Adequate Quality Research Articles

Deep Brain Stimulation Treatment for Genetic Parkinson's Disease: A Case Report

Parkinson's disease (PD) is the second most common neurodegenerative disease and its prevalence has been projected to double over the next 30 years. The diagnosis of PD is bradykinesia and resting tremor or rigidity. PD is a progressive neurodegenerative disease with both motor and nonmotor symptoms. There are many medical options for the treatment of PD but levodopa remains the mainstay. Deep brain stimulation (DBS) is a safe neurosurgical symptomatic treatment for eligible patients with advanced disease in whom medical therapy fails to provide adequate symptom control and a good quality of life or in whom dopaminergic drugs cause severe side effects such as dyskinesias. In this case report, a 44-year-old female patient with a history of tremor and genetic Parkinson's disease, who presented to the clinic with the complaint of excessive increase in tremor in recent years, firstly with drug treatment and then with DBS treatment is reported.

Cloud media video encoding: review and challenges

AbstractIn recent years, Internet traffic patterns have been changing. Most of the traffic demand by end users is multimedia, in particular, video streaming accounts for over 53%. This demand has led to improved network infrastructures and computing architectures to meet the challenges of delivering these multimedia services while maintaining an adequate quality of experience. Focusing on the preparation and adequacy of multimedia content for broadcasting, Cloud and Edge Computing infrastructures have been and will be crucial to offer high and ultra-high definition multimedia content in live, real-time, or video-on-demand scenarios. For these reasons, this review paper presents a detailed study of research papers related to encoding and transcoding techniques in cloud computing environments. It begins by discussing the evolution of streaming and the importance of the encoding process, with a focus on the latest streaming methods and codecs. Then, it examines the role of cloud systems in multimedia environments and provides details on the cloud infrastructure for media scenarios. After doing a systematic literature review, we have been able to find 49 valid papers that meet the requirements specified in the research questions. Each paper has been analyzed and classified according to several criteria, besides to inspect their relevance. To conclude this review, we have identified and elaborated on several challenges and open research issues associated with the development of video codecs optimized for diverse factors within both cloud and edge architectures. Additionally, we have discussed emerging challenges in designing new cloud/edge architectures aimed at more efficient delivery of media traffic. This involves investigating ways to improve the overall performance, reliability, and resource utilization of architectures that support the transmission of multimedia content over both cloud and edge computing environments ensuring a good quality of experience for the final user.

Effects of lifestyle factors on job-related stress and stress responses in police officers in Japan

Abstract Objective The aim of this study was to investigate the relationship between stress responses and lifestyle factors of police officers in Japan. Methods This study used a cross-sectional design. Of indivudals who underwent legally required health screenings in a Prefectural Police, 9633 men and 1086 women completed the Brief Job Stress Questionnaire. Then a multivariate analysis for various lifestyle factors was performed with high stress and six stress responses (low vitality, high irritability, high fatigue, high anxiety, substantial depressive feeling, and high somatic symptoms) as dependent variables. Results Of the potential covariates, short sleep duration consistently related to various stress and stress responses. The odds ratios of short sleep duration were consistently significant for high stress in men and women, for high irritability in men, for high fatigue in women, for high depressive feeling in men and women, and for high somatic symptoms in men and women. As for factors other than sleep duration, age, rank, marital status, overtime work, and rhythm of daily life were significantly associated with high stress and various stress responses. Conclusions The results of this study consistently showed that short sleep duration increases the risk of high stress and stress responses. Overall, more women than men in the police force reported short sleep duration, which may be due to work–family conflicts. Maintaining adequate sleep duration quality would reinforce preventive measures to avoid aggravation of stress status.

Improving The Quality Of Baby Sleep By Giving Massage To Babies

Background: The need for sleep is important for every individual. However, infants who experience sleep disturbances result in decreased sleep quality and affect their growth and development. One that can improve the quality of infant sleep by giving non-pharmacological therapy is baby massage. This study aims to analyze the effect of baby massage on infant sleep quality in Gandasari Village Area, Katapang District, Bandung Regency. Methods: This type of research is a pre experimental design using a one group pretest-posttest design approach. The sample of this study amounted to 30 infants who were taken by the total sampling method. This research instrument used standar procedure operational and questionnaire and paired sample T test statistical test. Results: The results showed that more than half of the respondents (63.3%) had poor sleep quality before baby massage, and more than half of the respondents (56.6%) had adequate sleep quality after baby massage. The paired sample T test statistical test shows that the significant value of p value = 0.000 < α (0.05), so Ha is accepted where there is an effect of baby massage on infant sleep quality in Gandasari Village Area, Katapang District. Conclusion: There is a significant influence between giving baby massage on infant sleep quality with p-value 0.000 < 0.05.

Where is the source? Water sources for non-resident students at the University of Kabianga, Kenya

The immense increase in residential developments around universities to provide private accommodation for the rapidly growing population of university students has constrained providing a safe, clean, and sufficient water supply. The Kenyan Constitution protects everyone`s fundamental right to access adequate water. However, the reality for non-resident students at the University of Kabianga (UoK) is far from their entitlements by the Kenyan Constitution. This project aims at establishing the sources of water available for non-resident students of the UoK. To achieve this, the study employed an exploratory approach that employed a descriptive survey. Its target population was the non-resident students (673 students) of the UoK, from whom a sample size of 250 students was selected. Simple random sampling was used in selecting the participants, while purposive random sampling was utilized to choose the study's private hostels (15 Hostels). The tools for data collection included questionnaires, key informant interviews, and an observation guide. The collected data was analyzed using SPSS to generate descriptive statistics. Findings obtained from the study revealed that most respondents (68%) relied on rainwater during the rainy season. However, most students (46%) relied on wells/boreholes, while 44% relied on private vendors during the dry season. In addition, majority of the respondents (61%), the available sources of water were not safe for drinking. In terms of challenged faced by the respondents in accessing water, time wastage while trying to access water was stated to be the main challenge (78%) as this highly affected their studies. Taken together, the study show that the water sources are unreliable, and this may not satisfy the demands of water in the area. The findings of this study will provide a basis for the provision of a sustainable water supply of adequate quality to non-resident students` hostels at the University of Kabianga and inform the stakeholders of appropriate measures that should be put in place to ensure adequate water supply to their tenants.

Assessment of microwave drying for rapid and convenient analysis of medicinal plants for quality assurance.

The safety and quality of many medicinally important herbs are compromised since farmers and small organizations are involved in the cultivation, aggregation, and primary processing of these herbs. Such organizations often lack adequate quality control facilities. To improve the safety and quality of herbal products, simple, rapid, and affordable quality control systems are required. The aim of this study was to assess the suitability of microwave oven-drying for moisture content (MC) determination and sample preparation of herbs in small organizations. Microwave oven-drying (720 W) and convective oven-drying at 105°C for MC determination were compared. The effects of three different drying methods (microwave oven-drying, low-temperature convective drying, and freeze-drying) on in vitro antioxidant and polyphenol oxidase (PPO) activity were determined, similarity analysis was conducted using HPLC signature spectra, and validation was performed with LC-MS focusing on one herb. Microwave oven-drying at 720 W significantly reduced the drying time (from hours to minutes), whereas the spatial variationof temperature in convective ovens set at 105°C can cause about 10% underestimation of MC. Microwave oven-dryingshowed similar macro-properties like freeze-drying and higher extractability (10%-20%) and in vitro antioxidant capacity (33%-66%) and lower PPO activity compared to low-temperature convective drying. HPLC signature spectra revealed strongsimilarity ofsoluble components between freeze-dried and microwave oven-dried herbs. LC-MS analysis demonstrated more common compounds between freeze-driedand microwave oven-driedCentella asiatica extracts, whereas convective tray-dried samples had fewer compounds common with samples obtained by freeze-drying or microwave oven-drying. Microwave oven-drying is rapid (tens of min) and shows small batch-to-batch variation compared to oven-drying at 105°C. The in vitro antioxidant assays and signature spectra can be used for assessing the source and purity or quality of a specific herb variety.

Ventilation regulations and occupant practices: undetectable pollution and invisible extraction

This sociotechnical investigation examines the use of ventilation systems in homes in London, UK. These homes were built with ventilation systems as described by guidance in the UK Building Regulations Approved Document F. These systems are assumed to provide adequate ventilation rates. However, previous measurements in these homes show that ventilation rates are inadequate. Using social practice theory as a framework to analyse the qualitative data, the intended use of the ventilation systems is compared to participants’ actual practices of manipulating the indoor air, revealing discrepancies between the two. Occupants had limited knowledge of indoor pollutants but were highly motivated to control and interact with the smells and air in their homes. They primarily used technologies that were not part of the planned system, because the latter’s functioning was opaque to occupants and not well connected to their other practices. The highlighted discrepancies in four case study homes between planned and actual ventilation system operation help to identify how future systems could be improved to ensure adequate ventilation rates and good indoor air quality in airtight homes. Policy relevance This research investigates the extent to which the intended operation of domestic ventilation systems set out in Approved Document F to the UK Building Regulations is accomplished in practice. The findings show that ventilation equipment is not used as intended. The research suggests a need for future guidance to more actively consider routes by which occupants can learn how to use and maintain their ventilation systems, and how to identify and remove indoor air pollution. There is a risk of continuing underventilation in homes unless efforts are made to ensure the systems are easily interpretable and robust to a reasonable range of internal conditions and social contexts.

MiRNA‐21 Inhibitor‐Loaded Cationic Liposomes Development using the Quality by Design Approach

AbstractThe success of efficiently delivering genetic material to target cells depends on developing an appropriate vector. Among the variety of nanocarriers used for gene therapy, cationic liposomes are the most investigated for delivering genetic material in different forms of cancer. Cationic liposomes contain lipids with positively charged head groups that form electrostatic bonds with the negatively charged phosphate group of nucleic acids, ensuring efficient loading of the genetic material. The aim of this study was the development and in vitro characterization of liposomal formulations for genetic material delivery using the Quality by Design (QbD) approach. We have employed the Design of Experiments (DoE) methodology to study the impact of selected formulation factors on the quality of the proposed non‐viral vectors. Among the varied factors, the ones that had an impact on the responses were the total lipid concentration and cationic lipid concentration. Two liposomal formulations with adequate critical quality attributes (CQAs) were selected for miRNA‐21 inhibitor encapsulation. We continued with the in vitro evaluation on lung cancer cell line. Fluorescence microscopy helped visualize the internalization of all liposomal formulations and apoptotic effects. Finally, we evaluated the cellular viability and migration events after treatment with the cationic liposomes.

Pharmacognostic, Physicochemical, Phytochemical and Chromatographic Characterization of Vaividanga Choornam, A Siddha Polyherbal Formulation

Standardization of herbal formulations as determined by the concentration of their activecomponents is essential to appraise the quality of drugs. The current study intends to investigate the phytochemical and physicochemical analyses of Vaividanga Choornam, a traditional Siddha polyherbal composition. This Vaividanga choornam contains the ingredients like Vaividangam (Embelica ribesBurm.), Milagu (Piper nigrumL.), Chukku (Zingiber officinale Rosc.), Omam (Trachyspermum ammi (L) Sprague), and Nilavaagai leaves (Cassia angustifolia Vahl. - syn. Cassia senna). It treatspitha diseases, constipation, indigestion, flatulence, burning sensation, bronchial asthma, and Kapha diseases. It is also an effective medicine for treating intestinal helminths caused by heavy worm burdens in young children. This study aims to estimate the quality of Vaividanga Choornam by performing pharmacognostic studies, preliminary phytochemical analysis, physiochemical parameters like ash value, extractive value, and loss on drying as per pharmacopoeial laboratory for Indian medicine guidelines, and also with the help of tests done with High-Performance Thin Layer Chromatography (HPTLC), FTIR Spectroscopy, and UV -Vis spectrometric analyses. The results obtained fromthose analyses showed the presence of various phytochemicals. The results indicate that the drug is of adequate quality and may be used to establish pharmacopeial standards of the medicine.

Clinical implications of subclinical left ventricular dysfunction in heart failure with preserved ejection fraction: The PARAGON-HF study.

Left ventricular (LV) subclinical impairment has been described in heart failure with preserved ejection fraction (HFpEF). We assessed the relationship between LV myocardial deformation by strain imaging and recurrent hospitalization for heart failure (HF) or cardiovascular death in a large international HFpEF population. We assessed two-dimensional speckle-tracking based global longitudinal strain (GLS) in 790 patients (mean age 74 ± 8 years, 54% female) with adequate image quality enrolled in the PARAGON-HF echocardiography study. We examined the relationship of GLS with total HF hospitalizations and cardiovascular death (the primary composite outcome) after accounting for clinical confounders. Approximately 47% of the population had evidence of LV subclinical dysfunction, defined as absolute GLS <16%. Impaired GLS was significantly associated with higher values of circulating baseline N-terminal pro-B-type-natriuretic peptide. After a median follow-up of 3.0 years, there were 407 total HF hospitalizations and cardiovascular deaths. After multivariable adjustment, worse GLS was associated with a greater risk for the primary composite outcome (adjusted hazard ratio per 1% decrease: 1.06; 95% confidence interval 1.02-1.11; p = 0.008). GLS did not modify the treatment effect of sacubitril/valsartan compared with valsartan for the composite outcome (p for interaction >0.1). In a large HFpEF population, impaired LV function was observed even among patients with preserved ejection fraction, and was associated with an increased risk of total HF hospitalizations or cardiovascular death, accounting for clinical confounders. These findings highlight the key role of subtle LV systolic impairment in the pathophysiology of HFpEF.

The development of a cryptoglandular anal fistula quality of life scale (AF-QoL).

Quality of life (QoL) is a crucial and core outcome in assessing the effectiveness of treatments for cryptoglandular anal fistula. Despite its extensive impact, there is a lack of patient-centred, disease-specific QoL measurement instruments of adequate quality. The aim of this study is to develop a disease-specific measurement instrument that can accurately measure QoL for patients with cryptoglandular anal fistula. Semi-structured qualitative patient interviews and a systematic review of current instruments were used to generate items for the draft instrument. This underwent successive rounds of cognitive interviews to refine its wording and structure. Individual item and overall scale content validity were determined by asking experts to rate the relevance of each item and those deemed irrelevant were removed. The final instrument then underwent psychometric testing and test-retest analysis to determine its sensitivity and stability. A total of 148 patients were involved in item generation, scale development and psychometric testing. A 22-item measurement instrument has been developed; it is scored on a scale of 0-100, where 0 indicates the worst QoL and 100 demonstrates perfect QoL. The scale demonstrates excellent internal consistency (Cronbach-α = 0.927), strong content and construct validity [correlation with Perianal Disease Activity Index = -0.713, Hospital Anxiety and Depression Anxiety (-0.659) and Depression (-0.673) subscales and Short Form-12 physical (0.609) and mental (0.589) component scales] and strong reliability and responsiveness. We have developed a cryptoglandular Anal Fistula Quality of Life scale (AF-QoL), a comprehensive, disease-specific patient reported outcome measure assessing QoL in patients with cryptoglandular anal fistula.

Evaluation of the Success of Autogenous Block Grafting in Atrophic Maxillary and Mandibular Ridges Prior to and After Implant Placement.

Dental implantology's success relies on adequate bone volume and quality, necessitating bone augmentation for implant placement. Primary lateral bone augmentation, utilizing autogenous block grafts, addresses horizontal bone loss. This study aims to evaluate the efficacy of autogenous block grafting, specifically ramus and fibula blocks, in addressing severe atrophic ridges before and after implant placement. Twenty-one patients underwent block grafting, predominantly using the ramus technique (80/20 ratio). CBCT measurements assessed horizontal grafting outcomes. Implant success and bone volume changes were analyzed. Post-grafting, bone width increased from 1.8-3.1 mm to 4.5-6 mm, exceeding critical thresholds. Implant success reached 95%, indicating the grafting techniques' effectiveness. Autogenous block grafting, especially with ramus and fibula blocks, transforms severe atrophic ridges, enabling successful implant integration. Long-term follow-up is essential for a comprehensive evaluation. This study provides crucial insights into autogenous block grafting's transformative impact on challenging cases, guiding future applications in reconstructive dentistry.

Not All Flat-Panel C-Arms Are Created Equal: A Comparison of Three Major Manufacturers.

Introduction: Flat-panel detector C-arms (FCs) are reported to reduce radiation exposure and improve image quality compared with conventional image intensifier C-arms (CCs). The purpose of this study was to compare radiation exposure and image quality between three commonly used FCs. Materials and Methods: A cadaver model was placed in the prone position to simulate percutaneous nephrolithotomy. We compared the following three FCs: OEC Elite CFD from GE HealthCare, Zenition 70 from Philips, and Ziehm Vision RFD from Ziehm Imaging. To measure the radiation dose, optically stimulated luminescence dosimeters (OSLDs) were utilized during five 300-second trials, conducted under three settings: automatic exposure control (AEC), AEC with low dose (LD), and LD with the lowest pulse rate (LDLP). Ten blinded urologists evaluated the image quality. Data were statistically analyzed using the analysis of variance (ANOVA) and Tukey's B post hoc tests. Results: In the AEC setting, the Philips C-arm demonstrated lower ventral OSLD exposure (42,446 mrad) compared with both the GE (51,076 mrad) and Ziehm (83,178 mrad; p < 0.001) C-arms. Similarly, in the LD setting, the Philips C-arm resulted in less ventral OSLD exposure (25,926 mrad) than both the Ziehm (30,956 mrad) and GE (38,209 mrad; p < 0.001) C-arms. Meanwhile, in the LDLP setting, the Ziehm C-arm showed less ventral OSLD exposure (4019 mrad) than both the GE (7418 mrad) and Philips (8229 mrad; p < 0.001) C-arms. All three manufacturers received adequate image quality ratings at the AEC and LD settings. However, at LDLP, the Ziehm C-arm received inadequate ratings in 8% of images, whereas both the GE and Philips C-arms received 100% adequate ratings (p = 0.016). Conclusions: Radiation produced by flat-panel C-arms varies dramatically, with the highest exposure (Ziehm) being almost double the lowest (Philips) in AEC. Improved picture quality at the lowest settings may come at the cost of increased radiation dose. Surgeons should carefully select the machine and settings to minimize radiation exposure while still preserving the image quality.

The equivalence of psychodynamic therapy and cognitive behavioral therapy for depressive disorders in adults: A meta-analytic review.

Meta-analyses on the relative efficacy of psychodynamic psychotherapy (PDT) and cognitive behavioral therapy (CBT) for depressive disorders are limited by heterogeneity in diagnostic samples and comparators and a lack of equivalence testing. We addressed this through a meta-analytic test of the equivalence of manualized PDT and CBT in treating adults with depressive disorders as determined by diagnostic interviews. Sensitivity analyses evaluated the impact of pretreatment differences, mixed diagnostic samples, author allegiance, study quality, year of publication and outliers on findings. A comprehensive literature search across multiple databases using reliable screening methods identified nine randomized controlled trials directly comparing manualized PDT and CBT for diagnosed depressive disorders in adults. Following pre-registration, we employed random effect models for our meta-analyses and two one-sided test procedures for equivalence testing. Independent raters determined that all studies were of adequate quality. Immediately posttreatment, depressive symptoms were statistically equivalent across PDT and CBT (k = 9; g = -0.11, 90% confidence interval [90% CI]: -0.24 to 0.02, pequivalence = .048, pNHST = .212, I2 = 32.7). At follow-up, the longest time point within a year, depressive symptoms were neither statistically equivalent nor statistically different (k = 6; g = -0.16, 90% CI: -0.31 to -0.02, pequivalence = .184, pNHST = .126, I2 = 0.00). The efficacy of manualized PDT is equal to manualized CBT immediately at posttreatment for depressive disorders in the adult general population. Nevertheless, insufficient data exists to reach a conclusion regarding equivalence at follow-up.

Effect of some physicochemical parameters on the decay rate of enteric bacteria isolated from River Owena, Nigeria

The significance of water in public health cannot be overemphasized. In Nigeria, many people living along the courses of water bodies still source and drink from the rivers and streams. There is, therefore, the need to determine the load of contamination and effect of pH and salinity on the decay rate of enteric bacteria in water samples from River Owena, Owena, Nigeria, in order to develop adequate water quality management. Water samples from River Owena were collected from three sampling points (inflow, middle course and the outflow) along the River Owena, Nigeria. The load of enteric bacteria in the water samples was enumerated using membrane filtration technique. The physicochemical parameters of the water samples were determined using standard methods. The incidence and prevalence of gastroenteritis in the community around River Owena was determined using a structured questionnaire. Microcosm studies were used to determine the decay rate of enteric bacteria at varying salinity and pH. Canonical correlation analysis was used to describe the relationship between the load of enteric bacteria and the incidence and prevalence of gastroenteritis in the community around River Owena. The incidence and prevalence of gastroenteritis in the community around River Owena were estimated to be 0.75 and 0.51, respectively. Escherichia coli had positive relationships with incidence (r = 0.76) and prevalence (r = 0.65). Similarly, faecal coliforms had positive relationships with incidence (r = 0.82) and prevalence of gastroenteritis (r = 0.67), while enterococci showed positive relationship with incidence (r = 0.59) and prevalence of gastroenteritis (r = 0.87). Increase in pH and salinity increased the decay rate of enteric bacteria thereby reducing the growth of enteric bacteria, the optimum pH for the growth and survival of enteric bacteria ranged between pH 5.0 and pH 7.0. The optimum salinity for the growth of enteric bacteria isolated in water samples from River Owena ranged between 10 and 50% salinity. Findings revealed high levels of faecal contamination at the different representative monitoring points on River Owena, pH and salinity influenced the load and decay rate of enteric bacteria in water from River Owena.

Quality of life at work of entrepreneurs in the municipality of Mossoró

In an increasingly globalized and competitive world, the success or failure of organizations depends on the quality of life at work in the administrative environment. It must be tied to a business plan that adapts the company's activities, which must be on favorable terms, since they are not complete if their employees are not well. Based on this assumption, the present work had as its main objective to analyze the Quality of life of the entrepreneurs of three pulp distributors in the city of Mossoró. This is a descriptive, qualitative research, the collection of data by means of a semi-structured interview. The main results indicate that pulp entrepreneurs in the municipality of Mossoró have an adequate Quality of Life at Work level. In that context, reflected through entrepreneurial strategies used to deal with the market risk they act.

Root canal morphology of anterior permanent teeth in Jordanian population using two classification systems: a cone-beam computed tomography study

BackgroundAdequate knowledge of root canal morphology and its variation is essential for success of root canal treatment and to overcome treatemnt failure. The aim of this study was to investigate the root and canal morphology of mandibular anterior teeth using 2 classification systems.Methods3342 lower anteriors were evaluated from 557 CBCT scans. The images were examined in sagittal, axial and coronal views using a CS 3D imaging software (V3.10.4, Carestream Dental). Demographic data recorded, the number of roots and canal’s morphology were described according to Vertucci and Ahmed classifications.ResultsFrequency of Type I configuration was significantly the highest in incisors and canines (76%, N = 2539), followed by Type III (20.6%, N = 687). Type II (1.1%, N = 37), IV (1.1%, N = 37), and V (0.3%, N = 11) were rarely encountered. 0.9% (N = 31) of the teeth could not be classified with the Vertucci System. The frequency of 2 roots (2MA in Ahmed classification) which has no correspondence in the Vertucci classification, was 1.1% (N = 38), it was significantly higher in canines and in females (35 canines and 3 laterals). A moderate correlation in root canal morpology was found between the left and right sides (V > 0.30). 80% (N = 2538) of the teeth did not exhibit any divergence/merging. The bifurcation level occurred mostly in the middle third of the root.ConclusionsOne fourth of anterior teeth had variation from the simple type I canal configuration and therefore requires attention during treatment. The new classification system offers a more accurate and simplified presentation of canal morphology.Clinical relevanceThe prevalence and mid root bifurcation of second canal in lower anteriors requires attention to ensure adequate quality root canal treatment without compromising the integrity of teeth.

Molecular and genetic characterization of LEPTOSPIRA spp. collection strains from the St. Petersburg Pasteur institute based on 16S rRNA gene sequencing data

Leptospirosis is a zoonotic disease found virtually worldwide. Microscopic Agglutination Test with live leptospira (MAT) is the reference method for the serological diagnosis of leptospirosis. MAT is based on assessing serum potential to agglutinate live reference serovar Leptospira maintained at a reference laboratory. At some laboratories having own collections of isolated and reference Leptospira strains applicable for serological diagnosis, those microorganisms are maintained for many years by repeated subculturing, that increases markedly a chance of strain cross-contamination. The lack of adequate quality control for reference strains may affect data of epidemiological studies. Control of Leptospira spp. reference strains purity and stability of their antigenic composition is very important for diagnosis of leptospirosis. The study objective was to compare the 16S rRNA gene nucleotide sequences of some Leptospira strains from the collection of the St. Petersburg Pasteur Institute to with relevant sequences uploaded to GenBank. In this study, 38 Leptospira strains were investigated. Nucleotide sequences of 36 strains were deposited in the international GenBank database, inconsistencies were revealed in two strains. The study found that the control Leptospira strains from the collection of the St. Petersburg Pasteur Institute had minimal dissimilarities from international control strains. The analysis of the resultant 16S rRNA sequences has shown the presence of point mutations, transitions, deletions and insertions, regardless of the strain species. The open leptospira pan-genome demonstrates high genomic variability in species due to the capability of leptospira for lateral gene transfer in order to adapt to changing environmental conditions. The massive acquisition and loss of genes give rise to an increased species diversity. The 16S rRNA gene is suitable for screening diagnostics; however, high level of the fragment similarity and close phylogenetic relationship between different species put bounds to its use in genotyping. The presence of point nucleotide mutations is most likely associated with the evolutionary mechanisms of leptospira, their ability to horizontal gene transfer and crossing-over, including ribosomal genes, but this assumption necessitates additional research. For specimen genotyping it is necessary to select alternative genes with high specificity and sufficient level of nucleotide divergence. The study shows a need for genetic analysis of collection strains in order to control the purity of cultures.

Microbiological Quality and Antimicrobial Resistance of Commercial Probiotic Products for Food-Producing Animals.

Probiotics have been popularly used in livestock production as an alternative to antibiotics. This study aimed to investigate the microbiological quality and phenotypic and genotypic antimicrobial resistance of bacteria in probiotic products sold for food animals. A total of 45 probiotic products were examined for the number of viable cells, species, and antimicrobial susceptibility; the contamination of Escherichia coli and Salmonella; and the presence of 112 genes encoding resistance to clinically important antimicrobials and transferability of AMR determinants. The results showed that 29 of 45 products (64.4%) were incorrectly labeled in either number of viable cells or bacterial species. None of the tested products were contaminated with E. coli and Salmonella. A total of 33 out of 64 bacterial isolates (51.6%) exhibited resistance to at least one antimicrobial agent. Of the 45 products tested, 16 (35.5%) carried AMR genes. Almost all AMR genes detected in probiotic products were not correlated to the AMR phenotype of probiotic strains formulated in the products. Three streptomycin-resistant Lactobacillus isolates could horizontally transfer their AMR determinants. The findings demonstrated that the probiotic products could serve as reservoirs for the spread of AMR genes and may not yield benefits to animals as claimed. The need for the adequate quality control of probiotic products is highlighted.

Abstract TMP10: Children With Sickle Cell Anemia Have Impaired Cerebrovascular Reactivity

Introduction: Sickle Cell Anemia (SCA) causes lower hemoglobin, leading to increased cerebral blood flow (CBF) to maintain cerebral oxygen metabolism (CMRO 2 ). Although CBF rises in childhood to meet higher CMRO 2 demands, further compensatory increases in CBF in children with SCA may tap into a limited hemodynamic reserve, increasing risk for infarct. Cerebrovascular reactivity (CVR) reflects hemodynamic reserve by measuring the vasculature’s response to vasoactive stimuli, particularly in the gray matter (GM). We hypothesized that children with SCA have lower GM CVR, regardless of CMRO 2 . Methods: We used magnetic resonance imaging of children with and without SCA to collect pseudocontinuous arterial spin labeling (pCASL) for CBF, asymmetric spin echo for oxygen extraction fraction (OEF) and blood oxygen level dependent (BOLD) data correlated with hypercapnic challenges for CVR. Lab draws confirmed Hemoglobin (Hb) values. CMRO 2 was calculated as CBF x OEF x Arterial Oxygen Content (1.36 x Hb x SpO 2 ). Continuous variable differences between groups were analyzed using the Mann-Whitney U test, and categorical variables using the Fisher’s exact test. Linear regression assessed the relationship between CVR and Hb. Reported significant relationships survived multiple comparisons correction. Results: A total of 35 participants, ages 8–22 years had quality CVR data [9 SCA subjects (5 male) and 26 controls (9 male)]. Of these, 8 SCA and 20 controls had adequate quality metabolic data. The groups are matched by age (p=0.56) and sex (p=0.43). Children with SCA had higher GM CBF (62.0 v 49.3 mL/100g/min; p=0.03), but similar GM CMRO 2 (1.81 v 1.42 mL/100g/min; p=0.07) than controls. GM CVR was significantly lower in SCA than controls (0.17 v 0.27 %/mmHg; p=0.0003). Lower CVR was associated with lower Hb (Figure) after adjusting for age and sex (p &lt;0.0001). Conclusion: Lower GM CVR in children with SCA indicates a lower hemodynamic reserve, likely related to the degree of anemia.