bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel Three-Component Phenazine-1-Carboxylic Acid 1,2-Dioxygenase in Sphingomonas wittichii DP58
Authors: Zhao Qiang , Hu Hong-Bo , Wang Wei , Huang Xian-Qing , Zhang Xue-Hong 
Published: February 2017

ABSTRACT

Phenazine-1-carboxylic acid, the main component of shenqinmycin, is widely used in southern China for the prevention of rice sheath blight. However, the fate of phenazine-1-carboxylic acid in soil remains uncertain.
Sphingomonas wittichii
DP58 can use phenazine-1-carboxylic acid as its sole carbon and nitrogen sources for growth. In this study, dioxygenase-encoding genes,
pcaA1A2
, were found using transcriptome analysis to be highly upregulated upon phenazine-1-carboxylic acid biodegradation. PcaA1 shares 68% amino acid sequence identity with the large oxygenase subunit of anthranilate 1,2-dioxygenase from
Rhodococcus maanshanensis
DSM 44675. The dioxygenase was coexpressed in
Escherichia coli
with its adjacent reductase-encoding gene,
pcaA3
, and ferredoxin-encoding gene,
pcaA4
, and showed phenazine-1-carboxylic acid consumption. The dioxygenase-, ferredoxin-, and reductase-encoding genes were expressed in
Pseudomonas putida
KT2440 or
E. coli
BL21, and the three recombinant proteins were purified. A phenazine-1-carboxylic acid conversion capability occurred
in vitro
only when all three components were present. However,
P. putida
KT2440 transformed with
pcaA1A2
obtained phenazine-1-carboxylic acid degradation ability, suggesting that phenazine-1-carboxylic acid 1,2-dioxygenase has low specificities for its ferredoxin and reductase. This was verified by replacing PcaA3 with RedA2 in the
in vitro
enzyme assay. High-performance liquid chromatography–mass spectrometry (HPLC-MS) and nuclear magnetic resonance (NMR) analysis showed that phenazine-1-carboxylic acid was converted to 1,2-dihydroxyphenazine through decarboxylation and hydroxylation, indicating that PcaA1A2A3A4 constitutes the initial phenazine-1-carboxylic acid 1,2-dioxygenase. This study fills a gap in our understanding of the biodegradation of phenazine-1-carboxylic acid and illustrates a new dioxygenase for decarboxylation.

IMPORTANCE
Phenazine-1-carboxylic acid is widely used in southern China as a key fungicide to prevent rice sheath blight. However, the degradation characteristics of phenazine-1-carboxylic acid and the environmental consequences of the long-term application are not clear.
S. wittichii
DP58 can use phenazine-1-carboxylic acid as its sole carbon and nitrogen sources. In this study, a three-component dioxygenase, PcaA1A2A3A4, was determined to be the initial dioxygenase for phenazine-1-carboxylic acid degradation in
S. wittichii
DP58. Phenazine-1-carboxylic acid was converted to 1,2-dihydroxyphenazine through decarboxylation and hydroxylation. This finding may help us discover the pathway for phenazine-1-carboxylic acid degradation.
Multitarget Quantitative PCR Improves Detection and Predicts Cultivability of the Pathogen Burkholderia pseudomallei
Authors: Göhler Andre , Trung Trinh Thanh , Hopf Verena , Kohler Christian , Hartleib Jörg , Wuthiekanun Vanaporn , Peacock Sharon J. , Limmathurotsakul Direk , Tuanyok Apichai , Steinmetz Ivo 
Published: February 2017

ABSTRACT

Burkholderia pseudomallei
is present in the environment in many parts of the world and causes the often-fatal disease melioidosis. The sensitive detection and quantification of
B. pseudomallei
in the environment are a prerequisite for assessing the risk of infection. We recently reported the direct detection of
B. pseudomallei
in soil samples using a quantitative PCR (qPCR) targeting a single type three secretion system 1 (TTSS1) gene. Here, we extend the qPCR-based analysis of
B. pseudomallei
in soil by validating novel qPCR gene targets selected from a comparative genomic analysis. Two hundred soil samples from two rice paddies in northeast Thailand were evaluated, of which 47% (94/200) were
B. pseudomallei
culture positive. The TTSS1 qPCR and two novel qPCR assays that targeted open reading frames (ORFs) BPSS0087 and BPSS0745 exhibited detection rates of 76.5% (153/200), 34.5% (69/200), and 74.5% (150/200), respectively. The combination of TTSS1 and BPSS0745 qPCR increased the detection rate to 90% (180/200). Combining the results of the three qPCR assays and the BPSS1187 nested PCR previously published, all 200 samples were positive by at least one PCR assay. Samples positive by either TTSS1 (
n
= 153) or BPSS0745 (
n
= 150) qPCR were more likely to be direct-culture positive, with odds ratios of 4.0 (95% confidence interval [CI], 1.7 to 9.5;
P
< 0.001) and 9.0 (95% CI, 3.1 to 26.4;
P
< 0.001), respectively. High
B. pseudomallei
genome equivalents correlated with high CFU counts by culture. In conclusion, multitarget qPCR improved the
B. pseudomallei
detection rate in soil samples and predicted culture positivity. This approach has the potential for use as a sensitive environmental screening method for
B. pseudomallei
.

IMPORTANCE
The worldwide environmental distribution of the soil bacterium
Burkholderia pseudomallei
remains to be determined. So far, most environmental studies have relied on culture-based approaches to detect this pathogen. Since current culture methods are laborious, are time consuming, and have limited sensitivity, culture-independent and more sensitive methods are needed. In this study, we show that a
B. pseudomallei
-specific qPCR approach can detect significantly higher numbers of
B. pseudomallei
-positive soil samples from areas where it is endemic compared with that from culture. The use of multiple independent
B. pseudomallei
-specific qPCR targets further increased the detection rate of
B. pseudomallei
compared with that from single targets. Samples with a high molecular
B. pseudomallei
load were more likely to be culture positive. We conclude that our quantitative multitarget approach might be useful in defining areas where there is a risk of
B. pseudomallei
infections in different parts of the world.
Multisite musculoskeletal pain in adolescence and later mental health disorders: a population-based registry study of Norwegian youth: the NAAHS cohort study
Authors: Eckhoff Christian , Straume Bjørn , Kvernmo Siv 
Published: February 2017

ObjectivesTo examine the association between multisite musculoskeletal pain in adolescence and mental health disorders in young adulthood.Design and settingData were obtained from a linkage between the Norwegian Patient Registry (2008–2012) and the Norwegian Arctic Adolescent Health Study, a school-based survey conducted among 10th grade students in North Norway (2003–2005).ParticipantsIn total, 3987 (68%) of all 5877 invited participants consented to the registry linkage.Outcome measuresMental healthcare use and disorders from age 18–20 to 23–25 years (5 years).MethodsMusculoskeletal pain was measured by the number of musculoskeletal pain sites. Multivariable logistic regression was used to explore the association with later mental healthcare use and disorders.ResultsMultisite adolescent musculoskeletal pain was significantly associated with an increase in mental healthcare use and mental health disorders in young adulthood. The relationship was stronger for anxiety and mood disorders, in both genders. Overall, the association between musculoskeletal pain and later mental health problems was attenuated after controlling for adolescent psychosocial and mental health problems, not by physical or sedentary activity. This could be due to confounding or mediation. However, when examining different mental health disorders, we found musculoskeletal pain to be significantly associated with anxiety disorders, and showing a strong trend in mood disorders, when adjusted for the adolescent factors.ConclusionsPhysicians should be aware that multisite adolescent pain is associated with mental health problems in adolescence, and that these adolescents are at increased risk of mental health disorders in young adulthood. As youth troubled by mental health problems commonly present physical symptoms it is important to examine for psychosocial problems in order to offer early interventions.
Perineal resuturing versus expectant management following vaginal delivery complicated by a dehisced wound (PREVIEW): a nested qualitative study
Authors: Dudley L , Kettle C , Waterfield J , Ismail Khaled M K 
Published: February 2017

ObjectiveTo explore women's lived experiences of a dehisced perineal wound following childbirth and how they felt participating in a pilot and feasibility randomised controlled trial (RCT).DesignA nested qualitative study using semistructured interviews, underpinned by descriptive phenomenology.Participants and settingA purposive sample of six women at 6–9 months postnatal who participated in the RCT were interviewed in their own homes.ResultsFollowing Giorgi's analytical framework the verbatim transcripts were analysed for key themes. Women's lived experiences revealed 4 emerging themes: (1) Physical impact, with sub-themes focusing upon avoiding infection, perineal pain and the impact of the wound dehiscence upon daily activities; (2) Psychosocial impact, with sub-themes of denial, sense of failure or self-blame, fear, isolation and altered body image; (3) Sexual impact; and (4) Satisfaction with wound healing. A fifth theme ‘participating in the RCT’ was ‘a priori’ with sub-themes centred upon understanding the randomisation process, completing the trial questionnaires, attending for hospital appointments and acceptability of the treatment options.ConclusionsTo the best of our knowledge, this is the first qualitative study to grant women the opportunity to voice their personal experiences of a dehisced perineal wound and their views on the management offered. The powerful testimonies presented disclose the extent of morbidity experienced while also revealing a strong preference for a treatment option.Trial registration numberISRCTN05754020; results.
ESPACOMP Medication Adherence Reporting Guidelines (EMERGE): a reactive-Delphi study protocol
Authors: Helmy R , Zullig L L , Dunbar-Jacob J , Hughes D A , Vrijens B , Wilson I B , De Geest S 
Published: February 2017

IntroductionMedication adherence is fundamental to achieving optimal patient outcomes. Reporting research on medication adherence suffers from some issues—including conceptualisation, measurement and data analysis—that thwart its advancement. Using the ABC taxonomy for medication adherence as the conceptual basis, a steering committee of members of the European Society for Patient Adherence, COMpliance, and Persistence (ESPACOMP) launched an initiative to develop ESPACOMP Medication Adherence Reporting Guidelines (EMERGE). This paper is a protocol for a Delphi study that aims to build consensus among a group of topic experts regarding an item list that will support developing EMERGE.Methods and analysisThis study uses a reactive-Delphi design where a group of topic experts will be asked to rate the relevance and clarity of an initial list of items, in addition to suggesting further items and/or modifications of the initial items. The initial item list, generated by the EMERGE steering committee through a structured process, consists of 26 items distributed in 2 sections: 4 items representing the taxonomy-based minimum reporting criteria, and 22 items organised according to the common reporting sections. A purposive sample of experts will be selected from relevant disciplines and diverse geographical locations. Consensus will be achieved through predefined decision rules to keep, delete or modify the items. An iterative process of online survey rounds will be carried out until consensus is reached.Ethics and disseminationAn ethics approval was not required for the study according to the Swiss federal act on research involving human beings. The participating experts will be asked to give an informed consent. The results of this Delphi study will feed into EMERGE, which will be disseminated through peer-reviewed publications and presentations at conferences. Additionally, the steering committee will encourage their endorsement by registering the guidelines at the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network and other relevant organisations.
Randomised trial assessing the impact of framing of fracture risk and osteoporosis treatment benefits in patients undergoing bone densitometry
Authors: Kalluru Rama , Petrie Keith J , Grey Andrew , Nisa Zaynah , Horne Anne M , Gamble Greg D , Bolland Mark J 
Published: February 2017

ObjectivesThe accuracy of patients' perception of risk is important for decisions about treatment in many diseases. We framed the risk of fracture and benefits of treatment in different ways and assessed the impact on patients' perception of fracture risk and intentions to take medication.DesignRandomised trial of 4 different presentations of fracture risk and likely benefits from osteoporosis treatment.SettingAcademic centre.Participants200 patients undergoing bone densitometry.InterventionPresentation that framed the patient's absolute fracture risk either as the chance of having or not having an event, with their likely benefits from osteoporosis treatment in natural frequencies or numbers needed to treat.OutcomesParticipants' views about their fracture risk and the need for osteoporosis treatment.ResultsThe median 5-year fracture risk threshold participants regarded as high enough to consider preventative medication was 50–60%, and did not change substantially after the presentation. The median (Q1, Q3) 5-year risk initially estimated by participants was 20% (10, 50) for any fracture and 19% (10, 40) for hip fracture. 61% considered their fracture risk was low or very low, and 59–67% considered their fracture risk was lower than average. These participant estimates were 2–3 times higher than Garvan calculator estimates for any fracture, and 10–20 times higher for hip fracture. Participant estimates of fracture risk halved after the presentation, but remained higher than the Garvan estimates (1.5–2 times for any fracture, 5–10 times for hip fracture). There was no difference in these outcomes between the randomised groups. Participants' intentions about taking medication to prevent fractures were not substantially affected by receiving information about fracture risk and treatment benefits.ConclusionsAltering the framing of estimated fracture risks and treatment benefits had little effect on participants' perception of the need to take treatment or their individual fracture risk.Trial registration numberACTRN12613001081707; Pre-results.
Feasibility of peer assessment and clinical audit to self-regulate the quality of physiotherapy services: a mixed methods study
Authors: Maas Marjo J M , Nijhuis-van der Sanden Maria W G , Driehuis Femke , Heerkens Yvonne F , van der Vleuten Cees P M , van der Wees Philip J 
Published: February 2017

ObjectivesTo evaluate the feasibility of a quality improvement programme aimed to enhance the client-centeredness, effectiveness and transparency of physiotherapy services by addressing three feasibility domains: (1) acceptability of the programme design, (2) appropriateness of the implementation strategy and (3) impact on quality improvement.DesignMixed methods study.Participants and setting64 physiotherapists working in primary care, organised in a network of communities of practice in the Netherlands.MethodsThe programme contained: (1) two cycles of online self-assessment and peer assessment (PA) of clinical performance using client records and video-recordings of client communication followed by face-to-face group discussions, and (2) clinical audit assessing organisational performance. Assessment was based on predefined performance indicators which could be scored on a 5-point Likert scale. Discussions addressed performance standards and scoring differences. All feasibility domains were evaluated qualitatively with two focus groups and 10 in-depth interviews. In addition, we evaluated the impact on quality improvement quantitatively by comparing self-assessment and PA scores in cycles 1 and 2.ResultsWe identified critical success features relevant to programme development and implementation, such as clarifying expectations at baseline, training in PA skills, prolonged engagement with video-assessment and competent group coaches. Self-reported impact on quality improvement included awareness of clinical and organisational performance, improved evidence-based practice and client-centeredness and increased motivation to self-direct quality improvement. Differences between self-scores and peer scores on performance indicators were not significant. Between cycles 1 and 2, scores for record keeping showed significant improvement, however not for client communication.ConclusionsThis study demonstrated that bottom-up initiatives to improve healthcare quality can be effective. The results justify ongoing evaluation to inform nationwide implementation when the critical success features are addressed. Further research is necessary to explore the sustainability of the results and the impact on client outcomes in a full-scale study.
Health Education and Activity – Lessening The Inequalities in mental health (HEA – LTI mental health)
Authors: Richmond Georgia , Kenny Conor , Ahmed Jabed , Stephenson Lucy , lindsay jamie , Earls Patrick , Mullin Donncha , Ryland Howard 
Published: February 2017

Patients suffering from mental health illness have considerably more physical health disease burden than the rest of the population and are more likely to die 10 to 20 years younger compared with their peers. Diabetes, cardiovascular and respiratory disease have been recognised as contributing factors to premature death. Furthermore patients with severe mental illness undertake lower levels of physical activity.The aim of the project was therefore to address the inequalities in physical health that affect patients with mental health illness through designing and implementing a sustainable, transferable, patient-centred education and activity intervention.The objective of the project was to increase patient motivation to change behaviour as a result of physical health interventions by increasing patients' physical health understanding, motivation to change their physical health behaviour, motivation to do exercise and by reducing their anxiety.The method used was a prospective cohort study in four eighteen bed psychosis inpatient units. The units were across two large London hospitals in one Hospital Trust involving male and female inpatients with a range of mental health issues.The intervention was comprised of two components. The first component was a weekly 45 minute teaching group designed in collaboration with patients focusing on the key domains that affect the physical health of mental health patients. Four discussion domains (heart health, diabetes and weight, smoking and lung disease, cancer screening and substance misuse) were undertaken, with each cycle lasting four weeks. The second component was a weekly 45 minute exercise group (‘normalisation activity’) in collaboration with patients and the multidisciplinary team.The intervention was evaluated at the end of each cycle and four cycles in total took place.Weekly pre and post intervention measures were undertaken comprising of a self reported change in understanding, motivation to change physical health behaviours, confidence to change, anxiety and motivation to exercise.The result was a 26% improvement in self-reported understanding across the four domains following teaching. Furthermore patient anxiety reduced by on average 35%, self-reported motivation to change increased by 20%, motivation to do exercise by 26% and confidence to change by 16% as a result of the intervention.The authors conclude that a collaborative approach to education and activity between the Multidisciplinary Team (MDT) and service user results in sustained improvement in understanding of physical health, motivation to change behaviour and to do exercise. It also results in improved confidence and reduced anxiety.
Progressive prediction of hospitalisation in the emergency department: uncovering hidden patterns to improve patient flow
Authors: Barak-Corren Yuval , Israelit Shlomo Hanan , Reis Ben Y 
Published: February 2017

IntroductionOne of the factors contributing to ED crowding is the lengthy delay in transferring an admitted patient from the ED to an inpatient department (ie, boarding time). An earlier start of the admission process using an automatic hospitalisation prediction model could potentially shorten these delays and reduce crowding.MethodsClinical, operational and demographic data were retrospectively collected on 80 880 visits to the ED of Rambam Health Care Campus in Haifa, Israel, from January 2011 to January 2012. Using these data, a logistic regression model was developed to predict patient disposition (hospitalisation vs discharge) at three progressive time points throughout the ED visit: within the first 10 min, within an hour and within 2 hours. The algorithm was trained on 50% of the data (n=40 440) and tested on the remaining 50%.ResultsDuring the study time period, 58 197 visits ended in discharge and 22 683 in hospitalisation. Within 1 hour of presentation, our model was able to predict hospitalisation with a specificity of 90%, sensitivity of 94% and an AUCof 0.97. Early clinical decisions such as testing for calcium levels were found to be highly predictive of hospitalisations. In the Rambam ED, the use of such a prediction system would have the potential to save more than 250 patient hours per day.ConclusionsData collected by EDs in electronic medical records can be used within a progressive modelling framework to predict patient flow and improve clinical operations. This approach relies on commonly available data and can be applied across different healthcare settings.
Emergency department syndromic surveillance to investigate the health impact and factors associated with alcohol intoxication in Reunion Island
Authors: Vilain Pascal , Larrieu Sophie , Mougin-Damour Katia , Marianne Dit Cassou Pierre-Jean , Weber Marc , Combes Xavier , Filleul Laurent 
Published: February 2017

In Reunion Island, alcohol is the most tried out psychoactive substance. To our knowledge, few indicators measuring the health burden of alcohol use exist on the island. In this context, an exploratory analysis based on syndromic surveillance data was implemented in order to describe the emergency department (ED) visits for alcohol intoxication (AI) and factors associated with their variations.An analysis of anonymized records routinely collected by the syndromic surveillance system was carried out. A daily indicator of ED visits for AI was built from a selection of ICD-10 codes between 2010 and 2012. Health impact of AI was first described comparing this indicator to all causes ED visits. Then, AI visits were analyzed with time-series methods using generalized additive Poisson regression models allowing for overdispersion. The following variables were included in the model: long-term trend, seasonality, day of the week, public and school holidays, days of festival and minimum social benefits payday.During the study period, 16 652 visits for AI were recorded in EDs of Reunion Island. AI visits were the second reason for ED visits (i.e. 4%) after traumatism. AI visits mainly concerned men (87%) and the age group of 25-54 years (69%). There was a significant increase in ED visits for AI during days of benefits payday, weekends and publics holidays.This study demonstrated the interest of syndromic surveillance to monitor non-infectious diseases. Time-series models showed a robust association between ED visits for AI and several factors.