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A novel strain of Planctomycetes, designated JC670T, was isolated from a high altitude (~ 2900 m above sea level) soil sample collected from Garhwal region in the Western Himalaya. Colonies of this strain were observed to be light pink coloured with spherical to oval shaped cells having crateriform structures distributed all over the cell surface. The cells divide by budding. Strain JC670T was found to grow well at pH 7.0 and pH 8.0 and to tolerate up to 2% NaCl (w/v). MK6 was the only respiratory quinone identified. The major fatty acids of strain JC670T were identified as C18:1ω9c, C18:0 and C16:0, and phosphatidylcholine, two unidentified phospholipids and six unidentified lipids are present as the polar lipids. The polyamines putrescine and sym-homospermidine were detected. Strain JC670T shows high 16S rRNA gene sequence identity (95.4%) with Paludisphaera borealis PX4T. The draft genome size of strain JC670T is 7.97 Mb, with G + C content of 70.4 mol%. Based on phylogenetic analyses with the sequences of ninety-two core genes, low dDDH value (20.6%), low gANI (76.8%) and low AAI (69.1%) results, differential chemotaxonomic and physiological properties, strain JC670T (= KCTC 72850T = NBRC 114339T) is recognised as the type strain of a new species of the genus Paludisphaera, for which we propose the name Paludisphaera soli sp. nov.

Prostate cancer has become a global health concern as it is one of the leading causes of mortality in males. With the emerging drug resistance to conventional therapies, it is imperative to unravel new molecular targets for disease prevention. Cytochrome P450 (P450s or CYPs) represents a unique class of mixed-function oxidases which catalyses a wide array of biosynthetic and metabolic functions including steroidogenesis and cholesterol metabolism. Several studies have reported the overexpression of the genes encoding CYPs in prostate cancer cells and how they can be used as molecular targets for drug discovery. But due to functional redundancy and overlapping expression of CYPs in several other metabolic pathways there are several impediments in the clinical efficacy of the novel drugs reported till now. Here we review the most crucial P450 enzymes which are involved in prostate cancer and how they can be used as molecular targets for drug discovery along with the clinical limitations of the currently existing CYP inhibitors.

Infectious diseases caused by numerous parasitic pathogens represent a global health conundrum. Several animal and plant pathogens are responsible for causing acute illness in humans and deadly plant infections. These pathogens have evolved a diverse array of infection strategies and survival methods within the host organism. Recent research has highlighted the role of protein kinases in the overall virulence and pathogenicity of the pathogens. Protein kinases (Pks) are a group of enzymes known to catalyse the phosphorylation of a wide variety of cellular substrates involved in different signalling cascades. They are also involved in regulating pathogen life cycle and infectivity. In this review, we attempt to address the role of parasite kinome in host infection, pathogen survival within the host tissue and thereby disease manifestation. The understanding of the parasite kinome can be a potential target for robust diagnosis and effective therapeutics.

Background: Lesbian, gay, bisexual and transgender (LGBT) individuals are a minority population with unique healthcare needs and challenges. Lack of focused education of medical providers in the healthcare needs of this vulnerable population creates a significant barrier to care and exacerbates health disparities faced by this population. Objective: To identify factors affecting self-perceived preparedness and comfort of medical trainees to address healthcare needs of LGB and transgender individuals at a large urban tertiary-care teaching hospital. Methods: An anonymous survey was emailed to 365 residents and fellows across all specialties at Albert …

Invasive plants are known to alter the soil microbial communities; however, the effects of co-occurring native and invasive congeners on the soil bacterial diversity and their predictive metabolic profiles are not known. Here, we compared the rhizosphere bacterial communities of invasive Prosopis juliflora and its native congener Prosopis cineraria using high-throughput sequencing of the 16S rRNA gene. Unweighted Pair Group Method with Arithmetic mean (UPGMA) based dendrogram revealed significant variation in the communities of these co-occurring Prosopis species. Additionally, Canonical Correspondence Analysis (CCA) based on microbial communities in addition to the soil physiochemical parameters viz. soil pH, electrical conductivity, moisture content and sampling depth showed ~ 80% of the variation in bacterial communities of the rhizosphere and control soil. We observed that Proteobacteria was the predominant phylum of P. juliflora rhizosphere and the control soil, while P. cineraria rhizosphere was dominated by Cyanobacteria. Notably, the invasive P. juliflora rhizosphere showed an enhanced abundance of bacterial phyla like Actinobacteria, Chloroflexi, Firmicutes and Acidobacteria compared to the native P. cineraria as well as the control soil. Predictive metagenomics revealed that the bacterial communities of the P. juliflora rhizosphere had a higher abundance of pathways involved in antimicrobial biosynthesis and degradation, suggesting probable exposure to enemy attack and an active response mechanism to counter it as compared to native P. cineraria. Interestingly, the higher antimicrobial biosynthesis predicted in the invasive rhizosphere microbiome is further corroborated by the fact that the bacterial isolates purified from the rhizosphere of P. juliflora belonged to genera like Streptomyces, Isoptericola and Brevibacterium from the phylum Actinobacteria, which are widely reported for their antibiotic production ability. In conclusion, our results demonstrate that the co-occurring native and invasive Prosopis species have significantly different rhizosphere bacterial communities in terms of composition, diversity and their predictive metabolic potentials. In addition, the rhizosphere microbiome of invasive Prosopis proffers it a fitness advantage and influences invasion success of the species.

Background Inappropriate use of prescription opioids is a growing public-health issue. We sought to estimate the proportion of traumatic injury patients using legal prescription opioids up to 1-year after hospitalization. Methods We used 2006–2014 claims data from TRICARE insurance to identify adults hospitalized secondary to trauma between 2007 and 2013. Prescription opioid use was evaluated for one-year post-discharge. Risk-adjusted Cox Proportional-hazards models were used to evaluate predictors of opioid discontinuation. Results Only 1% of patients sustained legal prescription opioid use at 1-year following trauma. Lower socioeconomic status (HR 0.92, 95% CI 0.87–0.98) and higher injury severity (HR 0.88, 95% CI 0.84–0.91) were associated with sustained use. Younger patients (HR 1.12, 95% CI 1.04–1.21) and Black patients (HR 1.09, 95% CI 1.04–1.15) were found to have a higher likelihood of opioid discontinuation. Conclusions In this population, adult patients who sustained trauma were not at high risk of sustained legal prescription opioid use.

Background Racial disparities in mortality exist among pediatric trauma patients; however, little is known about disparities in outcomes following discharge. Methods We conducted a longitudinal cohort study of children admitted for moderate to severe trauma, covered by TRICARE from 2006 to 2014. Patients were followed up to 90 days after discharge. All children 9 and 90 days of follow-up after discharge were included. Complications, readmissions and utilization of healthcare services up to 90 days after discharge were compared between Black and White patients. Results Of the 5192 children included, majority were White (74.6%, n = 3871), with 15.4% Black (n = 800) and 10.0% Other (n = 521). Most common injuries involved the extremities or the pelvic girdle followed by the head or neck. Complication and readmission rates were 3.6% and 8.9% within 30 days of discharge respectively and 4.4% and 9.3% within 90 days of discharge. 99.0% of children had at least one outpatient visit by 90 days. After adjusting for patient and injury characteristics no significant differences were detected between Black and White children in outcomes after discharge. Conclusions Universal insurance may help mitigate disparities in post discharge care in pediatric trauma populations by increasing access to outpatient services overall and within each racial group. Further studies are required to determine the appropriate timing and frequency of follow up care in order to achieve maximum reduction in use of acute care services after discharge.

Background Although inequities in trauma care are reported widely, some groups have theorized that universal health insurance would decrease disparities in care for disadvantaged minorities after a traumatic injury. We sought to examine the presence of racial disparities in outcomes and healthcare utilization at 30- and 90-days after discharge in this universally insured, racially diverse, American population treated for traumatic injuries. Methods This work studied adult beneficiaries of TRICARE treated at both military and civilian trauma centers 2006–2014. We included patients with an inpatient trauma encounter based on International Classification of Diseases, 9th revision (ICD-9) code. The mechanism and severity of injury, medical comorbidities, region and environment of care, and demographic factors were used as covariates. Race was considered the main predictor variable with Black patients compared to Whites. Logistic regression models were employed to assess for risk-adjusted differences in 30- and 90-day outcomes between Blacks and Whites. Results A total of 87,112 patients met the inclusion criteria. Traditionally encountered disparities for Black patients after trauma, including increased rates of mortality, were absent. We found a statistically significant decrease in the odds of 90-day complications for Blacks (OR 0.91; 95% CI 0.84–0.98; P = 0.01). Blacks also had lesser odds of readmission at 30-days (OR 0.87; 95% CI 0.79–0.94; P = 0.002) and 90-days (OR 0.86; 95% CI 0.79–0.93; P Conclusion Our findings support the idea that in a universally insured, equal access system, historic disparities for racial and ethnic minorities, including increased postinjury morbidity, hospital readmission, and postdischarge healthcare utilization, are decreased or even eliminated.

Background In 2009 the I-PASS Study Group was formed by patient safety, medical education, health services research, and clinical experts from multiple institutions in the United States and Canada. When the I-PASS Handoff Program, which was developed by the I-PASS Study Group, was implemented in nine hospitals, it was associated with a 30% reduction in injuries due to medical errors and significant improvements in handoff processes, without any adverse effects on provider work flow. Methods To effectively disseminate and adapt I-PASS for use across specialties and disciplines, a series of federally and privately funded dissemination and implementation projects were carried out following the publication of the initial study. The results of these efforts have informed ongoing initiatives intended to continue adapting and scaling the program. Results As of this writing, I-PASS Study Group members have directly worked with more than 50 hospitals to facilitate implementation of I-PASS. To further disseminate I-PASS, Study Group members delivered hundreds of academic presentations, including plenaries at scientific meetings, workshops, and institutional Grand Rounds. Some 3,563 individuals, representing more than 500 institutions in the 50 states in the United States, the District of Columbia, Puerto Rico, and 57 other countries, have requested access to I-PASS materials. Most recently, the I-PASSSM Patient Safety Institute has developed a virtual immersion training platform, mobile handoff observational tools, and processes to facilitate further spread of I-PASS. Conclusion Implementation of I-PASS has been associated with substantial improvements in patient safety and can be applied to a variety of disciplines and types of patient handoffs. Widespread implementation of I-PASS has the potential to substantially improve patient safety in the United States and beyond.

Objective To compare number of infections and health care utilization in children insured by TRICARE with recurrent acute otitis media (RAOM) managed surgically with tympanostomy tube (TT) placement compared with those managed medically. Study Design Retrospective matched cohort study. Setting TRICARE claims database from 2006 to 2010. Subjects and Methods We matched TRICARE beneficiaries ≤5 years of age diagnosed with RAOM who underwent TT placement with those managed medically using 1:1 coarsened-exact matching on age, sex, race, sponsor rank, and region. We used multivariable negative binomial regression to compare number of infections and health care utilization at 1 and 2 years. Outcomes were adjusted for rate of infection before treatment for RAOM, season of either TT placement or establishment of candidacy for TT placement, and comorbidities. Results Among 6659 pairs identified at 1-year follow-up, the TT group had fewer infections (1.96 vs 2.18, P < .001) and oral antibiotic prescriptions (1.52 vs 1.67, P < .001) but more visits to primary care physicians (4.36 vs 4.06, P < .0001) and otolaryngologists (1.21 vs 0.44, P < .0001) compared with the medically managed group. At 2-year follow-up, the benefits of TT placement were no longer seen. Conclusion TT placement for RAOM is associated with fewer infections and oral antibiotic prescriptions in the first year after surgery but more doctor visits. Benefits of TT placement do not appear to extend through the second year. Future research should investigate costs associated with TT placement vs medical management, as well as real-time health care utilization with impact on patient symptoms and quality of life.

To determine if racial differences exist in receipt of minimally invasive hysterectomy (defined as total vaginal hysterectomy [TVH] and total laparoscopic hysterectomy [TLH]) compared with an open approach (total abdominal hysterectomy [TAH]) within a universally insured patient population.Retrospective data analysis (Canadian Task Force classification II-2).The 2006-2010 national TRICARE (universal insurance coverage to US Armed Services members and their dependents) longitudinal claims data.Women aged 18 years and above who underwent hysterectomy stratified into 4 racial groups: white, African American, Asian, and "other."Receipt of hysterectomy (TAH, TVH, or TLH).We used risk-adjusted multinomial logistic regression models to determine the relative risk ratios of receipt of TVH and TLH compared with TAH in each racial group compared with referent category of white patients for benign conditions. Among 33 015 patients identified, 60.82% (n = 20 079) were white, 26.11% (n = 8621) African American, 4.63% (n = 1529) Asian, and 8.44% (n = 2786) other. Most hysterectomies (83.9%) were for benign indications. Nearly 42% of hysterectomies (n = 13 917) were TAH, 27% (n = 8937) were TVH, and 30% (n = 10 161) were TLH. Overall, 36.37% of white patients received TAH compared with 53.40% of African American patients and 51.01% of Asian patients (p .001). On multinomial logistic regression analyses, African American patients were significantly less likely than white patients to receive TVH (relative risk ratio [RRR], .63; 95% confidence interval [CI], .58-.69) or TLH (RRR, .65; 95% CI, .60-.71) compared with TAH. Similarly, Asian patients were less likely than white patients to receive TVH (RRR, .71; 95% CI, .60-.84) or TLH (RRR, .69; 95% CI, .58-.83) compared with TAH. Analyses by benign indications for surgery showed similar trends.We demonstrate that racial minority patients are less likely to receive a minimally invasive surgical approach compared with an open abdominal approach despite universal insurance coverage. Further work is warranted to better understand factors other than insurance access that may contribute to racial differences in surgical approach to hysterectomies.

Objective To assess parent and provider experience and shared understanding after a family-centered, multidisciplinary nighttime communication intervention (nurse–physician brief, family huddle, family update sheet). Methods We performed a prospective intervention study at a children's hospital from May 2013 to October 2013 (preintervention period) and May 2014 to October 2014 (postintervention period). Participants included 464 parents, 176 nurses, and 52 resident physicians of 582 hospitalized 0- to 17-year-old patients. Pre- versus postintervention, we compared parent/provider top-box scores (eg, "excellent") for experience with communication across several domains; and level of agreement (shared understanding) between parent, nurse, and resident reports of patients' reason for admission, overnight medical plan, and overall medical plan, as rated independently by blinded clinician reviewers (agreement = 74.7%, kappa = .60). Results Top-box parent experience improved for 1 of 4 domains: Experience and Communication With Nighttime Doctors (23.6% to 31.5%). Top-box provider experience improved for all 3 domains, including Communication and Shared Understanding With Families (resident rated, 16.5% to 35.1%; nurse rated, 32.2% to 37.9%) and Experience, Communication, and Shared Understanding With Other Providers (resident rated, 20.3% to 35.0%; nurse rated, 14.7% to 21.5%). Independently rated shared understanding remained unchanged for most domains but improved for parent–nurse composite shared understanding (summed agreement for reason for admission, overall plan, and overnight plan; 36.2% to 48.2%) and nurse–resident shared understanding regarding reason for admission (67.1% to 71.2%) and regarding overall medical plan (45.0% to 58.6%). All P Conclusions A family-centered, multidisciplinary nighttime communication intervention was associated with improvements in some, but not all, domains of parent/provider experience and shared understanding, particularly provider experience and nurse–family shared understanding. The intervention was promising but requires further refinement.

Groundnut oil (GNO) was modified to contain equal proportions of omega-6/ omega-3 fatty acids by blending with linseed oil. Blended oil (BLE) was subjected to interesterification reaction using immobilized lipase to prepare transesterified oil (TRA).A structured lipid (STR) was also prepared by acidolysis reaction usingGNO and omega-3 fatty acid concentrates from linseed oil. These oils were then fed to rats for a period of 60 days.A reduction in low density lipoprotein cholesterol level by 26 and 23% and a reduction in serum triglyceride concentration by 18.9 and 17.6% were observed in rats given TRA and STR, respectively, as compared with rats fed with GNO. Rats fed with BLE and interesterified oils showed incorporation of a-linolenic acid and an increase in eicosapentaenoic acid and docosahexaenoic acid in serum and liver lipids. These modified oils could be used for enriching Indian diets with omega-3 fatty acids. PRACTICAL APPLICATIONS There is a realization that dietary fat should contain balanced amount of omega-6 and omega-3 fatty acids. The oils used in Indian cooking generally contains high amount of omega-6 but not omega-3 fatty acids. The present investigation was undertaken to develop oil that can provide equal amounts of omega-6 and omega-3 fatty acids by the blending process. The fatty acids in blended oils were randomized through lipase catalyzed acidolysis and transesterification reaction. These modified oils significantly reduced the serum and liver lipids when fed to rats. The modified oils also showed altered physical properties. This study therefore showed that it is possible to restructure the edible oils through biotechnological approaches to get the desired fatty acid composition needed for better nutrition and required physical properties in oils.

The present study was undertaken to compare the alterations observed in the triacylglycerol (TAG) molecular species of blended and interesterified oils containing groundnut oil (GNO) and linseed oil (LIN). The blended oil (BLE) was subjected to a lipase catalyzed reaction to prepare transesterified oil (TRA). A structured lipid (STR) was also prepared by a lipase catalyzed acidolysis reaction of GNO and free fatty acids concentrate from LIN. The changes in the molecular species of modified lipids were determined by high performance liquid chromatography. The thermal profiles were determined by differential scanning calorimetry. In comparison with GNO, the triunsaturated triacylglycerols were increased and the disaturated triacylglycerol molecular species were decreased in TRA and STR. Both BLE and TRA showed a decrease in the onset temperature for crystallization as compared to that observed with GNO. The total transitional enthalpy for crystallization was higher for BLE, TRA and STR as compared to GNO. The melting temperature of TRA and STR showed a decrease in comparison to GNO, reflecting on the changes in the TAG molecules species present in the oil. Thus, interesterification of oils introduced changes in the physical properties of oils, even though the overall fatty acid composition of blended and interesterified oils remained similar.

The present study deals with the production of structured lipid containing omega-3 and omega-6 fatty acids in the ratio of 1:1 by incorporating omega-3 fatty acids (α-linolenic acid) from linseed oil into groundnut oil using lipase (Lipozyme IM from Rhizomucor miehei ) catalyzed acidolysis reaction in hexane. The reaction conditions were optimized by response surface methodology with a four-variable five-level central composite rotatable experimental design. The influence of four independent parameters, namely ratio of fatty acid concentrate from linseed to groundnut oil (0.66–1.98, w/w), reaction temperature (30–60 °C), enzyme concentration (1–5%) and reaction time (2–54 h) on omega-3 fatty acids incorporation into groundnut oil were optimized. Optimal conditions for the structured lipid containing omega-3 to omega-6 fatty acids in the ratio of 1:1 were determined to be; enzyme concentration 3.75% (w/w), temperature 37.5 °C, incubation time 30.81 h and ratio of free fatty acid concentrate from linseed oil to groundnut oil 1.16 (w/w).

In the current health care environment with increased scrutiny and growing concern regarding opioid use and abuse, there has been a push toward greater regulation over prescriptions of opioids. Trauma patients represent a population that may be affected by this regulation, as the incidence of pain at hospital discharge is greater than 95%, and opioids are considered the first line of treatment for pain management. However, the use of opioid prescriptions in trauma patients at hospital discharge has not been explored.To study the incidence and predictors of opioid prescription in trauma patients at discharge in a large national cohort.Analysis of adult (18-64 years), opioid-naive trauma patients who were beneficiaries of Military Health Insurance (military personnel and their dependents) treated at both military health care facilities and civilian trauma centers and hospitals between January 1, 2006, and December 31, 2013, was conducted. Patients with burns, foreign body injury, toxic effects, or late complications of trauma were excluded. Prior diagnosis of trauma within 1 year and in-hospital death were also grounds for exclusion. Injury mechanism and severity, comorbid conditions, mental health disorders, and demographic factors were considered covariates. The Drug Enforcement Administration's list of scheduled narcotics was used to query opioid use. Unadjusted and adjusted logistic regression models were used to determine the predictors of opioid prescription. Data analysis was performed from June 7 to August 21, 2016.Injury mechanism and severity, comorbid conditions, mental health disorders, and demographic factors.Prescription of opioid analgesics at discharge.Among the 33 762 patients included in the study (26 997 [80.0%] men; mean [SD] age, 32.9 [13.3] years), 18 338 (54.3%) received an opioid prescription at discharge. In risk-adjusted models, older age (45-64 vs 18-24 years: odds ratio [OR], 1.28; 95% CI, 1.13-1.44), marriage (OR, 1.26; 95% CI, 1.20-1.34), and higher Injury Severity Score (≥9 vs9: OR, 1.40; 95% CI, 1.32-1.48) were associated with a higher likelihood of opioid prescription at discharge. Male sex (OR, 0.76; 95% CI, 0.69-0.83) and anxiety (OR, 0.82; 95% CI, 0.73-0.93) were associated with a decreased likelihood of opioid prescription at discharge.The incidence of opioid prescription at discharge (54.3%) closely matches the incidence of moderate to severe pain in trauma patients, indicating appropriate prescribing practices. We advocate that injury severity and level of pain-not arbitrary regulations-should inform the decision to prescribe opioids.

Importance Medical errors and adverse events (AEs) are common among hospitalized children. While clinician reports are the foundation of operational hospital safety surveillance and a key component of multifaceted research surveillance, patient and family reports are not routinely gathered. We hypothesized that a novel family-reporting mechanism would improve incident detection. Objective To compare error and AE rates (1) gathered systematically with vs without family reporting, (2) reported by families vs clinicians, and (3) reported by families vs hospital incident reports. Design, Setting, and Participants We conducted a prospective cohort study including the parents/caregivers of 989 hospitalized patients 17 years and younger (total 3902 patient-days) and their clinicians from December 2014 to July 2015 in 4 US pediatric centers. Clinician abstractors identified potential errors and AEs by reviewing medical records, hospital incident reports, and clinician reports as well as weekly and discharge Family Safety Interviews (FSIs). Two physicians reviewed and independently categorized all incidents, rating severity and preventability (agreement, 68%-90%; κ, 0.50-0.68). Discordant categorizations were reconciled. Rates were generated using Poisson regression estimated via generalized estimating equations to account for repeated measures on the same patient. Main Outcomes and Measures Error and AE rates. Results Overall, 746 parents/caregivers consented for the study. Of these, 717 completed FSIs. Their median (interquartile range) age was 32.5 (26-40) years; 380 (53.0%) were nonwhite, 566 (78.9%) were female, 603 (84.1%) were English speaking, and 380 (53.0%) had attended college. Of 717 parents/caregivers completing FSIs, 185 (25.8%) reported a total of 255 incidents, which were classified as 132 safety concerns (51.8%), 102 nonsafety-related quality concerns (40.0%), and 21 other concerns (8.2%). These included 22 preventable AEs (8.6%), 17 nonharmful medical errors (6.7%), and 11 nonpreventable AEs (4.3%) on the study unit. In total, 179 errors and 113 AEs were identified from all sources. Family reports included 8 otherwise unidentified AEs, including 7 preventable AEs. Error rates with family reporting (45.9 per 1000 patient-days) were 1.2-fold (95% CI, 1.1-1.2) higher than rates without family reporting (39.7 per 1000 patient-days). Adverse event rates with family reporting (28.7 per 1000 patient-days) were 1.1-fold (95% CI, 1.0-1.2; P = .006) higher than rates without (26.1 per 1000 patient-days). Families and clinicians reported similar rates of errors (10.0 vs 12.8 per 1000 patient-days; relative rate, 0.8; 95% CI, .5-1.2) and AEs (8.5 vs 6.2 per 1000 patient-days; relative rate, 1.4; 95% CI, 0.8-2.2). Family-reported error rates were 5.0-fold (95% CI, 1.9-13.0) higher and AE rates 2.9-fold (95% CI, 1.2-6.7) higher than hospital incident report rates. Conclusions and Relevance Families provide unique information about hospital safety and should be included in hospital safety surveillance in order to facilitate better design and assessment of interventions to improve safety.

A seedling bioassay was used to determine the response of triallate-resistant (R) and -susceptible (S) wild oat populations to difenzoquat and EPTC. The bioassay, based on seedling shoot length at 10 d after treatment, provided a reliable and rapid means of determining if wild oat populations were resistant to difenzoquat. Using a bioassay concentration of 15 ppm difenzoquat, it was possible to identify populations that were resistant to the recommended foliar-applied rate (0.85 kg ai/ha). Expected herbicide dosages that reduced shoot length by 50% (ED50) derived from nonlinear regression analysis indicated three and two levels of response to difenzoquat among eight S and seven R populations, respectively, indicating within population variability in their response to difenzoquat. Of the populations tested, none was resistant to EPTC. On the contrary, some R populations had lower ED50values than did S populations, suggesting an increased sensitivity to EPTC.