárez Lucía , Costa-Grille Alba , Suárez-Dono Javier , Ferrón-Vidan Fernando , Pose-Reino Antonio 
Published: May 2018

ObjectivesTo evaluate the degree of compliance with the current guidelines regarding venous thromboembolism (VTE) prophylaxis in medical patients during admission and to identify risk factors linked to complications of VTE prophylaxis.DesignProspective cohort study.SettingThe Internal Medicine Department of the University Hospital of Santiago de Compostela (tertiary referral hospital).ParticipantsA total of 396 hospitalised, elderly patients who did not undergo surgery and had no active or previous oral anticoagulation or low molecular weight heparin (LMWH) treatment (during the previous year) and who received VTE prophylaxis during admission.Primary and secondary outcome measuresThe degree of compliance with the current guidelines was estimated by calculating PADOVA and IMPROVE indexes in all cases. We analysed the development of the following complications: major and minor bleeding, major and minor haematoma and decrease of platelet count.ResultsWe found that VTE prophylaxis was correctly indicated in 88.4% of patients. We found two (0.5%) cases with major bleeding, 17 (4.3%) with minor bleeding, 30 (7.6%) with decreased platelet count, 29 (7.3%) with major haematoma and 82 (20.7%) with minor haematoma. After multivariate logistic regression analysis, the presence of major haematomas was linked to obesity (OR 4.1; 95% CI 1.8 to 9.2, p=0.001), concomitant antiplatelet treatment (OR 2.7; 95% CI 1.1 to 6.5, p=0.03) and enoxaparin use (OR 3.5; 95% CI 1.1 to 10.9, p=0.029), and the presence of minor haematomas was associated with PADOVA index <4 points (OR 3.1; 95% CI 1.5 to 6.4, p=0.003) and diabetes mellitus (OR 2; 95% CI 1.1 to 3.7, p=0.031).ConclusionsComplications during VTE prophylaxis in elderly hospitalised medical patients are frequent even with correct application of current guidelines. The main factors linked to haematomas were obesity and concomitant antiplatelet treatment, the presence of which should lead physicians to exercise extreme caution. The use of tinzaparin for VTE prophylaxis in these patients could have a better safety profile.