Phenotypic and genotypic distribution of ESBL, AmpC β-lactamase and carbapenemase-producing Enterobacteriaceae in community-acquired and hospital-acquired urinary tract infections in Sri Lanka

Objectives: Although Sri Lanka belongs to a region with a high prevalence of extended-spectrum β-lactamase (ESBL), AmpC β-lactamase and carbapenemase-producing Enterobacteriaceae, data regarding antimicrobial resistance (AMR) is limited. We studied the prevalence and diversity of β-lactamases produced by Enterobacteriaceae urinary pathogens from two hospitals in the Western Province of Sri Lanka. Methods: ESBL, AmpC β-lactamase and carbapenemase production was detected by phenotypic testing followed by genotyping. Results: The species responsible for urinary tract infections (UTI) were Escherichia coli (69%), Klebsiella pneumoniae (16%) and Enterobacter sp (6%). The prevalence of ESBL (50%), AmpC β-lactamase (19%) and carbapenemase (11%) phenotypes was high, and greater in hospital-acquired (HA-UTI) (75%) than in community-acquired UTI (CA-UTI) (42%). Identification of CA-UTI caused by carbapenemase-producing Enterobacteriaceae (5%) is alarming. Only one ESBL gene, blaCTX- M-15, was detected. AmpC β-lactamase genes found in E. coli and K. pneumoniae were blaCMY-2, blaCMY-42 and blaDHA-1, while Enterobacter sp. carried blaACT-1. Carbapenemase genes were blaNDM-1, blaNDM-4, blaOXA-181 and blaOXA-232, while blaKPC, blaIMP and blaVIM were absent. Co-occurrence of multiple bla genes, with some isolates harbouring six different bla genes, was common. Carbapenem-resistant isolates without carbapenemase genes displayed mutations in the outer membrane porin genes, ompF of E. coli and ompK36 of K. pneumoniae. Factors associated with UTI with β-lactamase-producing Enterobacteriaceae were age ≥50 years, previous hospitalization, presence of an indwelling urinary catheter, history of diabetes mellitus or other chronic illness and recurrent urinary tract infections. Conclusion: This study adds to the currently scarce data on AMR in Sri Lanka

Vanishing cycles and mutation

This is the writeup of a talk given at the European Congress of Mathematics, Barcelona. It considers Picard-Lefschetz theory from the Floer cohomology viewpoint.Comment: 20 pages, LaTeX2e. TeXnical problem should now be fixed, so that the images will appear even if you download the .ps fil

The Zika Virus Individual Participant Data Consortium: A Global Initiative to Estimate the Effects of Exposure to Zika Virus during Pregnancy on Adverse Fetal, Infant, and Child Health Outcomes

This commentary describes the creation of the Zika Virus Individual Participant Data Consortium, a global collaboration to address outstanding questions in Zika virus (ZIKV) epidemiology through conducting an individual participant data meta-analysis (IPD-MA). The aims of the IPD-MA are to (1) estimate the absolute and relative risks of miscarriage, fetal loss, and short- and long-term sequelae of fetal exposure; (2) identify and quantify the relative importance of different sources of heterogeneity (e.g., immune profiles, concurrent flavivirus infection) for the risk of adverse fetal, infant, and child outcomes among infants exposed to ZIKV in utero; and (3) develop and validate a prognostic model for the early identification of high-risk pregnancies and inform communication between health care providers and their patients and public health interventions (e.g., vector control strategies, antenatal care, and family planning programs). By leveraging data from a diversity of populations across the world, the IPD-MA will provide a more precise estimate of the risk of adverse ZIKV-related outcomes within clinically relevant subgroups and a quantitative assessment of the generalizability of these estimates across populations and settings. The ZIKV IPD Consortium effort is indicative of the growing recognition that data sharing is a central component of global health security and outbreak response.</jats:p

Simonsenia aveniformis sp nov (Bacillariophyceae), molecular phylogeny and systematics of the genus, and a new type of canal raphe system

The genus Simonsenia is reviewed and S. aveniformis described as new for science by light and electron microscopy. The new species originated from estuarine environments in southern Iberia (Atlantic coast) and was isolated into culture. In LM, Simonsenia resembles Nitzschia, with bridges (fibulae) beneath the raphe, which is marginal. It is only electron microscope (EM) examination that reveals the true structure of the raphe system, which consists of a raphe canal raised on a keel (wing), supported by rib like braces (fenestral bars) and tube-like portulae; between the portulae the keel is perforated by open windows (fenestrae). Based on the presence of portulae and a fenestrated keel, Simonsenia has been proposed to be intermediate between Bacillariaceae and Surirellaceae. However, an rbcL phylogeny revealed that Simonsenia belongs firmly in the Bacillariaceae, with which it shares a similar chloroplast arrangement, rather than in the Surirellaceae. Lack of homology between the surirelloid and simonsenioid keels is reflected in subtle differences in the morphology and ontogeny of the portulae and fenestrae. The diversity of Simonsenia has probably been underestimated, particularly in the marine environment.Polish National Science Centre in Cracow within the Maestro program [N 2012/04/A/ST10/00544]; Sciences and Technologies Foundation-FCT (Portugal) [SFRH/BD/62405/2009]info:eu-repo/semantics/publishedVersio

The ρ(1S,2S)\rho(1S,2S), ψ(1S,2S)\psi(1S,2S), Υ(1S,2S)\Upsilon(1S,2S) and ψt(1S,2S)\psi_t(1S,2S) mesons in a double pole QCD Sum Rule

We use the method of double pole QCD sum rule which is basically a fit with two exponentials of the correlation function, where we can extract the masses and decay constants of mesons as a function of the Borel mass. We apply this method to study the mesons: $\rho(1S,2S)$, $\psi(1S,2S)$, $\Upsilon(1S,2S)$ and $\psi_t(1S,2S)$. We also present predictions for the toponiuns masses $\psi_t(1S,2S)$ of m(1S)=357 GeV and m(2S)=374 GeV.Comment: 14 pages, 11 figures in Braz J Phys (2016

Hanseni?ase: uma revisa?o de literatura / Leprosy: a literature review

INTRODUC?A?O: A Hanseni?ase, doenc?a infecciosa cro?nica granulomatosa, e? causada pelo bacilo a?lcool-acido resistente, Mycobaterium leprae, e afeta a humanidade desde os tempos antigos; pore?m, seu tratamento so? foi descoberto em 1940. Esta doenc?a e? conhecida, principalmente, por ser um fardo moral e social, sendo, portanto, muito estigmatizada. OBJETIVO: Este trabalho foi realizado com a finalidade de reunir dados da literatura para tentar elucidar a doenc?a com o intuito de auxiliar na melhor compreensa?o como um todo da hanseni?ase. DISCUSSA?O: A hanseni?ase e? uma doenc?a que inflige sumariamente os nervos e a derme, podendo provocar danos severos e irreversi?veis.

Localization of Secondary Metabolites in Marine Invertebrates: Contribution of MALDI MSI for the Study of Saponins in Cuvierian Tubules of H. forskali

BACKGROUND: Several species of sea cucumbers of the family Holothuriidae possess a particular mechanical defense system called the Cuvierian tubules (Ct). It is also a chemical defense system as triterpene glycosides (saponins) appear to be particularly concentrated in Ct. In the present study, the precise localization of saponins in the Ct of Holothuria forskali is investigated. Classical histochemical labeling using lectin was firstly performed but did not generate any conclusive results. Thus, MALDI mass spectrometry Imaging (MALDI-MSI) was directly applied and completed by statistical multivariate tests. A comparison between the tubules of relaxed and stressed animals was realized. RESULTS: These analyses allowed the detection of three groups of ions, corresponding to the isomeric saponins of the tubules. Saponins detected at m/z 1287 and 1303 were the most abundant and were apparently localized in the connective tissue of the tubules of both relaxed and stressed individuals. Saponins at m/z 1125 and 1141 were detected in lower amount and were present in tissues of relaxed animals. Finally, saponin ions at 1433, 1449, 1463 and 1479 were observed in some Ct of stressed holothuroids in the outer part of the connective tissue. The saponin group m/z 14xx seems therefore to be stress-specific and could originate from modifications of the saponins with m/z of 11xx. CONCLUSIONS: All the results taken together indicate a complex chemical defense mechanism with, for a single organ, different sets of saponins originating from different cell populations and presenting different responses to stress. The present study also reflects that MALDI-MSI is a valuable tool for chemical ecology studies in which specific chemical signalling molecules like allelochemicals or pheromones have to be tracked. This report represents one of the very first studies using these tools to provide a functional and ecological understanding of the role of natural products from marine invertebrates

Escleroderma diabeticorum: rara mas frequentemente na?o reconhecida complicac?a?o da diabetes mellitus / Scleroderma diabeticorum: rare but often not recognized complication of diabetes mellitus

INTRODUC?A?O: O scleroderma adultorum (SA) e? uma doenc?a rara do tecido conjuntivo, caracterizada por endurecimento da pele, geralmente em pescoc?o, ombros e tronco. De etiologia desconhecida e ini?cio insidioso, pode diminuir a mobilidade dos tecidos afetados. Por ser raro e causa de morbidade significativa, e? muito importante seu reconhecimento. METODOLOGIA: O relato do caso consistiu nas informac?o?es obtidas por meio de revisa?o do prontua?rio e entrevista com paciente, bem como na revisa?o de literatura com busca no PubMed/MEDLINE e Scielo acerca do tema. Foram utilizados os termos: “Dermatology” e “Scleroderma, Systemic”. RELATO DO CASO: paciente homem, 60 anos, com quadro insidioso ha? 4 anos de placas eritemato-infiltradas em pescoc?o e dorso. Diabe?tico ha? 20 anos, mal- controlado. Trigliceri?deos de 600, Hemoglobina glicada de 9; micologico direto e cultura para fungos negativos; histopatolo?gico com edema de?rmico e infiltrado de mononucleares perivasculares. Diagno?stico de esclerederma diabeticorum. Paciente evoluiu com melhora do controle glice?mico e amolecimento das placas. DISCUSSA?O: O reconhecimento dessa condic?a?o cuta?nea pode permitir o diagno?stico e tratamento precoce de DM, melhorando o progno?stico e qualidade de vida dos pacientes.1.                  Sattar MA, Diab S, Sugathan TN et al. Scleroedema diabeticorum: a minor but often unrecognized complication of diabetes mellitus. Diabet Med 1988;5:465-8. 2.                  Knobler, R., Moinzadeh, P., Hunzelmann, N., Kreuter, A., Cozzio, A., Mouthon, Krieg, T, et al. European dermatology forum S1-guideline on the diagnosis and treatment of sclerosing diseases of the skin, Part 2: Scleromyxedema, scleredema and nephrogenic systemic fibrosis. Journal of the European Academy of Dermatology and Venereology. 2017;31(10),1581–1594. 3. Tran K, Boyd KP, Robinson MR, Whitlow M. Scleredema diabeticorum. Dermatol Online J. 2013;19:207–18

Necro?lise Epide?rmica To?xica desencadeada por fenitoi?na: Um Relato de caso / Toxic Epidermal Necrolysis Triggered by Phenytoin: A Case Report

INTRODUC?A?O:A necro?lise epide?rmica to?xicae? desencadeada na maior parte das vezes por medicac?o?es, sendo caracterizada por necrose extensiva da epiderme acometendo mais de 30% da superfi?cie corpo?rea, levando o paciente a apresentar aspecto de grande queimado. As medicac?o?es mais comumente associadas sa?o o alopurinol, lamotrigina, sulfassalazina, anti-inflamato?rios na?o esteroidais e fa?rmacos oncolo?gicos. OBJETIVO: Neste estudo, discutimos os principais aspectos da necro?lise epide?rmica to?xica atrave?s de uma revisa?o de literatura ilustrada por um caso cli?nico. METODOLOGIA: Foi realizada uma revisa?o bibliogra?fica tomando-se por refere?ncia informac?o?es obtidas nas bases de dados online PubMed e SciELO. Artigos em ingle?s, portugue?s, france?s e espanhol foram inclui?dos e ilustrados com um caso cli?nico. RELATO DO CASO: O paciente analisado foi admitido no servic?o com leso?es descamativo bolhosas em 40% da superfi?cie corporal, hematu?ria macrosco?pica e taquicardia 48 horas apo?s uso de fenitoi?na. O paciente foi tratado na unidade de queimados, com suspensa?o da medicac?a?o e curativos seriados e teve um curso favora?vel da doenc?a sem sequelas. DISCUSSA?O: Apresentamos dados para orientar o tratamento de pacientes com necro?lise epide?rmica to?xica para cirurgio?es pla?sticos, pediatras, intensivistas, dermatologistas e me?dicos de emerge?ncia. Um alto ni?vel de suspeita e? necessa?rio para um diagno?stico e estratificac?a?o de risco adequados, e medidas e tratamento precoces de apoio devem ser realizados por uma equipe multidisciplinar treinada para minimizar os danos e a mortalidade. 

Domain wall brane in squared curvature gravity

We suggest a thick braneworld model in the squared curvature gravity theory. Despite the appearance of higher order derivatives, the localization of gravity and various bulk matter fields is shown to be possible. The existence of the normalizable gravitational zero mode indicates that our four-dimensional gravity is reproduced. In order to localize the chiral fermions on the brane, two types of coupling between the fermions and the brane forming scalar is introduced. The first coupling leads us to a Schr\"odinger equation with a volcano potential, and the other a P\"oschl-Teller potential. In both cases, the zero mode exists only for the left-hand fermions. Several massive KK states of the fermions can be trapped on the brane, either as resonant states or as bound states.Comment: 18 pages, 5 figures and 1 table, references added, improved version to be published in JHE