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Invasive, [beta]-hemolytic Streptococcus disease is associated with high rates of illness and death and substantial financial cost (1-3). Human pathogenic [beta]-hemolytic Streptococcus include Lancefield groups A (GAS, Streptococcus pyogenes), B [...]

This article discusses a case of hypervirulent Klebsiella pneumoniae infection in a 65-year-old man of Indonesian ethnicity with type 2 diabetes mellitus and hypertension. The patient initially presented with fevers and diabetic ketoacidosis and was treated for urosepsis. However, he later developed severe emphysematous cystitis, left-sided pyelonephritis, and prostatic abscess. The article highlights the devastating consequences of hypervirulent K. pneumoniae infection and emphasizes the importance of early identification and appropriate antimicrobial treatment. It also notes that while the infection is primarily endemic in Asia, its global prevalence is increasing, and clinicians should be aware of this life-threatening infection, particularly in multi-ethnic populations like Australia. [Extracted from the article]

Objectives: To examine the utility and efficacy of a multifaceted protocol for the administration of intravesical bacillus Calmette–Guerin (BCG) for non‐muscle‐invasive bladder cancer (NMIBC). Subjects and methods: A multicenter retrospective review was conducted among 83 patients undergoing Fremantle protocol intravesical BCG for NMIBC within 4 major hospitals in Western Australia between January 2016 and December 2018. The Fremantle protocol consists of weekly BCG instillations for 6 weeks during the induction phase, followed by monthly BCG instillations for 10 months during the maintenance phase with integrated clearance‐to‐proceed algorithms for urine MSU checks, flexible cystoscopies performed at 3 monthly intervals during maintenance BCG, and repeat GA cystoscopies with four quadrant bladder biopsies routinely obtained following the completion of induction and maintenance treatment. Results: For patients undergoing Fremantle protocol BCG, 98.8% (82/83) and 75.9% (63/83) of patients completed their induction and maintenance courses of BCG, respectively. Induction BCG was delivered over a median duration of 35 days (range 34–84 days), and maintenance BCG was delivered over a median duration of 266 days (range 1–682 days). The tumor recurrence rate was 10.8% (9/83) at the time of post‐induction biopsies, 2.4% (2/83) during maintenance treatment, 0% (0/60) at the time of post‐maintenance biopsies, and 8.8% (5/57) after a median further follow‐up of 16 months (range 0–51 months). Conclusion: The Fremantle protocol appears to be a safe and effective BCG regimen with several advantages over other BCG protocols, including high completion rates, low recurrence rates, and being highly pragmatic. [ABSTRACT FROM AUTHOR]

The NITROGEN LIMITATION ADAPTATION (NLA) protein is a RING-type E3 ubiquitin ligase that plays an essential role in the regulation of nitrogen and phosphate homeostasis. NLA is localized to two different subcellular sites (the plasma membrane and the nucleus), and contains four distinct domains: (i) a RING domain that mediates degradation of phosphate transporters at the plasma membrane; (ii) an SPX domain that facilitates NLA's interaction with the phosphate transporters, and also exists in other proteins that regulate the nuclear transcription factors that control the phosphate starvation response pathway; (iii) a linker domain that lies between the RING and SPX domains; and (iv) a C-terminal domain, which, like the linker region, is of unknown function. Here we carried out a mutational analysis of NLA, which indicated that all the domains are not only essential for proper functioning of the protein, but also mediate its localization to the plasma membrane and (or) nucleus, as well as to different subdomains within the nucleus. Overall, the results provide new insights to the distinct protein motifs within NLA and the role(s) that this protein serves at different subcellular sites with respect to the regulation of nitrogen-dependent phosphate homeostasis as well as other possible physiological functions. Keywords: nitrate-dependent phosphate homeostasis, NITROGEN LIMITATION ADAPTATION, subcellular protein localization, RING domain, SPX domain. La proteine NLA (acronyme de << NITROGEN LIMITATION ADAPTATION >>) est une ubiquitine ligase E3 a domaine RING qui joue un role essentiel dans la regulation de l'homeostasie de l'azote et du phosphate. La NLA se localise dans deux sites subcellulaires differents (la membrane plasmique et le noyau), et elle comprend quatre domaines distincts: (i) un domaine RING qui intervient dans la degradation des transporteurs de phosphate a la membrane plasmique; (ii) un domaine SPX, qui facilite l'interaction de la NLA avec les transporteurs de phosphate, et qui existe aussi a l'interieur d'autres proteines qui regulent les facteurs de transcription nucleaires controlant la voie de reponse a la privation en phosphate; (iii) un domaine linker qui se trouve entre les domaines RING et SPX et (iv) un domaine C-terminal qui, comme la region linker, est de fonction inconnue. Les auteurs ont realise une analyse mutationnelle de la NLA qui indiquait que les quatre domaines sont non seulement essentiels au fonctionnement adequat de la proteine, mais qu'ils interviennent aussi dans sa localisation a la membrane plasmique et/ou dans le noyau, de meme que dans differents sous-domaines a l'interieur du noyau. Dans l'ensemble, les resultats apportent un eclairage nouveau sur les motifs proteiques distincts a l'interieur de la NLA et sur les roles que joue cette proteine dans differents sites subcellulaires quant a la regulation de l'homeostasie du phosphate dependante de l'azote, de meme que sur d'autres fonctions physiologiques possibles. [Traduit par la Redaction] Mots-cles: homeostasie de phosphate dependante du nitrate, NLA (<< NITROGEN LIMITATION ADAPTATION >>), localisation subcellulaire de la proteine, domaine RING, domaine SPX., Introduction As a major component of most cellular macromolecules, including proteins, nucleic acids, and chlorophyll, nitrogen is essential for plant growth and development (Hawkesford et al. 2012). Consequently, plants subjected [...]

A common problem encountered when teaching database courses is that few large illustrative databases exist to support teaching and learning. Most database textbooks have small "toy" databases that are chapter objective specific, and thus do not support application over the complete domain of design, implementation and management concepts across a single database. The Northwind Traders sample database is available by Microsoft for download and use in Microsoft Access, and illustrates transactional processing for a fictitious company that imports (purchases) and exports (sells) specialty foods from around the world. The database contains sample tables, queries, forms, reports, Macros, VBA Class Objects, functions and modules, and other database features. Although the primary purpose for the database is to serve as an illustrative design template for students and practitioners, unfortunately the database and business processes are largely undocumented. This paper attempts to more completely document the business processes, including establishing business rules, describing relationships and participations, and discusses some problems with the existing design. Following understanding of the database and associated business processes, this paper can be used as both a teaching tool and a guide for practitioners using the Northwind Traders sample database as a design template. Additionally, it has been used successfully to introduce the concept of business processes and mapping them in an underlying database in introductory ERP courses.

Candida auris, first reported in Japan in 2009 (1), is an emerging pathogen that has caused severe disease in hospitalized patients in many countries, including India, South Africa, Spain, the [...]

Background: Western Australia (WA) was in a unique position to experience coronavirus disease 2019 (COVID‐19) in a highly vaccinated and geographically isolated population. Aim: To describe the COVID‐19 Omicron experience at the only quaternary hospital in WA following border opening from 3 March to 11 May 2022. Participants: A total of 158 adults with microbiologically confirmed COVID‐19 were admitted to the respiratory or intensive care unit (ICU). Outcomes: Admission numbers, disease severity, prevalence of COVID‐19 deterioration risk factors, immunisation status, severity of infection, immunosuppression and treatment regimen. Results: One hundred fifty‐eight COVID‐19–positive patients were admitted to the respiratory ward (n = 123) and the ICU (n = 35) during the study period. COVID‐19 infection was the primary admission reason in 32.9% of patients, 51.3% were male and the median age was 62 years. Aboriginal or Torres Strait Islanders (ATSI) were overrepresented (13.3%). Care was predominantly ward based (77.2%). Nearly half of the patients had mild COVID‐19 (49.4%). Dexamethasone was the most common treatment provided to patients (58.2%). The median length of stay was 5.8 days (interquartile range, 5–15). Eight patients died during the study period (5.1%), with three of those deaths attributable to COVID‐19. Conclusions: COVID‐19 case numbers following WA state border opening were of lower care acuity and disease severity than predicted. Two‐thirds of admissions were for other primary diagnoses, with incidental COVID detection. Hospital admissions were overrepresented by partially or unvaccinated patients and by ATSI Australians. An increase in social support along with general and geriatric medicine speciality input were required to treat hospitalised COVID‐19 cases in the WA Omicron wave. [ABSTRACT FROM AUTHOR]