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Bacteria have developed diverse strategies for defending their cell envelopes from external threats. In Firmicutes, one widespread strategy is to use Bce modules-membrane protein complexes that unite a peptide-detoxifying ABC transporter with a stress response coordinating two-component system. These modules provide specific, front-line defense for a wide variety of antimicrobial peptides and small molecule antibiotics as well as coordinate responses for heat, acid, and oxidative stress. Because of these abilities, Bce modules play important roles in virulence and the development of antibiotic resistance in a variety of pathogens, including Staphylococcus , Streptococcus , and Enterococcus species. Despite their importance, Bce modules are still poorly understood, with scattered functional data in only a small number of species. In this review, we will discuss Bce module structure in light of recent cryo-electron microscopy structures of the B. subtilis BceABRS module and explore the common threads and variations-on-a-theme in Bce module mechanisms across species. We also highlight the many remaining questions about Bce module function. Understanding these multifunctional membrane complexes will enhance our understanding of bacterial stress sensing and may point toward new therapeutic targets for highly resistant pathogens., Competing Interests: The authors declare no conflict of interest.

Introduction: The relationship between the Achilles tendon moment arm length (AT MA ) and the energy cost of running (E run ) has been disputed. Some studies suggest a short AT MA reduces E run while others claim a long AT MA reduces E run . For a given ankle joint moment, a short AT MA permits a higher tendon strain energy storage, whereas a long AT MA reduces muscle fascicle force and muscle energy cost but shortening velocity is increased, elevating the metabolic cost. These are all conflicting mechanisms to reduce E run , since AT energy storage comes at a metabolic cost. Neither of these proposed mechanisms have been examined together., Methods: We measured AT MA using the tendon travel method in 17 males and 3 females (24 ± 3 years, 75 ± 11 kg, 177 ± 7 cm). They ran on a motorized treadmill for 10 min at 2.5 m · s -1 while E run was measured. AT strain energy storage, muscle lengths, velocities and muscle energy cost were calculated during time-normalized stance from force and ultrasound data. A short (SHORT n  = 11, AT MA  = 29.5 ± 2.0 mm) and long (LONG, n  = 9, AT MA  = 36.6 ± 2.5 mm) AT MA group was considered based on a bimodal distribution of measured AT MA., Results: Mean E run was 4.9 ± 0.4 J · kg -1  · m -1 . The relationship between AT MA and E run was not significant ( r 2  = 0.13, p  = 0.12). Maximum AT force during stance was significantly lower in LONG (5,819 ± 1,202 N) compared to SHORT (6,990 ± 920 N, p  = 0.028). Neither AT stretch nor AT strain energy storage was different between groups (mean difference: 0.3 ± 1 J · step -1 , p  = 0.84). Fascicle force was significantly higher in SHORT (508 ± 93 N) compared to LONG (468 ± 84 N. p  = 0.02). Fascicle lengths and velocities were similar between groups ( p  > 0.72). Muscle energy cost was significantly lower in LONG (0.028 ± 0.08 J · kg · step -1 ) compared to SHORT (0.045 ± 0.14 J · kg · step -1 p  = 0.004). There was a significant negative relationship between AT MA and total muscle energy cost relative to body mass across the stance phase ( r  = -0.699, p  < 0.001)., Discussion: Together these results suggest that a LONG AT MA serves to potentially reduce E run by reducing the muscle energy cost of the plantarflexors during stance. The relative importance of AT energy storage and return in reducing E run should be re-considered., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Bennett, Machado and Fletcher.)

Background: Recent publications from a single research group have suggested that aldehyde-based high-level disinfectants (HLDs), such as ortho-phthalaldehyde (OPA), are not effective at inactivating HPVs and that therefore, patients may be at risk of HPV infection from medical devices. These results could have significant public health consequences and therefore necessitated evaluation of their reproducibility and clinical relevance., Methods: We developed methods and used standardised controls to: (1) quantify the infectious levels of clinically-sourced HPVs from patient lesions and compare them to laboratory-derived HPVs, (2) evaluate experimental factors that should be controlled to ensure consistent and reproducible infectivity measurements of different HPV genotypes, and (3) determine the efficacy of select HLDs., Findings: A novel focus forming unit (FFU) infectivity assay demonstrated that exfoliates from patient anogenital lesions and respiratory papillomas yielded infectious HPV burdens up to 2.7 × 10 3 FFU; therefore, using 2.2 × 10 2 to 1.0 × 10 4 FFU of laboratory-derived HPVs in disinfection assays provides a relevant range for clinical exposures. RNase and neutralising antibody sensitivities were used to ensure valid infectivity measures of tissue-derived and recombinant HPV preparations. HPV infectivity was demonstrated over a dynamic range of 4-5 log 10 ; and disinfection with OPA and hypochlorite was achieved over 3 to >4 log 10 with multiple genotypes of tissue-derived and recombinant HPV isolates., Interpretation: This work, along with a companion publication from an independent lab in this issue, address a major public health question by showing that HPVs are susceptible to HLDs., Funding: Advanced Sterilization Products; US NIH (R01CA207368, U19AI084081, P30CA118100)., Competing Interests: Declaration of Competing Interest M.A.O. reports grants, personal fees, and non-financial support from Advanced Sterilization Products, grants from U.S. National Institutes of Health, during the conduct of the study; A.G.W. reports personal fees and non-financial support from ASCCP, non-financial support from ACOG, non-financial support from Loktal Medical Electronics, personal fees and non-financial support from CSCCP (Chinese Society for colposcopy and cervical pathology, personal fees and non-financial support from Henan People's Regional Hospital, personal fees from Southcentral Foundation (Alaska Native Corp), non-financial support from FECOLSOG (Colombian colposcopy society), non-financial support from COMEGIC (Mexican colposcopy society), non-financial support from Doctors Hospital at Renaissance, non-financial support from MD Anderson, non-financial support from Univ Texas Rio Grande Valley, non-financial support from Global Coalition against Cervical Cancer, non-financial support from AIDS Malignancy Consortium, personal fees and non-financial support from Deaconess Beth Israel Hospital, personal fees and non-financial support from Texas Tech University, personal fees and non-financial support from ABPTGIC (Brazilian colposcopy society), outside the submitted work. V.B., N.A.P, R.T.S., E.C.B. and R.M. have nothing to disclose. A.S., J.Y. and M.R. are employees of Advanced Sterilization Products. G.E. is an employee and shareholder of Johnson & Johnson, which was the parent company for Advanced Sterilization Products and Janssen Pharmaceutica NV at the time the research was conducted., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: Advanced practice providers (APPs), including nurse practitioners and physician assistants, have been deployed in children's hospital-based academic pediatric otolaryngology practices for many years. However, this relationship in terms of prevalence, roles, financial consequences and satisfaction has not been examined. The objective of this study is to explore how APPs impact healthcare delivery in this setting., Methods: Pediatric otolaryngology chiefs of all academic children's hospitals in the US were electronically surveyed about the ways APPs intersected clinically and financially in their respective practice., Results: A total of 29 of 36 children's hospital-based pediatric otolaryngology practices completed the survey, of which 26 practices (90%) utilized APP. There were large variances within the APP practice cohort in faculty size (mean/median/range = 9.4/8.5/3-29); annual patient visits (mean/median = 18,373/17,600); number of practice site (mean/median/range = 4.3/4/2-9) and number of outpatient APP (mean/median/range = 6.3/5/1-30). No factors (faculty size, annual visits and number of practice sites) differentiated between the APP and non-APP practices. Among APP practices, significant correlation (p<.00001) was observed between size of APP cohort to faculty size and annual visits. 69% of the practices did not differentiate job functions of nurse practitioners and physician assistants. 85% of the practices utilized APPs in all practice sites and 19% utilized APPs in the operating room. 77% of APPs billed independently and 46% had on-site supervision. The most prevalent APP salary bracket based on 0-5, 6-10 and > 11 years of tenure were $76-100K (65%), $100-150K (77%) and $100-150K (86%), respectively. In 46% of the practices, APPs were able to generate enough revenue to cover more than 75% of their salary and 23% of practices generated a profit. 81% of the chiefs ranked the effectiveness of APPs as high (4 and 5) on a 5-point Likert scale., Discussion: The majority of academic pediatric otolaryngology practices employed APPs. Despite the diversity seen in practice complexity, APP functionality and financial impact, most found the APP model to be beneficial in improving patient care, patient access and faculty productivity., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Male dispersal from the natal group at or near maturity is a feature of most baboon (Papio) species. It potentially has profound effects upon population structure and evolutionary processes, but dispersal, especially for unusually long distances, is not readily documented by direct field observation. In this pilot study, we investigate the possibility of retrieving baboon population structure in yellow (Papio cynocephalus) and kinda (Papio kindae) baboons from the distribution of variation in a genome-wide set of 494 Alu insertion polymorphisms, made available via the recently completed Baboon Genome Analysis Consortium. Alu insertion variation in a mixed population derived from yellow and olive (Papio anubis) baboons identified each individual's proportion of heritage from either parental species. In an unmixed yellow baboon population, our analysis showed greater similarity between neighboring than between more distantly situated groups, suggesting structuring of the population by male dispersal distance. Finally (and very provisionally), an unexpectedly sharp difference in Alu insertion frequencies between members of neighboring social groups of kinda baboons suggests that intergroup migration may be more rare than predicted in this little known species., (© The Author 2017. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.)

The genus of Papio (baboon) has six recognized species separated into Northern and Southern clades, each comprised of three species distributed across the African continent. Geographic origin and phenotypic variants such as coat color and body size have commonly been used to identify different species. The existence of multiple hybrid zones, both ancient and current, have complicated efforts to characterize the phylogeny of Papio baboons. More recently, mitochondrial DNA (mtDNA) and Y-chromosome genetic markers have been utilized for species identification with particular focus on the hybrid zones. Alu elements accumulate in a random manner and are a novel source of identical by descent variation with known ancestral states for inferring population genetic and phylogenetic relationships. As part of the Baboon Genome Analysis Consortium, we assembled an Alu insertion polymorphism database of nearly 500 Papio-lineage specific insertions representing all six species and performed population structure and phylogenetic analyses. In this study, we have selected a subset of 48 species indicative Alu insertions and demonstrate their utility as genetic systems for the identification of baboon species within Papio. Individual elements from the panel are easy to genotype and can be used in a hierarchical fashion based on the original level of uncertainty. This Alu-48 panel should serve as a valuable tool during the maintenance of pedigree records in captive populations and assist in the forensic identification of fossils and potential hybrids in the wild., (© The Author 2017. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.)

We review 3 pediatric cases of extramedullary hematopoietic disease occurring in the orbit, ethmoid sinuses, and parotid gland, and present a review of the literature. Each of the 3 patients was taken to the operating room, and the biopsy specimens obtained were successful in establishing the diagnosis in every case. Head and neck manifestations of extramedullary hematopoietic disease are rare, indeed. However, these cases demonstrate that it is important for otolaryngologists, pediatricians, primary-care physicians, radiologists, and pathologists to maintain a high index of suspicion for extramedullary presentations of hematopoietic disease in the head and neck. A coordinated multidisciplinary approach, including the appropriate surgical approach for biopsy, will facilitate determination of the diagnosis and treatment plan.

Maternal and fetal events of the first trimester are examined with emphasis on the more common physiologic changes that occur. Suggestions are given for the management of nausea, breast tenderness, frequency of urination, and fatigue. Critical components of initial prenatal care are discussed and timing of subsequent visits recommended. The most common complications of early pregnancy, spontaneous abortion, and ectopic pregnancy are reviewed.