Quantifying the effectiveness of ultraviolet-C light at inactivating airborne Mycobacterium abscessus.

BACKGROUND: Mycobacterium abscessus (MABS) group are environmental organisms that can cause infection in people with cystic fibrosis (CF) and other suppurative lung diseases. There is potential for person-to-person airborne transmission of MABS among people with CF attending the same care centre. Ultraviolet light (band C, UV-C) is used for Mycobacterium tuberculosis control indoors; however, no studies have assessed UV-C for airborne MABS. AIM: To determine whether a range of UV-C doses increased the inactivation of airborne MABS, compared with no-UVC conditions. METHODS: MABS was generated by a vibrating mesh nebulizer located within a 400 L rotating drum sampler, and then exposed to an array of 265 nm UV-C light-emitting diodes (LED). A six-stage Andersen Cascade Impactor was used to collect aerosols. Standard microbiological protocols were used for enumerating MABS, and these quantified the effectiveness of UV-C doses (in triplicate). UV-C effectiveness was estimated using the difference between inactivation with and without UV-C. FINDINGS: Sixteen tests were performed, with UV-C doses ranging from 276 to 1104 µW s/cm2. Mean (±SD) UV-C effectiveness ranged from 47.1% (±13.4) to 83.6% (±3.3). UV-C led to significantly greater inactivation of MABS (all P-values ≤0.045) than natural decay at all doses assessed. Using an indoor model of the hospital environment, it was estimated that UV-C doses in the range studied here could be safely delivered in clinical settings where patients and staff are present. CONCLUSION: This study provides empirical in-vitro evidence that nebulized MABS are susceptible to UV-C inactivation.

"I don't want to be a patient": Peer mentoring partnership fosters communication for autistic university students.

Background: Despite recognition of the benefits of post-school education in improving life outcomes for autistic adults their university completion rates remain low.Aim: To explore the experiences of undergraduate autistic university students participating in specialist peer mentoring (SPM) to identify active ingredients in the peer mentoring process and to examine the impact of SPM on social communication.Material and method: A total of 30 (8 female; M age = 22.3; SD = 6.7) undergraduate autistic university students engaged in SPM participated in this study. A quantitative pre-test post-test design examined changes in autistic traits. In parallel, the experiences of participating in SPM were explored through semi-structured interviews.Results: Improvements were noted at post-test on the Social Responsiveness Scale-2 total score p = 0.02), and its Social Communication, (p = 0.03) and Social Motivation (p = 0.03) sub-scales. Four themes emerged from the interviews: Developing Partnership and Understanding, Modelling and Practising Communication, Psychological Support and Grading and Planning Skills.Conclusions: These results indicated that the mentor-mentee partnership was a crucial active ingredient of SPM. This partnership appeared to modify social cognition and motivation for autistic university students through modelling and practising communication.Significance: These results demonstrate that SPM can support participation at university for autistic university students.

P. aeruginosa blood stream infection isolates: A "full house" of virulence genes in isolates associated with rapid patient death and patient survival.

We have recently characterised the epidemiology of P. aeruginosa blood stream infection (BSI) in a large retrospective multicentre cohort study [1]. Utilising corresponding patient BSI isolates we aimed to characterise the genotypic virulence profile of the P. aeruginosa isolates that were associated with rapid death in the non-neutropenic host. Five P. aeruginosa BSI episodes were identified from a larger cohort of P. aeruginosa BSI episodes previously described by McCarthy et al. [1]. The genotypic profile of another 5 isolates from this cohort in whom the non-neutropenic host had survived one year post the BSI was also analysed for comparison. These isolates underwent Illumina whole genome sequencing, de novo assembly and annotation. A comprehensive suite of virulence genes was collated from the Pseudomonas Genome Database (http://www.pseudomonas.com/) and were searched by BLAST based analysis in assemblies of all BSI isolates [2]. There was extensive conservation of virulence genes across all of the BSI isolates studied. The exoU gene was found in two isolates from patients who died rapidly and in one isolate from a patient that survived one year post BSI. The higA and higB genes were detected in all isolates. The exlA gene was not detected in any of the isolates studied. These findings suggest that to cause a BSI that it is only the virulent P. aeruginosa isolate that succeeds. The virulence gene profile seen was independent of patient outcome. Further phenotypic correlation is required to determine if there is any difference in genotypic expression by the BSI isolates that were associated with rapid death of the host and those BSI isolates associated with host survival at one year.

Path Analysis of Campus Walkability/Bikeability and College Students' Physical Activity Attitudes, Behaviors, and Body Mass Index.

PURPOSE: The purpose of this study was to assess the relationship between the walkability/bikeability of college campuses and students' body mass index (BMI) with student physical activity (PA) attitudes and behaviors as potential mediators. DESIGN: Cross-sectional. SETTING: Thirteen university campuses. PARTICIPANTS: A total of 1384 student participants. MEASURES: Walkability/bikeability environmental score (ES): 12-item audit assessed an average of 44 path segments per campus. Students were measured for height and weight and completed online surveys. Physical activity stage of change/behavior intentions were assessed using the transtheoretical model. The Cognitive Behavioral Physical Activity Questionnaire assessed outcome expectations, self-regulation, and personal barriers. International Physical Activity Questionnaire assessed walking-, moderate-, and vigorous-intensity PA. ANALYSIS: Descriptive statistics, zero-order correlations, and path analysis with maximum likelihood estimation. RESULTS: The overall model fit was good with χ2 of 171.388 ( df = 18), P < .001, comparative fit index value of .95, and a root mean square of approximation of .079. After controlling for gender, there was a direct negative association between walkability/bikeability ES and BMI (ß = -.085) and positive association between personal barriers and BMI (ß = .134). Walkability/bikeability ES was positively associated with walking-intensity PA (ß = .010). Self-regulation was positively associated with moderate-intensity PA (ß = .213), which, in turn, was negatively associated with BMI (ß = -.057). CONCLUSIONS: The ease of walking and biking on a campus was related to college students' walking behavior and their BMI. Students' PA behavioral intentions were associated with moderate PA and lower BMI. These results provide evidence to focus on policies and structural supports for walkable/bikeable environments to supplement and enhance interventions encouraging individual behavior change for PA and weight management.

Pseudomonas aeruginosa blood stream infection isolates from patients with recurrent blood stream infection: Is it the same genotype?

The type identity of strains of Pseudomonas aeruginosa from primary and recurrent blood stream infection (BSI) has not been widely studied. Twenty-eight patients were identified retrospectively from 2008 to 2013 from five different laboratories; available epidemiological, clinical and microbiological data were obtained for each patient. Isolates were genotyped by iPLEX MassARRAY MALDI-TOF MS and rep-PCR. This showed that recurrent P. aeruginosa BSI was more commonly due to the same genotypically related strain as that from the primary episode. Relapse due to a genotypically related strain occurred earlier in time than a relapsing infection from an unrelated strain (median time: 26 vs. 91 days, respectively). Line related infections were the most common source of suspected BSI and almost half of all BSI episodes were associated with neutropenia, possibly indicating translocation of the organism from the patient's gut in this setting. Development of meropenem resistance occurred in two relapse isolates, which may suggest that prior antibiotic therapy for the primary BSI was a driver for the subsequent development of resistance in the recurrent isolate.

Simulated structural and magnetic behavior of Mn-Ti intercalated dichalcogenide crystals.

We present the results of extensive Monte Carlo simulations of intercalated manganese-titanium (Mn-Ti) layered TiS2 crystals. The computational model involves mixtures of Mn and Ti in various percentages placed on a triangular lattice with fixed lattice sites and up to five layers. The range of concentrations of intercalated Mn studied was 5% ⩽ X Mn ⩽ 33% and for Ti, 0% ⩽ X Ti ⩽ 15%, where X A denotes the percentage of the total number of lattice sites occupied by species A. The species are allowed to interact spatially through a screened Coulomb potential and magnetically with external and RKKY field terms. Structurally, the pure Mn systems present as disordered at very low densities and evolve through a 2 × 2 structure (perfect at X Mn = 25%) up to a [Formula: see text] × [Formula: see text] lattice (perfect at X Mn = 33%), with variations of the two 'perfect' lattice structures depending on density. Changes in density for pure Mn systems as well as those intercalated with both Mn and Ti dramatically affects the system's structural and magnetic properties, and the magnetic behavior of various morphological features present in the system are discussed. The RKKY interaction is adjusted based on the intercalant compositions and is very sensitive to structural variations in the intercalant layers. The composition ranges studied here encompass and exceed those that are experimentally accessible, which helps place experimentally relevant densities in perspective.

Infection in cystic fibrosis: impact of the environment and climate.

In many countries numbers of adults with cystic fibrosis (CF) exceed that of children, with median survival predicted to surpass 50 years. Increasing longevity is, in part, due to intensive therapies including eradication of early infection and suppressive therapies and pulmonary exacerbations. Initial infections with common CF pathogens are thought to arise from the natural environment. We review the impact of climate and environment on infection in CF. Specifically, several studies indicate that higher ambient temperatures, proximity to the equator and the summer season may be linked to the increased prevalence of Pseudomonas aeruginosa in people with CF. The environment may also play an important role in the acquisition of Gram negative organisms other than P. aeruginosa. There is emerging data suggesting that climatic and environmental factors are likely to impact on the risk of infection with NTM and fungi in people which are found extensively throughout the natural environment.

Metal-insulator transition in variably doped (Bi(1-x)Sb(x))2Se3 nanosheets.

Topological insulators are novel quantum materials with metallic surface transport but insulating bulk behavior. Often, topological insulators are dominated by bulk contributions due to defect induced bulk carriers, making it difficult to isolate the more interesting surface transport characteristics. Here, we report the synthesis and characterization of nanosheets of a topological insulator Bi2Se3 with variable Sb-doping levels to control the electron carrier density and surface transport behavior. (Bi(1-x)Sb(x))2Se3 thin films of thickness less than 10 nm are prepared by epitaxial growth on mica substrates in a vapor transport setup. The introduction of Sb in Bi2Se3 effectively suppresses the room temperature electron density from ∼4 × 10(13) cm(-2) in pure Bi2Se3 (x = 0) to ∼2 × 10(12) cm(-2) in (Bi(1-x)Sb(x))2Se3 at x ∼ 0.15, while maintaining the metallic transport behavior. At x ≳ ∼0.20, a metal-insulator transition (MIT) is observed, indicating that the system has transformed into an insulator in which the metallic surface conduction is blocked. In agreement with the observed MIT, Raman spectroscopy reveals the emergence of vibrational modes arising from Sb-Sb and Sb-Se bonds at high Sb concentrations, confirming the appearance of the Sb2Se3 crystal structure in the sample. These results suggest that nanostructured chalcogenide films with controlled doping can be a tunable platform for fundamental studies and electronic applications of topological insulator systems.

Observation of infrared-active modes in Raman scattering from topological insulator nanoplates.

Two infrared (IR)-active vibrational modes, observed at 93 and 113 cm(-1) in Raman scattering, are evidence of an inversion symmetry breakdown in thin (~10 nm) nanoplates of topological insulator Bi(2)Te(3) as-grown on SiO(2). Both Raman and IR modes are preserved after typical device fabrication processes. In nanoplates transferred to another SiO(2) substrate via contact printing, however, the IR modes are absent, and the Raman spectra are similar to those from bulk samples. The differences between as-grown and transferred nanoplates may result from nanoplate-substrate interactions.

Reconstructed Fermi surface of underdoped Bi2Sr2CaCu2O(8+δ) cuprate superconductors.

The Fermi surface topologies of underdoped samples of the high-T(c) superconductor Bi2Sr2CaCu2O(8+δ) have been measured with angle resolved photoemission. By examining thermally excited states above the Fermi level, we show that the observed Fermi surfaces in the pseudogap phase are actually components of fully enclosed hole pockets. The spectral weight of these pockets is vanishingly small at the magnetic zone boundary, creating the illusion of Fermi "arcs." The area of the pockets as measured in this study is consistent with the doping level, and hence carrier density, of the samples measured. Furthermore, the shape and area of the pockets is well reproduced by phenomenological models of the pseudogap phase as a spin liquid.

Properties of hydrogen terminated diamond as a photocathode.

Electron emission from the negative electron affinity (NEA) surface of hydrogen terminated, boron doped diamond in the [100] orientation is investigated using angle resolved photoemission spectroscopy (ARPES). ARPES measurements using 16 eV synchrotron and 6 eV laser light are compared and found to show a catastrophic failure of the sudden approximation. While the high energy photoemission is found to yield little information regarding the NEA, low energy laser ARPES reveals for the first time that the NEA results from a novel Franck-Condon mechanism coupling electrons in the conduction band to the vacuum. The result opens the door to the development of a new class of NEA electron emitter based on this effect.

Rapid single-nucleotide polymorphism-based identification of clonal Pseudomonas aeruginosa isolates from patients with cystic fibrosis by the use of real-time PCR and high-resolution melting curve analysis.

Pseudomonas aeruginosa genotyping relies mainly upon DNA fingerprinting methods, which can be subjective, expensive and time-consuming. The detection of at least three different clonal P. aeruginosa strains in patients attending two cystic fibrosis (CF) centres in a single Australian city prompted the design of a non-gel-based PCR method to enable clinical microbiology laboratories to readily identify these clonal strains. We designed a detection method utilizing heat-denatured P. aeruginosa isolates and a ten-single-nucleotide polymorphism (SNP) profile. Strain differences were detected by SYBR Green-based real-time PCR and high-resolution melting curve analysis (HRM10SNP assay). Overall, 106 P. aeruginosa sputum isolates collected from 74 patients with CF, as well as five reference strains, were analysed with the HRM10SNP assay, and the results were compared with those obtained by pulsed-field gel electrophoresis (PFGE). The HRM10SNP assay accurately identified all 45 isolates as members of one of the three major clonal strains characterized by PFGE in two Brisbane CF centres (Australian epidemic strain-1, Australian epidemic strain-2 and P42) from 61 other P. aeruginosa strains from Australian CF patients and two representative overseas epidemic strain isolates. The HRM10SNP method is simple, is relatively inexpensive and can be completed in <3 h. In our setting, it could be made easily available for clinical microbiology laboratories to screen for local P. aeruginosa strains and to guide infection control policies. Further studies are needed to determine whether the HRM10SNP assay can also be modified to detect additional clonal strains that are prevalent in other CF centres.

Quantum many-body calculation of mixed-parity pairing in the Sr2RuO4 superconductor induced by spin-orbit coupling.

The unusual superconducting state in Sr(2)RuO(4) has long been viewed as being analogous to a superfluid state in liquid (3)He. Nevertheless, calculations based on this odd-parity state are presently unable to completely reconcile the properties of Sr(2)RuO(4). Using a self-consistent quantum many-body scheme that employs realistic parameters, we are able to model several signature properties of the normal and superconducting states of Sr(2)RuO(4). We find that the dominant component of the model superconducting state is of even parity and closely related to superconducting state for the high-T(c) cuprates although a smaller odd-parity component is induced by spin-orbit coupling. This mixed pairing state gives a more complete representation of the complex phenomena measured in Sr(2)RuO(4).

Cough-generated aerosols of Pseudomonas aeruginosa and other Gram-negative bacteria from patients with cystic fibrosis.

BACKGROUND: Pseudomonas aeruginosa is the most common bacterial pathogen in patients with cystic fibrosis (CF). Current infection control guidelines aim to prevent transmission via contact and respiratory droplet routes and do not consider the possibility of airborne transmission. It was hypothesised that subjects with CF produce viable respirable bacterial aerosols with coughing. METHODS: A cross-sectional study was undertaken of 15 children and 13 adults with CF, 26 chronically infected with P aeruginosa. A cough aerosol sampling system enabled fractioning of respiratory particles of different sizes and culture of viable Gram-negative non-fermentative bacteria. Cough aerosols were collected during 5 min of voluntary coughing and during a sputum induction procedure when tolerated. Standardised quantitative culture and genotyping techniques were used. RESULTS: P aeruginosa was isolated in cough aerosols of 25 subjects (89%), 22 of whom produced sputum samples. P aeruginosa from sputum and paired cough aerosols were indistinguishable by molecular typing. In four cases the same genotype was isolated from ambient room air. Approximately 70% of viable aerosols collected during voluntary coughing were of particles

High-energy kink observed in the electron dispersion of high-temperature cuprate superconductors.

Photoemission studies show the presence of a high-energy anomaly in the observed band dispersion for two families of cuprate superconductors, Bi2Sr2CaCu2O8+delta and La 2-x BaxCuO4. The anomaly, which occurs at a binding energy of approximately 340 meV, is found to be anisotropic and relatively weakly doping dependent. Scattering from short range or nearest neighbor spin excitations is found to supply an adequate description of the observed phenomena.

Epidemiological analysis of methicillin-resistant Staphylococcus aureus isolates from adult patients with cystic fibrosis.

Using pulsed-field gel electrophoresis, we genotyped 21 methicillin-resistant Staphylococcus aureus isolates from patients attending an adult cystic fibrosis unit. Eleven patients exhibited pulsotypes related to 2 locally endemic strains. Eleven chronically colonized patients were assessed over a period of up to 2 years, and all demonstrated a retention of strain type.

Combination aerosol therapy to treat Burkholderia cepacia complex.

Burkholderia cepacia infection in cystic fibrosis (CF) patients is associated with significant morbidity and mortality, yet no definitive treatment is currently available. This report describes a new approach to treat B. cepacia infection in CF patients, using a combination of amiloride and tobramycin aerosols. Four adults with the typical clinical syndrome of CF were recruited after repeated positive sputum cultures for B. cepacia. Aerosols of amiloride and tobramycin were given three times daily for 1-6 months, and repeated sputum cultures were collected to assess efficacy. Three of the four patients treated with the combined therapy eradicated B. cepacia from their sputum cultures for at least 2 yrs, and there were no adverse events. This novel combination may provide a new therapeutic option for Burkholderia cepacia infections. Furthermore, the strategy of combining antibiotics with ion transport agents may have ramifications for the treatment of other multi-resistant organisms.

MRSA eradication in a health care worker with cystic fibrosis; re-emergence or re-infection?

Methicillin-resistant Staphylocosis aureus (MRSA) is an emerging infection in patients with cystic fibrosis (CF). MRSA may be a management dilemma for healthcare workers (HCWs) with CF. Eradication of MRSA with long-term rifampicin and fusidic acid can be achieved in patients with CF. We describe a case of recurrent MRSA infection in a HCW with CF. Molecular typing of the MRSA isolates supported re-infection rather than re-emergence of an earlier MRSA infection. Infection control advice for HCWs with CF who acquire MRSA remains controversial.

Orbital dependence of the fermi liquid state in Sr2RuO4.

We have used angle-resolved photoemission spectroscopy to determine the bulk electronic structure of Sr(2)RuO(4) above and below the Fermi liquid crossover near 25 K. Our measurements indicate that the properties of the system are highly orbital dependent. The quasi-2D gamma band displays Fermi liquid behavior while the remaining low energy bands show exotic properties consistent with quasi-1D behavior. In the Fermi liquid state below 25 K, the gamma band dominates the electronic properties, while at higher temperatures the quasi-1D beta and alpha bands become more important.