Prevalence of non-O157:H7 shiga toxin-producing Escherichia coli in diarrheal stool samples from Nebraska.

We determined the prevalence of Shiga toxin-producing Escherichia coli (STEC) in diarrheal stool samples from Nebraska by three methods: cefixime-tellurite sorbitol MacConkey (CT- SMAC) culture, enterohemorrhagic E. coli (EHEC) enzyme immunoassay, and stx1,2 polymerase chain reaction (PCR). Fourteen (4.2%) of 335 specimens were positive by at least one method (CT-SMAC culture [6 of 14], EHEC enzyme immunoassay [13 of 14], stx1,2 PCR [14 of 14]). Six contained serogroup O157, while non-O157 were as prevalent as O157 serogroups

Gait Mechanics are Influenced by Quadriceps Strength, Age, and Sex after Total Knee Arthroplasty

Although most patients are satisfied with outcomes after total knee arthroplasty (TKA), many retain preoperative altered gait mechanics. Identifying patient characteristics associated with gait mechanics will improve rehabilitation strategies and enhance our understanding of movement disorders. Therefore, the purpose of this study was to identify which patient characteristics are related to gait mechanics in the surgical limb during walking post-TKA. Patient characteristics included age, body mass, sex, quadriceps strength, self-reported function, and knee pain. General linear regression was used to compare patient characteristics associated with gait mechanics, after controlling for gait speed, functional capacity and time from surgery. We tested 191 patients cross-sectionally at 6–24 months after primary, unilateral TKA. Quadriceps weakness in the surgical limb was associated with less peak vertical ground reaction force (PvGRF) (β = .245, p = .044), knee extension moment (β = .283, p = .049), and knee extension excursion (β = .298, p = .038). Older age (β = .168, p = .050) was associated with less PvGRF. Quadriceps strength in the nonsurgical limb (β = −.357, p = .021) was associated with greater knee extension excursion in the surgical limb. Females with TKA (β = −.276, p = .007) had less knee flexion excursion compared to males. Faster gait speed was also associated with greater PvGRF (β = .585, p \u3c .001), knee extensor moment (β = .481, p \u3c .001), and knee flexion excursion (β = .318, p \u3c .001). Statement of Clinical Significance: This study showed quadriceps weakness, slower gait speed, older age and being female were related to altered gait mechanics post-TKA. These findings will help clinicians better educate patients and develop targeted interventions for improving care in patients post-TKA

Ileo-Colon Targeting of the Poorly Water-Soluble Drug Celecoxib Using a pH-Dependent Coating in Combination with Self-Emulsifying Drug Delivery or Solid Dispersion Systems

Targeting celecoxib to the ileo-colonic region could be beneficial for the treatment and prevention of colon cancer. Ileo-colonic targeting can be achieved by using pH-dependent coating systems such as ColoPulse. Celecoxib has poor aqueous solubility, which may jeopardize optimal treatment. Therefore, we combined a pH-dependent coating with self-emulsifying drug delivery systems (SEDDS) or with solid dispersion systems (SD); two approaches that are often used to improve the dissolution behavior of lipophilic drugs. The dissolution behavior of various formulations of both systems was investigated. Optimized formulations with and without precipitation inhibitors were coated with the ColoPulse and the release of celecoxib was tested under non-sink conditions using an in vitro dissolution system, simulating the pH gradient of the gastrointestinal tract. The dissolution behavior of SDs with and without precipitation inhibitor (sodium dodecyl sulfate) and the SEDDS without precipitation inhibitor was negatively impacted by the coating. Control experiments indicated that components of the coating released in the dissolution medium acted as precipitation mediators. However, the SEDDS formulation with HPMC 4000 cps as a precipitation inhibitor showed excellent dissolution behavior. We hypothesize that HPMC accumulates at the oil/water interface of the emulsion thereby stabilizing the emulsion resulting in maintenance of the supersaturated state

Silencing Heat Shock Protein 47 (HSP47) in Fibrogenic Precision-Cut Lung Slices:A Surprising Lack of Effects on Fibrogenesis?

Idiopathic pulmonary fibrosis (IPF) is a chronic disease that is characterized by the excessive deposition of scar tissue in the lungs. As currently available treatments are unable to restore lung function in patients, there is an urgent medical need for more effective drugs. Developing such drugs, however, is challenging because IPF has a complex pathogenesis. Emerging evidence indicates that heat shock protein 47 (HSP47), which is encoded by the gene Serpinh1, may be a suitable therapeutic target as it is required for collagen synthesis. Pharmacological inhibition or knockdown of HSP47 could therefore be a promising approach to treat fibrosis. The objective of this study was to assess the therapeutic potential of Serpinh1-targeting small interfering RNA (siRNA) in fibrogenic precision-cut lung slices prepared from murine tissue. To enhance fibrogenesis, slices were cultured for up to 144 h with transforming growth factor β1. Self-deliverable siRNA was used to knockdown mRNA and protein expression, without affecting the viability and morphology of slices. After silencing HSP47, only the secretion of fibronectin was reduced while other aspects of fibrogenesis remained unaffected (e.g., myofibroblast differentiation as well as collagen secretion and deposition). These observations are surprising as others have shown that Serpinh1-targeting siRNA suppressed collagen deposition in animals. Further studies are therefore warranted to elucidate downstream effects on fibrosis upon silencing HSP47

Providing Evidence about the Pandemic: Librarian Roles on a Rapid Response Team for COVID-19

This was presented at the 2021 Medical Library Association Annual Meeting [virtual].BACKGROUND: SARS-CoV-2 has led to a deluge of information. Health leaders/personnel need curated and synthesized information to aid their decision making regarding diagnosis, treatment, mitigation, reopening plans, etc. A collaboration involving the state department of health has been developed to respond to those needs. Several programs were created simultaneously, two of which depend on active librarian involvement. One focuses on rapid expert responses to questions from state leadership supported by annotated bibliographies. The other is a daily digest of emerging literature including reviews on patient care, law and ethics, communication, forecasting and surveillance, schools, and mitigation. DESCRIPTION: Librarians from several libraries at a university are responding to the need for synthesized high-quality information related to the pandemic. These librarians have expertise in the areas of evidence-based medicine, data management, public health, and law. From the beginning, librarians have been heavily involved in creating workflows related to project and data management. Project management included having a standard process for tracking questions, delivering information, and team development. Librarians developed the team through onboarding, defining roles, scheduling, consistent communication, and shared document templates. Librarians created data management processes such as citation management, readme files, file management/naming conventions, data backup, etc. Librarians encouraged adoption of creative commons license notices on public-facing work to make the information more accessible. Project assessment was built into workflows and includes tracking: questions, turn around time, updates, and return on investment. CONCLUSION: Since the inception of this program, librarians have answered over 108 questions and provided 18 updates to annotated bibliographies. The average turnaround time for creating annotated bibliographies is 16 hours with a range of 2-48 hours. In addition, librarians have provided searches to support over 900 blog posts for WISE Indiana. While the pandemic has been stressful, this project provided us with an outlet to support our state. In addition, this project has led to: increased visibility for librarians, salary savings for the library, and recognition for our contributions that led to the receipt of an Award for Excellence in Public Health from Dr. Kristina Box​, the State Health Commissioner for Indiana