Applied genomics for identification of virulent biothreats and for disease outbreak surveillance

Fortifying our preparedness to cope with biological threats by identifying and targeting virulence factors may be a preventative strategy for curtailing infectious disease outbreak. Virulence factors evoke successful pathogenic invasion, and the science and technology of genomics offers a way of identifying them, their agents and evolutionary ancestor. Genomics offers the possibility of deciphering if the release of a pathogen was intentional or natural by observing sequence and annotated data of the causative agent, and evidence of genetic engineering such as cloned vectors at restriction sites. However, to leverage and maximise the application of genomics to strengthen global interception system for real-time biothreat diagnostics, a complete genomic library of pathogenic and non-pathogenic agents will create a robust reference assembly that can be used to screen, characterise, track and trace new and existing strains. Encouraging ethical research sequencing pathogens found in animals and the environment, as well as creating a global space for collaboration will lead to effective global regulation and biosurveillance.

A Systematic Review of Longitudinal Studies Investigating the Association Between Early Life Maternal Depression and Offspring ADHD

Objective: The systematic review sought to understand the relationship between maternal depression and later ADHD in children. Method: Three databases were used to identify the studies (Medline, Web of Science and PsychInfo) resulting in 1,223 studies being screened and 14 articles being included in the review. Results: The majority of studies ( N = 11) reported a significant relationship between maternal depression (across both prenatal and postnatal periods) and ADHD symptoms in children. This relationship remained significant when temperament, or past ADHD symptoms were controlled for. Several methodological issues were identified including; overreliance on maternal report and parental ADHD not being accounted for in most studies. Conclusion: The review adds to the literature regarding the temporal relationship between maternal depression and the development of ADHD in children, and thus supports the case for improving access to mental health services for mothers as a preventative strategy in the development of child psychopathology.

Lifestyle Modification Improves Physical and Mental Health in Elderly Participants: Observational Study in a Controlled Environment

A 60-day observational study was conducted to evaluate how lifestyle modification principles relying upon a customized regimen of aerobic and muscle strength exercise, a plant-based diet and meditative stress reduction techniques may improve physical endurance and strength, mental health, and reverse normal aging associated with the average American lifestyle. All enrolled participants were generally in good health respective to their age. Several subjects had overlapping mild medical conditions. The results demonstrate that the intervention of a customized lifestyle modification regimen of regular daily exercise, a plant-based diet, and daily stress reduction practices, such as meditation and yoga, may provide a viable and beneficial preventative strategy as an anti-aging and wellness model to increase the physical and mental health of elderly men and women.

Factors associated with medical complications after body art among Israeli adults: a retrospective study

Introduction Body-art, including tattoos and piercings, is steadily increasing world-wide but with relatively limited reporting of adverse outcomes. The objective of the present study was to identify correlates that would facilitate a preventative strategy to minimize adverse effects of body-art. Methods We examined patterns of body-art, health risk and perceptions among 921 participants (54% female, mean age of 35; SD = 10.8) through in-person questionnaire. Results A significantly lower frequency of those with body-art acknowledged that not all venues (parlors, clinics, etc.) are safe in terms of health and hygiene (84.7%t vs. 96.6%, p < .001) as compared to those without body-art. Similarly, knowledge of the need for a Ministry of Health certification was reported with lower frequency (77.2% vs. 94.5%, p < .001) among those with body-art. Those who experienced medical complications reported higher frequencies of smoking cigarettes and hookah as well as using ecstasy (MDMA). The risk of medical complication after body-art was 4 times higher in those who used ecstasy (OR = 3.97; CI 1.0–14.4; p < 0.05). In addition, it was more than 3 times higher for street or home tattooing as compared to studio or a licensed medical center (OR = 3.59; CI 1.32–9.76; p < .01), as well as almost 3 times higher among those who did not receive information before performing body-art (OR = 2.70; CI 1.05–6.92; p < .05) and who had somebody other than themselves decide on the body-art design (OR = 2.68; CI 1.00–7.19; p < .05). Conclusions A targeted informational-preventative program should be developed, informed by the risks highlighted in this study. In addition, it would be necessary to draft policies related to regulation and enforcement in order to more effectively manage body-art service provision. The Ministry of Health should supervise and guide tattooists and practitioners regarding the health risks of body-art and offer training and raise awareness among potential clients.

What are the predictors of hand hygiene compliance in the intensive care unit? A cross-sectional observational study

Background: Although appropriate hand hygiene (HH) practices are recognised as the most effective preventative strategy for infection, adherence is suboptimal. Previous studies in intensive care units (ICUs) have found differences in HH compliance between those moments that protect the patient, and those that protect the healthcare provider. However, such studies did not control for other variables known to impact HH compliance. Aim: To examine HH among healthcare workers (HCWs) in ICU settings, and identify whether there is a statistical difference in HH compliance between patient-protective and self-protective moments, while controlling for other variables known to influence HH compliance (i.e. professional role, unit and shift time). Methods: A cross-sectional observational study was conducted in four ICUs across three Irish hospitals. Compliance was assessed according to the WHO’s ‘five moments for hand hygiene’. HCW professional role, total number of ‘opportunities’ for HH and whether compliance was achieved were recorded. Results: A total of 712 HH opportunities were recorded, with an overall compliance rate of 56.9%. Logistic regression analysis revealed that physicians, allied healthcare professionals and auxiliary staff were less likely than nurses to engage in HH. HCWs were more likely to comply during night shifts compared to morning shifts, and with self-protective as compared to patient-protective HH moments. Conclusion: The information provided in this study provides a data-driven approach that ICUs can use to tailor HH interventions to where, when and for whom they are most required.

Biocontrol of Stemphylium vesicarium and Pleospora allii on Pear by Bacillus subtilis and Trichoderma spp.: Preventative and Curative Effects on Inoculum Production

Trials under controlled and field conditions were conducted to establish the effect of strategies of application of biological control agents (BCAs) in the reduction of Stemphylium vesicarium and Pleospora allii inoculum production on pear leaf debris. Six BCAs based on different strains of Trichoderma spp. (Tr1, Tr2) and Bacillus subtilis (Bs1, Bs2, Bs3 and Bs4) were evaluated. Two strategies were tested in controlled experiments: application before (preventative strategy) or after (curative strategy) pear leaf debris colonization by S. vesicarium, evaluating the growth inhibition and sporulation of S. vesicarium and the pseudothecia production of P. allii. When the BCAs were applied preventatively, the efficacy of treatments based on B. subtilis was higher than those based on Trichoderma spp. in controlling the pathogen colonization, but that of controlling the inoculum production of S. vesicarium and P. allii was similar. However, when the BCAs were applied curatively, Trichoderma based products were more effective. In field trials, Trichoderma spp. Tr1 and B. subtlilis Bs1 produced a consistent 45–50% decrease in the number of S. vesicarium conidia trapped compared to the non-treated control. We conclude that Bacillus subtilis Bs1 and Trichoderma spp. Tr1 and Tr2 can be expected to reduce fungal inoculum during the pear vegetative period by at least 45–50%. Additionally, Trichoderma spp. Tr1 and Tr2 have the potential to reduce the fungal overwintering inoculum by 80% to 90%.

Prevention of Post-Operative Adhesions: A Comprehensive Review of Present and Emerging Strategies

Post-operative adhesions affect patients undergoing all types of surgeries. They are associated with serious complications, including higher risk of morbidity and mortality. Given increased hospitalization, longer operative times, and longer length of hospital stay, post-surgical adhesions also pose a great financial burden. Although our knowledge of some of the underlying mechanisms driving adhesion formation has significantly improved over the past two decades, literature has yet to fully explain the pathogenesis and etiology of post-surgical adhesions. As a result, finding an ideal preventative strategy and leveraging appropriate tissue engineering strategies has proven to be difficult. Different products have been developed and enjoyed various levels of success along the translational tissue engineering research spectrum, but their clinical translation has been limited. Herein, we comprehensively review the agents and products that have been developed to mitigate post-operative adhesion formation. We also assess emerging strategies that aid in facilitating precision and personalized medicine to improve outcomes for patients and our healthcare system.

Recurrent Acute Kidney Injury with Severe Loin Pain and Patchy Renal Ischaemia after Anaerobic Exercise without Renal Hypouricaemia in a New Zealand European Male

Acute kidney injury with severe loin pain and patchy renal ischaemia after anaerobic exercise (ALPE) is a rare clinical syndrome. ALPE has predominantly been described in Japanese and Korean populations to date. Many cases and most recurrent examples are associated with renal hypouricaemia. We describe a 28-year-old New Zealand European male without renal hypouricaemia who developed recurrent ALPE whilst performing elite-level sport. Avoiding elite-level anaerobic exercise was successful at preventing further episodes. This report confirms the first known case of ALPE in a New Zealand European male and raises the possibility that ALPE is an under-recognized condition. Long-term outcomes of recurrent ALPE remain unclear, and preventative strategies should be implemented to preserve renal function. Avoiding intense anaerobic exercise is an effective preventative strategy.