Development of a dna-based method for simultaneous detection of acinetobacter baumannii, antimicrobial resistance genes and its genotypes by dna fingerprinting

Acinetobacter species have emerged as important healthcare associated pathogens worldwide. Of the described Acinetobacter, A. baumannii constitutes as the most significant causative agent implicating various severe infections, especially ventilated associated pneumonia and bloodstream infections, associated high mortality and morbidity in patients. Current routine identification systems are unable to identify Acinetobacter to the species level. Hereof, this study aimed to develop a reliable tool for simultaneous detection of Acinetobacter genus, A. baumannii and four genes encoding the carbapenem-hydrolyzing class D β-lactamases, and to investigate the molecular epidemiology of carbapenem susceptible and non-susceptible A. baumannii clinical isolates in a hospital setting. A thermostabilized multiplex PCR assay was developed with primers designed on specific sequence regions of 16S rRNA gene, 33-36 kDa outer membrane protein and four carbapenem-hydrolyzing class D β-lactamase genes to achieve the goal of this study. An internal control was incorporated to validate reliability and robustness of the assay. Specific detection of Acinetobacter genus, A. calcoaceticus-A. baumannii complex and A. baumannii on pure bacterial cultures and spiked blood cultures was demonstrated using the developed assay. The assay yielded detection limits of 100 pg of purified DNA and 106 CFU/ml with DNA thermolysates prepared from either bacterial cultures or spiked human whole blood specimens. The assay was capable to detect at least one CFU of bacterial cells in a pre-enriched medium. The assay detected Acinetobacter with its resistance genes in three hours with high specificity and sensitivity (100%). Accelerated stability evaluation of thermostabilized multiplex PCR reagents demonstrated that vacuum-dried mixes were stable at room temperature for approximately 232 days. The developed thermostabilized multiplex PCR assay enabled simultaneous bacterial identification and detection of its resistance gene which would be useful in rapid diagnosis to reduce morbidity and mortality of patients with Acinetobacter infections. Speciation on Acinetobacter isolates recovered from 115 blood specimens collected over 24-month period with amplified ribosomal DNA restriction analysis was performed. A. baumannii (60.87%; 70 isolates) was found to be the predominant Acinetobacter genomic species followed by A. nosocomialis (19.13%; 22 isolates). Of the total 115 Acinetobacter isolates, 46.09% and 5.22% of A. baumannii and Acinetobacter species, respectively, were carbapenems-resistant. Pulsed-field gel electrophoresis was performed to ascertain genetic relatedness of carbapenem susceptible and non-susceptible A. baumannii clinical isolates. All the carbapenem non-susceptible A. baumannii isolates were consistently found to harbour β-lactamase gene, blaOXA-51-like (100%; all 70 isolates) and blaOXA-23-like (34.29%; 24 isolates). Two predominant clusters contained of mostly carbapenems non-susceptible A. baumannii isolates were observed in each year of study. Based on the multiple-locus variable-number tandem-repeat analysis, the characterized A. baumannii isolates mostly belonged to the international clonal lineage II, of which is worldwide distributed. Finding of this study further demonstrated the emergence of carbapenem resistance in members within the Acinetobacter genus (other than A. baumannii), emphasizing the importance of wisely prescribed antimicrobial agents and stringent implementing infection control measures to reduce further the development of resistance phenotypes and clonal spreading in clinical settings

Personal Exposure to Submicrometer Particles and Heart Rate Variability in Human Subjects

We conducted a study on two panels of human subjects—9 young adults and 10 elderly patients with lung function impairments—to evaluate whether submicrometer particulate air pollution was associated with heart rate variability (HRV). We measured these subjects’ electrocardiography and personal exposure to number concentrations of submicrometer particles with a size range of 0.02–1 μm (NC(0.02–1)) continuously during daytime periods. We used linear mixed-effects models to estimate the relationship between NC(0.02–1) and log(10)-transformed HRV, including standard deviation of all normal-to-normal intervals (SDNN), square root of the mean of the sum of the squares of differences between adjacent NN intervals (r-MSSD), low frequency (LF, 0.04–0.15 Hz), and high frequency (HF, 0.15–0.40 Hz), adjusted for age, sex, body mass index, tobacco exposure, and temperature. For the young panel, a 10,000-particle/cm(3) increase in NC(0.02–1) with 1–4 hr moving average exposure was associated with 0.68–1.35% decreases in SDNN, 1.85–2.58% decreases in r-MSSD, 1.32–1.61% decreases in LF, and 1.57–2.60% decreases in HF. For the elderly panel, a 10,000-particle/cm(3) increase in NC(0.02–1) with 1–3 hr moving average exposure was associated with 1.72–3.00% decreases in SDNN, 2.72–4.65% decreases in r-MSSD, 3.34–5.04% decreases in LF, and 3.61–5.61% decreases in HF. In conclusion, exposure to NC(0.02–1) was associated with decreases in both time-domain and frequency-domain HRV indices in human subjects

Hazardous Apoptotic Effects of 2-Bromopropane on Maturation of Mouse Oocytes, Fertilization, and Fetal Development

2-Bromopropane (2-BP) is used as an alternative to ozone-depleting cleaning solvents. Previously, we reported that 2-BP has cytotoxic effects on mouse blastocysts and is associated with defects in subsequent development. Here, we further investigate the effects of 2-BP on oocyte maturation and subsequent pre- and post-implantation development, both in vitro and in vivo. Notably, 2-BP induced a significant reduction in the rates of oocyte maturation, fertilization, and in vitro embryonic development. Treatment of oocytes with 2-BP during in vitro maturation (IVM) resulted in increased resorption of postimplantation embryos and decreased fetal weights. Experiments with a mouse model disclosed that consumption of drinking water containing 20 μM 2-BP led to decreased oocyte maturation in vivo and fertilization in vitro, as well as impairment of early embryonic development. Interestingly, pretreatment with a caspase-3-specific inhibitor effectively prevented 2-BP-triggered hazardous effects, suggesting that embryonic impairment by 2-BP occurs via a caspase-dependent apoptotic process. A study using embryonic stem cells as the assay model conclusively demonstrated that 2-BP induces cell death processes through apoptosis and not necrosis, and inhibits early embryo development in mouse embryonic stem cells. These results collectively confirm the hazardous effects of 2-BP on embryos derived from pretreated oocytes

Cytotoxic Effects of CdSe Quantum Dots on Maturation of Mouse Oocytes, Fertilization, and Fetal Development

Quantum dots (QDs) are useful novel luminescent markers, but their embryonic toxicity is yet to be fully established, particularly in oocyte maturation and sperm fertilization. Earlier experiments by our group show that CdSe-core QDs have cytotoxic effects on mouse blastocysts and are associated with defects in subsequent development. Here, we further investigate the influence of CdSe-core QDs on oocyte maturation, fertilization, and subsequent pre- and postimplantation development. CdSe-core QDs induced a significant reduction in the rates of oocyte maturation, fertilization, and in vitro embryo development, but not ZnS-coated CdSe QDs. Treatment of oocytes with 500 nM CdSe-core QDs during in vitro maturation (IVM) led to increased resorption of postimplantation embryos and decreased placental and fetal weights. To our knowledge, this is the first study to report the negative impact of CdSe-core QDs on mouse oocyte development. Moreover, surface modification of CdSe-core QDs with ZnS effectively prevented this cytotoxicity

Machine Learning-Derived Prenatal Predictive Risk Model to Guide Intervention and Prevent the Progression of Gestational Diabetes Mellitus to Type 2 Diabetes : Prediction Model Development Study

Publisher Copyright: © Mukkesh Kumar, Li Ting Ang, Cindy Ho, Shu E Soh, Kok Hian Tan, Jerry Kok Yen Chan, Keith M Godfrey, Shiao-Yng Chan, Yap Seng Chong, Johan G Eriksson, Mengling Feng, Neerja KarnaniBackground: The increasing prevalence of gestational diabetes mellitus (GDM) is concerning as women with GDM are at high risk of type 2 diabetes (T2D) later in life. The magnitude of this risk highlights the importance of early intervention to prevent the progression of GDM to T2D. Rates of postpartum screening are suboptimal, often as low as 13% in Asian countries. The lack of preventive care through structured postpartum screening in several health care systems and low public awareness are key barriers to postpartum diabetes screening. Objective: In this study, we developed a machine learning model for early prediction of postpartum T2D following routine antenatal GDM screening. The early prediction of postpartum T2D during prenatal care would enable the implementation of effective strategies for diabetes prevention interventions. To our best knowledge, this is the first study that uses machine learning for postpartum T2D risk assessment in antenatal populations of Asian origin. Methods: Prospective multiethnic data (Chinese, Malay, and Indian ethnicities) from 561 pregnancies in Singapore's most deeply phenotyped mother-offspring cohort study-Growing Up in Singapore Towards healthy Outcomes-were used for predictive modeling. The feature variables included were demographics, medical or obstetric history, physical measures, lifestyle information, and GDM diagnosis. Shapley values were combined with CatBoost tree ensembles to perform feature selection. Our game theoretical approach for predictive analytics enables population subtyping and pattern discovery for data-driven precision care. The predictive models were trained using 4 machine learning algorithms: logistic regression, support vector machine, CatBoost gradient boosting, and artificial neural network. We used 5-fold stratified cross-validation to preserve the same proportion of T2D cases in each fold. Grid search pipelines were built to evaluate the best performing hyperparameters. Results: A high performance prediction model for postpartum T2D comprising of 2 midgestation features-midpregnancy BMI after gestational weight gain and diagnosis of GDM-was developed (BMI_GDM CatBoost model: AUC=0.86, 95% CI 0.72-0.99). Prepregnancy BMI alone was inadequate in predicting postpartum T2D risk (ppBMI CatBoost model: AUC=0.62, 95% CI 0.39-0.86). A 2-hour postprandial glucose test (BMI_2hour CatBoost model: AUC=0.86, 95% CI 0.76-0.96) showed a stronger postpartum T2D risk prediction effect compared to fasting glucose test (BMI_Fasting CatBoost model: AUC=0.76, 95% CI 0.61-0.91). The BMI_GDM model was also robust when using a modified 2-point International Association of the Diabetes and Pregnancy Study Groups (IADPSG) 2018 criteria for GDM diagnosis (BMI_GDM2 CatBoost model: AUC=0.84, 95% CI 0.72-0.97). Total gestational weight gain was inversely associated with postpartum T2D outcome, independent of prepregnancy BMI and diagnosis of GDM (P = .02; OR 0.88, 95% CI 0.79-0.98). Conclusions: Midgestation weight gain effects, combined with the metabolic derangements underlying GDM during pregnancy, signal future T2D risk in Singaporean women. Further studies will be required to examine the influence of metabolic adaptations in pregnancy on postpartum maternal metabolic health outcomes. The state-of-the-art machine learning model can be leveraged as a rapid risk stratification tool during prenatal care.Peer reviewe

Vitamin D, the placenta and early pregnancy:effects on trophoblast function

Pregnancy is associated with significant changes in vitamin D metabolism, notably increased maternal serum levels of active vitamin D, 1,25-dihydroxyvitamin (1,25(OH)2D). This appears to be due primarily to increased renal activity of the enzyme 25-hydroxyvitamin D-1α-hydroxylase (CYP27B1) that catalyzes synthesis of 1,25(OH)2D, but CYP27B1 expression is also prominent in both the maternal decidua and fetal trophoblast components of the placenta. The precise function of placental synthesis of 1,25(OH)2D remains unclear, but is likely to involve localised tissue-specific responses with both decidua and trophoblast also expressing the vitamin D receptor (VDR) for 1,25(OH)2D. We have previously described immunomodulatory responses to 1,25(OH)2D by diverse populations of VDR-expressing cells within the decidua. The aim of the current review is to detail the role of vitamin D in pregnancy from a trophoblast perspective, with particular emphasis on the potential role of 1,25(OH)2D as a regulator of trophoblast invasion in early pregnancy. Vitamin D-deficiency is common in pregnant women, and a wide range of studies have linked low vitamin D status to adverse events in pregnancy. To date most of these studies have focused on adverse events later in pregnancy, but the current review will explore the potential impact of vitamin D on early pregnancy, and how this may influence implantation and miscarriage

Injurious Effects of Curcumin on Maturation of Mouse Oocytes, Fertilization and Fetal Development via Apoptosis

Curcumin, a common dietary pigment and spice, is a hydrophobic polyphenol derived from the rhizome of the herb Curcuma longa. Previously, we reported a cytotoxic effect of curcumin on mouse embryonic stem cells and blastocysts and its association with defects in subsequent development. In the present study, we further investigated the effects of curcumin on oocyte maturation and subsequent pre- and post-implantation development, both in vitro and in vivo. Notably, curcumin induced a significant reduction in the rate of oocyte maturation, fertilization, and in vitro embryonic development. Treatment of oocytes with curcumin during in vitro maturation (IVM) led to increased resorption of postimplantation embryos and decreased fetal weight. Experiments with an in vivo mouse model disclosed that consumption of drinking water containing 40 μM curcumin led to decreased oocyte maturation and in vitro fertilization as well as early embryonic developmental injury. Finally, pretreatment with a caspase-3-specific inhibitor effectively prevented curcumin-triggered injury effects, suggesting that embryo impairment by curcumin occurs mainly via a caspase-dependent apoptotic process

Automated Machine Learning (AutoML)-Derived Preconception Predictive Risk Model to Guide Early Intervention for Gestational Diabetes Mellitus

The increasing prevalence of gestational diabetes mellitus (GDM) is contributing to the rising global burden of type 2 diabetes (T2D) and intergenerational cycle of chronic metabolic disorders. Primary lifestyle interventions to manage GDM, including second trimester dietary and exercise guidance, have met with limited success due to late implementation, poor adherence and generic guidelines. In this study, we aimed to build a preconception-based GDM predictor to enable early intervention. We also assessed the associations of top predictors with GDM and adverse birth outcomes. Our evolutionary algorithm-based automated machine learning (AutoML) model was implemented with data from 222 Asian multi-ethnic women in a preconception cohort study, Singapore Preconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO). A stacked ensemble model with a gradient boosting classifier and linear support vector machine classifier (stochastic gradient descent training) was derived using genetic programming, achieving an excellent AUC of 0.93 based on four features (glycated hemoglobin A(1c) (HbA(1c)), mean arterial blood pressure, fasting insulin, triglycerides/HDL ratio). The results of multivariate logistic regression model showed that each 1 mmol/mol increase in preconception HbA(1c) was positively associated with increased risks of GDM (p = 0.001, odds ratio (95% CI) 1.34 (1.13-1.60)) and preterm birth (p = 0.011, odds ratio 1.63 (1.12-2.38)). Optimal control of preconception HbA(1c) may aid in preventing GDM and reducing the incidence of preterm birth. Our trained predictor has been deployed as a web application that can be easily employed in GDM intervention programs, prior to conception.Peer reviewe

Exploring how socioeconomic status affects neighbourhood environments? : effects on obesity risks : a longitudinal study in Singapore

Research on how socioeconomic status interacts with neighbourhood characteristics to influence disparities in obesity outcomes is currently limited by residential segregation-induced structural confounding, a lack of empirical studies outside the U.S. and other 'Western' contexts, and an over-reliance on cross-sectional analyses. This study addresses these challenges by examining how socioeconomic status modifies the effect of accumulated exposures to obesogenic neighbourhood environments on children and mothers' BMI, drawing from a longitudinal mother-child birth cohort study in Singapore, an Asian city-state with relatively little residential segregation. We find that increased access to park connectors was associated with a decrease in BMI outcomes for mothers with higher socioeconomic status, but an increase for those with lower socioeconomic status. We also find that increased access to bus stops was associated with an increase in BMIz of children with lower socioeconomic status, but with a decrease in BMIz of children with higher socioeconomic status, while increased access to rail stations was associated with a decrease in BMIz of children with lower socioeconomic status only. Our results suggest that urban interventions might have heterogeneous effects by socioeconomic status.Peer reviewe

Prepregnancy adherence to plant-based diet indices and exploratory dietary patterns in relation to fecundability

Background Modest associations have been reported between specific food groups or nutrients and fecundability [measured by time to pregnancy (TTP)]. Examining overall diets provides a more holistic approach towards understanding their associations with fecundability. It is not known whether plant-based diets indices or exploratory dietary patterns are associated with fecundability. Objectives We examine the associations between adherence to 1) plant-based diet indices; and 2) exploratory dietary patterns and fecundability among women planning pregnancy. Methods Data were analyzed from the Singapore Preconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO) study. Prepregnancy diet was assessed using a semi-quantitative FFQ from which the overall, healthful, and unhealthful plant-based diet indices (oPDI, hPDI, and uPDI, respectively) were calculated. Exploratory dietary patterns were derived using factor analysis based on 44 predefined food groups. Participants were categorized into quintiles based on their dietary pattern scores. TTP (expressed in menstrual cycles) was ascertained within a year from the prepregnancy dietary assessment. Discrete-time proportional hazard models, adjusted for confounders, were used to estimate fecundability ratios (FRs) and 95% CIs, with FR > 1 indicating a shorter TTP. Results Among 805 women, 383 pregnancies were confirmed by ultrasound scans. Compared with women in the lowest quintile, those in the highest quintile of the uPDI had reduced fecundability (FR of Q5 compared with Q1, 0.65; 95% CI, 0.46-0.91; P trend, 0.009). Conversely, greater adherence to the hPDI was associated with increased fecundability (1.46; 95% CI, 1.02-2.07; P trend, 0.036). The oPDI was not associated with fecundability. Among the 3 exploratory dietary patterns, only greater adherence to the Fast Food and Sweetened Beverages (FFSB) pattern was associated with reduced fecundability (0.61; 95% CI, 0.40-0.91; P trend, 0.018). Conclusions Greater adherence to the uPDI or the FFSB dietary pattern was associated with reduced fecundability among Asian women. Greater adherence to the hPDI may be beneficial for fecundability, though this requires confirmation by future studies.Peer reviewe