Inducible ‘AmpC-type’ chromosomal cephalosporinases have been reported to be differentially expressed in different biotypes of Yersinia entercolocolitica. AmpD amidases are key regulators of the ...expression of ampC genes in Y. entercolocolitica as their inactivation results in hyper production of AmpC. To understand the differences in regulation of ampC expression in different biotypes of Y. enterocolitica, characteristics of ampD homologs were studied in strains of Y. enterocolitica belonging to five biotypes namely 1A, 1B, 2, 3 and 4. Our results indicated that the mechanisms which regulate expression of ampC might differ in different biotypes. While a three-step regulation mechanism seemed to be functional in biotypes 2, 3 and 4, a two-step regulation mechanism using other AmiD like proteins might be functional in biotypes 1A and 1B. The existence of ampD homolog(s)-mediated expression of ampC in other members of the family Enterobacteriaceae may provide further credence to our findings.
•AmpC cephalosporinases are differentially expressed in different biotypes of Y. entercolocolitica•AmpD amidases – regulators of ampC expression were studied in strains of five biotypes 1A, 1B, 2, 3 and 4•Two homologs of ampD and a two-step regulation mechanism was observed in biotypes 1A and 1B•Three homologs of ampD and a three-step regulation mechanism was observed in biotypes 2, 3 and 4
Nontuberculous mycobacteria (NTM) are environmentally acquired opportunistic pathogens that can cause chronic lung disease. Within the U.S., Hawai'i shows the highest prevalence rates of NTM lung ...infections. Here, we investigated a potential role for active volcanism at the Kīlauea Volcano located on Hawai'i Island in promoting NTM growth and diversity. We recovered NTM that are known to cause lung disease from plumbing biofilms and soils collected from the Kīlauea environment. We also discovered viable Mycobacterium avium, Mycobacterium abscessus, and Mycobacterium intracellulare subsp. chimaera on volcanic ash collected during the 2018 Kīlauea eruption. Analysis of soil samples showed that NTM prevalence is positively associated with bulk content of phosphorus, sulfur, and total organic carbon. In growth assays, we showed that phosphorus utilization is essential for proliferation of Kīlauea‐derived NTM, and demonstrate that NTM cultured with volcanic ash adhere to ash surfaces and remain viable. Ambient dust collected on O'ahu concurrent with the 2018 eruption contained abundant fresh volcanic glass, suggestive of inter‐island ash transport. Phylogenomic analyses using whole genome sequencing revealed that Kīlauea‐derived NTM are genetically similar to respiratory isolates identified on other Hawaiian Islands. Consequently, we posit that volcanic eruptions could redistribute environmental microorganisms over large scales. While additional studies are needed to confirm a direct role of ash in NTM dispersal, our results suggest that volcanic particulates harbor and can redistribute NTM and should therefore be studied as a fomite for these burgeoning, environmentally acquired respiratory infections.
Plain Language Summary
Nontuberculous mycobacteria (NTM) can cause environmentally acquired lung infections in susceptible individuals. While NTM infections are linked to household exposures, there are likely non‐household routes of acquisition. Hawai'i is a geographic hotspot for NTM lung disease, but the island‐specific environmental niches for NTM remain poorly understood. Thus, a greater knowledge of where susceptible individuals acquire their infections is an important public health endeavor that may lead to actions to mitigate potential sources of NTM exposures. In the current work, we show that particulate matter collected from Kīlauea Volcano on Hawai'i Island harbors Mycobacterium avium, Mycobacterium abscessus, and Mycobacterium intracellulare subsp. chimaera. Microbiologic, environmental, and NTM genetic data demonstrate that volcanic ash may act as a novel vehicle for the dispersal of clinically relevant NTM.
Key Points
Long‐range transport of hitch‐hiking infectious agents has never been reported for volcanic eruptions globally
Ash recovered from the 2018 Kīlauea Volcano eruption harbors species of nontuberculous mycobacteria (NTM) known to cause lung disease
Genomic evaluation reveals Kīlauea‐derived NTM are genetically similar to respiratory isolates identified on other Hawaiian Islands
Possession of mechanisms for iron acquisition and its storage enhances the ability of the bacteria to survive in the iron‐limiting environment of the host. In this study, 81 strains of Yersinia ...enterocolitica biovar 1A isolated from various clinical (n = 51) and non‐clinical (n = 30) sources were investigated for the presence of the genes related to iron acquisition and storage. Important genes which were present in more than 85% of the strains included hasA, foxA, bfr, bfd, ftnA, and hmsT as well as the fhuCDB, fepBDGCfesfepA, feoAB, yfuABCD, hemPRSTUV, and hmsHFRS gene clusters. Majority of these genes is being reported for the first time in biovar 1A strains and showed significant homology with genes present in the known pathogenic biovars of Y. enterocolitica. However, no significant difference was observed in the distribution of iron acquisition and storage‐related genes among clinical and non‐clinical biovar 1A strains. Thus, it may be suggested that the presence of iron acquisition and storage‐related genes per se might not be responsible for the supposedly better ability of clinical biovar 1A strains to cause infections in humans. However, in the backdrop of this data, the need to undertake functional studies are highly recommended.
Some people with chronic epilepsy (PWE) make clinically unnecessary, and potentially avoidable, visits to hospital emergency departments. Whilst expensive, it is not known how to reduce them. We ...recently conducted the first trial of an epilepsy-nurse specialist intervention which aimed to optimise self-management skills in PWE attending emergency departments and advise them on appropriate emergency services use. Based on in-depth semi-structured interviews, we here report the perceived support needs of patients who have attended a emergency department for epilepsy and the benefits of the intervention which they identified. Nested qualitative study. After receiving the intervention, 20 participants were invited to interview. They described their experience of the intervention, to what extent they valued it and its benefits and limitations. Interviews were audio-recorded, transcribed and thematically analysed. Most valued the additional support. Those who previously used emergency departments most perceived greatest benefit. Participants felt it redressed limitations to usual care, including providing information about living with epilepsy, and an opportunity to discuss feelings about epilepsy. Perceived benefits included improvements in emotional well-being, confidence dealing with seizures and medication adherence. The intervention was acceptable to patients. People with epilepsy who had attended a emergency department on more than one occasion perceived most benefit. This suggests they want additional care. Some perceived benefits in domains possibly causally related to emergency department use. This suggests the intervention, with optimisation, may have the components to reduce emergency department visits. Our results provide insights into how to support PWE who attend emergency departments and how needs differ amongst this group.
There are still few dermatological studies on morphea. We evaluated the epidemiological and clinical features and management of pediatric morphea, reporting dermatologists experience.
A multicenter ...retrospective observational study was carried out on the epidemiological and clinical features and management of the disease between 01/01/2009 and 01/10/2014 in 10 Italian Dermatological Units.
We collected the data of 69 children affected by: circumscribed morphea (39.1%); linear morphea of trunk and limbs (14.5%); en coupe de sabre morphea (ECDS) (14.5%); progressive facial hemiatrophy (8.7%); generalized form (18.8%); mixed morphea (4.4%). The mean age at onset was 6.86±3.21 years, mainly between 2 and 8 years, but is statistically significantly lower for ECDS (4.5±3.03). Localizations were: head/neck (30.4%), limbs (26.1%), trunk (14.5%), 2 or more sites (29%), most often the trunk plus limbs. Extracutaneous manifestations were observed in 26.1% patients. 10 patients presented a second autoimmune disorder. Treatments were topical in 26.1% cases and systemic (alone or associated with topical treatments) in 68.1%.
There was a lack of uniformity in the management of patients and an increasing awareness of dermatologists on the use of systemic therapies, in particular of methotrexate, which is no longer exclusive to rheumatologists. Methotrexate causes stabilization and improvement of the clinical signs, but topical creams are still considered adjuvant or maintenance therapies during/after the use of systemic drugs.
The present study showed the physicochemical and functional properties of protein isolates prepared from male and female common carp (Cyprinus carpio) muscle using pH‐shift method. The alkali (BPIs) ...and acid (APIs) protein isolates showed higher protein content than raw muscle. The decline in fat and ash content due to the removal of connective tissue during separation process was observed. The color properties of isolates varied significantly between gender as well as processing methods which could be related to total pigment content. The processing methods and gender differences resulted a significant variation in water absorption capacity, emulsifying activity index, emulsifying stability index, foaming stability, storage modulus, loss modulus, and Greinforcement. The SDS‐PAGE analysis showed the presence of different molecular weight polypeptides influencing functional and rheological properties of protein isolates from both genders. The present study overall depicted rheological and functional properties of BPIs and APIs from male were better than that of female.
Practical applications
Common carp being an exotic fish is cultured throughout India, especially in northern region. The present study entails comparative analysis of physicochemical, functional, and rheological properties of FPIs (BPIs and APIs) by pH‐shift method from both genders. The results from present study suggested that understanding the functionality of protein isolates prepared from different genders and processing methods can enhance their application as ingredients in food industry to make them more suitable for human consumption.
This study conducted at the PDM Dental College and Research Institute, Haryana, India, had the purpose of developing a teaching method based upon a five‐step method for teaching clinical skills to ...students proposed by the American College of Surgeons. This five‐step teaching method was used to place fissure sealants as an initial procedure by dental students in clinics. The sealant retention was used as an objective evaluation of the skill learnt by the students. The sealant retention was 92 percent at six‐ and twelve‐month evaluations and 90 percent at the eighteen‐month evaluation. These results indicate that simple methods can be devised for teaching clinical skills and achieve high success rates in clinical procedures requiring multiple steps.
Germline
PTEN
pathogenic variants cause a spectrum of disorders collectively labeled
PTEN
Hamartoma Tumor Syndrome (PHTS) and featured by hamartomas, developmental anomalies and increased cancer ...risk. Studies on experimental models provided evidence that
PTEN
is a “haploinsufficient” tumor-suppressor gene, however, mechanisms involved in the pathogenesis of clinical manifestations in PHTS patients remain elusive. Beyond analyzing clinical and molecular features of a series of 20 Italian PHTS patients, we performed molecular investigations to explore the mechanisms involved in the pathogenesis of
PTEN
-associated manifestations, with special focus on mucocutaneous manifestations. Typical mucocutaneous features were present in all patients assessed, confirming that these are the most important clue to the diagnosis. The most frequent were papules located in the trunk or extremities (73.7%), oral mucosa papules (68.4%), acral/palmoplantar keratosis and facial papules (both 57.9%), according with literature data. Molecular analyses on one trichilemmoma suggested that the wild-type
PTEN
allele was retained and expressed, reinforcing the evidence that
PTEN
does not require a second somatic hit to initiate pathogenic processes. Unexpectedly, one patient also displayed a cutaneous phenotype consistent with atypical mole/melanoma syndrome; no variants were detected in known melanoma genes, but Whole Exome Sequencing showed the rare truncating variant c.495G>A in the
CDH13
gene that might have cooperated with
PTEN
-haploinsufficiency to generate such phenotype. Our findings confirm the reproducibility of known PHTS manifestations in real-world practice, highlighting the role of mucocutaneous manifestations in facilitating prompt diagnosis of the syndrome, and provide some insights into the pathogenic process induced by
PTEN
alterations, which may contribute to its understanding.
We completed a systematic literature review of
in vivo
animal models that use arthrotomy-based methods to study particle-induced peri-implant osteolysis. The purpose of the review was to characterize ...the models developed to date, to determine the questions addressed, to assess scientific rigor and transparency and to identify gaps in knowledge. We probed three literature databases (Medline, Embase and Scopus) and found 77 manuscripts that fit the search parameters. In the most recent 10 years, researchers mainly used rat and mouse models, whereas in the previous 20 years large animal, canine and rabbit models were more common. The studies have demonstrated several pathophysiology pathways, including macrophage migration, particle phagocytosis, increased local production of cytokines and lysosomal enzymes, elevated bone resorption and suppressed bone formation. The effect of variation in particle characteristics and concentration received limited attention with somewhat mixed findings. Particle contamination by endotoxin was shown to exacerbate peri-implant osteolysis. The possibility of early diagnosis was demonstrated through imaging and biomarker approaches. Several studies showed that both local and systemic delivery of bisphosphonates inhibits the development of particle-induced osteolysis. Other methods of inhibiting osteolysis include the use of anabolic agents and altering the implant design. Few studies examined non-surgical rescue of loosened implants, with conflicting results with alendronate. We found that the manuscripts often lacked the methodological detail now advocated by the ARRIVE guidelines, suggesting that improvement in reporting would be useful to maximize rigor and transparency.
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