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Preservation techniques that maintain the viability of an organ graft between retrieval from the donor and implantation into the recipient remain a critical aspect of solid organ transplantation. While traditionally preservation is accomplished with static cold storage, advances in ex vivo dynamic machine perfusion, both hypothermic and normothermic, have allowed for prolongation of organ viability and recovery of marginal organs effectively increasing the usable donor pool.However, the use of these novel machine perfusion technologies likely exposes the recipient to additional infectious risk either through clonal expansion of pathogens derived during organ recovery or de novo exogenous acquisition of pathogens while the organ remains on the machine perfusion circuit. There is a paucity of high‐quality studies that have attempted to quantify infection risk, although it appears that prolonging the time on the machine perfusion circuit and normothermic parameters increases the risk of infection. Conversely, the use of ex vivo machine perfusion unlocks new opportunities to detect and treat donor‐derived infections before implantation into the recipient.This review seeks to reveal how the use of ex vivo machine perfusion strategies may augment the risk of infection in the organ recipient as well as outline ways that this technology could be leveraged to enhance our ability to manage donor‐derived infections. [ABSTRACT FROM AUTHOR]

Joseph Conrad's 'Karain: A Memory' (1897) is not often cited as a landmark of literary modernism. Conrad's Malay story appeared during the year in which The Nigger of the 'Narcissus' announced his arrival as an author with modernist ambitions. It also belongs to the same Blackwood's period of his early career that produced arguably his most celebrated work, 'Heart of Darkness'. Whereas these stories consensually exemplify Conrad's modernism, 'Karain' tends to be construed as an early working-through of the contemporary popular influences that shaped his literary output. Yet, in a significant sense, it also dramatizes the colonial encounter that defined some of the conceptual contours of modernism. This essay explores the story's composition, early transmission and reception, its self-conscious engagement with its popular cultural lineage, and Conrad's parallel emergence as a writer of 'challenging' fiction. Its aim is not merely to recuperate 'Karain' as a work of early modernism, nor simply to re-evaluate Conrad's story as a rehearsal, in terms of its interrogative relationship with imperialism, for some of his more overtly anti-colonialist fiction. Rather, its wider focus is on how Conrad's story reflects upon the nature of empire and modernism as mutually sustaining enterprises, and, counter to the view of other modernist authors such as T. S. Eliot, how colonial fiction and modernist writing are not antithetical but rather interrelated literary practices. [ABSTRACT FROM AUTHOR]

Background: Amoebic keratitis is a potentially blinding eye infection caused by ubiquitous, free-living, environmental acanthamoebae, which are known to harbor bacterial endosymbionts. A Chlamydia-like endosymbiont has previously enhanced Acanthamoeba virulence in vitro. We investigated the potential effect of Acanthamoeba-endosymbiont coinfection in a human corneal tissue model representing clinical amoebic keratitis infection.Methods: Environmental and corneal Acanthamoeba isolates from the American Type Culture Collection were screened for endosymbionts by amplifying and sequencing bacterial 16S as well as Chlamydiales-specific DNA. Each Acanthamoeba isolate was used to infect EpiCorneal cells, a 3-dimensional human corneal tissue model. EpiCorneal cells were then treated with azithromycin, doxycycline, or control medium to determine whether antibiotics targeting common classes of bacterial endosymbionts attenuated Acanthamoeba virulence, as indicated by decreased observed cytopathic effect and inflammatory biomarker production.Results: A novel endosymbiont closely related to Mycobacterium spp. was identified in Acanthamoeba polyphaga 50495. Infection of EpiCorneal cells with Acanthamoeba castellanii 50493 and A. polyphaga 50372 led to increased production of inflammatory cytokines and cytopathic effects visible under microscopy. These increases were attenuated by azithromycin and doxycycline.Conclusions: Our findings suggest that azithromycin and doxycycline may be effective adjuvants to standard antiacanthamoebal chemotherapy by potentially abrogating virulence-enhancing properties of bacterial endosymbionts. [ABSTRACT FROM AUTHOR]

mexCD - oprJ is an envelope stress-inducible multidrug efflux operon of P seudomonas aeruginosa. A gene encoding a homologue of the NfxB repressor of this operon, PA4596, occurs downstream of oprJ and was proposed as a second repressor of this efflux operon. Inactivation of this gene had no impact on mexCD - oprJ expression in cells not exposed to envelope stress although its loss under envelope stress conditions yielded a > 10-fold increase in mexCD - oprJ expression. Consistent with PA4596 functioning as a mexCD - oprJ repressor, the purified protein was able to bind to a DNA fragment carrying the mexCD - oprJ promoter region. Expression of PA4596 was induced under conditions of envelope stress dependent on the AlgU envelope stress sigma factor, consistent with PA4596 operating under envelope stress conditions where it possibly serves to moderate envelope stress-inducible mexCD - oprJ expression. nfxB mutants showed elevated PA4596 expression and purified NfxB bound to DNA encompassing the PA4596 upstream region, an indication that NfxB functions as a repressor of PA4596 expression. Elimination of PA4596 in P . aeruginosa lacking nfxB and hyperexpressing mexCD - oprJ had no additional impact on mexCD - oprJ expression, regardless of the presence of envelope stress, suggesting that PA4596 repressor activity may be dependent on NfxB. This envelope stress-regulated repressor of mexCD - oprJ has been renamed esrC. [ABSTRACT FROM AUTHOR]

This article explores the interfaces between the representation of non-European, native peoples in Joseph Conrad's 1902 short story 'The End of the Tether' and the anthropology of W. H. R. Rivers. After outlining some of the ethnographic contexts impacting on Conrad's representation of Malay indigeneity, I focus on Rivers's ideas about 'primitive vision', arguing that these ideas, drawn from fieldwork conducted in parts of the world that Conrad knew from his sea years, and current and influential when 'The End of the Tether' was first published, can be felt in the representation of the other in Conrad's tale. [ABSTRACT FROM AUTHOR]

This article focuses on ‘The Planter of Malata’, the first of four tales from Joseph Conrad’s 1915 collection of short fiction, Within the Tides. Despite the weight of scholarship devoted to Conrad, this Australian-set story has yet to receive much, comparatively speaking, in the way of critical investigation. Conrad’s story is, I argue, of interest to cultural historians and literary critics alike. After briefly placing it in the context of Conrad’s personal contact with Australia during his sea years, I consider the story against a broader debate then taking place, concerning the political vision of a ‘White Australia’. I explore how Conrad’s story is attentive to an historical shift in European perceptions of Australia, from being regarded as inimical to European settlement during its early phases, to attempts during the late-nineteenth and early-twentieth century to cultivate Australia as a space solely for whites, as adumbrated in the ‘White Australia’ legislation that followed Federation in 1901. Although generally dismissed as a dry-run for Conrad’s 1915 novel Victory, and judged a critical failure by the standards set by his earlier fiction, in terms of the historical issues to which it is attuned ‘The Planter of Malata’ stands on its own as a work of considerable richness. [ABSTRACT FROM PUBLISHER]

Background: Suboptimal agreement between molecular assays for the detection of Acanthamoeba spp. in clinical specimens has been demonstrated, and poor assay sensitivity directly imperils the vision of those affected by amoebic keratitis (AK) through delayed diagnosis. We sought to develop and validate a single Taqman real time PCR assay targeting the Acanthamoeba 18S rRNA gene that could be used to enhance sensitivity and specificity when paired with reference assays. Methods: Biobanked DNA from surplus delinked AK clinical specimens and 10 ATCC strains of Acanthamoeba was extracted. Sequence alignment of 66 18S rRNA regions from 12 species of Acanthamoeba known to cause keratitis informed design of a new TaqMan primer set. Performance of the new assay was compared to the 2 assays used currently in our laboratory. Results: Among 24 Acanthamoeba-positive and 83 negative specimens by the CDC reference standard, performance characteristics of the newly designed primer set were as follows: sensitivity 100%, specificity 94%, PPV 82.8%, and NPV 100%. Compared to culture, sensitivity of the new primer set was 100%, and specificity 96%. No cross-reactivity of the primer set to non-acanthamoebae, including Balamuthia and Naegleria, was found. Conclusions: We have validated a real time PCR assay for the diagnosis of AK, and in doing so, have overcome important barriers to rapid and sensitive detection of acanthamoebae, including limited sensitivity and specificity of commonly used assays. [ABSTRACT FROM AUTHOR]

Testing for other I I. scapularis i coinfections should be considered if the patient has compelling clinical or laboratory findings that are consistent with a secondary pathogen or if the patient requires admission to hospital. Our patient was immunocompromised because of end-stage renal failure, and had severe human granulocytic anaplasmosis complicated by HLH and coinfection with both I B. burgdoferi i and Powassan virus. The I Ixodes scapularis i tick is a vector implicated in multiple tickborne illnesses, including Lyme disease, human granulocytic anaplasmosis, babesiosis and Powassan virus disease. [Extracted from the article]

Backgound: Species of the Leishmania Viannia (L. V.) subgenus harbor the double-stranded Leishmania RNA virus 1 (LRV-1), previously identified in isolates from Brazil and Peru. Higher levels of LRV-1 in metastasizing strains of L. V. guyanensis have been documented in both human and murine models, and correlated to disease severity.Methods: Expression of proinflammatory biomarkers, including interleukin (IL) 1β, tumor necrosis factor alpha (TNF-α), CXCL10, CCL5, IL-6, and superoxide dismutase, in human macrophages infected with 3 ATCC and 5 clinical isolates of L. V. braziliensis, L. V. guyanensis, and L. V. panamensis for 24 and 48 hours were measured by commercial enzyme immunoassay. Analyses were performed at 24 and 48 hours, stratified by LRV-1 status and species.Results: LRV-1-positive L. V. braziliensis demonstrated significantly lower expression levels of TNF-α (P = .01), IL-1β (P = .0015), IL-6 (P = .001), and CXCL10 (P = .0004) compared with LRV-1-negative L. V. braziliensis. No differences were observed in strains of L. V. panamensis by LRV-1 status.Conclusions: Compared to LRV-1-negative L. V. braziliensis, LRV-1-positive strains of L. V. braziliensis produced a predominant Th2-biased immune response, correlated in humans to poorer immunologic control of infection and more severe disease, including mucosal leishmaniasis. Effects of LRV-1 on the pathogenesis of American tegumentary leishmaniasis may be species specific. [ABSTRACT FROM AUTHOR]

The article explores the future of medical education at a time when it is facing the need to accommodate the growing diverse needs of its patients. Topics discussed include the changes being adopted into medical school admissions tests like the move of the Association of American Medical Colleges to integrate psychology, sociology and behavioral science into their test and the dilemma over the discordance between quality of life and length of life.