An Investigation of Bacterial Ribonucleases as an Antibiotic Target

Antibiotics have been commonly used in medical practice for over 40 years. However, the misuse and overuse of current antibiotics is thought to be the primary cause for the increase in antibiotic resistance. Many current antibiotics target the bacterial ribosome. Antibiotics such as aminoglycosides and macrolides specifically target the 30S or 50S subunits to inhibit bacterial growth. During the assembly of the bacterial ribosome, ribosomal RNA of the 30S and 50S ribosomal subunits is processed by bacterial ribonucleases (RNases). RNases are also involved in the degradation and turnover of this RNA during times of stress, such as the presence of an antibiotic. This makes ribonucleases a potential target for novel antibiotics. It was shown that Escherichia coli mutants that were deficient for RNase III, RNase E, RNase R, RNase G, or RNase PH had an increase in ribosomal subunit assembly defects. These mutant bacterial cells also displayed an increased sensitivity to neomycin and paromomycin antibiotics. My research has also shown that an inhibitor of RNases, vanadyl ribonucleoside complex, potentiated the effects of an aminoglycoside and a macrolide antibiotic in wild type Escherichia coli, methicillin sensitive Staphylococcus aureus, and methicillin resistant Staphylococcus aureus. RNases are essential enzymes in both rRNA maturation and degradation. Based on this and previous work, the inhibition of specific RNases leads to an increased sensitivity to antibiotics. This work demonstrates that the inhibition of RNases might be a new target to combat antibiotic resistance

ERISA Subrogation and the Controversy over Sereboff: Silencing the Critics, the Divided Bench Is a Legitimate Standard

ERISA protects employees in the administration ofemployer-sponsored benefit plans. When a party is injuredby third parties and a health and welfare benefit plangoverned by ERISA pays benefits, conflicts have arisenbetween insurers seeking subrogation and individualsseeking full recovery. Injured parties claim they shouldnot have to reimburse insurers while insurers denyresponsibility for damage caused by third parties. TheSupreme Court set the standard for plan fiduciary rightsto ERISA subrogation in Sereboff v. Mid Atlantic MedicalServices, Inc. Sereboff held that the plain wording of 29U.S.C. § 1132(a)(3) means equitable relief available underthe historically divided courts of law and equity. TheCourt reasoned that the statute specifies only equitablerelief\u27 rather than specific categories of equitable relief,such as constructive trusts and equitable liens.Controversy continues as scholars criticize the standard asunsupported by ERISA and contrary to ERISA\u27s purposes.This Note asserts that the standard is supported by statuteand precedent: Mertens v. Hewitt Associates and Great-West Life & Annuity Insurance Co. v. Knudson. ThisNote concludes that the Court established a workablestandard, the ultimate legitimacy of which lies in theequitable balance it achieves between fiduciary rights to enforce ERISA plan subrogation provisions and theprotection of beneficiaries. The critics should accept theCourt\u27s equitable solution: equitable relief under thedivided bench

COVID-19 Surveillance Testing of Healthcare Personnel Drives Universal Masking Practice

Health Care Professionals (HCP) are at increased risk of COVID-19 infection due to the unpredictable clinical presentation of COVID-19 disease, limited SARS-CoV-2 testing, personal protective equipment (PPE) shortages, and the inherent inability to distance from patients. Infected HCP may infect others including coworkers leading to a simultaneous increase of number of infections and decreased availability of HCP in a community. [1] Due to PPE shortages, many healthcare systems have faced difficult decisions regarding utilization of PPE to protect HCP and patients and the communities they serve. We describe Norton Healthcare’s success utilizing surveillance COVID-19 testing of HCP to inform the decision to increase the use of PPE during a PPE shortage in the form of universal masking. Many healthcare systems could benefit from surveillance COVID-19 testing of HCP and universal masking of HCP

Emergence of COVID-19 and Patterns of Early Transmission in an Appalachian Sub-Region

Background: In mid-March 2020, very few cases of COVID-19 had been confirmed in the Central Blue Ridge Region, an area in Appalachia that includes 47 jurisdictions across northeast Tennessee, western North Carolina, and southwest Virginia. Authors described the emergence of cases and outbreaks in the region between March 18 and June 11, 2020. Methods: Data were collected from the health department websites of Tennessee, North Carolina, and Virginia beginning in mid-March for an ongoing set of COVID-19 monitoring projects, including a newsletter for local healthcare providers and a Geographic Information Systems (GIS) dashboard. In Fall 2020, using these databases, authors conducted descriptive and geospatial cluster analyses to examine case incidence and fatalities over space and time. Results: In the Central Blue Ridge Region, there were 4432 cases on June 11, or 163.22 cases per 100,000 residents in the region. Multiple days during which a particularly high number of cases were identified in the region were connected to outbreaks reported by local news outlets and health departments. Most of these outbreaks were linked to congregate settings such as schools, long-term care facilities, and food processing facilities. Implications: By examining data available in a largely rural region that includes jurisdictions across three states, authors were able to describe and disseminate information about COVID-19 case incidence and fatalities and identify acute and prolonged local outbreaks. Continuing to follow, interpret, and report accurate and timely COVID-19 case data in regions like this one is vital to residents, businesses, healthcare providers, and policymakers

Why Every Hospital Needs a COVID-19 Clinical Case Review Team

A hospital’s response to a global pandemic requires a coordinated effort to provide consistent guidance as information rapidly changes. In the early months of the COVID-19 pandemic, diagnosis and subsequent containment was challenging due to unfamiliarity with disease presentation, unknown reverse transcription-polymerase chain reaction sensitivity and inconsistent access to testing supplies. A centralized COVID-19 clinical case review team can provide guidance on test interpretation, isolation, resource coordination and more

Regional Management Units for Marine Turtles: A Novel Framework for Prioritizing Conservation and Research across Multiple Scales

Background: Resolving threats to widely distributed marine megafauna requires definition of the geographic distributions of both the threats as well as the population unit(s) of interest. In turn, because individual threats can operate on varying spatial scales, their impacts can affect different segments of a population of the same species. Therefore, integration of multiple tools and techniques - including site-based monitoring, genetic analyses, mark-recapture studies and telemetry - can facilitate robust definitions of population segments at multiple biological and spatial scales to address different management and research challenges. Methodology/Principal Findings: To address these issues for marine turtles, we collated all available studies on marine turtle biogeography, including nesting sites, population abundances and trends, population genetics, and satellite telemetry. We georeferenced this information to generate separate layers for nesting sites, genetic stocks, and core distributions of population segments of all marine turtle species. We then spatially integrated this information from fine-to coarse-spatial scales to develop nested envelope models, or Regional Management Units (RMUs), for marine turtles globally. Conclusions/Significance: The RMU framework is a solution to the challenge of how to organize marine turtles into units of protection above the level of nesting populations, but below the level of species, within regional entities that might be on independent evolutionary trajectories. Among many potential applications, RMUs provide a framework for identifying data gaps, assessing high diversity areas for multiple species and genetic stocks, and evaluating conservation status of marine turtles. Furthermore, RMUs allow for identification of geographic barriers to gene flow, and can provide valuable guidance to marine spatial planning initiatives that integrate spatial distributions of protected species and human activities. In addition, the RMU framework - including maps and supporting metadata - will be an iterative, user-driven tool made publicly available in an online application for comments, improvements, download and analysis

Susceptibility and Antibody Response of the Laboratory Model Zebra Finch (Taeniopygia guttata) to West Nile Virus

Since the introduction of West Nile virus (WNV) into North America in 1999 a number of passerine bird species have been found to play a role in the amplification of the virus. Arbovirus surveillance, observational studies and experimental studies have implicated passerine birds (songbirds, e.g., crows, American robins, house sparrows, and house finches) as significant reservoirs of WNV in North America, yet we lack a tractable passerine animal model for controlled studies of the virus. The zebra finch (Taeniopygia guttata) serves as a model system across a diversity of fields, and here we develop the zebra finch a songbird model for WNV. Like many natural hosts of WNV, we found that zebra finches developed sufficient viremia to serve as a competent host, yet in general resisted mortality from infection. In the Australian zebra finch (AZF) T. g. castanotis, we detected WNV in the majority of sampled tissues by 4 days post injection (dpi). However, WNV was not detected in tissues of sacrificed birds at 14 dpi, shortly after the development of detectable anti-WNV antibodies in the majority of birds indicating successful viral clearance. We compared susceptibility between the two zebra finch subspecies AZF and Timor zebra finch (TZF) T. g. guttata. Compared to AZF, WNV RNA was detected in a larger proportion of challenged TZF and molecular detection of virus in the serum of TZF was significantly higher than in AZF. Given the observed moderate host competence and disease susceptibility, we suggest that zebra finches are appropriate as models for the study of WNV and although underutilized in this respect, may be ideal models for the study of the many diseases carried and transmitted by songbirds

The knowledge, attitudes, and behavior of marriage and family therapists regarding eating disorders: What are the training needs?

The purpose of the study was to assess marriage and family therapists' (MFT) knowledge, attitude, and behavior regarding eating disorders in order to identify which areas MFTs need to be trained in regarding the treatment of eating disorders. The present study included 202 MFTs and the results indicate that the more knowledge of eating disorders an MFT has, the more likely he or she is to have a positive attitude towards clients with eating disorders and engage in behaviors that could increase the identification of eating disorders and success in treatment of clients with eating disorders. Therefore, increasing MFTs knowledge of eating disorders could increase MFTs favorable attitudes towards eating disorders; thus, making them more likely to engage in behaviors that could increase the early identification as well as increase the probability of successful treatment of clients with life threatening eating disorders. The implications, limitations, and suggestions for future research are discussed