Whole-genome sequencing analysis reveals the spread of a vanB-carrying transposon among different vancomycin-resistant Enterococcus faecium clinical isolates in a non-endemic setting

Background: Vancomycin-resistant enterococci (VRE), particularly Enterococcus faecium (VREfm), can cause serious nosocomial infections, and have been responsible for healthcare-associated outbreaks. Spreading of VREfm can occur both clonally and by the dissemination of mobile genetic elements. Aim: To report prospective analysis of whole-genome sequencing (WGS) data, including both core-genome multi-locus sequence typing (cgMLST) and transposon analysis, during a vanB VREfm outbreak. Methods: Screening for vanB-positive VREfm isolates was performed by real-time polymerase chain reaction (PCR) on an overnight enriched broth and, if positive, subculture was performed. vanB-positive VREfm isolates underwent WGS. Generated data were used for molecular typing that was performed by cgMLST using SeqSphere. For transposon characterization, sequence data were mapped against the reference sequence of transposon Tn1549 using CLC Genomics Workbench, or de-novo assemblies were used for BLASTN comparisons. Results: In total, 1358 real-time PCRs were performed. Two hundred and fifty-one specimens from 207 patients tested positive on PCR for vanB, of which 13 specimens obtained from six patients were identified as vanB VREfm positive on culture. These six patients harboured seven unique isolates belonging to four cluster types: CT118 (N=2), CT2483 (N=3), CT2500 (N=1) and CT2501 (N=1). Transposon analysis revealed the presence of an identical vanB-carrying transposon in the isolates cultured from all six patientsBackground: Vancomycin-resistant enterococci (VRE), particularly Enterococcus faecium (VREfm), can cause serious nosocomial infections, and have been responsible for healthcare-associated outbreaks. Spreading of VREfm can occur both clonally and by the dissemination of mobile genetic elements.Aim: To report prospective analysis of whole-genome sequencing (WGS) data, including both core-genome multi-locus sequence typing (cgMLST) and transposon analysis, during a vanB VREfm outbreak.Methods: Screening for vanB-positive VREfm isolates was performed by real-time polymerase chain reaction (PCR) on an overnight enriched broth and, if positive, subculture was performed. vanB-positive VREfm isolates underwent WGS. Generated data were used for molecular typing that was performed by cgMLST using SeqSphere. For transposon characterization, sequence data were mapped against the reference sequence of transposon Tn1549 using CLC Genomics Workbench, or de-novo assemblies were used for BLASTN comparisons.Results: In total, 1358 real-time PCRs were performed. Two hundred and fifty-one specimens from 207 patients tested positive on PCR for vanB, of which 13 specimens obtained from six patients were identified as vanB VREfm positive on culture. These six patients harboured seven unique isolates belonging to four cluster types: CT118 (N=2), CT2483 (N=3), CT2500 (N=1) and CT2501 (N=1). Transposon analysis revealed the presence of an identical vanB-carrying transposon in the isolates cultured from all six patients that could be linked based on epidemiological data.Conclusion: A vanB VREfm outbreak occurred in the study hospital, including six patients with isolates belonging to four cluster types. In-depth transposon analysis revealed that &amp; nbsp;dissemination of transposon Tn1549 rather than clonal spread was the cause of the outbreak.(C)&amp; nbsp;2021 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.</p

Measurement of Spin Correlation Parameters ANN_{NN}, ASS_{SS}, and A_SL{SL} at 2.1 GeV in Proton-Proton Elastic Scattering

At the Cooler Synchrotron COSY/J\"ulich spin correlation parameters in elastic proton-proton (pp) scattering have been measured with a 2.11 GeV polarized proton beam and a polarized hydrogen atomic beam target. We report results for A$_{NN}$, A$_{SS}$, and A_${SL}$ for c.m. scattering angles between 30$^o$ and 90$^o$. Our data on A$_{SS}$ -- the first measurement of this observable above 800 MeV -- clearly disagrees with predictions of available of pp scattering phase shift solutions while A$_{NN}$ and A_${SL}$ are reproduced reasonably well. We show that in the direct reconstruction of the scattering amplitudes from the body of available pp elastic scattering data at 2.1 GeV the number of possible solutions is considerably reduced.Comment: 4 pages, 4 figure

Youth Gambling: The health and wellbeing of New Zealand secondary school students in 2012

Gambling has become a widely available activity in today’s society (Hardoon & Derevensky, 2002; Turchi & Derevensky, 2006). In fact, many researchers “have noted that an entire generation has now grown up in an era when lottery and casino gambling is widely available and heavily advertised” (Volberg, Gupta, Griffiths, Ólason, & Delfabbro, 2010, p. 3). Evidence suggests that it has become a popular past-time not only for adults, but also for children and young people (Derevensky & Gupta, 2000; Gupta & Derevensky, 1998a; Hardoon & Derevensky, 2002; Jacobs, 2000; Splevins, Mireskandari, Clayton, & Blaszczynski, 2010; Turchi & Derevensky, 2006). Moreover, research indicates that gambling is one of the first risky activities that adolescents become involved with (i.e. they begin gambling prior to experimentation with alcohol, drugs, sexual behaviour) (Volberg, et al., 2010). Whilst for many youth involvement in gambling does not result in problematic behaviour, others go on to experience serious problems (Dickson, Derevensky, & Gupta, 2003). A vast range of adolescent gambling prevalence studies that have been undertaken over the past 25 years, across different countries, and incorporating general populations as well as youth specifically. Rates of youth problem gambling have often been found to be higher than the rates identified for adults (Huang & Boyer, 2007; Shaffer & Hall, 1996; Welte, Barnes, Tidwell, & Hoffman, 2008; Williams, Page, Parke, & Rigbye, 2008), with some estimating them to be more than double those of adults (Gupta & Derevensky, 1998a; Jackson, Dowling, Thomas, Bond, & Patton, 2008; Lesieur, et al., 1991), or up to three times as high (Rigbye, 2010). However, it has also been recognised that there is far less research in this field compared to that which has explored other youth risk behaviours such as substance use (Blinn-Pike, Worthy, & Jonkman, 2010). The gap in New Zealand-based information regarding prevalence of youth gambling has been identified previously (Bellringer, et al., 2003; Rossen, Tse, & Vaidya, 2009) and in 2003 it was recommended that research be undertaken to measure the involvement of New Zealand youth in gambling as well as associated factors and gambling-related problems (Bellringer, et al., 2003). A limited body of research has since employed various sources of data to consider youth gambling in New Zealand (e.g. Gray, 2010; Ministry of Health, 2008, 2009; Rossen, 2008; Rossen, Butler, & Denny, 2011). An extremely valuable source of information on New Zealand youth is the University of Auckland’s (UoA) National youth health and wellbeing surveys. To date, the UoA’s Adolescent Health Research Group (AHRG) has completed three National youth health and wellbeing surveys. The Youth2000 Survey Series aim to provide nationally representative information on the health and wellbeing of young people attending New Zealand secondary schools. The Survey Series includes a wide range of questions about issues that contribute to the health and wellbeing of young people (such as substance use, injuries and violence, home and family) and allow researchers to take an ecological approach to identifying overall risk and protective factors in young people’s lives. Youth’12, a survey of 8,500 secondary school students throughout New Zealand, is the most recent survey to be undertaken by the AHRG. The inclusion of gambling items in the Youth’12 survey provides a unique opportunity to examine the impacts of gambling and problem gambling on secondary school students throughout New Zealand within an ecological framework. This report was commissioned by the Ministry of Health and begins with a comprehensive review of the local and international youth gambling literature, followed by an overview of the Youth2000 Survey Series and methodology for Youth’12. A thorough analysis of Youth’12 gambling items was undertaken with results being reported under the following eight categories (detailed results for each set of analyses are also provided in the appendices): - Students and their own gambling (Section Five); - Unhealthy gambling amongst students (Section Six); - Attitudes and motivating factors towards gambling (Section Seven); - The impacts of others’ gambling on students (Section Eight); and, - Risk and protective factors for student gambling (Section Nine); - Gambling and Māori taitamariki in Aotearoa (Section 10); - Gambling and Pacific young people in New Zealand (Section 11); and, - Gambling and Asian young people in New Zealand (Section 12). Finally, a discussion chapter provides an overview of the findings and implications

A Precision Measurement of pp Elastic Scattering Cross Sections at Intermediate Energies

We have measured differential cross sections for \pp elastic scattering with internal fiber targets in the recirculating beam of the proton synchrotron COSY. Measurements were made continuously during acceleration for projectile kinetic energies between 0.23 and 2.59 GeV in the angular range $30 \leq \theta_{c.m.} \leq 90$ deg. Details of the apparatus and the data analysis are given and the resulting excitation functions and angular distributions presented. The precision of each data point is typically better than 4%, and a relative normalization uncertainty of only 2.5% within an excitation function has been reached. The impact on phase shift analysis as well as upper bounds on possible resonant contributions in lower partial waves are discussed.Comment: 23 pages 29 figure

Cation- and vacancy-ordering in Li_xCoO_2

Using a combination of first-principles total energies, a cluster expansion technique, and Monte Carlo simulations, we have studied the Li/Co ordering in LiCoO_2 and Li-vacancy/Co ordering in CoO_2. We find: (i) A ground state search of the space of substitutional cation configurations yields the (layered) CuPt structure as the lowest-energy state in the octahedral system LiCoO_2 (and CoO_2), in agreement with the experimentally observed phase. (ii) Finite temperature calculations predict that the solid-state order- disorder transitions for LiCoO_2 and CoO_2 occur at temperatures (~5100 K and ~4400 K, respectively) much higher than melting, thus making these transitions experimentally inaccessible. (iii) The energy of the reaction E(LiCoO_2) - E(CoO_2) - E(Li) gives the average battery voltage V of a Li_xCoO_2/Li cell. Searching the space of configurations for large average voltages, we find that CuPt (a monolayer superlattice) has a high voltage (V=3.78 V), but that this could be increased by cation randomization (V=3.99 V), partial disordering (V=3.86 V), or by forming a 2-layer Li_2Co_2O_4 superlattice along (V=4.90 V).Comment: 12 Pages, RevTeX galley format, 5 figures embedded using epsf Phys. Rev. B (in press, 1998

Influence of Age on Upper Arm Cuff Blood Pressure Measurement

Blood pressure (BP) is a leading global risk factor. Increasing age is related to changes in cardiovascular physiology that could influence cuff BP measurement, but this has never been examined systematically and was the aim of this study. Cuff BP was compared with invasive aortic BP across decades of age (from 40 to 89 years) using individual-level data from 31 studies (1674 patients undergoing coronary angiography) and 22 different cuff BP devices (19 oscillometric, 1 automated auscultation, 2 mercury sphygmomanometry) from the Invasive Blood Pressure Consortium. Subjects were aged 64±11 years, and 32% female. Cuff systolic BP overestimated invasive aortic systolic BP in those aged 40 to 49 years, but with each older decade of age, there was a progressive shift toward increasing underestimation of aortic systolic BP (P<0.0001). Conversely, cuff diastolic BP overestimated invasive aortic diastolic BP, and this progressively increased with increasing age (P<0.0001). Thus, there was a progressive increase in cuff pulse pressure underestimation of invasive aortic PP with increasing decades of age (P<0.0001). These age-related trends were observed across all categories of BP control. We conclude that cuff BP as an estimate of aortic BP was substantially influenced by increasing age, thus potentially exposing older people to greater chance for misdiagnosis of the true risk related to BP

Using Routinely Collected Administrative Data in Public Health Research: Geocoding Alcohol Outlet Data

We describe our process of geocoding alcohol outlets to create a national longitudinal exposure dataset for Wales, United Kingdom from 2006 to 2011. We investigated variation in the availability of data items and the quality of alcohol outlet addresses held within unitary authorities. We used a standard geocoding method augmented with a manual matching procedure to achieve a fully spatially referenced dataset. We found higher quality addresses are held for outlets based in urban areas, resulting in the automatic geocoding of 68 % of urban outlets, compared to 48 % in rural areas. Missing postcodes and a lack of address structure contributed to a lower geocoding proportion. An urban rural bias was removed with the development of a manual matching procedure. Only one-half of the unitary authorities provided data on on/off sales and opening times, which are important availability factors. The resulting outlet dataset is suitable for contributing to the evidence-base of alcohol availability and alcohol-related harm. Local government should be encouraged to use standardised data fields, including addresses, to enable accurate geocoding of alcohol outlets and facilitate research that aims to prevent alcohol-related harm. Standardising data collection would enable efficient secondary data reuse using record linkage techniques, allowing the retrospective creation and evaluation of population-based natural experiments to provide evidence for policy and practice

Metallothionein – overexpression as a highly significant prognostic factor in melanoma: a prospective study on 1270 patients

Metallothioneins (MT) are ubiquitous, intracellular small proteins with high affinity for heavy metal ions. In the last decades, it was shown that MT overexpression in a variety of cancers is associated with resistance to anticancer drugs and is combined with a poor prognosis. In this prospective study, we examined the role of MT overexpression in melanoma patients as a prognostic factor for progression and survival. Between 1993 and 2004, 3386 patients with primary cutaneous melanoma were investigated by using a monoclonal antibody against MT on routinely fixed, paraffin-embedded tissues. In all, 1270 patients could be followed up for further statistical analysis (Fisher's exact test, Mantel–Haenszel χ2 test, Kaplan–Meier curves). The MT data of disease-free interval and overall survival were compared univariately and multivariately in Cox regression analysis. Immunohistochemical overexpression of MT in tumour cells of patients with primary melanoma (310 of 1270; 24.4%) was associated with a higher risk for progression (117 of 167; 70.1%) and reduced survival (80 of 110; 72.7%) of the disease (P<0.0001). Similarly, Kaplan–Meier curves gave highly significant disadvantages for the MT-positive group. Univariate analysis (relative risk 7.4; 95% confidence interval (CI) 5.2–10.2; P<0.0001 for progression; relative risk 7.1; 95% CI 4.7–10.9; P<0.0001 for survival), as well as multivariate analysis with other prognostic markers resulted in MT overexpression as a highly significant and independent factor for prognosis in primary melanoma