Characterisation of atypical enteropathogenic E. coli strains of clinical origin

BACKGROUND: Enteropathogenic E. coli (EPEC) is a prominent cause of diarrhoea, and is characterised in part by its carriage of a pathogenicity island: the locus for enterocyte effacement (LEE). EPEC is divided into two subtypes according to the presence of bundle-forming pili (BFP), a fimbrial adhesin that is a virulence determinant of typical EPEC (tEPEC), but is absent from atypical EPEC (aEPEC). Because aEPEC lack BFP, their virulence has been questioned, as they may represent LEE-positive Shiga toxin-producing E. coli (STEC) that have lost the toxin-encoding prophage, or tEPEC that have lost the genes for BFP. To determine if aEPEC isolated from humans in Australia or New Zealand fall into either of these categories, we undertook phylogenetic analysis of 75 aEPEC strains, and compared them with reference strains of EPEC and STEC. We also used PCR and DNA hybridisation to determine if aEPEC carry virulence determinants that could compensate for their lack of BFP. RESULTS: The results showed that aEPEC are highly heterogeneous. Multilocus sequence typing revealed that 61 of 75 aEPEC strains did not belong to known tEPEC or STEC clades, and of those that did, none expressed an O:H serotype that is frequent in tEPEC or STEC strains associated with disease. PCR for each of 18 known virulence-associated determinants of E. coli was positive in less than 15% of strains, apart from NleB which was detected in 30%. Type I fimbriae were expressed by all aEPEC strains, and 12 strains hybridised with DNA probes prepared from either bfpA or bfpB despite being negative in the PCR for bfpA. CONCLUSION: Our findings indicate that clinical isolates of aEPEC obtained from patients in Australia or New Zealand are not derived from tEPEC or STEC, and suggest that functional equivalents of BFP and possibly type I fimbriae may contribute to the virulence of some aEPEC strains

Assessment of origin and fate of contaminants along mining-affected Rio Montevecchio (SW Sardinia, Italy): A hydrologic-tracer and environmental mineralogy study

Hydrologic tracer techniques were applied to Rio Montevecchio (SW Sardinia, Italy), a stream affected by mine drainage, allowing the calculation of discharge and contaminant loads. Discharge along the stream showed a constant increase throughout the 2.7 km-long study reach, up to 13.6 l/s at the last synoptic point. Calculated loads of mine-related constituents were large, reaching values of 1780 kg/day for, 340 kg/day for Zn, 47 kg/day for Fe, and 50 kg/day for Mn. The difference of the cumulative instream metal loads between the first and the last synoptic sampling points indicated gains of 421 kg/day for Zn, 2080 kg/day for, 56 kg/day for Mn, and 50 kg/day for Fe. The source areas critical for contaminants loading were almost all concentrated in the first 800 meters of the stream, with the exception of Pb, whose loading occurs evenly along the whole study reach. Precipitation of secondary minerals along the streambed was responsible for a very high attenuation of Al and Fe loads (66% and 77%) and affected also and Zn loads, though less effectively. Rio Montevecchio has the second highest metal load among the rivers investigated with tracer techniques in SW Sardinia. In comparison with Rio Irvi, which has one order of magnitude higher metal loads, natural attenuation processes limit the loads in Rio Montevecchio. Results are useful to clarify the hydrogeochemical paths involved in the release and attenuation of pollutants, improving our understanding of stream responses to contamination and aiding development of site-specific remediation actions

Education, implementation, and teams : 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with treatment recommendations

For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of Recommendations, Assessment, Development, and Evaluation guidance. Furthermore, 4 scoping reviews and 7 evidence updates assessed any new evidence to determine if a change in any existing treatment recommendation was required. The topics covered included training for the treatment of opioid overdose; basic life support, including automated external defibrillator training; measuring implementation and performance in communities, and cardiac arrest centers; advanced life support training, including team and leadership training and rapid response teams; measuring cardiopulmonary resuscitation performance, feedback devices, and debriefing; and the use of social media to improve cardiopulmonary resuscitation application

Education, implementation, and teams : 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with treatment recommendations

For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of Recommendations, Assessment, Development, and Evaluation guidance. Furthermore, 4 scoping reviews and 7 evidence updates assessed any new evidence to determine if a change in any existing treatment recommendation was required. The topics covered included training for the treatment of opioid overdose; basic life support, including automated external defibrillator training; measuring implementation and performance in communities, and cardiac arrest centers; advanced life support training, including team and leadership training and rapid response teams; measuring cardiopulmonary resuscitation performance, feedback devices, and debriefing; and the use of social media to improve cardiopulmonary resuscitation application

A longitudinal online interprofessional education experience involving family nurse practitioner students and pharmacy students

© 2017 Taylor & Francis. Interprofessional education (IPE) continues to gain traction worldwide. Challenges integrating IPE into health profession programmes include finding convenient times, meeting spaces, and level-appropriate assignments for each profession. This article describes the implementation of a 21-month prospective cohort study pilot programme for the Master of Science in nursing family nurse practitioner (FNP) and doctor of pharmacy (PharmD) students at a private university in the United States. This IPE experience utilised a blended approach for the learning activities; these students had initial and final sessions where they met face-to-face, with asynchronous online activities between these two sessions. The online assignments, discussions, and quizzes during the pilot programme involved topics such as antimicrobial stewardship, hormone replacement therapy, human papilloma virus vaccination, prenatal counselling, emergency contraception, and effects of the Affordable Care Act on practice. The results suggested that the FNP students held more favourable attitudes about online IPE and that the PharmD students reported having a clearer understanding of their own roles and those of the other participating healthcare students. However, the students also reported wanting more face-to-face interaction during their online IPE experience. Implications from this study suggest that effective online IPE can be supported by ensuring educational parity between students regarding the various topics discussed and a consistent approach of the required involvement for all student groups is needed. In addition, given the students desire for more face-to-face interaction, it may be beneficial to offer online IPE activities for a shorter time period. It is anticipated that this study may inform other programmes that are exploring innovative approaches to provide IPE to promote effective collaboration in patient care

Structural and magnetic characterization of maghemites prepared from Al-substituted magnetites

Synthetic aluminum-substituted maghemites were characterized by total chemical analysis, powder X-ray diffraction (XRD), Mössbauer spectroscopy (ME), and vibrating sample magnetometry (VSM). The aim was to determine the structural, magnetic, and hyperfine properties of γ-Fe2-xAl xO3 as the Al concentration is varied. The XRD results of the synthetic products were indexed exclusively as maghemite. Increasing Al for Fe substitution decreased the mean crystalline dimension and shifted all diffraction peaks to higher º2θ angles. The a0 dimension of the cubic unit cell decreased with increasing Al according to the equation a o = 0.8385 - 3.63 x 10-5 Al (R²= 0.94). Most Mössbauer spectra were composed of one sextet, but at the highest substitution rate of 142.5 mmol mol-1 Al, both a doublet and sextet were obtained at 300 K. All hyperfine parameters from the sub-spectra were consistent with high-spin Fe3+ (0.2 a 0.7 mms-1) and suggested a strong superparamagnetic component associated with the doublet. The magnetic hyperfine field of the sextets decreased with the amount of Al-substitution [Bhf (T) = 49.751 - 0.1202Al; R² = 0.94] while the linewidth increased linearly. The saturation magnetization also decreased with increasing isomorphous substitution

Exploring Stigmergic Collaboration and Task Modularity Through an Expert Crowdsourcing Annotation System: The Case of Storm Phenomena in the Euro-Atlantic Region

Extreme weather events, such as windstorms, hurricanes, and heat waves, exert a significant impact on global natural catastrophes and pose substantial challenges for weather forecasting systems. To enhance the accuracy and preparedness for extreme weather events, this study explores the potential of using expert crowdsourcing in storm forecasting research through the application of stigmergic collaboration. We present the development and implementation of an expert Crowdsourcing for Semantic Annotation of Atmospheric Phenomena (eCSAAP) system, designed to leverage the collective knowledge and experience of meteorological experts. Through a participatory co-creation process, we iteratively developed a web-based annotation tool capable of capturing multi-faceted insights from weather data and generating visualizations for expert crowdsourcing campaigns. In this context, this article investigates the intrinsic coordination among experts engaged in crowdsourcing tasks focused on the semantic annotation of extreme weather events. The study brings insights about the behavior of expert crowds by considering the cognitive biases and highlighting the impact of existing annotations on the quality of data gathered from the crowd and the collective knowledge generated. The insights regarding the crowdsourcing dynamics, particularly stigmergy, offer a promising starting point for utilizing stigmergic collaboration as an effective coordination mechanism for weather experts in crowdsourcing platforms but also in other domains requiring expertise-driven collective intelligence

Missed Opportunities for Prevention of Perinatal Transmission of Hepatitis B: A Retrospective Cohort Study

BACKGROUND: Perinatal transmission of hepatitis B virus (HBV) can occur despite postexposure prophylaxis (PEP). Recent literature suggests that antiviral treatment during pregnancy when maternal HBV DNA levels are elevated can further decrease vertical transmission. However, HBV DNA screening is not routinely performed antenatally