SYN-004 (ribaxamase), an oral beta-lactamase, mitigates antibiotic-mediated dysbiosis in a porcine gut microbiome model

AIM

To evaluate an antibiotic inactivation strategy to protect the gut microbiome from antibiotic-mediated damage.

METHODS AND RESULTS

SYN-004 (ribaxamase) is an orally delivered beta-lactamase intended to degrade penicillins and cephalosporins within the gastrointestinal tract to protect the microbiome. Pigs (20 kg, n = 10) were treated with ceftriaxone (CRO) (IV, 50 mg kg^-1 , SID) for 7 days and a cohort (n = 5) received ribaxamase (PO, 75 mg, QID) for 9 days beginning the day before antibiotic administration. Ceftriaxone serum levels were not statistically different in the antibiotic-alone and antibiotic + ribaxamase groups, indicating ribaxamase did not alter systemic antibiotic levels. Whole-genome metagenomic analyses of pig faecal DNA revealed that CRO caused significant changes to the gut microbiome and an increased frequency of antibiotic resistance genes. With ribaxamase, the gut microbiomes were not significantly different from pretreatment and antibiotic resistance gene frequency was not increased.

CONCLUSION

Ribaxamase mitigated CRO-mediated gut microbiome dysbiosis and attenuated propagation of the antibiotic resistance genes in pigs.

SIGNIFICANCE AND IMPACT OF THE STUDY

Damage of the microbiome can lead to overgrowth of pathogenic organisms and antibiotic exposure can promote selection for antibiotic-resistant micro-organisms. Ribaxamase has the potential to become the first therapy designed to protect the gut microbiome from antibiotic-mediated dysbiosis and reduce emergence of antibiotic resistance.

Minimally invasive periacetabular osteotomy using a modified Smith-Petersen approach: technique and early outcomes

AIMS

Periacetabular osteotomy is an effective way of treating symptomatic hip dysplasia. We describe a new minimally invasive technique using a modification of the Smith-Peterson approach. We performed a prospective, longitudinal cohort study to assess for any compromise in acetabular correction when using this approach, and to see if the procedure would have a higher complication rate than that quoted in the literature for other approaches. We also assessed for any improvement in functional outcome.

PATIENTS AND METHODS

From 168 consecutive patients (189 hips) who underwent acetabular correction between March 2010 and March 2013 we excluded those who had undergone previous pelvic surgery for DDH and those being treated for acetabular retroversion. The remaining 151 patients (15 men, 136 women) (166 hips) had a mean age of 32 years (15 to 56) and the mean duration of follow-up was 2.8 years (1.2 to 4.5). In all 90% of cases were Tönnis grade 0 or 1. Functional outcomes were assessed using the Non Arthritic Hip Score (NAHS), University of California, Los Angeles (UCLA) and Tegner activity scores.

RESULTS

The mean pre-operative lateral centre-edge angle was 14.2° (-5° to 30°) and the mean acetabular index was 18.4° (4° to 40°). Post-operatively these were 31° (18° to 46°) and 3° (-7° to 29°), respectively, a significant improvement in both (p < 0.001). Allogenic blood transfusion was required in two patients (1.2%). There were no major nerve or vascular complications, and no wound infections. At the time of last follow-up, we noted a significant improvement in functional outcome scores: UCLA improved by 2.31 points, Tegner improved by 1.08 points, and the NAHS improved by 25.4 points (p < 0.001 for each). Hypermobility and longer duration of surgery were significant negative predictors for a good post-operative UCLA score, while residual retroversion was a positive predictor of post-operative UCLA score.

CONCLUSION

We have found this approach to be safe and effective, facilitating early recovery from surgery. Cite this article: Bone Joint J 2017;99-B:22-8.

Perceptions of Healthcare Professionals on the Usage of Percutaneous Endoscopic Gastrostomy in a Teaching Hospital from a Middle-Income South East Asian Country

OBJECTIVE

To explore the perceptions of healthcare professionals' (HCPs) in a South East Asian nation towards percutaneous endoscopic gastrostomy (PEG) feeding.

DESIGN

Semi-structured, qualitative interviews.

SETTINGS

A teaching hospital in Kuala Lumpur, Malaysia.

PARTICIPANTS

A total of 17 healthcare professionals aged 23-43 years, 82% women.

RESULTS

Thematic analysis revealed five themes that represent HCPs' perceptions in relation to the usage of PEG feeding: 1) knowledge of HCPs, 2) communication, 3) understanding among patients, and 4) financial and affordability.

CONCLUSION

The rationale for reluctance towards PEG feeding observed in this regions was explained by lack of education, knowledge, communication, team work, and financial support. Future studies should assess the effects of educational programmes among HCPs and changes in policies to promote affordability on the utilization of PEG feeding in this region.

Transient Weakening of Earth's Magnetic Shield Probed by a Cosmic Ray Burst

The GRAPES-3 tracking muon telescope in Ooty, India measures muon intensity at high cutoff rigidities (15-24 GV) along nine independent directions covering 2.3 sr. The arrival of a coronal mass ejection on 22 June 2015 18:40 UT had triggered a severe G4-class geomagnetic storm (storm). Starting 19:00 UT, the GRAPES-3 muon telescope recorded a 2 h high-energy (∼20  GeV) burst of galactic cosmic rays (GCRs) that was strongly correlated with a 40 nT surge in the interplanetary magnetic field (IMF). Simulations have shown that a large (17×) compression of the IMF to 680 nT, followed by reconnection with the geomagnetic field (GMF) leading to lower cutoff rigidities could generate this burst. Here, 680 nT represents a short-term change in GMF around Earth, averaged over 7 times its volume. The GCRs, due to lowering of cutoff rigidities, were deflected from Earth's day side by ∼210° in longitude, offering a natural explanation of its night-time detection by the GRAPES-3. The simultaneous occurrence of the burst in all nine directions suggests its origin close to Earth. It also indicates a transient weakening of Earth's magnetic shield, and may hold clues for a better understanding of future superstorms that could cripple modern technological infrastructure on Earth, and endanger the lives of the astronauts in space.

Three-Dimensional Icosahedral Phase Field Quasicrystal

We investigate the formation and stability of icosahedral quasicrystalline structures using a dynamic phase field crystal model. Nonlinear interactions between density waves at two length scales stabilize three-dimensional quasicrystals. We determine the phase diagram and parameter values required for the quasicrystal to be the global minimum free energy state. We demonstrate that traits that promote the formation of two-dimensional quasicrystals are extant in three dimensions, and highlight the characteristics required for three-dimensional soft matter quasicrystal formation.

Influence of triazine herbicide exposure on guppies (poecilia sphenops) aromatase activities, altered sex steroid concentration and vitellogenin induction

Atrazine, a herbicide is one the most toxic and sustaining pollutants in aquatic environment. It is detectable in surface water and in underground sources of drinking water. Many studies indicate that atrazine might be a potent endocrine disrupting xenobiotic. There are limited studies have revealed that the effects of atrazine on sex steroids hormones, vitellogenin and induction of aromatase, gonadosomatic index and hepatosomatic index. In this study, juvenile Poecilia sphenops fish was exposed to three different (0.83, 1.25 and 2.5 ppm) concentration of atrazine for 100 d. Changes in plasma and gonadal content and concentrations of sex steroids and vitellogenin protein in poecilia sphenops under laboratory conditions were assessed. The low level of the atrazine show estrogenic effect in males, as determined by a shortage of testosterone induction. Present study suggests that low induction of plasma vitellogenin and aromatase in male fish become suitable biomarkers of exposure to estrogenic chemicals.

Psychological distress, job dissatisfaction, and somatic symptoms in office workers in 6 non-problem buildings in the Midwest

BACKGROUND

Researchers examined office worker characteristics and reports of non-specific somatic symptoms in 6 non-problem buildings in the Midwestern United States.

METHODS

We assessed office workers for demographic characteristics and somatic symptoms that occurred in the workplace. Sampling was conducted over a 1-week period in each building over 4 seasons. Our team administered the Medical Outcome Survey questionnaire, the Brief Symptom Inventory, and the Job Content Questionnaire to individuals at each site, comparing office workers reporting no symptoms to those reporting ≥4 symptoms.

RESULTS

Self-reported nonspecific somatic symptoms were frequent in office workers in non-problem buildings. High symptom levels were associated with younger age, female sex, psychological distress, impaired quality of life, and poor job satisfaction.

CONCLUSIONS

The findings suggest that office workers frequently report somatic symptoms they believe are related to the workplace even in buildings considered non-problematic. People with high symptom levels perceived as related to the workplace are psychologically distressed, have impaired quality of life, and feel dissatisfied and powerless in the workplace.

An Approach for Setting Inventory Norms for a Two-Echelon Supply Chain

Managing inventories is crucial to the objective of minimizing supply chain costs. This paper presents an approach for setting inventory norms in context of a real-life case of an industry which practices Vendor Managed Inventory (VMI). The role of warehouses and the inventories held by them becomes significant in such an environment. This paper presents a two-phase approach to determine various components of inventory norms taking into account lead time and demand variability. Innovative strategic product classification has been done to decide upon stocking quantity at warehouses.

Characterization of bioresidues for biooil production through pyrolysis

Biomass is a renewable resource utilized to produce energy, fuels and chemicals. In this study, 25 bioresidues were selected and the physical, chemical, thermal and elemental analyses of the residues were studied as per standard methods. The bioresidues were pyrolyzed at 450°C in a fixed bed reactor to produce biooil. Among the residues, paper (pinfed computer) and Parthenium produced maximum (45%) and minimum biooil (6.33%), respectively. Arecanut stalk, redgram stalk, rice husk, wheat husk, maize cob, coir pith, Cumbu Napier grass Co5, Prosopis wood and paper resulted in a better biooil yield. Models were developed to predict the effect of constituents of bioresidues on the yield of biooil. The volatile matter and cellulose had significant effect on biooil yield. Biooil thus obtained can be used as fuel that may replace considerable fossil fuels.