scholarly journals Evaluation of Portability and Cost of a Fluorescent PCR Ribotyping Protocol for Clostridium difficile Epidemiology

2015 ◽  
Vol 53 (4) ◽  
pp. 1192-1197 ◽  
Author(s):  
Jonathan N. V. Martinson ◽  
Susan Broadaway ◽  
Egan Lohman ◽  
Christina Johnson ◽  
M. Jahangir Alam ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Low Cost ◽  
Cost Effective ◽  
Pcr Primers ◽  
The United States ◽  
Content Type ◽  
Fluorescent Pcr ◽  
Address Data ◽  
Pcr Ribotyping ◽  
Data Portability

Clostridium difficileis the most commonly identified pathogen among health care-associated infections in the United States. There is a need for accurate and low-cost typing tools that produce comparable data across studies (i.e., portable data) to help characterize isolates during epidemiologic investigations ofC. difficileoutbreaks and sporadic cases of disease. The most popularC. difficile-typing technique is PCR ribotyping, and we previously developed methods using fluorescent PCR primers and amplicon sizing on a Sanger-style sequencer to generate fluorescent PCR ribotyping data. This technique has been used to characterize tens of thousands ofC. difficileisolates from cases of disease. Here, we present validation of a protocol for the cost-effective generation of fluorescent PCR ribotyping data. A key component of this protocol is the ability to accurately identify PCR ribotypes against an online database (http://walklab.rcg.montana.edu) at no cost. We present results from a blinded multicenter study to address data portability across four different laboratories and three different sequencing centers. Our standardized protocol and centralized database for typing ofC. difficilepathogens will increase comparability between studies so that important epidemiologic linkages between cases of disease and patterns of emergence can be rapidly identified.

scholarly journals Inflammasome Activation Contributes to Interleukin-23 Production in Response to Clostridium difficile

mBio ◽  
2015 ◽  
Vol 6 (1) ◽  
Author(s):  
Carrie A. Cowardin ◽  
Sarah A. Kuehne ◽  
Erica L. Buonomo ◽  
Chelsea S. Marie ◽  
Nigel P. Minton ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Disease Severity ◽  
Tissue Damage ◽  
The United States ◽  
Host Cells ◽  
Inflammasome Activation ◽  
Content Type ◽  
Danger Signals ◽  
Interleukin 23 ◽  
Molecular Patterns

ABSTRACT  Clostridium difficileis the most common hospital-acquired pathogen, causing antibiotic-associated diarrhea in over 250,000 patients annually in the United States. Disease is primarily mediated by toxins A and B, which induce potent proinflammatory signaling in host cells and can activate an ASC-containing inflammasome. Recent findings suggest that the intensity of the host response to infection correlates with disease severity. Our lab has identified the proinflammatory cytokine interleukin-23 (IL-23) as a pathogenic mediator during C. difficile infection (CDI). The mechanisms by which C. difficile induces IL-23, however, are not well understood, and the role of toxins A and B in this process is unclear. Here, we show that toxins A and B alone are not sufficient for IL-23 production but synergistically increase the amount of IL-23 produced in response to MyD88-dependent danger signals, including pathogen-associated molecular patterns (PAMPs) and host-derived damage associated molecular patterns (DAMPs). Danger signals also enhanced the secretion of IL-1β in response to toxins A and B, and subsequent IL-1 receptor signaling accounted for the majority of the increase in IL-23 that occurred in the presence of the toxins. Inhibition of inflammasome activation in the presence of extracellular K+likewise decreased IL-23 production. Finally, we found that IL-1β was increased in the serum of patients with CDI, suggesting that this systemic response could influence downstream production of pathogenic IL-23. Identification of the synergy of danger signals with toxins A and B via inflammasome signaling represents a novel finding in the mechanistic understanding of C. difficile-induced inflammation.IMPORTANCEClostridium difficileis among the leading causes of death due to health care-associated infection, and factors determining disease severity are not well understood. C. difficile secretes toxins A and B, which cause inflammation and tissue damage, and recent findings suggest that some of this tissue damage may be due to an inappropriate host immune response. We have found that toxins A and B, in combination with both bacterium- and host-derived danger signals, can induce expression of the proinflammatory cytokines IL-1β and IL-23. Our results demonstrate that IL-1β signaling enhances IL-23 production and could lead to increased pathogenic inflammation during CDI.

scholarly journals First Environmental Investigation of Toxigenic Clostridium difficile at a Large Hospital in Bangladesh

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S406-S406
Author(s):  
M Jahangir Alam ◽  
Khurshida Begum ◽  
Tasnuva Rashid ◽  
Irtiza Hasan ◽  
Jacob McPherson ◽  
...  
Keyword(s):  
Developing Countries ◽  
Clostridium Difficile ◽  
Enrichment Culture ◽  
Large Hospital ◽  
Environmental Investigation ◽  
Fluorescent Pcr ◽  
High Prevalence ◽  
Pcr Ribotyping ◽  
Developed World ◽  
Culture Positive

Abstract Background Toxigenic Clostridium difficile is the most common cause of infectious diarrhea in hospitalized patients in the developed world and an emerging pathogen in developing countries due to increased use of broad-spectrum antibiotics. Although likely ubiquitous worldwide, the prevalence of toxigenic C. difficile spores in the hospital environs of developing countries is poorly understood. The objectives of the study are to isolate and characterize C. difficile from the hospital environs of a large hospitals in Dhaka, Bangladesh. Methods As part of our environmental surveillance effort, we collected 330 shoe-bottom swab samples from hospital employees, patients, and visitors inside of a large hospital in Dhaka, Bangladesh. Samples were analyzed for C. difficile using anaerobic enrichment culture and molecular methods. Suspected colonies from cycloserine cefoxitin fructose agar (CCFA) plates were identified by PCR (tcdA, tcdB, cdtA, cdtB and tpi genes) and strain typed using fluorescent PCR ribotyping, and MLVA methods. Results A total 149 of 333 (44.7%) shoe-bottom swab samples were culture positive for C. difficile of which 19.8% samples were toxigenic (tcdA and tcdB) C. difficile. A total of 11 distinct ribotypes were identified from 58 toxigenic C. difficile isolates tested. Predominant ribotypes were F053-163 (24.1%), F017 (20.7%), F106 (19.0%), F014-020 (17.2%). Other ribotypes were R001, F005, F010, F018, F054, F216, and FP407. No R027 and R078 C. difficile isolated. A broad MLVA diversity has been seen among the tested strains. Conclusion We identified a high prevalence of toxigenic C. difficile with diverse ribotypes from hospital environmental shoe-bottom swabs in Bangladesh. This is the first hospital environmental report of C. difficile from Bangladesh. Disclosures All authors: No reported disclosures.

scholarly journals Cross-Sectional Study Reveals High Prevalence of Clostridium difficile Non-PCR Ribotype 078 Strains in Australian Veal Calves at Slaughter

2013 ◽  
Vol 79 (8) ◽  
pp. 2630-2635 ◽  
Author(s):  
Daniel R. Knight ◽  
Sara Thean ◽  
Papanin Putsathit ◽  
Stan Fenwick ◽  
Thomas V. Riley
Keyword(s):  
Clostridium Difficile ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Adult Cattle ◽  
Content Type ◽  
Retail Meats ◽  
High Prevalence ◽  
Pcr Ribotyping ◽  
Ribotype 078

ABSTRACTRecent reports in North America and Europe ofClostridium difficilebeing isolated from livestock and retail meats of bovine origin have raised concerns about the risk to public health. To assess the situation in Australia, we investigated the prevalence and genetic diversity ofC. difficilein adult cattle and calves at slaughter. Carcass washings, gastrointestinal contents, and feces were collected from abattoirs across five Australian states. Selective culture, toxin profiling, and PCR ribotyping were performed. The prevalence ofC. difficilewas 56% (203/360 samples) in feces from <7-day-old calves, 3.8% (1/26) in 2- to 6-month-old calves, and 1.8% (5/280) in adult cattle. Three PCR ribotypes (RTs), RT127, RT033, and RT126, predominated in <7-day-old calves and comprised 77.8% (158/203 samples) of isolates. RT056, which has not been reported in cattle before, was found in 16 <7-day-old calves (7.7%). Surprisingly, RT078 strains, which dominate production animal carriage studies in the Northern Hemisphere, were not isolated.

Low-barrier-to-entry data tools: creating and sharing humanities data

2016 ◽  
Vol 34 (2) ◽  
pp. 268-285 ◽  
Author(s):  
Linda L. Rath
Keyword(s):  
Low Cost ◽  
Data Access ◽  
Digital Collections ◽  
Skill Levels ◽  
Content Type ◽  
Limited Experience ◽  
Address Data ◽  
Barrier To Entry ◽  
General Experience ◽  
Participant Observer

Purpose – The purpose of this paper is to determine whether TAMS Analyzer and Viewshare are viable free and open source software data sharing and creation tools for those with limited funding and technological skills. Design/methodology/approach – The participant observer method was used to collect experiential evidence while applying the tools to a collection of text-, image-, and video-based digital cultural records. Findings – TAMS Analyzer was found to be a low barrier to entry tool for those with coding and qualitative data analysis experience. Those with general experience will be able to create datasets with the support of manuals and tutorials, while those with limited experience may find it difficult to use. Viewshare was found to be a low barrier to entry tool for sharing data online, and accessible for all skill levels. Research limitations/implications – TAMS Analyzer supports Mac and Linux platforms only, so a low-cost software recommendation was made for those in Windows environments. Practical implications – Librarians can use these tools to address data access gaps while promoting library digital collections. Social implications – With a greater understanding of data tools, librarians can be advisors, collaborators, agents for data culture, and relevant participants in digital humanities scholarship. Originality/value – The research evaluates both the capabilities of the tools and the barriers to using or accessing them, which are often neglected. The paper addresses a need in the literature for greater scrutiny of tools that are a critical component of the data ecology, and will further assist librarians when connecting scholars to tools of inquiry in an environment with limited funding and technical support.

scholarly journals Real-time structural health monitoring for concrete beams: a cost-effective ‘Industry 4.0’ solution using piezo sensors

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Arka Ghosh ◽  
David John Edwards ◽  
M. Reza Hosseini ◽  
Riyadh Al-Ameri ◽  
Jemal Abawajy ◽  
...  
Keyword(s):  
Structural Health Monitoring ◽  
Real Time ◽  
Health Monitoring ◽  
Industry 4.0 ◽  
Concrete Beams ◽  
Low Cost ◽  
Cost Effective ◽  
Content Type ◽  
Structural Health ◽  
Non Destructive

PurposeThis research paper adopts the fundamental tenets of advanced technologies in industry 4.0 to monitor the structural health of concrete beam members using cost-effective non-destructive technologies. In so doing, the work illustrates how a coalescence of low-cost digital technologies can seamlessly integrate to solve practical construction problems.Design/methodology/approachA mixed philosophies epistemological design is adopted to implement the empirical quantitative analysis of “real-time” data collected via sensor-based technologies streamed through a Raspberry Pi and uploaded onto a cloud-based system. Data was analysed using a hybrid approach that combined both vibration-characteristic-based method and linear variable differential transducers (LVDT).FindingsThe research utilises a novel digital research approach for accurately detecting and recording the localisation of structural cracks in concrete beams. This non-destructive low-cost approach was shown to perform with a high degree of accuracy and precision, as verified by the LVDT measurements. This research is testament to the fact that as technological advancements progress at an exponential rate, the cost of implementation continues to reduce to produce higher-accuracy “mass-market” solutions for industry practitioners.Originality/valueAccurate structural health monitoring of concrete structures necessitates expensive equipment, complex signal processing and skilled operator. The concrete industry is in dire need of a simple but reliable technique that can reduce the testing time, cost and complexity of maintenance of structures. This was the first experiment of its kind that seeks to develop an unconventional approach to solve the maintenance problem associated with concrete structures. This study merges industry 4.0 digital technologies with a novel low-cost and automated hybrid analysis for real-time structural health monitoring of concrete beams by fusing several multidisciplinary approaches into one integral technological configuration.

scholarly journals Comparison of Multilocus Sequence Typing and the Xpert C. difficile/Epi Assay for Identification of Clostridium difficile 027/NAP1/BI

2015 ◽  
Vol 54 (3) ◽  
pp. 775-778 ◽  
Author(s):  
Tracy McMillen ◽  
Mini Kamboj ◽  
N. Esther Babady
Keyword(s):  
United States ◽  
Clostridium Difficile ◽  
Confidence Interval ◽  
Multilocus Sequence Typing ◽  
The United States ◽  
Content Type ◽  
Presumptive Identification ◽  
Good Agreement

Clostridium difficile027/NAP1/BI is the most commonC. difficilestrain in the United States. The XpertC. difficile/Epi assay allows rapid, presumptive identification ofC. difficileNAP1. We compared XpertC. difficile/Epi to multilocus sequence typing for identification ofC. difficileNAP1 and found “very good” agreement at 97.9% (κ = 0.86; 95% confidence interval, 0.80 to 0.91).

Prospects for the global economy in 2018

2017 ◽  
Keyword(s):  
United States ◽  
Global Economy ◽  
Low Cost ◽  
Commodity Prices ◽  
Balance Of Power ◽  
The United States ◽  
Industrial Growth ◽  
Content Type ◽  
The Us ◽  
Open Markets

Subject PROSPECTS 2018: Global economy Significance Global GDP growth is likely to edge higher in 2018 as trade, investment and employment expand. However, monetary policy is gradually tightening, fiscal expansion is limited and there is little chance of a repeat of the surprise boost from trade seen in 2017 or a recovery in productivity. Inflation may remain obdurately low in the United States, Japan and the euro-area but not sufficiently to deter the US Federal Reserve (Fed) and the ECB from gently reeling in their bond-buying programmes. Modestly higher commodity prices should support economic recovery in resource producers. Impacts The timing of elections in the United States, Canada and Mexico may prolong the NAFTA trade talks into 2019 or beyond. China will battle any US attempts to constrain its innovation and access to technology, which it sees as key to its rebalancing. Technological progress and more open markets exacerbate the unpredictability of jobs and wages, but policy will increasingly address this. Automation means the job intensive low-cost industrial growth engine is now less effective; developing countries must consider new models. A better balance of power between multinationals, international organisations and governments will be key to global tax cooperation.

scholarly journals Multicenter, Double-Blind, Randomized, Phase 2 Study Evaluating the Novel Antibiotic Cadazolid in Patients with Clostridium difficile Infection

2015 ◽  
Vol 59 (10) ◽  
pp. 6266-6273 ◽  
Author(s):  
Thomas Louie ◽  
Carl Erik Nord ◽  
George H. Talbot ◽  
Mark Wilcox ◽  
Dale N. Gerding ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clinical Response ◽  
Recurrence Rate ◽  
Primary Endpoint ◽  
Clinical Cure ◽  
The United States ◽  
Phase 2 ◽  
Double Blind ◽  
Content Type ◽  
Phase 2 Study

ABSTRACTCadazolid, a novel fluoroquinolone-oxazolidinone antibiotic, exhibits potentin vitroactivity againstClostridium difficile, including the epidemic BI/NAP1/027 strain. This multicenter, randomized, double-blind, active reference group, phase 2 study evaluated the efficacy and safety of oral cadazolid in treatment of adult patients withC. difficileinfection (CDI). Eligible patients with first occurrence/first recurrence of CDI were randomized 1:1:1:1 to 250, 500, or 1,000 mg cadazolid twice daily (BID) or oral 125 mg vancomycin four times daily (QID) for 10 days. The primary endpoint was clinical cure at test of cure (48 ± 24 h after the end of treatment; modified intent-to-treat population), defined as resolution of diarrhea with no further CDI treatment required. Secondary endpoints included recurrence rate, sustained clinical response (clinical cure without recurrence), and time to diarrhea resolution. Of 84 patients enrolled, 20, 22, 20, and 22 received 250, 500, or 1,000 mg cadazolid BID or 125 mg vancomycin QID, respectively. The primary endpoint was achieved in 76.5% (80% confidence interval [CI], 58.4, 89.3), 80.0% (63.9, 91.0), 68.4% (51.1, 82.5), and 68.2% (52.3, 81.3) of patients, respectively. There was no evidence of a cadazolid dosage-dependent response. Each dosage of cadazolid resulted in a lower recurrence rate than with vancomycin (18.2 to 25.0% versus 50%). Consequently, higher sustained clinical response rates were observed with cadazolid (46.7 to 60.0%) than with vancomycin (33.3%). The times to diarrhea resolution were similar for cadazolid and vancomycin. Cadazolid was well tolerated, with no safety signal observed. The results of this phase 2 study support further clinical development of cadazolid. (This study has been registered in the United States at ClinicalTrials.gov under registration no. NCT01222702 and in Europe with the European Medicines Agency under registration no. EUDRA-CT 2010-020941-29.)

EU aviation liberalisation aims face challenges

2015 ◽  
Keyword(s):  
Low Cost ◽  
The United States ◽  
Content Type ◽  
Eu Policy ◽  
Consumer Rights ◽  
Airport Capacity ◽  
Industry Consolidation ◽  
Eu Referendum ◽  
The Uk ◽  
New London

Subject The European Commission's new aviation strategy. Significance The European Commission's new aviation strategy, published on December 7, largely reaffirms existing EU policy directions in the sector. These include the wish to address the commercial threat to European airlines represented by Gulf and Asian carriers. The strategy's main innovation is in raising the possibility of allowing more foreign investment in EU airlines. However, this is hedged with qualifications and contingencies. Overall, the Commission's proposals remain undeveloped. Impacts A January 20-21 EU Aviation Summit will provide the first indication of reactions to the strategy and possible next steps. As in telecoms, EU policy faces a tension between supporting consumer rights and choice, and industry consolidation and investment. Airline ownership liberalisation could become a source of conflict with the United States. The implications of 'Brexit' for air travellers, especially on low-cost carriers, are likely to feature in the UK EU referendum campaign. The decision now expected in 2016 on a new London runway will be among the most disputed but significant moves on European airport capacity.

scholarly journals Immigrant women, nature and mental health

2020 ◽  
Vol 16 (4) ◽  
pp. 359-372
Author(s):  
Catherine Anne Nicole Lorentzen ◽  
Berit Viken
Keyword(s):  
Mental Health ◽  
Immigrant Women ◽  
Qualitative Content Analysis ◽  
Low Cost ◽  
Cost Effective ◽  
Well Being ◽  
Natural Environments ◽  
Content Type ◽  
Individual Interviews ◽  
Effective Strategies

Purpose There is a need for cost-effective strategies to counteract mental health challenges among immigrant women. This study aims to identify how nature might improve the mental health status of immigrant women residing in Norway. Design/methodology/approach Qualitative data were gathered through individual interviews with 14 immigrant women from Iran (2), Poland (2), Palestine, Afghanistan, Congo, Kenya, Thailand, Russia, Portugal, Latvia, Colombia and Bulgaria. Findings The qualitative content analysis revealed that interaction with nature positively influenced the immigrant women’s mental health. This occurred because of the following: exposure to nature itself, leading to mood enhancements; familiarization with the new country’s culture, nature, climate and language, facilitating feelings of mastery, attachment and belonging; social interactions, promoting immediate well-being and future social support; interacting with nature in familiar ways, reducing feelings of alienation/loss; and physical activity, improving mood and stress-related conditions. These mental health improvements were a result of interactions with various types of natural environments. Originality/value This study supports the promotion of interaction with nature among immigrant women as part of low-cost public health work. Practitioners should consider multiple arenas for potential nature-related mental health gains.

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