Blunt weapons in the roman imperial army. A multidisciplinary approach to the clava from experimental archaeology to forensic anthropology

The wooden club (clava) is rarely associated with the image of Roman soldiers, perhaps because it was considered an unconventional weapon with ethnic attributes and/or specific combat roles. Nonetheless, it is attested in the archaeological record and some ancient texts. The panoply and the military career of the soldiers represented on the tombstones of Catavignus son of Ivomagus (1st century AD) and Marcus Aurelius Alexis (early 3rd century AD) offered us the possibility to reconsider the use of the club as an offensive weapon within the Imperial Roman army. The authors made a replica of the clava using historical tools and manufacturing techniques. A series of tests have then been performed to investigate the use of the club in combat. The possible traumas on human targets were also evaluated with a forensic anthropological approach. The results suggest the essential role of flexion and rotation of the kinetic chain «hip/shoulder/ arm» in wielding the clava. This movement requires a much more mobile combat style that can prove very effective against heavily armoured targets due to the weapon's high-impact force and a more extended reach than more conventional Roman sidearms

Polyclonal outbreak of bacteremia caused by Burkholderia cepacia complex and the presumptive role of ultrasound gel

AbstractA nosocomial polyclonal outbreak associated to bacteremia caused by different Burkholderia cepacia complex (BCC) species and clones is reported. Molecular characterization identified Burkholderia stabilis, Burkholderia contaminans, and Burkholderia ambifaria among BCC isolates obtained from patients in neonatal and adult intensive care units. BCC was also isolated from an intrinsically contaminated ultrasound gel, which constituted the presumptive BCC source. Prior BCC outbreak related to contaminated ultrasound gels have been described in the setting of transrectal prostate biopsy. Outbreak caused strains and/or clones of BCC have been reported, probably because BCC are commonly found in the natural environment; most BCC species are biofilm producers, and different species may contaminate an environmental source. The finding of multiple species or clones during the analysis of nosocomial BCC cases might not be enough to reject an outbreak from a common source

Polyclonal outbreak of bacteremia caused by Burkholderia cepacia complex and the presumptive role of ultrasound gel

AbstractA nosocomial polyclonal outbreak associated to bacteremia caused by different Burkholderia cepacia complex (BCC) species and clones is reported. Molecular characterization identified Burkholderia stabilis, Burkholderia contaminans, and Burkholderia ambifaria among BCC isolates obtained from patients in neonatal and adult intensive care units. BCC was also isolated from an intrinsically contaminated ultrasound gel, which constituted the presumptive BCC source. Prior BCC outbreak related to contaminated ultrasound gels have been described in the setting of transrectal prostate biopsy. Outbreak caused strains and/or clones of BCC have been reported, probably because BCC are commonly found in the natural environment; most BCC species are biofilm producers, and different species may contaminate an environmental source. The finding of multiple species or clones during the analysis of nosocomial BCC cases might not be enough to reject an outbreak from a common source

Membrane anchoring stabilizes and favors secretion of New Delhi metallo-β-lactamase

Carbapenems, 'last-resort' β-lactam antibiotics, are inactivated by zinc-dependent metallo-β-lactamases (MBLs). The host innate immune response withholds nutrient metal ions from microbial pathogens by releasing metal-chelating proteins such as calprotectin. We show that metal sequestration is detrimental for the accumulation of MBLs in the bacterial periplasm, because those enzymes are readily degraded in their nonmetallated form. However, the New Delhi metallo-β-lactamase (NDM-1) can persist under conditions of metal depletion. NDM-1 is a lipidated protein that anchors to the outer membrane of Gram-negative bacteria. Membrane anchoring contributes to the unusual stability of NDM-1 and favors secretion of this enzyme in outer-membrane vesicles (OMVs). OMVs containing NDM-1 can protect nearby populations of bacteria from otherwise lethal antibiotic levels, and OMVs from clinical pathogens expressing NDM-1 can carry this MBL and the bla[subscript NDM] gene. We show that protein export into OMVs can be targeted, providing possibilities of new antibacterial therapeutic strategies.Kinship Foundation. Searle Scholars ProgramMassachusetts Institute of Technology. Department of Chemistr

Rationale and design of an independent randomised controlled trial evaluating the effectiveness of aripiprazole or haloperidol in combination with clozapine for treatment-resistant schizophrenia

<p>Abstract</p> <p>Background</p> <p>One third to two thirds of people with schizophrenia have persistent psychotic symptoms despite clozapine treatment. Under real-world circumstances, the need to provide effective therapeutic interventions to patients who do not have an optimal response to clozapine has been cited as the most common reason for simultaneously prescribing a second antipsychotic drug in combination treatment strategies. In a clinical area where the pressing need of providing therapeutic answers has progressively increased the occurrence of antipsychotic polypharmacy, despite the lack of robust evidence of its efficacy, we sought to implement a pre-planned protocol where two alternative therapeutic answers are systematically provided and evaluated within the context of a pragmatic, multicentre, independent randomised study.</p> <p>Methods/Design</p> <p>The principal clinical question to be answered by the present project is the relative efficacy and tolerability of combination treatment with clozapine plus aripiprazole compared with combination treatment with clozapine plus haloperidol in patients with an incomplete response to treatment with clozapine over an appropriate period of time. This project is a prospective, multicentre, randomized, parallel-group, superiority trial that follow patients over a period of 12 months. Withdrawal from allocated treatment within 3 months is the primary outcome.</p> <p>Discussion</p> <p>The implementation of the protocol presented here shows that it is possible to create a network of community psychiatric services that accept the idea of using their everyday clinical practice to produce randomised knowledge. The employed pragmatic attitude allowed to randomly allocate more than 100 individuals, which means that this study is the largest antipsychotic combination trial conducted so far in Western countries. We expect that the current project, by generating evidence on whether it is clinically useful to combine clozapine with aripiprazole rather than with haloperidol, provides physicians with a solid evidence base to be directly applied in the routine care of patients with schizophrenia.</p> <p>Trial Registration</p> <p><b>Clincaltrials.gov Identifier</b>: NCT00395915</p

Il catalogo elettronico delle traduzioni latine di Galeno: manoscritti ed edizioni

Il catalogo intende raccogliere tutte le traduzioni latine di Galeno e dello pseudo-Galeno e tutti i testi latini pseudogalenici, dalla tarda antichità fino al XVII sec., i loro autori e i loro testimoni: manoscritti dall'VIII-IX sec. ed edizioni dal 1473. Si articola in cinque schede - opere, traduzioni, manoscritti, edizioni, traduttori - che sono tra loro connesse e che forniscono informazioni e descrizioni specifiche, con relativi riferimenti bibliografici ed eventuale indicazione di riproduzioni disponibili in rete, nel caso di manoscritti e di edizioni. Galeno (129-216) ha avuto una grande importanza nella storia della medicina e della scienza fino al XIX sec., e in Occidente è stato letto, studiato e commentato principalmente in latino. Le sue numerose opere sono state tradotte dalla tarda antichità dal greco, e poi dall'arabo dall'XI sec., e in seguito più volte ritradotte fino alla fine XVI sec., quando erano inserite nel curriculum delle facoltà di medicina di tutta Europa. Hermann Diels, nell'ambito di un progetto dell'Akademie der Wissenschften di Berlino, ha pubblicato nel 1905-7 il catalogo dei manoscritti dei medici greci, che per la parte latina è ampiamente incompleto e insoddisfacente. Richard Durling (1932-1999), dalla fine degli anni Cinquanta, ha lavorato sulla traduzione latina di Galeno e ha pubblicato il censimento delle edizioni di Galeno stampate dal 1473 al 1599 nel Journal of the Warburg and Courtald Institutes del 1961, e due articoli sui manoscritti latini di Galeno che correggono ed integrano il Diels, entrambi in Traditio, l'uno nel 1967 e l'altro nel 1981. Ha inoltre raccolto osservazioni su circa seicento manoscritti latini di Galeno, utilizzando microfilms provenienti da biblioteche di tutto il mondo - oggi conservati presso la National Library of Medicine di Bethesda, negli Stati Uniti - in vista della pubblicazione di un volume nella serie del Catalogus Translationum et Commentariorum, che tuttavia non si è realizzata. Dopo la sua morte, avvenuta il 5 giugno 1999, questo materiale è stato affidato dalla vedova Sheila a Stefania Fortuna che, insieme con Anna Maria Raia, ne ha rivisto una parte e l'ha pubblicata nel volume di Traditio del 2006, in un terzo articolo che corregge ed integra il Diels. Il catalogo elettronico delle traduzioni latine di Galeno vuole mettere a disposizione le osservazioni di Richard Durling nel loro complesso, continuare il lavoro di catalogazione, fornire aggiornamenti sulle ricerche svolte nel settore e stimolarne di nuove. È stato realizzato con i finanziamenti del Prin 2008 e dell'Università Politecnica delle Marche. Stefania Fortuna ne è responsabile e curatrice; Michaelangiola Marchiaro ha compilato le schede dei manoscritti, utilizzando il materiale inedito di Durling, consultando cataloghi e visionando direttamente numerosi manoscritti conservati nelle bilioteche italiane (soprattutto Roma e Firenze); Signum, il Centro informatico per le discipline umanistiche della Scuola Normale Superiore di Pisa, ha realizzato il programma. Hanno collaborato anche Clara Provenziani (schede delle edizioni), Anna Maria Raia (schede delle opere). Il catalogo è dedicato alla memoria di Richard Durling e di Virginia Brown. Per il momento sono disponibili le descrizioni di circa 500 manoscritti con relative schede delle traduzioni e delle opere

Characterization of the diverse plasmid pool harbored by the blaNDM-1-containing Acinetobacter bereziniae HPC229 clinical strain

Acinetobacter bereziniae is an environmental microorganism with increasing clinical incidence, and may thus provide a model for a bacterial species bridging the gap between the environment and the clinical setting. A. bereziniae plasmids have been poorly studied, and their characterization could offer clues on the causes underlying the leap between these two different habitats. Here we characterized the whole plasmid content of A. bereziniae HPC229, a clinical strain previously reported to harbor a 44-kbp plasmid, pNDM229, confer ring carbapenem and aminoglycoside resistance. We identified five extra plasmids in HPC229 ranging from 114 to 1.3 kbp, including pAbe229-114 (114 kbp) encoding a MOBP111 relaxase and carrying heavy metal resistance, a bacteriophage defense BREX system and four different toxin-antitoxin (TA) systems. Two other replicons, pAbe229-15 (15.4 kbp) and pAbe229-9 (9.1 kbp), both encoding MOBQ1 relaxases and also carrying TA systems, were found. The three latter plasmids contained Acinetobacter Rep_3 superfamily replication initiator protein genes, and functional analysis of their transfer regions revealed the mobilizable nature of them. HPC229 also harbors two smaller plasmids, pAbe229-4 (4.4 kbp) and pAbe229-1 (1.3 kbp), the former bearing a ColE1-type replicon and a TA system, and the latter lacking known replication functions. Comparative sequence analyses against deposited Acinetobacter genomes indicated that the above five HPC229 plasmids were unique, although some regions were also present in other of these genomes. The transfer, replication, and adaptive modules in pAbe229-15, and the stability module in pAbe229-9, were bordered by sites potentially recognized by XerC/XerD site-specific tyrosine recombi nases, thus suggesting a potential mechanism for their acquisition. The presence of Rep_3 and ColE1-based replication modules, different mob genes, distinct adaptive functions including resistance to heavy metal and other environmental stressors, as well as antimicrobial resistance genes, and a high content of XerC/XerD sites among HPC229 plasmids provide evidence of substantial links with bacterial species derived from both environmental and clinical habitats.Para citar este articulo: Brovedan M, Repizo GD, Marchiaro P, Viale AM, Limansky A (2019) Characterization of the diverse plasmid pool harbored by the blaNDM-1- containing Acinetobacter bereziniae HPC229 clinical strain. PLoS ONE 14(11): e0220584. https://doi.org/10.1371/journal.pone.0220584Fil: Brovedan, Marco. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario (IBR -CONICET); Argentina.Fil: Brovedan, Marco. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Departamento de Microbiología; Argentina.Fil: Repizo, Guillermo Daniel. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario (IBR -CONICET); Argentina.Fil: Repizo, Guillermo Daniel. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Departamento de Microbiología; Argentina.Fil: Marchiaro, Patricia M. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario (IBR -CONICET); Argentina.Fil: Marchiaro, Patricia M. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Departamento de Microbiología; Argentina.Fil: Viale, Alejandro M. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario (IBR -CONICET); Argentina.Fil: Viale, Alejandro M. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Departamento de Microbiología; Argentina.Fil: Limansky, Adriana S. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario (IBR -CONICET); Argentina.Fil: Limansky, Adriana S. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Departamento de Microbiología; Argentina

Pseudomonas putida group species as reservoirs of mobilizable Tn402-like class 1 integrons carrying blaVIM-2 metallo-β-lactamase genes

The Pseudomonas putida group (P. putida G) is composed of at least 21 species associated with a wide range of environments, including the clinical setting. Here, we characterized 13 carbapenem-resistant P. putida G clinical isolates bearing class 1 integrons/transposons (class 1 In/Tn) carrying blaVIM-2 metallo-β-lactamase gene cassettes obtained from hospitals of Argentina. Multilocus sequencing (MLSA) and phylogenetic analyses based on 16S rDNA, gyrB and rpoD sequences distinguished 7 species among them. blaVIM-2 was found in three different cassette arrays: In41 (blaVIM-2-aacA4), In899 (only blaVIM-2), and In528 (dfrB1-aacA4-blaVIM-2). In41 and In899 were associated with complete tniABQC transposition modules and IRi/IRt boundaries characteristic of the Tn5053/Tn402 transposons, which were designated Tn6335 and Tn6336, respectively. The class 1 In/Tn element carrying In528, however, exhibited a defective tni module bearing only the tniC (transposase) gene, associated with a complete IS6100 bounded with two oppositely-oriented IRt end regions. In some P. putida G isolates including P. asiatica, P. juntendi, P. putida G/II, and P. putida G/V, Tn6335/Tn6336 were carried by pLD209-type conjugative plasmids capable of self-mobilization to P. aeruginosa or Escherichia coli. In other isolates of P. asiatica, P. putida G/II, and P. monteiliieilii, however, these blaVIM-2-containing class 1 In/Tn elements were found inserted into the res regions preceding the tnpR (resolvase) gene of particular Tn21 subgroup members of Tn3 transposons. The overall results reinforce the notion of P. putida G members as blaVIM-2 reservoirs, and shed light on the mechanisms of dissemination of carbapenem resistance genes to other pathogenic bacteria in the clinical setting.Fil: Brovedan, Marco Alcides. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario (IBR-CONICET); Argentina.Fil: Marchiaro, Patricia M. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario (IBR-CONICET); Argentina.Fil: Díaz, María S. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario (IBR-CONICET); Argentina.Fil: Faccone, Diego. ANLIS Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Bacteriología. Servicio Antimicrobiano; Argentina.Fil: Corso, Alejandra. ANLIS Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Bacteriología. Servicio Antimicrobiano; Argentina.Fil: Pasteran, Fernando. ANLIS Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Bacteriología. Servicio Antimicrobiano; Argentina.Fil: Viale, Alejandro M.Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario (IBR-CONICET); Argentina.Fil: Limansky, Adriana S. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario (IBR-CONICET); Argentina