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Oxacillin (bactericidal) and tetracycline (bacteriostatic) are clinically relevant antibiotics that are routinely prescribed to treat Staphylococcus aureus infections but not conventionally used in combination. There is an urgent need for treatment regimens that can act upon biofilms during infection, associated with chronic infections on indwelling devices, as well as acute planktonic (systemic) infection. Here we show that in an in vitro model oxacillin and tetracycline act synergistically against S. aureus UAMS-1 biofilms, reducing the concentration of both antibiotics necessary to eradicate an established biofilm. Using an in vivo zebrafish larval infection model with S.aureus NewHG, they display improved bacterial clearance compared to each drug alone and can counteract a loss of host phagocytes, an important innate defence against S. aureus. In these cases, the bacteriostatic nature of tetracycline enhances rather than dampens the bactericidal action of oxacillin, although an exact mechanism remains to be elucidated. We suggest a dual therapy could be of clinical use against biofilm-forming S. aureus and has a potential use in patients with a compromised immune system. [ABSTRACT FROM AUTHOR]

Aim: There is limited literature available about necrotising enterocolitis (NEC) in low‐ and middle‐income countries. This study sought to determine the proportion, pattern and risk factors for mortality among very low birth weight (VLBW) neonates with NEC in a middle‐income setting. Methods: A retrospective observational cohort study was conducted on all infants with birth weights less than 1501 g admitted from 2018 to 2020 at Groote Schuur Hospital, Cape Town, South Africa. Data were obtained from the Vermont Oxford Network and hospital folders. Results: A total of 104/1582 (6.6%) neonates were diagnosed with NEC with a median onset of 8 days of life. The mortality rate was 39.0%, compared to the all‐cause mortality rate of 18.7% for VLBW neonates. Thirty‐two (32.0%) neonates with NEC were transferred for surgery of whom 10 (31.3%) died. Small for gestational age (p = 0.13), NEC stage 2B or above (p = 0,002), a positive blood culture (p = 0.018), a raised C‐reactive protein (p = 0.013), hyponatraemia (p = 0.004), anaemia requiring blood transfusion (p = 0.003) and thrombocytopenia requiring platelet transfusion (p = 0.033) were associated with mortality. A positive blood culture was found in 37.0% with a predominance of Klebsiella pneumoniae isolates. Conclusion: NEC has an early onset and a high mortality rate in our setting. [ABSTRACT FROM AUTHOR]

Background. With the advancement of neonatal care there has been a decrease in mortality rates of very low-birthweight (VLBW) (=1 500 g) infants worldwide. However, this has been at the cost of increased morbidity in this vulnerable group. Currently there are little up to date data on short-term morbidities for VLBW infants in low and middle-income countries. Objectives. The primary objective was to describe the neonatal mortality rate in infants weighing 401 to 1 500 g admitted to Groote Schuur Hospital neonatal unit over a 9-year period. Secondary objectives were to evaluate the main neonatal short-term morbidities. Methods. We conducted a secondary analysis of prospectively collected observational data. All VLBW infants admitted to GSH neonatal unit from 2012 - 2020 were included in the study. Data were benchmarked against the Vermont Oxford Network (VON) database. Results. A total of 4 645 infants were included in the study. The overall mortality rate was 19.8%, which remained static over the study period. There was a significantly higher mortality rate associated with decreasing birthweight. The mortality rate for outborn v. inborn infants was higher: 30.3% v. 18.4% (p=0.046). There was a significant risk of higher short-term morbidity in infants <1 000 g. The survival rate without major morbidity was 68.5% which compared favourably with that of the VON. Conclusion. The results demonstrate that mortality rates are higher compared with developed countries. However, and importantly, survival without morbidity was comparable. Strategies to improve mortality and morbidity in VLBW infants are multifaceted and require a collaborative and innovative approach. [ABSTRACT FROM AUTHOR]

To examine the relationship between antisperm antibody (ASA), pregnancy rates, and method of conception following vasectomy reversal, given that before and after vasectomy reversal, patients wonder if ASAs will prevent them from achieving pregnancy and American Urological Association vasectomy guidelines call for additional research to answer this question. We performed retrospective chart review and phone interview of patients who underwent vasectomy reversal at our institution from 1/1/2000 to 12/31/2018. We excluded patients who underwent vasectomy reversal for pain, or without postoperative semen analysis with ASA. We categorized patients as having low (<50%) or high (≥50%) ASA levels using the first postoperative semen analysis. Our primary outcome was pregnancy rate, including method of conception. Differences in pregnancy rates were tested using Fisher exact test. Two hundred and four patients were chart reviewed. Median age at time of surgery was 40 years and median obstruction interval was 7.3 years. Median partner age was 32 years. One hundred sixty-four (80%) patients underwent bilateral vasovasostomy. Eighty-five patients (42%) had low (<50%) ASA levels and 119 (58%) had high (≥50%) ASA levels. Sixty-seven patients completed phone interviews. Of 27 men with low ASA levels, 19 (70%) achieved a pregnancy with 16 (59%) spontaneous pregnancy. Of 40 men with high ASA levels, 30 (75%) achieved a pregnancy with 16 (40%) spontaneous pregnancy. The Fisher exact test P -value was.2. ASA levels are not associated with pregnancy rate or method of conception after vasectomy reversal. These findings can improve patient counseling before and after vasectomy reversal. [ABSTRACT FROM AUTHOR]

Post-orgasmic illness syndrome (POIS) is a rare disorder associated with a debilitating symptoms post-ejaculation associated with significant impairment in quality of life. The mechanism of the disease is unclear, but hypersensitivity to semen and/or seminal fluid has been postulated. We present a case of POIS successfully treated with omalizumab suggesting a possible role for this therapy in POIS treatment and management. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the tasks and time required for budgeting and setting realistic project timelines and recruitment targets for research • To gain insight into the workload associated with conducting qualitative research • To appreciate the time and effort involved with conducting qualitative interviews with research participants Background: Appropriate costing and allocation of resources is vital to ensure that recruitment to a study is achieved on time and on target. However, there is little guidance concerning the workload associated with qualitative research. Aim: To review the planned versus actual workloads in a qualitative sub-study following elective cardiac surgery in children. Discussion: Parents of children approached for a clinical trial were invited to participate in a semi-structured interview to explore their views about making decisions concerning their children's participation in the trial. A workload audit was conducted using anticipated points of contact with participants, and the duration of activities identified in the protocol and Health Research Authority statement of activities; these were compared with timed activities documented by the research team. Conclusion: The current system did not anticipate or capture the workload associated with conducting a relatively straightforward qualitative sub-study of a clinical trial with a research-engaged patient group. Implications for practice: Understanding the hidden workload associated with qualitative research is vital in ensuring that project timelines, recruitment targets and funding for research staff are realistic. [ABSTRACT FROM AUTHOR]

We presented the case of an adult patient with hyper‐IgE syndrome (HIES) who was admitted acutely with a large hydropneumothorax from lung consolidation, a bronchopleural fistula and pleural infection. He has had recurrent pulmonary and skin infections since childhood and longstanding pneumatoceles. He was treated with systemic antibiotics and chest tube drainage. Administration of two doses of low‐dose intrapleural therapy (1 mg tissue plasminogen activator and 5 mg deoxyribonuclease) allowed complete evacuation of his residual loculated pleural fluid, aided resolution of his infection without provoking a significant air leak and avoided the need for surgery. [ABSTRACT FROM AUTHOR]

Background: Universal mental health screening and psychosocial assessment during pregnancy have been recommended as best practice, but uptake of universal programs in the private hospital system has been slow. Aim: The aim of this study was to evaluate the Pre‐admission Midwife Appointment Program (PMAP), an antenatal mental health screening program at the Mater Hospital, Sydney. Materials and Methods: In this mixed‐methods design study, PMAP interview data were collected for a consecutive series of 485 women who attended the PMAP during a 10‐month period. Women also completed two postnatal telephone interviews (10 weeks and 9 months postpartum). The interviews involved depression screening and questions about the program. Results: Of the 485 participants, 4.1% screened positive for depression on the Edinburgh Postnatal Depression Scale. In total, 19% were identified as currently suffering from, or at risk of developing, perinatal mental health issues; referrals to support services were provided for the 13% who were not already linked in with appropriate supports. All women displayed a decrease in depressive symptom severity from pregnancy to 10 weeks and 9 months postpartum. The PMAP was viewed positively by consumers, with >93% viewing the program as helpful and >98% saying that they would recommend the program to others. Additional program benefits identified included opportunities to gain practical information and prepare for motherhood and to think/reflect on their emotional well‐being. Conclusions: Given the observed rates of psychosocial risk among this sample, related referral opportunities and positive consumer feedback, we recommend other Australian private hospitals consider implementing PMAP or similar programs. [ABSTRACT FROM AUTHOR]

Fetal scalp electrodes are a common intervention in the UK, in circumstances where monitoring via an abdominal transducer is ineffective. However, there are cases in which a fetal scalp electrode does not ensure continuous transmission of the fetal heart rate, and its application and continued presence can cause distress and discomfort to the birthing person. Research reveals that fetal scalp electrodes are associated with neonatal morbidity and mortality, as well as maternal infection. Given the limitations of continuous fetal monitoring, the author posits that the use of these devices should only occur with clear clinical indications and fully informed consent from the birthing person. [ABSTRACT FROM AUTHOR]

Aim: Over two thirds of newborn deaths occur in Africa and South Asia, and respiratory failure is a major contributor of these deaths. The exact availability of continuous positive airway pressure (CPAP) and surfactant in Africa is unknown. The aim of this study was to describe the availability of newborn respiratory care treatments in the countries of Africa. Methods: Surveys, in English, French and Portuguese, were sent to neonatal leaders in all 48 continental countries and the two islands with populations over 1 million. Results: Forty‐nine (98%) countries responded. Twenty‐one countries reported less than 50 paediatricians, and 12 countries had no neonatologists. Speciality neonatal nursing was recognised in 57% of countries. Most units were able to provide supplemental oxygen. CPAP was available in 63% and 67% of the most well‐equipped government and private hospitals. Surfactant was available in 33% and 39% of the most well‐equipped public and private hospitals, respectively. Availability of CPAP and surfactant was greatly reduced in smaller cities. Continuous oxygen saturation monitoring was only available in 33% of countries. Conclusion: The availability of proven life‐saving interventions in Africa is inadequate. There is a need to sustainably improve availability and use of these interventions. [ABSTRACT FROM AUTHOR]

The article presents a hypothesis on the autoimmunity elicited by the chemokine response to adenovirus vector vaccines may underlie vaccine-induced immune thrombotic thrombocytopaenia. Topics include vaccination has formed the critical component of the public health response for the prevention of severe illness and death with multiple different vaccines; and increase in unusual thrombotic events temporally associated with the AstraZeneca vaccine.

Background. Prematurity is a major risk factor for intraventricular haemorrhage (IVH). Premature infants often require respiratory support. There is little information on neonates with IVH on respiratory support in low- and middle-income countries. Objective. To describe the characteristics and short-term outcomes of very-low-birthweight (VLBW) infants with IVH receiving respiratory support in a tertiary neonatal unit with resource limitations. Methods. This was a matched retrospective observational study. The population included VLBW infants with IVH, who received positive pressure respiratory support between January 2014 and December 2016. Severe IVH was compared with mild IVH. Results. One hundred and fifty infants were included in the study; 56 (37%) received continuous positive airway pressure (CPAP) only and 94 (63%) mechanical ventilation. Severe IVH was associated with surfactant therapy across both ventilation groups (p=0.03). Infants with severe IVH had prolonged oxygen requirements at 28 days (79% v. 38%; p=0.01) (odds ratio (OR) 6.11; 95% confidence interval (CI) 1.19 - 31.34; p=0.03) v. those with mild IVH. Severe IVH and the presence of coagulopathy were the strongest predictors of death in both ventilation groups (p <0.0001). Pulmonary haemorrhage was the most common cause of death in severe IVH and blood culture-confirmed sepsis in mild IVH. Periventricular leukomalacia (PVL) was associated with severe IVH in invasive ventilation (OR 6.67; 95% CI 1.11 - 40.17). Conclusion. VLBW infants with severe IVH who are mechanically ventilated or with coagulopathy have a high mortality, with pulmonary haemorrhage being the prominent cause of death. These prognostic factors may assist in end-of-life care in resource-limited settings. [ABSTRACT FROM AUTHOR]

Class A serine β-lactamases (SBLs) are key antibiotic resistance determinants in Gram-negative bacteria. SBLs neutralize β-lactams via a hydrolytically labile covalent acyl-enzyme intermediate. Klebsiella pneumoniae carbapenemase (KPC) is a widespread SBL that hydrolyzes carbapenems, the most potent β-lactams; known KPC variants differ in turnover of expandedspectrum oxyimino-cephalosporins (ESOCs), for example, cefotaxime and ceftazidime. Here, we compare ESOC hydrolysis by the parent enzyme KPC-2 and its clinically observed double variant (P104R/V240G) KPC-4. Kinetic analyses show that KPC-2 hydrolyzes cefotaxime more efficiently than the bulkier ceftazidime, with improved ESOC turnover by KPC-4 resulting from enhanced turnover (kcat), rather than altered KM values. High-resolution crystal structures of ESOC acyl-enzyme complexes with deacylation-deficient (E166Q) KPC-2 and KPC-4 mutants show that ceftazidime acylation causes rearrangement of three loops; the Ω, 240, and 270 loops, which border the active site. However, these rearrangements are less pronounced in the KPC-4 than the KPC-2 ceftazidime acylenzyme and are not observed in the KPC-2:cefotaxime acylenzyme. Molecular dynamics simulations of KPC:ceftazidime acyl-enyzmes reveal that the deacylation general base E166, located on the Ω loop, adopts two distinct conformations in KPC-2, either pointing "in" or "out" of the active site; with only the "in" form compatible with deacylation. The "out" conformation was not sampled in the KPC-4 acyl-enzyme, indicating that efficient ESOC breakdown is dependent upon the ordering and conformation of the KPC Ω loop. The results explain how point mutations expand the activity spectrum of the clinically important KPC SBLs to include ESOCs through their effects on the conformational dynamics of the acyl-enzyme intermediate. [ABSTRACT FROM AUTHOR]

In resource-restricted regions, respiratory distress syndrome (RDS) data are often underreported, making the determination of effective interventions and their outcome difficult. The combination of oxygen, nasal continuous positive airway pressure (CPAP) and surfactant therapy has the potential to prevent 42% of RDS-related deaths in sub-Saharan Africa, despite the financial implications. This article provides a brief overview on the status of RDS management, mainly nasal CPAP and surfactant therapy in very-low-birth-weight infants, in resource-restricted regions of sub-Saharan Africa. Data from the public health sector, as compared to the private health sector, of the Western Cape province, South Africa, are used to illustrate what RDS management strategies are able to accomplish in a resource-restricted region. Upscaling of all components (antenatal care, antenatal corticosteroids, prevention of hypothermia and RDS management strategies) are required to decrease premature infant mortality rates in resource-restricted areas. [ABSTRACT FROM AUTHOR]

Background. Invasive group B streptococcal disease (iGBS) is an important cause of morbidity and mortality in newborns globally and is more common in Sub-Saharan Africa and South Africa. Few studies describe newborn iGBS cases in the Western Cape, leaving limited data to guide local prevention and treatment strategies. Objective. To describe all cases of newborn iGBS at Groote Schuur Hospital (GSH), Western Cape, between January 2015 and December 2020. Methods. A retrospective review was conducted of all blood or cerebrospinal fluid-positive cases of newborn iGBS between January 2015 and December 2020. Results. Thirty-five cases of iGBS were included in the study, 51% with early-onset disease (EoD) and 49% with late-onset disease (LoD). The median gestational age at birth was 27 and 31.5 weeks in the LoD and EoD groups, respectively. The median birth weight was 900 g and 1 812 g in the LoD and EoD groups, respectively. Meningitis was more common in the LoD group and pneumonia was more common in the EoD group. The overall mortality rate was 23%, with similar mortality rates in the EoD and LoD groups (22% and 24%, respectively). Invasive GBS disease accounted for a cumulative 274 intensive care unit days during the study period. Conclusion. Invasive GBS disease in newborns at GSH is associated with a high mortality rate, with this study showing similar mortality rates between the EoD and LoD groups. [ABSTRACT FROM AUTHOR]

Interstitial lung disease (ILD) encompasses a large group of pulmonary conditions sharing common clinical, radiological and histopathological features as a consequence of fibrosis of the lung interstitium. The majority of ILDs are idiopathic in nature with possible genetic predisposition, but is also well recognised as a complication of connective tissue disease or with certain environmental, occupational or drug exposures. In recent years, a concerted international effort has been made to standardise the diagnostic criteria in ILD subtypes, formalise multidisciplinary pathways and standardise treatment recommendations. In this review, we discuss some of the current challenges around ILD diagnostics, the role of serological testing, especially, in light of the new classification of Interstitial Pneumonia with Autoimmune Features (IPAF) and discuss the evidence for therapies targeted at idiopathic and immune‐related pulmonary fibrosis. [ABSTRACT FROM AUTHOR]

Background. There are inconsistent published data describing the influence of maternal anaesthetic type during caesarean section (CS) on outcomes of preterm neonates. Objectives. To describe indications and type of anaesthesia in preterm neonates, and their short-term outcomes, comparing spinal anaesthesia (SA) to general anaesthesia (GA). Methods. Data were collected retrospectively on preterm babies born at 28 - 35 weeks’ gestation by CS between 1 January and 30 September 2014 at Groote Schuur Hospital, Cape Town, South Africa. Babies with missing data were excluded. The largest group of babies with similar indications for delivery were identified from the theatre register. Baseline characteristics and short-term outcomes for this group were extracted from an existing prospective data base, and compared between those delivered under SA and GA. Results. Data were available for 226 deliveries, having excluded 23 with incomplete data. Most babies (75%) were delivered under SA. The most common indication for CS was ‘cardiotocograph abnormalities’, in 139 deliveries. Within this group, SA was the more frequent (81.7% v. 12.9%), while GA was associated with lower Apgar scores (p<0.001) and more intubation at birth (p=0.004). There was no difference in mortality when comparing SA with GA. Conclusion. Our data suggest a sedative effect of maternal GA on preterm babies delivered by CS, and the need for staff with advanced resuscitation skills. This study provides novel baseline data in our setting, but these data need to be validated in a prospective study. [ABSTRACT FROM AUTHOR]

The β-lactams retain a central place in the antibacterial armamentarium. In Gram-negative bacteria, β-lactamase enzymes that hydrolyze the amide bond of the four-membered β-lactam ring are the primary resistance mechanism, with multiple enzymes disseminating on mobile genetic elements across opportunistic pathogens such as Enterobacteriaceae (e.g., Escherichia coli) and non-fermenting organisms (e.g., Pseudomonas aeruginosa). β-Lactamases divide into four classes; the active-site serine β-lactamases (classes A, C and D) and the zinc-dependent or metallo-β-lactamases (MBLs; class B). Here we review recent advances in mechanistic understanding of each class, focusing upon how growing numbers of crystal structures, in particular for β-lactam complexes, and methods such as neutron diffraction and molecular simulations, have improved understanding of the biochemistry of β-lactam breakdown. A second focus is β-lactamase interactions with carbapenems, as carbapenem-resistant bacteria are of grave clinical concern and carbapenem-hydrolyzing enzymes such as KPC (class A) NDM (class B) and OXA-48 (class D) are proliferating worldwide. An overview is provided of the changing landscape of β-lactamase inhibitors, exemplified by the introduction to the clinic of combinations of β-lactams with diazabicyclooctanone and cyclic boronate serine β-lactamase inhibitors, and of progress and strategies toward clinically useful MBL inhibitors. Despite the long history of β-lactamase research, we contend that issues including continuing unresolved questions around mechanism; opportunities afforded by new technologies such as serial femtosecond crystallography; the need for new inhibitors, particularly for MBLs; the likely impact of new β-lactam:inhibitor combinations and the continuing clinical importance of β-lactams mean that this remains a rewarding research area. Unlabelled Image [ABSTRACT FROM AUTHOR]

High expression of VEGF is associated with immature angiogenesis within the urinary bladder wall and bladder afferent nerve sensitization, leading to visceral hyperalgesia and pelvic pain. Research suggests a shift in VEGF alternative splice variant (VEGF-Axxxa and VEGF-Axxxb) expression with several pathologies (e.g., neuropathic pain and inflammation) as well as differing effects on pain. Translational studies have also demonstrated increased total VEGF expression in the bladders of women with interstitial cystitis/bladder pain syndrome. In the present study, we quantified VEGF alternative splice variant expression in lower urinary tract tissues under control conditions and with cyclophosphamide (CYP)-induced cystitis. Using conscious cystometry and intravesical instillation of a potent and selective VEGF receptor 2 (VEGFR2) tyrosine kinase inhibitor (Ki-8751, 1 mg/kg) in Wistar rats (male and female) with acute and chronic CYP-induced cystitis and control (no CYP) rats, we further determined the functional effects of VEGFR2 blockade on bladder function. With VEGFR2 blockade, bladder capacity increased (P ≤ 0.01) in male and female control rats as well as in male and female rats with acute (P ≤ 0.05) or chronic (P ≤ 0.01 or P ≤ 0.05, respectively) CYP-induced cystitis. Void volume also increased in female control rats (P ≤ 0.01) and female rats with acute (P ≤ 0.05) or chronic (P ≤ 0.05) CYP-induced cystitis as well as in male control rats (P ≤ 0.05) and male rats with chronic CYP-induced cystitis (P ≤ 0.01). These data suggest that VEGF may be a biomarker for interstitial cystitis/bladder pain syndrome and that targeting VEGF/VEGFR2 signaling may be an effective treatment. [ABSTRACT FROM AUTHOR]

How cells maintain their size has been extensively studied under constant conditions. In the wild, however, cells rarely experience constant environments. Here, we examine how the 24-h circadian clock and environmental cycles modulate cell size control and division timings in the cyanobacterium Synechococcus elongatus using single-cell time-lapse microscopy. Under constant light, wildtype cells follow an apparent sizer-like principle. Closer inspection reveals that the clock generates two subpopulations, with cells born in the subjective day following different division rules from cells born in subjective night. A stochastic model explains how this behavior emerges from the interaction of cell size control with the clock. We demonstrate that the clock continuously modulates the probability of cell division throughout day and night, rather than solely applying an on-off gate to division, as previously proposed. Iterating between modeling and experiments, we go on to identify an effective coupling of the division rate to time of day through the combined effects of the environment and the clock on cell division. Under naturally graded light-dark cycles, this coupling narrows the time window of cell divisions and shifts divisions away from when light levels are low and cell growth is reduced. Our analysis allows us to disentangle, and predict the effects of, the complex interactions between the environment, clock, and cell size control. [ABSTRACT FROM AUTHOR]

Loss of bladder control is a challenging outcome facing patients with spinal cord injury (SCI). We report that systemic blocking of pro-nerve growth factor (proNGF) signaling through p75 with a CNS-penetrating small-molecule p75 inhibitor resulted in significant improvement in bladder function after SCI in rodents. The usual hyperreflexia was attenuated with normal bladder pressure, and automatic micturition was acquired weeks earlier than in the controls. The improvement was associated with increased excitatory input to the spinal cord, in particular onto the tyrosine hydroxylase-positive fibers in the dorsal commissure. The drug also had an effect on the bladder itself, as the urothelial hyperplasia and detrusor hypertrophy that accompany SCI were largely prevented. Urothelial cell loss that precedes hyperplasia was dependent on p75 in response to urinary proNGF that is detected after SCI in rodents and humans. Surprisingly, death of urothelial cells and the ensuing hyperplastic response were beneficial to functional recovery. Deleting p75 from the urothelium prevented urothelial death, but resulted in reduction in overall voiding efficiency after SCI. These results unveil a dual role of proNGF/p75 signaling in bladder function under pathological conditions with a CNS effect overriding the peripheral one. [ABSTRACT FROM AUTHOR]

The majority of multi-spanning membrane proteins are co-translationally inserted into the bilayer by the Sec pathway. An important subset of membrane proteins have globular, cofactor-containing extracytoplasmic domains requiring the dual action of the co-translational Sec and post-translational Tat pathways for integration. Here, we identify further unexplored families of membrane proteins that are dual Sec-Tat-targeted. We establish that a predicted heme- molybdenum cofactor-containing protein, and a complex polyferredoxin, each require the concerted action of two translocases for their assembly. We determine that the mechanism of handover from Sec to Tat pathway requires the relatively low hydrophobicity of the Tat-dependent transmembrane domain. This, coupled with the presence of C-terminal positive charges, results in abortive insertion of this transmembrane domain by the Sec pathway and its subsequent release at the cytoplasmic side of the membrane. Together, our data points to a simple unifying mechanism governing the assembly of dual targeted membrane proteins. [ABSTRACT FROM AUTHOR]

Highlights from the article: JC virus is recognised as the cause for progressive multifocal leukoencephalopathy (PML), an often-devastating central nervous system infection resulting from reactivation of latent virus, almost exclusively seen in immunosuppressed patients. Whereas PML results from JC virus infection of brain glial cells, infection of granule neurons in the cerebellum results in granule cell neuronopathy (GCN). Whilst the gold standard for diagnosis is histological evidence of lytic JC virus infection of granule cells on brain biopsy, in the appropriate clinical and radiological setting GCN may be diagnosed by detection of JC virus DNA in CSF [[1]].

Objective: We have developed a Doppler method for the estimation of cerebral perfusion pressure (CPP) using noninvasive techniques. Our objective was to evaluate our new method in pregnant women.Methods and Materials: Laboring women with a lumbar epidural in situ had transcranial Doppler interrogation of the maternal middle cerebral artery (MCA) to measure systolic, diastolic, and mean velocities. A pressure transducer was connected to the epidural catheter and pressure was recorded. Systolic (SBP), diastolic (DBP), and mean (MAP) blood pressure were taken with a Dinamap monitor. Doppler estimated CPP (mm Hg) = [V(mean)/(V(mean) - V(diastolic)](MAP - DBP) and directly measured CPP = MAP - Epidural pressure data were plotted on a Bland-Altman graph with limits of agreement. The mean difference (the mean of the sum of both positive and negative differences) and absolute difference (the mean of the sum of the absolute differences) were calculated. In addition, linear and polynomial regression analyses were performed.Results: Twenty laboring women were studied. All had normal pregnancies. The mean maternal age was 28 +/- 7 years and the mean gestational age was 39 +/- 2 weeks. The mean maternal MAP was 77 +/- 12 mm Hg. The Bland-Altman plot showed a mean difference of 2.2 mm Hg at a mean CPP of 65 +/- 12 mm Hg; with a standard deviation of 4.8 mm Hg, the absolute difference was 3.9 +/- 3.0 mm Hg at a mean CPP of 65 +/- 12 mm Hg. The regression analysis showed an r = 0.92, r(2) = 0.86, and p < 0.0001.Conclusions: Our formula allows the estimation of CPP using a simple calculation and noninvasively acquired data. This method may be of use for frequent, easy, and accurate CPP and intracranial pressure estimation and may, as such, have significant research and clinical applications. [ABSTRACT FROM AUTHOR]

Interstitial lung disease (ILD) is a significant complication of Sjögren syndrome (SS) associated with increased morbidity and mortality. The mainstay of treatment remains corticosteroid administration, with or without additional immunosuppressive therapies. Preliminary studies in SS have shown benefit in glandular and serologic parameters following treatment with the CTLA4 immunoglobulin fusion protein abatacept. Topical tacrolimus has been effective for ocular symptoms in SS, but systemic therapy has not been reported. We describe the first case, to our knowledge, of the successful use of a combination of systemic tacrolimus and abatacept in severe refractory SS and related ILD. [ABSTRACT FROM AUTHOR]

Theta burst stimulation (TBS) of the cerebellum, a potential therapy for neurological disease, can modulate corticospinal excitability via the dentato-thalamo-cortical pathway, but it is uncertain whether its effects are mediated via inhibitory or facilitatory networks. The aim of this study was to investigate the effects of 30Hz cerebellar TBS on the N100 waveform of the TMS-evoked potential (TEP), a marker of intracortical GABAB-mediated inhibition. 16 healthy participants (aged 18–30 years; 13 right handed and 3 left handed) received 30Hz intermittent TBS (iTBS), continuous TBS (cTBS) or sham stimulation over the right cerebellum, in three separate sessions. The first 8 participants received TBS at a stimulus intensity of 80% of active motor threshold (AMT), while the remainder received 90% of AMT. Motor evoked potentials (MEP) and TEP were recorded before and after each treatment, by stimulating the first dorsal interosseus area of the left motor cortex. Analysis of the 13 right handed participants showed that iTBS at 90% of AMT increased the N100 amplitude compared to sham and cTBS, without significantly altering MEP amplitude. cTBS at 80% of active motor threshold decreased the N100 amplitude and cTBS overall reduced resting MEP amplitude. The study demonstrates effects of 30Hz cerebellar TBS on inhibitory cortical networks that may be useful for treatment of neurological conditions associated with dysfunctional intracortical inhibition. [ABSTRACT FROM AUTHOR]

Highlights: [•] A citywide building energy simulation approach is proposed based on LiDAR. [•] The local environment is explicitly incorporated into our model. [•] Individual buildings are attributed with energy performance parameters. [•] Results compare closely with widely-used building energy simulation software. [ABSTRACT FROM AUTHOR]

There have been many reported adverse incidents due to syringe driver use, most of which have been attributable to human error. In this paper we present a previously unreported, but potentially widespread practice which may result in significant over or under-delivery of medication. Even with the naked eye it is evident that syringes of equal volume have different dimensions and to quantify this we sectioned a range of syringes and measured the inner and outer dimensions. Extensive menus for syringe brand and volumes are available on syringe drivers, offering users greater flexibility. However, this feature also allows users to select an incorrect syringe brand with potential consequences for drug delivery. We measured outputs under all selectable permutations, to determine the degree of fluid delivery variation and discovered inaccuracies in volumes ranging from 10% under-delivery to 24% over-delivery. There is a wide variation in syringe metrics and complex syringe menus may increase errors, resulting in significant under or over-delivery of medication. Availability of more than one brand of syringe in a clinical area increases the risk of adverse drug delivery events. Systems need to be implemented to minimise the risk of adverse events. [ABSTRACT FROM AUTHOR]

Objective:To prevent bilirubin induced brain injury in the newborn, repeated blood withdrawals are necessary to ascertain bilirubin levels and institute care. Noninvasive, painless and bloodless screening using transcutaneous bilirubinometry is the standard of care for term and near term neonates but there is still debate about its use with preterm neonates. The aims of this study were to determine how transcutaneous bilirubin (TcB) level measured from the interscapular site related to total serum bilirubin (TSB) level and to compare performance of TcB from the forehead, sternum and interscapular sites in identifying preterm neonates in need of phototherapy.Study Design:This was a cross sectional study conducted at Groote Schuur level III neonatal unit. Over a 5-month period 122 consecutive preterm neonates <35 weeks gestational age were enrolled. TcBs were measured over the forehead, sternum and interscapular area. Pearson's correlation coefficients and differences between TSB and TcBs were computed. P-value <0.05 was considered significant.Result:The median gestational age of the study participants was 31 weeks (range: 24 to 34 weeks), the median TSB level was 81.5 μmol l−1 (range: 25 to 229 μmol l−1) and 45% had a TSB at the phototherapy threshold. The correlation coefficients for TcBs ranged from 0.859 to 0.929 (P<0.001). The difference between TSB and TcBs ranged from −86 to +51 μmol l−1. With respect to initiating phototherapy, the interscapular site had the highest sensitivity of 94% and lowest false negative rate of 6%.Conclusion:Using transcutaneous bilirubinometry, the interscapular site is superior and safer for screening preterm neonates. [ABSTRACT FROM AUTHOR]

Background The postmortem diagnosis of anaphylaxis remains difficult due to the lack of specific biomarkers. Mast cell tryptase (MCT) levels are used as a marker of mast cell degranulation in living patients and elevated levels have also been described in postmortem serum samples in anaphylaxis-associated deaths, although elevated levels may also be seen in non-anaphylaxisassociated deaths. Objective To investigate the effects of cause of death, site of blood sampling, degree of sample haemolysis and the presence of opiates on postmortem MCT levels. Method We obtained sera from three collection sites from 189 non-suspicious coronial postmortems and aortic samples from 10 anaphylactic deaths to characterise postmortem MCT. Results MCT were elevated (>11.4 μg/L) in 57% of aortic samples, 58% of femoral samples and 30% of subclavian samples. In aortic samples, there were significantly higher levels of MCT in anaphylaxisassociated deaths compared with other causes of death. Aortic MCT levels >110 μg/L had a sensitivity of 80% and specificity of 92.1% for anaphylaxis-associated deaths. There was a significant correlation between MCT and degree of sample haemolysis but no correlation with the presence of opiates. Conclusions Moderately elevated MCT levels are common in postmortem sera. Aortic values >110 μg/L may support a diagnosis of anaphylaxis-associated death, although the diagnosis should not be based on this test alone. There was significant variation between sample sites and reference ranges for individual sample sites should be established. [ABSTRACT FROM AUTHOR]

Highlights: [•] We demonstrate techniques to extract building morphology attributes from LiDAR. [•] We predict building age from LiDAR-derived metrics using a random forests machine learning algorithm. [•] We relate and discuss building energy parameters from energy audit records to predicted age. [Copyright &y& Elsevier]

A bibliography on the subject of flowering time and biology of plants is presented, which includes several articles of 2008 such as "FLC or not FLC: the other side of vernalization" by C.M. Alexandre and colleagues, "Towards molecular breeding of reproductive traits in cereal crops" by S. Dwivedi and colleagues, and "Effects of photo and thermo cycles on flowering time in barley: a genetical phenomics approach" by P. Szucs and colleagues.

A bibliography on the subject of plant biology is presented, which includes several articles of 2007 such as "Sex determination in papaya" by R. Ming and colleagues, "Understanding flowers and flowering: an integrated approach" by B. J. Glover, and "Flowering transition in grapevine" by P. Cubas and colleagues.

This study examined continuing education (CE) priorities among mental health professionals in KwaZulu-Natal, South Africa. Participant informants were 102 (67.1%) of the 152 professionals enrolled for a mental health symposium event. The sample comprised 73.5% women, 59.8% psychologists and 52.9% public service workers. Data were collected through self-report questionnaires tapping participant work contexts, commonly encountered mental health problems, client age groups, mental health problems they wished to learn more about, current methods of accessing CE, use of web-based academic resources, and membership of formalised CE groups. In addition, participants were asked to rank their broad learning priority areas including ethics and related issues. Participants listed mood disorders (40.1%) and anxiety disorders (22.4%) as the commonest problems they dealt with, and cited mood disorders (27.3%), child or developmental issues (21.8%) and anxiety disorders (18.2%) as the areas they most needed CE. Treatment issues, followed by ethics/legal/human rights issues, were also prioritized as learning areas. [ABSTRACT FROM AUTHOR]

Reaction of 6-methyl-2-pyridone (Hmhp) with Na or K metal, or with Rb or Cs 2-ethylhexoxide, in an appropriate single or mixed solvent, yields a series of solvated polymeric complexes with the empirical formulae M(mhp)(H2O)2 [(1), M = Na; (2), M = K], M(mhp)(H2O) [(3), M = Rb; (4), M = Cs] and Cs(mhp)( ROH) [(5), R = Me; (6), R = Et]. All of the products have been crystallographically characterized and show sheet polymeric structures, except for a double-chain structure for (2). In all of the structures, mhp− and solvent molecules function as bridging ligands; two metal ions are bridged (μ2) by each solvent molecule in (1), (5) and (6), while (2) contains both μ2 and μ3 triple bridges, and (3) and (4) display highly unusual μ4 quadruple bridging of metal ions by water molecules. The pyridonate O atom bridges two or three metal ions in each case. Nitrogen is also involved in coordination to the heavier metals; it bonds to a single ion in (3) and (4), but has an almost unprecedented bridging role in (5) and (6). As a result of the extensive bridging by ligands, coordination numbers between 6 and 8 are achieved for the metal ions. In each structure, all solvent OH groups form hydrogen bonds to pyridonate O and, in some cases, N atoms. With one exception, these are the first reported pyridonate complexes of the alkali metals Na-Cs that do not also include transition metals. [ABSTRACT FROM AUTHOR]

Abstract: The complexity of built form and land cover has often limited detailed model estimates of solar irradiance in the urban canopy. These limitations arise largely from difficulties in generating contiguous detailed spatial representations of solar obstructing features such as buildings and trees. This study presents a method that integrates remotely sensed datasets across spatial scales for estimating irradiance in urban areas. The method draws largely on airborne Light Detection and Ranging (LiDAR) technology with specific focus on estimating radiation transmission through urban vegetation. The incoming irradiance above the urban canopy is determined using atmospheric transmission derived from geostationary satellite imagery to provide a long-term record of seasonal fluctuations in cloud cover, and the associated direct and diffuse irradiance. Individual model components are analyzed for three urban study areas to assess the interactions between input model parameters and patterns of different urban form. Results indicate that representations of trees as opaque objects substantially underestimate solar irradiance across urban form types, demonstrating up to a 18% underestimate of direct irradiance in treed residential areas. Both atmospheric transmittance and urban form are also shown to be critical model parameters, and are discussed with reference to unique considerations for generating estimates of urban irradiance. [Copyright &y& Elsevier]

Abstract: The regulation of cell cycle rate is essential for the correct timing of proliferation and differentiation during development. Changes to cell cycle rate can have profound effects on the size, shape and cell types of a developing organ. We previously identified a zebrafish mutant ceylon (cey) that has a severe reduction in T cells and hematopoietic stem/progenitor cells (HSPCs). Here we find that the cey phenotype is due to absence of the gene transducin (beta)-like 3 (tbl3). The tbl3 homolog in yeast regulates the cell cycle by maintaining rRNA levels and preventing p53-induced cell death. Zebrafish tbl3 is maternally expressed, but later in development its expression is restricted to specific tissues. Tissues expressing tbl3 are severely reduced in cey mutants, including HSPCs, the retina, exocrine pancreas, intestine, and jaw cartilage. Specification of these tissues is normal, suggesting the reduced size is due to a reduced number of differentiated cells. Tbl3 MO injection into either wild-type or p53−/− mutant embryos phenocopies cey, indicating that loss of tbl3 causes specific defects in cey. Progression of both hematopoietic and retinal development is delayed beginning at 3 day post fertilization due to a slowing of the cell cycle. In contrast to yeast, reduction of Tbl3 causes a slowing of the cell cycle without a corresponding increase in p53 induced cell death. These data suggest that tbl3 plays a tissue-specific role regulating cell cycle rate during development. [Copyright &y& Elsevier]

It is becoming clear that individual animals exhibit behaviours that are repeatable, consistent and predictable across various contexts and time, and that may be correlated to form behavioural syndromes. The influence of parasitism on host behaviour, although well-documented, is only now being examined in a multi-trait context, and behavioural syndromes provide a framework for such investigations. We test the hypothesis that parasites modify host behavioural syndromes by quantifying the relationship between infection by four trematode species and the correlations, repeatability and consistency of three host behaviours (activity, aggression and boldness) in a freshwater fish, Gobiomorphus cotidianus, in the presence and absence of a predator odour. There was a significant correlation between activity and aggression, and both these behaviour showed higher values in the presence of a chemical predator cue. Of the behaviours tested, only aggression responses were significantly related to infection with one of the parasites, Apatemon sp. Activity, aggression and boldness scores were repeatable across test sessions, but much less so in the presence of a predator cue. Interestingly, individual-level consistency in activity and aggression was significantly associated with infection by Telogaster opisthorchis, Deretrema philippae and/or Apatemon sp., with the direction of the association depending on the behaviour tested. These findings suggest that behavioural syndromes may not only be targets for adaptive host manipulation by parasites, but also that, even if through mere pathology, parasites could act as external agents generating variation in behavioural syndromes. [ABSTRACT FROM AUTHOR]

Two-dimensional oscillatory oblique stagnation-point flow towards a plane wall is investigated. The problem is a generalisation of the steady oblique stagnation-point flow examined by previous workers. Far from the wall, the flow is composed of an irrotational orthogonal stagnation-point flow with a time-periodic strength, a simple shear flow of constant vorticity, and a time-periodic uniform stream. An exact solution of the Navier-Stokes equations is sought for which the flow stream function depends linearly on the coordinate parallel to the wall. The problem formulation reduces to a coupled pair of partial differential equations in time and one spatial variable. The first equation describes the oscillatory orthogonal stagnation-point flow discussed by previous workers. The second equation, which couples to the first, describes the oblique component of the flow. A description of the flow velocity field, the instantaneous streamlines, and the particle paths is sought through numerical solutions of the governing equations and via asymptotic analysis. [ABSTRACT FROM AUTHOR]

High-resolution single nucleotide polymorphism (SNP) arrays have been effectively implemented as a first tier test in clinical cytogenetics laboratories for the detection of constitutional chromosomal abnormalities in patients with suspected genomic disorders. We recently published our experience utilizing SNP array analysis of bone marrow aspirates as a clinical test for patients with suspected leukemia or lymphoma in the Clinical Cancer Cytogenetics Laboratory at The Children’s Hospital of Philadelphia. In the present report we summarize our clinical experience using the Illumina HumanHap610 BeadChip array (Illumina, San Diego, CA) for whole genome analysis of pediatric solid tumors. A total of 168 DNA samples isolated from a variety of solid tumors, including brain tumors, sarcomas, neuroblastomas, and Wilms tumors, as well as benign neoplasms and reactive processes, were analyzed over a 2 1/2 year period. One hundred thirty-seven of 168 (82%) specimens had at least one copy number alteration or region of loss of heterozygosity detected by the SNP array. Thirty-three of 168 (20%) of cases had a normal karyotype or targeted fluorescence in situ hybridization (FISH) study, but had an abnormal finding by the array analysis. Sixty-three of 168 (37%) samples for which cytogenetic studies were unsuccessful or not performed demonstrated an abnormal array result. In 44 of 168 cases (26%) the array and karyotype or FISH were abnormal, but each demonstrated alterations not detected by the other methodology. Based on our experience in the last 2 1/2 years, we suggest that SNP array analysis can be used as a first tier clinical test for the majority of pediatric solid tumors. [Copyright &y& Elsevier]

Abstract: Targeted sampling of water was performed in streams, the river mouth, and the municipal drinking-water tap in the vicinity of San Francisco, South Leyte, Philippines. Samples were processed on site and transported back to Sweden for analysis by gas chromatography mass spectrometry to identify and quantify the pesticides commonly used in the area. Collaborations were initiated with employees at the local Department of Agriculture and Municipal Disaster Coordinating Council to learn more about the rice cultivation in this area and times for spraying. Detectable levels of pesticides λ-cyhalothrin, cypermethrin and deltamethrin (0.0005–1.4μg/L) were found in representative water samples. In 47% of samples the detected levels exceeded the recommended limit values for pesticides in surface water according to Swedish guidelines (). The analysis of samples taken at the river mouth revealed measurable levels of λ-cyhalothrin and cypermethrin, which means that residues of pesticides applied to rice paddy fields were shown to end up at the river mouth. The success of the sampling and analysis methods was confirmed by the data which was in accordance with the expected effect of dilution from day to day. Variable levels of insecticides in the river and all the way down to the sea may have adverse health effects on people using the water and on the aquatic environment, including sensitive coral reefs. This situation is applicable not only to the Philippines, but also to the whole of Southeast Asia, with approximately 70% of their human population living in coastal areas. As Southeast Asia encompasses approximately 34% of the world''s coral reefs and between a quarter and a third of the world''s mangroves, as well as the global biodiversity triangle formed by the Malay Peninsula, the Philippines, and New Guinea, the need to reduce the impacts of marine pollution in this region is of great importance. [Copyright &y& Elsevier]

In 22q11.2 deletion patients, the normal decrease in T lymphocyte counts after 1-2 years is blunted such that relatively T lymphocyte numbers increase over early childhood, probably via post-thymic expansion of peripheral lymphocytes. This may leave less T lymphocyte receptor (TCR) diversity than when derived from naive thymic emigrants. We analysed TCR Vβ repertoire on 27 22q11.2 chromosome deletion patients. No patient had infection at sampling. CD3CD4 recent thymic emigrants (RTEs) were identified by CD45RA and CD31 expression. TCR Vβ repertoire was determined using four-colour flow cytometry. Patients and controls showed significant TCR Vβ family usage differences between CD3CD4 and CD3CD4 T lymphocyte subpopulations. Vβ family abnormalities (±3 SD of controls) were identified in 18/27 (67%) patients and 12/47 (25%) controls. In patients, the magnitude of expansions was increased, with some Vβ families representing 37% of the cells present in the subpopulations. There was a significant increase in frequency of abnormalities in CD3CD4 ( P < 0.001) and CD3CD4 T lymphocytes ( P < 0.05) in patients. A total of 11/16 patients had an abnormal CD4CD25 TCR Vβ repertoire. There was no difference in expansions/contractions between CD4CD25 and CD4 T lymphocyte repertoires ( P = 0.575) for individual patients but significant differences in expansions/contractions between CD4CD25 and CD8 T lymphocytes repertoires ( P = 0.011). There was bias in Vβ usage between CD3CD4 and CD3CD4 T lymphocyte subsets. A total of 67% patients had TCR Vβ repertoire abnormalities, with a trend towards increased repertoire abnormalities with fewer RTEs, suggesting thymic output plays an important role in TCR repertoire diversity. There was no correlation between skewed repertoire and symptoms of infection or autoimmunity. [ABSTRACT FROM AUTHOR]

This review looks at the main issues around immediate hypersensitivity and the role and limitations of testing. The majority of literature on antibiotic hypersensitivity relates to β-lactam antibiotics, mainly because of the heavy usage of this class of drugs. Concerns around cross-reactivity always worry clinicians, particularly in the emergency situation. Reasonable data now exist in relation to β-lactam antibiotics and derivatives, which enable appropriate risk management to be undertaken. The available literature for other classes of antibiotics is also discussed. [ABSTRACT FROM AUTHOR]

The research in this paper addresses human-environment interactions in Canadian cities by examining the spatial distribution of vegetation in relation to various socioeconomic indicators. Specifically, intercity and intracity comparisons are evaluated using correlation analysis and geographically weighted regression (GWR). Vegetation abundance estimates derived from spectral mixture analysis of Landsat imagery are compared with Canadian census data for the cities of Montreal, Toronto, and Vancouver to quantify vegetation-related environmental equity in Canada's largest urban centres. Results exhibit strong and consistent correlations between median family income and vegetation fraction for Montreal (r = 0.473), Toronto (r = 0.467), and Vancouver (r = 0.456). Furthermore, examining the GWR results suggests that employing an adaptive bandwidth kernel technique with a manual selection of ten neighbours for each observation provides a greater range and higher median values for local regression estimates (Montreal: 0.69; Toronto: 0.74; Vancouver: 0.73) as compared with the Akaike information criterion-selection method. Finally, we discuss the potential application of the presented analysis techniques for urban planning and community-development initiatives, specifically associated with managing vegetation-related environmental equity at various scales. Possible applications of these techniques for urban planning purposes are discussed, and key methodological considerations for performing such an analysis are highlighted. [ABSTRACT FROM AUTHOR]

Individuals, families, networks, and botanic gardens have made records of flowering times of a wide range of plant species over many years. These data can highlight year to year changes in seasonal events (phenology) and those datasets covering long periods draw interest for their perspective on plant responses to climate change. Temperate flowering phenology is complex, using environmental cues such as temperature and photoperiod to attune flowering to appropriate seasonal conditions. Here we give an overview of flowering phenological recording, outline different patterns of flowering, and look at the interpretation of datasets in relation to seasonal and climatic change. [ABSTRACT FROM PUBLISHER]

Abstract: Vitellogenin is produced in the liver of sexually mature female fish in response to endogenous estrogens. Exogenous estrogens also induce synthesis of vitellogenin in the liver of male and juvenile fish and vitellogenin is a frequently used biomarker for estrogen exposure. The epigenetic state, e.g. histone acetylation and DNA methylation, in the region of a gene or in its 5′ flanking region influences the gene expression. DNA methylation positions in multicellular eukaryotes are mostly found on cytosine bases located 5′ to guanine, i.e. in CpG sites. Here, we have for the first time analyzed the DNA methylation levels of three CpG sites located in the 5′ flanking region of the vitellogenin I gene in liver and brain from adult zebrafish (Danio rerio) utilizing Pyrosequencing technology. This sequencing technique allows determination of methylation levels of multiple individual CpG sites. Our purpose was to assess any differences in methylation levels related to sex, tissue and exposure to estrogen. Out of the seven vitellogenin genes identified in the zebrafish, vitellogenin I is the most highly expressed during vitellogenesis. We found that the methylation levels of all three CpG sites were higher in male liver than in female liver. In brain, which does not express vitellogenin, females and males showed similar, high methylation levels in the analyzed CpG positions. Exposure of adult zebrafish to 17α-ethinylestradiol (100ng/L) for 14 days decreased the methylation levels in the 5′ flanking region of vitellogenin I in the liver in both females and males. These results suggest that induced expression of vitellogenin in fish following exposure to estrogens might involve alterations in DNA methylation. [Copyright &y& Elsevier]

Abstract: Two new, potentially cyclometalating terdentate ligands bearing phosphonate substituents, Et2O3P-N^C(H)^N (5) and Et2O3P-C(H)^N^N (7), have been prepared. The corresponding ruthenium complexes, [1]+ and [2]+, respectively, were obtained by reaction with [RuCl3(tpy)]. Complexes [1]+ and [2]+ display electronic properties characteristic for cyclometalated ruthenium complexes. The platinum complex [3], of N^C(H)^N ligand 5, was also prepared and is highly phosphorescent in solution. In general, the phosphonate group electronically behaves equivalent to a carboxylate moiety. [Copyright &y& Elsevier]