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In the present work we study the effect of unparticle modified static potentials on the energy levels of the hydrogen atom. By using Rayleigh–Schrödinger perturbation theory, we obtain the energy shift of the ground state and compare it with experimental data. Bounds on the unparticle energy scale U as a function of the scaling dimension and the coupling constant λ are derived. We show that there exists a parameter region where bounds on U ar are stringent, signaling that unparticles could be tested in atomic physics experiments.
Several members of the genus Legionella cause Legionnaires’ disease, a potentially debilitating form of pneumonia. Studies frequently focus on the abundant number of virulence factors present in this genus. However, what is often overlooked is the role of secondary metabolites from Legionella. Following whole genome sequencing, we assembled and annotated the Legionella parisiensis DSM 19216 genome. Together with 14 other members of the Legionella, we performed comparative genomics and analysed the secondary metabolite potential of each strain. We found that Legionella contains a huge variety of biosynthetic gene clusters (BGCs) that are potentially making a significant number of novel natural products with undefined function. Surprisingly, only a single Sfp-like phosphopantetheinyl transferase is found in all Legionella strains analyzed that might be responsible for the activation of all carrier proteins in primary (fatty acid biosynthesis) and secondary metabolism (polyketide and non-ribosomal peptide synthesis). Using conserved active site motifs, we predict some novel compounds that are probably involved in cell-cell communication, differing to known communication systems. We identify several gene clusters, which may represent novel signaling mechanisms and demonstrate the natural product potential of Legionella.
Infective endocarditis (IE) is a life-threatening disease that is associated with high morbidity and mortality. Its long-term prognosis strongly depends on a timely and optimized antibiotic treatment. Therefore, identification of the causative pathogen is crucial and currently based on blood cultures followed by characterization and susceptibility testing of the isolate. However, antibiotic treatment starting prior to blood sampling or IE caused by fastidious or intracellular microorganisms may cause negative culture results. Here we investigate the additional diagnostic value of broad-range PCR in combination with direct sequencing on resected heart tissue or swabs in patients with tissue or swab culture-negative IE in a routine clinical setting. Sensitivity, specificity, and positive and negative predictive values of broad-range PCR from diagnostic material in our patients were 33.3%, 76.9%, 90.9%, and 14.3%, respectively. We identified a total of 20 patients (21.5%) with tissue or culture-negative IE who profited by the additional application of broad-range PCR. We conclude that broad-range PCR on resected heart tissue or swabs is an important complementary diagnostic approach. It should be seen as an indispensable new tool for both the therapeutic and diagnostic management of culture-negative IE and we thus propose its possible inclusion in Duke's diagnostic classification scheme.
The gut microbiome is significantly altered in inflammatory bowel diseases, but the basis of these changes is not well understood. We have combined metagenomic and metatranscriptomic profiling of the gut microbiome to assess modifications to both bacterial community structure and transcriptional activity in a mouse model of colitis. By using transcriptomic analysis of colonic tissue and luminal RNA derived from the host, we have also characterised how host transcription relates to the microbial transcriptional response in inflammation. In colitis, increased abundance and transcription of diverse microbial gene families involved in responses to nutrient deprivation, antimicrobial peptide production and oxidative stress support an adaptation of multiple commensal genera to withstand a diverse set of environmental stressors in the inflammatory environment. These data are supported by a transcriptional signature of activated macrophages and granulocytes in the gut lumen during colitis, a signature that includes the transcription of the key antimicrobial genes S100a8 and S100a9 (calprotectin). Genes involved in microbial resistance to oxidative stress, including Dps/ferritin, Fe-dependent peroxidase and glutathione S-transferase were identified as changing to a greater extent at the level of transcription than would be predicted by DNA abundance changes, implicating a role for increased oxygen tension and/or host-derived reactive oxygen species in driving transcriptional changes in commensal microbes.
Microwave sensors in medical environments play a significant role due to the contact-less and non-invasive sensing mechanism to determine dielectric properties of tissue. In this work, a theranostic sensor based on Split Ring Resonators (SRRs) is presented that provides two operation modes to detect and treat tumor cells, exemplary in the liver. For the detection mode, resonance frequency changes due to abnormalities are evaluated, and in the treatment mode, microwave ablation is performed. The planar sensor structure can be integrated into a needle like a surgery tool that evokes challenges concerning size limitations and biocompatibility. To meet the size requirements and provide a reasonable operating frequency, properties of oval shaped SRRs are investigated. By elongating the radius of the SRR in one direction, the resonance frequency can be decreased significantly compared to circular SRR by a factor of two below 12 GHz. In order to validate the detection and treatment characteristics of the sensor, full wave simulations and measurements are examined. Clear resonance shifts are detected for loading the sensor structures with phantoms mimicking healthy and malignant tissue. For treatment mode evaluation, ex vivo beef liver tissue was ablated leading to a lesion zone 1.2 cm × 1 cm × 0.3 cm with a three minute exposure of maximum 2.1 W
Populism is widely thought to be in tension with liberal democracy. This article clarifies what exactly is problematic about populism from a liberal–democratic point of view and goes on to develop normative standards that allow us to distinguish between more and less legitimate forms of populism. The point of this exercise is not to dismiss populism in toto; the article strives for a more subtle result, namely, to show that liberal democracy can accommodate populism provided that the latter conforms to particular discursive norms. What the article calls a ‘liberal ethics of populism’ turns out to be closely bound up with a broader ethics of peoplehood, understood as a way of articulating who ‘the people’ are in a way that is compatible with liberal–democratic principles of political justification. Such an ethics, concludes the article, inevitably has a much wider audience than populist political actors: its addressees are all those who seek legitimately to exercise power in the name of the people.
"Che tempo, che tempo": Geology and Environment in Max Frisch’s 'Der Mensch erscheint im Holozän'
(2016)
Critical readings of Frisch’s Der Mensch erscheint im Holozän [Man in the Holocene] have tended to read its heterogeneous and inter-medial form as a code for the mental disintegration of its protagonist. This paper argues instead that this feature can be seen as a poetological engagement with geological and climatic timescales. Due to its hybrid form, the incorporation of a multiplicity of textual fragments and pictorial representations, the text undermines both conventional definitions of narrative and representations of nature. Holozän’s non-linear structure establishes an aesthetic of slowness that ushers in an awareness of the utterly different time schemes of geological and climatic processes. Furthermore, the importance of the material features, such as an interplay between text and image and the disconnected, paratactical arrangement of sentences mirrors the novel’s focus on natural phenomena. Frisch’s narrative establishes a poetics that tries to reach beyond the confinements of an anthropocentric perspective and thereby subverts the borders between culture and environment.
Cryptochromes are a ubiquitous group of blue-light absorbing flavoproteins that in the mammalian retina have an important role in the circadian clock. In birds, cryptochrome 1a (Cry1a), localized in the UV/violet-sensitive S1 cone photoreceptors, is proposed to be the retinal receptor molecule of the light-dependent magnetic compass. The retinal localization of mammalian Cry1, homologue to avian Cry1a, is unknown and it is open whether mammalian Cry1 is also involved in magnetic field sensing. To constrain the possible role of retinal Cry1, we immunohistochemically analysed 90 mammalian species across 48 families in 16 orders, using an antiserum against the Cry1 C-terminus that in birds labels only the photo-activated conformation. In the Carnivora families Canidae, Mustelidae and Ursidae and in some Primates, Cry1 was consistently labeled in the outer segment of the shortwave-sensitive S1 cones. This finding would be compatible with a magnetoreceptive function of Cry1 in these taxa. In all other taxa, Cry1 was not detected by the antiserum that likely also in mammals labels the photo-activated conformation, although Western blots showed Cry1 in mouse retinal cell nuclei. We speculate that in the mouse and the other negative-tested mammals Cry1 is involved in circadian functions as a non-light-responsive protein.
Objective: Chronically HCV-infected orthotopic liver transplantation (OLT) recipients appear to have improved outcomes when their immunosuppressive regimen includes a mammalian target of rapamycin (mTOR) inhibitor. The mechanism underlying this observation is unknown.
Design: We used virological assays to investigate mTOR signalling on the HCV replication cycle. Furthermore, we analysed HCV RNA levels of 42 HCV-positive transplanted patients treated with an mTOR inhibitor as part of their immunosuppressive regimen.
Results: The mTOR inhibitor rapamycin was found to be a potent inhibitor for HCV RNA replication in Huh-7.5 cells as well as primary human hepatocytes. Half-maximal inhibition was observed at 0.01 µg/mL, a concentration that is in the range of serum levels seen in transplant recipients and does not affect cell proliferation. Early replication cycle steps such as cell entry and RNA translation were not affected. Knockdown of raptor, an essential component of mTORC1, but not rictor, an essential component of mTORC2, inhibited viral RNA replication. In addition, overexpression of raptor led to higher viral RNA replication, demonstrating that mTORC1, but not mTORC2, is required for HCV RNA replication. In 42 HCV-infected liver-transplanted or kidney-transplanted patients who were switched to an mTOR inhibitor, we could verify that mTOR inhibition decreased HCV RNA levels in vivo.
Conclusions: Our data identify mTORC1 as a novel HCV replication factor. These findings suggest an underlying mechanism for the observed benefits of mTOR inhibition in HCV-positive OLT recipients and potentiate further investigation of mTOR-containing regimens in HCV-positive recipients of solid organ transplants.
One of the major challenges of allogeneic stem cell transplantation (allo-SCT) is to reduce the risk of graft-versus-host disease (GVHD) while boosting the graft-versus-leukemia (GVL) effect. The reconstitution of natural killer (NK) cells following allo-SCT is of notable interest due to their known capability to induce GVL without GVHD. Here, in this study, we investigate the association between the incidence and severity of acute graft-versus-host disease (aGVHD) and the early reconstitution of NK cell subsets following allo-SCT. We analyzed 342 samples from 107 patients using flow cytometry, with a focus on immature CD56high and mature cytotoxic CD56dim NK cells. Longitudinal analysis of immune reconstitution after allo-SCT showed that the incidence of aGVHD was associated with a delayed expansion of the entire NK cell population, in particular the CD56high subset. Notably, the disturbed reconstitution of the CD56high NK cells also correlated with the severity of aGVHD.
Following up on earlier investigations, the present research aims at validating the construct impostor phenomenon by taking other personality correlates into account and to examine whether the impostor phenomenon is a construct in its own right. In addition, gender effects as well as associations with dispositional working styles and strain are examined. In an online study we surveyed a sample of N = 242 individuals occupying leadership positions in different sectors. Confirmatory factor analyses provide empirical evidence for the discriminant validity of the impostor phenomenon. In accord with earlier studies we show that the impostor phenomenon is accompanied by higher levels of anxiety, dysphoric moods, emotional instability, a generally negative self-evaluation, and perfectionism. The study does not reveal any gender differences concerning the impostor phenomenon. With respect to working styles, persons with an impostor self-concept tend to show perfectionist as well as procrastinating behaviors. Moreover, they report being more stressed and strained by their work. In sum, the findings show that the impostor phenomenon constitutes a dysfunctional personality style. Practical implications are discussed.
Much is known about when children acquire an understanding of mental states, but few, if any, experiments identify social contexts in which children tend to use this capacity and dispositions that influence its usage. Social exclusion is a common situation that compels us to reconnect with new parties, which may crucially involve attending to those parties’ mental states. Across two studies, this line of inquiry was extended to typically developing preschoolers (Study 1) and young children with and without anxiety disorder (AD) (Study 2). Children played the virtual game of toss “Cyberball” ostensibly over the Internet with two peers who first played fair (inclusion), but eventually threw very few balls to the child (exclusion). Before and after Cyberball, children in both studies completed stories about peer-scenarios. For Study 1, 36 typically developing 5-year-olds were randomly assigned to regular exclusion (for no apparent reason) or accidental exclusion (due to an alleged computer malfunction). Compared to accidental exclusion, regular exclusion led children to portray story-characters more strongly as intentional agents (intentionality), with use of more mental state language (MSL), and more between-character affiliation in post-Cyberball stories. For Study 2, 20 clinically referred 4 to 8-year-olds with AD and 15 age- and gender-matched non-anxious controls completed stories before and after regular exclusion. While we replicated the post regular-exclusion increase of intentional and MSL portrayals of story-characters among non-anxious controls, anxious children exhibited a decline on both dimensions after regular exclusion. We conclude that exclusion typically induces young children to mentalize, enabling more effective reconnection with others. However, excessive anxiety may impair controlled mentalizing, which may, in turn, hamper effective reconnection with others after exclusion.
Understanding a sentence and integrating it into the discourse depends upon the identification of its focus, which, in spoken German, is marked by accentuation. In the case of written language, which lacks explicit cues to accent, readers have to draw on other kinds of information to determine the focus. We study the joint or interactive effects of two kinds of information that have no direct representation in print but have each been shown to be influential in the reader's text comprehension: (i) the (low-level) rhythmic-prosodic structure that is based on the distribution of lexically stressed syllables, and (ii) the (high-level) discourse context that is grounded in the memory of previous linguistic content. Systematically manipulating these factors, we examine the way readers resolve a syntactic ambiguity involving the scopally ambiguous focus operator auch (engl. “too”) in both oral (Experiment 1) and silent reading (Experiment 2). The results of both experiments attest that discourse context and local linguistic rhythm conspire to guide the syntactic and, concomitantly, the focus-structural analysis of ambiguous sentences. We argue that reading comprehension requires the (implicit) assignment of accents according to the focus structure and that, by establishing a prominence profile, the implicit prosodic rhythm directly affects accent assignment.
Background: Prophylactic mesh-augmented reinforcement during closure of abdominal wall incisions has been proposed in patients with increased risk for development of incisional hernias (IHs). As part of the BioMesh consensus project, a systematic literature review has been performed to detect those studies where MAR was performed with a non-permanent absorbable mesh (biological or biosynthetic).
Methods: A computerized search was performed within 12 databases (Embase, Medline, Web-of-Science, Scopus, Cochrane, CINAHL, Pubmed publisher, Lilacs, Scielo, ScienceDirect, ProQuest, Google Scholar) with appropriate search terms. Qualitative evaluation was performed using the MINORS score for cohort studies and the Jadad score for randomized clinical trials (RCTs).
Results: For midline laparotomy incisions and stoma reversal wounds, two RCTs, two case–control studies, and two case series were identified. The studies were very heterogeneous in terms of mesh configuration (cross linked versus non-cross linked), mesh position (intraperitoneal versus retro-muscular versus onlay), surgical indication (gastric bypass versus aortic aneurysm), outcome results (effective versus non-effective). After qualitative assessment, we have to conclude that the level of evidence on the efficacy and safety of biological meshes for prevention of IHs is very low. No comparative studies were found comparing biological mesh with synthetic non-absorbable meshes for the prevention of IHs.
Conclusion: There is no evidence supporting the use of non-permanent absorbable mesh (biological or biosynthetic) for prevention of IHs when closing a laparotomy in high-risk patients or in stoma reversal wounds. There is no evidence that a non-permanent absorbable mesh should be preferred to synthetic non-absorbable mesh, both in clean or clean-contaminated surgery.
This paper reflects on legal pluralism. How did medieval societies incorporate both unwritten customs and written law at the same time? How did they constitute the process of finding justice? What is the essense of legal pluralism, and will it help us understand the situation of Taiwan’s indigenous population?
We aim to solve these problems by taking a closer look at medieval Saxony: for around 400 years, both laws given by the authorities and traditional customs in Saxony worked fine in parallel. The latter were put into writing by the legal practitioner Eike von Repgow around 1230 for reasons unknown. We refer to his collection of laws and customs of the Saxons as the Sachsenspiegel ("Mirror of Saxons").
While Saxons certainly differed from Taiwan’s indigenous population for many reasons, such as the supposedly weaker egalitarianism among the Saxons than among at least some indigenous groups, the two show some remarkable similarities nonetheless. Just like the Taiwanese Gaya, the Sachsenspiegel’s spiritual origin raises the claim to validity. Furthermore, comparing the handling of a person’s sale of inherited property, the legal situations in the Sachsenspiegel and Taiwan’s unwritten customs resemble each other. The heir can transfer only property he acquired personally. Furthermore, the author discusses the different character of courts and procedure under oral law in contrast to written modern law.
Finally, the paper concludes with some remarks about a learned commentary on the Sachsenspiegel written around 1325, combined with an outlook on the possible future of Taiwanese customs.
Circulation of legal knowledge, ideas, norms and practices has taken place throughout legal history, shaping legal experiences in different corners of the world. Over the past couple of years, approaches to the study of such circulations have changed radically. Legal historians have adopted approaches from cultural studies and transnational history in order to gain a deeper understanding of the complexities inherent in these processes. ...
The graph theoretical analysis of structural magnetic resonance imaging (MRI) data has received a great deal of interest in recent years to characterize the organizational principles of brain networks and their alterations in psychiatric disorders, such as schizophrenia. However, the characterization of networks in clinical populations can be challenging, since the comparison of connectivity between groups is influenced by several factors, such as the overall number of connections and the structural abnormalities of the seed regions. To overcome these limitations, the current study employed the whole-brain analysis of connectional fingerprints in diffusion tensor imaging data obtained at 3 T of chronic schizophrenia patients (n = 16) and healthy, age-matched control participants (n = 17). Probabilistic tractography was performed to quantify the connectivity of 110 brain areas. The connectional fingerprint of a brain area represents the set of relative connection probabilities to all its target areas and is, hence, less affected by overall white and gray matter changes than absolute connectivity measures. After detecting brain regions with abnormal connectional fingerprints through similarity measures, we tested each of its relative connection probability between groups. We found altered connectional fingerprints in schizophrenia patients consistent with a dysconnectivity syndrome. While the medial frontal gyrus showed only reduced connectivity, the connectional fingerprints of the inferior frontal gyrus and the putamen mainly contained relatively increased connection probabilities to areas in the frontal, limbic, and subcortical areas. These findings are in line with previous studies that reported abnormalities in striatal–frontal circuits in the pathophysiology of schizophrenia, highlighting the potential utility of connectional fingerprints for the analysis of anatomical networks in the disorder.
Chronic or repeated stress, particularly psychosocial stress, is an acknowledged risk factor for numerous affective and somatic disorders in modern societies. Thus, there is substantial evidence showing that chronic stress can increase the likelihood of major depressive disorder and anxiety disorders, as well as cardiovascular diseases, irritable bowel syndrome and pain syndromes, to name but a few, in vulnerable individuals. Although a number of pharmacological agents are available to treat such stress-related disorders, many patients do not respond to them, and those who do often report a number of side effects. ...
This article compares the legislation promulgated by the Synod of Granada (1572) and the Third Mexican Provincial Council (1585) regarding procedural canonical law. Diego Romano, bishop of Puebla, served as a vehicle between the Spanish and Mexican Assemblies, and he was clearly inspired by the former when drafting the latter. The article pays attention to the level of appropriation and via a comparison of the texts addresses the question whether it is possible to say that Iberian procedural law was copied by the prelate.
Atmospheric aerosols and their effect on clouds are thought to be important for anthropogenic radiative forcing of the climate, yet remain poorly understood1. Globally, around half of cloud condensation nuclei originate from nucleation of atmospheric vapours2. It is thought that sulfuric acid is essential to initiate most particle formation in the atmosphere3,4, and that ions have a relatively minor role5. Some laboratory studies, however, have reported organic particle formation without the intentional addition of sulfuric acid, although contamination could not be excluded6,7. Here we present evidence for the formation of aerosol particles from highly oxidized biogenic vapours in the absence of sulfuric acid in a large chamber under atmospheric conditions. The highly oxygenated molecules (HOMs) are produced by ozonolysis of α-pinene. We find that ions from Galactic cosmic rays increase the nucleation rate by one to two orders of magnitude compared with neutral nucleation. Our experimental findings are supported by quantum chemical calculations of the cluster binding energies of representative HOMs. Ion-induced nucleation of pure organic particles constitutes a potentially widespread source of aerosol particles in terrestrial environments with low sulfuric acid pollution.
Cross education is the process whereby training of one limb gives rise to increases in the subsequent performance of its opposite counterpart. The execution of many unilateral tasks is associated with increased excitability of corticospinal projections from primary motor cortex (M1) to the opposite limb. It has been proposed that these effects are causally related. Our aim was to establish whether changes in corticospinal excitability (CSE) arising from prior training of the opposite limb determine levels of interlimb transfer. We used three vision conditions shown previously to modulate the excitability of corticospinal projections to the inactive (right) limb during wrist flexion movements performed by the training (left) limb. These were: (1) mirrored visual feedback of the training limb; (2) no visual feedback of either limb; and (3) visual feedback of the inactive limb. Training comprised 300 discrete, ballistic wrist flexion movements executed as rapidly as possible. Performance of the right limb on the same task was assessed prior to, at the mid point of, and following left limb training. There was no evidence that variations in the excitability of corticospinal projections (assessed by transcranial magnetic stimulation (TMS)) to the inactive limb were associated with, or predictive of, the extent of interlimb transfer that was expressed. There were however associations between alterations in muscle activation dynamics observed for the untrained limb, and the degree of positive transfer that arose from training of the opposite limb. The results suggest that the acute adaptations that mediate the bilateral performance gains realized through unilateral practice of this ballistic wrist flexion task are mediated by neural elements other than those within M1 that are recruited at rest by single-pulse TMS.
Thomas Reedy (1842-1929), gardener from 1854-1926 at Camden Park, the family estate of the Macarthurs in western Sydney was sent by Sir William Macarthur on the Chevert Expedition to New Guinea in 1875. He collected plants on islands off the Queensland coast; Cape Grenville; around the Somerset outpost on the tip of Cape York; on islands in the Torres Strait; and around two locations on the mainland of southern Papua New Guinea. Reedy sent or brought back 800-1000 living plants, in addition to an unknown number of seeds, and at least 157 dried specimens, the latter sent to Baron Ferdinand von Mueller in Melbourne. This study is focused on locating the dried plant specimens now held in herbaria and highlighting their significance.
Reedy is something of an enigma with little ever written about him. His initial has been presented erroneously since 1875 and has gone through various morphs including J, P, M and T; searches for Reedy best use all these initials or
just his family name.
Melichrus urceolatus R.Br. (family Ericaceae) (Urn heath) is a small shrub endemic to eastern Australia found in open grassy woodlands and heath from southern Queensland to central Victoria. Very little is known of its ecology, particularly in relation to its pollination and reproductive strategies. Most Melichrus species are thought to be animal-pollinated, but some floral traits of Melichrus urceolatus suggest wind pollination. Here, I describe an observation of parasitic wasps (Diapriidae sp.) found inside Melichrus urceolatus flowers in a Box-Gum Grassy Woodland remnant in Albury, New South Wales and discuss the ecological significance of the observation.
A survey of the population of the parasitic herb Thesium australe R.Br. (family Santalaceae) in Booroolong Nature Reserve, northwest of Armidale, found it was restricted to an eastern facing lower slope on metasediments, within regenerating grassy woodland of Eucalyptus nova-anglica H.Deane & Maiden (New England Peppermint) and a predominantly Themeda triandra Forssk. (Kangaroo Grass) and Sorghum leiocladum (Hack.) C.E.Hubb. (Native Sorghum) understorey. The population is in two clusters over a total area approximately 260 m long by 40 m wide and was estimated to be about 800 individuals at the time of survey (May 2014). Current threats include a maintenance trail, erosion of creek bank, stray cattle and sheep, rabbits and Rubus anglocandicans A.Newton (Blackberry) invasion. It is recommended that further searches be conducted and that monitoring occur on a regular basis using the permanently marked sites and methodology used in this survey.
Naree and Yantabulla stations (31,990 ha) are found 60 km south-east of Hungerford and 112 km north-west of Bourke, New South Wales (lat. 29° 55'S; long. 150°37'N). The properties occur on the Cuttaburra Creek within the Mulga Lands Bioregion. We describe the vegetation assemblages found on these properties within three hierarchical levels (Group, Alliance & Association). Vegetation levels are defined based on flexible UPGMA analysis of coverabundance scores of all vascular plant taxa. These vegetation units are mapped based on extensive ground truthing, SPOT5 imagery interpretation and substrate. Three ‘Group’ level vegetation types are described: Mulga Complex, Shrublands Complex and Floodplain Wetlands Complex. Within these Groups nine ‘Alliances’ are described: Rat’s tail Couch – Lovegrass Grasslands, Canegrass Grasslands, Lignum – Glinus Shrublands, Coolibah – Black Box Woodlands, Turpentine – Button Grass – Windmill Grass Shrublands, Turpentine – Hop Bush – Kerosene Grass shrublands and Mulga Shrublands. Sixteen ‘Associations’ are described 1) Mulga – Poplar Box Shrubland, 2) Mulga – Poplar Box – Bastard Mulga Shrubland, 3) Turpentine – Hop Bush – Senna Shrubland, 4) Turpentine – Elegant Wattle – Boobialla Shrubland, 5) Turpentine – Hop Bush – Daisy Bush Shrubland, 5) Belah – Rosewood – Turpentine Bush Shrubland, 6) Belah – Rosewood – Turpentine Bush Shrubland, 7) Ironwood – Leopardwood – Supplejack Shrubland, 8) Yapunyah – Black Box – River Cooba Woodland, 9) Coolibah – River Cooba – Yapunyah Woodland, 10) Rat’s tail Couch – Lovegrass – Fairy Grass Grassland and Herbfield, 11) Rat’s tail Couch – Lovegrass – Purslane Grassland and Herbfield, 12) Darling Pratia – Rat’s tail Couch – Spike Rush Herbfield, 13) Canegrass Grassland, 14) Glinus – Groundsel – Lignum Herbfield, 15) Poplar Box – Mulga – Coolibah Woodland and 16) Black Box Woodland. In total 355 vascular plant taxa were found of which 6% were considered exotic in origin. A population of Dentella minutissima; a species listed as threatened (endangered) under the New South Wales Threatened Species Conservation Act 1995 was found. A summary of select structural and habitat attributes within Alliances is also presented.
The shrub Nematolepis ovatifolia (F. Muell.) Paul G. Wilson (family Rutaceae) is endemic to the alpine and subalpine areas of the Snowy Mountains, Australia, where it dominates large areas of heath. Mass dieback was observed in the spring/summer of 2012. Damage at first was confined to the tips of branches, a symptom that could be due to frost damage and/or pathogen-induced water stress. Subsequently, whole stems and shrubs died and new areas of chlorosis appeared on smaller shrubs. Surveys of 186 sites covering the geographical range of the shrub in the summers of 2013/14 and 2014/15 found that 59 populations were definitely dieback affected, 92 had early symptoms and 35 were healthy. Two possible causes were investigated: killing frost and pathogens, with insect attack being a further cause of defoliation. The root rot pathogen, Phytophthora cambivora was isolated from one washed root sample and from one of five soil/ root samples. In 2014/15, in five sites where symptomatic plants were monitored, most plants recovered to a condition where they were considered unaffected in March 2015. It is possible that symptomatic plants had in fact suffered frost damage. Hence populations with early symptoms were grouped with healthy populations for analysis of proximity to trails. Compared with these, dieback affected populations were significantly closer to trails. It could not be determined when the pathogen was introduced, as it could have been imported on earthmoving equipment or by subsequent users of trails. It was apparently well spread before spring of 2012 but infection of plants was not evident. Its sudden eruption in spring of 2012 may have been facilitated by two warm and wet La Nina years, with mean growing season soil temperature up to 1.5°C higher than the long term mean and growing season rainfall double the long term mean. Plant death occurred in the hottest year on record in Australia, with the average alpine treeline growing season soil temperature of 9.2°C in 2012/13 being >2.0°C above the long term mean.
The recently described shrub Epacris browniae (family Ericaceae) an endemic Blue Mountains species, occurs on treeless, dry, rocky, Sydney Montane Heath, on Narrabeen and Hawkesbury Sandstone in the upper Blue Mountains, 100 km west of Sydney, New South Wales, (c. 33° 40' S; 150° 22' E) at altitudes above 800 m, and within the 1300 mm Average Annual Rainfall isohyet. Based on our surveys in the Blue Mountains (incorporating 46 locations), the Area of Occurrence of the species is estimated at 525 square km, within which the Area of Occupation is 25 hectares. The northern limit is Mt Wilson, southern limit, Mt Solitary, western limit appears to lie between Clarence and Narrow Neck (Katoomba) and eastern limit is Lawson Ridge.
The species grows either on flat terrain or on gentle southern or western slopes, sometimes blending into escarpment complex, on soils of moderate acidity (pH 6.5–6.8) and good drainage, associated most commonly with Banksia ericifolia and, in descending order of abundance, with Leptospermum trinervium, Allocasuarina distyla, Kunzea capitata, Allocasuarina nana and Hakea dactyloides.
Epacris browniae flowers in November and seeds ripen in March. Seeds are shiny, brown, minutely warty, about 0.6 mm long, and weigh 0.038 mg.
Epacris browniae does not resprout after fire. Average stem diameters at three sites with known single fire histories correlate strongly with likely maximum age and confirm that the species is a facultative reseeder with a potential lifespan of up to 50 years.
Despite its relatively narrow habitat and area of occupancy Epacris browniae is well conserved within National Parks in the Blue Mountains but its susceptibility to Phytophthora, an exotic pathogen in the Blue Mountains is unknown.
Along with barley and rice, maize provides staple food for more than half of the world population. Maize ears are regularly infected with fungal pathogens of the Fusarium genus, which, besides reducing yield, also taint grains with toxic metabolites. In an earlier work, we have shown that maize ears infection with single Fusarium strains was detectable through volatile sensing. In nature, infection most commonly occurs with more than a single fungal strain; hence we tested how the interactions of two strains would modulate volatile emission from infected ears. For this purpose, ears of a hybrid and a dwarf maize variety were simultaneously infected with different strains of Fusarium graminearum and F. verticillioides and, the resulting volatile profiles were compared to the ones of ears infected with single strains. Disease severity, fungal biomass, and the concentration of the oxylipin 9-hydroxy octadecadienoic acid, a signaling molecule involved in plant defense, were monitored and correlated to volatile profiles. Our results demonstrate that in simultaneous infections of hybrid and dwarf maize, the most competitive fungal strains had the largest influence on the volatile profile of infected ears. In both concurrent and single inoculations, volatile profiles reflected disease severity. Additionally, the data further indicate that dwarf maize and hybrid maize might emit common (i.e., sesquiterpenoids) and specific markers upon fungal infection. Overall this suggests that volatile profiles might be a good proxy for disease severity regardless of the fungal competition taking place in maize ears. With the appropriate sensitivity and reliability, volatile sensing thus appears as a promising tool for detecting fungal infection of maize ears under field conditions.
This article analyzes how cultural translation was carried out in Manuel Quintín Lame’s interpretation of Law 89 of 1980 during the indigenous revolt that took place in Tierradentro – Cauca (Colombia) between 1914 and 1916: riots that were popularly referred to as La Quintiada. The main focus here is on Lame and his contemporaries’ visions of justice regarding the possession of the land as a way to account for the richness and complexity of the »cultural baggage« behind legal transfer processes. The purpose of this exercise is to detail the extrajuridical elements involved in legal transfers and the opportunities that a cultural translation of law approach can bring in order to understand this process.
Hunter Valley Weeping Myall Woodland is listed as a Critically Endangered Ecological Community (CEEC) under both the New South Wales Threatened Species Conservation (TSC) Act 1995 and the Commonwealth Environment Protection and Biodiversity Conservation (EPBC) Act 1999. Uncertainty regarding the provenance of Weeping Myall (Acacia pendula) in the Hunter has led to questioning of the place of Hunter Valley Weeping Myall Woodland CEEC in State and Commonwealth legislation. A recent publication has endorsed its legislative listing, largely based on the co-association of Weeping Myall with a range of other semi-arid species in some parts of the Hunter Valley. We counter this argument and show that the semi-arid species present in low rainfall areas on Permian sediments of the Hunter Valley floor are in fact more widespread than previously documented. Through examination of distributional records, we demonstrate that these species display no fidelity to purported Hunter Valley Weeping Myall Woodland, but instead occur in a range of other vegetation communities across much of the central and upper Hunter Valley. Habitat suitability modelling undertaken for Acacia pendula shows there to be nearly 900 times the 200 ha of pre-European extent, or 20 times the area of occupancy previously estimated for this community. We also revisit an earlier ordination analysis which showed a divergence in sample data potentially representative of Hunter Valley Weeping Myall Woodland. We add new samples and provide a revised classification of the purported community, which shows that sample plots from two forms of Hunter Valley Weeping Myall Woodland are floristically indistinguishable from comparative data in 20-25 year old mining rehabilitation forests of Eucalyptus cladocalyx, and native grasslands derived predominantly from landscapes of Eucalyptus crebra and Eucalyptus moluccana. Relevant legislation requires any threatened community to be identifiable based on a particular species assemblage and its area of occupancy. We question whether Hunter Valley Weeping Myall Woodland is recognisable with and without the presence of Acacia pendula. We argue that the identification of Hunter Valley Weeping Myall Woodland is unachievable without the visual cue of Acacia pendula, and note that for some time regional botanists have used this species’ presence as a de facto diagnostic tool to identify this community; in fact, there are no examples of the community having been identified as such in the absence of Acacia pendula. Finally, following from our ordination results, and the presence of key diagnostic species within more widespread grassy woodlands and derived native grasslands, we suggest that 200 years of anthropogenic disturbance across the Hunter Valley has sufficiently masked any distributional pattern of western semi-arid species that might have once occurred. We contend that there is little value in conserving a purported community that cannot be confidently delineated in numerical classifications, lacks a consistent and diagnostic suite of characteristic species, and for which there is uncertainty over the origins of its dominant, flagship species, Acacia pendula.
Social law is an important cornerstone of the normative constitution of the modern state, if not one the most important. The stability of market-based societies in the current era primarily resulted from both the existence of legally guaranteed provisions against the risks of life and the legal mechanisms that make the social inequalities bearable – or, at the very least, that ensure a minimum standard of living and prevent those affected from being completely excluded from social participation. Social law is, however, not just a stabilizing element for democratically constituted market societies in a normal situation. Over the course of the 20th century, it was also used to great effect by dictatorial and authoritarian regimes as a means of securing power, and it was employed more often in times of war and crisis in order to keep peace within the state, to attenuate or pacify fragile social situations, not to mention to generate social consensus. Throughout all the ups and downs of recent history, social law has remained a key element involved in the shaping of society. ...
If a report on state and perspectives of the history of social law is to be written, two problems involving demarcation have to be dealt with in advance. 1. What is social law? 2. What kind of literature has to be considered as a part of the history of social law? In both cases the boundaries can definitely be drawn in a subjective manner and can be oriented towards the interests and competences of the author insofar as the criteria are plausible. ...
This article examines the reflections on legal translation set out in two Relaciones written by the 16th century Spanish jurist Alonso de Zorita. These serve as excellent illustrations for the creative dimension motivating several of the proposals for the adaptation of Castilian law to native legal custom in the Americas. My analysis focuses on some of the linguistic issues implied by Zorita’s proposal for the restoration of an idealized pre-Hispanic polity: the use of the native pictorial legal sources, and it considers some of the issues and dilemmas related to their proper interpretation and translation.
Purpose. To introduce additional methods to detect and to quantify single pathogens in the complex biofilm formation on an antibacterial dental material.
Materials and Methods. A conventional (ST) and an antibacterial dental composite (B) were manufactured. In vitro: specimens were incubated with a mixture of early colonizers. Bacterial adhesion was analyzed by TaqMan PCR after 8/24 h. In situ: TaqMan PCR and 16S rRNA Next Generation Sequencing (NGS) were performed.
Results. In vitro: after 8 h incubation, B was covered by 58.6% of the bacterial amount that was attached to ST. After 24 h, the amount of attached bacteria to ST remained constant on ST only slightly lower on B. In situ: after 8 h the amount of adhering A. viscosus and S. mitis was prominent on ST and reduced on B. NGS revealed that S. sanguinis, S. parasanguinis, and Gemella sanguinis were the mainly attached species with S. sanguinis dominant on ST and S. parasanguinis and G. sanguinis dominant on B.
Conclusions. Initial biofilm formation was altered by B. A shift between actinomycetes and streptococci was observed in situ. TaqMan PCR and 16S rRNA NGS revealed comparable results in situ and demonstrated the usefulness of NGS to characterize complex bacterial communities.
Nuclear factor of activated T-cells (NFAT) and NF-kB pathway associated processes are involved in the pathogenesis of various inflammatory disorders, for example, periodontal disease. The activation of these pathways is controlled by the regulator of calcineurin 1 (RCAN1). The aim of this study was to elucidate the role of RCAN1 in periodontal disease. Healthy and inflamed periodontal tissues were analyzed by immunohistochemistry and immunofluorescence using specific rabbit polyclonal anti-RCAN1 antibodies. For expression analysis human umbilical vein endothelial cells (HUVEC) were used. HUVEC were incubated for 2 h with Vascular Endothelial Growth Factor (VEGF) or with wild type and laboratory strains of Porphyromonas gingivalis (P. gingivalis). Expression analysis of rcan1 and cox2 was done by real time PCR using specific primers for rcan1.4 and cox2. The expression of rcan1 was found to be significantly suppressed in endothelial cells of chronically inflamed periodontal tissues compared to healthy controls. Rcan1 and cox2 were significantly induced by VEGF and wild type and laboratory P. gingivalis strains. Interestingly, the magnitude of the rcan1 and cox2 induction was strain dependent. The results of this study indicate that RCAN1 is suppressed in endothelial cells of chronically inflamed periodontal tissues. During an acute infection, however, rcan1 seems to be upregulated in endothelial cells, indicating a modulating role in immune homeostasis of periodontal tissues.
Atrial fibrillation (AF) is one of the most common arrhythmias in adults and is associated with a high incidence of stroke and heart failure (HF). Despite the advance of AF catheter ablation during the past decades, the high reoccurrence rate of AF after catheter ablation urges improvements of diagnostic approaches, therapies, and technologies. P. D. Dallaglio et al. reviewed the role of adenosine in pulmonary vein isolation in a meta-analysis of 11 studies. The analysis revealed that adenosine is useful to unmask dormant connection (DC) after a first ablation procedure and further ablation at sites of DC would reduce the rate of redo procedures for postablation AF recurrence. The authors also suggested that the use of adenosine should be accompanied by sufficient waiting time. ...
Hereditary Parkinson’s disease can be triggered by an autosomal dominant overdose of alpha-Synuclein (SNCA) or the autosomal recessive deficiency of PINK1. We recently showed that the combination of PINK1-knockout with overexpression of A53T-SNCA in double mutant (DM) mice potentiates phenotypes and reduces survival. Now we studied brain hemispheres of DM mice at age of 18 months in a hypothesis-free approach, employing a quantitative label-free global proteomic mass spectrometry scan of posttranslational modifications focusing on methyl-arginine. The strongest effects were documented for the adhesion modulator CMAS, the mRNA decapping/deadenylation factor PATL1, and the synaptic plasticity mediator CRTC1/TORC1. In addition, an intriguing effect was observed for the splicing factor PSF/SFPQ, known to interact with the dopaminergic differentiation factor NURR1 as well as with DJ-1, the protein responsible for the autosomal recessive PARK7 variant of PD. CRTC1, PSF, and DJ-1 are modulators of PGC1alpha and of mitochondrial biogenesis. This pathway was further stressed by dysregulations of oxygen sensor EGLN3 and of nuclear TMPO. PSF and TMPO cooperate with dopaminergic differentiation factors LMX1B and NURR1. Further dysregulations concerned PRR18, TRIO, HNRNPA1, DMWD, WAVE1, ILDR2, DBNDD1, and NFM. Thus, we report selective novel endogenous stress responses in brain, which highlight early dysregulations of mitochondrial homeostasis and midbrain vulnerability.
West African Savanna ecosystems are undergoing severe changes in their vegetation composition due to the impact of human land use and changes in climatic conditions. This study aims to examine the effect of climate, land use, and their interaction on species richness and composition of West African herbaceous vegetation. Plot based vegetation sampling was done in Burkina Faso. Specific richness and diversity indices were used to determine the effect of land use, climate, and their interaction. An importance value was computed to determine herbaceous species dominating the communities. Frequency of species is used to examine their distribution pattern. The results showed that climate significantly influenced herbaceous specific richness more than land use. However, land use had a significant effect on herbaceous vegetation composition. Herbaceous species diversity changed with environmental conditions. The floristic composition of dominant species is driven by both climate and land use. The frequency of distribution demonstrated that herbaceous species occurrences were more influenced by the mixed effect of climate and land use than their separate effects. Occasional and rare species are the most important part of herbaceous vegetation. Thus heterogeneity of Savanna ecosystem and vulnerability of herbaceous species are high.
The paper titled "Cure of Chronic Viral Infection and Virus-Induced Type 1 Diabetes by Neutralizing Antibodies" has been retracted as it was found that the paper was unintentionally published twice by the journal’s former publisher. The version of record of this paper is available at http://dx.doi.org/10.1080/17402520600800721.
Evading innate immunity is a prerequisite for pathogenic microorganisms in order to survive in their respective hosts. Concerning Lyme disease spirochetes belonging to the Borrelia (B.) burgdorferi sensu lato group, a broad range of diverse vertebrates serve as reservoir or even as incidental hosts, including humans. The capability to infect multiple hosts implies that spirochetes have developed sophisticated means to counter the destructive effects of complement of humans and various animals. While the means by which spirochetes overcome the hosts immune defense are far from being completely understood, there is a growing body of evidence suggesting that binding of the key regulator of the alternative pathway, Factor H, plays a pivotal role for immune evasion and that Factor H is an important determinant of host specificity. This review covers (i) the contribution of complement in host-specificity and transmissibility of Lyme disease spirochetes; (ii) the involvement of borrelial-derived determinants to host specificity; (iii) the interplay of human and animal Factor H with complement-acquiring surface proteins of diverse borrelial species; and (iv) the potential role of additional animal complement proteins in the immune evasion of spirochetes.
Background: This study evaluated the effects of a combined innovative training regime consisting of stochastic resonance whole-body vibration (SR-WBV) and a dance video game (DVG) on physical performance and muscle strength in long-term-care dwelling elderly.
Methods: Thirthy long-term-care elderly were randomly allocated to an intervention group (IG; n = 16) receiving combined SR-WBV training and DVG, or a sham group (SG; n = 14). IG performed five sets one minute of SR-WBV, with one minute rest between sets (base frequency 3 Hz up to 6 Hz, Noise 4) during the first five weeks on three days per week. From week five to eight a DVG was added to SR-WBV for IG on three days per week. SG performed a five-set SR-WBV program (1 Hz, Noise 1) lasting five times one minute, with one minute rest in between, three days a week. From week five to eight stepping exercises on a trampoline were added on three days per week. Primary outcome: Short physical performance battery (SPPB). Secondary outcome: isometric maximal voluntary contraction (IMVC), and sub phases of IMVC (Fsub), isometric rate of force development (IRFD) and sub time phases of IRFD (IRFDsub) were measured at baseline, after four and eight weeks. ANOVA with repeated measures was used for analyses of time and interaction effects and MANOVA determined between group intervention effects.
Results: Between group effects revealed significant effects on the SPPB primary outcome after four weeks F(1, 27) = 6.17; p = 0.02) and after eight weeks F(1,27) = 11.8; p = 0.002). Secondary muscle function related outcome showed significant between group effects in IG on IRFD, Fsub 30 ms, 100 ms, 200 ms and IRFDsub 0-30 ms, 0-50 ms, 0-100 ms and 100-200 ms compared to SG (all p < 0.05).
Conclusions: Eight weeks SR-WBV and DVG intervention improved lower extremity physical function and muscle strength compared to a sham intervention in long-term-care elderly. SR-WBV and DVG seems to be effective as a training regime for skilling up in long-term-care elderly.
Interaction of gold nanoparticles (AuNPs) in the vicinity of cells’ membrane with a pulsed laser (λ = 532 nm, τ = 1 ns) leads to perforation of the cell membrane, thereby allowing extracellular molecules to diffuse into the cell. The objective of this study was to develop an experimental setting to deliver molecules into primary human gingival fibroblasts (pHFIB-G) by using ns-laser pulses interacting with AuNPs (study group). To compare the parameters required for manipulation of pHFIB-G with those needed for cell lines, a canine pleomorphic adenoma cell line (ZMTH3) was used (control group). Non-laser-treated cells incubated with AuNPs and the delivery molecules served as negative control. Laser irradiation (up to 35 mJ/cm2) resulted in a significant proportion of manipulated fibroblasts (up to 85%, compared to non-irradiated cells: p < 0.05), while cell viability (97%) was not reduced significantly. pHFIB-G were perforated as efficiently as ZMTH3. No significant decrease of metabolic cell activity was observed up to 72 h after laser treatment. The fibroblasts took up dextrans with molecular weights up to 500 kDa. Interaction of AuNPs and a pulsed laser beam yields a spatially selective technique for manipulation of even primary cells such as pHFIB-G in high throughput.
The mitotic spindle assembly checkpoint (SAC) maintains genome stability and marks an important target for antineoplastic therapies. However, it has remained unclear how cells execute cell fate decisions under conditions of SAC‐induced mitotic arrest. Here, we identify USP9X as the mitotic deubiquitinase of the X‐linked inhibitor of apoptosis protein (XIAP) and demonstrate that deubiquitylation and stabilization of XIAP by USP9X lead to increased resistance toward mitotic spindle poisons. We find that primary human aggressive B‐cell lymphoma samples exhibit high USP9X expression that correlate with XIAP overexpression. We show that high USP9X/XIAP expression is associated with shorter event‐free survival in patients treated with spindle poison‐containing chemotherapy. Accordingly, aggressive B‐cell lymphoma lines with USP9X and associated XIAP overexpression exhibit increased chemoresistance, reversed by specific inhibition of either USP9X or XIAP. Moreover, knockdown of USP9X or XIAP significantly delays lymphoma development and increases sensitivity to spindle poisons in a murine Eμ‐Myc lymphoma model. Together, we specify the USP9X–XIAP axis as a regulator of the mitotic cell fate decision and propose that USP9X and XIAP are potential prognostic biomarkers and therapeutic targets in aggressive B‐cell lymphoma.
The excellent results of dispersion‐corrected density functional theory (DFT‐D) calculations for static systems have been well established over the past decade. The introduction of dynamics into DFT‐D calculations is a target, especially for the field of molecular NMR crystallography. Four 13C ss‐NMR calibration compounds are investigated by single‐crystal X‐ray diffraction, molecular dynamics and DFT‐D calculations. The crystal structure of 3‐methylglutaric acid is reported. The rotator phases of adamantane and hexamethylbenzene at room temperature are successfully reproduced in the molecular dynamics simulations. The calculated 13C chemical shifts of these compounds are in excellent agreement with experiment, with a root‐mean‐square deviation of 2.0 ppm. It is confirmed that a combination of classical molecular dynamics and DFT‐D chemical shift calculation improves the accuracy of calculated chemical shifts.
Background: Neurotoxic envenomation following bites by kraits (Bungarus species) is a leading cause of snakebite mortality in South Asia. Over a long time, this had been attributed only to one species, the common krait (Bungarus caeruleus). However, recent research has provided increasing evidence of the involvement of several krait species. Here, we report a fatal case of neurotoxic envenomation following the bite of a greater black krait (Bungarus niger) in Nepal.
Case presentation: A 33-year-old man was bitten in the outdoor corridor of his home in the eastern hills of Ilam district while handling a snake he thought to be non-venomous. He subsequently developed severe abdominal pain, frequent vomiting, and signs of neurotoxic envenomation leading to respiratory paralysis. The patient did not respond to Indian polyvalent antivenom given 4 h after the bite and died under treatment 8 h after the bite. This is the second time that a B. niger was observed in Nepal, the first documented case of envenomation by this species in the country and the sixth reported case worldwide.
Conclusions: Previous distribution records – from eastern India and western Nepal, from western hills in Nepal, and from lowland localities in India and Bangladesh – indicate risk of envenomation by B. niger throughout the low and intermediate elevations of Nepal up to at least 1,500 m above sea level. As very few people in Nepal bring killed snakes to healthcare centers and because there is a general belief among local people that there are no kraits in the hills, bites by B. niger are likely to be misdiagnosed and underreported.
Altitude training and respiratory muscle training (RMT) have been reported to improve performance in elite and well-trained athletes. Several devices (altitude and RMT) have been developed to help athletes gain the competitive edge. The Elevation Training Mask 2.0 (ETM) purportedly simulates altitude training and has been suggested to increase aerobic capacity (VO2max), endurance performance, and lung function. Twenty-four moderately trained subjects completed 6 weeks of high-intensity cycle ergometer training. Subjects were randomized into a mask (n = 12) or control (n = 12) group. Pre and post-training tests included VO2max, pulmonary function, maximal inspiration pressure, hemoglobin and hematocrit. No significant differences were found in pulmonary function or hematological variables between or within groups. There was a significant improvement in VO2max and PPO in both the control (13.5% and 9.9%) and mask (16.5% and 13.6%) groups. There was no difference in the magnitude of improvement between groups. Only the mask group had significant improvements in ventilatory threshold (VT) (13.9%), power output (PO) at VT (19.3%), respiratory compensation threshold (RCT) (10.2%), and PO at RCT (16.4%) from pre to post-testing. The trends for improvements in VT and PO at VT between groups were similar to improvements in RCT and PO at RCT, but did not reach statistical significance (VT p = 0.06, PO at VT p = 0.170). Wearing the ETM while participating in a 6-week high-intensity cycle ergometer training program does not appear to act as a simulator of altitude, but more like a respiratory muscle training device. Wearing the ETM may improve specific markers of endurance performance beyond the improvements seen with interval training alone.
Background: Multidrug-resistant Gram-negative bacteria (MRGN) and the infections they cause are a serious threat and a challenge to the healthcare system. This particularly applies to carbapenem-resistant Gram-negative bacteria (CRGN). Currently, the introduction of a nationwide mandatory notification system for CRGN in Germany is under consideration. Against this background, this paper presents an analysis of the mandatory reporting system for CRGN in effect since November 2011 in the federal state of Hesse (Germany).
Materials and methods: All carbapenem-resistant Gram-negative bacteria and the detected carbapenemases reported to the public health department of the city of Frankfurt am Main, Hesse, Germany, on the basis of the mandatory notification system were analyzed.
Results: 827 CRGN cases were reported to the public health department of Frankfurt/Main between April 2012 and December 2015. The following bacterial species were reported: Pseudomonas spp. (n=268), Acinetobacter spp. (n=183), Klebsiella spp. (n=195), Enterobacter spp. (n=77), Escherichia coli (n=75) and others (n=29). Between 2012 and 2015, a reduction of the CRGN reports was noticed, mainly due to changes in the reporting of Pseudomonas spp. Between 2012 and 2015, the total number of notifications decreased slightly, although the number of reported CRGN in screening samples increased, thus giving no indication of a decreased testing frequency. For 10.5% of the patients, the place of residence was not Germany, 18.0% of the patients had previously stayed in hospitals abroad, often in countries with a high CRGN prevalence. CRGN bacteria were reported from all of Frankfurt’s hospitals, and 3.9% were reported from out-patient care facilities. Carbapenemases were detected and reported in 251 CRGN bacteria, including 73 OXA-48, 76 OXA-23, 56 NDM subtypes, and 21 KPC subtypes. There have been no major epidemiological signs of outbreak scenarios.
Discussion: CRGN bacteria are already widespread in patients from hospitals and out-patient care facilities. Clearly, infection control measurements should therefore not only include hospital patients but also those receiving out-patient care. Screening strategies focused on patients from foreign countries with high MRGN prevalence is not sufficient, as only 10.5% of MRGN patients resided in those countries, and only 18% of the patients had been previously treated in a foreign hospital. In a public health context, infection control measures should therefore encompass broader screening strategies.