Efficacy of different AV7909 dose regimens in a nonclinical model of pulmonary anthrax.

Pulmonary anthrax caused by exposure to inhaled , the most lethal form of anthrax disease, is a continued military and public health concern for the United States. The vaccine AV7909, consisting of the licensed anthrax drug substance AVA adjuvanted with CpG7909, induces high levels of toxin neutralizing antibodies in healthy adults using fewer doses than AVA. This study compares the ability of one- or two-dose regimens of AV7909 to induce a protective immune response in guinea pigs challenged with a lethal dose of aerosolized spores 6 weeks after the last vaccine dose.

The Microevolution of Antifungal Drug Resistance in Pathogenic Fungi.

The mortality rates of invasive fungal infections remain high because of the limited number of antifungal drugs available and antifungal drug resistance, which can rapidly evolve during treatment. Mutations in key resistance genes such as were postulated to be the predominant cause of antifungal drug resistance in the clinic. However, recent advances in whole genome sequencing have revealed that there are multiple mechanisms leading to the microevolution of resistance.

Identifying Non-Traditional Approaches to Swallowing Rehabilitation: A Scoping Review.

In recent years, dysphagia care has shifted toward a more patient-centered approach. This means that dysphagia clinicians are considering more factors in the treatment process including the goals of care, quality of life, and cultural values. The purpose of this scoping review was to examine relevant research and identify dysphagia interventions outside of those traditionally used by dysphagia clinicians that may improve swallowing function.

A Phenomenological Exploration of Experiences Related to Learning Styles Among Undergraduate Medical Students in a Barbadian Medical School.

Introduction: Learning style (LS) frameworks have been implemented by educators to promote participatory learning in order to strengthen learner engagement and to enhance learning outcomes. Self-efficacy has been shown to have an association with learning style and is a predictor of clinical performance and other qualities in medical students. This study examined the perspectives of second and final year medical students in a Caribbean-based medical school, relative to their learning approaches, teaching exposures and preparation for assessments.

Coproduced resources to support parents caring for children with gastrostomies.

Objective: To describe and disseminate a package of support for parents who care for children with gastrostomies, consisting of a library of videos and resources to support families from referral for gastrostomy surgery, to long-term support at home.

Methods: The resources were systematically developed and evaluated by parents, hospital and community-based nurses, paediatricians, a surgeon and researchers.

Results: The videos empower families, reduce their anxiety and increase their confidence, providing support throughout the families' journey.

Scalable Quantum Logic Spectroscopy.

In quantum logic spectroscopy (QLS), one species of trapped ion is used as a sensor to detect the state of an otherwise inaccessible ion species. This extends precision measurements to a broader class of atomic and molecular systems for applications like atomic clocks and tests of fundamental physics. Here, we develop a new technique based on a Schrödinger cat interferometer to address the problem of scaling QLS to larger ion numbers.

Complete Genome Sequence of Microbacterium foliorum Bacteriophage Librie.

Bacteriophage Librie was isolated from a soil sample from Clarksville, TN, using the bacterium Microbacterium foliorum. Librie has a 39,941 bp genome with 62 predicted protein-coding genes and 1 predicted gene for tRNA. Based on its gene content similarity to actinobacteriophages, Librie is grouped with phages in cluster EA5.

Carer preferences of route of administration of transmucosal diamorphine and willingness to take part in a randomised controlled trial: an interview study (DIPPER).

Background: Children and young people are usually given liquid morphine by mouth for breakthrough pain, which can take thirty minutes to work. A faster-acting, quickly absorbed, needle-free pain medicine, that is easy to administer is needed such as transmucosal (sublingual, buccal, intranasal) diamorphine. Research evidence relating to the administration of medication for breakthrough pain in children and young people is limited.

Molecular mechanisms underlying the emergence of polygenetic antifungal drug resistance in mismatch repair mutants of .

Background: Fungal infections are common life-threatening diseases amongst immunodeficient individuals. Invasive fungal disease is commonly treated with an azole antifungal agent, resulting in selection pressure and the emergence of drug resistance. Antifungal resistance is associated with higher mortality rates and treatment failure, making the current clinical management of fungal disease very challenging.

Mutators Enhance Adaptive Micro-Evolution in Pathogenic Microbes.

Adaptation to the changing environmental conditions experienced within a host requires genetic diversity within a microbial population. Genetic diversity arises from mutations which occur due to DNA damage from exposure to exogenous environmental stresses or generated endogenously through respiration or DNA replication errors. As mutations can be deleterious, a delicate balance must be obtained between generating enough mutations for micro-evolution to occur while maintaining fitness and genomic integrity.

Analysis of Pathogenic Bacterial and Yeast Biofilms Using the Combination of Synchrotron ATR-FTIR Microspectroscopy and Chemometric Approaches.

Biofilms are assemblages of microbial cells, extracellular polymeric substances (EPS), and other components extracted from the environment in which they develop. Within biofilms, the spatial distribution of these components can vary. Here we present a fundamental characterization study to show differences between biofilms formed by Gram-positive methicillin-resistant (MRSA), Gram-negative , and the yeast-type using synchrotron macro attenuated total reflectance-Fourier transform infrared (ATR-FTIR) microspectroscopy.

Broad-Spectrum Solvent-free Layered Black Phosphorus as a Rapid Action Antimicrobial.

Antimicrobial resistance has rendered many conventional therapeutic measures, such as antibiotics, ineffective. This makes the treatment of infections from pathogenic micro-organisms a major growing health, social, and economic challenge. Recently, nanomaterials, including two-dimensional (2D) materials, have attracted scientific interest as potential antimicrobial agents.

Diagnosis of colorectal and emergency surgical site infections in the era of enhanced recovery: an all-Wales prospective study.

Aim: Surgical site infections (SSIs) are associated with increased morbidity, hospital stay and cost. The literature reports that 25% of patients who undergo colorectal surgical procedures develop a SSI. Due to the enhanced recovery programme, patients are being discharged earlier with some SSIs presenting in primary care, making accurate recording of SSIs difficult.

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery.

Aim: There is a requirement for an expansive and up to date review of the management of emergency colorectal conditions seen in adults. The primary objective is to provide detailed evidence-based guidelines for the target audience of general and colorectal surgeons who are responsible for an adult population and who practise in Great Britain and Ireland.

Methods: Surgeons who are elected members of the Association of Coloproctology of Great Britain and Ireland Emergency Surgery Subcommittee were invited to contribute various sections to the guidelines.

Management of delirium in a medical and surgical intensive care unit.

What Is Known And Objective: Delirium has been associated with increased mortality and prolonged hospital length of stay among critical care patients. Furthermore, treatment of delirium remains variable amongst clinicians due to limited evidence. The objective of this study was to determine the local incidence of delirium and to characterize the effectiveness and safety of pharmacological therapy used to treat delirium.

Vasopressin for Septic Shock in a Medical-Surgical Intensive Care Unit.

Background: Critically ill patients often need vasopressors to treat hypotension related to septic shock and to maintain adequate systemic perfusion. Although the 2017 guidelines of the Surviving Sepsis Campaign recommend norepinephrine as first-line therapy, they also state that vasopressin may be considered as an adjunctive agent for patients with refractory shock. Limited evidence is available for directing optimal administration of vasopressin.

Significant Enhancement of Antimicrobial Activity in Oxygen-Deficient Zinc Oxide Nanowires.

The fabrication of antimicrobial surfaces that exhibit enhanced activity toward a large variety of microbial species is one of the major challenges of our time. In fact, the negative effects associated with both bacterial and fungal infections are enormous, especially considering that many microbial species are developing resistance to known antibiotics. In this work, we show how a combination of a specific surface morphology and surface chemistry can create a surface that exhibits nearly 100% antimicrobial activity toward both Gram-negative and Gram-positive bacteria and fungal cells.

Second-Scale Coherence Measured at the Quantum Projection Noise Limit with Hundreds of Molecular Ions.

Cold molecules provide an excellent platform for quantum information, cold chemistry, and precision measurement. Certain molecules have enhanced sensitivity to beyond standard model physics, such as the electron's electric dipole moment (eEDM). Molecular ions are easily trappable and are therefore particularly attractive for precision measurements where sensitivity scales with interrogation time.

Psychological sequelae of colonic resections.

Aim: The prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) in the general population has been estimated to be 5.9%, 3.3% and 4.

A spontaneous mutation in DNA polymerase POL3 during in vitro passaging causes a hypermutator phenotype in Cryptococcus species.

Passaging of microbes in vitro can lead to the selection of microevolved derivatives with differing properties to their original parent strains. One well characterised instance is the phenotypic differences observed between the series of strains derived from the type strain of the human pathogenic fungus Cryptococcus neoformans. A second case was reported in the close relative Cryptococcus deneoformans, in which a well-studied isolate ATCC 24067 (52D) altered its phenotypic characteristics after in vitro passaging in different laboratories.

Lighting Up Mutation: a New Unbiased System for the Measurement of Microbial Mutation Rates.

Although mutation drives evolution over long and short terms, measuring and comparing mutation rates accurately have been particularly difficult. This is especially true when mutations lead to an alteration in fitness. E.

Inequalities in health? An update on the effect of social deprivation for patients with breast cancer in South East Wales.

Background: Breast cancer, historically a disease of more affluent women, has increased in incidence for women from areas of greater social deprivation, yet prognosis is worse for these women. This study identifies differences in presentation, treatment and prognostic factors between the socioeconomic groups.

Methods: Patient data obtained from the prospectively maintained Welsh national Cancer Network Information System Cymru, for an 11-year period, were categorised according to Welsh Index of Multiple Deprivation quintiles.