Investigation and response to an outbreak of Neisseria meningitidis serogroup Y ST-1466 urogenital infections, Australia.

Abstract: In 2023, an increased number of urogenital and anorectal infections with Neisseria meningitis serogroup Y (MenY) were reported in New South Wales (NSW). Whole genome sequencing (WGS) found a common sequence type (ST-1466), with limited sequence diversity. Confirmed outbreak cases were NSW residents with a N. meningitidis isolate matching the cluster sequence type; probable cases were NSW residents with MenY isolated from a urogenital or anorectal site from 1 July 2023 without WGS testing. Of the 41 cases, most were men (n = 27), of whom six reported recent contact with a female sex worker. Five cases were men who have sex with men and two were female sex workers. Laboratory alerts regarding the outbreak were sent to all Australian jurisdictions through the laboratories in the National Neisseria Network. Two additional states identified urogenital MenY ST-1466 infections detected in late 2023. Genomic analysis showed all MenY ST-1466 sequences were interspersed, suggestive of an Australia-wide outbreak. The incidence of these infections remains unknown, due to varied testing and reporting practices both within and across jurisdictions. Isolates causing invasive meningococcal disease (IMD) in Australia are typed, and there has been no MenY ST-1466 IMD recorded in Australia to end of March 2024. Concerns remain regarding the risk of IMD, given the similarity of these sequences with a MenY ST-1466 IMD strain causing a concurrent outbreak in the United States of America.

How do gender and military sexual trauma impact PTSD symptoms in cognitive processing therapy and prolonged exposure?

OBJECTIVE: Effectiveness of evidence-based psychotherapy (EBP) for PTSD can vary based on gender and trauma type, with poorer outcomes for men and sexual traumas. Among veterans receiving EBPs for PTSD, the effects of the interaction between gender and military sexual trauma (MST) on treatment outcome are unclear. This study examined how gender and MST impact PTSD symptoms following cognitive processing therapy (CPT) and prolonged exposure (PE). METHOD: We conducted a national, retrospective cohort study of all post 9/11 veterans who had a PTSD diagnosis from 10/2001-9/2017 at VHA facilities and >1 psychotherapy visit. Inclusion criteria included completion of ≥8 CPT/PE sessions and pre- and post-treatment PCL (N = 9711). Mixed-effects linear regression models were conducted, separately by treatment, to examine associations between changes in PTSD symptoms and gender, MST, and their interactions with time. RESULTS: For both treatments, there were no significant differences in pre-treatment PCL by gender or MST, and PCL decreased significantly over time. In adjusted models, only the gender by time interaction on pre-to-post-CPT change was significant (p < .001); the decrease in women's PCL was 2.67 points greater, compared to men. CONCLUSIONS: Women veterans demonstrated greater reductions in PTSD symptoms from CPT. There were no differences by gender for PE, suggesting men and women veterans benefit similarly. Results suggest outcomes may be impacted by gender socialization when utilizing certain cognitive behavioral techniques. MST, regardless of gender, did not impact PTSD outcomes for either treatment. Both CPT and PE may thus be effective for veterans irrespective of MST history.

'What vision?': experiences of Team members in a community service for adults with intellectual disabilities.

BACKGROUND: In the UK, the closure of 'long-stay' hospitals was accompanied by the development of community teams (CTs) to support people with intellectual disabilities (IDs) to live in community settings. The self-reported experiences of staff working in such teams have been neglected. METHODS: Focusing on a single county-wide service, comprising five multi-disciplinary and inter-agency CTs, we measured perceptions among the health care and care management Team members of (1) their personal well-being; (2) the functioning of their team; and (3) the organisation's commitment to quality, and culture. RESULTS: Almost three-quarters of the questionnaires were returned (73/101; 72%). The scores of health care practitioners and care managers were very similar: (1) the MBI scores of more than half the respondents were 'of concern'; (2) similarly, almost four in ten respondents' scores on the Vision scale of the TCI were 'of concern'; (3) the perceived commitment to quality (QIIS-II Part 2) was uncertain; and (4) the organisational culture (QIIS-II, Part 1) was viewed as primarily hierarchical. DISCUSSION: The perceived absence of a vision for the service, combined with a dominant culture viewed by its members as strongly focussed on bureaucracy and process, potentially compromises the ability of these CTs to respond proactively to the needs of people with IDs. Given the changes in legislation, policy and practice that have taken place since CTs were established, it would be timely to revisit their role and purpose.

Using food-web theory to conserve ecosystems.

Food-web theory can be a powerful guide to the management of complex ecosystems. However, we show that indices of species importance common in food-web and network theory can be a poor guide to ecosystem management, resulting in significantly more extinctions than necessary. We use Bayesian Networks and Constrained Combinatorial Optimization to find optimal management strategies for a wide range of real and hypothetical food webs. This Artificial Intelligence approach provides the ability to test the performance of any index for prioritizing species management in a network. While no single network theory index provides an appropriate guide to management for all food webs, a modified version of the Google PageRank algorithm reliably minimizes the chance and severity of negative outcomes. Our analysis shows that by prioritizing ecosystem management based on the network-wide impact of species protection rather than species loss, we can substantially improve conservation outcomes.

A Demonstration Project in New York and Virginia: Retrofitting Cost-Effective Roll-over Protective Structures (CROPS) on Tractors.

The NIOSH cost-effective roll-over protective structure (CROPS) demonstration project sought to determine whether three prototype roll-over protective structures (ROPS) designed to be retrofitted on Ford 8N, Ford 3000, Ford 4000, and Massey Ferguson 135 tractors could be installed in the field and whether they would be acceptable by the intended end users (farmers). There were a total of 50 CROPS. demonstrators (25 in New York and 25 in Virginia), with 45 observers attending the New York CROPS demonstrations and 36 observers attending the Virginia CROPS demonstrations, for a total of 70 participants in New York and 61 in Virginia. The oldest retrofitted tractors were 77 to 62 years old, while the newest retrofitted tractors were 40 to 37 years old. The most frequently retrofitted tractor in the CROPS demonstration project was a Ford 3000 series tractor (n = 19; 38%), followed by Ford 4000 (n = 11; 22%), Massey Ferguson 135 (n = 11; 22%), and Ford 8N (n = 9; 18%). A major issue of CROPS retrofitting was the rear wheel fenders. The effort involved in disassembling the fenders (removing the old bolts was often faster by cutting them with a torch), modifying the fender mounting brackets, and then reinstalling the fenders with the CROPS generally required the most time. In addition, various other semi-permanent equipment attachments, such as front-end loaders, required additional time and effort to fit with the CROPS. Demonstrators were asked to rank the reasons why they had not retrofitted their tractors with ROPS until they had enrolled in the CROPS demonstration program. ROPS "cost too much" was ranked as the primary reason for participants in both states (80% for New York and 88% for Virginia). The second highest ranked reasons were "ROPS wasn't available" for Virginia (80%) and "hassle to find ROPS" for New York (69%). The third highest ranked reasons were "not enough time to find ROPS" for New York (67%) and "hassle to find ROPS" for Virginia (79%). All demonstrators and observers indicated that they were glad to have participated in the CROPS project.

Toluidine blue aids in detection of dysplasia and carcinoma in suspicious oral lesions.

OBJECTIVES: Accurate clinical identification of 'higher-risk' oral premalignant lesions or 'higher-risk' areas within lesions is important. Assessment methods that predict their presence have great utility. SUBJECTS AND METHODS: A cross-sectional, observational study enrolled a consecutive sample of consenting patients diagnosed with oral leukoplakia, erythroleukoplakia, or erythroplakia. Medical history, visual oral examination, ViziLite(®) examination, toluidine blue staining (TBlue(®) ), and finally a biopsy were completed in a single clinic visit. Seventy-seven of 100 examined lesions in 43 patients were biopsied. Sensitivity, specificity, and positive and negative predictive values were computed for visual examination, ViziLite(®) , and TBlue(®) using biopsy results as the gold standard. RESULTS: The sensitivity of TBlue(®) in detecting high-risk lesions (carcinoma in situ or carcinoma) was 94 (71-100, P < 0.0003) and specificity 45 (32-58, P < 0.53), while for carcinoma, sensitivity was 100 (54-100, P < 0.032) and specificity 39 (28-52, P < 0.097). The results of ViziLite(®) testing either by itself or in combination with the information from toluidine blue testing revealed low sensitivity for the detection of high-risk lesions. CONCLUSIONS: Clinical examination of leukoplakia, erythroplakia, or erythroleukoplakia lesions combined with toluidine blue staining may aid in the identification of severe dysplasia (carcinoma in situ) or carcinoma. This may help in determining whether, when, and where (the site within a lesion) a biopsy should be taken.

Concept identification for a power take-off shielding campaign.

ABSTRACT Machinery entanglements, specifically power take-off (PTO) entanglements, are a leading cause of injuries and fatalities on farms. In order to address this life-threatening issue, a social marketing campaign is being developed to reduce barriers and emphasize motivators to shielding. This article discusses the process of designing, testing, and selecting concepts to be used in the campaign. Small-group discussions (triads) were held to test 13 message concepts. Participants were asked to provide feedback and select the two messages that they believed to be most powerful. Upon completion, three message concepts were selected to be finalized.

Increases in ROPS pricing from 2006-2012 and the impact on ROPS demand.

In 2006, a social marketing campaign was developed to increase the installation of rollover protective structures (ROPS) on unprotected New York tractors. Using data gathered from the program's hotline, the impact of price increases on farmers' interest in ROPS is examined. Pricing data were obtained for all rigid ROPS kits commercially available in the U.S. since 2006. These data were stratified into two groups of ROPS suppliers: (1) tractor manufacturers that sell ROPS for their own tractors, referred to in this study as original equipment manufacturers (OEMs), and (2) aftermarket (AM) ROPS suppliers. The trend in price increases was contrasted with the change in the consumer price index (CPI), the probability of retrofitting within quintiles of cost was estimated, and the increase in ROPS prices over time was plotted The average price increase for a ROPS kit (excluding shipping and installation) over the six years of the study was 23.3% for OEM versus 60.5% for AM (p < 0.0001). Out-of-pocket expenses held steady for OEM versus a six-year increase of $203 for AM (p = 0.098). The probability of a farmer retrofitting dropped monotonically from 66.9% in the lowest ROPS cost quintile to 23% in the highest. If these trends continue, the proportion of inquiries resulting in a ROPS retrofit will fall below 20% by 2020 for AM ROPS. Based on other trends identified in the literature, it is reasonable to assume that decreases in ROPS installation are likely to affect the tractor owners who are most likely to need these safety devices.

Supervised machine learning and logistic regression identifies novel epistatic risk factors with PTPN22 for rheumatoid arthritis.

Investigating genetic interactions (epistasis) has proven difficult despite the recent advances of both laboratory methods and statistical developments. With no 'best' statistical approach available, combining several analytical methods may be optimal for detecting epistatic interactions. Using a multi-stage analysis that incorporated supervised machine learning and methods of association testing, we investigated epistatic interactions with a well-established genetic factor (PTPN22 1858T) in a complex autoimmune disease (rheumatoid arthritis (RA)). Our analysis consisted of four principal stages: Stage I (data reduction)-identifying candidate chromosomal regions in 292 affected sibling pairs, by predicting PTPN22 concordance using multipoint identity-by-descent probabilities and a supervised machine learning algorithm (Random Forests); Stage II (extension analysis)-testing detailed genetic data within candidate chromosomal regions for epistasis with PTPN22 1858T in 677 cases and 750 controls using logistic regression; Stage III (replication analysis)-confirmation of epistatic interactions in 947 cases and 1756 controls; Stage IV (combined analysis)-a pooled analysis including all 1624 RA cases and 2506 control subjects for final estimates of effect size. A total of seven replicating epistatic interactions were identified. SNP variants within CDH13, MYO3A, CEP72 and near WFDC1 showed significant evidence for interaction with PTPN22, affecting susceptibility to RA.

Accelerated prediction of recombinant protein production in Saccharomyces cerevisiae by using rapid monitoring techniques.

The use of a stopped-flow analyser for the monitoring of the production of a secreted recombinant protein, a wild-type cutinase, from S. cerevisiae CEN.PK111-32D pUR7320 is described. Induction is through use of a galactose promoter, and the monitoring facility is used to record the formation of the cutinase and cell density with optical density measurements. A range of induction conditions was studied with a view to using the monitoring to predict the likely level of cutinase formation. Results achieved within 4 to 5 h of induction were of sufficient quality to allow the use of simple modelling relating cutinase formation and cell production to predict likely final specific activities of the product. The utility of such monitoring and prediction is discussed with regards to improved process confidence and definition during fermentation production.

Mechanisms of nephrotoxicity from metal combinations: a review.

The common environmental pollutants arsenic, lead, and cadmium are each known to induce chronic renal disease and the molecular mechanisms of such toxic events are being clarified. Nephrotoxicity of these metals is due to the fact that urinary elimination is a main route of excretion, and the proximal tubules are especially sensitive due to their high reabsorptive activity. Renal pathological effects of these metals vary with the chemical form of the metal, the dose, and whether the exposure is acute or chronic in nature. The few isolated studies of combined metal exposures indicate that these pathological effects may be altered due to unknown interactions of these metals within the kidney. Biological factors within the cell such as metal binding proteins and inclusion bodies may also influence metal-metal interactions. Further research is needed to specify the parameters or criteria by which metal interactions is to be assessed for unique biological response patterns to aid in the risk assessment analysis of environmental and occupational metal exposures.

Coping strategies and integrative meaning as moderators of chronic illness.

This study contrasted the moderating effects of deriving integrative meaning (a primary appraisal process) with the use of specific, cognitive-behavioral strategies (a secondary appraisal process) in confronting stressors involving harm or loss. Eighty young adults and eighty older participants with varying levels of chronic illness were assessed. Open-ended responses to recalled experiences with illness and death were coded for integrative meaning and use of specific cognitive-behavioral strategies. In young adults with higher levels of chronic illness, a greater tendency to use specific cognitive-behavioral strategies was related to higher morale. In older participants, a greater tendency to derive integrative meaning was related to increased morale, regardless of illness levels.

Crystal morphology prediction and morphology variation in NaIO4 and NaIO4.3H2O.

Attachment energies computed with only Coulomb potentials have been utilized to predict crystal morphologies for NaIO(4), sodium iodate, and the hydrate NaIO(4).3H(2)O, sodium iodate trihydrate [actually Na(H(3)O)(IO(3))(OH)(3)]. As with other previously studied water-soluble ionic compounds, these two systems exhibit a systematic relationship between the early growth morphology and that of mature crystals; this relationship can in each case be reproduced by adjusting one attachment energy value. Morphology prediction for these two substances is of particular interest because NaIO(4).3H(2)O is a polar crystal and involves extensive hydrogen bonding, and because obtaining the observed morphology for NaIO(4) involved consideration of solvent desorption at the growing faces.

The well of loneliness, or the gospel according to Radclyffe Hall.

Radclyffe Hall's 1928 novel, The Well of Loneliness, is repeatedly described as a "bible" of lesbian literature. The novel itself repeatedly alludes to biblical stories, especially the story of Christ. Yet there has been little sustained analysis of the biblical language of the novel. Most feminist and lesbian critics have dismissed the biblical allusions and language as unfortunate and politically regressive; religious critics have ignored the novel. This essay reexamines the biblical nature of the novel, especially its portrayal of the lesbian Stephen Gordon as a Christ figure. The study further claims a creative and interventionary power in Hall's use of biblical narratives and tropes, a power traceable in public reception to the novel and in courtroom reactions to the use of spiritual language in a text about lesbianism. By writing the life of a lesbian as a kind of gospel of inversion, Hall turns a language of condemnation into a language of validation, making her use of biblical language a kind of Foucauldian "reverse discourse." The novel's power lies in its portrayal of a lesbian messiah, and in its joining of sexological and religious discourses.

The long-stem bipolar prosthesis in surgery of the hip.

More than 500 hips, with either displaced fractures of the femoral neck or primary or revision total hip arthroplasty, were treated by a straight, long-stem (305-mm), Bateman-type bipolar model (BBM). The BBM was not porous coated, and it is not cemented in place. The femoral component is secured in the femoral canal by means of biomechanical fixation. It is biologic by bone ingrowth through the fenestration in the proximal neck. It is mechanical by a snug fit in the isthmus and by three-point fixation within the shaft. The removed femoral head is morselized in the bone mill and packed into the prepared femoral canal to enhance a tight fit. The collar of the BBM transfers stress to the calcar. Postoperative roentgenograms show incorporation of bone graft within the fenestration of the prosthesis and no stress shielding of the calcar. The acetabulum requires reaming only if it is shallow or asymmetric. It usually presents no problem except in revision total hip arthroplasty. The present authors have used the BBM almost exclusively since 1981. After eight years, the BBM has stood up well to the test of time and presented few major problems.

Effect of acidotropic amines on the accumulation of newly synthesized membrane and luminal proteins in Chinese-hamster ovary (CHO) cell lysosomes.

Lysosomes were isolated by sequential gradient centrifugation [Madden, Wirt & Storrie (1987) Arch. Biochem. Biophys. 257, 27-38] from control or acidotropic-amine-treated Chinese-hamster ovary (CHO) cells. By marker-enzyme analysis, the preparation from chloroquine or NH4Cl-treated cells was about 25-fold enriched for lysosomes compared with the postnuclear supernatant and contained little or no marker activities for the plasma membrane, rough endoplasmic reticulum, Golgi apparatus, mitochondria, cytosol and peroxisomes. The yield of amine-treated lysosomes was about 60% relative to the postnuclear supernatant. Electron microscopy and cytochemistry demonstrated that the amine-treated preparation was highly purified. Cytochemical analyses after a short-term pulse of horseradish peroxidase revealed that endosomal contamination of the lysosomal preparation was less than 1%. Lysosomal polypeptides were biosynthetically labelled with [35S]methionine and identified by SDS/polyacrylamide-gel electrophoresis. As expected, the bulk accumulation of luminal proteins into lysosomes was decreased. The bulk accumulation of membrane proteins was increased by acidotropic amine treatment. There were also several qualitative differences in each lysosomal compartment, with new species observed and other species absent. These data suggest that a low pH is not necessary for the normal accumulation of the bulk of membrane proteins in lysosomes and that membrane trafficking from Golgi apparatus to lysosomes occurs at a high rate in acidotropic-amine-treated CHO cells.

Purification and characterization of lysosomes from Chinese hamster ovary cells.

Lysosomes were isolated from Chinese hamster ovary cells by fractionation of a postnuclear supernatant in consecutive density gradients. By marker enzyme analysis, the preparation was 63-fold enriched for lysosomes compared to the homogenate and contained at most trace amounts of marker activities for plasma membrane, Golgi, endoplasmic reticulum, peroxisomes, cytosol, and mitochondria. The lysosomes were intact as indicated by greater than 95% latency of beta-hexosaminidase activity, and the yield was about 12% relative to the homogenate. By electron microscopy, the lysosomal preparation contained very few mitochondrial profiles. By cytochemistry, greater than 80% of the organelle profiles were positive for the native lysosomal marker, acid phosphatase, and profiles were positive for long-term internalized horseradish peroxidase, an endocytic marker for lysosomes. By sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the lysosomal preparation displayed a unique pattern of polypeptides and was devoid of mitochondrial contamination. Lysosomes were fractionated into membrane and lumenal compartments by Na2CO3 treatment. Each compartment contained 20-30 distinct electrophoretic species ranging from 18 to 200 kDa. Each polypeptide could be assigned to either the membrane or lumenal compartment. A comparison of silver-stained polypeptides with those metabolically labeled with [35S]methionine indicated that, with the possible exception of an 18-kDa species, all of the major lysosomal polypeptides in both compartments were derived by endogenous synthesis in these exponentially growing fibroblasts.

The preparative isolation of mitochondria from Chinese hamster ovary cells.

A "hybrid" discontinuous gradient consisting of 6% Percoll overlaid on metrizamide separated mitochondria from other organelles in a Chinese hamster ovary cell postnuclear supernatant in a single 15-min centrifugation. The mitochondrial preparation contained about 25% of the mitochondrial marker, cytochrome-c oxidase, in a form that was about 90% latent. Based on the postnuclear supernatant, cytochrome-c oxidase activity was enriched approximately 45-fold. Trace amounts of lysosomal, rough endoplasmic reticular, Golgi, peroxisomal, plasma membrane, and cytosolic markers were found in the preparation. Electron microscopy revealed that the preparation consisted almost exclusively of mitochondria with only minor amounts of contaminating organelles. Analysis of the mitochondrial preparation by sodium dodecyl sulfate-polyacrylamide gel electrophoresis demonstrated that the mitochondrial preparation had a unique protein profile compared to the postnuclear supernatant and other gradient interfaces. Separation of the mitochondria into membrane and lumenal (matrix) fractions by treatment with 100 mM Na2CO3, pH 11.5, also indicated that the mitochondria were intact; they were rich in lumenal proteins. The data indicate that the mitochondria represent maximally about 2.2% of Chinese hamster ovary cell postnuclear supernatant protein. These isolated mitochondria should prove useful for problems in molecular cell biology.