Development of multidrug-resistant Mycobacterium tuberculosis in the biofilm of a peritoneal-venous shunt.

A patient with ascites received a peritoneal-venous shunt for presumed cirrhosis, however surgical specimens grew Mycobacterium tuberculosis (MTb) sensitive to all anti-tuberculous drugs. Directly-Observed-Therapy (DOT) led to improvement followed by relapse with multidrug resistant MTb (MDRTB). We discuss pathways for selection of MDRTB within mycobacterial biofilm. This case illustrates the potential for development of MDRTB in patients with long-term indwelling catheters. We emphasize catheter removal and if not possible continuing follow-up for symptoms and signs of relapse.

Politics v. science: How President Trump's war on science impacted public health and environmental regulation.

During his campaign for president, Joe Biden vowed to "end the politics and follow the science" when dealing with the COVID-19 pandemic and other public health and environmental crises. He was immediately criticized by then President Trump, who cast "listen[ing] to the scientists" as something only a fool would do, and warned that it would result in a "massive [economic] depression." It is hardly surprising that Trump would take that position. After all, the Trump administration routinely prioritized economic interests, and worked tirelessly to remove what it viewed as unnecessary regulatory burdens on economic activity. The Trump administration regularly suppressed, downplayed, or simply ignored scientific research demonstrating the need for regulation to protect public health and the environment. The Biden administration has vowed to reverse course, but faces challenges in doing so due to the widespread assault on science led by former President Trump. The Trump administration's efforts to undermine science are documented in the Silencing Science Tracker, an online database, which records anti-science actions taken by the federal, state, and local governments. Drawing on more than four years of tracker data-from Trump's election to Biden's inauguration-we show that the Trump presidency fundamentally changed how federal government agencies perform, use, and communicate scientific research. While the Biden administration has taken initial steps to undo some of those changes, it still has significant work to do to restore the role of science in federal government decision-making. Its task is made more difficult by the public distrust of science engendered by the Trump presidency.

Knowledge levels, attitude and beliefs of men towards the Digital Rectal Examinations (DRE): A study in Trinidad

Objective: To determine knowledge levels, attitudes and beliefs of men 40 years and over regarding Digital Rectal Examination (DRE). The investigators considered this crucial following the scourge of prostate cancer in Trinidad and Tobago, and seeming lack of the use of the DRE, a noted method of screening for the condition for early detection. Design and Methodology: A cross-sectional descriptive study was undertaken using all men totaling 216, who were 40 years and over, and who gave their informed consent, attending a central mall in Trinidad in the month of April 2018. Data was collected using researchers'- designed self-administered questionnaire. Data was collected and collated manually but analysed with the aid of the SPSS version 20. Result: Results indicate that the men (a) were knowledgeable (95.8%) about DRE, (b) had positive belief (96.3%) about DRE and its medical significance, and (c) had good attitudes (73.6%) towards DRE. Further, men's knowledge levels and beliefs were not significantly associated with their selected demography, namely age, religion, educational level, marital status and ethnicity (p>0.05. However, their attitudes were associated with their ethnicity only (p<0.03). Conclusion: Results suggest that perhaps the attitudes and beliefs are better predictors of intentions than knowledge. This needs to be explored further given the need to curb the prevalence of prostate cancer among men in Trinidad and Tobago.

A successful model for longitudinal community-engaged health research: the 2040 Partners for Health Student Program.

Introduction: Community-based participatory research [CBPR] is an emerging approach to collaborative research aimed at creating locally effective and sustainable interventions. The 2040 Partners for Health student program was developed as a unique model of longitudinal CBPR. Analysis of this program and its components illuminates both the challenges and the opportunities inherent in community engagement. Methods: The program rests on a foundation of a community-based, non-profit organization and a supportive academic university centre. Inter-professional health students and community members of underserved populations work together on different health projects by employing an adapted CBPR methodology. Three successful examples of sustainable CBPR projects are briefly described. Results: The three projects are presented as primary outcomes resulting from this model. Benefits and challenges of the model as an approach to community-engaged research are discussed as well as secondary benefits of student participation. Conclusion: The 2040 Partners for Health student program represents a successful model of CBPR, illuminating common challenges and reiterating the profound value of community-engaged research.

Oxidation of a guanine derivative coordinated to a Pt(IV) complex initiated by intermolecular nucleophilic attacks.

In this study we report that fac-[Pt(IV)(dach)(9-EtG)Cl(3)](+) (dach = d,l-1,2-diaminocyclohexane, 9-EtG = 9-ethylguanine) in high pH (pH 12) or phosphate solution (pH 7.4) produces 8-oxo-9-EtG and Pt(II) species. The reaction in H(2)(18)O revealed that the oxygen atom in hydroxide or phosphate ends up at the C8 position of 8-oxo-G. The kinetics of the redox reaction was first order with respect to both Pt(IV)-G and free nucleophiles (OH(-) and phosphate). The oxidation of G initiated by hydroxide was approximately 30∼50 times faster than by phosphate in 100 mM NaCl solutions. The large entropy of activation of OH(-1) (ΔS(‡) = 26.6 ± 4.3 J mol(-1) K(-1)) due to the smaller size of OH(-) is interpreted to be responsible for the faster kinetics compared to phosphate (ΔS(‡) = -195.5 ± 11.1 J mol(-1) K(-1)). The enthalpy of activation for phosphate reaction is more favorable relative to the OH(-) reaction (ΔH(‡) = 35.4 ± 3.5 kJ mol(-1) for phosphate vs. 96.6 ± 11.4 kJ mol(-1) for OH(-1)). The kinetic isotope effect of H8 was determined to be 7.2 ± 0.2. The rate law, kinetic isotope effect, and isotopic labeling are consistent with a mechanism involving proton ionization at the C8 position as the rate determining step followed by two-electron transfer from G to Pt(IV).

Molecular detection of Babesia equi in infected and carrier horses by polymerase chain reaction.

Twenty-three blood samples were used in this study; five were from five naturally infected horses with Babesia equi (B. equi), while eighteen were from asymptomatic horses with equine babesiasis from different localities in Egypt. All samples were subjected to microscopic examination, indirect fluorescent antibody test (IFA) and polymerase chain reaction (PCR). The carrier animals were microscopically detected in 7 out of 18 samples (38.8%) and in 9 of 18 by using IFA (50%), whereas PCR revealed that 14 samples were positive (78%). Two synthetic oligonucleotide primers, based on the B. equi merozoite antigen gene (EMA-1) were used. A 819 bps DNA fragment is specifically amplified from the gene encoding EMA-1 of B. equi. Our results demonstrate that PCR is a valuable technique for routine detection of B. equi in chronically infected horses, even at low parasitaemia levels.

A common high molecular weight antigen of Babesia bovis isolates from Mexico.

Cattle from an area of Mexico endemic with Babesia bovis infections have a dominant antibody response to a 152kDa antigen of the Tamaulipas strain of B. bovis. A mAb termed PB/5, showing a specific reactivity to this 152kDa antigen in Western blots, was identified. The mAb which reacted with the blunt end of B. bovis in an indirect fluorescent antibody test also reacted to a 152kDa antigen in two other isolates (Nuevo Leon and Yucatan), and a 175kDa antigen in the Huasteca B. bovis isolate from Mexico. Polyclonal monospecific sera from a calf inoculated with mAb-affinity purified 152kDa antigen (Tamaulipas strain) identified B. bovis by the indirect fluorescent antibody test and two antigens of B. bovis (65kDa and 152kDa) in Western blot. Since the epitope reacting to the mAb PB/5 is conserved, this antigen provides a basis for developing a diagnostic test or an immunogen.