Background. The impact of bacterial clonality on infections caused byStaphylococcus aureus is unclear. Methods. Three hundred seventy-nine S. aureus isolates (125 methicillin-resistant S. aureus [MRSA] and 254 methicillin-susceptible S. aureus [MSSA]) were genotyped by spa typing and multilocus sequence typing. For MRSA isolates, the staphylococcal chromosomal cassette mec (SCCmec) element was also typed. Three clinical categories were identified: nasal carriage only ( ), uncomplicated infection ( ), and bacteremia with hematogn p 118 n p 104 enous complications ( ). n p 157 Results. By use of eBURST, 18 clonal complexes (CCs) were found in 371 isolates. Eight CCs accounted for 89% of isolates and occurred in all clinical categories. CC5 () and CC30 ( ) exhibited a significant P p .0025 P p .0308 trend toward more frequent hematogenous complications. Isolates within spa types 2 and 16 showed the same significant trend and grouped within CC5 and CC30, respectively. SCCmec II isolates also showed the same significant trend compared with SCCmec IV; 96% were CC5 or CC30.Conclusions. Although most S. aureus genotypes exhibited the capacity to cause invasive disease, strains within CC5 and CC30 exhibited a significant trend toward increasing levels of hematogenous complications. Isolates within these CCs were also implicated by use of spa and SCCmec typing. The genetic determinants underlying these findings remain to be demonstrated.

The objective of this experiment was to determine the effect of a beta-glucanase-protease enzyme blend product (EBP) on fecal digestibility (FD), apparent ileal digestibility (AID), standardized ileal digestibility, and digestibility in the hindgut of growing pigs. Twelve ileal-cannulated, growing barrows (38.2 +/- 0.5 kg) were housed in individual metabolism crates, blocked by previous feed intake into 3 groups with 4 pigs each, and randomly assigned to 1 of 4 treatments within a square (group) of 3 replications of 4 x 4 Latin square design. Treatments were basal diet (Basal), Basal + 0.05% of EBP (0.05% EBP), Basal + 0.10% of EBP (0.10% EBP), and hydrolyzed casein for measurement of endogenous amino acids. The Basal diet consisted of corn and soybean meal and was calculated to have 3.36 Mcal of ME/kg and 1.1% of total lysine, as-fed basis. Feed intake of each replicate of the Latin square during the first period was 85% of the minimum feed intake of the 4 pigs during the preliminary period and was equalized within each square. The feeding level was increased by 100 g/d in each subsequent period. Each of the experimental periods was 14 d, including 4 d of dietary adaptation, 5 d of fecal collection, 3 d of transition period, and 2 d of ileal collection. Ileal effluents were collected continuously for the same 12-h interval each day. Pigs fed the EBP demonstrated increased (P < 0.05) FD of DM, OM, energy, CP, nonfiber carbohydrate, total dietary fiber, insoluble dietary fiber, acid-hydrolyzed fat, ash, Ca, and P compared with pigs fed Basal. The AID of NDF and hemicellulose was increased (P < 0.05) by supplying the EBP either at 0.05 or 0.10% in the diets, but AID of DM and energy was not increased. The AID of acid-hydrolyzed fat tended to be greater (P = 0.051) for the pigs fed the EBP than for those fed Basal. Ileal digestibility of most amino acids was not affected by treatment, but the EBP reduced the apparent and standardized digestibility of methionine, alanine, and serine (P < 0.05). The difference between FD and AID of hemicellulose was lower (P < 0.05) for the pigs fed the EBP than for those fed Basal. These results demonstrated that the EBP fed to growing pigs improved the FD of DM, OM, energy, CP, nonfiber carbohydrate, total dietary fiber, acid-hydrolyzed fat, Ca, and P, and the AID of NDF and hemi-cellulose, but the standardized ileal digestibility of amino acids was not improved by supplying the EBP in corn-soybean meal-based diets of growing pigs.

Residents of Appalachia, especially those in rural Appalachia, are generally considered to be medically underserved. In fact, cancer mortality in Appalachia, especially in rural Appalachia, is higher than it is in the remainder of the United States. Developing from the Appalachia Leadership Initiative on Cancer, the Appalachia Cancer Network (ACN) is a network of academic and community organizations that seek to conduct surveillance, intervention, and dissemination research to reduce this excess cancer burden in Appalachia. The purpose of this report is to (1) describe the approach to cancer control research in ACN, a Special Population Network, among the medically underserved of Appalachia, and (2) to put forward observations from this experience to enhance the research of other academic and community networks among underserved populations. ACN has instituted a conceptual model, organizational structure, and other methods to foster this research and to develop junior and community-based investigators. Important issues and questions related to the effectiveness of such research networks have also been articulated.

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conclusionsThis advice document advocates for a multidisciplinary approach to cancer care in response to the distress experienced by cancer patients and their families. The recommendations will be useful in future to measure performance, quality of practice, and access to psychosocial services.