A Study Comparing “Better Body Bags” Versus Standard White Body Bags to Estimate Relative Preservation of Human Genomic and Morphological Information

In disaster scenarios, identification of the dead usually is delayed until after help is given to the living. During delays in recovery and transport of deceased individuals, decomposition of soft tissues will occur at a fast rate if individuals are not refrigerated. The Better Body Bag, or BBB, was designed for the International Committee of the Red Cross (ICRC) with features such as a vacuum seal, reflective coating, and absorbent pad to help delay the onset of decomposition that could render someone unidentifiable. In this study, the BBB was tested to determine if the individuals placed within a BBB yielded a more complete Short Tandem Repeat (STR) profile and lower Total Body Score (TBS) score as compared to individuals within standard white body bags and individuals placed with no covering. Twenty-five donors total were placed at University of Tennessee’s Anthropology Research Facility (ARF) in experiments that tested the vacuum seal mechanism of the BBB or repeated opening and closure of the BBB. Each experiment lasted 21 days over the course of just over a year. The results of this study are statistically inconclusive as to if vacuum sealing assists in preservation of the individual, though they do indicate that the BBB is significantly better at preserving DNA than if an individual was left with no covering. Furthermore, a standard white body bag and a BBB are comparable for morphological preservation (TBS) among donors that were immediately placed into bags, though qualitatively, BBB donors appear to be visually in better condition on day 21 than standard white body bag donors if 48 hours has elapsed prior to placement in the bags. This study demonstrates that the BBBs are a viable alternative to standard white body bags in disaster scenarios if DNA analysis is expected to be the identification modality. In other cases, such as where antemortem dental or medical records exist, a standard white body bag may provide sufficient morphological preservation as compared to an uncovered individual during the time it takes for an identification to be made

Evaluating the pediatric mental health care continuum at an American health system

OBJECTIVE: To describe trends in the pediatric mental health care continuum and identify potential gaps in care coordination. METHODS: We used electronic medical record data from October 2016 to September 2019 to characterize the prevalence of mental health issues in the pediatric population at a large American health system. This was a single institution case study. From the electronic medical record data, primary mental health discharge and readmission diagnoses were identified using RESULTS: Major depressive disorder and other mood disorders comprised 49.6% and 89.4% of diagnoses in the emergency department and inpatient settings respectively compared to 9.0% of ambulatory care diagnoses and were among top reasons for readmission. Additionally, only 1% of all ambulatory care encounters had a care navigation component, whereas 86% of care navigation encounters were for mental health-associated reasons. CONCLUSIONS: Major depressive disorder and other mood disorders were more common diagnoses in the emergency department and inpatient settings, which could signal gaps in care coordination. Bridging potential gaps in care coordination could reduce emergency department and inpatient utilization through increasing ambulatory care navigation resources, improving training, and restructuring financial incentives to facilitate ambulatory care diagnosis and management of major depressive disorder and mood disorders. Furthermore, health systems can use our descriptive analytic approach to serve as a reasonable measure of the current state of pediatric mental health care in their own patient population

Crystallographic Evidence of Drastic Conformational Changes in the Active Site of a Flavin-Dependent

The soil actinomycete Kutzneria sp. 744 produces a class of highly decorated hexadepsipeptides, which represent a new chemical scaffold that has both antimicrobial and antifungal properties. These natural products, known as kutznerides, are created via nonribosomal peptide synthesis using various derivatized amino acids. The piperazic acid moiety contained in the kutzneride scaffold, which is vital for its antibiotic activity, has been shown to derive from the hydroxylated product of l-ornithine, l-N5-hydroxyornithine. The production of this hydroxylated species is catalyzed by the action of an FAD- and NAD(P)H-dependent N-hydroxylase known as KtzI. We have been able to structurally characterize KtzI in several states along its catalytic trajectory, and by pairing these snapshots with the biochemical and structural data already available for this enzyme class, we propose a structurally based reaction mechanism that includes novel conformational changes of both the protein backbone and the flavin cofactor. Further, we were able to recapitulate these conformational changes in the protein crystal, displaying their chemical competence. Our series of structures, with corroborating biochemical and spectroscopic data collected by us and others, affords mechanistic insight into this relatively new class of flavin-dependent hydroxylases and adds another layer to the complexity of flavoenzymes.National Center for Research Resources (U.S.) (P41RR012408)National Institute of General Medical Sciences (U.S.) (P41GM103473

Construction and biochemical characterization of recombinant cytoplasmic forms of the IucD protein (lysine:N6-hydroxylase) encoded by the pColV-K30 aerobactin gene cluster

The aerobactin gene cluster in pColV-K30 consists of five genes (iucABCD iutA); four of these (iucABCD) are involved in aerobactin biosynthesis, whereas the fifth one (iutA) encodes the ferriaerobactin outer membrane receptor. iucD encodes lysine:N6-hydroxylase, which catalyzes the first step in aerobactin biosynthesis. Regardless of the method used for cell rupture, we have consistently found that IucD remains membrane bound, and repeated efforts to achieve a purified and active soluble form of the enzyme have been unsuccessful. To circumvent this problem, we have constructed recombinant IucD proteins with modified amino termini by creating three in-frame gene fusions of IucD to the amino-terminal amino acids of the cytoplasmic enzyme beta-galactosidase. Two of these constructs resulted in the addition to the iucD coding region of a hydrophilic leader sequence of 13 and 30 amino acids. The other construct involved the deletion of the first 47 amino acids of the IucD amino terminus and the addition of 19 amino acids of the amino terminus of beta-galactosidase. Cells expressing any of the three recombinant IucD forms were found to produce soluble N6-hydroxylysine. One of these proteins, IucD439, was purified to homogeneity from the soluble fraction of the cell lysates, and it was capable of participating in the biosynthesis of aerobactin, as determined in vitro by a cell-free system and in vivo by a cross-feeding bioassay. A medium ionic strength of 0.25 (250 mM NaCl) or higher was required to maintain the protein in a catalytically functional, tetrameric state.(ABSTRACT TRUNCATED AT 250 WORDS