Publications by authors named "Jessica Jones"

157 Publications

Biochemical and Virulence Characterization of Isolates From Clinical and Environmental Sources.

Front Cell Infect Microbiol 2021 26;11:637019. Epub 2021 Feb 26.

Division of Seafood Science and Technology, Gulf Coast Seafood Laboratory, U.S. Food and Drug Administration, Dauphin Island, AL, United States.

is a deadly human pathogen for which infections occur seafood consumption (foodborne) or direct contact with wounds. Virulence is not fully characterized for this organism; however, there is evidence of biochemical and genotypic correlations with virulence potential. In this study, biochemical profiles and virulence genotype, based on 16S rRNA gene () and virulence correlated gene () types, were determined for 30 clinical and 39 oyster isolates. Oyster isolates were more biochemically diverse than the clinical isolates, with four of the 20 tests producing variable (defined as 20-80% of isolates) results. Whereas, for clinical isolates only mannitol fermentation, which has previously been associated with virulence potential, varied among the isolates. Nearly half (43%) of clinical isolates were the more virulent genotype (B/C); this trend was consistent when only looking at clinical isolates from blood. The majority (64%) of oyster isolates were the less virulent genotype (A or AB/E). These data were used to select a sub-set of 27 isolates for virulence testing with a subcutaneously inoculated, iron-dextran treated mouse model. Based on the mouse model data, 11 isolates were non-lethal, whereas 16 isolates were lethal, indicating a potential for human infection. Within the non-lethal group there were eight oyster and three clinical isolates. Six of the non-lethal isolates were the less virulent genotype (A/E or AB/E) and two were B/C with the remaining two of mixed genotype (AB/C and B/E). Of the lethal isolates, five were oysters and 11 were clinical. Eight of the lethal isolates were the less virulent genotype and seven the more virulent genotype, with the remaining isolate a mixed genotype (A/C). A discordance between virulence genotype and individual mouse virulence parameters (liver infection, skin infection, skin lesion score, and body temperature) was observed; the variable most strongly associated with mouse virulence parameters was season (warm or cold conditions at time of strain isolation), with more virulent strains isolated from cold conditions. These results indicate that biochemical profiles and genotype are not significantly associated with virulence potential, as determined by a mouse model. However, a relationship with virulence potential and seasonality was observed.
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http://dx.doi.org/10.3389/fcimb.2021.637019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952748PMC
February 2021

Associations Between Health Care Transition Preparation Among Youth in the US and Other Components of a Well-Functioning System of Services.

J Adolesc Health 2021 Mar 9. Epub 2021 Mar 9.

The National Alliance to Advance Adolescent Health/Got Transition, Washington, District of Columbia, USA.

Purpose: This study examines the relationships between receipt of health care transition (HCT) preparation among US youth and five other components of a well-functioning system of services (family partnership in decision-making, medical home, early/continuous screening for special health care needs [SHCN], continuous/adequate health insurance, access to community-based services).

Methods: Data came from the combined 2016-2017 National Survey of Children's Health (n = 29,617 youth ages 12-17). Parents/caregivers answered questions about their child's health care experiences, which were combined to measure receipt of HCT preparation and the other five components of a well-functioning system of services. Unadjusted and adjusted analyses were conducted to examine associations, stratified by youth with and without special health care needs (YSHCN/non-YSHCN).

Results: About 16.7% of YSCHN and 13.9% of non-YSHCN received HCT preparation (p = .0040). Additionally, 25.3% of YSHCN and 27.3% of non-YSHCN received all five remaining components of a system of services (p = .1212). HCT preparation was positively associated with receipt of the combined five components among both YSHCN (adjusted prevalence rate ratio = 1.53, 95% confidence interval: 1.20-1.86) and non-YSHCN (adjusted prevalence rate ratio = 1.63, 95% confidence interval: 1.39-1.88). Regarding individual system of services components, early and continuous screening for SHCN was significantly associated with HCT preparation for both populations. For non-YSHCN only, having a medical home was associated with HCT preparation. The remaining three components were not associated with HCT preparation for either population after adjusting for sociodemographic characteristics.

Conclusions: Among both YSHCN and non-YSHCN, HCT preparation is positively associated with receipt of early and continuous screening for SHCN as well as the five combined components of a well-functioning system of services.
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http://dx.doi.org/10.1016/j.jadohealth.2021.01.006DOI Listing
March 2021

Metabolically healthy obese vs. Metabolic syndrome - The crosslink between nutritional exposure to bisphenols and physical exercise.

Med Hypotheses 2021 Apr 18;149:110542. Epub 2021 Feb 18.

School of Education Health and Human Performance, Fairmont State University, United States. Electronic address:

Obesity has become a worldwide pandemic as well as a major contributing factor to the increasing rate of type 2 diabetes (T2D). However, there is an intriguing variance demonstrated by a subset of obesity defined as metabolically healthy obesity (MHO). MHO individuals are less prone to develop obesity-related metabolic complications, such as metabolic syndrome (MetS) and further T2D. The exact reason why an MHO person does not present the cluster of risk factors associated with insulin resistance is unknown due to the challenge to mimic MHO in experimental settings. However, MHO individuals present lower sedentary behaviors in comparison to individuals with MetS, which might indicate that an adaptation to skeletal muscle, such as increased insulin sensitivity and glucose transporter (GLUT4), could play a major role in their healthy characteristics. The hypothesis invoked in this paper is that lower exposure to bisphenol together with increased levels of physical exercise underlie the physiological aspects behind MHO characteristics. Evidence suggests that exposure to "obseogens," such as bisphenol A (BPA), appears to impair insulin secretion and insulin response in cells containing GLUT4. Epidemiological studies have associated higher levels of BPA, as well as bisphenol S and F, in children with a risk for MetS development. Therefore, the combination between low bisphenol exposure and increased physical exercise may not necessarily affect body weight, but it could modify several metabolic pathways inhibiting insulin resistance, which characterize the heathy status of the MHO. If confirmed, this hypothesis could lead to therapeutic approaches to reverse MetS and inhibit T2D onset.
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http://dx.doi.org/10.1016/j.mehy.2021.110542DOI Listing
April 2021

Time series analysis and mechanistic modelling of heterogeneity and sero-reversion in antibody responses to mild SARS‑CoV-2 infection.

EBioMedicine 2021 Mar 2;65:103259. Epub 2021 Mar 2.

Institute of Cardiovascular Sciences, University College London, London, UK; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.

Background: SARS-CoV-2 serology is used to identify prior infection at individual and at population level. Extended longitudinal studies with multi-timepoint sampling to evaluate dynamic changes in antibody levels are required to identify the time horizon in which these applications of serology are valid, and to explore the longevity of protective humoral immunity.

Methods: Healthcare workers were recruited to a prospective cohort study from the first SARS-CoV-2 epidemic peak in London, undergoing weekly symptom screen, viral PCR and blood sampling over 16-21 weeks. Serological analysis (n =12,990) was performed using semi-quantitative Euroimmun IgG to viral spike S1 domain and Roche total antibody to viral nucleocapsid protein (NP) assays. Comparisons were made to pseudovirus neutralizing antibody measurements.

Findings: A total of 157/729 (21.5%) participants developed positive SARS-CoV-2 serology by one or other assay, of whom 31.0% were asymptomatic and there were no deaths. Peak Euroimmun anti-S1 and Roche anti-NP measurements correlated (r = 0.57, p<0.0001) but only anti-S1 measurements correlated with near-contemporary pseudovirus neutralising antibody titres (measured at 16-18 weeks, r = 0.57, p<0.0001). By 21 weeks' follow-up, 31/143 (21.7%) anti-S1 and 6/150 (4.0%) anti-NP measurements reverted to negative. Mathematical modelling revealed faster clearance of anti-S1 compared to anti-NP (median half-life of 2.5 weeks versus 4.0 weeks), earlier transition to lower levels of antibody production (median of 8 versus 13 weeks), and greater reductions in relative antibody production rate after the transition (median of 35% versus 50%).

Interpretation: Mild SARS-CoV-2 infection is associated with heterogeneous serological responses in Euroimmun anti-S1 and Roche anti-NP assays. Anti-S1 responses showed faster rates of clearance, more rapid transition from high to low level production rate and greater reduction in production rate after this transition. In mild infection, anti-S1 serology alone may underestimate incident infections. The mechanisms that underpin faster clearance and lower rates of sustained anti-S1 production may impact on the longevity of humoral immunity.

Funding: Charitable donations via Barts Charity, Wellcome Trust, NIHR.
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http://dx.doi.org/10.1016/j.ebiom.2021.103259DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920816PMC
March 2021

The adaptation and feasibility of dialectical behaviour therapy for adults with intellectual developmental disabilities and transdiagnoses: A pilot community-based randomized controlled trial.

J Appl Res Intellect Disabil 2021 Feb 17. Epub 2021 Feb 17.

Department of Psychiatry, Queen's University, Kingston, ON, Canada.

Introduction: Preliminary evidence suggests dialectical behaviour therapy (DBT) may be beneficial for persons with intellectual disabilities. This pilot randomized controlled trial aimed to determine the feasibility of adapted DBT for adults with intellectual disabilities and co-morbid psychiatric disorders in the community.

Methods: An adapted DBT programme (aDBT-ID) was delivered to adults with mild-to-moderate intellectual disability (n = 20) and their caregivers (n = 20). A single-blind, mixed-methods design was employed with treatment (n = 10) and control (n = 10). In addition to feasibility, pre-post-measures of emotional regulation, anger and mental health were taken from clients and caregivers.

Results: Results suggest it was feasible and beneficial to deliver adapted DBT in the community. Qualitative findings found both participants and caregivers were satisfied with the treatment delivery. No differences between conditions were found.

Conclusion: This pilot study highlights the feasibility of adapted DBT for individuals with intellectual disabilities and the practicalities of delivering community-based inclusive research.
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http://dx.doi.org/10.1111/jar.12860DOI Listing
February 2021

Healthcare Workers Bioresource: Study outline and baseline characteristics of a prospective healthcare worker cohort to study immune protection and pathogenesis in COVID-19.

Wellcome Open Res 2020 12;5:179. Epub 2020 Oct 12.

Institute of Cardiovascular Science, University College London, London, UK.

: Most biomedical research has focused on sampling COVID-19 patients presenting to hospital with advanced disease, with less focus on the asymptomatic or paucisymptomatic. We established a bioresource with serial sampling of health care workers (HCWs) designed to obtain samples before and during mainly mild disease, with follow-up sampling to evaluate the quality and duration of immune memory. : We conducted a prospective study on HCWs from three hospital sites in London, initially at a single centre (recruited just prior to first peak community transmission in London), but then extended to multiple sites 3 weeks later (recruitment still ongoing, target n=1,000). Asymptomatic participants attending work complete a health questionnaire, and provide a nasal swab (for SARS-CoV-2 RNA by RT-PCR tests) and blood samples (mononuclear cells, serum, plasma, RNA and DNA are biobanked) at 16 weekly study visits, and at 6 and 12 months. : Preliminary baseline results for the first 731 HCWs (400 single-centre, 331 multicentre extension) are presented. Mean age was 38±11 years; 67% are female, 31% nurses, 20% doctors, and 19% work in intensive care units. COVID-19-associated risk factors were: 37% black, Asian or minority ethnicities; 18% smokers; 13% obesity; 11% asthma; 7% hypertension and 2% diabetes mellitus. At baseline, 41% reported symptoms in the preceding 2 weeks. Preliminary test results from the initial cohort (n=400) are available: PCR at baseline for SARS-CoV-2 was positive in 28 of 396 (7.1%, 95% CI 4.9-10.0%) and 15 of 385 (3.9%, 2.4-6.3%) had circulating IgG antibodies. : This COVID-19 bioresource established just before the peak of infections in the UK will provide longitudinal assessments of incident infection and immune responses in HCWs through the natural time course of disease and convalescence. The samples and data from this bioresource are available to academic collaborators by application  https://covid-consortium.com/application-for-samples/.
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http://dx.doi.org/10.12688/wellcomeopenres.16051.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7836029PMC
October 2020

Continuous glucose monitoring: A review of the evidence in type 1 and 2 diabetes mellitus.

Diabet Med 2021 Jan 26:e14528. Epub 2021 Jan 26.

Department of Endocrinology, Austin Health, Heidelberg, Vic., Australia.

Context And Aim: Continuous glucose monitoring (CGM) is becoming widely accepted as an adjunct to diabetes management. Compared to standard care, CGM can provide detailed information about glycaemic variability in an internationally standardised ambulatory glucose profile, enabling more informed user and clinician decision making. We aimed to review the evidence, user experience and cost-effectiveness of CGM.

Methods: A literature search was conducted by combining subject headings 'CGM' and 'flash glucose monitoring', with key words 'type 1 diabetes' and 'type 2 diabetes', limited to '1999 to current'. Further evidence was obtained from relevant references of retrieved articles.

Results: There is a strong evidence for CGM use in people with type 1 diabetes, with benefits of reduced glycated haemoglobin and hypoglycaemia, and increased time in range. While the evidence for CGM use in type 2 diabetes is less robust, similar benefits have been demonstrated. CGM can improve diabetes-related satisfaction in people with diabetes (PWD) and parents of children with diabetes, as well as the clinician experience. However, CGM does have limitations including cost, accuracy and perceived inconvenience. Cost-effectiveness analyses have indicated that CGM is a cost-effective adjunct to type 1 diabetes management that is associated with reduced diabetes-related complications and hospitalisation.

Conclusions: Continuous glucose monitoring is revolutionising diabetes management. It is a cost-effective adjunct to diabetes management that has the potential to improve glycaemic outcomes and quality of life in PWD, especially type 1 diabetes.
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http://dx.doi.org/10.1111/dme.14528DOI Listing
January 2021

Comparison of reported versus measured content of over-the-counter and prescription prenatal multivitamins and minerals.

J Am Pharm Assoc (2003) 2021 Jan 4. Epub 2021 Jan 4.

Objective: To examine the measured contents of over-the-counter (OTC) and prescription (Rx) prenatal multivitamins and minerals (PMVMs) and compare the findings with the amounts reported on the nutrition labels. The findings were subsequently examined on the basis of cost and ability to adequately supplement dietary intake during pregnancy on the basis of The National Academies' dietary reference intakes (DRIs) and tolerable upper intake levels.

Methods: This was an observational convenience sample of OTC and Rx PMVMs available through online retailers and retail pharmacies. The amounts of folic acid, vitamin B, vitamin C, and choline were measured in triplicate using mass spectrometry.

Results: Twenty OTC and 16 Rx PMVMs were evaluated. The average measured quantities of the vitamins were not statistically different from the mean reported quantities for OTC and Rx PMVMs. When a standard diet was combined with the labeled nutrition information, 95% of the OTC PMVMs and 88% of the Rx PMVMs met the DRIs for folic acid and vitamins B and C. When a standard diet was combined with the actual measured PMVM quantities, 79% of the OTC PMVMs and 82% of the Rx PMVMs met the DRIs for folic acid and vitamins B and C. The measured choline content, with and without diet considerations, did not meet the DRIs. No statistically significant difference was found for the adequacy of supplementation between the OTC and Rx PMVMs on the basis of cost.

Conclusion: On the basis of a comparison of the measured and reported values for folic acid, vitamin C, vitamin B, and choline, it seems that either OTC or Rx PMVMs at low or high cost can be recommended to supplement diets and meet the DRIs during pregnancy for these vitamins.
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http://dx.doi.org/10.1016/j.japh.2020.12.010DOI Listing
January 2021

The upper respiratory tract microbiome of indigenous Orang Asli in north-eastern Peninsular Malaysia.

NPJ Biofilms Microbiomes 2021 01 5;7(1). Epub 2021 Jan 5.

Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK.

Much microbiome research has focused on populations that are predominantly of European descent, and from narrow demographics that do not capture the socio-economic and lifestyle differences which impact human health. Here we examined the airway microbiomes of the Orang Asli, the indigenous peoples of Malaysia. A total of 130 participants were recruited from two sites in the north-eastern state of Terengganu in Peninsular Malaysia. Using 16S rRNA sequencing, the nasal microbiome was significantly more diverse in those aged 5-17 years compared to 50+ years (p = 0.023) and clustered by age (PERMANOVA analysis of the Bray-Curtis distance, p = 0.001). Hierarchical clustering of Bray-Curtis dissimilarity scores revealed six microbiome clusters. The largest cluster (n = 28; 35.4%) had a marked abundance of Corynebacterium. In the oral microbiomes Streptococcus, Neisseria and Haemophilus were dominant. Using conventional microbiology, high levels of Staphylococcus aureus carriage were observed, particularly in the 18-65 age group (n = 17/36; 47.2% 95% CI: 30.9-63.5). The highest carriage of pneumococci was in the <5 and 5 to 17 year olds, with 57.1% (4/7) and 49.2% (30/61), respectively. Sixteen pneumococcal serotypes were identified, the most common being the nonvaccine-type 23A (14.6%) and the vaccine-type 6B (9.8%). The prevalence of pneumococcal serotypes covered by pneumococcal conjugate vaccines support introduction into a Malaysian national immunisation schedule. In addition, the dominance of Corynebacterium in the airway microbiomes is intriguing given their role as a potentially protective commensal with respect to acute infection and respiratory health.
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http://dx.doi.org/10.1038/s41522-020-00173-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7785749PMC
January 2021

Effect of antidepressant use on length of hospitalization in patients on anti-infective therapy.

J Psychiatr Res 2021 02 19;134:97-101. Epub 2020 Dec 19.

University of California Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA. Electronic address:

Compared to those without depression, acutely-ill patients with depression hospitalized for an infection usually have poor outcomes, including increased length of stay (LOS).

Purpose: The primary objective was to evaluate the LOS between patients receiving an anti-infective with and without any antidepressant use. Secondary objectives were to examine LOS based on acuity of care and age.

Methods: Using a cross-sectional design, hospitalized adult patients who received anti-infective agents between January 1, 2017 and October 31, 2019 for ≥7 days were included. Univariate and multivariate analyses were conducted to determine statistical significance.

Results: A total of 17,651 patient encounters were included in the study. Of all patient encounters, 5165 (29%) received antidepressants concurrently with anti-infectives, with mean age of 57 years ± 17.3. Patients receiving concurrent antidepressants experienced longer LOS compared with patients not receiving antidepressants [20 vs 16 days, 95% confident interval (CI): 3.98-5.18, p < 0.001]. Stratified by intensive care unit (ICU) admission during hospital encounters and age ≥ 65 years, patients receiving antidepressants had longer LOS (25 vs 18 days, CI: 5.63-8.61, p < 0.001, and 18 vs 15 days, CI: 2.39-4.04, p < 0.001, respectively). After controlling for gender and ethnicity, antidepressant use and ICU admission were independently associated with increased LOS.

Conclusion: Patients who received both an antidepressant and an anti-infective agent had significantly increased LOS, including those in the ICU and in the elderly population. Future studies are needed to assess the impact of concomitant antidepressant use on mortality and other clinical outcomes in patients hospitalized with an infection.
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http://dx.doi.org/10.1016/j.jpsychires.2020.12.050DOI Listing
February 2021

Discordant neutralizing antibody and T cell responses in asymptomatic and mild SARS-CoV-2 infection.

Sci Immunol 2020 12;5(54)

Department of Infectious Disease, Imperial College London, London, UK.

Understanding the nature of immunity following mild/asymptomatic infection with SARS-CoV-2 is crucial to controlling the pandemic. We analyzed T cell and neutralizing antibody responses in 136 healthcare workers (HCW) 16-18 weeks after United Kingdom lockdown, 76 of whom had mild/asymptomatic SARS-CoV-2 infection captured by serial sampling. Neutralizing antibodies (nAb) were present in 89% of previously infected HCW. T cell responses tended to be lower following asymptomatic infection than in those reporting case-definition symptoms of COVID-19, while nAb titers were maintained irrespective of symptoms. T cell and antibody responses were sometimes discordant. Eleven percent lacked nAb and had undetectable T cell responses to spike protein but had T cells reactive with other SARS-CoV-2 antigens. Our findings suggest that the majority of individuals with mild or asymptomatic SARS-CoV-2 infection carry nAb complemented by multispecific T cell responses at 16-18 weeks after mild or asymptomatic SARS-CoV-2 infection.
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http://dx.doi.org/10.1126/sciimmunol.abf3698DOI Listing
December 2020

Out-of-Pocket Health Care Expenditures Among United States Children: Parental Perceptions and Past-Year Expenditures, 2016 to 2017.

Acad Pediatr 2021 04 20;21(3):480-487. Epub 2020 Nov 20.

Departments of Population, Family and Reproductive Health and Pediatrics, Johns Hopkins Bloomberg School of Public Health (CS Minkovitz), Baltimore, Md.

Objective: To examine the association between parental perceptions of out-of-pocket (OOP) health care costs for their child and the total amount of OOP health care expenditures for that child during the past year.

Methods: We used data from the 2016 and 2017 National Surveys of Children's Health, cross-sectional, parent-reported, and nationally representative surveys of noninstitutionalized US children, ages 0 to 17 years. We conducted bivariate analyses to assess characteristics associated with the amount of OOP expenditures and parental perceptions of these costs. We estimated adjusted prevalence ratios for parental perceptions of OOP costs using logistic regression.

Results: Based on parent report, nearly two thirds (65.7%) of children incurred some amount of past-year OOP expenditures, with 13.3% of children incurring expenditures of ≥$1000. Parents reported that costs were unreasonable for 35.3% of children with past-year expenditures. The amount of OOP spending was associated with parents' perceptions that costs were unreasonable, with 16.5% of those with $1 to 249 in expenditures reporting unreasonable costs compared to 77.5% of those with >$5,000 in expenditures (P < .05). In adjusted analyses, high OOP expenditures, non-Hispanic white race/ethnicity, lack of health insurance, low household income, parental education levels less than a college degree, and foreign-born nativity status were associated with reports of unreasonable costs (P < .05).

Conclusions: This study demonstrates an association between attitudinal and economic measures of health care expenditures for children while demonstrating differences in the perception of costs by measures of family economic vulnerability. Results may inform efforts to assess adequacy of health insurance coverage.
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http://dx.doi.org/10.1016/j.acap.2020.11.014DOI Listing
April 2021

Increasing Health Care Workers' Proficiency With Using Professional Medical Interpretation: A Workshop.

MedEdPORTAL 2020 11 9;16:11017. Epub 2020 Nov 9.

Clinical Professor, Department of Pediatrics, Stanford School of Medicine.

Introduction: Families with limited English proficiency are at risk for poor outcomes and medical errors due to barriers in communication. The use of professional medical interpretation has been linked to improved access to care, improved patient satisfaction, and better outcomes. However, medical interpretation remains underutilized, and the literature lacks guidelines for training health care workers in its use. This workshop aims to teach the skills needed to access and appropriately use professional medical interpretation.

Methods: Our team included two residents, two fellows, two faculty members, and two fellowship coordinators. This 90-minute workshop targeted at health care workers included a warm-up activity, role-play with three different types of interpretation, and large-group discussion. Anonymous evaluations were collected at the end of the workshop.

Results: The workshop was presented at six academic conferences (three local, one regional, and two national). Postworkshop evaluations were collected from 53 participants from multiple health care backgrounds (including medical students, residents, and physicians). The majority of participants reported that the workshop met learning objectives (98%), represented a valuable use of time (98%), and included useful handouts (92%). In addition, 90% of participants reported that the information shared in the workshop would be applied to their medical practice. Themes that emerged from postworkshop evaluations included participants' intentions to change their practice, to augment training for other providers, and to pursue institutional change.

Discussion: This workshop fills an important gap in medical education and provides a comprehensive orientation to interpretation resources and best practices.
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http://dx.doi.org/10.15766/mep_2374-8265.11017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7666837PMC
November 2020

Phylogenetic and Biogeographic Patterns of Vibrio parahaemolyticus Strains from North America Inferred from Whole-Genome Sequence Data.

Appl Environ Microbiol 2021 01 15;87(3). Epub 2021 Jan 15.

FDA, Division of Seafood Science and Technology, Gulf Coast Seafood Laboratory, Dauphin Island, Alabama, USA

is the most common cause of seafood-borne illness reported in the United States. The draft genomes of 132 North American clinical and oyster isolates were sequenced to investigate their phylogenetic and biogeographic relationships. The majority of oyster isolate sequence types (STs) were from a single harvest location; however, four were identified from multiple locations. There was population structure along the Gulf and Atlantic Coasts of North America, with what seemed to be a hub of genetic variability along the Gulf Coast, with some of the same STs occurring along the Atlantic Coast and one shared between the coastal waters of the Gulf and those of Washington State. Phylogenetic analyses found nine well-supported clades. Two clades were composed of isolates from both clinical and oyster sources. Four were composed of isolates entirely from clinical sources, and three were entirely from oyster sources. Each single-source clade consisted of one ST. Some human isolates lack , , and some type III secretion system (T3SS) genes, which are established virulence genes of Thus, these genes are not essential for pathogenicity. However, isolates in the monophyletic groups from clinical sources were enriched in several categories of genes compared to those from monophyletic groups of oyster isolates. These functional categories include cell signaling, transport, and metabolism. The identification of genes in these functional categories provides a basis for future in-depth pathogenicity investigations of is the most common cause of seafood-borne illness reported in the United States and is frequently associated with shellfish consumption. This study contributes to our knowledge of the biogeography and functional genomics of this species around North America. STs shared between the Gulf Coast and the Atlantic seaboard as well as Pacific waters suggest possible transport via oceanic currents or large shipping vessels. STs frequently isolated from humans but rarely, if ever, isolated from the environment are likely more competitive in the human gut than other STs. This could be due to additional functional capabilities in areas such as cell signaling, transport, and metabolism, which may give these isolates an advantage in novel nutrient-replete environments such as the human gut.
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http://dx.doi.org/10.1128/AEM.01403-20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7848924PMC
January 2021

Presentation, Treatment Response and Short-Term Outcomes in Paediatric Multisystem Inflammatory Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS).

J Clin Med 2020 Oct 14;9(10). Epub 2020 Oct 14.

Department of Rheumatology, Alder Hey Children's NHS Foundation Trust Hospital, Liverpool L14 5AB, UK.

The novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the pathogen responsible for Coronavirus Disease 2019 (COVID-19). Whilst most children and young people develop mild symptoms, recent reports suggest a novel paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). Case definition and classification are preliminary, treatment is empiric and disease-associated outcomes are unclear. Here, we report 29 patients with PIMS-TS who were diagnosed, admitted and treated in the English North West between March and June 2020. Consistent with patterns observed internationally, cases peaked approximately 4 weeks after the initial surge of COVID-19-like symptoms in the UK population. Clinical symptoms included fever (100%), skin rashes (72%), cardiovascular involvement (86%), conjunctivitis (62%) and respiratory involvement (21%). Some patients had clinical features partially resembling Kawasaki disease (KD), toxic shock syndrome and cytokine storm syndrome. Male gender (69%), black, Asian and other minority ethnicities (BAME, 59%) were over-represented. Immune modulating treatment was used in all, including intravenous immunoglobulin (IVIG), corticosteroids and cytokine blockers. Notably, 32% of patients treated with IVIG alone went into remission. The rest required additional treatment, usually corticosteroids, with the exception of two patients who were treated with TNF inhibition and IL-1 blockade, respectively. Another patient received IL-1 inhibition as primary therapy, with associated rapid and sustained remission. Randomized and prospective studies are needed to investigate efficacy and safety of treatment, especially as resources of IVIG may be depleted secondary to high demand during future waves of COVID-19.
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http://dx.doi.org/10.3390/jcm9103293DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7602286PMC
October 2020

Effect of Gear Type on Vibrio spp. Levels in Farm-Raised Oysters (Crassostrea virginica) after Routine Handling and Resubmersion.

J Food Prot 2021 Mar;84(3):381-388

U.S. Food and Drug Administration, Division of Seafood Science and Technology, Gulf Coast Seafood Laboratory, 1 Iberville Drive, Dauphin Island, Alabama 36528, USA.

Abstract: During routine handling, cultured oysters are removed from the water and exposed to elevated temperatures, causing growth of Vibrio vulnificus and Vibrio parahaemolyticus within them. Farmers can resubmerse oysters in the water, allowing elevated Vibrio spp. levels to return to ambient levels within the oysters. Previous resubmersion research is limited to one aquaculture gear type during studies performed from June to September. This study aims to expand knowledge about the recovery times needed for elevated Vibrio levels in handled oysters from two common gear types (the adjustable longline system and the OysterGro system) during early and midsummer periods. Oysters held in both gear types were subjected to being tumbled and refrigerated or desiccated and then resubmersed into water in May and July 2018 and 2019. Vibrio spp. levels were measured before and after the treatments, and 3, 7, and 14 days after resubmersion, and were compared with levels in submersed oysters. All samples were tested for V. vulnificus, total V. parahaemolyticus, and pathogenic V. parahaemolyticus (tdh+/trh+). Water temperatures in May were significantly lower (∼5°C; P ≤ 0.009) than in July, corresponding to lower V. vulnificus levels (-0.67 log MPN/g) and higher tdh+/trh+ levels (+0.56 to 0.63 log MPN/g) in control oysters. The average Vibrio spp. levels in control oysters from each trial did not differ between the gear types (P ≥ 0.08). Elevated V. vulnificus levels recovered to ambient levels after 7 days in May and 3 days in July, regardless of gear or handling. For V. parahaemolyticus, the desiccated oysters required 14 days to recover in May and 7 days in July, whereas the tumbled and refrigerated oysters required 14 days or more in both months. This study had limited replication in each month, but the data suggest that the resubmersion times differ between the gear types, treatment types, and months. Future studies with more replications are needed to determine whether these trends continue.

Highlights:
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http://dx.doi.org/10.4315/JFP-20-318DOI Listing
March 2021

Effects of tumbling, refrigeration and subsequent resubmersion on the abundance of Vibrio vulnificus and Vibrio parahaemolyticus in cultured oysters (Crassostrea virginica).

Int J Food Microbiol 2020 Dec 26;335:108858. Epub 2020 Sep 26.

Auburn University Shellfish Laboratory, School of Fisheries, Aquaculture, and Aquatic Sciences, Auburn University, 150 Agassiz Street, Dauphin Island, AL 36528, USA.

Routine handling of oysters is a common industry practice for off-bottom oyster aquaculture, which aims to produce a high-quality oyster. These practices expose oysters to elevated temperatures and interrupt filter feeding, which can increase Vibrio vulnificus and V. parahaemolyticus levels within the oyster. The resubmersion of oysters after exposure to conditions where the time-temperature controls are exceeded is as an effective mitigation strategy to allow elevated levels of Vibrio spp. to "recover", or return to ambient levels, prior to harvest. Previous work examined the effect of desiccation on recovery times; the objective of this study was to evaluate the effect of additional handling treatments [tumbled and refrigerated (TR), tumbled and not refrigerated (TNR), not tumbled and refrigerated (NTR), and not tumbled and not refrigerated (NTNR)] on the time needed for V. vulnificus, total V. parahaemolyticus, and pathogenic V. parahaemolyticus (tdh+/trh+) to recover in oysters. A set of non-treated (control) oysters remained submerged throughout the study to determine the ambient Vibrio spp. (inclusive of genotypes) levels within oysters. Vibrio spp. levels were measured immediately before (pre) and after (post) the treatments, and 1, 2, 4, 7, 10, and 14 days after resubmersion using a three-tube MPN real-time PCR method. The non-refrigerated oysters (TNR, NTNR) had Vibrio spp. levels 1.54 to 2.10 log MPN/g higher than the pre-treatment levels, while the Vibrio spp. levels in refrigerated oysters were not significantly higher than pre-treatment levels. After resubmersion, Vibrio spp. levels increased by 0.84 to 1.78 log MPN/g in the refrigerated oysters (TR, NTR). Vibrio spp. levels in oysters returned to ambient after 1-7 days of resubmersion, depending on the handling treatment and the Vibrio spp. These results provide data on handling treatments not previously reported and further support the seven-day resubmersion requirement for farmers in Alabama using the adjustable longline system.
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http://dx.doi.org/10.1016/j.ijfoodmicro.2020.108858DOI Listing
December 2020

Emerging Viral and Bacterial Infections: Within an Era of Opioid Epidemic.

Infect Dis Ther 2020 Dec 11;9(4):737-755. Epub 2020 Sep 11.

Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, San Diego, CA, USA.

The opioid epidemic is a public health crisis that continues to impact healthcare in the United States of America (USA). While changes in opioid prescribing have curbed the medical use of opioids, the increase in nonmedical use, largely driven by injection drug use (IDU), has contributed to the escalating incidence of opioid use disorder (OUD). Furthermore, IDU is associated with high-risk injection practices that can increase the risk of acquiring viral and bacterial infections. Here in this comprehensive review, we aimed to summarize the epidemiology and management of OUD, along with the screening and antimicrobial treatment of associated infections, specifically focused on human immunodeficiency virus, hepatitis C virus, skin and soft tissue infections, endocarditis, and osteomyelitis. Medication-assisted therapy (MAT) and infection guidelines from the USA will be presented.
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http://dx.doi.org/10.1007/s40121-020-00335-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680496PMC
December 2020

Transcription of mtDNA and dyslipidemia are ameliorated by aerobic exercise in type 2 diabetes.

Mol Biol Rep 2020 Sep 17;47(9):7297-7303. Epub 2020 Aug 17.

Department of Biology, Federal University of Jataí, Jataí, Brazil.

Physical inactivity and unhealthy food intake are strongly associated with the growing prevalence of type 2 diabetes (T2D). Dyslipidemia, a characteristic of T2D patient, contributes to an increase in intra-myocellular lipid accumulation and mitochondria dysfunction, in skeletal muscle cells and further to insulin resistance. The aim of this study was to evaluate the effect of aerobic exercise on dyslipidemia, mitochondrial homeostasis and mitochondrial DNA (mtDNA) transcription in T2D- induced animals. Wistar rats (8 weeks old) were fed a diet containing 60% fat over 9 weeks, at day 14 a single injection of STZ (25 mg/kg) was administered (T2D-induced). At week 3 of the experiment half of the animals started on an aerobic exercise 5-days/week. Blood and soleus muscle were collected at 9th experimental week. Abdominal fat, blood glucose, triglyceride, low-density-lipoprotein and high-density lipoprotein (HDL), and cellular mtDNA copy number, cytochrome b (cytb) mRNA and 8-isoprostane were measured. T2D-induced animals exhibited changes in blood glucose, weight gain, abdominal fat, LDL and muscular 8-isoprostane, mtDNA copy number and cytb mRNA. Aerobic exercise attenuated the increase in weight gain and abdominal fat and the decreased cytb mRNA, and increased HDL. Our results suggest that aerobic exercise might not affect all characteristics related to the development of T2D in the same way. However, since T2D is a multifactorial disease, improvement in parameters such as HDL levels, abdominal fat and weight gain induced by aerobic exercise might delay or inhibit the onset of T2D.
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http://dx.doi.org/10.1007/s11033-020-05725-8DOI Listing
September 2020

A machine-vision approach for automated pain measurement at millisecond timescales.

Elife 2020 08 6;9. Epub 2020 Aug 6.

Department of Biology, University of Pennsylvania, Philadelphia, United States.

Objective and automatic measurement of pain in mice remains a barrier for discovery in neuroscience. Here, we capture paw kinematics during pain behavior in mice with high-speed videography and automated paw tracking with machine and deep learning approaches. Our statistical software platform, PAWS (Pain Assessment at Withdrawal Speeds), uses a univariate projection of paw position over time to automatically quantify seven behavioral features that are combined into a single, univariate pain score. Automated paw tracking combined with PAWS reveals a behaviorally divergent mouse strain that displays hypersensitivity to mechanical stimuli. To demonstrate the efficacy of PAWS for detecting spinally versus centrally mediated behavioral responses, we chemogenetically activated nociceptive neurons in the amygdala, which further separated the pain-related behavioral features and the resulting pain score. Taken together, this automated pain quantification approach will increase objectivity in collecting rigorous behavioral data, and it is compatible with other neural circuit dissection tools for determining the mouse pain state.
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http://dx.doi.org/10.7554/eLife.57258DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7434442PMC
August 2020

Comparison of the platelet activation status of single-donor platelets obtained with two different cell separator technologies.

Transfusion 2020 Sep 29;60(9):2067-2078. Epub 2020 Jul 29.

Department of Pathology and Laboratory Medicine and Centre for Blood Research and Canadian Blood Services, University of British Columbia, Vancouver, British Columbia, Canada.

Background: The microparticle content (MP%) of apheresis platelets-a marker of platelet activation-is influenced by donor factors and by external stressors during collection and storage. This study assessed the impact of apheresis technology and other factors on the activation status (MP%) of single-donor apheresis platelets.

Study Design And Methods: Data from six US hospitals that screened platelets by measuring MP% through dynamic light scattering (ThromboLUX) were retrospectively analyzed. Relative risks (RRs) were derived from univariate and multivariable regression models, with activation rate (MP% ≥15% for plasma-stored platelets; ≥10% for platelet additive solution [PAS]-stored platelets) and MP% as outcomes. Apheresis platform (Trima Accel vs Amicus), storage medium (plasma vs PAS), pathogen reduction, storage time, and testing location were used as predictors.

Results: Data were obtained from 7511 platelet units collected using Trima (from 16 suppliers, all stored in plasma, 20.0% were pathogen-reduced) and 2456 collected using Amicus (from four different collection facilities of one supplier, 65.0% plasma-stored, 35.0% PAS-stored, none pathogen-reduced). Overall, 30.0% of Trima platelets were activated compared to 45.6% of Amicus platelets (P < .0001). Multivariable analysis identified apheresis platform as significantly associated with platelet activation, with a lower activation rate for Trima than Amicus (RR: 0.641, 95% confidence interval [CI]: 0.578; 0.711, P < .0001) and a 6.901% (95% CI: 5.926; 7.876, P < .0001) absolute reduction in MP%, when adjusting for the other variables.

Conclusion: Trima-collected platelets were significantly less likely to be activated than Amicus-collected platelets, irrespective of the storage medium, the use of pathogen reduction, storage time, and testing site.
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http://dx.doi.org/10.1111/trf.15934DOI Listing
September 2020

Androgen-Mediated Anti-inflammatory Cellular Processes as Therapeutic Targets in Lupus.

Front Immunol 2020 23;11:1271. Epub 2020 Jun 23.

Department of Inflammation and Immunity, Cleveland Clinic, Lerner Research Institute, Cleveland, OH, United States.

Systemic Lupus Erythematosus (SLE), among many other auto-immune diseases, is known to be more prevalent in females than in males. This observation has served as the foundation for studies into how sex hormones may interact with the immune system to either drive or inhibit immune activation. Early studies using castration in lupus mouse models showed the potential protective effect of testosterone against lupus development. These studies were later corroborated by observational studies in lupus patients, who upon treatment with testosterone therapy, displayed decreased disease burden. However, there are numerous limitations to treating (especially female) lupus patients with testosterone. Thus, identification of testosterone-targeted cellular and molecular mechanisms affecting immune activation is an attractive target for lupus treatment in the future. Recent studies have examined the effects of androgens on the activation of anti-inflammatory processes. As such, immunoregulatory cell types including myeloid-derived suppressor cells (MDSCs) and regulatory T and B cells have been shown to be susceptible to manipulation by sex hormones. Here, we review studies of SLE and lupus-like disease in which testosterone or testosterone-derivatives were used to skew an ongoing immune reaction toward an anti-inflammatory state. Via evaluation of both clinical studies and immunologic models we propose new areas for research with the goal of identifying testosterone-driven anti-inflammatory mediators suitable for therapeutic targeting in patients with lupus and other autoimmune diseases.
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http://dx.doi.org/10.3389/fimmu.2020.01271DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7324484PMC
April 2021

Effect of Ploidy on Vibrio parahaemolyticus and Vibrio vulnificus Levels in Cultured Oysters.

J Food Prot 2020 Jul 10. Epub 2020 Jul 10.

2Auburn University Shellfish Laboratory, School of Fisheries, Aquaculture, and Aquatic Sciences, Auburn University, 150 Agassiz Street, Dauphin Island, AL 36528, USA.

Vibrio parahaemolyticus and V. vulnificus are naturally occuring human pathogenic bacteria commonly found in estuarine environments where oysters are cultured. The use of triploid oysters has increased, due to their rapid growth rate and that they maintain a high quality throughout the year. Previous work suggested levels of Vibrio spp. may be lower in triploid oysters, as compared to diploids. Therfore, this study aimed to determine if there is a difference in the abundances of V. parahaemolyticus and V. vulnificus between half-sibling diploid and triploid oysters. In four trials, 100 individual oysters (either iced or temperature abused) were analyzed for V. parahaemolyticus and V. vulnificus using direct plating followed by colony hybridization. Mean levels of V. parahaemolyticus in iced and abused diploid oysters were 3.55 and 4.21 log CFU/g, respectively. Mean levels in iced and abused triploid oysters were 3.49 and 4.27 log CFU/g, respectively. Mean levels of V. vulnificus in iced and abused diploid oysters were 3.53 and 4.56 log CFU/g, respectively. Mean levels in iced and abused triploid oysters were 3.54 and 4.55 log CFU/g, respectively. The differences in Vibrio spp. abundances between diploid and triploid oysters was not significant (p>0.05). However, the differences across treatments were significant (p<0.05), with the exception of V. parahaemolyticus levels in trial 3 (p=0.83). Variation between individual oysters was also observed, with 12 of 808 measurements being outside of the 95 th percentile. This phenomenon of occasional statistical outliers ("hot" or "cold" oysters) has been previously described and supports the appropriateness of composite sampling to account for inherent animal variability. In summary, the data indicate that abundances of V. parahaemolyticus and V. vulnificus are not dependent on the ploidy of cultured oysters, but vary with the type of handling.
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http://dx.doi.org/10.4315/JFP-20-202DOI Listing
July 2020

Enhancing Collaborative Learning for Quality Improvement: Evidence from the Improving Clinical Flow Project, a Breakthrough Series Collaborative with Project ECHO.

Jt Comm J Qual Patient Saf 2020 08 18;46(8):448-456. Epub 2020 May 18.

Background: This project engaged teams from Federally Qualified Health Centers (FQHCs) in a quality improvement (QI) collaborative to improve clinical flow (increase quality and efficiency of operations), using a novel combination of Breakthrough Series Collaborative tools with Project ECHO's telementoring model. This mixed methods study describes the collaborative and evaluates its success in generating improvement and developing QI capacity at participating FQHCs.

Methods: The 18-month collaborative used three in-person/virtual learning session workshops and weekly telementoring sessions with brief lectures and case-based learning. Participants engaged in QI work (for example, PDSAs [Plan-Do-Study-Act]) and tracked data for 10 care system measures to evaluate progress. These data were averaged across consistently reporting sites for standard run chart analysis. Semistructured interviews assessed the effectiveness and value of the approach for participants.

Results: Fifteen sites across the United States participated for one year (Cohort 1); 10 sites continued to 18 months (Cohort 2). Cohort 2 evidenced improvement for 6 measures: Patient/Family Experience, Patient Time Valued, Empanelment, Cycle Time, Colorectal Cancer Screening Rate, and Third Next Available Appointment. Progress varied across sites and measures. Participant interviews indicated value from both in-person and virtual activities, increased QI knowledge, and professional growth, as well as challenges when participants lacked time, engagement, leadership support, and consistent and committed staff.

Conclusion: This novel collaborative structure is promising. Evidence indicates progress in building QI capacity and improving processes and patient experience across participating FQHCs. Future iterations should address barriers to improvement identified here. Additional work is needed to compare the efficacy of this approach to other collaborative modes.
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http://dx.doi.org/10.1016/j.jcjq.2020.04.013DOI Listing
August 2020

The Adipocyte Acquires a Fibroblast-Like Transcriptional Signature in Response to a High Fat Diet.

Sci Rep 2020 02 11;10(1):2380. Epub 2020 Feb 11.

Department of Biochemistry, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.

Visceral white adipose tissue (vWAT) expands and undergoes extensive remodeling during diet-induced obesity. Much is known about the contribution of various stromal vascular cells to the remodeling process, but less is known of the changes that occur within the adipocyte as it becomes progressively dysfunctional. Here, we performed a transcriptome analysis of isolated vWAT adipocytes to assess global pathway changes occurring in response to a chronic high fat diet (HFD). The data demonstrate that the adipocyte responds to the HFD by adopting a fibroblast-like phenotype, characterized by enhanced expression of ECM, focal adhesion and cytoskeletal genes and suppression of many adipocyte programs most notably those associated with mitochondria. This study reveals that during obesity the adipocyte progressively becomes metabolically dysfunctional due to its acquisition of fibrogenic functions. We propose that mechano-responsive transcription factors such as MRTFA and SRF contribute to both upregulation of morphological genes as well as suppression of mitochondrial programs.
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http://dx.doi.org/10.1038/s41598-020-59284-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7012923PMC
February 2020

Incidence and Fusion of Os Trigonum in a Healthy Pediatric Population.

J Pediatr Orthop 2019 Oct;39(9):e718-e721

Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center.

Background: Accessory ossicles off the talus (os trigonum) are a common radiographic finding seen within the foot with variable symptomatology in adult and pediatric patients. Although most studies have examined the incidence of these anatomic variants in a retrospective manner, few have longitudinally followed the behavior of os trigonum over time. The aim of this study was to investigate the incidence, mean age of appearance and fusion, and fusion rate of os trigonum in a large cohort of asymptomatic pediatric patients.

Methods: A total of 2620 serial digitized unilateral foot and ankle radiographs from 261 healthy white children (age range, 0.25 to 7 y at enrollment) were retrospectively reviewed. Radiographs were examined to determine the incidence of os trigonum, noting age of appearance and if present, the age of fusion. Skeletal maturity was graded based on ossification pattern of the calcaneal apophysis.

Results: Radiographic evidence of os trigonum was present in 18% of patients (n=16 females, n=15 males) with radiographs extending 1 SD beyond the average age of os trigonum appearance. There was no difference in incidence between females and males (P=0.27), and os trigonum was found to appear at a significantly younger age in females (9.1±1.8 y) than males (10.4±2.0 y, P=0.04). Overall, 70% (n=26) of subjects with os trigonum achieved fusion by age 17 (mean, 9.5±1.6 y in females, 11.2±1.6 in males) with no significant difference between sexes (P=0.61). Grading of skeletal maturity at the time of fusion showed that both male and female subjects underwent fusion on average between calcaneal stages 2 and 3 (P=0.5).

Conclusions: This study confirms a relatively large prevalence of os trigonum in a random pediatric population, and clarifies both the average age of onset and high rate of fusion at a relatively narrow range of skeletal maturity.

Level Of Evidence: Prognostic level II-retrospective study.
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http://dx.doi.org/10.1097/BPO.0000000000001016DOI Listing
October 2019

Efficacy of Tea Tree Oil in the Treatment of Equine Streptothricosis.

J Equine Vet Sci 2019 08 16;79:79-85. Epub 2019 May 16.

Department of Biological Sciences, Randolph College, Lynchburg, VA. Electronic address:

Streptothricosis is a dermatitis characterized by matted tufts of hair and coalescing, pustular crusts that affects many livestock species, including horses. It results from cutaneous infection by the actinobacterium Dermatophilus congolensis. For economic reasons, the ailment is often treated with commercially available over-the-counter (OTC) products or home remedies rather than prescribed medications. This study aimed to determine the efficacy of tea tree oil (TTO), an essential oil of Melaleuca alternifolia, as an OTC treatment for streptothricosis. Bacteria were isolated from presumptive streptothricosis lesions on horses at a farm in Forest, Virginia. These isolates were microbiologically and genetically confirmed to be D. congolensis. The antimicrobial activity of TTO against D. congolensis isolates was determined by minimum inhibitory concentration and disc diffusion assays and compared with three OTC products advertised specifically for the treatment of "rain rot," a colloquial term for streptothricosis. A 1% TTO solution (v/v, in baby oil) and the three selected OTC products were applied to equine streptothricosis lesions to evaluate in vivo resolution of the lesions. Tea tree oil exhibited antimicrobial behavior against D. congolensis in vitro and produced marked improvement of streptothricosis lesions in vivo. These results have implications for development of TTO as a possible treatment for streptothricosis.
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http://dx.doi.org/10.1016/j.jevs.2019.05.011DOI Listing
August 2019

Development of a Mouse Pain Scale Using Sub-second Behavioral Mapping and Statistical Modeling.

Cell Rep 2019 08;28(6):1623-1634.e4

Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. Electronic address:

Rodents are the main model systems for pain research, but determining their pain state is challenging. To develop an objective method to assess pain sensation in mice, we adopt high-speed videography to capture sub-second behavioral features following hind paw stimulation with both noxious and innocuous stimuli and identify several differentiating parameters indicating the affective and reflexive aspects of nociception. Using statistical modeling and machine learning, we integrate these parameters into a single index and create a "mouse pain scale," which allows us to assess pain sensation in a graded manner for each withdrawal. We demonstrate the utility of this method by determining sensations triggered by three different von Frey hairs and optogenetic activation of two different nociceptor populations. Our behavior-based "pain scale" approach will help improve the rigor and reproducibility of using withdrawal reflex assays to assess pain sensation in mice.
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http://dx.doi.org/10.1016/j.celrep.2019.07.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6724534PMC
August 2019

Providers' Perceptions of Parental Human Papillomavirus Vaccine Hesitancy: Cross-Sectional Study.

JMIR Cancer 2019 Jul 2;5(2):e13832. Epub 2019 Jul 2.

Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.

Background: Human papillomavirus (HPV) vaccine hesitancy among parents contributes to low vaccination coverage in adolescents. To improve health care provider communication and vaccine recommendation practices with hesitant parents, it is important to understand how providers perceive parental HPV vaccine hesitancy.

Objective: This study aimed to characterize perceived reasons for parental HPV vaccine hesitancy and identify factors associated with perceived parental hesitancy among providers at community-based pediatric clinics.

Methods: In 2018, providers in 23 community-based pediatric clinics in Tennessee were invited to complete a Web-based baseline survey as part of a larger quality improvement study focused on HPV vaccine uptake. These survey data were used for a cross-sectional, secondary data analysis. Scale scores ranging from 0 to 100 were calculated for provider self-efficacy (confidence in ability to recommend HPV vaccine), provider outcome expectations (expectations that recommendation will influence parents' decisions), and perceived parental HPV vaccine hesitancy. Provider confidence in HPV vaccine safety and effectiveness were categorized as high versus low. Clinic-level exposures examined were clinic size and rural-urban location. Descriptive analyses were used to characterize perceived parental barriers by provider type. Mixed-effects linear regression models were fit taking one exposure variable at a time, whereas controlling for provider type, age, gender, and race to identify provider- and clinic-level factors associated with perceived parental barriers to HPV vaccination.

Results: Of the 187 providers located in the 23 clinics, 137 completed the survey. The majority of physician providers were white and female, with a higher percentage of females among nurse practitioners (NPs) and physician assistants (PAs). The most common parental barriers to HPV vaccination perceived by providers were concerns about HPV vaccine safety (88%), child being too young (78%), low risk of HPV infection for child through sexual activity (70%), and mistrust in vaccines (59%). In adjusted mixed models, perceived parental HPV vaccine hesitancy was significantly associated with several provider-level factors: self-efficacy (P=.001), outcome expectations (P<.001), and confidence in HPV vaccine safety (P=.009). No significant associations were observed between perceived parental HPV vaccine hesitancy and clinic-level factors clinic size nor location.

Conclusions: Researchers developing provider-focused interventions to reduce parental HPV vaccine hesitancy should consider addressing providers' self-efficacy, outcome expectations, and confidence in HPV vaccine safety to help providers communicate more effectively with HPV vaccine hesitant parents.
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http://dx.doi.org/10.2196/13832DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6632100PMC
July 2019

Clustering of Isolates Using MLST and Whole-Genome Phylogenetics and Protein Motif Fingerprinting.

Front Public Health 2019 8;7:66. Epub 2019 May 8.

Institute of Marine Sciences, University of North Carolina at Chapel Hill, Morehead City, NC, United States.

is a ubiquitous and abundant member of native microbial assemblages in coastal waters and shellfish. Though is predominantly environmental, some strains have infected human hosts and caused outbreaks of seafood-related gastroenteritis. In order to understand differences among clinical and environmental strains, we used high quality DNA sequencing data to compare the genomes of isolates ( = 43) from a variety of geographic locations and clinical and environmental sample matrices. We used phylogenetic trees inferred from multilocus sequence typing (MLST) and whole-genome (WG) alignments, as well as a novel classification and genome clustering approach that relies on protein motif fingerprints (MFs), to assess relationships between strains and identify novel molecular targets associated with virulence. Differences in strain clustering at more than one position were observed between the MLST and WG phylogenetic trees. The WG phylogeny had higher support values and strain resolution since isolates of the same sequence type could be differentiated. The MF analysis revealed groups of protein motifs that were associated with the pathogenic MLST type ST36 and a large group of clinical strains isolated from human stool. A subset of the stool and ST36-associated protein motifs were selected for further analysis and the motif sequences were found in genes with a variety of functions, including transposases, secretion system components and effectors, and hypothetical proteins. DNA sequences associated with these protein motifs are candidate targets for future molecular assays in order to improve surveys of pathogenic in the environment and seafood.
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http://dx.doi.org/10.3389/fpubh.2019.00066DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519141PMC
May 2019