Abundance of Colistin-Resistance Genes in Retail Meats in Vietnam.

The degree of contamination of retail meat with colistin-resistant bacteria and its potential contribution to dissemination within communities remains to be determined. Thus, we aimed to elucidate the contamination status of colistin-resistance genes, indicative of colistin-resistant bacteria, in retail meats in Vietnam. In total, 46 chicken and 49 pork meats from stores in Vietnam and Japan were examined. Multiplex real-time polymerase chain reaction with TaqMan probes was performed for detecting mcr-1, mcr-3, and Escherichia coli 16S rRNA. Colistin-resistant bacteria in meats were isolated using selective media. The minimum inhibitory concentrations of colistin were determined using the broth microdilution method. The results showed that 70.7% of chicken meats in Vietnam were contaminated with both mcr-1 and mcr-3. Meanwhile, mcr-1 and mcr-3 were detected in 15.9% and 40.9% of pork meat, respectively. Only mcr-3 was detected in 40% of chicken in Japan. In addition, mcr-1-harboring E. coli and mcr-3-harboring Aeromonas were isolated from chicken meats in Vietnam. Some of these isolates showed colistin resistance. These results showed that most retail meats were highly contaminated with colistin-resistance genes. Notably, our results suggest that mcr-3 is more prevalent in the contaminated samples compared with mcr-1.

Chromosomal qnrB19-carrying Escherichia coli isolated from the stool sample of a community resident in Ecuador.

We identified a chromosomal qnrB19 gene within a transposon in a colistin-resistant Escherichia coli strain isolated from the stool sample of an Ecuadorian resident. This finding suggests a more stable acquisition of quinolone resistance on chromosomes than that on plasmids and the potential for propagation to other DNA structures.

Comparative genome analysis of colistin-resistant Escherichia coli harboring mcr isolated from rural community residents in Ecuador and Vietnam.

The spread of colistin-resistant bacteria among rural community residents of low- and middle-income countries is a major threat to community health. Although the mechanism of the spread of colistin-resistant bacteria in communities is unknown, geographic and regional characteristics may influence it. To elucidate the spread mechanism of colistin-resistant bacteria, we analyzed the genomes of colistin-resistant Escherichia coli isolated from Vietnam and Ecuador residents, which are geographically and socially different. Stool specimens of 139 and 98 healthy residents from Ecuador and Vietnam rural communities, respectively, were analyzed for colistin-resistant E. coli with mcr. Its prevalence in the residents of all the communities assessed was high and approximately equal in both countries: 71.8% in Ecuador and 69.4% in Vietnam. A phylogenetic tree analysis revealed that the sequence type of colistin-resistant E. coli was diverse and the major sequence types were different between the two countries. The location of mcr in the isolates showed that the proportion of chromosomal mcr was 35.1% and 8.5% in the Vietnam and Ecuador isolates, respectively. Most of these chromosomal mcr genes (75%-76%) had an intact mcr-transposon Tn6330. Contrastingly, the replicon types of the mcr-carrying-plasmids were diverse in both countries, but almost all belonged to IncI2 in Ecuador and IncX1/X4 in Vietnam. Approximately 26%-45% of these mcr-plasmids had other resistance genes, which also varied between countries. These results suggest that although the overall profile of the colistin-resistant E. coli isolates is diverse in these countries, the phylogenesis of the isolates and mcr-carrying plasmids has regional characteristics. Although the contributing factors are not clear, it is obvious that the overall profile of colistin-resistant bacteria dissemination varies between countries. Such different epidemic patterns are important for establishing country-specific countermeasures against colistin-resistant bacteria.

Publication bias in simulation model studies: The case of ethanol literature.

In this study, we explore the potential for publication bias using market simulation results that estimate the effect of US ethanol expansion on corn prices. We provide a new test of whether the publication process routes market simulation results into one of the following two narratives: food-versus-fuel or greenhouse gas (GHG) emissions. Our research question is whether model results with either high price or large land impact are favored for publication in one body of literature or the other. In other words, a model that generates larger price effects might be more readily published in the food-versus-fuel literature while a model that generates larger land use change and GHG emissions might find a home in the GHG emission literature. We develop a test for publication bias based on matching narrative and normalized price effects from simulated market models. As such, our approach differs from past studies of publication bias that typically focus on statistically estimated parameters. This focus could have broad implications: if in the future more studies assess publication bias of quantitative results that are not statistically estimated parameters, then important inferences about publication bias could be drawn. More specifically, such a body of literature could explore the potential that practices common in either statistical methods or other methods tend to encourage or deter publication bias. Turning back to the present case, our findings in this study do not detect a relationship between food-versus-fuel or GHG narrative orientation and corn price effects. The results are relevant to debates about biofuel impacts and our approach can inform the publication bias literature more generally.

Occult Vancomycin-Resistant Enterococcus faecium ST117 Displaying a Highly Mutated vanB2 Operon.

Rare information is available on clinical Enterococcus faecium encountered in Sardinia, Italy. This study investigated the antimicrobial susceptibility profiles and genotypic characteristics of E. faecium isolated at the University Hospital of Sassari, Italy, using the Vitek2 system and PCR, MLST, or WGS. Vitek2 revealed two VanB-type vancomycin-resistant Enterococcus faecium (VREfm) isolates (MICs mg/L = 8 and ≥32) but failed to detect vancomycin resistance in one isolate (MIC mg/L ≤ 1) despite positive genotypic confirmation of vanB gene, which proved to be vancomycin resistant by additional phenotypic methods (MICs mg/L = 8). This vanB isolate was able to increase its vancomycin MIC after exposure to vancomycin, unlike the "classic" occult vanB-carrying E. faecium, becoming detectable by Vitek 2 (MICs mg/L ≥ 32). All three E. faecium had highly mutated vanB2 operons, as part of a chromosomally integrated Tn1549 transposon, with common missense mutations in VanH and VanB2 resistance proteins and specific missense mutations in the VanW accessory protein. There were additional missense mutations in VanS, VanH, and VanB proteins in the vanB2-carrying VREfm isolates compared to Vitek2. The molecular typing revealed a polyclonal hospital-associated E. faecium population from Clade A1, and that vanB2-VREfm, and nearly half of vancomycin-susceptible E. faecium (VSEfm) analyzed, belonged to ST117. Based on core genome-MLST, ST117 strains had different clonal types (CT), excluding nosocomial transmission of specific CT. Detecting vanB2-carrying VREfm isolates by Vitek2 may be problematic, and alternative methods are needed to prevent therapeutic failure and spread.

Horizontal transfer of a plasmid possessing mcr-1 marked with a single nucleotide mutation between Escherichia coli isolates from community residents.

OBJECTIVES: The widespread dissemination of phenotypic colistin-resistant (COR) bacteria in the community threatens public health. The horizontal gene transfer of the mobile colistin resistance gene via plasmids is thought to be one of the main mechanisms for dissemination. However, genotypic evidence to prove this in community settings is limited. This study used genome analysis to demonstrate the direct horizontal colistin resistance gene transfer via plasmids in isolates from the community. RESULTS: A total of 19 isolates of COR Escherichia coli from stool specimens of 23 residents from seven households in the Vietnamese community were assessed in this study. The whole-genome sequence data of isolates were acquired using a combination of DNBSEQ short-reads and Nanopore long-read sequencing. Analysis of genomic data was performed using online tools such as Geneious. Analysis of the genomic information of COR E. coli isolates revealed that the isolates from two residents of different households had a similar IncP1 plasmid possessing mcr-1.1, marked with a single nucleotide mutation at the same position. The study provided direct evidence to prove that mcr was horizontally transmitted among bacteria in community residents.

Hip Contact Force Magnitude and Regional Loading Patterns Are Altered in Those with Femoroacetabular Impingement Syndrome.

PURPOSE: The magnitude and location of hip contact force influence the local mechanical environment of the articular tissue, driving remodeling. We used a neuromusculoskeletal model to investigate hip contact force magnitudes and their regional loading patterns on the articular surfaces in those with femoroacetabular impingement (FAI) syndrome and controls during walking. METHODS: An EMG-assisted neuromusculoskeletal model was used to estimate hip contact forces in eligible participants with FAI syndrome ( n = 41) and controls ( n = 24), walking at self-selected speed. Hip contact forces were used to determine the average and spread of regional loading for femoral and acetabular articular surfaces. Hip contact force magnitude and region of loading were compared between groups using statistical parametric mapping and independent t -tests, respectively ( P < 0.05). RESULTS: All of the following findings are reported compared with controls. Those with FAI syndrome walked with lower-magnitude hip contact forces (mean difference, -0.7 N·BW -1 ; P < 0.001) during first and second halves of stance, and with lower anteroposterior, vertical, and mediolateral contact force vector components. Participants with FAI syndrome also had less between-participant variation in average regional loading, which was located more anteriorly (3.8°, P = 0.035) and laterally (2.2°, P = 0.01) on the acetabulum but more posteriorly (-4.8°, P = 0.01) on the femoral head. Participants with FAI syndrome had a smaller spread of regional loading across both the acetabulum (-1.9 mm, P = 0.049) and femoral head (1 mm, P < 0.001) during stance. CONCLUSIONS: Compared with controls, participants with FAI syndrome walked with lower-magnitude hip contact forces that were constrained to smaller regions on the acetabulum and femoral head. Differences in regional loading patterns might contribute to the mechanobiological processes driving cartilage maladaptation in those with FAI syndrome.

Fusion plasmid carrying the colistin resistance gene mcr of Escherichia coli isolated from healthy residents.

OBJECTIVES: The extensive spread of colistin resistance represents an enormous concern to infectious disease treatment, because colistin is one of the few effective antibiotics against multidrug-resistant bacterial infections, including carbapenem-resistant bacteria. This dissemination can be caused by plasmid transfer containing the colistin resistance gene mcr. Therefore, the plasmid host range affects horizontal gene transfer. This study reports a fusion plasmid of different incompatibility types, which could easily expand the plasmid host range, allowing widespread mcr prevalence in the microbial community. METHODS: Genome sequences of colistin-resistant Escherichia coli isolates from stool specimens of healthy human residents in Ecuador were determined using the DNBSEQ and MinION platforms. Hybrid genome assembly was performed using Unicycler, and the genomes were annotated using DFAST. Genome analysis was performed using the Geneious Prime software. RESULTS: Two colistin-resistant E. coli strains isolated separately from different residents presented mcr-carrying plasmids with fused different incompatibility types, IncFIA, IncHIIA, and IncHIIB. The phylogenies of these host bacteria were different. The sizes of the mcr-carrying fusion plasmids pLR-06 and pLR-50 with the full Tn6330 mcr-transposon were 260 Kbp and 198 Kbp, respectively. Both fusion plasmids possessed other resistance genes, including tet(B), tet(M), blaTEM-1b, sul3, cmlA1, aadA1, aadA2, fosA3, and dfrA12. CONCLUSION: This is the first report of a fusion plasmid comprising different incompatibility types with mcr from colistin-resistant E. coli strains isolated from community residents. The mcr fusion plasmid may play a crucial role in achieving horizontal mcr transmission and the evolution of the multidrug resistance plasmid among hosts.

Physics-Based Simulations to Predict the Differential Effects of Motor Control and Musculoskeletal Deficits on Gait Dysfunction in Cerebral Palsy: A Retrospective Case Study.

Physics-based simulations of walking have the theoretical potential to support clinical decision-making by predicting the functional outcome of treatments in terms of walking performance. Yet before using such simulations in clinical practice, their ability to identify the main treatment targets in specific patients needs to be demonstrated. In this study, we generated predictive simulations of walking with a medical imaging based neuro-musculoskeletal model of a child with cerebral palsy presenting crouch gait. We explored the influence of altered muscle-tendon properties, reduced neuromuscular control complexity, and spasticity on gait dysfunction in terms of joint kinematics, kinetics, muscle activity, and metabolic cost of transport. We modeled altered muscle-tendon properties by personalizing Hill-type muscle-tendon parameters based on data collected during functional movements, simpler neuromuscular control by reducing the number of independent muscle synergies, and spasticity through delayed muscle activity feedback from muscle force and force rate. Our simulations revealed that, in the presence of aberrant musculoskeletal geometries, altered muscle-tendon properties rather than reduced neuromuscular control complexity and spasticity were the primary cause of the crouch gait pattern observed for this child, which is in agreement with the clinical examination. These results suggest that muscle-tendon properties should be the primary target of interventions aiming to restore an upright gait pattern for this child. This suggestion is in line with the gait analysis following muscle-tendon property and bone deformity corrections. Future work should extend this single case analysis to more patients in order to validate the ability of our physics-based simulations to capture the gait patterns of individual patients pre- and post-treatment. Such validation would open the door for identifying targeted treatment strategies with the aim of designing optimized interventions for neuro-musculoskeletal disorders.

SimCP: A Simulation Platform to Predict Gait Performance Following Orthopedic Intervention in Children With Cerebral Palsy.

Gait deficits in cerebral palsy (CP) are often treated with a single-event multi-level surgery (SEMLS). Selecting the treatment options (combination of bony and soft tissue corrections) for a specific patient is a complex endeavor and very often treatment outcome is not satisfying. A deterioration in 22.8% of the parameters describing gait performance has been reported and there is need for additional surgery in 11% of the patients. Computational simulations based on musculoskeletal models that allow clinicians to test the effects of different treatment options before surgery have the potential to drastically improve treatment outcome. However, to date, no such simulation and modeling method is available. Two important challenges are the development of methods to include patient-specific neuromechanical impairments into the models and to simulate the effect of different surgical procedures on post-operative gait performance. Therefore, we developed the SimCP framework that allows the evaluation of the effect of different simulated surgeries on gait performance of a specific patient and includes a graphical user interface (GUI) that enables performing virtual surgery on the models. We demonstrated the potential of our framework for two case studies. Models reflecting the patient-specific musculoskeletal geometry and muscle properties are generated based solely on data collected before the treatment. The patient's motor control is described based on muscle synergies derived from pre-operative EMG. The GUI is then used to modify the musculoskeletal properties according to the surgical plan. Since SEMLS does not affect motor control, the same motor control model is used to define gait performance pre- and post-operative. We use the capability gap (CG), i.e., the difference between the joint moments needed to perform healthy walking and the joint moments the personalized model can generate, to quantify gait performance. In both cases, the CG was smaller post- then pre-operative and this was in accordance with the measured change in gait kinematics after treatment.

Prevalence, Species Distribution, and Related Factors of Fish-Borne Trematode Infection in Ninh Binh Province, Vietnam.

Background. Clonorchis sinensis/Opisthorchis viverrini and minute intestinal flukes (MIF) such as Haplorchis pumilio and H. taichui are fish-borne trematodes (FBT) that may coexist in regions where local people have a habit of eating raw fish like Vietnam. Responses to FBT should be verified according to the data on the distribution of these flukes. This study aims to explore the prevalence of different species of FBT and related factors among local people in a northern province of Vietnam. Methods. A cross-sectional study was conducted in Kim Son and Yen Khanh districts, Ninh Binh province, between March 2016 and March 2017. Four hundred people aged 15 years or older were interviewed and gave stool samples. The FBT eggs in faecal samples were enumerated by modified formalin-ether technique and identified by sequencing of the second internal transcribed spacer (ITS2) region. Result. Among the 400 persons, 19.5% were infected with FBT. On univariate analysis, eating raw fish was the main risk factor (odds ratios (OR)) of 6.769 (95% confidence interval (CI) of 2.655-17.259) followed by being of male gender (3.994 (CI95% 2.117-7.536)) and drinking alcohol (2.680 (CI95% 1.440-4.986)), respectively. There was no risk of increased infection among those living at home without hygienic latrines, those living close to rivers or having ponds, or those raising cats or dogs. By multivariate analysis, FBT infection was only related to the consumption of raw fish and gender. Seventy stool samples with a sufficient amount of faecal matter were subjected to DNA extraction, 42.85% of them yielded DNA production, and all were of Clonorchis sinensis. Conclusion. Results of the study showed the high prevalence of infection of fish-borne trematode, mostly C. sinensis among humans in Ninh Binh province. The prevention of FBT should be strengthened with programs detailed according to the distribution of FBT in different endemic areas.

Individuals with mild-to-moderate hip osteoarthritis exhibit altered pelvis and hip kinematics during sit-to-stand.

BACKGROUND: Performance of the sit-to-stand (STS) task is compromised in individuals with advanced hip osteoarthritis (OA). Understanding how STS performance is altered in individuals with mild-to-moderate hip OA may inform interventions to improve function and slow disease progression. RESEARCH QUESTION: Do trunk, pelvis, and hip biomechanics differ during a STS task between individuals with mild-to-moderate hip OA and a healthy, age-matched control group? METHODS: Thirteen individuals with mild-to-moderate symptomatic and radiographic hip OA and seventeen healthy, age-matched controls performed a standardized STS task. Data were acquired using a three-dimensional motion capture system. The primary outcome measures were task duration, sagittal and frontal plane trunk, pelvis, and hip joint angles, and sagittal and frontal plane trunk and hip joint moments. Comparisons of lower-limb measures were between the most affected side in the hip OA group and a randomly chosen limb for the control group, termed the index limb, prior to and following lift-off from the chair. RESULTS: Participants with mild-to-moderate hip OA took longer to perform the STS task compared to controls. Prior to lift-off, the hip OA group exhibited greater posterior pelvic tilt, greater pelvic rise on the index side and less hip joint flexion relative to controls. Following lift-off, the hip OA group exhibited greater pelvic rise on the index side compared to controls. SIGNIFICANCE: Individuals with mild-to-moderate hip OA exhibit subtle alterations in movement strategy compared to healthy controls when completing a STS task similar, to a small extent, to adaptations reported in advanced stages of the disease. Interventions to target these features and prevent further decline in physical function may be warranted in the management of mild-to-moderate hip OA while the opportunity remains.

Selective dorsal rhizotomy improves muscle forces during walking in children with spastic cerebral palsy.

BACKGROUND: Selective dorsal rhizotomy aims to reduce spasticity in children with cerebral palsy. Early investigations indicated postoperative weakness, whereas more recent studies showed that selective dorsal rhizotomy either does not change or improves muscle strength. All previous studies assessed muscle strength in a static position, which did not represent the walking situation. The aim of this study was to analyze the influence of selective dorsal rhizotomy on muscle forces during gait. METHODS: Motion capture data of 25 children with spastic cerebral palsy and 10 typically developing participants were collected. A musculoskeletal OpenSim model was used to calculate joint kinematics, joint kinetics and muscle forces during gait. Static optimization and an electromyography-informed approach to calculate muscle forces were compared. A Muscle-Force-Profile was introduced and used to compare the muscle forces during walking before and after a selective dorsal rhizotomy. FINDINGS: Independent of the approach used (electromyography-informed versus static optimization), selective dorsal rhizotomy significantly normalized forces in spastic muscles during walking and did not reduce the contribution of non-spastic muscles. INTERPRETATION: This study showed that selective dorsal rhizotomy improves dynamic muscle forces in children with cerebral palsy and leads to less gait pathology, as shown in the improvement in joint kinematics and joint kinetics. Individual muscle force analyses using the Muscle-Force-Profile extend standard joint kinematics and joint moment analyses, which might improve clinical-decision making in children with cerebral palsy in the future. The reference data of our participants and MATLAB code for the Muscle-Force-Profile are publicly available on simtk.org/projects/muscleprofile.

A calibrated EMG-informed neuromusculoskeletal model can appropriately account for muscle co-contraction in the estimation of hip joint contact forces in people with hip osteoarthritis.

Abnormal hip joint contact forces (HJCF) are considered a primary mechanical contributor to the progression of hip osteoarthritis (OA). Compared to healthy controls, people with hip OA often present with altered muscle activation patterns and greater muscle co-contraction, both of which can influence HJCF. Neuromusculoskeletal (NMS) modelling is non-invasive approach to estimating HJCF, whereby different neural control solutions can be used to estimate muscle forces. Static optimisation, available within the popular NMS modelling software OpenSim, is a commonly used neural control solution, but may not account for an individual's unique muscle activation patterns and/or co-contraction that are often evident in pathological population. Alternatively, electromyography (EMG)-assisted neural control solutions, available within CEINMS software, have been shown to account for individual activation patterns in healthy people. Nonetheless, their application in people with hip OA, with conceivably greater levels of co-contraction, is yet to be explored. The aim of this study was to compare HJCF estimations using static optimisation (in OpenSim) and EMG-assisted (in CEINMS) neural control solutions during walking in people with hip OA. EMG-assisted neural control solution was more consistent with both EMG and joint moment data than static optimisation, and also predicted significantly higher HJCF peaks (p < 0.001). The EMG-assisted neural control solution also accounted for more muscle co-contraction than static optimisation (p = 0.03), which probably contributed to these higher HJCF peaks. Findings suggest that the EMG-assisted neural control solution may estimate more physiologically plausible HJCF than static optimisation in a population with high levels of co-contraction, such as hip OA.

Subject-specific calibration of neuromuscular parameters enables neuromusculoskeletal models to estimate physiologically plausible hip joint contact forces in healthy adults.

In-vivo hip joint contact forces (HJCF) can be estimated using computational neuromusculoskeletal (NMS) modelling. However, different neural solutions can result in different HJCF estimations. NMS model predictions are also influenced by the selection of neuromuscular parameters, which are either based on cadaveric data or calibrated to the individual. To date, the best combination of neural solution and parameter calibration to obtain plausible estimations of HJCF have not been identified. The aim of this study was to determine the effect of three electromyography (EMG)-informed neural solution modes (EMG-driven, EMG-hybrid, and EMG-assisted) and static optimisation, each using three different parameter calibrations (uncalibrated, minimise joint moments error, and minimise joint moments error and peak HJCF), on the estimation of HJCF in a healthy population (n = 23) during walking. When compared to existing in-vivo data, the EMG-assisted mode and static optimisation produced the most physiologically plausible HJCF when using a NMS model calibrated to minimise joint moments error and peak HJCF. EMG-assisted mode produced first and second peaks of 3.55 times body weight (BW) and 3.97 BW during walking; static optimisation produced 3.75 BW and 4.19 BW, respectively. However, compared to static optimisation, EMG-assisted mode generated muscle excitations closer to recorded EMG signals (average across hip muscles R2 = 0.60 ±â€¯0.37 versus R2 = 0.12 ±â€¯0.14). Findings suggest that the EMG-assisted mode combined with minimise joint moments error and peak HJCF calibration is preferable for the estimation of HJCF and generation of realistic load distribution across muscles.

Photophysics of "Floppy" Dyads as Potential Biomembrane Probes.

In the study a dyad (C6 probe), constructed of two dyes with highly different hydrophobicities, was investigated by steady-state and time-resolved spectroscopic techniques in chloroform, methanol, and in phospholipid vesicles, respectively. The dyad was built on two dyes: the lipophilic benzo[a]pyrene (BaP) and the hydrophilic sulforhodamine B (SRB). The dyes were linked via a short, but flexible alkyl chain (six C-atoms). Based on their spectroscopic properties, BaP and SRB showed a very efficient non-radiative resonance energy transfer in solution. Incorporation into a lipid bilayer limited the relative flexibility (degree of freedom) between donor and acceptor and was used for the investigation of fundamental photophysical aspects (especially of FRET) as well as to elucidate the potential of the dyad to probe the interface of vesicles (or cells). The location of the two dyes in vesicles and their respective accessibility for interactions with dye-specific antibodies was investigated. Based on the alteration of the anisotropy, on the rotational correlation time as well as on the diffusion coefficient the incorporation of the C6 probe into the vesicles was evaluated. Especially the limitation in the relative movements of the two dyes was considered and used to differentiate between potential parameters, that influence the energy transfer in the dyad. Transient absorption spectroscopy (TAS) and pulsed-interleave single molecule fluorescence experiments were performed to better understand the intramolecular interactions in the dyad. Finally, in a showcase for a biosensing application of the dyads, the binding of an SRB-specific antibody was investigated when the dyad was incorporated in vesicles. Graphical Abstract.

Emergence of unusual vanA/vanB2 genotype in a highly mutated vanB2-vancomycin-resistant hospital-associated E. faecium background in Vietnam.

Enterococcus faecium has become a globally disseminated nosocomial pathogen mainly because of acquisition and diffusion of virulence factors and multidrug resistance determinants, including glycopeptides, which are some of the last resort antimicrobials used to treat more serious infections common in high-risk patients. In this study we investigated and characterized hospital-associated (HA) E. faecium isolates collected at Hue Central Hospital, Vietnam. Our results highlighted the spread among hospital wards of a surprisingly heterogeneous multidrug-resistant E. faecium population comprising five different CC17-related sequence types (STs), of which 46% VREf carry the vanB gene. Whole genome sequencing of selected E. faecium isolates showed that VREf from different STs carried the same chromosomal integrated Tn1549-like transposon, with a highly mutated vanB2-operon, showing an increased level of vancomycin resistance (VanB phenotype) and able, in one isolate, to confer resistance to teicoplanin (VanA incongruent phenotype). Two unusual vanA/vanB2-type strains were detected within the vanB2-type ST17 population, harbouring a Tn1546-vanA-like transposon in pJEG40-like plasmids. Wg-SNPs-based analysis showed the genetic relatedness of VSEf/VREf of the same STs and indicated lateral exchange of the Tn1549-like element among isolates followed by clonal expansion. Microevolution among ST17 isolates, including the vanA/vanB2-type strains, and inter-wards VREf transmission, were highlighted. The use of teicoplanin is strongly discouraged in the study hospital because of the spreading of Tn1549-vanB2 associated to teicoplanin resistance. A rational use of glycopeptides and effective surveillance measures are required to reduce nosocomial VSEF/VREf spread and to avoid the rise of unusual and misleading VREf genotypes.

Antibody Binding at the Liposome-Water Interface: A FRET Investigation toward a Liposome-Based Assay.

Different signal amplification strategies to improve the detection sensitivity of immunoassays have been applied which utilize enzymatic reactions, nanomaterials, or liposomes. The latter are very attractive materials for signal amplification because liposomes can be loaded with a large amount of signaling molecules, leading to a high sensitivity. In addition, liposomes can be used as a cell-like "bioscaffold" to directly test recognition schemes aiming at cell-related processes. This study demonstrates an easy and fast approach to link the novel hydrophobic optical probe based on [1,3]dioxolo[4,5-f]-[1,3]benzodioxole (DBD dye mm239) with tunable optical properties to hydrophilic recognition elements (e.g., antibodies) using liposomes for signal amplification and as carrier of the hydrophobic dye. The fluorescence properties of mm239 (e.g., long fluorescence lifetime, large Stokes shift, high photostability, and high quantum yield), its high hydrophobicity for efficient anchoring in liposomes, and a maleimide bioreactive group were applied in a unique combination to build a concept for the coupling of antibodies or other protein markers to liposomes (coupling to membranes can be envisaged). The concept further allowed us to avoid multiple dye labeling of the antibody. Here, anti-TAMRA-antibody (DC7-Ab) was attached to the liposomes. In proof-of-concept, steady-state as well as time-resolved fluorescence measurements (e.g., fluorescence depolarization) in combination with single molecule detection (fluorescence correlation spectroscopy, FCS) were used to analyze the binding interaction between DC7-Ab and liposomes as well as the binding of the antigen rhodamine 6G (R6G) to the antibody. Here, the Förster resonance energy transfer (FRET) between mm239 and R6G was monitored. In addition to ensemble FRET data, single-molecule FRET (PIE-FRET) experiments using pulsed interleaved excitation were used to characterize in detail the binding on a single-molecule level to avoid averaging out effects.

Patterns of antimicrobial resistance in intensive care unit patients: a study in Vietnam.

BACKGROUND: Antimicrobial resistance has emerged as a major concern in developing countries. The present study sought to define the pattern of antimicrobial resistance in ICU patients with ventilator-associated pneumonia. METHODS: Between November 2014 and September 2015, we enrolled 220 patients (average age ~ 71 yr) who were admitted to ICU in a major tertiary hospital in Ho Chi Minh City, Vietnam. Data concerning demographic characteristics and clinical history were collected from each patient. The Bauer-Kirby disk diffusion method was used to detect the antimicrobial susceptibility. RESULTS: Antimicrobial resistance was commonly found in ceftriaxone (88%), ceftazidime (80%), ciprofloxacin (77%), cefepime (75%), levofloxacin (72%). Overall, the rate of antimicrobial resistance to any drug was 93% (n = 153/164), with the majority (87%) being resistant to at least 2 drugs. The three commonly isolated microorganisms were Acinetobacter (n = 75), Klebsiella (n = 39), and Pseudomonas aeruginosa (n = 29). Acinetobacter baumannii were virtually resistant to ceftazidime, ceftriaxone, piperacilin, imipenem, meropenem, ertapenem, ciprofloxacin and levofloxacin. High rates (>70%) of ceftriaxone and ceftazidime-resistant Klebsiella were also observed. CONCLUSION: These data indicated that critically ill patients on ventilator in Vietnam were at disturbingly high risk of antimicrobial resistance. The data also imply that these Acinetobacter, Klebsiella, and Pseudomonas aeruginosa and multidrug resistance pose serious therapeutic problems in ICU patients. A concerted and systematic effort is required to rapidly identify high risk patients and to reduce the burden of antimicrobial resistance in developing countries.

Accuracy and Reliability of Marker-Based Approaches to Scale the Pelvis, Thigh, and Shank Segments in Musculoskeletal Models.

Gait analysis together with musculoskeletal modeling is widely used for research. In the absence of medical images, surface marker locations are used to scale a generic model to the individual's anthropometry. Studies evaluating the accuracy and reliability of different scaling approaches in a pediatric and/or clinical population have not yet been conducted and, therefore, formed the aim of this study. Magnetic resonance images (MRI) and motion capture data were collected from 12 participants with cerebral palsy and 6 typically developed participants. Accuracy was assessed by comparing the scaled model's segment measures to the corresponding MRI measures, whereas reliability was assessed by comparing the model's segments scaled with the experimental marker locations from the first and second motion capture session. The inclusion of joint centers into the scaling process significantly increased the accuracy of thigh and shank segment length estimates compared to scaling with markers alone. Pelvis scaling approaches which included the pelvis depth measure led to the highest errors compared to the MRI measures. Reliability was similar between scaling approaches with mean ICC of 0.97. The pelvis should be scaled using pelvic width and height and the thigh and shank segment should be scaled using the proximal and distal joint centers.