Deployment of Infectious Disease Experts an Prevalence of Antimicrobial Resistance in Okayama: A Call for Training of Specialists

Objective During the ongoing global pandemic of novel coronavirus disease 2019 (COVID-19), an emerging infectious disease, the implementation and execution of infection prevention and control (IPC) is of paramount importance. In this study, we aimed to assess the current deployment of infection control medical personnel in Okayama prefecture, who are supposed to play an essential role to prevent the outbreak of infectious diseases, and the current prevalence of antimicrobial-resistant (AMR) bacteria isolated in Okayama. Materials and methods This was a descriptive study using publicly available data. The numbers of infectious disease (ID)-doctors and the certified nurses in infection control (CNIC) per 100,000 population in 47 prefectures in Japan were calculated. We then compared the detected proportions of AMR pathogens among the prefectures in 2019 to be employed as a comparative parameter, which was obtained from Japan Nosocomial Infections Surveillance (JANIS) data. Results The number of ID-doctors was the 11th highest in Japan; however, they were unevenly distributed in southern Okayama, particularly at three tertiary hospitals. While the deployment of CNIC was geographically less uneven in the prefecture, their number was lower than the domestic average. According to the JANIS data, isolation rates of AMR pathogens were high in Okayama compared to other prefectures in Japan: vancomycin-resistant Enterococcus faecium (the third-worst); cefotaxime-resistant Escherichia coil and Klebsiella pneunioniae (the third-worst and the second-worst, respectively); and meropenem-resistant Pseudomonas aeruginosa (the worst). Conclusions Our assessment provides underlying data and reinforces the need for educating multi-professional experts in the field of infectious diseases to prevent future public health threats in Okayama

A patient with human coronavirus NL63 falsely diagnosed with COVID-19; Lesson learned for the importance of definitive diagnosis

The gold standard for the diagnosis of coronavirus disease 2019 (COVID-19) is a nucleic acid detection test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which may occasionally reveal false-positive or false-negative results. Herein, we describe the case of a patient infected with human coronavirus NL63 (HCoV-NL63) who was falsely diagnosed with COVID-19 using the Ampdirect™ 2019-nCoV detection kit (Shimadzu Corporation, Japan) and admitted to a COVID-19 hospital ward. We suspected a cross-reaction between HCoV-NL63 and SARS-CoV-2; however, the reported genome sequences of HCoV-NL63 and N1/N2 primers for SARS-CoV-2 do not correspond. Thus, the patient was supposed to be false positive by the instrument, possibly due to contamination. Although the issue of a false-negative result has been the focus of much attention to prevent the spread of the disease, a false positive is fraught with problems as well. Physicians should recognize that unnecessary isolation violates human rights and a careful diagnosis is indispensable when the results of laboratory testing for COVID-19 are unclear, for instance if the duplicate PCR test is partially positive or the CT value is high

Independent subbases and non-redundant codings of separable metrizable spaces

AbstractThe notion of an independent subbase was introduced by H. Tsuiki to apply non-redundant {0,1,⊥}ω-code representations to topological spaces. We prove that every dense in itself, separable, metrizable space X has an independent subbase and, if dimX⩽n in addition, then X has an independent subbase of dimension n. We also study other properties of subbases related to non-redundant {0,1,⊥}ω-codings

Disgust and the rubber hand illusion: a registered replication report of Jalal, Krishnakumar, and Ramachandran (2015)

Abstract Heightened experience of disgust is a feature of obsessive-compulsive disorder (OCD), particularly contamination-related OCD (C-OCD). Previous studies of the rubber hand illusion (RHI) reported that the sense of body ownership is related to the interaction between vision, touch, and proprioception. One recent study demonstrated a link between the RHI and disgust, suggesting that there is an interaction between these three perceptual modalities and disgust (Jalal et al., PLOS ONE 10:e0139159, 2015). However, there have been no direct replications of this initial study. We therefore performed a direct replication of Jalal et al.’s (PLOS ONE 10:e0139159, 2015) study. We examined 133 participants (based on a power analysis) to determine whether placing contamination-related stimuli on a rubber hand causes OCD-like disgust among healthy participants experiencing the RHI. That is, we tested whether Japanese participants experience more intense disgust when the rubber hand and the participant’s hidden hand are stroked synchronously than when stroked asynchronously, in order to replicate and examine the cross-cultural validity of this effect. The main finding of the original study by Jalal and colleagues was successfully replicated in a large sample. Some inconsistencies in one of the control procedures exploring coldness sensations during the RHI were found, which could possibly be due to cross-cultural differences or the improved statistical power of the present study. Based on the present replication study, we conclude that an intervention using the RHI as proposed by Jalal et al. (PLOS ONE 10:e0139159, 2015) might potentially be useful for the treatment of OCD following replications in clinical OCD populations. Preregistration details: This study was preregistered with Cognitive Research: Principles and Implications. The Authors’ protocol received in-principle acceptance on 31 March 2017. The preregistered protocol is available here: https://doi.org/10.6084/m9.figshare.6217295

Carbon monoxide binding properties of domain-swapped dimeric myoglobin

Myoglobin (Mb) is a monomeric oxygen storage hemoprotein, and has been shown to form a domain-swapped dimer. In this study, monomeric and dimeric carbon monoxide (CO)-bound Mb (MbCO) exhibited similar absorption spectra. The CO stretching frequencies of MbCO were observed at 1,932 and 1,944 cm-1 for both monomeric and dimeric MbCO. The resonance Raman (RR) bands for the stretching between the heme iron and axial ligands were observed at the same frequencies for the monomer and dimer of deoxygenated Mb (deoxyMb) and MbCO, respectively (ν Fe-His, 220 cm-1; ν Fe-C, 507 cm-1), showing that the Fe-His bond strength of deoxyMb and the Fe-CO bond strength of MbCO did not change by the dimerization. Time-resolved RR measurements showed that the dynamics of the structural changes at the heme active site after CO photo-dissociation of MbCO was similar between monomeric and dimeric Mb [monomer, (5.2 ± 1.8) × 106 s-1; dimer, (6.2 ± 1.1) × 106 s-1 at room temperature]. These results show that the heme coordination structure, the protein environment around the bound CO, and the protein relaxation character are similar between monomeric and dimeric MbCO. Although the active site structure was similar between the monomer and dimer, the CO binding rate constant of dimeric Mb [(1.01 ± 0.03) × 106 M-1 s-1 at 20 °C] was about twice larger than that of the monomer [(0.52 ± 0.02) × 106 M-1 s-1 at 20 °C], presumably due to the expansion of the channel between the Xe3 cavity and the solvent by the dimerization

Protein Dynamics of Isolated Chains of Recombinant Human Hemoglobin Elucidated by Time-Resolved Resonance Raman Spectroscopy

Protein dynamics of isolated chains of recombinant human adult hemoglobin (rHb) following ligand photolysis were studied by time-resolved resonance Raman spectroscopy. In the time-resolved spectra, we observed frequency shifts of the iron–histidine stretching [ν­(Fe-His)] and γ₇ bands and an intensity change of the ν₈ band for both the isolated α- and β-chains, showing that a primary metastable form was present in the initial tens of nanoseconds following the photolysis. Similar spectral changes were reported for human adult hemoglobin and rHb. Common spectral changes between isolated chains and hemoglobin indicated that structural changes reflected by the spectral changes were characteristic of the hemoglobin subunits. The heme modes suggested that the primary metastable form had a more disordered orientation of propionates and a less strained environment than the deoxy form. The spectral changes of the isolated α-chain were faster than those of the β-chain. In spite of the fact that the isolated β-chain formed a tetramer in a similar fashion to rHb, the spectral changes were much slower than those of rHb. The present study shows that intersubunit interactions affected the rates of the structural changes of the heme pocket. Characteristics of the tertiary structure dynamics of hemoglobin are discussed