bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Antibiotic Use on Carbapenem Resistance in Pseudomonas aeruginosa: Is There a Role for Antibiotic Diversity?
Authors: Plüss-Suard C. , Pannatier A. , Kronenberg A. , Mühlemann K. , Zanetti G. 
Published: January 2013

ABSTRACT

In this study, we aimed to evaluate the relationship between the rates of resistance of
Pseudomonas aeruginosa
to carbapenems and the levels and diversity of antibiotic consumption. Data were retrospectively collected from 20 acute care hospitals across 3 regions of Switzerland between 2006 and 2010. The main outcome of the present study was the rate of resistance to carbapenems among
P. aeruginosa
. Putative predictors included the total antibiotic consumption and carbapenem consumption in defined daily doses per 100 bed days, the proportion of very broad-spectrum antibiotics used, and the Peterson index. The present study confirmed a correlation between carbapenem use and carbapenem resistance rates at the hospital and regional levels. The impact of diversifying the range of antibiotics used against
P. aeruginosa
resistance was suggested by (i) a positive correlation in multivariate analysis between the above-mentioned resistance and the proportion of consumed antibiotics having a very broad spectrum of activity (coefficient = 1.77; 95% confidence interval, 0.58 to 2.96;
P
< 0.01) and (ii) a negative correlation between the resistance and diversity of antibiotic use as measured by the Peterson homogeneity index (coefficient = −0.52;
P
< 0.05). We conclude that promoting heterogeneity plus parsimony in the use of antibiotics appears to be a valuable strategy for minimizing the spread of carbapenem resistance in
P. aeruginosa
in hospitals.
In Vitro
Sensitivities of Plasmodium falciparum Isolates from the China-Myanmar Border to Piperaquine and Association with Polymorphisms in Candidate Genes
Authors: Hao Mingming , Jia Dandan , Li Qing , He Yongshu , Yuan Lili , Xu Shuhui , Chen Kexuan , Wu Jia , Shen Lijuan , Sun Lin , Zhao Hongbin , Yang Zhaoqing , Cui Liwang 
Published: January 2013

ABSTRACT

The recent reports of resistance in
Plasmodium falciparum
to artemisinin derivatives and their partner drugs demand intensive studies toward understanding the molecular mechanisms of resistance. In this study, we examined the
in vitro
susceptibility of 63
P. falciparum
field isolates collected from the China-Myanmar border area to chloroquine (CQ) and piperaquine (PPQ). Parasite isolates remained highly resistant to CQ, with the geometric mean 50% inhibitory concentration (IC
50
) of 252.7 nM and a range of 51.9 to 1,052.0 nM. In comparison, these parasites had a geometric mean IC
50
of 28.4 nM for PPQ, with a fairly wide range of 5.3 to 132.0 nM, suggesting that certain parasite isolates displayed relatively high levels of resistance to PPQ. Interestingly, within the 4 years of study, the parasites exhibited a continuous decline in susceptibilities to both CQ and PPQ, and there was a significant correlation between responses to CQ and PPQ (Pearson correlation coefficient = 0.79,
P
< 0.0001). Consistent with the CQ-resistant phenotype, all parasites carried the
pfcrt
K76T mutation, and most parasites had the CVIET type that is prevalent in Southeast Asia. In contrast,
pfmdr1
mutations were relatively rare, and no gene amplification was detected. Only the
pfmdr1
N1042D mutation was associated with resistance to CQ. For the
pfmrp1
gene, four substitutions reached relatively high prevalence of >22%, and the I876V mutation was associated with reduced sensitivity to CQ. However, we could not establish a link between PPQ responses and the polymorphisms in the three genes associated with quinoline drug resistance.
CD11a Regulates Effector CD8 T Cell Differentiation and Central Memory Development in Response to Infection with Listeria monocytogenes
Authors: Bose Tina O. , Pham Quynh-Mai , Jellison Evan R. , Mouries Juliette , Ballantyne Christie M. , Lefrançois Leo 
Published: January 2013

ABSTRACTβ2 (CD18) integrins with α-chains CD11a, -b, -c, and -d are important adhesion molecules necessary for leukocyte migration and cellular interactions. CD18 deficiency leads to recurrent bacterial infections and poor wound healing due to reduced migration of leukocytes to inflammatory sites. CD8 T cells also upregulate CD11a, CD11b, and CD11c upon activation. However, the role these molecules play for CD8 T cellsin vivois not known. To determine the function of individual β2 integrins, we examined CD8 T cell responses toListeria monocytogenesinfection in CD11a-, CD11b-, and CD11c-deficient mice. The absence of CD11b or CD11c had no effect on the generation of antigen-specific CD8 T cells. In contrast, the magnitude of the primary CD8 T cell response in CD11a-deficient mice was significantly reduced. Moreover, the response in CD11a−/−mice exhibited reduced differentiation of short-lived effector cells (KLRG1hiCD127lo), although cytokine and granzyme B production levels were unaffected. Notably, CD11a deficiency resulted in greatly enhanced generation of CD62L+central memory cells. Surprisingly, CD8 T cells lacking CD11a mounted a robust secondary response to infection. Taken together, these findings demonstrated that CD11a expression contributes to expansion and differentiation of primary CD8 T cells but may be dispensable for secondary responses to infection.
The Surface Layer of Tannerella forsythia Contributes to Serum Resistance and Oral Bacterial Coaggregation
Authors: Shimotahira Naohiro , Oogai Yuichi , Kawada-Matsuo Miki , Yamada Sakuo , Fukutsuji Kenji , Nagano Keiji , Yoshimura Fuminobu , Noguchi Kazuyuki , Komatsuzawa Hitoshi 
Published: January 2013

ABSTRACT

Tannerella forsythia
is an anaerobic, Gram-negative bacterium involved in the so-called “red complex,” which is associated with severe and chronic periodontitis. The surface layer (S-layer) of
T. forsythia
is composed of cell surface glycoproteins, such as TfsA and TfsB, and is known to play a role in adhesion/invasion and suppression of proinflammatory cytokine expression. Here we investigated the association of this S-layer with serum resistance and coaggregation with other oral bacteria. The growth of the S-layer-deficient mutant in a bacterial medium containing more than 20% non-heat-inactivated calf serum (CS) or more than 40% non-heat-inactivated human serum was significantly suppressed relative to that of the wild type (WT). Next, we used confocal microscopy to perform quantitative analysis on the effect of serum. The survival ratio of the mutant exposed to 100% non-heat-inactivated CS (76% survival) was significantly lower than that of the WT (97% survival). Furthermore, significant C3b deposition was observed in the mutant but not in the WT. In a coaggregation assay, the mutant showed reduced coaggregation with
Streptococcus sanguinis
,
Streptococcus salivarius
, and
Porphyromonas gingivalis
but strong coaggregation with
Fusobacterium nucleatum
. These results indicated that the S-layer of
T. forsythia
plays multiple roles in virulence and may be associated with periodontitis.
The Type VI Secretion System Encoded in Salmonella Pathogenicity Island 19 Is Required for Salmonella enterica Serotype Gallinarum Survival within Infected Macrophages
Authors: Blondel Carlos J. , Jiménez Juan C. , Leiva Lorenzo E. , Álvarez Sergio A. , Pinto Bernardo I. , Contreras Francisca , Pezoa David , Santiviago Carlos A. , Contreras Inés 
Published: January 2013

ABSTRACT

Salmonella enterica
serotype Gallinarum is the causative agent of fowl typhoid, a disease characterized by high morbidity and mortality that causes major economic losses in poultry production. We have reported that
S
. Gallinarum harbors a type VI secretion system (T6SS) encoded in
Salmonella
pathogenicity island 19 (SPI-19) that is required for efficient colonization of chicks. In the present study, we aimed to characterize the SPI-19 T6SS functionality and to investigate the mechanisms behind the phenotypes previously observed
in vivo
. Expression analyses revealed that SPI-19 T6SS core components are expressed and produced under
in vitro
bacterial growth conditions. However, secretion of the structural/secreted components Hcp1, Hcp2, and VgrG to the culture medium could not be determined, suggesting that additional signals are required for T6SS-dependent secretion of these proteins.
In vitro
bacterial competition assays failed to demonstrate a role for SPI-19 T6SS in interbacterial killing. In contrast, cell culture experiments with murine and avian macrophages (RAW264.7 and HD11, respectively) revealed production of a green fluorescent protein-tagged version of VgrG soon after
Salmonella
uptake. Furthermore, infection of RAW264.7 and HD11 macrophages with deletion mutants of SPI-19 or strains with genes encoding specific T6SS core components (
clpV
and
vgrG
) revealed that SPI-19 T6SS contributes to
S
. Gallinarum survival within macrophages at 20 h postuptake. SPI-19 T6SS function was not linked to
Salmonella
-induced cytotoxicity or cell death of infected macrophages, as has been described for other T6SS. Our data indicate that SPI-19 T6SS corresponds to a novel tool used by
Salmonella
to survive within host cells.
Pathology and Pathophysiology of Inhalational Anthrax in a Guinea Pig Model
Authors: Savransky Vladimir , Sanford Daniel C. , Syar Emily , Austin Jamie L. , Tordoff Kevin P. , Anderson Michael S. , Stark Gregory V. , Barnewall Roy E. , Briscoe Crystal M. , Lemiale-Biérinx Laurence , Park Sukjoon , Ionin Boris , Skiadopoulos Mario H. 
Published: January 2013

ABSTRACT

Nonhuman primates (NHPs) and rabbits are the animal models most commonly used to evaluate the efficacy of medical countermeasures against anthrax in support of licensure under the FDA's “Animal Rule.” However, a need for an alternative animal model may arise in certain cases. The development of such an alternative model requires a thorough understanding of the course and manifestation of experimental anthrax disease induced under controlled conditions in the proposed animal species. The guinea pig, which has been used extensively for anthrax pathogenesis studies and anthrax vaccine potency testing, is a good candidate for such an alternative model. This study was aimed at determining the median lethal dose (LD
50
) of the
Bacillus anthracis
Ames strain in guinea pigs and investigating the natural history, pathophysiology, and pathology of inhalational anthrax in this animal model following nose-only aerosol exposure. The inhaled LD
50
of aerosolized Ames strain spores in guinea pigs was determined to be 5.0 × 10
4
spores. Aerosol challenge of guinea pigs resulted in inhalational anthrax with death occurring between 46 and 71 h postchallenge. The first clinical signs appeared as early as 36 h postchallenge. Cardiovascular function declined starting at 20 h postexposure. Hematogenous dissemination of bacteria was observed microscopically in multiple organs and tissues as early as 24 h postchallenge. Other histopathologic findings typical of disseminated anthrax included suppurative (heterophilic) inflammation, edema, fibrin, necrosis, and/or hemorrhage in the spleen, lungs, and regional lymph nodes and lymphocyte depletion and/or lymphocytolysis in the spleen and lymph nodes. This study demonstrated that the course of inhalational anthrax disease and the resulting pathology in guinea pigs are similar to those seen in rabbits and NHPs, as well as in humans.
Disparities in fatal and non-fatal injuries between Irish travellers and the Irish general population are similar to those of other indigenous minorities: a cross-sectional population-based comparative study
Authors: Abdalla Safa , Kelleher Cecily C , Quirke Brigid , Daly Leslie ,   on behalf of the All-Ireland traveller Health Study team
Published: January 2013

ObjectivesTo assess recent disparities in fatal and non-fatal injury between travellers and the general population in Ireland.DesignA cross-sectional population-based comparative study.SettingRepublic of Ireland.ParticipantsPopulation census and retrospective mortality data were collected from 7042 traveller families, travellers being those identified by themselves and others as members of the traveller community. Retrospective injury incidence was estimated from a survey of a random sample of travellers in private households, aged 15 years or over (702 men and 961 women). Comparable general population data were obtained from official statistical reports, while retrospective incidence was estimated from the Survey of Lifestyle, Attitude and Nutrition 2002, a random sample of 5992 adults in private households aged 18 years or over.Outcome measuresPotential Years of Life Lost (PYLL), Standardised Mortality Ratios (SMR), Standardised Incidence Ratios (SIR) and Case Fatality Ratios (CFR).ResultsInjury accounted for 36% of PYLL among travellers, compared with 13% in the general population. travellers were more likely to die of unintentional injury than the general population (SMR=454 (95% CI 279 to 690) in men and 460 (95% CI 177 to 905) in women), with a similar pattern for intentional injury (SMR=637 (95% CI 367 to 993) in men and 464 (95% CI 107 to 1204 in women). They had a lower incidence of unintentional injury but those aged 65 years or over were about twice as likely to report an injury. Travellers had a higher incidence of intentional injuries (SIR=181 (95% CI 116 to 269) in men and 268 (95% CI 187 to 373) in women). Injury CFR were consistently higher among travellers.ConclusionsIrish travellers continue to bear a disproportionate burden of injury, which calls for scaling up injury prevention efforts in this group. Prevention and further research should focus on suicide, alcohol misuse and elderly injury among Irish travellers.
Extending access to specialist services: the impact of an onsite helipad and analysis of the first 100 flights
Authors: Freshwater Eleanor S , Dickinson Phillip , Crouch Robert , Deakin Charles D , Eynon C Andy 
Published: January 2013

BackgroundIn November 2011, University Hospital Southampton (UHS), now a major trauma centre, opened its onsite helipad, allowing patients to be brought to the emergency department (ED) directly by air ambulance. Prior to this, helicopters were required to land at a local playing field and the patient had to be transferred by land ambulance. This study aims to investigate the impact this change in practice has had on the flow of patients to the ED.MethodsThe authors completed a retrospective case analysis of the first 100 patients brought directly to UHS by helicopter. Data were obtained from ED notes and helicopter provider databases. Analysis was conducted on the type of incident and appropriateness of referral. Incident locations were plotted geographically.Results100 patients arrived at UHS ED by helicopter between 17 November 2011 and 31 March 2012. Of these, 79 were primary helicopter emergency medical service (HEMS) missions and 21 were secondary transfers from other hospitals. Of the HEMS patients, 38 were likely to have been transported to another hospital, had there not been an onsite helipad at UHS. 29 passed another suitable receiving hospital en route and therefore may have come to UHS for speciality services.ConclusionsThe provision of an onsite, 24 h helipad facility at UHS has resulted in a significant number of patients being transported to the hospital by helicopter who might otherwise have attended an alternative hospital.
Association of out-of-hospital advanced airway management with outcomes after traumatic brain injury and hemorrhagic shock in the ROC hypertonic saline trial
Authors: Wang Henry E , Brown Siobhan P , MacDonald Russell D , Dowling Shawn K , Lin Steve , Davis Daniel , Schreiber Martin A , Powell Judy , van Heest Rardi , Daya Mohamud 
Published: January 2013

ObjectivePrior studies suggest adverse associations between out-of-hospital advanced airway management (AAM) and patient outcomes after major trauma. This secondary analysis of data from the Resuscitation Outcomes Consortium Hypertonic Saline Trial evaluated associations between out-of-hospital AAM and outcomes in patients suffering isolated severe traumatic brain injury (TBI) or haemorrhagic shock.MethodsThis multicentre study included adults with severe TBI (GCS ≤8) or haemorrhagic shock (SBP ≤70 mm Hg, or (SBP 71–90  mm Hg and heart rate ≥108 bpm)). We compared patients receiving out-of-hospital AAM with those receiving emergency department AAM. We evaluated the associations between airway strategy and patient outcomes (28-day mortality, and 6-month poor neurologic or functional outcome) and airway strategy, adjusting for confounders. Analysis was stratified by (1) patients with isolated severe TBI and (2) patients with haemorrhagic shock with or without severe TBI.ResultsOf 2135 patients, we studied 1116 TBI and 528 shock; excluding 491 who died in the field, did not receive AAM or had missing data. In the shock cohort, out-of-hospital AAM was associated with increased 28-day mortality (adjusted OR 5.14; 95% CI 2.42 to 10.90). In TBI, out-of-hospital AAM showed a tendency towards increased 28-day mortality (adjusted OR 1.57; 95% CI 0.93 to 2.64) and 6-month poor functional outcome (1.63; 1.00 to 2.68), but these differences were not statistically significant. Out-of-hospital AAM was associated with poorer 6-month TBI neurologic outcome (1.80; 1.09 to 2.96).ConclusionsOut-of-hospital AAM was associated with increased mortality after haemorrhagic shock. The adverse association between out-of-hospital AAM and injury outcome is most pronounced in patients with haemorrhagic shock.
The delivery of the new prehospital emergency medicine curriculum: reflections on a pilot programme in the UK
Authors: McQueen Carl , Wyse Matthew 
Published: January 2013

IntroductionPre-hospital Emergency Medicine is a subspecialty of Emergency Medicine and Anaesthesia in the UK, overseen by the Inter-collegiate Board for Training in Pre-hospital Emergency Medicine (IBTPHEM). Organisations delivering General Medical Council (GMC) approved programmes require clear educational governance frameworks to ensure high standards of training. This study outlines the experiences of an Emergency Medicine trainee during an Out of Programme Year with a regional Air Ambulance service in the UK.MethodsRetrospective review of the clinical logbook for an Emergency Medicine trainee during a 12-month attachment with an Air Ambulance service in the UK. IBTPHEM assessment tools were completed to complement the clinical logbook. Clinical experience and the degree of clinical supervision were compared with the standards published by the IBTPHEM.ResultsSupervision rates were similar to those in other pilots (17.33%). Clinical workload was comparable with that reported in other organisations. More advanced procedures (eg, conscious sedation/prehospital anaesthetics) were completed than in IBTPHEM pilot programmes. The vast majority of curriculum elements detailed by the IBTPHEM were fulfilled.ConclusionsThe experiences of an Emergency Medicine trainee in pilot programme at a regional Air Ambulance in the UK compared favourably with the results of formal pilots of the IBTPHEM programme conducted at other centres. The IBTPHEM assessment tools are appropriately designed and sufficient in number to ensure that fulfilment of the curriculum elements can be recorded and trainee development monitored. Areas for future developments in training and support, notably in curriculum areas regarding the management of obstetric prehospital emergencies, are suggested.
Adaptive Equi-Energy Sampler
Authors: Schreck Amandine , Fort Gersende , Moulines Eric 
Published: January 2013

Markov chain Monte Carlo (MCMC) methods allow to sample a distribution known up to a multiplicative constant. Classical MCMC samplers are known to have very poor mixing properties when sampling multimodal distributions. The Equi-Energy sampler is an interacting MCMC sampler proposed by Kou, Zhou and Wong in 2006 to sample difficult multimodal distributions. This algorithm runs several chains at different temperatures in parallel, and allow lower-tempered chains to jump to a state from a higher-tempered chain having an energy “close” to that of the current state. A major drawback of this algorithm is that it depends on many design parameters and thus, requires a significant effort to tune these parameters.
In this article, we introduce an Adaptive Equi-Energy (AEE) sampler that automates the choice of the selection mecanism when jumping onto a state of the higher-temperature chain. We prove the ergodicity and a strong law of large numbers for AEE, and for the original Equi-Energy sampler as well. Finally, we apply our algorithm to motif sampling in DNA sequences.
Prognostic Value of Energy Loss Index in Asymptomatic Aortic Stenosis
Authors: Bahlmann Edda , Gerdts Eva , Cramariuc Dana , Gohlke-Baerwolf Christa , Nienaber Christoph A. , Wachtell Kristian , Seifert Reinhard , Chambers John B. , Kuck Karl Heinz , Ray Simon 
Published: January 2013

Background—
Aortic valve area index adjusted for pressure recovery (energy loss index [ELI]) has been suggested as a more accurate measure of aortic stenosis (AS) severity, but its prognostic value has not been determined in a prospective study.

Methods and Results—

The relation between baseline ELI and rate of aortic valve events and combined total mortality and hospitalization for heart failure resulting from the progression of AS was assessed by multivariate Cox regression and reclassification analysis in 1563 patients with initial asymptomatic AS in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. During 4.3 years follow-up, a total of 498 aortic valve events and 181 combined total mortalities and hospitalizations for heart failure caused by the progression of AS occurred. In Cox regression analyses, 1-cm
2
/m
2
lower baseline ELI predicted a 2-fold higher risk both for aortic valve events and for combined total mortality and hospitalization for heart failure independently of baseline peak aortic jet velocity or mean aortic gradient and independently of aortic root size (all
P
<0.05). In reclassification analysis, ELI improved the prediction of aortic valve events by 13% (95% confidence interval, 5–19), whereas the prediction of combined total mortality and hospitalization for heart failure resulting from the progression of AS did not improve significantly.

Conclusions—
In asymptomatic AS patients without known atherosclerotic disease or diabetes mellitus, ELI provides independent and additional prognostic information to that derived from conventional measures of AS severity, suggesting that ELI should be measured in such patients.

Clinical Trial Registration Information—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00092677.
Understanding Enmity and Friendship in World Politics: The Case for a Diplomatic Approach
Authors: Bjola Corneliu 
Published: January 2013

Summary
This article invites diplomatic scholars to a debate about the identity of diplomacy as a field of study and the contributions that it can make to our understanding of world politics relative to international relations theory (IR) or foreign policy analysis (FPA). To this end, the article argues that the study of diplomacy as a method of building and managing relationships of enmity and friendship in world politics can most successfully firm up the identity of the discipline. More specifically, diplomacy offers a specialized form of knowledge for understanding how to draw distinctions between potential allies versus rivals, and how to make and unmake relationships of enmity and friendship in world politics.