Microbiology

Retraction Note to: Ecological Significance of Microdiversity: Coexistence Among Casing Soil Bacterial Strains Through Allocation of Nutritional Resource The Editor-in-Chief has retracted this article [1] because of significant overlap with a previously published article by Jaspers and Overmann [2]. All authors agree to this retraction.

Detection of Wolbachia Phage (WO) in Indian Lac Insect [ Kerria lacca (Kerr.)] and Its Implications Abstract Wolbachia, a maternally inherited bacterium induces reproductive alterations in its hosts such as feminization of males, male killing and parthenogenesis. It is the most diverse endosymbiont infecting more than 70% of the insects ranging from pests to pollinators. Kerria lacca—a hemipteran is a sedentary, oriental insect known to produce lac—the only resin of animal origin. The present study was conducted to screen the presence of Wolbachia and its associated phages in the two infrasubspecific forms (four insect lines) of K. lacca viz. kusmi and rengeeni differing from each other on the basis of host preference. Wolbachia and its associated phage were found to be prevalent in all the insect lines analyzed. We, hereby, report the presence of WO-phage (Wolbachia phage) for the first time in K. lacca. Further, phylogenetic data differentiated the kusmi and rengeeni infrasubspecific forms into two different groups on the basis of WO-phage sequences.

Importance of the 3′-Terminal Nucleotide of the Forward Primer for Nucleoprotein Gene Detection of Viral Hemorrhagic Septicemia Virus by Conventional Reverse-Transcription PCR Abstract Viral hemorrhagic septicemia virus (VHSV), causing severe diseases in farmed fish, is detected and genotyped using conventional reverse-transcription PCR (cRT-PCR) targeting the nucleoprotein gene with corresponding VN F (forward) and VN R (reverse) primers. However, these primers have low sensitivity to VHSV subtype IVa; I investigated the cause for the poor cRT-PCR performance using various primer combinations. The results demonstrated that a 3′-end mismatch in the VN F primer reduced sensitivity and plays a critical role in VHSV detection by cRT-PCR.

Spoilage Bacteria Identification and Food Safety Risk Assessment of Whole Soybean Curd Abstract As a highly hydrated gel-type food, soybean curd is perishable and the development of spoilage bacteria has been described. Whole soybean curd (WSC), an innovative soy product retains the most nutrients in raw ingredients and exhibits more nutritive value compared with conventional soybean curd (CSC). However, the risk assessment of WSC is not well evaluated up to now. In this study, the same species of spoilage microorganism were separated from WSC and CSC. Two main spoilage strains were separated and identified as B. subtilis and B. cereus. The risk ranking scores of WSC was higher than that of CSC but still within medium risk range. In summary, we reported the presence of B. subtilis and B. cereus in WSC for the first time. Further, application of the risk ranger tool confirmed that the risk profile of WSC was medium and acceptable.

Putative Role of Bacterial Biosorbent in Metal Sequestration Revealed by SEM–EDX and FTIR Abstract Bacterial exopolysaccharides (EPS) play a critical role in sequestration of metals from contaminated environment. Considering these, this study was aimed at extracting EPS from metal tolerant Pseudomonas aeruginosaCPSB1 and Azotobacter chroococcum CAZ3 and to ascertain its role in metal removal. P. aeruginosa CPSB1 and A. chroococcum CAZ3 secreted 1306.7 and 1660 µg mL−1 EPS, respectively in the presence of 200 and 100 µg mL−1 Pb, respectively with glucose as C source. The binding of metal ions to bacterial EPS was validated by SEM and EDX. The functional group involved in metal chelation was revealed by FT-IR. The metal ions were adsorbed onto EPS and hence, EPS could play a crucial role in metal detoxification. Due to this novel trait, P. aeruginosa CPSB1 and A. chroococcum CAZ3 could be developed as bioinoculant to cleanup metal contaminated sites.

Molecular Mechanism of Antibiotic Resistance: The Untouched Area of Future Hope Abstract The treatment of bacterial infections is becoming increasingly ineffective due to rapid mutation which leads to antibiotic resistant and resistant bacteria become more prevalent. As a result the existing antibiotics are gradually obsolete and again new drugs are needed to be designed for the same threat. However, the prediction of evolutionary processes/antibiotic resistance is uncertain. Still, the understanding of mode of evolution of resistance in bacteria is a determining step in the preclinical development of new antibiotics, because drug developers assess the risk of resistance arising against a drug during preclinical development. Multidrug efflux pump systems play an important role for making multidrug resistance to a range of clinically important antibiotics in gram-negative bacteria like Pseudomonas aeruginosa, which lower the intracellular drug concentration by exporting incoming antibiotics across the membranes. We tried to show that the wild type susceptible bacteria P. aeruginosa modified its genetic makeup at mutational hotspots under stress. This strain may either become multidrug resistant or remain susceptible depending on position of amino acid changes in regulatory proteins of efflux pump. Multidrug resistant strain made significant changes at the amino acid positions, 103rd (G → A) and 126th (E → V) through the mutation on the nucleotide position of 308th (G → C); both 377th (A → T) and 378th (G → T), respectively in mexR, a repressor of mexAB-oprM efflux pump. This mutant protein showed low affinity with their operator. But the alteration at 103th position (G → A) in mexR may provide almost similar structural and functional stability as wild type. It was found that mutation was seemed to be well regulated within the limit and position specific under stress which might be back to its original form by supplying counter stress unless addition or deletion takes place.

Microbial Inoculants Assisted Growth of Chrysopogon zizanioides Promotes Phytoremediation of Salt Affected Soil Abstract Restoration of salt-affected soil through cultivation Chrysopogon zizanioides is a promising approach. The two way benefit of such an approach is that reclamation of salt-affected soil concomitant to improve plant growth and increased yield of essential oil produced in the plants roots. Earlier studies showed physiological changes and reduced growth of C. zizanioides under salinity. In the present study, plant growth promoting microorganisms viz. Pseudomonas monteilii, Bacillus megaterium, Azotobacter chroococcum and Rhizophagus intraradices were used as bio-inoculants for cultivation of C. zizanioides under salt-affected soil. Bio-inoculants in combination with vermicompost significantly increased the growth and productivity of C. zizanioides under salt-affected soil, and simultaneously improved soil health. When compared to control, the soil physico-chemical and biological properties of bio-inoculants treated plants was significantly improved. The reclamation of salt-affected soil was evident by the significant decrease in the level of soil pH (11.0%), electrical conductivity (23.5%), sodium adsorption ratio (15.3%), and exchangeable sodium percent (12.4%) of bio-inoculants treated plants. The improvement of soil cation exchange capacity indicated the decrease in soil salinity. Whereas increase in the microbial count (four-fold), AMF spores (447 spores), dehydrogenase (six-fold), acid (two-fold) and alkaline phosphatase (five-fold) activities in rhizosphere soil of bio-inoculant treated plants indicated the improved biological properties. A positive correlation of plant biomass production to soil organic carbon, total Kjeldahl nitrogen, available phosphorus and cation exchange capacity depicted improved nutrients content in rhizosphere soil of bio-inoculant treated plants. The findings of this study suggest that P. monteilii and R. intraradices with vermicompost can be effectively used as bio-inoculants for encouragement of phytoremediation in salt-affected soil.

Anti-biofilm and Antibacterial Activity of Allium sativum Against Drug Resistant Shiga-Toxin Producing Escherichia coli (STEC) Isolates from Patient Samples and Food Sources Abstract Escherichia coli (E. coli) colonizes human intestinal tract and is usually harmless to the host. However, several strains of E. coli have acquired virulent genes and could cause enteric diseases, urinary tract and even brain infections. Shiga toxin producing Escherichia coli (STEC) is an enterohaemorrhagic E. coli (EHEC) which can result in bloody diarrhoea and could potentially lead to deadly heamolytic uremic syndrome (HUS). STEC is one of the important food borne pathogens that causes food poisoning leading to diarrhoea and number of STEC outbreaks have occurred across the world. The use of standard antibiotics to treat STEC infection is not recommended as it increases the production of shiga toxin which could lead to HUS. Therefore, use of alternative approaches which include use of plant products to treat STEC infections have been gaining attention. The objective of this study was to evaluate the antibacterial and anti-biofilm activity of garlic (Allium sativum) against STEC strains isolated from various patient and food samples using in vitro assays. The microbiological isolation of STEC from various patient and food samples resulted in eight STEC isolates of which seven strains were multidrug resistant. Antibacterial assay results indicated that all the strains exhibited dose dependent sensitivity towards garlic with zone of inhibition diameters ranging from 7 to 24 mm with 15 µl of fresh garlic extract (FGE). Minimum inhibitory  concentration (MIC) of FGE for isolates ranged from 30 to 140 µl/ml. Interestingly, the biofilm formation of all isolates in presence of 4% of FGE decreased by 35 to 59%. FTIR analysis indicated that treatment with 1% FGE results in compositional and content changes in the biofilm. In addition, the total carbohydrate content of biofilm was reduced by 40% upon 1% FGE treatment. The results of the present study report for the first time the antibacterial and anti-biofilm activity of garlic against STEC. The findings will enable development of novel garlic organosulfide based drugs for the prevention and treatment of STEC infections.

Pattern of Antimicrobial Sensitivity in Microbiologically Documented Infections in Neutropenic Patients with Haematological Malignancies: A single Center Study Abstract Febrile neutropenia is a medical emergency that complicates the clinical course and treatment of haematological malignancies, significantly enhancing the financial burden and worsening the overall outcome. This study was carried out to evaluate the efficacy of institution's current first-line antibiotic regimen for febrile neutropenia in view of recent spectrum of institution's local flora and its susceptibility pattern. 163 episodes of microbiologically documented infections in 110 adult patients were studied over a period of 1 year. Of 110 patients, 61 patients were male. The mean age of the patient population, mean absolute neutrophil count and temperature as documented were 30.1 years (SD ± 16.8), 450 cells/ul, and 101.9 °C respectively. Gram-negative and gram-positive organisms accounted for 79% and 21% of the febrile neutropenic infections respectively. E. coli and Staphylococcus aureus were the most common gram positive and gram negative pathogens respectively. A susceptibility pattern of > 60% was documented for all the gram negative pathogen's associated febrile neutropenic infections for the current first-line antibiotic combination of Piperacillin/Tazobactum and Amikacin. Comparative analysis of results with the institutional data of 2015 study revealed no statistically significant difference in the resistance pattern of the organisms hence, validating the persistent use of Piperacillin/Tazobacum and Amikacin combination as a potent and efficacious therapy for febrile neutropenia patients with haematological malignancies. However, continuous surveillance remains prudent for the emerging changes in the spectrum and resistance pattern of local flora so that timely revision of empirical antibiotic regimens can save the added financial burdens and associated high morbidity and mortality.

Agrobacterium-Mediated Transformation of Diaporthe schini Endophytes Associated with Vitis labrusca L. and Its Antagonistic Activity Against Grapevine Phytopathogens Abstract Fungus-caused diseases are among the greatest losses in grapevine culture. Biological control of pathogens by endophytes may be used to decrease fungicide application rates and environmental impacts. Previously, Diaporthe sp. B46-64 and C27-07 were highlighted as antagonists of grapevine phytopathogens. Herein, molecular multigene (ITS-TUB-TEF1) identification and phylogenetic analysis allowed the identification of these endophytes as belonging to Diaporthe schini species. Agrobacterium tumefaciens-mediated transformation was employed for obtaining 14 stable and traceable gfp- or DsRed-expressing transformants, with high transformation efficiency: 96% for the pFAT-GFP plasmid and 98% for pCAM-DsRed plasmid. Transformants were resistant to hygromycin B with gene hph confirmed by polymerase chain reaction and proved to be mitotically stable, expressing the fluorescent phenotype, with morphological differences in the colonies when compared with wild strains. In vitro antagonism tests revealed an increased antagonistic activity of some transformant strains. The current genetic transformation of D. schini mediated by A. tumefaciens proved to be an efficient technique within the randomized insertion of reporter genes for the monitoring of the strain in the environment.

Medizinrecht

Michael Quaas, Rüdiger Zuck, Thomas Clemens und Julia Maria Gokel, Medizinrecht. Öffentliches Medizinrecht – Pflegeversicherungsrecht – Arzthaftpflichtrecht – Arztstrafrecht

Rahmenverfahrensordnung für die Gutachterkommissionen und Schlichtungsstellen der Ärztekammern

Schnarchen im Zweibettzimmer als Wahlleistungsmangel Zusammenfassung 1. Für die Wahlleistungsvereinbarung zwischen den Parteien sind die Vorschriften über das Wohnraummietrecht anzuwenden. 2. Das Wesen eines Zweibettzimmers liegt in der Teilung des Zimmers mit einer weiteren Person; dass die jeweils andere Person sich geräuschlos verhält, ist nicht Teil des Vertrages.

Rechtsprechung kurz berichtet

Anmerkung zu AG Essen, Urt. v. 9.4.2018/4.12.2018 – 15 C 78/18

Gerhard Igl, Gesetz über die Pflegeberufe (Pflegeberufegesetz – PflBG). Pflegeberufe-Ausbildungs- und -Prüfungsverordnung (PflAPrV), Pflegeberufe-Ausbildungsfinanzierungsverordnung (PflAFinV), Praxiskommentar

Anmerkung zu BSG, Urt. v. 16.5.2018 – B 6 KA 1/17 (Hessisches LSG)

Anmerkung zu LSG Nordrhein-Westfalen, Beschl. v. 18.6.2018 – L 11 KA 12/18 BER (LSG Düsseldorf)

Die Verletzung des Anspruchs auf rechtliches Gehör Zusammenfassung Berücksichtigt das Gericht eine für den Umfang der ärztlichen Aufklärung wichtige wissenschaftliche Veröffentlichung nicht, auf die sich der Parteivortrag ausdrücklich gestützt hat, so stellt dies eine Verletzung des Rechts auf das rechtliche Gehör dar.

Bewerberauswahl nach partieller Öffnung eines Planungsbereichs gemäß §23 Abs. 3 S. 1 Nr. 3 Bedarfsplanungs-Richtlinie 2007 Zusammenfassung 1. Im Gegensatz zur Rechtsauffassung des Bundesministeriums für Gesundheit ist der Gemeinsame Bundesausschuss dazu legitimiert, die Verfahrensweise bei der Anordnung oder Aufhebung von Zulassungsbeschränkungen näher auszugestalten. 2. Nach partieller Öffnung eines Planungsbereichs hat der Berufungsausschuss gemäß §23 Abs. 3 S. 1 Nr. 3 BedarfsplRL 2007 den Bewerber bei mehreren Bewerbern nicht nur nach pflichtgemäßem Ermessen unter Berücksichtigung der beruflichen Eignung, der Dauer der bisherigen ärztlichen Tätigkeit, des Approbationsalters und der Dauer der Eintragung in die Warteliste auszuwählen, sondern auch die Vorgaben eines rechtskräftigen LSG-Urteils zu berücksichtigen. 3. Die Zulassungsgremien sind auch dann, wenn sie mehrere Bewerber hinsichtlich der Dauer der ärztlichen Tätigkeit und des Approbationsalters als gleichrangig bewerten, nicht gehindert, im Rahmen von §23 Abs. 3 S. 1 Nr. 3 BedarfsplRL 2007 die unterschiedlichen beruflichen Werdegänge und die damit verbundenen unterschiedlichen Erfahrungen bei der Frage der beruflichen Eignung zu berücksichtigen. (Leitsätze des Bearbeiters)

Police and Criminal Psychology

Physical Fitness and Psychological Hardiness as Predictors of Parasympathetic Control in Response to Stress: a Norwegian Police Simulator Training Study Abstract The individual biopsychological response to a specific stressor is the result of a complex interplay between many different factors including physiology, behavior, and personality. The goal of the present study was to explore the potential link between physical fitness, hardiness (Kobasa 1979), and the individual autonomic stress arousal experienced during a stressful police training situation (active shooter). Eighty-four police students participated in the study and were randomly assigned to either a high-stress or a low-stress testing condition. Hardiness was measured with the Dispositional Resilience Scale (Hystad et al. 2010). Physical fitness was assessed with \( \dot{\mathrm{V}}{\mathrm{O}}_{2\max } \) . Parasympathetic control was measured using heart rate variability (HRV), i.e., the root mean square successive difference (RMSSD). Regression analysis showed that psychological hardiness had a negative main effect on change in parasympathetic activity from baseline to the testing phase (B = − 1.43, t = − 2.81, p = 0.007). Larger withdrawal of parasympathetic activation for high-hardy individuals in this phase of the study can be interpreted as an adaptive adjustment to the task set in front of them. A second regression analysis showed that both psychological hardiness (B = − 1.47, t = 3.68, p < 0.001) and physical fitness (B = 0.89, t = 2.85, p = 0.006) had significant main effects on change of parasympathetic activity entering the recovery phase of the study. Both regression coefficients were positive, with higher scores on hardiness and physical fitness predicting greater parasympathetic activation at stress offset. Overall, the results suggest that psychological hardiness and physical fitness may be important factors in how operational stress affects the individual in a police setting. Those high in hardiness and good physical form seem to be better able to recuperate and reset after a stressful incident, something that can be vital in an operational context. These results will be discussed in relation to the existing literature in the field.

Validation and Calibration of the Spanish Police Intimate Partner Violence Risk Assessment System (VioGén) Abstract This study describes the rationale, development, and validation of the intimate partner violence (IPV) police risk assessment forms of the VioGén System of the Spanish Ministry of Interior (VPR4.0 and VPER4.0), which promote greater predictive effectiveness and an improvement in the IPV law enforcement prevention. A validation study of the mentioned protocols is presented, including inter-observer reliability, estimated by the equivalence or inter-judge reliability method, while the convergent validity of these protocols was calculated with the RVD-BCN protocol. The sample consisted of 6613 new cases of IPV included in the VioGén System over a period of 2 months and which were longitudinally followed up for 6 months. The discrimination indexes are not only the summarized odds ratio (OR), area under the ROC curve (AUC), sensitivity, and specificity, but also the calibration indexes positive predictive value (PPV) and negative predictive value (NPV). The results show the suitability of using procedures which, in a coordinated manner, incorporate two risk assessment instruments, one for a first screening assessment and a second one to re-assess IPV danger situations on a regular basis. The values obtained are within the margins reported by different meta-analyses regarding this type of instruments, which supports their use for professional practice.

Stalking Victimization: Examining the Impact of Police Action and Inaction on Victim-Reported Outcome Abstract Drawing data from a sample of stalking victims, this study assessed the impact of nine subsequent police actions, including police inaction, on victim-reported outcome of their stalking situation after the incident was reported to the police. The outcome variable has three response categories: the situation got worse, the situation stayed the same, and the situation got better. The author found three of the nine police actions were significantly related to the outcome variable. The author found that victims were more likely to report that their stalking situation improved when the responding officer took a report or warned the perpetrator. The author also found that police inaction increased the odds of victims reporting that their stalking situation worsened as well as the odds of victims reporting that their stalking situation improved. Implications of these findings are discussed.

Job Competencies of Border Security Officers in Singapore Abstract Border security officers are a country's first line of defense against undesirable people, cargo, and conveyances. Operational lapses could therefore greatly undermine the safety and security of the country. As such, informed understanding of border security officers' competencies is crucial to ensure that the right individuals are selected for the job. An exploratory job analysis study was conducted with Singapore's border security officers to identify the knowledge, skills, abilities, and other characteristics (KSAOs) essential for effective job performance. Data collection for this study includes collection of qualitative data on border security officers' job functions, tasks, and KSAOs required. The information was subsequently compiled into a Job Analysis Survey (JAS), where officers were asked to rate the KSAOs in terms of their importance and frequency of use in border security work. Results indicated that the major job functions performed by non-supervisory officers include primary immigration clearance of travelers and goods, while those performed by supervisory officers include secondary clearance and people management. Analysis of the list of KSAOs derived from the Job Analysis results revealed that there was generally a large overlap of KSAOs essential for both non-supervisory and supervisory officers to perform their job well. Some differences were observed as well due to the slightly different nature of work undertaken by the two groups of officers. The results of the present study along with its implications were further explored in the paper.

Examining the Effectiveness of Mental Health Education on Law Enforcement: Knowledge and Attitudes Abstract This study examined the effectiveness of the mental health module of a basic law enforcement training program in increasing knowledge of symptoms of mental illness and reducing related biases in newly hired law enforcement officers. The training module was investigated through the administration of a general knowledge questionnaire mirroring the training material and the AQ-27—a tool that measures stigmatizing attitudes. The results of this study show that training regarding the symptoms of mental illness can increase a law enforcement officer's general knowledge of psychological disorder and reduce bias against people with mental illness. The implications for the findings are that a mental health training module administered during basic law enforcement training should improve interactions between law enforcement and the diverse communities they serve by increasing knowledge and decreasing bias around mental illness.

Research Briefs

Police Profanity and Public Judgments of Guilt and Effectiveness in Officer-Involved Shootings Abstract Police shooting decisions have come under increasing scrutiny, and the degree to which potential jurors and witnesses understand those decisions is increasingly important. Officers under the stress of shooting situations may use profanity which may be recorded, but which does not relate to tactical outcomes. This research addressed how such profanity may influence public assessment of police performance. A paragraph was provided to respondents, describing a situation in which a male officer shot an armed adult male perpetrator. The officer was presented as either having used or not used profanity in the situation. Respondents were asked to address the officer's performance under these two different sets of conditions. Profanity resulted in a significantly higher perceived level of officer guilt in these situations, and a diminished perception of his professionalism, but did not result in a lower level of perception as to whether the officer had successfully resolved the situation or had done the "right thing." Results are discussed in terms of current cognitive theory and of practical application in the field and in court.

Dance Like No One's Watching: the Influence of Demand Characteristics When Examining Lineups via Computer or In-Person Abstract Lineup administrators may inadvertently bias an eyewitness' identification; as such, the blind-lineup administration is recommended to combat this bias. Three studies examined eyewitness identification accuracy when the lineup is presented on a computer versus in-person to determine whether computer-administrated lineups could replace in-person lineups to ensure blind administration. Study 1 (N = 378) varied whether the administration was on a computer versus in-person across the simultaneous, elimination, and wildcard procedures. Overall, participants were more accurate when presented with the online administration; moreover, participants were more accurate in target-absent lineups when presented with a simultaneous or elimination procedure compared to the wildcard procedure. Study 2 (N = 367) was similar to study 1 but used different stimuli and included the simultaneous, elimination, and elimination-plus procedures. Identification accuracy was comparable for online and in-person administration. Study 3 (N = 219) sought to examine why online administration was superior in study 1 by varying whether the researcher was present only during the identification task. When the researcher was present, participants were more likely to make a foil identification in the simultaneous procedure compared to the elimination procedure. The results of these three studies suggest that computer-administrated lineups may be a feasible solution to ensure blind administration.

Recent Police Recruits' Existing Knowledge of the Police and Organisational Commitment Abstract In recent years, increasing attention has been paid to police officers' organisational commitment. This research paper contributes to this growing body of knowledge by investigating commitment amongst recent police recruits. The paper examines the extent to which new recruits' existing knowledge of the police service prior to becoming an officer predicts organisational commitment, and different possible sources of this pre-entry knowledge. Using a sample of 236 recent police recruits in England and Wales, the study observed a significant relationship between recent recruits' existing knowledge of the police service and their organisational commitment. Prior police work experience (both paid and voluntary) significantly predicted existing knowledge of the police service, and in turn organisational commitment. In comparison, pre-entry police training did not predict existing knowledge of the police service, and moreover was found to negatively predict organisational commitment. The implications of these findings are discussed in relation to proposed changes to recruitment and entry routes into policing in England and Wales.

Fantasy, Opportunity, Homicide: Testing Classifications of Necrophilic Behaviour Abstract Although one of the more understudied sexual paraphilias, as an increasing number of cases are reported, it becomes pertinent to revisit academic analyses of necrophilia, particularly those attempts at classifying necrophilic behaviour. A case study is presented here of the development and enactment of necrophilic desire to determine the most appropriate means of categorising necrophilic behaviours. The study finds that until a stronger cohort of offenders can be established, a broader classification tool is preferable to excessive subdivisions of behaviour in grouping and understanding necrophilic activities, with the addendum that necrophiles can display a range of behaviours at any one time. Directions for law enforcement and clinicians are offered whilst the literature base is expanded.

Urban Health

Population Size Estimates of Street Children in Iran: Synthesis of Multiple Methods Abstract We used four methods (direct count, indirect count, wisdom of the crowd, and unique object multiplier) to map and estimate the population size of street children in six major cities in Iran in 2017. In aggregate for the six cities, the number of street children was estimated at 5296 (interquartile range [IQR] 4122-7071) using the median of the four methods. This corresponds to a rate of 16.3 (IQR 12.5–24.5) per 10,000 children age 5–18 years old, or 3.2 (IQR 2.4–5.3) per 10,000 total population. The total number for street children in the country is estimated at 26,000 (IQR 20,239–34,719) children. Results can help policy-makers advocate for resources, plan programs, and evaluate the reach of programs for street children. The maps created through the course of the population size estimation exercise can also guide outreach efforts to provide street children with health and social welfare services.

Perceptions of Neighborhood Environment, Sense of Community, and Self-Rated Health: an Age-Friendly City Project in Hong Kong Abstract To examine the relationships between perceptions of neighborhood environment, sense of community, and self-rated heath, we recruited 1798 people aged 60 years and older living in Hong Kong. With reference to the checklist of the essential features of age-friendly cities developed by the World Health Organization, perceptions of neighborhood environment were assessed using a questionnaire covering physical and social environmental domains, which mapped onto "outdoor spaces and buildings," "transportation," "housing," "social participation," "respect and social inclusion," "civic participation and employment," "communication and information," and "community support and health services." Sense of community was measured by the Brief Sense of Community Scale. Self-rated health was assessed by a single question. The relationships between these measures were analyzed using partial correlations, multivariate regression models, and path analyses. The mean age of the participants was 71.7 years; of which 54.3% were women. In multivariate regression models, perceived neighborhood environments were positively associated with sense of community and self-rated health. Among the domains of perceived neighborhood environment, "transportation" and "respect and social inclusion" were the physical and the social environmental domains most strongly associated with sense of community, respectively. In addition, sense of community accounted for part of the relationship between perceived neighborhood environments and self-rated health. The results of this study support the importance of perceived neighborhood environments for the sense that older person has of one's community, and self-rated health of older people which may be enhanced through the improvement of neighborhood environments.

Understanding Embodiment in Place-Health Research: Approaches, Limitations, and Opportunities Abstract Research on how place affects health continues to grow. Within the place-health research field, there is increasing focus on how place becomes embodied—i.e., how place-based social and environmental experiences and exposures "get under our skin" to affect physiological functioning and health. While much has been learned, currently favored place-embodiment research approaches present limitations that inhibit continued gains in understanding. This article presents a brief summary of place-health literature related to place-embodiment, highlighting common approaches. Core limitations are then discussed with an eye towards improving research going forward, highlighting mixed-method, spatially dynamic, and participatory intergenerational approaches as promising considerations.

Urban Heat Island and Future Climate Change—Implications for Delhi's Heat Abstract UrbClim, the urban climate model, is used for short- and long-term projections of climate for Delhi. The projections are performed for RCP8.5 using an ensemble of 11 GCM model outputs. Various heat stress indices were employed to understand the role of urban heat island (UHI) in influencing the present and future urban climate of the city. UHI intensity based on 5% warmest nights (TNp95) was 4.1 °C and exhibits negligible change over time. However, the impact of UHI on other heat stress indices is very strong. Combined hot days and tropical nights (CHT) that influenced 58–70% of the reference time frame are expected to rise to 68–77% in near-future and to 91–97% in far-future time periods. For reference time period, urban areas experience 2.3 more number of heat wave days (NHWD) than rural areas per summer season. This difference increases to 7.1 in short-term and 13.8 in long-term projections. Similar to this trend, frequency of heat waves (FHW) for urban areas is also expected to increase from 0.8 each summer season in reference time frame to 2.1 and 5.1 in short- and long-term projections. The urban-rural difference for duration of heat waves (DHW) appears to increase from 1.7 days in past to 2.3 and 2.2 days in future, illustrating that DHW for cities will be higher than non-urban areas at least by 2 days. The intensity of heat wave (IHW) for urban land uses increases from 40 °C in reference time frame to 45 °C in short-term projection to 49 °C in far future. These values for non-urban land use were 33 °C during the baseline time period and are expected to increase to 42 °C and 46 °C in near- and far-future time frames. The results clearly indicate the contribution of UHI effects in intensifying the impacts of extreme heat and heat stress in the city.

The Risk of Tuberculosis among Populations Living in Slum Settings: a Systematic Review and Meta-analysis Abstract According to the WHO, half of the 10.4 million incident cases of TB in 2016 came from five countries where 20–50% of the urban population live in slums. Crowded living conditions and limited access to healthcare further contribute to the burden of TB in urban slums. This article aims to assess the odds of the burden of TB in urban slums through a systematic review and meta-analysis. Four electronic databases were searched for studies published between 1993 and 2017, with TB defined as at least one sputum smear-positive. The review followed the PRISMA protocol and information was extracted from articles for a full-text review to determine eligibility. Odds ratios were calculated for studies reporting sputum smear-positive TB cases in slum settings with national incidence as a comparison. Summary estimates were calculated using the random effects model (95% CI) and publication bias was assessed through funnel plot analysis. A quality assessment of included articles was also conducted. This meta-analysis was conducted across three categories: (1) across all 22 studies, (2) studies utilizing Active Case Finding, and (3) studies conducted in a high TB-HIV setting. The odds of sputum smear-positive TB were significantly higher across all three categories of analysis. Compared with national TB incidence rates, the combined odds ratio of smear-positive TB within slums was 2.96 (2.84, 3.09; p < 0.01). The combined odds ratio for smear-positive TB with active case finding across 15 studies was 2.85 (2.71, 2.99; p < 0.01). Among the 11 studies that reported incidence of smear-positive TB with prevalent TB-HIV coinfection in the community, the combined odds ratio for slum residents with the random effects model was 2.48 (2.34, 2.63; p < 0.01). Using Egger's funnel plot, publication bias was not detected within the three categories of analysis. The findings of this analysis indicate that the odds of developing TB are almost five times as great in urban slums. Reaching the most vulnerable and often overlooked groups in slums is crucial to achieving the SDGs and End TB Strategy by 2035.

Social Network Structures in African American Churches: Implications for Health Promotion Programs Abstract The prevalence of obesity among African Americans is higher than among other racial/ethnic groups. African American churches hold a central role in promoting health in the community; yet, church-based interventions have had limited impact on obesity. While recent studies have described the influence of social networks on health behaviors, obesity interventions informed by social network analysis have been limited. We conducted a cross-sectional study with 281 African American men and women from three churches in northeast urban cities in the USA. Data were collected on sociodemographic and clinical factors and anthropometrics. Using a social network survey applying a name generator, we computed network level metrics. Exponential random graph models (ERGM) were performed to examine whether each structural property found in the empirical (observed) networks occurred more frequently than expected by chance by comparing the empirical networks to the randomly simulated networks. Overall, church friendship networks were sparse (low density). We also found that while friendship ties were more reciprocated between dyads in church networks, and there were more tendencies for clustering of friendships (significant positive transitive closure) than in random networks, other characteristics such as expansiveness (number of actors with a great number of friends) did not differ from what would be expected by chance in random networks. These data suggest that interventions with African American churches should not assume a unitary network through which a single intervention should be used.

Using Index of Concentration at the Extremes as Indicators of Structural Racism to Evaluate the Association with Preterm Birth and Infant Mortality—California, 2011–2012 Abstract Disparities in adverse birth outcomes for Black women continue. Research suggests that societal factors such as structural racism explain more variation in adverse birth outcomes than individual-level factors and societal poverty alone. The Index of Concentration at the Extremes (ICE) measures spatial social polarization by quantifying extremes of deprived and privileged social groups using a single metric and has been shown to partially explain racial disparities in black carbon exposures, mortality, fatal and non-fatal assaults, and adverse birth outcomes such as preterm birth and infant mortality. The objective of this analysis was to assess if local measures of racial and economic segregation as proxies for structural racism are associated and preterm birth and infant mortality experienced by Black women residing in California. California birth cohort files were merged with the American Community Survey by zip code (2011–2012). The ICE was used to quantify privileged and deprived groups (i.e., Black vs. White; high income vs. low income; Black low income vs. White high income) by zip code. ICE scores range from − 1 (deprived) to 1 (privileged). ICE scores were categorized into five quintiles based on sample distributions of these measures: quintile 1 (least privileged)–quintile 5 (most privileged). Generalized linear mixed models were used to test the likelihood that ICE measures were associated with preterm birth or with infant mortality experienced by Black women residing in California. Black women were most likely to reside in zip codes with greater extreme income concentrations, and moderate extreme race and race + income concentrations. Bivariate analysis revealed that greater extreme income, race, and race + income concentrations increased the odds of preterm birth and infant mortality. For example, women residing in least privileged zip codes (quintile 1) were significantly more likely to experience preterm birth (race + income ICE OR = 1.31, 95% CI = 1.72–1.46) and infant mortality (race + income ICE OR = 1.70, 95% CI = 1.17–2.47) compared to women living in the most privileged zip codes (quintile 5). Adjusting for maternal characteristics, income, race, and race + income concentrations remained negatively associated with preterm birth. However, only race and race + income concentrations remained associated with infant mortality. Findings support that ICE is a promising measure of structural racism that can be used to address racial disparities in preterm birth and infant mortality experienced by Black women in California.

Personal Versus Group Experiences of Racism and Risk of Delivering a Small-for-Gestational Age Infant in African American Women: a Life Course Perspective Abstract The majority of studies investigating the relationship between racism/racial discrimination and birth outcomes have focused on perceived experiences of racism/racial discrimination directed at oneself (personal racism). However, evidence suggests individuals report with greater frequency racism/racial discrimination directed at friends, family members, or other members of their racial/ethnic group (group racism). We examined how much African American (AA) women report lifetime experiences of perceived racism or racial discrimination, both personal and group, varied by maternal age. We also investigated whether reports of personal and group racism/racial discrimination were associated with the risk of delivering a small-for-gestational age (SGA) infant and how much maternal age in relation to developmental life stages (adolescence [≤ 18 years], emerging adulthood [19–24 years], and adulthood [≥ 25 years]) moderated the relationship. Data stem from the Baltimore Preterm Birth Study, a hybrid prospective/retrospective cohort study that enrolled 872 women between March 2000 and July 2004 (analyzed in 2016–2017). Spline regression analyses demonstrated a statistically significant (p value for overall association < 0.001) and non-linear (p value = 0.044) relationship between maternal age and the overall racism index. Stratified analysis showed experiences of racism overall was associated with a higher odds ratio of delivering an SGA infant among AA women aged ≥ 25 years (OR = 1.45, 95% CI 1.02–2.08). The overall racism index was not associated with the SGA infant odds ratio for emerging adults (OR = 0.86, 95% CI 0.69–1.06) or adolescents (OR = 0.92, 95% CI 0.66–1.28). Multiple aspects of racism and the intersection between racism and other contextual factors need to be considered.

Childbearing Motivations and Desires, Fertility Beliefs, and Contraceptive Use among Urban African-American Adolescents and Young Adults with STI Histories Abstract This study explored the influence of STI history on childbearing motivations, fertility beliefs, current childbearing desires, and contraception use among urban African-American adolescents and young adults (AYA). Secondary data were from the Neighborhood Influences on Adolescent and Young Adult Health (NIAAH) study, conducted from 2004 to 2007. Sample included 517 AYA ages 15–24 years (male: n = 199, female: n = 318). Linear and logistic regression models examined gender differences in childbearing motivations (CBM) and desires, fertility beliefs, condom, and contraception use. Logistic regression models were constructed to examine age, pregnancy history, and STI fertility knowledge as potential confounders. AYA men (3.29) and AYA women (3.23) had similar CBM mean scores. AYA women had more positive CBM and used condoms less. Condom use was not associated with CBM among AYA men (OR = 0.71, p = 0.069). Low beliefs about fertility (OR = 0.52, p = 0.003) and prior pregnancy (OR = 5.27, p = 0.002) were associated with current childbearing desires among AYA women. AYA men's low fertility beliefs were only associated with current childbearing desires (OR = 0.56, p = 0.044). AYA men reported more contraception use (67.46 vs. 55.04%), especially with no partner pregnancy history (OR = 0.26, p = 0.017). Younger men (15 to 18 years old) reported more contraception or condom use compared to older AYA men (19–25 years old) (OR = 0.40, p = 0.016). Young men reporting a partner's prior pregnancy used fewer condoms or contraception (OR = 0.23, p = 0.028). STI history did not influence CBM in this sample of urban youth. Prior pregnancy experiences and chronological age, however, were important milestones shaping proximal motivations and desires to bear children, beliefs about fertility, and contraception behaviors.

Separate and Sick: Residential Segregation and the Health of Children and Youth in Metropolitan Statistical Areas Abstract The purpose of this study was to better understand residential segregation and child/youth health by examining the relationship between a measure of Black-White residential segregation, the index of dissimilarity, and a suite of child and youth health measures in 235 U.S. metropolitan statistical areas (MSAs). MSAs are urban areas with a population of 50,000 or more and adjacent communities that share a high degree of economic and social integration. MSAs are defined by the Office of Management and Budget. Health-related measures included child mortality (CDC WONDER), teen births (NCHS natality data), children in poverty (SAIPE program), and disconnected youth (Measure of America). Simple linear regression and two-level hierarchical linear regression models, controlling for income, total population, % Black, and census region, examined the association between segregation and Black health, White health, and Black-White disparities in health. As segregation increased, Black children and youth had worse health across all four measures, regardless of MSA total and Black population size. White children and youth in small MSAs with large Black populations had worse levels of disconnected youth and teen births with increasing segregation, but no associations were found for White children and youth in other MSAs. Segregation worsened Black-White health disparities across all four measures, regardless of MSA total and Black population size. Segregation adversely affects the health of Black children in all MSAs and White children in smaller MSAs with large Black populations, and these effects are seen in measures that span all of childhood. Residential segregation may be an important target to consider in efforts to improve neighborhood conditions that influence the health of families and children.

Extremophiles

In Memoriam: Maria Ciaramella (1958–2018)

Fungi, a neglected component of acidophilic biofilms: do they have a potential for biotechnology? Abstract Fungi from extreme environments, including acidophilic ones, belong to biotechnologically most attractive organisms. They can serve as a source of enzymes and metabolites with potentially uncommon properties and may actively participate within bioremediation processes. In respect of their biotechnological potential, extremophilic fungi are mostly studied as individual species. Nevertheless, microorganisms rarely live separately and they form biofilms instead. Living in biofilms is the most successful life strategy on the Earth and the biofilm is the most abundant form of life in extreme environments including highly acidic ones. Compared to bacterial fraction, fungal part of acidophilic biofilms represents a largely unexplored source of organisms with possible use in biotechnology and especially data on biofilms of highly acidic soils are missing. The functioning of the biofilm results from interactions between organisms whose metabolic capabilities are efficiently combined. When we look on acidophilic fungi and their biotechnological potential we should take this fact into account as well. The practical problem to be resolved in connection with extensive studies of exploitable properties and abilities of acidophilic fungi is the methodology of isolation of strains from the nature. In this respect, novel isolation techniques should be developed.

Response of neutrophilic Shewanella violacea to acid stress: growth rate, organic acid production, and gene expression Abstract Neutrophilic Shewanella violacea is isolated from deep-sea sediments and its response to high pressure and high salinity has been investigated. Here, the pure effects of acidic pH on S. violacea physiology were examined, aiming at further understanding of its stress response mechanism. S. violacea could grow at initial pH of 5.0–7.0 without pH adjustment during the test at atmospheric pressure, and the lowest growth rate was obtained at pH 5.0. The pH of the same growth culture with an initial pH of 5.0 rose toward a neutral pH of ~ 7.0 at the exponential growth phase, indicating that S. violacea has a mechanism for acid neutralization. When S. violaceacells were grown at the fixed pH of 5.0, about five times higher concentrations of butyric and isovaleric acids were produced than at pH 7.0. The expression level of the genes encoding three enzymes for isovaleric acid synthesis from l-leucine was also found to be upregulated in S. violacea cells grown at the fixed pH of 5.0 compared with at pH 7.0 through RNA-seq analysis. Therefore, S. violacea at least produces isovaleric acid in its response to acid stress, which further deepens our understanding of the stress response mechanism inherent in this bacterium.

Alkaline soda Lake Velika Rusanda (Serbia): the first insight into diatom diversity of this extreme saline lake Abstract Alkaline soda lakes are unique habitats found in specific geographic regions, usually with dry climate. The Carpathian Basin is one of those regions very important for habitat and biodiversity conservation in Europe, with natural soda lakes found in Austria, Hungary and Serbia. In comparison to other two countries from Central Europe, algal biodiversity studies of saline soda lakes in Serbia are scarce. Lake Velika Rusanda has the highest measured salinity of all saline lakes in the Carpathian Basin and there were no reports of its diatom species richness and diversity till now. We conducted 2-year investigation programme to study biodiversity and seasonal dynamics of diatoms in this lake. A total of 27 diatom taxa were found, almost all of them attached to reed and much less in benthos and plankton. Five new diatom species for Serbia were recorded, Craticula halopannonica, Navicymbula pusilla, Hantzschia weyprechtii, Nitzschia thermaloides and Navicula staffordiae. The last mentioned is new for Europe as well. Lake Velika Rusanda is inhabited mostly by alkaliphilous and halophilic diatoms. Since diatoms are used as bioindicators in soda lakes, our results will improve their further application in ecological status assessment of these fragile habitats in the Carpathian Basin.

Enrichment of anaerobic heterotrophic thermophiles from four Azorean hot springs revealed different community composition and genera abundances using recalcitrant substrates Abstract DGGE analysis combined with a metagenomic approach was used to get insights into heterotrophic anoxic enrichment cultures of four hot springs of Vale das Furnas, Portugal, using the recalcitrant substrate spent coffee ground (SCG). Parallel enrichment cultures were performed using the major components of spent coffee ground, namely arabinogalactan, galactomannan, cellulose, and proteins. DGGE revealed that heterotrophic thermophilic bacteria are highly abundant in the hydrothermal springs and significant differences in community composition depending on the substrate were observed. DNA, isolated from enrichment cultures of different locations that were grown on the same substrate were pooled, and the respective metagenomes were analyzed. Results indicated that cultures grown on recalcitrant substrate SCG consists of a totally different thermophilic community, dominated by Dictyoglomus. Enrichments with galactomannan and arabinogalactan were dominated by Thermodesulfovibrio, while cultures with casein and cellulose were dominated by Thermus. This study indicates the high potential of thermophilic bacteria degrading recalcitrant substrate such as SCG and furthermore how the accessibility to complex polymers shapes the bacterial community.

The diversity, distribution, and pathogenic potential of cultivable fungi present in rocks from the South Shetlands archipelago, Maritime Antarctica Abstract We studied the molecular taxonomy and diversity of cultivable rock fungi from Antarctic islands. From 50 rock samples, 386 fungal isolates were obtained and identified as 33 taxa of 20 genera. The genera Cladophialophora, Cladosporium, Cyphellophora, Eichleriella, Paracladophialophora, and Penicillium displayed the highest densities. Ecological diversity indices showed that the fungal assemblages are diverse and rich with low dominance. The genera Cladophialophora, Cladosporium, and Penicillium showed a broad distribution from rocks of the various islands. One hundred and fifty-nine fungi, grown at 37 °C, were identified as Penicillium chrysogenum, Fusarium sp., and Rhodotorula mucilaginosa. One hundred and three fungi displayed haemolytic activity, 81 produced proteinase, 9 produced phospholipase, and 25 presented dimorphism and a spore diameter ≤ 4 µm. The Antarctic Peninsula region appears to be under the effects of global climate changes, which may expose and accelerate the rock's weathering processes, and expose and release cryptic fungi and other microbes, especially those with innate pathogenic potential, previously arrested in rocks. Consequently, these rocks and their particles may represent a vehicle for the dispersal of microbial propagules, including those able to spread pathogens, along, across, and out of Antarctica.

Labelling halophilic Archaea using 13 C and 15 N stable isotopes: a potential tool to investigate haloarchaea consumption by metazoans Abstract The use of stable isotope (SI) labelling and tracing of live diets is currently considered one of the most comprehensive tools to detect their uptake and assimilation by aquatic organisms. These techniques are indeed widely used in nutritional studies to follow the fate of specific microbial dietary components, unraveling trophic interactions. Nevertheless, to the current date our understanding of aquatic trophic relationships has yet to include a whole domain of life, the Archaea. The aim of the present research was, therefore, to describe a halophilic Archaea (haloarchaea) labelling procedure, using the SI 13C and 15N, to enable the application of SI tracing in future studies of haloarchaea consumption by aquatic metazoans. To this end, three 13C enriched carbon sources and two 15N enriched nitrogen sources were tested as potential labels to enrich cells of three haloarchaea strains when supplemented to the culture medium. Our overall results indicate 13C-glycerol as the most effective carbon source to achieve an efficient 13C enrichment in haloarchaea cells, with Δδ13C values above 5000‰ in all tested haloarchaea strains. As for 15N enriched nitrogen sources, both (15NH4)2SO4 and 15NH4Cl seem to be readily assimilated, also resulting in efficient 15N enrichment in haloarchaea cells, with Δδ15N values higher than 20,000‰. We believe that the proposed methodology will allow for the use of SI labelled haloarchaea biomass in feeding tests, potentially providing unambiguous confirmation of the assimilation of haloarchaea biomass by aquatic metazoans.

Temperature adaptation of DNA ligases from psychrophilic organisms Abstract DNA ligases operating at low temperatures have potential advantages for use in biotechnological applications. For this reason, we have characterized the temperature optima and thermal stabilities of three minimal Lig E-type ATP-dependent DNA ligase originating from Gram-negative obligate psychrophilic bacteria. The three ligases, denoted Vib-Lig, Psy-Lig, and Par-Lig, show a remarkable range of thermal stabilities and optima, with the first bearing all the hallmarks of a genuinely cold-adapted enzyme, while the latter two have activity and stability profiles more typical of mesophilic proteins. A comparative approach based on sequence comparison and homology modeling indicates that the cold-adapted features of Vib-Lig may be ascribed to differences in surface charge rather than increased local or global flexibility which is consistent with the contemporary emerging paradigm of the physical basis of cold adaptation of enzymes.

Sedimentary Marl mudstone as a substrate in a xeric environment revealed by microbiome analysis Abstract The sedimentary Marl mudstone soil is composed primarily of CaCO3, and is an important pedologic and geomorphologic element known as Marl, extensively dispersed in slopes and ridges in the northern Negev Desert, Israel. The wide Marl soil-layer areas are barren, with well-developed streamsides and no perennial vegetation cover. Soil systems in the Negev Desert have been widely studied, yet very little information was collected on Marl soils, and even less on the microbiome present in the Negev. Thus, an evaluation of the microbial-community inhabitants in a Marl soil layer was conducted in an attempt to distinguish between Marl with surface green mat and bare Marl soil layer. Our objective was to investigate the microbiome and abiotic components of the upper layer (0–5 cm) of Marl and Marl-with-green-mat soil collected in the Negev Desert. Plate-counting enabled the estimation of fungal and bacterial population size, while nested polymerase chain reaction (nPCR) and Ion Torrent sequencing were used to analyze biological diversity. The results indicate significant differences in microbial biomass and microbial-community diversity between Marl and Marl-green mat, despite similar pH levels. Further study is needed to enhance understanding of the activity of the biotic components and their contribution to slope stabilization.

Change in the microbial community of saline geothermal fluids amended with a scaling inhibitor: effects of heat extraction and nitrate dosage Abstract Geothermal plants are often affected by corrosion caused by microbial metabolites such as H2S. In the Bad Blumau (Austria) geothermal system, an increase in microbially produced H2S was observed in the hot (107 °C) and scaling inhibitor-amended saline fluids and in fluids that had cooled down (45 °C). Genetic fingerprinting and quantification revealed the dominance, increasing abundance and diversity of sulfate reducers such as Desulfotomaculum spp. that accompanied the cooling and processing of the geothermal fluids. In addition, a δ34S isotopic signature showed the microbial origin of the H2S that has been produced either chemolithotrophically or chemoorganotrophically. A nitrate addition test in a test pipe as a countermeasure against the microbial H2S formation caused a shift from a biocenosis dominated by bacteria of the phylum Firmicutes to a community of Firmicutes and Proteobacteria. Nitrate supported the growth of nitrate-reducing sulfur-oxidizing Thiobacillus thioparus, which incompletely reduced nitrate to nitrite. The addition of nitrate led to a change in the composition of the sulfate-reducing community. As a result, representatives of nitrate- and nitrite-reducing SRB, such as Desulfovibrio and Desulfonatronum, emerged as additional community members. The interaction of sulfate-reducing bacteria and nitrate-reducing sulfur-oxidizing bacteria (NR-SOB) led to the removal of H2S, but increased the corrosion rate in the test pipe.

Mental Health

Beliefs and Attitudes About the Dissemination and Implementation of Internet-Based Self-Care Programs in a Large Integrated Healthcare System Abstract Behavioral intervention technologies (BITs) are online programs or mobile applications that deliver behavioral health interventions for self-care. The dissemination and implementation of such programs in U.S. healthcare systems has not been widely undertaken. To better understand these phenomena, we explored perspectives on BIT deployment in the Veterans Health Administration. Interviews from 20 providers, administrators, and policy makers were analyzed using qualitative methods. Eight themes were identified including the use of traditional healthcare delivery models, strategies for technology dissemination and implementation, internet infrastructure, leadership, health system structure, regulations, and strategic priorities. This research suggests policy, funding, and strategy development initiatives to promote the implementation and dissemination of BITs.

Treatment of Veterans with Psychiatric Diagnoses Nationally in the Veterans Health Administration: A Comparison of Service Delivery by Mental Health Specialists and Other Providers Abstract Patients with psychiatric disorders are treated by both mental health specialists and non-specialists. We use national data from the Veterans Health Administration to evaluate changing proportions of patients seen exclusively by non-specialists during the study year (FY 2012) limit as well as differences in socio-demographic, clinical and service use characteristics. There has been a five-fold increase in veterans with mental disorders seen by non-specialists over 20 years from 7 to 38%, findings similar to those in non-VA settings. Veterans treated by mental health specialists were younger, more likely to have been homeless and disabled, and had more severe and more numerous psychiatric diagnoses. There is a need to maintain specialty services and to strengthen non-specialty care through education and research.

Policy Levers to Promote Access to and Utilization of Children's Mental Health Services: A Systematic Review Abstract Policies have potential to help families obtain behavioral healthcare for their children, but little is known about evidence for specific policy approaches. We reviewed evaluations of select policy levers to promote accessibility, affordability, acceptability, availability, or utilization of children's mental and behavioral health services. Twenty articles met inclusion criteria. Location-based policy levers (school-based services and integrated care models) were associated with higher utilization and acceptability, with mixed evidence on accessibility. Studies of insurance-based levers (mental health parity and public insurance) provided some evidence for affordability outcomes. We found no eligible studies of workforce development or telehealth policy levers, or of availability outcomes.

Policy Impacts of the Australian National Perinatal Depression Initiative: Psychiatric Admission in the First Postnatal Year Abstract This paper helps to quantify the impact of the Australian National Perinatal Depression Initiative (NPDI) on postnatal inpatient psychiatric hospitalisation. Based on individual hospital admissions data from New South Wales and Western Australia, we found that the NPDI reduced inpatient psychiatric hospital admission by up to 50% [0.9% point reduction (95% CI 0.70–1.22)] in the first postnatal year. The greatest reduction was observed for adjustment disorders. The NPDI appears to be associated with fewer post-birth psychiatric disorders hospital admissions; this suggests earlier detection of psychiatric disorders resulting in early care of women at risk during their perinatal period.

Effectiveness of Health and Social Service Networks for Severely Mentally Ill Patients' Outcomes: A Case–Control Study Abstract Mental health and social care services networks aim to provide patients with continuity of care and support their recovery. There is, however, no conclusive evidence of their effectiveness. Since 2011, Belgium has been implementing a nation-wide reform of mental health care by commissioning service networks. Using a case–control design, we assessed the reform's effectiveness for continuity of care, social integration, quality of life, and re-hospitalization for 1407 patients from 23 networks. Greater reform exposure was associated with a slight improvement in continuity of care, but not with other outcomes. We concluded that service networks alone do not affect patient-level outcomes.

Work Stress and Satisfaction with Leadership Among Nurses Encountering Patient Aggression in Psychiatric Care: A Cross-Sectional Survey Study Abstract We examined the associations between work stress (job strain, effort-reward imbalance), perceived job insecurity, workplace social capital, satisfaction with leadership and working hours in relation to the likelihood of encountering patient aggression (overall exposure, assaults on ward property, mental abuse, physical assaults). We conducted a cross-sectional survey for nurses (N = 923) in 84 psychiatric units. Both work stress indicators were associated higher odds for different types of patient aggression. Poorer satisfaction with leadership was associated with higher odds for overall exposure to patient aggression. These findings were robust to adjustment for several nurse and work characteristics, and unit size.

"We're All in this Together": Peer-specialist Contributions to a Healthy Lifestyle Intervention for People with Serious Mental Illness Abstract This qualitative study explored peer specialists' contributions to a healthy lifestyle intervention for obese/overweight individuals with serious mental illness (SMI) living in supportive housing. Intervention participants, peer specialists, and supervisors were interviewed and a grounded model emerged from the data identifying essential interpersonal attributes of the peer specialist-participant relationship. Peer specialists' disclosure of their own experiences making health behaviors changes was critical for building participants' motivation and ability to try lifestyle changes. Findings can inform peer specialist training and practice standards and facilitate the expansion of peer-delivered interventions to improve the physical health of people with SMI.

Implementing Evidence Based Practices for Children's Mental Health: A Case Study in Implementing Modular Treatments in Community Mental Health Abstract There is strong enthusiasm for utilizing implementation science in the implementation of evidence-based programs in children's community mental health, but there remains work to be done to improve the process. Despite the proliferation of implementation frameworks, there is limited literature providing case examples of overcoming implementation barriers. This article examines whether the use of three implementations strategies, a structured training and coaching program, the use of professional development portfolios for coaching, and a progress monitoring data system, help to overcome barriers to implementation by facilitating four implementation drivers at a community mental health agency. Results suggest that implementation is a process of recognizing and adapting to both predictable and unpredictable barriers. Furthermore, the use of these implementation strategies is important in improving implementation outcomes.

Developing a Strategy to Embed Peer Support into Mental Health Systems Abstract Globally, health care systems stakeholders have encouraged health systems change that reflects recovery oriented practice. The implementation and integration of Peer Support Workers is one such strategy. Yet, what factors should be considered in the implementation of these roles? How can services be integrated effectively? Recent literature will be reviewed to explore current knowledge about peer support, and offer considerations for effective implementation of peer supports into current health care systems.

Help-Seeking by Parental Caregivers of Individuals with Intellectual Disabilities and Dual Diagnosis Abstract This study examined the roles of stigma and of enabling factors in help-seeking by parental caregivers of individuals with intellectual disabilities and dual diagnosis. Questionnaires were completed by 195 family caregivers. Lower family stigma was related to higher personal enabling factors (e.g. knowledge about services and previous experience in seeking help), which in turn was related to higher help-seeking behaviors. Higher professional enabling factors (e.g. attitude of the professional, services in the vicinity) were related to higher intentions to seek help, which were related to higher help-seeking behaviors. Professionals can help families achieve a greater sense of self-efficacy in their own help-seeking process by providing them with knowledge about services and facilitating a more positive experience in the process.

Microbiology

PmrAB and PhoPQ Variants in Colistin-Resistant Enterobacter spp. Isolates in Korea Abstract In this study, we investigated the amino acid variations and mRNA expression of PhoPQ and PmrAB two-component regulatory systems in colistin-resistant Enterobacter cloacae isolates from Korea. We determined the nucleotide sequences of phoP, phoQ, pmrA, and pmrB in 51 colistin-resistant, 5 colistin-susceptible, and 8 skip-well isolates and consequently, the corresponding amino acid sequences as well. PhoPQ and PmrAB sequences showed large variations among the isolates (14, 67, 20, and 68 sites, respectively). Although there was some discrepancy between the genes, the colistin-resistant E. cloacae isolates were grouped into four clades and the susceptible isolates were grouped into two clades. We did not find any distinct amino acid substitutions associated with colistin resistance. Furthermore, mRNA expression of phoQ and pmrB was not significantly higher in the colistin-resistant isolates. Our data suggests that the colistin resistance mechanisms might be different in E. cloacae when compared to other gram-negative bacteria.

Oral Nickel Changes of Intestinal Microflora in Mice Abstract Nickel, a silver-colored metal found in nature, is a common cause of allergic contact dermatitis. Nevertheless, the existence of inflammatory reaction to oral nickel exposure remains controversial. The following study investigates whether oral nickel can change the intestinal microflora in mice. A total of 20 female ICR mice were randomly divided into two groups: the oral nickel group (Group O) and the control group (Group C). Group O received water containing 400 µM NiSO4·6H2O, while group C was given pure water for 21 days. The content of nickel in the kidneys was determined by atomic absorption spectrophotometry, while the composition of bacterial community in the cecum was detected by 16S rDNA sequencing. The results were subsequently validated by real-time quantitative PCR with genus and species specific primers. Compared to Group C, significantly higher nickel levels were observed in Group O (P = 0.016); however, our data suggested that oral administration of 400 µM NiSO4·6H2O was nontoxic to the animals. (No statistical difference in body animal weight was found between Group O and Group C, before and after oral administration of nickel.) At the genus level, significantly higher relative abundance of Bacteroides (P = 0.016) and Intestinimonas (P = 0.018), and significantly lower relative abundance of Lachnospiraceae_NK4A136_group (P = 0.002) and Lachnospiraceae_UCG-001_group (P = 0.042) were observed in the oral nickel group compared to the control group. In addition, Group O had significantly lower ratio of Firmicutes/Bacteroides (P = 0.008). The results of real-time quantitative PCR further confirmed that the amplicon mass of Bacteroides and B. fragilis in the Group O was significantly higher compared to C group (P = 0.034 and P = 0.02). Oral nickel could change the intestinal microflora in mice, thus suggesting that oral nickel alters the interaction between the host and the intestinal flora.

Functional Replacement of the BioC and BioH Proteins of Escherichia coli Biotin Precursor Biosynthesis by Ehrlichia chaffeensis Novel Proteins Abstract The biosynthesis of the pimelate moiety of biotin in Escherichia coli requires two specialized proteins, BioC and BioH. However, the enzymes that have BioC- or BioH-like activities show remarkable sequence diversity among biotin-producing bacteria. Here, we report that the intracellular rickettsial pathogen Ehrlichia chaffeensis encodes two novel proteins, BioT and BioU, which functionally replace the E. coli BioC and BioH proteins, respectively. The desthiobiotin assays demonstrated that these two proteins make pimeloyl-acyl carrier protein (ACP) from the substrate malonyl-ACP with the aid of the FAS II pathway, through the expected pimeloyl-ACP methyl ester intermediate. BioT and BioU homologues seem restricted to the species of Ehrlichia and its close relative, Anaplasma. Taken together, the synthesis of the biotin precursor in E. chaffeensis appears to be catalyzed by two novel BioC- and BioH-like proteins.

Association of Listeria monocytogenes LIPI-1 and LIPI-3 marker llsX with invasiveness Abstract Listeria monocytogenes is an opportunistic pathogen that is widely distributed in the environment. The evolution of its genome has exhibited differences in virulence among strains of the same species. Listeria monocytogenes LIPI-3 (Listeria Pathogenicity Island 3) and LIPI-1 (Listeria Pathogenicity Island 1) are considered responsible for the increased virulence in some strains. The aim of this study was to detect LIPI-1 genes and the llsX gene belonging to LIPI-3 in invasive strains of L. monocytogenes and to establish whether there is a relationship among the invasiveness, presence of the llsX and LIPI-1 genes, and the source of the strains. The results showed that 70% of the strains were invasive, and all these strains except one possessed LIPI-1, which suggests that although there is a correlation between LIPI-1 and invasiveness, the independent mechanisms of LIPI-1 may contribute to invasiveness. In contrast, 35% of the total strains were positive for llsX and were invasive; thus, the results revealed that there is a strong association between llsX and the invasiveness of L. monocytogenes in HEp-2 cells (HeLa contaminant/epithelial in origin). In addition, there is no other association with any other variable in this study. Moreover, the authors found that LIPI-1 and llsX are more frequently found in fresh than in frozen vegetables. Together, the findings provide an approximation for the better understanding of Listeriolysin S (LLS) and its role in the pathogenesis of L. monocytogenes, and a possible relation between virulence factors and food-storage temperature.

Insights into the Draft Genome Sequence of the Kiwifruit-Associated Pathogenic Isolate Pseudomonas fluorescens AHK-1 Abstract Pseudomonas fluorescens is a physiologically diverse species of bacteria present in many habitats, which possesses multifunctional traits that provide it with the capability to exhibit biological control activities, promote plant health or cause plant disease. Here, we present the draft genome sequence of the kiwifruit-associated pathogenic isolate AHK-1 of P. fluorescens, which was isolated from the diseased leaves of kiwifruit plants. The genome size of AHK-1 was found to be 7,035,786 bp, with a G + C content of 60.88%. It is predicted to contain a total of 6327 genes, of which 3998 were homologous to genes in the other two sequenced P. fluorescensisolates (SBW25 and GcM5-1A) and 946 were unique to AHK-1 based on comparative genomic analysis. Furthermore, we identified several candidate virulence factors in the genome of AHK-1, including the fliA gene encoding flagellar biosynthetic protein for biosynthesis, and the genes for components of type VI, III, and IV secretion systems. This genomic resource will serve as a reference for better understanding the genetics of pathogenic and non-pathogenic strains, and will help to elucidate the pathogenic mechanisms of P. fluorescens associated with plant disease.

Selection of Optimized Reference Genes for qRT-PCR Normalization in Xanthomonas campestris pv. campestris Cultured in Different Media Abstract Black rot is a cruciferous disease caused by Xanthomonas campestris pv. campestris (Xcc) and results in significant economic losses worldwide; therefore, elucidation of the mechanism of Xcc pathogenesis is urgently required. In this study, we aimed to select optimized reference genes to verify the relative quantification of virulent genes in Xcc. Xcc strains were cultured in three different media [basic medium (MMX), hrp-inducing medium (MMXC) and rich medium (NYG)] and the expression stability of five candidate genes [thymidylate synthase (thyA), DNA gyrase subunit B (gyrB), DNA-directed RNA polymerase subunit beta, glyceraldehyde-3-phosphate dehydrogenase and 16S ribosomal RNA (16S rRNA)] was evaluated using BestKeeper, GeNorm, and NormFinder software programs. Quantitative real-time PCR (qRT-PCR) analysis confirmed that two Xcc effector genes were hrpX/hrpG-regulated in MMXC using selected genes as controls. Finally, gyrB and thyA were validated as the optimized reference genes of Xcc cultured in MMXC, and qRT-PCR analysis was demonstrated to be an efficient alternative to Gus-activity detection for the analysis of Xcc expression. This information will be useful in the future studies of Xcc, especially those seeking new functional genes.

Identification and Characterization of an Autophagy-Related Gene Acatg12 in Acremonium chrysogenum Abstract Autophagy is a highly conserved mechanism to overcome various stresses and recycle cytoplasmic components and organelles. Ubiquitin-like (UBL) protein Atg12 is a key protein involved in autophagosome formation through stimulation of Atg8 conjugation to phosphatidylethanolamine. Here, we describe the identification of the autophagy-related gene Acatg12, encoding an Atg12 homologous protein in the cephalosporin C producing fungus Acremonium chrysogenum. Disruption of Acatg12 impaired the delivery and degradation of eGFP-Atg8, indicating that the autophagic process was blocked. Meanwhile, conidiation was dramatically reduced in the Acatg12 disruption mutant (∆Acatg12). In contrast, cephalosporin C production was increased twofold in ∆Acatg12, but fungal growth was reduced after 6 days fermentation. Consistent with these results, the transcriptional level of the cephalosporin biosynthetic genes was increased in ∆Acatg12. The results extend our understanding of autophagy in filamentous fungi.

Microbial Bioleaching of Ag, Au and Cu from Printed Circuit Boards of Mobile Phones Abstract Electronic waste (E-Waste) is consumed at high speed in the world. These residues contain metals that increase their price each year, generating new research on the ability of microorganisms to recover the metals from these wastes. Therefore, this work evaluated the biologic lixiviation of Cu, Ag and Au from printed circuit boards (PCB) of mobile phones by three strains of Aspergillus niger, Candida orthopsilosis, Sphingomonas sp. and their respective consortia, in addition to leaching with citric acid. The microorganisms were cultured in mineral media with 0.5 g of PCB, and the treatments with 1M citric acid were added the same amount of PCB. All treatments were incubated for 35 days at room temperature. The results showed that Sphingomonas sp. MXB8 and the consortium of C. orthopsilosis MXL20 and A. niger MXPE6 can increase their dry biomass by 147% and 126%, respectively, in the presence of PCB. In the bioleaching of metals, the inoculation of A. niger MXPE6, the consortium of Sphingomonas sp. MXB8/C. orthopsilosis MXL20 and Sphingomonas sp. MXB8 leached 54%, 44.2% and 35.8% of Ag. The consortium of A. niger MX5 and A. niger MXPE6 showed a leaching of 0.53% of Au. A. niger MX5 leaching 2.8% Cu. Citric acid increased Cu leaching by 280% compared to treatments inoculated with microorganisms. Although further research is required, A. niger MXPE6 and the consortium of Sphingomonas sp. MXB8/C. orthopsilosis MXL20 could be an alternative to recover Ag from PCB of mobile phones.

Phylogenetic Studies on the Prodigiosin Biosynthetic Operon Abstract Prodigiosin and undecylprodigiosin are tripyrrolic red pigmented antibiotics produced by certain bacteria. Many strains of Serratia and certain other Gammaproteobacteria produce prodigiosin and undecylprodigiosin is produced by certain strains of Streptomyces. This is a multistage process which involves the synthesis of a bipyrrolic compound from L-proline and its subsequent condensation with a mono pyrrole synthesized from 2-octenal in the case of prodigiosin and malonyl-CoA in the case of undecylprodigiosin respectively. We have carried out sequence analysis of the genes involved in the pathway and identified the distribution of the prodigiosin producing genes amongst the various bacteria which have been fully sequenced. The presence of the operon was clearly seen in certain clustered branches suggesting inheritance from a common ancestor. This was further confirmed by the absence of traits observed in horizontally acquired genes like, GC content variation, codon bias or the presence of mobile elements. Multiple sequence alignment of the promoter of the prodigiosin operon in seven fully sequenced Serratia marcescens strains showed excellent homology. Putative regulatory elements in this region were identified by sequence analysis studies and many of them have been found to influence pigment production. The undecylprodigiosin gene cluster on the other hand, shows homology to other gene clusters involved in the production of other pyrrole-containing antibiotics of the genus Streptomyces. This coupled with the presence of ORFs with three different promoters could indicate lateral gene transfer. Hence the evolution of undecylprodigiosin operon could be an example of convergent evolution.

Volatile Compounds Produced by Cyanobacteria Isolated from Mangrove Environment Abstract Cyanobacterial communities from the Brazilian Atlantic coast have been recently sampled through cultured and non-cultured approaches. The maintenance of cyanobacterial strains in laboratory cultures is an important source of material for biological and chemical evaluation as well as biotechnological investigations. In this way, this work aimed to identify, for the first time, by means of GC–MS analyses, the nonpolar chemical profiles of four morphologically distinct cyanobacterial strains: Cyanobium sp. CENA178, Cyanobium sp. CENA181, Oxynema sp. CENA135 and Nostoc sp. CENA175, which were previously isolated from Brazilian mangroves. Six distinct classes of volatile compounds were identified: acids, alcohols, fatty aldehydes, esters, ketones and aliphatic hydrocarbons, from which 12 compounds were detected. The predominant compounds were 1-octadecyne and tetradecanoic acid, obtained from Oxynema sp. CENA135 and; the last one being also observed in Cyanobium sp. CENA181. In addition, the aliphatic hydrocarbon heptadecane was produced by these cyanobacterial strains as well as by Nostoc sp. CENA175. The compounds produced by the studied cyanobacteria have already been reported as possessing pharmaceutical properties such as antioxidant, cytotoxic and antimicrobial activities, besides industrial importance as source of intermediates for biofuel production. It is also important to mention that, considering the number of non-identified compounds, which were not compatible with the searched databases, these strains are promising sources of new compounds, denoting the need for more studies. Accordingly, since these strains were isolated from saline or brackish waters, it is also expected that they might be cultivated in waters not used for human consumption, enabling a low-cost approach for biomass and metabolites production.