Isolation of Escherichia coli

The isolation and characterization of Escherichia coli O157:H7 strains from 22 out of 174 fecal samples from petting zoo animals representing twenty-two different species (camel, lion, goats, zebra, bear, baboon monkey, Siberian monkey, deer, elk, llama, pony, horses, fox, kangaroo, wolf, porcupine, chickens, tiger, ostrich, hyena, dogs, and wildcats) were investigated. One petting Al-Zawraa zoological society of Baghdad was investigated for E. coli O157:H7 over a 16-month period that spanned two summer and two autumn seasons. Variation in the occurrence of E. coli O157:H7-positive petting zoo animals was observed, with animals being culture positive only in the summer months but not in the spring, autumn, or winter. E. coli O157:H7 isolates were distinguished by agglutination with E. coli O157:H7 latex reagent (Oxoid), identified among the isolates, which showed that multiple E. coli strains were isolated from one petting zoo animal, in which a single animal simultaneously shed multiple E. coli strains; E. coli O157:H7 was isolated only by selective enrichment culture of 2 g of petting zoo animal feces. In contrast, strains other than O157:H7 were cultured from feces of petting zoo animals without enrichment

骨細胞のRANKL発現におけるTNF-αの直接的影響：骨免疫学的相互作用

要約のみTohoku University溝口到課

骨細胞のRANKL発現におけるTNF-αの直接的影響：骨免疫学的相互作用

要約のみTohoku University溝口到課

Attitudes of Middle Eastern Societies towards Organ Donation: The Effect of Demographic Factors among Jordanian Adults

Background: Organ donation gives thousands of patients a renewed chance at living full and active lives. Unfortunately, the need for organs does not match their availability. This study aims to analyze the effect of demographic factors on the knowledge and awareness of the Jordanian society towards organ donation. Methods: This cross-sectional study was conducted using a self-administered online questionnaire. We included 1041 adult Jordanians from all the governorates of the Hashemite Kingdom of Jordan. Results: Of the 1041 participants, only 124 (11.9%) had previously singed organ donation card. Overall, 827 (79.4%) were fully accepting organ donation. Among 782 participants in the medical field, 639 (81.7%) fully accepted organ donation, compared to 188 out of 259 (72.6%) in the non-medical field (p= 0.002), with no significant effect of any demographic factor on the willingness to sign organ donation card. There was significant difference in the acceptance of donation from brain dead donors (p< 0.001), with participants from medical field and male participants having higher acceptance rates when compared with non-medical and female participants, respectively. The main barrier for organ donation was found to be the desire to be buried as a whole (58.2%), followed by traditional beliefs (47.4%), and family refusal (42.2%). Conclusions: In conclusion, an educational strategy can improve organ donation awareness from an early age by spreading actionable information through social media and conducting nationwide public campaigns

A Systematic Review of Gynecological Morbidity Among Women in the Reproductive Age

This study aimed at systematically reviewing the Gynecological Morbidity among women in the reproductive age by summarizing the prevalence of gynecological morbidity among reproductive age women is provided to develop research priorities. This systematic review was conducted based on PRISMA guidelines. The authors searched all published articles on the prevalence of gynecological morbidity. Electronic data bases such as PubMed were searched to identify observational studies on the subject. The study concluded that the polled prevalence of overall gynecological morbidity was high. This pooled prevalence enabled us to conclude that the effect of gynecological morbidities is high to hamper the productivity of reproductive age women in the world particularly in a developing nations

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Ongoing strategies to improve antimicrobial utilization in hospitals across the Middle East and North Africa (MENA) : findings and implications

Antimicrobial resistance (AMR) is an increasing global concern, increasing costs, morbidity, and mortality. National action plans (NAPs) to minimize AMR are one of several global and national initiatives to slow down rising AMR rates. NAPs are also helping key stakeholders understand current antimicrobial utilization patterns and resistance rates. The Middle East is no exception with high AMR rates. Antibiotic point prevalence surveys (PPS) provide a better understanding of existing antimicrobial consumption trends in hospitals, and assist with the subsequent imple-mentation of antimicrobial stewardship programs (ASPs). These are important NAP activities. We examined current hospital consumption trends across the Middle East along with documented ASPs. A narrative assessment of 24 PPS studies in the Region found that, on average, more than 50% of in-patients received antibiotics, with Jordan having the highest rate at 98.1%. Published studies ranged in size from single to 18 hospitals. The most prescribed antibiotics were ceftriax-one, metronidazole, and penicillin. In addition, significant postoperative antibiotic prescribing lasting up to five days or longer was common to avoid surgical site infections. These findings have resulted in a variety of suggested short-, medium-, and long-term actions among key stakehold-ers, including governments and healthcare workers, to improve and sustain future antibiotic prescribing in order to decrease AMR throughout the Middle East

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The Direct Effect of TNF-α on Osteocyte RANKL Expression: Interactions in Osteoimmunology

Tohoku University博士（歯学）博士学位論文 (Thesis(doctor))要約のみthesi

Evaulating key parameters impacting asphaltene permeability reduction behavior in micro-pores during carbon dioxide injection

Asphaltene is a heavy component of crude oil that can deposit in the pores of the formation and result in permeability reduction, and with time, pore plugging. Understanding the behavior of asphaltene and the mechanism by which it precipitates and deposits in the crude oil is vital in reducing asphaltene damage in the formation. Also, by evaluating asphaltene permeability reduction in the formation, we can predict the behavior of the asphaltene and determine the extent to which pore plugging will occur. This research studies the impact of carbon dioxide (CO2) pressure, temperature, and oil viscosity on asphaltene permeability reduction. These parameters were chosen in this study based on their proven significant impact on asphaltene instability in the crude oil. The research discusses the concept of Asphaltene Delayed Plugging Index, based on an observation of initial and secondary asphaltene plugging behavior. Although the impact of asphaltene pore plugging have been extensively studied, this research focuses on identifying the optimum time at which asphaltene mitigation must take place before severe damage occurs. It was found that asphaltene exhibited an initial permeability reduction which occurs rapidly. This initial permeability reduction did not completely cease oil production, but rather reduced flow. The initial pore plugging can be mitigated easily if detected early. If the secondary plugging occurs, complete cessation of production usually occurred, and it is very difficult to mitigate. Based on this, the research bridges between initial and secondary asphaltene pore plugging to determine the optimum time for asphaltene mitigation