The documented survival of pathogenic bacteria including Listeria monocytogenes (LM), shiga toxin-producing Escherichia coli (STEC), and Salmonella during the manufacture and aging of some cheeses highlights the need for additional interventions to enhance food safety. Unfortunately, few interventions are compliant with the Standards of Identity for cheese. Protective bacterial cultures (PC) represent actionable, natural interventions. However, supportive data for commercially produced PCs regarding their efficacy against pathogens and potential antagonism with each other and cheesemaking cultures are scant, thereby impeding their potential use by the cheese industry. The overall objective of this study was to identify commercially produced PCs that exert antimicrobial activity towards pathogens with minimal impact on beneficial cheese microbes. Direct antagonism and agar well diffusion assays were used to determine the impact of 10 commercially produced PCs on the growth of starter cultures and cultures of ripening bacteria and fungi. Deferred antagonism was used to evaluate the potential for antimicrobial effects against LM, STEC, and Salmonella. PCs and starter cultures were co-cultured in UHT milk to determine the effects of co-culture on starter acidification profiles when incubated according to a simulated cheese-making temperature profile (4 h at 35°C followed by 20 h at 20°C). Compatibility assays suggest that PC antagonism is microbe and strain specific. Only one PC negatively impacted the acidification of the starters tested. PC antagonism of ripening bacteria and fungi growth varied but was consistent within species. All PCs displayed deferred inhibition of LM, STEC, and Salmonella growth but to varying degrees. These data identify commercial PCs with potential for the control of pathogens and characterize their compatibility with cheesemaking cultures for future use by cheesemakers and investigations of their efficacy in the production of cheese.AIMS We aimed to quantify the effect of preventive percutaneous coronary intervention (PCI to non-infarct arteries) on cardiac death and non-fatal myocardial infarction (MI) in patients with ST-elevation myocardial infarction (STEMI) according to whether the decision to carry out preventive PCI was based on angiographic visual inspection (AVI alone) or AVI plus Fractional Flow Reserve if AVI showed significant stenosis (AVI plus FFR). METHODS AND RESULTS Randomised trials comparing preventive PCI with no preventive PCI in STEMI without shock were identified by a systematic literature search and categorised according to whether they used AVI alone or AVI plus FFR to select patients for preventive PCI. Random effects meta-analyses and tests of heterogeneity were used to compare the two categories in respect of cardiac death and MI as a combined outcome and individually. Eleven eligible trials were identified. For cardiac death and MI the relative risk estimates for AVI alone versus AVI plus FFR were 0.39 (0.25-0.61) and 0.85 (0.57-1.28) respectively (p = 0.01 for difference), for cardiac death alone the estimates were 0.36 (0.19-0.71) and 0.79 (0.36-1.77) respectively (p = 0.15 for difference) and for MI alone, 0.41 (0.23-0.73) and 0.98 (0.62-1.56) respectively (p = 0.04 for difference). CONCLUSIONS In preventive PCI among STEMI patients, AVI alone achieves an approximate 60% reduction in cardiac death and MI but selecting patients using FFR in AVI positive patients loses much of the benefit. AVI is best used without FFR in this group of patients. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions please email journals.permissions@oup.com.Triaging burn patients is a daunting task because burn injuries are rare; this inexperience leads to uncertainty in treatment and referral algorithms. Our regional burn center's catchment area includes eight states. Outlying facilities consult via telephone through the medical center's transfer center. Referring provider assessments of depth or size of injury infrequently correlates with burn provider's assessments. This causes over- and under-triage of patients managed outside of burn centers. A quality improvement telemedicine project was developed to allow burn providers to review photos with referring providers to determine best management, provide pertinent education, and initiate appropriate and timely resuscitation. Details tracked include date of service, consulting provider, follow-up education offered, and whether the image reviewed changed or confirmed the requested plan of care. Of the 155 cases between January 2017 and August 2018, 24.5% of patient images changed the initial transfer decision, and 75.5% confirmed the initial plan of care. Of the cases requiring change of plan, 60.5% were down-triaged to outpatient care and 39.5% were up-triaged to transfer. Implementation of this telemedicine program has increased efficiency of resource utilization, timely resuscitation, appropriate transfer of patients requiring admission, and real-time education. Findings suggest advanced practice providers' assessments are similar to those of referring physicians. These observations may have significant implications on Emergency Medical Treatment and Labor Act (EMTALA) guidelines defining physician to physician consultation and support efficient use of available resources. Telemedicine facilitates access to specialized care and improves fiscal responsibility. © The Author(s) 2020. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.AIMS Hepatocyte growth factor-regulated tyrosine kinase substrate (Hgs), a key component of the endosomal sorting complex required for transport (ESCRT), has been implicated in many essential biological processes. However, the physiological role of endogenous Hgs in the vascular system has not previously been explored. Here, we have generated brain endothelial cell (EC) specific Hgs knockout mice to uncover the function of Hgs in EC polarity and cerebrovascular stability. METHODS AND RESULTS Knockout of Hgs in brain ECs led to impaired endothelial apicobasal polarity and brain vessel collapse in mice. We determined that Hgs is essential for recycling of VE-cadherin to the plasma membrane, since loss of Hgs blocked trafficking of endocytosed VE-cadherin from early endosomes to recycling endosomes, and impaired the motility of recycling endosomes.  https://www.selleckchem.com/products/trastuzumab-emtansine-t-dm1-.html  Supportively, overexpression of the motor kinesin family member 13A (KIF13A) restored endosomal recycling and rescued abrogated polarized trafficking and distribution of VE-cadherin in Hgs knockdown ECs.