bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outbreak of Klebsiella pneumoniae Carbapenemase-2-Producing K. pneumoniae Sequence Type 11 in Taiwan in 2011
Authors: Lee Chun-Ming , Liao Chun-Hsing , Lee Wen-Sen , Liu Yung-Ching , Mu Jung-Jung , Lee Meng-Chih , Hsueh Po-Ren 
Published: July 2012

ABSTRACT

From June to September 2011, a total of 305 ertapenem-nonsusceptible
Enterobacteriaceae
isolates (MICs of ertapenem ≥ 1 μg/ml) were collected from 11 hospitals in different parts of Taiwan. The MICs of 12 antimicrobial agents against these isolates were determined using the broth microdilution method, and genes for carbapenemases were detected using PCR. Genotypes of isolates possessing carbapenemase genes were identified by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing. The ertapenem-nonsusceptible
Enterobacteriaceae
isolates included
Klebsiella pneumoniae
(
n
= 219),
Escherichia coli
(
n
= 64),
Enterobacter cloacae
(
n
= 15), and other species (
n
= 7). Seven (2.3%) of the ertapenem-nonsusceptible
Enterobacteriaceae
isolates exhibited colistin MICs of >4 μg/ml, and 24 (7.9%) were not susceptible to tigecycline (MICs > 2 μg/ml). A total of 29 (9.5%) isolates carried genes encoding carbapenemases, namely,
K. pneumoniae
carbapenemase-2 (KPC-2) in 16 (7.3%) isolates of
K. pneumoniae
(KPC-2-KP) and IMP-8 in 5 (2.3%) isolates of
K. pneumoniae
, 5 (33.3%) isolates of
E. cloacae
, 1 isolate of
E. coli
, 1 isolate of
Klebsiella oxytoca
, and one isolate of
Citrobacter freundii
. The 16 KPC-2-KP isolates were isolated from patients at four different hospitals in northern Taiwan. All 16 of the KPC-2-KP isolates were susceptible to amikacin and colistin and had a similar pulsotype (pulsotype 1) and the same sequence type (sequence type 11). Infections due to KPC-2-KP mainly occurred in severely ill patients in the intensive care unit (
n
= 14, 88%). Four patients with infections due to KPC-2-KP died within 14 days of hospitalization. The findings are the first to demonstrate intrahospital and interhospital dissemination of KPC-2-KP in northern Taiwan.
Existence of Separate Domains in Lysin PlyG for Recognizing Bacillus anthracis Spores and Vegetative Cells
Authors: Yang Hang , Wang Dian-Bing , Dong Qiuhua , Zhang Zhiping , Cui Zongqiang , Deng Jiaoyu , Yu Junping , Zhang Xian-en , Wei Hongping 
Published: July 2012

ABSTRACT

As a potential antimicrobial, the bacteriophage lysin PlyG has been reported to specifically recognize
Bacillus anthracis
vegetative cells only and to kill
B. anthracis
vegetative cells and its germinating spores. However, how PlyG interacts with
B. anthracis
spores remains unclear. Herein, a 60-amino-acid domain in PlyG (residues 106 to 165), located mainly in the previously identified catalytic domain, was found able to specifically recognize
B. anthracis
spores but not vegetative cells. The exosporium of the spores was found to be the most probable binding target of this domain. This is the first time that a lysin for spore-forming bacteria has been found to have separate domains to recognize spores and vegetative cells, which might help in understanding the coevolution of phages with spore-forming bacteria. Besides providing new biomarkers for developing better assays for identifying
B. anthracis
spores, the newly found domain may be helpful in developing PlyG as a preventive antibiotic to reduce the threat of anthrax in suspected exposures to
B. anthracis
spores.
Role of Heme Oxygenase-1 in Polymyxin B-Induced Nephrotoxicity in Rats
Authors: Dezoti Fonseca Cassiane , Watanabe Mirian , Vattimo Maria de Fátima Fernandes 
Published: July 2012

ABSTRACT

Polymyxin B (PMB) is a cationic polypeptide antibiotic with activity against multidrug-resistant Gram-negative bacteria. PMB-induced nephrotoxicity consists of direct toxicity to the renal tubules and the release of reactive oxygen species (ROS) with oxidative damage. This study evaluated the nephroprotective effect of heme oxygenase-1 (HO-1) against PMB-induced nephrotoxicity in rats. Adult male Wistar rats, weighing 286 ± 12 g, were treated intraperitoneally once a day for 5 days with saline, hemin (HO-1 inducer; 10 mg/kg), zinc protoporphyrin (ZnPP) (HO-1 inhibitor; 50 μmol/kg, administered before PMB on day 5), PMB (4 mg/kg), PMB plus hemin, and PMB plus ZnPP. Renal function (creatinine clearance, Jaffe method), urinary peroxides (ferrous oxidation of xylenol orange version 2 [FOX-2]), urinary thiobarbituric acid-reactive substances (TBARS), renal tissue thiols, catalase activity, and renal tissue histology were analyzed. The results showed that PMB reduced creatinine clearance (
P
< 0.05), with an increase in urinary peroxides and TBARS. The PMB toxicity caused a reduction in catalase activity and thiols (
P
< 0.05). Hemin attenuated PMB nephrotoxicity by increasing the catalase antioxidant activity (
P
< 0.05). The combination of PMB and ZnPP incremented the fractional interstitial area of renal tissue (
P
< 0.05), and acute tubular necrosis in the cortex area was also observed. This is the first study demonstrating the protective effect of HO-1 against PMB-induced nephrotoxicity.
Topical Neutralization of Interleukin-17 during Experimental Pseudomonas aeruginosa Corneal Infection Promotes Bacterial Clearance and Reduces Pathology
Authors: Zaidi Tanweer S. , Zaidi Tauqeer , Pier Gerald B. , Priebe Gregory P. 
Published: July 2012

ABSTRACTThe proinflammatory cytokine interleukin-17 (IL-17) is involved in neutrophilic tissue infiltration, contributing to both microbial clearance as well as inflammation-associated tissue damage. Its role during bacterial corneal infections is unknown. We hypothesized that IL-17 responses would be detrimental in this setting and tested the impact of IL-17 receptor deficiency or antibody-mediated neutralization of IL-17 in a murine model ofPseudomonas aeruginosaulcerative keratitis after scratch injury. We found that, compared with infected corneas from wild-type mice, those from IL-17 receptor (IL-17R)-deficient mice had significantly lower corneal pathology scores, neutrophil influx, and intracellular bacterial levels. Infected IL-17R-deficient corneas had low intercellular adhesion molecule 1 (ICAM-1) expression, and ICAM-1-deficient mice were similarly resistant to infection. Topical treatment with polyclonal antibodies to IL-17 resulted in significant reductions in corneal pathology and also lowered bacterial counts after infection with six different laboratory or clinicalP. aeruginosastrains, including both invasive and cytotoxic strains. Thus, neutralization of IL-17 duringP. aeruginosacorneal infection reduces neutrophil influx and pathology without compromising bacterial clearance and offers a promising new avenue for therapy of these potentially sight-threatening infections.
The K1K2 Region of Lys-Gingipain of Porphyromonas gingivalis Blocks Induction of HLA Expression by Gamma Interferon
Authors: Yun Peter L. , Li Nan , Collyer Charles A. , Hunter Neil 
Published: July 2012

ABSTRACTIn the context of periodontal disease, cysteine proteinases or gingipains fromPorphyromonas gingivalishave been implicated in the hydrolysis of cytokines, including gamma interferon (IFN-γ). This cytokine plays a crucial role in host defenses, in part, by regulating expression of major histocompatibility complex molecules. Our recent analysis has identified three structurally defined modules, K1, K2, and K3, of the hemagglutinin region of the lysine gingipain Kgp. These three structurally homologous domains have a common β-sandwich topology that is similar to that found in a superfamily of adhesins and carbohydrate binding domains. The three Kgp hemagglutinin modules are distinguished by variation in some of the loops projecting from the β-sandwich core. Recombinant products corresponding to both single and multidomain regions as well as native Kgp bound IFN-γ with similar affinities. Among the adhesin domain constructs, only the K1K2 polypeptide inhibited the upregulation of HLA-1 expression in a human erythroleukemia (K562) line induced by both recombinant and native IFN-γ. The K1K2 polypeptide also inhibited HLA-DR expression induced by IFN-γ in human umbilical vein endothelial cells. These effects were competitively inhibited by coincubation with sodium or potassium chloride solution. The N-terminal residues of IFN-γ were implicated in mediating the effect of K1K2, while antibody binding to loop 1 of K2 blocked the action of K1K2. The findings indicate the potential significance of structurally defined Kgp adhesin modules in the inactivation of IFN-γ but also the potential of K1K2 in locating the target for the catalytic domain of Kgp.
Evolution and Virulence Contributions of the Autotransporter Proteins YapJ and YapK of Yersinia pestis CO92 and Their Homologs in Y. pseudotuberculosis IP32953
Authors: Lenz Jonathan D. , Temple Brenda R. S. , Miller Virginia L. 
Published: July 2012

ABSTRACT

Yersinia pestis
, the causative agent of plague, evolved from the gastrointestinal pathogen
Yersinia pseudotuberculosis
. Both species have numerous type Va autotransporters, most of which appear to be highly conserved. In
Y. pestis
CO92, the autotransporter genes
yapK
and
yapJ
share a high level of sequence identity. By comparing
yapK
and
yapJ
to three homologous genes in
Y. pseudotuberculosis
IP32953 (YPTB0365, YPTB3285, and YPTB3286), we show that
yapK
is conserved in
Y. pseudotuberculosis
, while
yapJ
is unique to
Y. pestis
. All of these autotransporters exhibit >96% identity in the C terminus of the protein and identities ranging from 58 to 72% in their N termini. By extending this analysis to include homologous sequences from numerous
Y. pestis
and
Y. pseudotuberculosis
strains, we determined that these autotransporters cluster into a YapK (YPTB3285) class and a YapJ (YPTB3286) class. The YPTB3286-like gene of most
Y. pestis
strains appears to be inactivated, perhaps in favor of maintaining
yapJ
. Since autotransporters are important for virulence in many bacterial pathogens, including
Y. pestis
, any change in autotransporter content should be considered for its impact on virulence. Using established mouse models of
Y. pestis
infection, we demonstrated that despite the high level of sequence identity,
yapK
is distinct from
yapJ
in its contribution to disseminated
Y. pestis
infection. In addition, a mutant lacking both of these genes exhibits an additive attenuation, suggesting nonredundant roles for
yapJ
and
yapK
in systemic
Y. pestis
infection. However, the deletion of the homologous genes in
Y. pseudotuberculosis
does not seem to impact the virulence of this organism in orogastric or systemic infection models.
Oxylator and SCUBA dive regulators: useful utilities for in-water resuscitation
Authors: Winkler Bernd E , Froeba Gebhard , Koch Andreas , Kaehler Wataru , Muth Claus-Martin 
Published: July 2012

IntroductionIn water resuscitation has been reported to enhance the outcome of drowning victims. Mouth-to-mouth ventilation during swimming is challenging. Therefore, the efficacy of ventilation utilities was evaluated.MethodsVentilation was assessed with the Oxylator ventilator, as well as the consecutive self-contained underwater breathing apparatus (SCUBA) regulators using an anaesthetic test lung: Poseidon Cyklon 5000, Poseidon XStream, Apeks TX 100, Spiro Arctic, Scubapro Air2 and Buddy AutoAir.ResultsOxylator, Apeks TX 100, Arctic and Buddy AutoAir delivered reliable peak pressures and tidal volumes. In contrast, the ventilation parameters remarkably depended on duration and depth of pressing the purge button in Poseidon Cyklon 5000, Poseidon XStream and Scubapro Air2. Critical peak pressures occurred during ventilation with all these three regulators.DiscussionThe use of Poseidon Cyklon 5000, Poseidon XStream and Scubapro Air2 regulators is consequently not recommended for in-water ventilation. With the limitation that the devices were tested with a test lung and not in a human field study, Apeks TX 100, Spiro Arctic and Buddy AutoAir might be used for emergency ventilation and probably ease in-water resuscitation for the dive buddy of the victim. Professional rescue divers could be equipped with the Oxylator and an oxygen tank to achieve an early onset of efficient in-water ventilation in drowning victims.
Triage vital signs do not correlate with serum lactate or base deficit, and are less predictive of operative intervention in penetrating trauma patients: a prospective cohort study
Authors: Caputo Nicholas , Fraser Robert , Paliga Andrew , Kanter Marc , Hosford Karlene , Madlinger Robert 
Published: July 2012

BackgroundTriage vital signs are often used to help determine a trauma patient's haemodynamic status. Recent studies have demonstrated that these may not be very specific in determining major injury. The purpose of this study was to determine if there is any correlation between triage vital signs, base deficit (BD) and lactate, and to determine the odds of operative intervention in penetrating trauma patients.MethodsA prospective observational cohort study was undertaken. Baseline vital signs, BD and lactate were recorded in all patients for whom the trauma team was activated. Pearson correlation and coefficient (ρ) were calculated. ORs were calculated.Results75 patients were enrolled. Pearson correlations and coefficients calculated for lactate to systolic blood pressure were: −0.052 (ρ=0.0011, 95% CI −0.225 to 0.228); lactate and HR: 0.23 (ρ=0.0166, 95% CI −0.211 to 0.242); lactate and RR: 0.23 (ρ=0.054, 95% CI −0.174 to 0.277). BD to systolic blood pressure were: 0.003 (ρ=0.00001, 95% CI −0.229 to 0.224); BD and HR: −0.19 (ρ=0.038, 95% CI −0.399 to 0.038); BD and RR: −0.019 (ρ=0.0004, 95% CI −0.244 to 0.208). Odds of operative intervention were greater in patients with abnormally high lactate, OR 4.17 (95% CI 1.57 to 11), but not for BD, OR 2.53 (95% CI 0.99 to 6.45), or any of the vital signs.ConclusionsTriage vital signs have no correlation to lactate or BD levels in penetrating trauma patients. Odds of operative intervention are greater in patients with abnormally high serum lactate levels, but not in those with abnormal triage vital signs or BD.
Early Predictors of Survival to and After Heart Transplantation in Children With Dilated Cardiomyopathy
Authors: Pietra Biagio A. , Kantor Paul F. , Bartlett Heather L. , Chin Clifford , Canter Charles E. , Larsen Ranae L. , Edens R. Erik , Colan Steven D. , Towbin Jeffrey A. , Lipshultz Steven E. , Kirklin James K. , Naftel David C. , Hsu Daphne T. 
Published: July 2012

Background—
The importance of clinical presentation and pretransplantation course on outcome in children with dilated cardiomyopathy listed for heart transplantation is not well defined.

Methods and Results—

The impact of age, duration of illness, sex, race, ventricular geometry, and diagnosis of myocarditis on outcome in 261 children with dilated cardiomyopathy enrolled in the Pediatric Cardiomyopathy Registry and Pediatric Heart Transplant Study was studied. End points included listing as United Network for Organ Sharing status 1, death while waiting, and death after transplantation. The median age at the time of diagnosis was 3.4 years, and the mean time from diagnosis to listing was 0.62±1.3 years. Risk factors associated with death while waiting were ventilator use and older age at listing in patients not mechanically ventilated (
P
=0.0006 and
P
=0.03, respectively). Shorter duration of illness (
P
=0.04) was associated with listing as United Network for Organ Sharing status 1. Death after transplantation was associated with myocarditis at presentation (
P
=0.009), nonwhite race (
P
<0.0001), and a lower left ventricular end-diastolic dimension
z
score at presentation (
P
=0.04). In the myocarditis group, 17% (4 of 23) died of acute rejection after transplantation.

Conclusions—
Mechanical ventilator use and older age at listing predicted death while waiting, whereas nonwhite race, smaller left ventricular dimension, and myocarditis were associated with death after transplantation. Although 97% of children with clinically or biopsy-diagnosed myocarditis at presentation survived to transplantation, they had significantly higher posttransplantation mortality compared with children without myocarditis, raising the possibility that preexisting viral infection or inflammation adversely affects graft survival.
Monthly Weather Forecasts in a Pest Forecasting Context: Downscaling, Recalibration, and Skill Improvement
Authors: Hirschi Martin , Spirig Christoph , Weigel Andreas P. , Calanca Pierluigi , Samietz Jörg , Rotach Mathias W. 
Published: July 2012

AbstractMonthly weather forecasts (MOFCs) were shown to have skill in extratropical continental regions for lead times up to 3 weeks, in particular for temperature and if weekly averaged. This skill could be exploited in practical applications for implementations exhibiting some degree of memory or inertia toward meteorological drivers, potentially even for longer lead times. Many agricultural applications fall into these categories because of the temperature-dependent development of biological organisms, allowing simulations that are based on temperature sums. Most such agricultural models require local weather information at daily or even hourly temporal resolution, however, preventing direct use of the spatially and temporally aggregated information of MOFCs, which may furthermore be subject to significant biases. By the example of forecasting the timing of life-phase occurrences of the codling moth (Cydia pomonella), which is a major insect pest in apple orchards worldwide, the authors investigate the application of downscaled weekly temperature anomalies of MOFCs for use in an impact model requiring hourly input. The downscaling and postprocessing included the use of a daily weather generator and a resampling procedure for creating hourly weather series and the application of a recalibration technique to correct for the original underconfidence of the forecast occurrences of codling moth life phases. Results show a clear skill improvement of up to 3 days in root-mean-square error over the full forecast range when incorporating MOFCs as compared with deterministic benchmark forecasts using climatological information for predicting the timing of codling moth life phases.
Early support visits by district nurses to cancer patients at home: A multi-perspective qualitative study
Authors: Griffiths Jane , Ewing Gail , Rogers Margaret 
Published: July 2012

Background: Many palliative cancer patients spend much of their last year at home. In the UK, district nurses make frequent support visits to patients and carers at this time, yet surprisingly little is known about their supportive role in palliative care. Current studies are limited to district nurses’ reports of practice, which offer limited insight into their content. Patients’ and carers’ views on district nurse support visits are largely unknown. Aim: To present findings of a multi-perspective study that explored how district nurse early support visits are both described and carried out. Design: Focus groups with district nurses to explore views on the purpose of early support visits. Observation of support visits to identify how they are conducted. Patient and carer interviews to elucidate and verify district nurse data. Setting and participants: Participants included 58 district nurses, 10 palliative care patients and nine carers from four Primary Care Trusts in contrasting urban and rural locations. Results: District nurses had difficulty articulating early support visits. Observations however revealed a complex role comprising extensive physical and practical assessments, practical interventions, information giving, liaison, facilitation and referral. Patients and carers confirmed that they felt valued, reassured and supported by district nurses. Conclusions: A multi-perspective approach provided new insights into district nurse support visits. Monitoring work described appears to have additional psycho-social benefits for patients and carers. The supportive role of district nurses needs to be clearly articulated and recognised so that colleagues, patients and carers access this valuable resource for palliative care patients.
The Illness Density Index (IDI): A longitudinal measure of treatment efficacy
Authors: Kelley Mary E , Franco Alexandre R , Mayberg Helen S , Holtzheimer Paul E 
Published: July 2012

Background A reliable and meaningful quantitative index of success is paramount in the trial of any new treatment. However, existing methods for defining response and remission for treatments tested for psychiatric disorders are limited in that they often minimize the variance in change over time among individual patients and generally use arbitrarily chosen levels of functioning at specified times during treatment. Purpose To suggest and determine the properties of an alternative measure of treatment success, the Illness Density Index (IDI), that may be more sensitive to fluctuations in symptoms over the course of treatment compared to existing measures. Methods We examined data from 64 depressed patients with multiple assessments of the Hamilton Depression Rating Scale (HDRS) over 12 weeks of randomized treatment in order to compare and contrast varying numerical definitions of response and remission, including percent change and linear slope over time. Results Examination of the indices comparing the within-sample rank of individual patients revealed that these indices agree in cases where patients have little or no response as well as clear and sustained response, while they differ in patients who have a slow (or late) response as well as relapse during the treatment course. Limitations The measure may not be useful for all types of studies, especially short-term treatment trials. Conclusions The IDI is highly correlated with both categorical (e.g., remission) and continuous (e.g., percent change) definitions of treatment success. Furthermore, it differentiates certain trajectories of change that current definitions do not. Thus, the proposed index may be a valuable addition to current measures of efficacy, especially when trying to identify biological substrates of illness or predictors of long-term outcome.