Pathogenesis of antibiotic-associated diarrhea (AAD)---a systematic review

A common complication of antibiotic use is the development of diarrheal illness. The pathogenesis of antibiotic associated diarrhea (AAD) may be mediated through alteration of intestinal microbiota, overgrowth of opportunistic pathogens, and direct drug toxicity on the gut. Alterations in the intestinal microbiota result in metabolic imbalances, loss of colonization resistance and in turn allow proliferation of opportunistic pathogens. Currently less than 33% of AAD cases can be attributable to Clostridium difficile leaving a large number of cases undiagnosed and poorly treated. Although the pathogenesis of Clostridium difficile infection (CDI) has been well documented, the role of other putative microbial etiologies (Clostridium perfringens, Staphylococcus aureus, Klebsiella oxytoca, Candida species) and their pathogenic mechanisms in AAD has been unclear. This review provides a comprehensive and systematic approach to the existing data on AAD and includes concise descriptions of the pathogenesis of CDI and non-CDI AAD in the form of figures.^

Magnetic properties and oxide petrography of ODP Hole 111-504B

Magnetic properties measurements were performed on 47 samples drilled during Leg 111 of the Ocean Drilling Program and oxide petrography was studied in 32 samples taken at depths throughout the sheeted dike complex in Hole 504B. Integration of these data with results from previous DSDP legs shows that while natural remanent magnetization is constant with depth, magnetic susceptibility increases and median demagnetizing field and the Q ratio decrease with depth in the section. These trends appear to be a result of an increase in deuteric oxidation and a decrease in hydrothermal alteration of primary titanomagnetite with depth. A distinct change in stable magnetic inclination occurs between the extrusive basalts and the sheeted dikes and may be a result of tectonic rotation of the upper extrusive basalts.

Paleomagnetic of lower Cretaceous sediments from the Argo and Gascoyne Abyssal Plain

Lower Cretaceous sediments were sampled for magnetostratigraphy at three sites. ODP Site 765 and DSDP Site 261, in the Argo Abyssal Plain, consist primarily of brownish-red to gray claystone having hematite and magnetite carriers of characteristic magnetization. ODP Site 766, in the Gascoyne Abyssal Plain, consists mainly of dark greenish-gray volcaniclastic turbidites with magnetite as the carrier of characteristic magnetization. Progressive thermal demagnetization (Sites 765 and 261) or alternating field demagnetization (Site 766) yielded well-defined polarity zones and a set of reliable paleolatitudes. Magnetic polarity chrons were assigned to polarity zones using biostratigraphic correlations. Late Aptian chron M"-1"r, a brief reversed-polarity chron younger than MOr, is a narrow, 40-cm feature delimited in Hole 765C. Early Aptian reversed-polarity chron MOr is also present in Hole 765C. Polarity chrons Mir through M3r were observed in the Barremian of all three sites. Valanginian and Hauterivian polarity chrons can be tentatively assigned to polarity zones only in Hole 766A. The paleolatitude of this region remained at 35° to 37°S from the Berriasian through the Aptian. During this interval, there was approximately 16° of clockwise rotation, with the oriented sample suites of Site 765 displaying a Berriasian declination of 307° to an Aptian declination of 323°. These results are consistent with the interpolated Early Cretaceous apparent polar wander for Australia, but indicate that this region was approximately 5? farther north than predicted.

Atmospheric, oceanic and hydrological polar motion excitation mechanisms based on a combination of geometric and gravimetric space observations

The goal of our study is to determine accurate time series of geophysical Earth rotation excitations to learn more about global dynamic processes in the Earth system. For this purpose, we developed an adjustment model which allows to combine precise observations from space geodetic observation systems, such as Satellite Laser Ranging (SLR), Global Navigation Satellite Systems (GNSS), Very Long Baseline Interferometry (VLBI), Doppler Orbit determination and Radiopositioning Integrated on Satellite (DORIS), satellite altimetry and satellite gravimetry in order to separate geophysical excitation mechanisms of Earth rotation. Three polar motion time series are applied to derive the polar motion excitation functions (integral effect). Furthermore we use five time variable gravity field solutions from Gravity Recovery and Climate Experiment (GRACE) to determine not only the integral mass effect but also the oceanic and hydrological mass effects by applying suitable filter techniques and a land-ocean mask. For comparison the integral mass effect is also derived from degree 2 potential coefficients that are estimated from SLR observations. The oceanic mass effect is also determined from sea level anomalies observed by satellite altimetry by reducing the steric sea level anomalies derived from temperature and salinity fields of the oceans. Due to the combination of all geodetic estimated excitations the weaknesses of the individual processing strategies can be reduced and the technique-specific strengths can be accounted for. The formal errors of the adjusted geodetic solutions are smaller than the RMS differences of the geophysical model solutions. The improved excitation time series can be used to improve the geophysical modeling.

Paleomagnetic reconstructions of sediments at ODP Sites 135-840 and 135-841

The geometry of the Tonga Arc implies that it has rotated approximately 17° clockwise away from the Lau Ridge as the Lau Basin formed in between. Questions have arisen about the timing of the opening, whether the arc behaved rigidly, and whether the opening occurred instead from motion of the Lau Ridge, the remanent arc. We undertook to address these questions by taking paleomagnetic samples from sediment cores drilled on the Tonga Arc at Sites 840 and 841, orienting the samples in azimuth, and comparing the paleodeclinations to expected directions. Advanced hydraulic piston corer (APC) cores from Holes 840C and 841A were oriented during drilling with a tool based on a magnetic compass and attached to the core barrel. Samples from Hole 841B were drilled with a rotary core barrel (RCB) and therefore are azimuthally unoriented. They were oriented by identifying faults and dipping beds in the core and aligning them with the same features in the Formation MicroScanner (FMS) wireline logs, which were themselves oriented with a three-axis magnetometer in the FMS tool. The best results came from the APC cores, which yielded a mean pole at -69.0°S, 112.2°E for an age of 4 Ma. This pole implies a declination anomaly of 20.8° ± 12.6° (95% confidence limit), which appears to have occurred by tectonic rotation of the Tonga Arc. This value is almost exactly that expected from the geometry of the arc and implies that it did indeed rotate clockwise as a rigid body. The large uncertainty in azimuth results from core orientation errors, which have an average standard deviation of 18.6°. The youngest cores used to calculate the APC pole contain sediments deposited during Subchron 2A (2.48-3.40 Ma), and their declinations are indistinguishable from the others. This observation suggests that most of the rotation occurred after their deposition; this conclusion must be treated with caution, however, because of the large azimuthal orientation errors. Poles from late and early Miocene sediments of Hole 841B are more difficult to interpret. Samples from this hole are mostly normal in polarity, fail a reversal test, and yield poles that suggest that the normal-polarity directions may be a recent overprint. Late Miocene reversed-polarity samples may be unaffected by this overprint; if so, they imply a declination anomaly of 51.1° ± 11.5°. This observation may indicate that, for older sediments, Tonga forearc rotations are larger than expected.

A constitutive model for the in-plane mechanical behavior of nonwoven fabrics

A constitutive model is presented for the in-plane mechanical behavior of nonwoven fabrics. The model is developed within the context of the finite element method and provides the constitutive response for a mesodomain of the fabric corresponding to the area associated to a finite element. The model is built upon the ensemble of three blocks, namely fabric, fibers and damage. The continuum tensorial formulation of the fabric response rigorously takes into account the effect of fiber rotation for large strains and includes the nonlinear fiber behavior. In addition, the various damage mechanisms experimentally observed (bond and fiber fracture, interfiber friction and fiber pull-out) are included in a phenomenological way and the random nature of these materials is also taken into account by means of a Monte Carlo lottery to determine the damage thresholds. The model results are validated with recent experimental results on the tensile response of smooth and notched specimens of a polypropylene nonwoven fabric.

Bile Acids Induce Glucagon-Like Peptide 2 Secretion with Limited Effects on Intestinal Adaptation in Early Weaned Pigs

Early weaning is a stressful event characterized by a transient period of intestinal atrophy that may be mediated by reduced secretion of glucagon-like peptide (GLP) 2. We tested whether enterally fed bile acids or plant sterols could increase nutrient-dependent GLP-2 secretion and improve intestinal adaptation in weanling pigs. During the first 6 d after weaning, piglets were intragastrically infused once daily with either deionized water -control-, chenodeoxycholic acid -CDC; 60mg/kg body weight-, or b-sitoesterol -BSE; 100 mg/kg body weight-. Infusing CDC increased plasma GLP-2 -P menor que 0.05- but did not affect plasma GLP-1 and feed intake. The intestinal expression of Glp2r -glucagon-like peptide 2 receptor-, Asbt -sodium-dependent bile acid transporter-, Fxr -farnesoid X receptor-, and Tgr5 -guanosine protein?coupled bile acid receptor- genes were not affected by CDC treatment. The intragastric administration of CDC did not alter the weight and length of the intestine, yet increased the activation of caspase-3 in ileal villi -P menor que 0.02- and the expression of Il6 -interleukin 6; P menor que 0.002- in the jejunum. In contrast, infusing BSE did not affect any of the variables that were measured. Our results show that the enteral administration of the bile acid CDC potentiates the nutrient-induced secretion of endogenous GLP-2 in early-weaned pigs. Bile acid?enhanced release of GLP-2, however, did not result in improved intestinal growth, morphology, or inflammation during the postweaning degenerative phase.

Effects of the correction of particle microbial contamination and particle transit model in the rumen on in situ protein evaluation of grass hays.

Effects of considering the particle comminution rate -kc- in addition to particle rumen outflow -kp- and the ruminal microbial contamination on estimates of by-pass and intestinal digestibility of DM, organic matter and crude protein were examined in perennial ryegrass and oat hays. By-pass kc-kp-based values of amino acids were also determined. This study was performed using particle transit, in situ and 15N techniques on three rumen and duodenum-cannulated wethers. The above estimates were determined using composite samples from rumen-incubated residues representative of feed by-pass. Considering the comminution rate, kc, modified the contribution of the incubated residues to these samples in both hays and revealed a higher microbial contamination, consistently in oat hay and only as a tendency for crude protein in ryegrass hay. Not considering kc or rumen microbial contamination overvalued by-pass and intestinal digestibility in both hays. Therefore, non-microbial-corrected kp-based values of intestinal digested crude protein were overestimated as compared with corrected and kc-kp-based values in ryegrass hay -17.4 vs 4.40%- and in oat hay -5.73 vs 0.19%-. Both factors should be considered to obtain accurate in situ estimates in grasses, as the protein value of grasses is very conditioned by the microbial synthesis derived from their ruminal fermentation. Consistent overvaluations of amino acid by-pass due to not correcting microbial contamination were detected in both hays, with large variable errors among amino acids. A similar degradation pattern of amino acids was recorded in both hays. Cysteine, methionine, leucine and valine were the most degradation-resistant amino acids.

Shake-table tests of a reinforced concrete frame designed following modern codes: seismic performance and damage evaluation

This paper presents shake-table tests conducted on a two-fifths-scale reinforced concrete frame representing a conventional construction design under current building code provisions in the Mediterranean area. The structure was subjected to a sequence of dynamic tests including free vibrations and four seismic simulations in which a historical ground motion record was scaled to levels of increasing intensity until collapse. Each seismic simulation was associated with a different level of seismic hazard, representing very frequent, frequent, rare and very rare earthquakes. The structure remained basically undamaged and within the inter-story drift limits of the "immediate occupancy" performance level for the very frequent and frequent earthquakes. For the rare earthquake, the specimen sustained significant damage with chord rotations of up to 28% of its ultimate capacity and approached the upper bound limit of inter-story drift associated with "life safety". The specimen collapsed at the beginning of the "very rare" seismic simulation. Besides summarizing the experimental program, this paper evaluates the damage quantitatively at the global and local levels in terms of chord rotation and other damage indexes, together with the energy dissipation demands for each level of seismic hazard. Further, the ratios of column-to-beam moment capacity recommended by Eurocode 8 and ACI-318 to guarantee the formation of a strong column-weak beam mechanism are examined.

Wheat allergy in celiac children

Gluten is the main structural protein complex of wheat with equivalent toxic proteins found in other cereals (rye, barley, and oats) which are responsible for different immunologic responses with different clinical expressions of disease. The spectrum of gluten-related disorders has been classified according to pathogenic, clinical, and epidemiological differences in three main forms: (i) wheat allergy (WA), an IgE-mediated disease; (ii) autoimmune disease, including celiac disease (CD), dermatitis herpetiformis, and gluten ataxia; and (iii) possibly immune-mediated, gluten sensitivity [1]. WA is an immunologic Th2 response with typical manifestations which can vary from dermatological, respiratory, and/or intestinal to anaphylactic reactions. In contrast, CD is an autoimmune disorder, a gliadin-specific T-cell response which is enhanced by the action of intestinal tissue transglutaminase (tTG), with a wide clinical spectrum including symptomatic cases with either intestinal (e.g., chronic diarrhea, weight loss) or extraintestinal features (e.g., anemia, osteoporosis, neurologic disturbances) and silent forms that are occasionally discovered as a result of serological screening [1]. We studied wheat allergy in two children with early diagnosis of CD, who developed immediate allergic symptoms after eating small amounts of wheat flour.

Induction of epithelial chloride secretion by channel-forming cryptdins 2 and 3

Salt and water secretion from intestinal epithelia requires enhancement of anion permeability across the apical membrane of Cl− secreting cells lining the crypt, the secretory gland of the intestine. Paneth cells located at the base of the small intestinal crypt release enteric defensins (cryptdins) apically into the lumen. Because cryptdins are homologs of molecules known to form anion conductive pores in phospholipid bilayers, we tested whether these endogenous antimicrobial peptides could act as soluble inducers of channel-like activity when applied to apical membranes of intestinal Cl− secreting epithelial cells in culture. Of the six peptides tested, cryptdins 2 and 3 stimulated Cl− secretion from polarized monolayers of human intestinal T84 cells. The response was reversible and dose dependent. In contrast, cryptdins 1, 4, 5, and 6 lacked this activity, demonstrating that Paneth cell defensins with very similar primary structures may exhibit a high degree of specificity in their capacity to elicit Cl− secretion. The secretory response was not inhibited by pretreatment with 8-phenyltheophyline (1 μM), or dependent on a concomitant rise in intracellular cAMP or cGMP, indicating that the apically located adenosine and guanylin receptors were not involved. On the other hand, cryptdin 3 elicited a secretory response that correlated with the establishment of an apically located anion conductive channel permeable to carboxyfluorescein. Thus cryptdins 2 and 3 can selectively permeabilize the apical cell membrane of epithelial cells in culture to elicit a physiologic Cl− secretory response. These data define the capability of cryptdins 2 and 3 to function as novel intestinal secretagogues, and suggest a previously undescribed mechanism of paracrine signaling that in vivo may involve the reversible formation of ion conductive channels by peptides released into the crypt microenvironment.

Search for the pathogenesis of the differing phenotype in two compound heterozygote Hungarian brothers with the same genotypic triosephosphate isomerase deficiency

In a Hungarian family with triosephosphate isomerase (TPI) deficiency, two compound heterozygote brothers were found with the same severe decrease in TPI activity, but only one of them had the classical symptoms. In search for the pathogenesis of the differing phenotype of the same genotypic TPI deficiency, an increase in red cell membrane fluidity was found. There were roughly 100% and 30% more 16:0/20:4 and 18:0/20:4 diacyl-phosphatidylcholine species in erythrocytes from the two TPI-deficient brothers than in the probes from healthy controls. The activities of acethylcholinesterase and calmodulin induced Ca2+ ATPase were significantly enhanced in erythrocytes from the propositus as compared with those of the neurologically symptom-free brother and other members of the TPI-deficient family as well as to those from healthy controls. Both enzymes are crucially involved in the function of nerve cells. The observed differences in membrane fluidity and enzyme activities between the erythrocytes from the phenotypically differing TPI-deficient brothers underline the importance of investigations into the effect of biophysical changes in the lipid environment of the membrane proteins on the development of disseminated focal neurological disorders of unknown pathogenic origin.

Quorum sensing controls expression of the type III secretion gene transcription and protein secretion in enterohemorrhagic and enteropathogenic Escherichia coli

Enterohemorrhagic Escherichia coli O157:H7 and enteropathogenic E. coli cause a characteristic histopathology in intestinal cells known as attaching and effacing. The attaching and effacing lesion is encoded by the Locus of Enterocyte Effacement (LEE) pathogenicity island, which encodes a type III secretion system, the intimin intestinal colonization factor, and the translocated intimin receptor protein that is translocated from the bacterium to the host epithelial cells. Using lacZ reporter gene fusions, we show that expression of the LEE operons encoding the type III secretion system, translocated intimin receptor, and intimin is regulated by quorum sensing in both enterohemorrhagic E. coli and enteropathogenic E. coli. The luxS gene recently shown to be responsible for production of autoinducer in the Vibrio harveyi and E. coli quorum-sensing systems is responsible for regulation of the LEE operons, as shown by the mutation and complementation of the luxS gene. Regulation of intestinal colonization factors by quorum sensing could play an important role in the pathogenesis of disease caused by these organisms. These results suggest that intestinal colonization by E. coli O157:H7, which has an unusually low infectious dose, could be induced by quorum sensing of signals produced by nonpathogenic E. coli of the normal intestinal flora.

Kinetic characterization of brush border myosin-I ATPase

Brush border myosin-I (BBM-I) is a single-headed unconventional myosin found in the microvilli of intestinal epithelial cells. We used stopped-flow kinetic analysis to measure the rate and equilibrium constants for several steps in the BBM-I ATPase cycle. We determined the rates for ATP binding to BBM-I and brush border actomyosin-I (actoBBM-I), the rate of actoBBM-I dissociation by ATP, and the rates for the steps in ADP dissociation from actoBBM-I. The rate and equilibrium constants for several of the steps in the actoBBM-I ATPase are significantly different from those of other members of the myosin superfamily. Most notably, dissociation of the actoBBM-I complex by ATP and release of ADP from actoBBM-I are both very slow. The slow rates of these steps may play a role in lengthening the time spent in force-generating states and in limiting the maximal rate of BBM-I motility. In addition, release of ADP from the actoBBM-I complex occurs in at least two steps. This study provides evidence for a member of the myosin superfamily with markedly divergent kinetic behavior.

d-myo-Inositol 1,4,5,6-tetrakisphosphate produced in human intestinal epithelial cells in response to Salmonella invasion inhibits phosphoinositide 3-kinase signaling pathways

Several inositol-containing compounds play key roles in receptor-mediated cell signaling events. Here, we describe a function for a specific inositol polyphosphate, d-myo-inositol 1,4,5,6-tetrakisphosphate [Ins(1,4,5,6)P4], that is produced acutely in response to a receptor-independent process. Thus, infection of intestinal epithelial cells with the enteric pathogen Salmonella, but not with other invasive bacteria, induced a multifold increase in Ins(1,4,5,6)P4 levels. To define a specific function of Ins(1,4,5,6)P4, a membrane-permeant, hydrolyzable ester was used to deliver it to the intracellular compartment, where it antagonized epidermal growth factor (EGF)-induced inhibition of calcium-mediated chloride (Cl−) secretion (CaMCS) in intestinal epithelia. This EGF function is likely mediated through a phosphoinositide 3-kinase (PtdIns3K)-dependent mechanism because the EGF effects are abolished by wortmannin, and three different membrane-permeant esters of the PtdIns3K product phosphatidylinositol 3,4,5-trisphosphate mimicked the EGF effect on CaMCS. We further demonstrate that Ins(1,4,5,6)P4 antagonized EGF signaling downstream of PtdIns3K because Ins(1,4,5,6)P4 interfered with the PtdInsP3 effect on CaMCS without affecting PtdIns3K activity. Thus, elevation of Ins(1,4,5,6)P4 in Salmonella-infected epithelia may promote Cl− flux by antagonizing EGF inhibition mediated through PtdIns3K and PtdInsP3.