Whole-genome sequencing of Klebsiella pneumoniae isolates to track strain progression in a single patient with recurrent urinary tract infection

Klebsiella pneumoniae is an important uropathogen that increasingly harbors broad-spectrum antibiotic resistance determinants. Evidence suggests that some same-strain recurrences in women with frequent urinary tract infections (UTIs) may emanate from a persistent intravesicular reservoir. Our objective was to analyze K. pneumoniae isolates collected over weeks from multiple body sites of a single patient with recurrent UTI in order to track ordered strain progression across body sites, as has been employed across patients in outbreak settings. Whole-genome sequencing of 26 K. pneumoniae isolates was performed utilizing the Illumina platform. PacBio sequencing was used to create a refined reference genome of the original urinary isolate (TOP52). Sequence variation was evaluated by comparing the 26 isolate sequences to the reference genome sequence. Whole-genome sequencing of the K. pneumoniae isolates from six different body sites of this patient with recurrent UTI demonstrated 100% chromosomal sequence identity of the isolates, with only a small P2 plasmid deletion in a minority of isolates. No single nucleotide variants were detected. The complete absence of single-nucleotide variants from 26 K. pneumoniae isolates from multiple body sites collected over weeks from a patient with recurrent UTI suggests that, unlike in an outbreak situation with strains collected from numerous patients, other methods are necessary to discern strain progression within a single host over a relatively short time frame.</p

Analysis and clinical findings of cases positive for the novel synthetic cannabinoid receptor agonist MDMB-CHMICA

Context: MDMB-CHMICA is a synthetic cannabinoid receptor agonist which has caused concern due to its presence in cases of adverse reaction and death. Method: 43 cases of suspected synthetic cannabinoid ingestion were identified from patients presenting at an Emergency Department and from post-mortem casework. These were subjected to liquid-liquid extraction using tertiary-butyl methyl ether and quantitatively analysed by Electospray Ionisation Liquid Chromatography – tandem Mass Spectrometry. For positive samples, case and clinical details were sought and interrogated. Results: 11 samples were found positive for MDMB-CHMICA. Concentrations found ranged from &lt;1 – 22 ng/mL (mean: 6 ng/mL, median: 3 ng/mL). The age range was 15 – 44 years (mean: 26 years, median: 21 years), with the majority (82%) of positive results found in males. Clinical presentations included hypothermia, hypoglycaemia, syncope, recurrent vomiting, altered mental state and serotonin toxicity, with corresponding concentrations of MDMB-CHMICA as low as &lt;1 ng/mL. Duration of hospitalisation ranged from 3 – 24 hours (mean: 12 hours, median: 8 hours). Discussion: The concentration range presented in this case series is indicative of MDMB-CHMICA having a high potency, as is known to be the case for other synthetic cannabinoid receptor agonists. The age range and gender representation were consistent with that reported for users of other drugs of this type. The clinical presentations observed were typical of synthetic cannabinoid receptor agonists and show the difficulties in identifying reactions potentially associated with drugs of this type. Conclusion: The range of MDMB-CHMICA concentrations in Emergency Department presentations (n=9) and post-mortem cases (n=2) was reported. No correlation between the concentration of this drug and clinical presentation or cause of death was reported in this sample. However, the potential for harm associated with low concentrations of MDMB-CHMICA and the symptoms of toxicity being non-specific was highlighted

The Effect of Ambient Temperature on Cold Start Urban Traffic Emissions for a Real World SI Car

The influence of ambient temperature on exhaust emissions for an instrumented Euro 1 SI car was determined. A real world test cycle was used, based on an urban drive cycle that was similar to the ECE urban drive cycle. It was based on four laps of a street circuit and an emissions sample bag was taken for each lap. The bag for the first lap was for the cold start emissions. An in-vehicle direct exhaust dual bag sampling technique was used to simultaneously collect exhaust samples upstream and downstream of the three-way catalyst (TWC). The cold start tests were conducted over a year, with ambient temperatures ranging from – 2°C to 32°C. The exhaust system was instrumented with thermocouples so that the catalyst light off temperature could be determined. The results showed that CO emissions for the cold start were reduced by a factor of 8 downstream of catalyst when ambient temperature rose from -2°C to 32°C, the corresponding hydrocarbon emissions were reduced by a factor of 4. There was no clear relationship between NOx emissions and ambient temperature. For subsequent laps of the test circuit the reduction of CO and HC emissions as a function of ambient temperature was lower. The time for catalyst light off increased by 50% as the ambient temperature was reduced. The results show that the vehicle used is unlikely to meet the new – 7oC cold start CO emission regulations

Intercomparison of standard resolution and high resolution TOVS soundings with radiosonde, lidar, and surface temperature/humidity data

One objective of the FIRE Cirrus IFO is to characterize relationships between cloud properties inferred from satellite observations at various scales to those obtained directly or inferred from very high resolution measurements. Satellite derived NOAA-9 high and standard resolution Tiros Operational Vertical Sounder (TOVS) soundings are compared with directly measured lidar, surface temperature, humidity, and vertical radiosonde profiles associated with the Ft. McCoy site. The results of this intercomparison should be useful in planning future cloud experiments

A Landscape Cannot Be A Homeland

This is the author accepted manuscript. The final version is available from Taylor & Francis via the DOI in this record.What is the problem for which landscape is the answer? In this paper, I offer a response to this question, first posed at a meeting of landscape researchers in Brussels in 2011. I argue that the problem can be defined as ontopology, or what I call here homeland thinking, and I propose that a landscape cannot be a homeland. The salience of landscape as a critical term instead involves modes of thinking and feeling that chafe against invocations of homeland as a site of existential inhabitation, as a locus of sentiment and attachment, and a wellspring of identity. The paper explores the connections between ideas of landscape and homeland through discussions of the European Landscape Convention, phenomenology and the term homeland itself. I conclude by arguing that a landscape must be understood as a kind of dislocation or distancing from itself. There are, after all, no original inhabitants

Investigating hookworm genomes by comparative analysis of two Ancylostoma species

Background Hookworms, infecting over one billion people, are the mostly closely related major human parasites to the model nematode Caenorhabditis elegans. Applying genomics techniques to these species, we analyzed 3,840 and 3,149 genes from Ancylostoma caninum and A. ceylanicum. Results Transcripts originated from libraries representing infective L3 larva, stimulated L3, arrested L3, and adults. Most genes are represented in single stages including abundant transcripts like hsp-20 in infective L3 and vit-3 in adults. Over 80% of the genes have homologs in C. elegans, and nearly 30% of these were with observable RNA interference phenotypes. Homologies were identified to nematode-specific and clade V specific gene families. To study the evolution of hookworm genes, 574 A. caninum / A. ceylanicum orthologs were identified, all of which were found to be under purifying selection with distribution ratios of nonsynonymous to synonymous amino acid substitutions similar to that reported for C. elegans / C. briggsae orthologs. The phylogenetic distance between A. caninum and A. ceylanicum is almost identical to that for C. elegans / C. briggsae. Conclusion The genes discovered should substantially accelerate research toward better understanding of the parasites' basic biology as well as new therapies including vaccines and novel anthelmintics

The Structural Complexity of (Bi0.5Na0.5)TiO3-BaTiO3 as Revealed by Raman Spectroscopy

The structural phase diagram of the Pb-free ferroelectric (Na1/2Bi1/2)1-xBaxTiO3 (NBT-BT), x<0.1, has been explored by Raman spectroscopy at temperatures from 10 to 470 K. The data provide clear evidence for a proposed temperature-independent morphotropic phase boundary at x \approx 0.055. However, there is no evidence for a structural phase transition across T \approx 370 K for x > 0.055, where bulk-property anomalies appear to signal a transition to a nonpolar or antiferroelectric phase. The results identify that the phase above 370 K shows short-range ionic displacements that are identical to those in the long-range-ordered phase below 370 K. These conclusions provide a natural interpretation of the weak piezoelectric response in this system and have important implications for the search for Pb-free piezoelectrics.Comment: 21 pages, 5 figure

Casimir Force between a Dielectric Sphere and a Wall: A Model for Amplification of Vacuum Fluctuations

The interaction between a polarizable particle and a reflecting wall is examined. A macroscopic approach is adopted in which the averaged force is computed from the Maxwell stress tensor. The particular case of a perfectly reflecting wall and a sphere with a dielectric function given by the Drude model is examined in detail. It is found that the force can be expressed as the sum of a monotonically decaying function of position and of an oscillatory piece. At large separations, the oscillatory piece is the dominant contribution, and is much larger than the Casimir-Polder interaction that arises in the limit that the sphere is a perfect conductor. It is argued that this enhancement of the force can be interpreted in terms of the frequency spectrum of vacuum fluctuations. In the limit of a perfectly conducting sphere, there are cancellations between different parts of the spectrum which no longer occur as completely in the case of a sphere with frequency dependent polarizability. Estimates of the magnitude of the oscillatory component of the force suggest that it may be large enough to be observable.Comment: 18pp, LaTex, 7 figures, uses epsf. Several minor errors corrected, additional comments added in the final two sections, and references update

The effect of individual radiographers on rates of attendance to breast screening: A 7-year retrospective study

AIM: To establish whether individual radiographers had significantly different rescreening rates whilst controlling for other known confounding factors. MATERIALS AND METHODS: Women aged 50e69 years were identified from a state-wide screening database at their first screening attendance during the study period (2007e2013). The radiographer performing this index screen and potential confounding factors were recorded and subsequent screening behaviour was assessed. Clients with abnormal screens and those known to have died during the time period were excluded. A univariate analysis of the data from 160,028 women was assessed using the chi-square test to compare those women who attended their next mammography with non-re-attenders. Logistic regression was used to calculate the likelihood of “re-attendance success” across a range of variables. The probability of re-attendance for 11 randomly selected radiographers was determined from the logistic regression model, whilst controlling for other variables. RESULTS: Comparison of non-re-attenders (n¼49,698) with 110,330 (69%) women attending the next round of screening revealed significant differences, including radiographer (Wald statistics¼1188, p\u3c0.000) even when all other known factors were controlled. CONCLUSION: This large, population-level study demonstrates that individual radiographer factors appear to influence a women’s decision to return for their next screening round. Further research is required to identify reasons for differing rescre