Desiccation tolerance is associated with Staphylococcus aureus hypertransmissibility, resistance and infection development in the operating room.

BACKGROUND: Desiccation tolerance increases Staphylococcus aureus survival and risk of transmission. A better understanding of factors driving intraoperative transmission of S. aureus pathogens may lead to innovative improvements in intraoperative infection control. AIMS: To determine whether desiccation tolerance is associated with intraoperative S. aureus transmission, and to examine typical transmission dynamics for desiccation-tolerant isolates in the operating room in order to provide the impetus for development of improved intraoperative infection control strategies. METHODS: S. aureus isolates (N=173) were collected from anaesthesia work area reservoirs in 274 operating room environments. Desiccation tolerance was assessed and the potential association with sequence type (ST) and clonal transmission was evaluated. Whole cell genome analysis and pulsed-field gel electrophoresis analysis were used to compare desiccation-tolerant isolates with causative organisms of infection. FINDINGS: S. aureus ST 5 isolates had greater desiccation tolerance than all other intraoperative STs [ST 5, N=34, median Day 2 colony-forming unit (cfu) survival 0.027% ± 0.029%; other STs, N=139, median Day 2 cfu survival 0.0091% ± 1.41%; corrected P=0.0001]. ST 5 was associated with increased risk of clonal transmission (relative risk 1.82, 95% confidence interval 1.23-2.71, P=0.003). ST 5 transmission was linked by whole cell genome analysis to postoperative infection. CONCLUSIONS: Increased desiccation tolerance is associated with intraoperative transmission of S. aureus ST 5 isolates that are linked to postoperative infection. Future work should determine whether attenuation of desiccation-tolerant, intraoperative ST 5 strains can impact the incidence of healthcare-associated infections.

Development of a low-maintenance measurement approach to continuously estimate methane emissions: A case study.

The chemical breakdown of organic matter in landfills represents a significant source of methane gas (CH4). Current estimates suggest that landfills are responsible for between 3% and 19% of global anthropogenic emissions. The net CH4 emissions resulting from biogeochemical processes and their modulation by microbes in landfills are poorly constrained by imprecise knowledge of environmental constraints. The uncertainty in absolute CH4 emissions from landfills is therefore considerable. This study investigates a new method to estimate the temporal variability of CH4 emissions using meteorological and CH4 concentration measurements downwind of a landfill site in Suffolk, UK from July to September 2014, taking advantage of the statistics that such a measurement approach offers versus shorter-term, but more complex and instantaneously accurate, flux snapshots. Methane emissions were calculated from CH4 concentrations measured 700m from the perimeter of the landfill with observed concentrations ranging from background to 46.4ppm. Using an atmospheric dispersion model, we estimate a mean emission flux of 709µgm-2s-1 over this period, with a maximum value of 6.21mgm-2s-1, reflecting the wide natural variability in biogeochemical and other environmental controls on net site emission. The emissions calculated suggest that meteorological conditions have an influence on the magnitude of CH4 emissions. We also investigate the factors responsible for the large variability observed in the estimated CH4 emissions, and suggest that the largest component arises from uncertainty in the spatial distribution of CH4 emissions within the landfill area. The results determined using the low-maintenance approach discussed in this paper suggest that a network of cheaper, less precise CH4 sensors could be used to measure a continuous CH4 emission time series from a landfill site, something that is not practical using far-field approaches such as tracer release methods. Even though there are limitations to the approach described here, this easy, low-maintenance, low-cost method could be used by landfill operators to estimate time-averaged CH4 emissions and their impact downwind by simultaneously monitoring plume advection and CH4 concentrations.

MicroRNA-101 regulated transcriptional modulator SUB1 plays a role in prostate cancer.

MicroRNA-101, a tumor suppressor microRNA (miR), is often downregulated in cancer and is known to target multiple oncogenes. Some of the genes that are negatively regulated by miR-101 expression include histone methyltransferase EZH2 (enhancer of zeste homolog 2), COX2 (cyclooxygenase-2), POMP (proteasome maturation protein), CERS6, STMN1, MCL-1 and ROCK2, among others. In the present study, we show that miR-101 targets transcriptional coactivator SUB1 homolog (Saccharomyces cerevisiae)/PC4 (positive cofactor 4) and regulates its expression. SUB1 is known to have diverse role in vital cell processes such as DNA replication, repair and heterochromatinization. SUB1 is known to modulate transcription and acts as a mediator between the upstream activators and general transcription machinery. Expression profiling in several cancers revealed SUB1 overexpression, suggesting a potential role in tumorigenesis. However, detailed regulation and function of SUB1 has not been elucidated. In this study, we show elevated expression of SUB1 in aggressive prostate cancer. Knockdown of SUB1 in prostate cancer cells resulted in reduced cell proliferation, invasion and migration in vitro, and tumor growth and metastasis in vivo. Gene expression analyses coupled with chromatin immunoprecipitation revealed that SUB1 binds to the promoter regions of several oncogenes such as PLK1 (Polo-like kinase 1), C-MYC, serine-threonine kinase BUB1B and regulates their expression. Additionally, we observed SUB1 downregulated CDKN1B expression. PLK1 knockdown or use of PLK1 inhibitor can mitigate oncogenic function of SUB1 in benign prostate cancer cells. Thus, our study suggests that miR-101 loss results in increased SUB1 expression and subsequent activation of known oncogenes driving prostate cancer progression and metastasis. This study therefore demonstrates functional role of SUB1 in prostate cancer, and identifies its regulation and potential downstream therapeutic targets of SUB1 in prostate cancer.

Yield stimulation of a commonly grown cultivar of Phaseolus vulgaris L. at near-ambient ozone concentrations.

Seeds of Phaseolus vulgaris L. ev. Nerina were hand-sown inside open-top chambers (OTCs) in which the plants were exposed to charcoal-filtered air (CF treatment), ambient air (NF), or ambient air with added 6, 12, 18, 25 or 30 nl 1-1 of ozone (NF6, NF12, NF18, NF25 and NF30 treatments, respectively). Exposure commenced as the crop emerged and continued on a daily basis until the end of the season. Ozone (O3 ) was added between 10.00 and 18.00 h GMT. The seasonal 7 h mean O3 concentrations ranged from 10 nl l-1 in the CF treatment to 50 nl l-1 in the NF30 treatment. The growth and yield of P. vulgaris ev. Nerina demonstrated two distinct responses to O3 depending upon concentration. At seasonal 7 h means of 20, 26 and 32 nl l-1 (NF, NF6 and NF12 treatments respectively), the yield increased relative to that of the CF treatment. The increase in yield peaked at 48% in the NF6 treatment (P < 0.05), and was associated with a 55 % increase in the maximum leaf number, longer retention of the canopy, and a 45 % increase in the number of pods present at the final harvest. In contrast, seasonal 7 h mean O3 concentrations of 38, 45 and 50 nl l-1 (NF18, NF25 and NF30 treatments) caused 26-42 % reductions in the yield of P. vulgaris. The leaves of such plants developed extensive symptoms of O3 injury and were prematurely abscised from the plants. The reductions in yield were due to a decrease in the numbers of seeds per pod and in the weights of individual seeds.

Perceptions of the elderly among nursing home aides of three black cultural groups.

The Perceptions of the Elderly Scale (PES) was administered to a sample of 246 aides working in nursing homes in the New York Metropolitan Area. The aides represented three Black American cultural groups: African Americans, English-speaking Caribbean Blacks (including Jamaicans, Trinidadians, and Barbadians) and Haitians. Members of these groups make up the overwhelming majority of nursing home aides in New York City. The results indicated that aides from all three groups had generally favorable attitudes toward the elderly, but the English-speaking Caribbean groups expressed significantly more favorable attitudes than aides in either of the two other groups. The observed differences were attributed to the traditional role of the older individual within West Indian culture as disciplinarian and authority figure. Implications for in-service education are discussed.

Attitudes toward nursing home residents among aides of three cultural groups.

This study assesses attitudes toward elderly nursing home clients as interviewed by 255 aides from three Black cultural groups: Afro-Americans; English-speaking Caribbeans; and Haitians. Results indicate that aides from all three groups had generally positive attitudes toward the elderly and the English-speaking Caribbean group expressed the most positive attitudes. Aides did express some negative attitudes toward the families of the elderly residents for not taking care of the elderly at home. Results were interpreted as reflecting the cultural norms of the three groups which included the infrequent placement of elderly persons in nursing homes. Findings indicated a need for inservice workshops in cultural diversity for aides who serve clients from different cultural groups. Social work curricula should prepare graduate social workers to conduct such experiences.

The impact of local surface changes in Borneo on atmospheric composition at wider spatial scales: coastal processes, land-use change and air quality.

We present results from the OP3 campaign in Sabah during 2008 that allow us to study the impact of local emission changes over Borneo on atmospheric composition at the regional and wider scale. OP3 constituent data provide an important constraint on model performance. Treatment of boundary layer processes is highlighted as an important area of model uncertainty. Model studies of land-use change confirm earlier work, indicating that further changes to intensive oil palm agriculture in South East Asia, and the tropics in general, could have important impacts on air quality, with the biggest factor being the concomitant changes in NO(x) emissions. With the model scenarios used here, local increases in ozone of around 50 per cent could occur. We also report measurements of short-lived brominated compounds around Sabah suggesting that oceanic (and, especially, coastal) emission sources dominate locally. The concentration of bromine in short-lived halocarbons measured at the surface during OP3 amounted to about 7 ppt, setting an upper limit on the amount of these species that can reach the lower stratosphere.

Mayer-Rokitansky-Küster-Hauser syndrome: sexuality, psychological effects, and quality of life.

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital condition in which a genetic female is born with vaginal agenesis and a rudimentary to absent uterus. This condition affects a woman's ability to menstruate, to engage in penile-vaginal intercourse, and to bear children. Much has been published about how best to create a neovagina in women with MRKH, but little has been written about the psychological impact of MRKH and quality of life outcomes for women with the condition. A review of the extant literature published from 1955 to 2007 supports that (1) surgical or non-surgical creation of a neovagina alone does not ensure a successful psychological outcome, (2) psychological support at critical times can be helpful, and (3) how professionals use language to discuss the condition may positively or negatively influence a female's experience of MRKH. This article discusses the implications that existing knowledge has on future research and on clinical practice. Understanding how women with MRKH cope with and adjust to the condition will help healthcare professionals provide optimal care.

A century of delusions in south west Scotland.

Two groups of patients admitted to psychiatric hospital in Dumfries were studied, drawn from the periods 1880-1889 and 1970-1979. Feighner criteria were applied to make three diagnostic categories - depression, mania and schizophrenia - and the occurrence and content of delusions were noted for each. A significant decline in the prevalence of delusional depressive illness was found between the two periods, and a similar trend was noted for delusional manic illness. In contrast, the prevalence of delusional schizophrenic illness was stable. This decline is taken to reflect a change in the phenomenology of affective illness since last century in South West Scotland. The content of delusions is also discussed.

Cellular immunity to possible synovial antigens in rheumatoid arthritis.

A reaction has been demonstrated between extracts of synovial cells removed from intact rheumatoid knee joints and autologous leucocytes. The cell mediated immunity test system used was leucocyte migration inhibition. Variable reactions were found with a spectrum of allogeneic extracts when donor leucocytes came from married or transfused females or transfused males. Leucocytes from healthy (nontransfused) males showed no reaction with any of the extracts. As a period of cell culture was used prior to preparation of this extract to remove nonspecific inhibitory substances, native immunoglobulins, and complexes, the data are best explained by the presence of a foreign pathogen or altered cell component in the synovial cells of these rheumatoid patients.

The Nithsdale Schizophrenia Survey. VI. Relatives' expressed emotion: prevalence, patterns, and clinical assessment.

A review of all known schizophrenics (n = 142) in Nithsdale, Scotland, found 50% were living with relatives or friends. Of these, 32% had high contact with a relative showing high expressed emotion (EE); put another way, 87% of all Nithsdale schizophrenics were not living in a high contact/high EE family. Parents were more critical than spouses, and more showed emotional over-involvement. A retrospective review showed a trend, not of statistical significance, towards a higher admission rate to in-patient care in patients from high EE homes. Of relatives believed by a consultant psychiatrist to be neither critical nor hostile, 80% fell into the low EE category, but only 44% thought hostile or critical belonged to the high EE category; that is, the clinician had a wider view of high EE than the Camberwell Family Interview. Relative's scores on a short patient-rejection scale were higher in high EE than in low EE relatives, but the wide scatter of scores suggested the scale could not be used to identify an individual relative with high EE.

The Nithsdale schizophrenia survey. V. Follow-up of tardive dyskinesia at 3 1/2 years.

The point-prevalence of tardive dyskinesia in schizophrenics from a discrete geographical area (Nithsdale, in Dumfries and Galloway Region) in 1981, 1982, and 1984 was 31%, 27%, and 30% respectively. This suggests that the prevalence of tardive dyskinesia in a community of schizophrenics has reached a plateau. In 12% of patients there was persistent dyskinesia, i.e. abnormal involuntary movements were present at all three assessments. Persistent dyskinesia was more common in older patients. The severity of tardive dyskinesia fluctuated between assessments in 41% of patients, indicating that it is only a transient feature in some cases.

A comparison of self-injury and self-poisoning from the Regional Poisoning Treatment Centre, Edinburgh.

Injury and poisoning episodes at the Regional Poisoning Treatment Centre, Edinburgh, were compared for the years 1980-1986. Injury was more likely to be associated with youth, male sex and single status. When these demographic differences were controlled for, injury was found to be associated with the following clinical variables: personality disorder, previous psychiatric inpatient status, use of alcohol at the time of parasuicide and alcohol problems, and the social variables-violence against others and received from relatives in the preceding 5 years, criminal record and unemployment. These have been consistently associated with repetition of parasuicide. A history of injury as a putative marker of repetition and the clinical implication of its association with alcohol problems are discussed.

The Scottish survey of chronic day-patients.

All chronic day-patients (n = 422), defined as patients aged 18-64 years attending a day facility of a psychiatric hospital or general hospital psychiatric unit continuously for more than a year, were identified in hospitals and units serving 56% of the Scottish population. The number of day patients was 14.8 per 100,000 of the general population, but the range between hospitals was very great--0 to 37.7 per 100,000--indicating the patchy development of such care. A typical day patient was a rather chronic middle-aged male schizophrenic, who lived on his own or with ageing parents. Most patients' accommodation was satisfactory, but the occupational activity of more than a third was inappropriate; 18% could have attended a local authority sheltered workshop if one had been available.

The Scottish survey of new chronic in-patients: two year follow up.

'New chronic inpatients' (patients aged 18-64 years in hospital more than one but less than six years) were followed-up two years after identification in the catchment areas of 14 psychiatric hospitals, serving 56% of the Scottish population. Nine per cent had died, 71% remained in-patients, and 20% had been discharged; 40% of those discharged had no contact with after-care services, and 37% of those remaining in hospital did not need in-patient care. Discharged patients were younger, had been in hospital a shorter time, and less often had organic brain disease. Only 13% of patients who, when first identified, had been rated at a low functioning level had been discharged; 64% of those remaining in-patients at follow up had such a rating.

The Scottish survey of psychiatric rehabilitation and support services.

Rehabilitation and support services in psychiatric hospitals and general hospital psychiatric units serving two-thirds of the population of Scotland were reviewed. Although there are wide between-hospital differences, especially between rural and urban areas, the National Health Service in Scotland is making considerable efforts to provide staffing, accommodation, occupational activities, and support services for the long term mentally ill. Services provided by local authorities, with the exception of group homes, are seriously deficient. The total number of services provided by an individual hospital correlated highly with an assessment of its adequacy in providing such services in relation to other hospitals. A simple count of services may therefore be used to assess adequacy. There was also a correlation between the range of a hospital's services and numbers of misplaced new chronic in-patients.