bluuebunny/crossref_metadata_2025 huggingface dataset:
SlS5H silencing reveals specific pathogen-triggered salicylic acid metabolism in tomato
Authors: Payá C. , Minguillón S. , Hernández M. , Miguel S. M. , Campos L. , Rodrigo I. , Bellés J. M. , López-Gresa M. P. , Lisón P.
Published: November 2022

Background

Salicylic acid (SA) is a major plant hormone that mediates the defence pathway against pathogens. SA accumulates in highly variable amounts depending on the plant-pathogen system, and several enzyme activities participate in the restoration of its levels. Gentisic acid (GA) is the product of the 5-hydroxylation of SA, which is catalysed by S5H, an enzyme activity regarded as a major player in SA homeostasis. GA accumulates at high levels in tomato plants infected by Citrus Exocortis Viroid (CEVd), and to a lesser extend uponPseudomonas syringaeDC3000 pv.tomato(Pst) infection.

Results

We have studied the induction of tomatoSlS5Hgene by different pathogens, and its expression correlates with the accumulation of GA. Transient over-expression ofSlS5HinNicotiana benthamianaconfirmed that SA is processed by SlS5H in vivo.SlS5H-silenced tomato plants were generated, displaying a smaller size and early senescence, together with hypersusceptibility to the necrotrophic fungusBotrytis cinerea. In contrast, these transgenic lines exhibited an increased defence response and resistance to both CEVd andPstinfections. Alternative SA processing appears to occur for each specific pathogenic interaction to cope with SA levels. InSlS5H-silenced plants infected with CEVd, glycosylated SA was the most discriminant metabolite found. Instead, inPst-infected transgenic plants, SA appeared to be rerouted to other phenolics such as feruloyldopamine, feruloylquinic acid, feruloylgalactarate and 2-hydroxyglutarate.

Conclusion

UsingSlS5H-silenced plants as a tool to unbalance SA levels, we have studied the re-routing of SA upon CEVd andPstinfections and found that, despite the common origin and role for SA in plant pathogenesis, there appear to be different pathogen-specific, alternate homeostasis pathways.
Effect of inpatient antibiotic treatment among older adults with delirium found with a positive urinalysis: a health record review
Authors: Joo Pil , Grant Lars , Ramsay Tim , Nott Caroline , Zvonar Rosemary , Jia Jason , Yadav Krishan , Mollanji Eisi , He William , Eagles Debra
Published: November 2022

Background

Among older adults with delirium and positive urinalysis, antibiotic treatment for urinary tract infection is common practice, but unsupported by literature or guidelines. We sought to: i) determine the rate of antibiotic treatment and the proportion of asymptomatic patients (other than delirium) in this patient population, and ii) examine the effect of antibiotic treatment on delirium resolution and adverse outcomes.

Methods

A health record review was conducted at a tertiary academic centre from January to December 2020. Inclusion criteria were age ≥ 65, positive delirium screening assessment, positive urinalysis, and admission to general medical units. Outcomes included rates of antibiotic treatment, delirium on day 7 of admission, and 30-day adverse outcomes. We compared delirium and adverse outcome rates in antibiotic-treated vs. non-treated groups. We conducted subgroup analyses among asymptomatic patients.

Results

We included 150 patients (57% female, mean age 85.4 years). Antibiotics were given to 86%. The asymptomatic subgroup (delirium without urinary symptoms or fever) comprised 38% and antibiotic treatment rate in this subgroup was 68%. There was no significant difference in delirium rate on day 7 between antibiotic-treated vs. non-treated groups, (entire cohort RR 0.94 [0.41–2.16] and asymptomatic subgroup RR 0.69 [0.22–2.15]) or in 30-day adverse outcomes.

Conclusions

Older adults with delirium and positive urinalysis in general medical inpatient units were frequently treated with antibiotics – often despite the absence of urinary or other infectious symptoms. We failed to find evidence that antibiotic treatment in this population is associated with delirium resolution on day 7 of admission.
Building engagement to support adoption of community-based substance use prevention initiatives
Authors: Halsall Tanya , Mahmoud Kianna , Pouliot Annie , Iyer Srividya N.
Published: November 2022

Background

System-level approaches that target social determinants of health are promising strategies to support substance use prevention, holistic youth development and wellbeing. Yet, the youth services system is largely based on individual-focused programs that do not adequately account for social determinants of health and place the responsibility for wellness on the individual. There is a need to understand how to enhance adoption of complex system-level approaches that support comprehensive youth development. The Icelandic Prevention Model (IPM) represents a collaborative initiative that takes an ecological, system-level approach to prevent substance use and promote wellness in youth. This research was designed to examine key stakeholder perceptions to better understand social motivations and contextual complexities that influence stakeholder support to garner community-level adoption of the IPM in a rural Canadian community.

Methods

This research applies a case study approach using qualitative interviews to explore strategies to support uptake in the early stages of IPM adoption associated with developing community buy-in and acceptance. A thematic analysis was applied using QSR NVivo.

Results

Nine interviews were conducted with community partners leading the implementation of the IPM. Three over-arching themes emerged from the data: 1) Motivating influences 2) Strategies to develop buy-in, and 3) Resistance to the adoption of the IPM. Findings reflect issues that affect behaviour change in system transformation in general as well as upstream prevention and the IPM, in particular.

Conclusions

The findings from this research describe critical insight derived from implementing community-driven initiatives that are designed to support health promotion. It contributes new scientific knowledge related to implementation of complex system-level innovations and practical information that is useful for communities interested in implementing the IPM or following similar approaches to prevent substance use.
An internet-based educational intervention for mothers targeting preschoolers’ weight management promotion (PWMP): a pilot study
Authors: Ghofranipour Fazlollah , Hamzavi Zarghani Najmeh , Mohammadi Eesa , Mehrizi Ali Asghar Haeri , Tavousi Mahmoud , De Craemer Marieke , Cardon Greet
Published: November 2022

Background

The prevalence of overweight and obesity among children has raised public health concerns. This study aimed to design and evaluate a behaviour change intervention program to promote weight management among Tehranian preschoolers.

Methods

The PRECEDE-PROCEED model is one of the most popular models in health education used to develop and evaluate most educational interventions. In this one-group pre and post-pilot study, 13 mothers of preschoolers were recruited from preschools in Tehran (the capital of Iran), in August 2020. Mothers received a six-week educational intervention, including text messages and educational videos via WhatsApp, to increase their self-efficacy to overcome barriers changing their children’s lifestyle. Mothers reported preschoolers’ height and weight to assess Body Mass Index and filled out the Food Frequency Questionnaire, the Persian version of the children's health-related quality of life questionnaire, and demographic features. The “Children’s physical activity and sedentary behaviors checklist,” newly designed by the researchers, was also filled out by mothers. These behaviors were measured according to the minutes that children were involved in these activities in a day, and the days they spent in a week for them. All variables were measured at baseline, immediately after the intervention and three months later. Data analysis was performed using SPSS IBM statistics version 22. Friedman test was used to evaluate changes over time.

Results

The findings demonstrated that the mean BMI z-score stayed steady between baseline, immediately after the intervention and after three months (P = 0.60). Besides, after three months, the intervention programme led to a decrease in soft drink consumption (P = 0.001), and an increase in parental perception of their child’s general health (P = 0.05), the parental concern regarding their child’s emotional and physical health (P = 0.002) and minutes of physical activity per day (P = 0.02). However, fruit intake decreased (P = 0.01), and simple sugar, such as cube, increased (P = 0.03).

Conclusion

Results from this study are promising but should be interpreted with caution and should be replicated on a larger scale and compared with a control group to evaluate whether effects are maintained in a larger sample.
HIV and syphilis knowledge, perceptions, and practices among Myanmar migrant workers in Samut Sakhon Province, Thailand
Authors: Paloga Alfrison , Arthan Dumrongkiet , Maneekan Pannamas , Kitcharoen Patreeya , Wattanapisit Apichai , Paratthakonkun Chirawat , Phuanukoonnon Suparat , Tun Shoon Lei Nyan Wai , Soonthornworasiri Ngamphol
Published: November 2022

Background

Thailand has been one of the largest migration hubs in Southeast Asia for the past four decades and keeps attracting migrants from neighboring countries. Due to difficulties associated with their status, migration can place individuals at a heightened risk for sexually transmitted diseases. This study aimed to examine factors influencing HIV and syphilis preventive behaviors among Myanmar migrants in Samut Sakhon, Thailand.

Methods

A cross-sectional mixed-method study was conducted among Myanmar migrants aged 18 years and above in Samut Sakhon Province, Thailand. To fulfill this study's aims, four hundred seventy-three respondents completed a survey to provide quantitative data, and eight participants completed in-depth qualitative interviews. The factors associated with protective sexual behaviors were identified with multiple logistic regression analysis of the quantitative study data and thematic analysis of the qualitative data.

Results

The respondents showed good knowledge of HIV and syphilis (50.1%), but over half (55.6%) exhibited the negative perception of sexually transmitted disease prevention; about 81.4% of male respondents never used a condom when they had sexual intercourse in the past year. Based on multivariate analysis, income expenses-balance (adjusted odds ratio (AOR) = 2.379, 95% confidence interval (CI): 1.002–5.731, p = 0.049), number of sex partners (AOR = 3.044, 95% CI: 1.339–6.924, p = 0.008), and having sex with a prostitute (AOR = 6.085, 95% CI: 1.28–28.918, p = 0.023) were all statistically associated with unprotected sex. In the qualitative analysis, knowledge, understanding, beliefs; the influence of culture, community, and environment; and condom perceptions were also important factors.

Conclusion

Low use of condoms in sexual practice was identified, and the appropriate intervention or approach to improve the utilization of condoms in the community was provided.
Is the reconstruction of medial support important for revision following failed treatment of femoral trochanteric fractures? a retrospective comparative study
Authors: Qi Lin , Zhang Wei , Chang Zuhao , Zuo Zhaoxia , Li Jiaqi , Li Jiantao , Chen Hua , Tang Peifu
Published: November 2022

Background

Hip-preserving revision in patients with failed treatment of femoral trochanteric fracture is still a major challenge. Whether the medial support reconstruction could benefit the patients and improve the success rate of hip-preserving revision is still controversial. Hence, the purpose of this study was to evaluate the clinical significance and prognosis of medial support reconstruction during the hip-preserving revision of failed femoral trochanteric fracture treatment.

Methods

Patients with failed femoral trochanteric fractures treatments addressed by hip-preserving revision at our hospital from January 2014 to December 2020 were analyzed retrospectively. 31 patients were included and divided into a medial support group (n = 16) and a non-medial support group (n = 15). The fracture healing rate was the primary measurement. In addition, the differences in Oxford Hip Score (OHS), quality of life, surgical trauma, and complications were also evaluated.

Results

The fracture healing rate (100%, 16/16 vs. 66.67%, 10/15), the OHS (42.06 ± 4.12 vs. 30.93 ± 11.56, M ± SD), and the mental component score of the 12-item Short-Form Survey (SF-12) (54.48 ± 5.38 vs. 47.90 ± 3.47, M ± SD), were significantly better and the incidence of complications [0(0/16) vs. 40%(6/15)] was significantly lower in the medial support group than the non-medial support group (p < 0.05). No significant differences in the physical component score of the SF-12, surgical trauma and reduction in collodiaphyseal angle of affected femur were observed between groups.

Conclusions

The reconstruction of medial support seems important for revision following failed treatment of femoral trochanteric fractures. Due to the medial augmentation and improvement of the mechanical stability for proximal femur, the patients might benefit from fracture healing prognosis and functional.
Impact of advanced practice nurses in hospital units on compliance with clinical practice guidelines: a quasi-experimental study
Authors: Pol-Castañeda Sandra , Rodriguez-Calero Miguel Angel , Villafáfila-Gomila Carlos Javier , Blanco-Mavillard Ian , Zaforteza-Lallemand Concepción , Ferrer-Cruz Francisco , De Pedro-Gómez Joan Ernest
Published: November 2022

Background

Incorporating the best available evidence into clinical practice is a determining challenge for healthcare professionals and organisations. The role of advanced practice nurses is viewed as a facilitator to adapt guideline recommendations to suit specific contexts and to overcome barriers to implementation. In this study, we evaluate the impact of advanced practice nurses on clinical indicators of hospitalised patients and on adherence to recommendations derived from two clinical practice guidelines (pressure ulcer prevention and treatment and vascular access device management).

Methods

Quasi-experimental study in five intervention (IU) and five control (CU) hospital units at three hospitals in Spain (period 2018–19). Five advanced practice nurses were incorporated into IU, with the intention that would produce attitudinal changes and enhance the skills and knowledge of the nursing team regarding 18 clinical practice recommendations. In this study, 41 indicators were evaluated through direct observation of all patients admitted, at monthly intervals for 1 year. Outcomes were assessed by means of a descriptive, multi-line regression and association analysis.

Results

The study population was composed of 3742 inpatients admitted for pressure ulcer assessment and 2631 fitted with vascular access devices. By the end of the study period, all variables had improved in the IU, where average compliance with recommendations was statistically significantly higher (pressure ulcer guidance 7.9 ± 1.9 vs 6.0 ± 1.7. OR 1.86, 95% CI 1.67–2.05; vascular access devices guidance 5.4 ± 1.4 vs 4.4 ± 1,6. OR 1.06, 95% CI 0.95–1.17). The prevalence of pressure lesions and catheter-related adverse events decreased statistically significantly in the IU compared to the CU. The prevalence of pressure ulcers decreases (5.7% in IU vs 8.7% in CU p < 0.005) as well as the prevalence of adverse events related to the catheter (14% In IU vs 21.6% in CU p < 0.005). The unnecessary catheters decressed in IU 10.9% VS CU 15.8% (p < 0.005).

Conclusions

The incorporation of an advanced practice nurse statistically significantly improves clinical indicators related to the prevention and treatment of pressure ulcers and to the management of vascular access devices.

Trial registration

ISRCTN18259923 retrospectively registered on 11/02/2022.
Rural-urban prescribing patterns by primary care and behavioral health providers in older adults with serious mental illness
Authors: Muench Ulrike , Jura Matthew , Thomas Cindy Parks , Perloff Jennifer , Spetz Joanne
Published: November 2022

Background

Older adults with serious mental illness (SMI) often have multiple comorbidities and complex medication schedules. Shortages of behavioral health specialists (BHSs), especially in rural areas, frequently make primary care providers (PCPs) the only clinician managing this complex population. The aim of this study was to describe rural/urban psychiatric medication prescribing in older adults with SMI by PCPs and BHSs, and by clinician type.

Methods

This retrospective descriptive analysis used 2018 Medicare data to identify individuals with a bipolar, major depression, schizophrenia, or psychosis diagnosis and examined medication claims for antianxiety, antidepressants, antipsychotics, hypnotics, and anticonvulsants. Descriptive statistics summarized percentage of medications provided by PCPs and BHSs stratified by rural and urban areas and by drug class. Additional analyses compared psychiatric prescribing patterns by physicians, advanced practice registered nurses (APRNs), and physician assistants (PAs).

Results

In urban areas, PCPs prescribed at least 50% of each psychiatric medication class, except antipsychotics, which was 45.2%. BHSs prescribed 40.7% of antipsychotics and less than 25% of all other classes. In rural areas, percentages of psychiatric medications from PCPs were over 70% for each medication class, except antipsychotics, which was 60.1%. Primary care physicians provided most psychiatric medications, between 36%-57% in urban areas and 47%-65% in rural areas. Primary care APRNs provided up to 13% of prescriptions in rural areas, which was more than the amount prescribed by BHS physicians, expect for antipsychotics. Psychiatric mental health APRNs provided up to 7.5% of antipsychotics in rural areas, but their prescribing contribution among other classes ranged between 1.1%-3.6%. PAs provided 2.5%-3.4% of medications in urban areas and this increased to 3.9%-5.1% in rural areas.

Conclusions

Results highlight the extensive roles of PCPs, including APRNs, in managing psychiatric medications for older adults with SMI.
Workplace violence at emergency departments, Ain Shams University Hospitals, Cairo, Egypt
Authors: Assil Altaf O. , Salem Amna A. , Mokhtar Omnya A. , Taha Omnia H. , Ramadan Amany M. , Mansour Amal H. R. , Awad Amal A. E. , El-Hossainy Amira A. , Khattab Amir A. , Salem Alshaymaa M. , Dalaab Amany E. A. , Azab Sonya M. S.
Published: November 2022

Background

The present study aimed to determine the prevalence and forms of workplace violence (WPV) at the emergency departments (EDs) of Ain Shams University Hospitals (ASUH), Cairo and identify risk factors for WPV.

Methods

A cross-sectional study was conducted at the EDs of ASUH comprising attending physicians and nurses using a self-administered structured questionnaire. Interviews were conducted with patients and relatives attending these departments to explore attitudes toward WPV against healthcare workers.

Results

The present study comprised 108 healthcare professionals working in EDs. Verbal violence was the most common type of WPV (86.1%), followed by sexual (48.1%) and physical violence (34.3%). Patient relatives were the most common perpetrator of all types of violence. A lack of facilities was the most common risk factor for violence (82.4%), followed by overcrowding (50.9%) and patient culture (47.2%). On the other hand, approximately 78% of interviewed patients and relatives agreed that the occurrence of violence at EDs was due to several triggering factors, including improper manner of communication by healthcare workers (63.2%), lack of facilities (32.4%), waiting time (22.1%), and unmet expectations (22.1%).

Conclusion

WPV represents a significant issue in EDs with violent behavior against healthcare workers widely accepted by attending patients.
Associations between PM2.5 exposure and Alzheimer’s Disease prevalence Among elderly in eastern China
Authors: Yang Li , Wan Wenjie , Yu Caiyan , Xuan Cheng , Zheng Pinpin , Yan Jing
Published: November 2022

Background

Studies showed that PM2.5 might be associated with various neurogenic diseases such as Alzheimer’s Disease (AD). However, this topic had been little studied in Zhejiang province of China. 

Methods

In 2018, we established a cohort of AD high-risk population with 1,742 elderly aged 60 and above. In 2020, the cohort was followed up, a total of 1,545 people participated the 2 surveys. Data collection included questionnaires and basic physical examinations. The average residential exposure to PM2.5 for each participant, that in a 5-years period prior to the first survey, was estimated using a satellite-based spatial statistical model. We determined the association between PM2.5 and AD prevalence by cox proportional hazards regression model. 

Results

This study showed that an increase in the PM2.5 level was an important associated risk factor that contributed to AD. The average PM2.5 exposure levels among the study population ranged from 32.69 μg/m3 to 39.67 μg/m3 from 2013 to 2017, which were much higher than 5 μg/m3 that specified in the WHO air quality guidelines. There was an association between PM2.5 exposure and AD, and the correlations between PM2.5 and Mini-Mental State Examination, Montreal cognitive assessment scale scores were statistically significant. An increase in the PM2.5 level by 10 μg/m3 elevated the risk of AD among residents by 2%-5% (HR model 2-model 4 = 1.02 to 1.05, CI model 2-model 4 = 1.01–1.10). The subgroups of male, with old age, with low education levels, used to work as farmers or blue-collar workers before retirement, overweight and obese were associated with a higher effect of PM2.5.

Conclusions

Reducing PM2.5 exposure might be a good way to prevent AD.
Predictive factors for severe long-term chronic kidney disease after acute kidney injury requiring renal replacement therapy in critically ill patients: an ancillary study of the ELVIS randomized controlled trial
Authors: Soum Edouard , Timsit Jean-François , Ruckly Stephane , Gruson Didier , Canet Emmanuel , Klouche Kada , Argaud Laurent , Garrouste-Orgeas Maïté , Mariat Christophe , Vincent François , Cayot Sophie , Darmon Michael , Bohé Julien , Schwebel Carole , Bouadma Lila , Dupuis Claire , Souweine Bertrand , Lautrette Alexandre
Published: November 2022

Background

Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is a serious complication in the ICU that results in increased mortality and risk of chronic kidney disease (CKD). Some studies suggest RRT modality may have an impact on long-term renal recovery after AKI. However, other predictive factors of severe long-term CKD in ICU patients with AKI requiring RRT are unknown.

Methods

We performed an ancillary study of the multicenter ELVIS trial in the population with AKI requiring RRT. Patients alive 3 months after RRT initiation were eligible. Serum creatinine levels available at 3, 6 and 12 months and 3 and 5 years were recorded. CKD stage was determined according to the glomerular filtration rate as estimated by the CKD-EPI formula. At each timepoint, two groups of patients were compared, a no/mild CKD group with normal or mildly to moderately decreased renal function (stages 1, 2 and 3 of the international classification) and a severe CKD group (stages 4 and 5). Our objective was to identify predictive factors of severe long-term CKD.

Results

Of the 287 eligible patients, 183 had follow-up at 3 months, 136 (74.3%) from the no/mild CKD group and 47 (25.7%) from the severe CKD group, and 122 patients at 5 years comprising 96 (78.7%) from the no/mild CKD group and 26 (21.3%) from the severe CKD group. Multivariate analysis showed that a long RRT period was associated with severe CKD up to 12 months (ORM12 = 1.03 95% CI [1.02–1.05] per day) and that a high SOFA score at the initiation of RRT was not associated with severe CKD up to 5 years (ORM60 = 0.85 95% CI [0.77–0.93] per point).

Conclusion

Severe long-term CKD was found in 21% of ICU survivors who underwent RRT for AKI. The duration of the RRT in AKI patients was identified as a new predictive factor for severe long-term CKD. This finding should be taken into consideration in future studies on the prognosis of ICU patients with AKI requiring RRT.

Trial registration ELVIS trial was registered with ClinicalTrials.gov, number: NCT00875069 (June 16, 2014), and this ancillary study was registered with ClinicalTrials.gov, number: NCT03302624 (October 6, 2017).
Manipulating chromatin architecture in C. elegans
Authors: Carter John L. , Kempton Colton E. , Hales Emily D. S. , Johnson Steven M.
Published: November 2022

Background

Nucleosome-mediated chromatin compaction has a direct effect on the accessibility of trans-acting activators and repressors to DNA targets and serves as a primary regulatory agent of genetic expression. Understanding the nature and dynamics of chromatin is fundamental to elucidating the mechanisms and factors that epigenetically regulate gene expression. Previous work has shown that there are three types of canonical sequences that strongly regulate nucleosome positioning and thus chromatin accessibility: putative nucleosome-positioning elements, putative nucleosome-repelling sequences, and homopolymeric runs of A/T. It is postulated that these elements can be used to remodel chromatin in C. elegans. Here we show the utility of such elements in vivo, and the extreme efficacy of a newly discovered repelling sequence, PRS-322.

Results

In this work, we show that it is possible to manipulate nucleosome positioning in C. elegans solely using canonical and putative positioning sequences. We have not only tested previously described sequences such as the Widom 601, but also have tested additional nucleosome-positioning sequences: the Trifonov sequence, putative repelling sequence-322 (PRS-322), and various homopolymeric runs of A and T nucleotides.

Conclusions

Using each of these types of putative nucleosome-positioning sequences, we demonstrate their ability to alter the nucleosome profile in C. elegans as evidenced by altered nucleosome occupancy and positioning in vivo. Additionally, we show the effect that PRS-322 has on nucleosome-repelling and chromatin remodeling.
Epigenetic and transcriptomic reprogramming in monocytes of severe COVID-19 patients reflects alterations in myeloid differentiation and the influence of inflammatory cytokines
Authors: Godoy-Tena Gerard , Barmada Anis , Morante-Palacios Octavio , de la Calle-Fabregat Carlos , Martins-Ferreira Ricardo , Ferreté-Bonastre Anna G. , Ciudad Laura , Ruiz-Sanmartín Adolfo , Martínez-Gallo Mónica , Ferrer Ricard , Ruiz-Rodriguez Juan Carlos , Rodríguez-Ubreva Javier , Vento-Tormo Roser , Ballestar Esteban
Published: November 2022

Background

COVID-19 manifests with a wide spectrum of clinical phenotypes, ranging from asymptomatic and mild to severe and critical. Severe and critical COVID-19 patients are characterized by marked changes in the myeloid compartment, especially monocytes. However, little is known about the epigenetic alterations that occur in these cells during hyperinflammatory responses in severe COVID-19 patients.

Methods

In this study, we obtained the DNA methylome and transcriptome of peripheral blood monocytes from severe COVID-19 patients. DNA samples extracted from CD14 + CD15- monocytes of 48 severe COVID-19 patients and 11 healthy controls were hybridized on MethylationEPIC BeadChip arrays. In parallel, single-cell transcriptomics of 10 severe COVID-19 patients were generated. CellPhoneDB was used to infer changes in the crosstalk between monocytes and other immune cell types.

Results

We observed DNA methylation changes in CpG sites associated with interferon-related genes and genes associated with antigen presentation, concordant with gene expression changes. These changes significantly overlapped with those occurring in bacterial sepsis, although specific DNA methylation alterations in genes specific to viral infection were also identified. We also found these alterations to comprise some of the DNA methylation changes occurring during myeloid differentiation and under the influence of inflammatory cytokines. A progression of DNA methylation alterations in relation to the Sequential Organ Failure Assessment (SOFA) score was found to be related to interferon-related genes and T-helper 1 cell cytokine production. CellPhoneDB analysis of the single-cell transcriptomes of other immune cell types suggested the existence of altered crosstalk between monocytes and other cell types like NK cells and regulatory T cells.

Conclusion

Our findings show the occurrence of an epigenetic and transcriptional reprogramming of peripheral blood monocytes, which could be associated with the release of aberrant immature monocytes, increased systemic levels of pro-inflammatory cytokines, and changes in immune cell crosstalk in these patients.
Combined anaerobic digestion of chicken manure and corn straw: study on methanogenic potential and microbial diversity
Authors: Feng Lei , Lin Xiaoyu , Li Xu
Published: November 2022

Purpose

To explore the methane production potential and microbial community changes of combined anaerobic digestion of chicken manure and corn straw. Increase methane production, reduce the environmental pollution caused by the burning of livestock manure and straw, and provide some theoretical references for the construction and operation of actual biogas projects.

Methods

Different proportions (3%, 5%, 10%) of corn straw were added to the anaerobic digestion systems of chicken manure in order to improve the C/N ratio and to evaluate the feasibility and potential synergistic effect on the co-digestion. The key point was to use 16S rDNA sequencing to analyze the relationship between the microbial diversity and the hydrolase activity during the anaerobic digestion.

Result

The results showed that the volumetric gas production of methane in the 3% straw addition group was 227.66 ml/gVS, which was 18% higher than the cumulative methane production in the pure chicken manure experimental group. However, with the increase of straw concentration, methane production and the utilization rate of the raw materials continued to decrease. The change in activity of each hydrolase was in agreement with changes in hydrolytic acidifying bacteria, and the activity of the main hydrolase also increased with the addition of straw; the correlation coefficient was 0.9943. Sequencing results showed that the dominant strains of methanogenic archaea were Methanosarcina, Methanosaeta, Methanobacterium, and Methanospirillum. Mainly for hydrogen-eating, acetic acid-eating methanogens, its role is to use H2, methanol and acetic acid, and other substances to metabolize methane, and convert it into CH4 and CO2.

Conclusion

The addition of a small amount of straw enhanced the production capacity of hydrogen-nutritive methane to some extent, and the species richness and evenness were also improved, reducing the pollution caused by livestock manure to the environment while controlling the pollution caused by straw burning.

Graphical Abstract
Methotrexate-induced acute cardiotoxicity requiring veno-arterial extracorporeal membrane oxygenation support: a case report
Authors: Shah Sareena , Haeger-Overstreet Kristen , Flynn Brigid
Published: November 2022

Background

Methotrexate is an antifolate antimetabolite that inhibits the activity of dihydrofolate reductase by acting as a false substrate, which leads to defects of DNA synthesis, specifically the inhibition of purine and pyrimidine synthesis. Thus, methotrexate is a powerful agent for treating autoimmune diseases and cancer. In general, methotrexate is thought to be cardioprotective and reports of methotrexate-induced cardiomyopathy are rare. We present a case of methotrexate-induced severe cardiotoxicity diagnosed by exclusion of all other potential causes.

Case presentation

The patient was a 54-year-old Caucasian man presenting to an outside hospital with a chief complaint of abdominal pain and bloating who reported taking methotrexate up to 20 mg per week for systemic sclerosis. After a transthoracic echocardiogram found a left ventricular ejection fraction of 10% and coronary catheterization demonstrated no significant disease, he was transferred to our hospital for advanced heart failure therapies. His condition deteriorated, and he was eventually placed on veno-arterial extracorporeal membrane oxygenation. Owing to a lack of an identifiable etiology of cardiac failure, toxicology consultation recommended 24 hours of intravenous leucovorin therapy to overcome any residual and potentially cardiotoxic methotrexate still in his system. Over the next 5 days, his cardiac function improved daily, such that on day 5 of extracorporeal membrane oxygenation, he had a left ventricular ejection fraction of 40% and was able to be decannulated. Two days later, his ejection fraction improved to 60% and normal right ventricular function. Initially, his renal function improved while on extracorporeal membrane oxygenation, but over the next week deteriorated such that he required intermittent hemodialysis until hospital discharge.

Conclusions

After a process of elimination, the most likely cause of this patient’s acute decline and rapid recovery of bi-ventricular function was methotrexate toxicity. Leucovorin may have aided the reversal of methotrexate toxicity.
The revised recommendation for administering vitamin C in septic patients: the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020
Authors:   Guideline committee of The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020,   Japanese Society of Intensive Care Medicine, Egi Moritoki ,   Japanese Association for Acute Medicine, Ogura Hiroshi
Published: November 2022

Given the available clinical evidence through the literature search when the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 was being created, we suggested administering vitamin C to such patients. Recently, several randomized control trials have been published, some of which suggested the harmful effect of vitamin C in terms of mortality or persistent organ dysfunction. Therefore, we performed updated systematic reviews and meta-analyses. Accordingly, we revised our recommendation as “We suggest against administering vitamin C to septic patients (GRADE 2D: certainty of evidence = “very low”).”
Resolving the conflicts around Par2 opposing roles in regeneration by comparing immune-mediated and toxic-induced injuries
Authors: Reches Gal , Blondheim Shraga Netta R. , Carrette Florent , Malka Assaf , Saleev Natalia , Gubbay Yehuda , Ertracht Offir , Haviv Izhak , Bradley Linda M. , Levine Fred , Piran Ron
Published: November 2022

Background

Different factors may lead to hepatitis. Among which are liver inflammation and poisoning. We chose two hepatitis models, typical for these two underlying causes. Thus, we aimed to characterize the role of protease-activated receptor 2 (Par2) in liver regeneration and inflammation to reconcile Par2 conflicting role in many damage models, which sometimes aggravates the induced damage and sometimes alleviates it.

Methods

WT and knockout (Par2KO) mice were injected with concanavalin A (ConA) to induce immune-mediated hepatitis or with carbon tetrachloride (CCl4) to elicit direct hepatic damage. To distinguish the immune component from the liver regenerative response, we conducted bone marrow (BM) replacements of WT and Par2KO mice and repeated the damage models.

Results

ConA injection caused limited damage in Par2KO mice livers, while in the WT mice severe damage followed by leukocyte infiltration was evident. Reciprocal BM replacement of WT and Par2KO showed that WT BM-reconstituted Par2KO mice displayed marked liver damage, while in Par2KO BM-reconstituted WT mice, the tissue was generally protected.

In the CCl4 direct damage model, hepatocytes regenerated in WT mice, whereas Par2KO mice failed to recover. Reciprocal BM replacement did not show significant differences in hepatic regeneration. In Par2KO mice, hepatitis was more apparent, while WT recovered regardless of the BM origin.

Conclusions

We conclude that Par2 activation in the immune system aggravates hepatitis and that Par2 activation in the damaged tissue promotes liver regeneration. When we incorporate this finding and revisit the literature reports, we reconciled the conflicts surrounding Par2’s role in injury, recovery, and inflammation.
Association of cellular immunity with severity of COVID-19 from the perspective of antigen-specific memory T cell responses and cross-reactivity
Authors: Fujii Shin-ichiro , Yamasaki Satoru , Iyoda Tomonori , Shimizu Kanako
Published: November 2022

Coronaviruses regularly cause outbreaks of zoonotic diseases characterized by severe pneumonia. The new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused the global pandemic disease COVID-19 that began at the end of 2019 and spread rapidly owing to its infectious nature and rapidly progressing pneumonia. Although the infectivity of SARS-CoV-2 is high, indicated by the worldwide spread of the disease in a very short period, many individuals displayed only subclinical infection, and some of them transmitted the disease to individuals who then developed a severe symptomatic infection. Furthermore, there are differences in the severity of infection across countries, which can be attributed to factors such as the emergence of viral mutations in a short period of time as well as to the immune responses to viral factors. Anti-viral immunity generally consists of neutralizing antibodies that block viral infection and cytotoxic CD8+ T cells that eliminate the virus-infected cells. There is compelling evidence for the role of neutralizing antibodies in protective immunity in SARS-CoV-2 infection. However, the role of CD4+ and CD8+ T cells after the viral entry is complex and warrants a comprehensive discussion. Here, we discuss the protection afforded by cellular immunity against initial infection and development of severe disease. The initial failure of cellular immunity to control the infection worsens the clinical outcomes and functional profiles that inflict tissue damage without effectively eliminating viral reservoirs, while robust T cell responses are associated with mild outcomes. We also discuss persistent long-lasting memory T cell-mediated protection after infection or vaccination, which is rather complicated as it may involve SARS-CoV-2-specific cytotoxic T lymphocytes or cross-reactivity with previously infected seasonal coronaviruses, which are largely related to HLA genotypes. In addition, cross-reactivity with mutant strains is also discussed. Lastly, we discuss appropriate measures to be taken against the disease for immunocompromised patients. In conclusion, we provide evidence and discuss the causal relationship between natural infection- or vaccine-mediated memory T cell immunity and severity of COVID-19. This review is expected to provide a basis to develop strategies for the next generation of T cell-focused vaccines and aid in ending the current pandemic.
Impact of COVID-19 on endoscopic follow-up of gastroesophageal varices
Authors: Elsayed Amr M. , Fouad Yasser M. , Hassan Hatem A. , Hassanin Taha M. , Abbas Abbas M. , Hassnine Alshymaa A.
Published: November 2022

Background

Portal hypertension is considered as a major complication of liver cirrhosis. Endoscopy plays a main role in managing of gastrointestinal complications of portal hypertension. Endoscopists are at increased risk for COVID-19 infection because upper gastrointestinal (GI) endoscopy is a high-risk aerosol-generating procedure and may be a potential route for COVID-19.

Objectives

To compare the outcome between cirrhotic patients who underwent classic regular endoscopic variceal ligation after primary bleeding episode every 2–4 weeks, and those presented during the era of COVID-19 and their follow-up were postponed 2 months later.

Methods

This retrospective study included cross-matched 238 cirrhotic patients with portal hypertension presented with upper GI bleeding, 112 cirrhotic patients presented during the era of COVID19 (group A) underwent endoscopic variceal ligation, another session after 2 weeks and their subsequent follow-up was postponed 2 months later, and 126 cirrhotic patients as control (group B) underwent regular endoscopic variceal band ligation after primary bleeding episode every 2–4 weeks.

Results

Eradication of varices was achieved in 32% of cases in group A, and 46% in group was not any statistically significant (p > 0.05); also, there was no any statistical significant difference between both groups regarding occurrence of rebleeding, post endoscopic symptoms, and mortality rate (p > 0.05).

Conclusion

Band ligation and injection of esophageal and gastric vary every 2 months were as effective and safe as doing it every 2 to 4 weeks after primary bleeding episode for further studies and validation.
Preferred technique of creating pneumoperitoneum for laparoscopy by pediatric surgeons
Authors: Shah Amar A. , Shah Anirudh V.
Published: November 2022

Background

Minimally invasive pediatric surgery has gained popularity over open conventional surgery as it offers benefits to both patients and health care practitioners. Creation of pneumoperitoneum is a must for any laparoscopic procedure. Different pediatric surgeons have their individual preferences regarding the technique to create pneumoperitoneum prior to laparoscopy. The aim of this study was to evaluate the preference of technique for the creation of pneumoperitoneum in pediatric laparoscopy among Indian Pediatric Surgeons. The study was designed by communication with members of the Indian Association of Pediatric Surgeons using a predefined questionnaire. 180 pediatric surgeons responded to the survey. The respondents included pediatric surgeons in institutional and private practice. The reasons behind their preference were enumerated and evaluated.

Results

Seventy-one percent of pediatric surgeons preferred the primary open technique for the creation of pneumoperitoneum. Seventeen percent exclusively used Veress needle whereas 12% were using both techniques varying from patient to patient.

Conclusion

Creation of pneumoperitoneum remains an important safety issue for all pediatric surgeons. Pediatric Surgeons in India prefer using the primary open technique for the creation of pneumoperitoneum for laparoscopic surgery.
The PRINCIPAL Network: A Model to Optimize Infection Care and Prevention in Pediatric Oncology in the Latin American Region
Authors: Caniza Miguela A. , Homsi Maysam R. , Vázquez Milka , Gutierrez Ivan F. , Kopsidas Ioannis , Mukkada Sheena , Friedrich Paola , Metzger Monika
Published: November 2022

PURPOSE

Children with cancer are at high risk for poor outcomes, and health care providers are often unfamiliar with best practices in infection care and prevention (IC&P) in this small and fragile population. Graduates of training courses in IC&P in immunocompromised hosts identified a need for a community that would enable members to share health care experiences, provide resources for continuing medical education, and foster collaborative research and quality improvement opportunities. We developed a Latin American network, Prevencionistas e Infectólogos para Cáncer Pediátrico en América Latina, to grow and sustain the expertise of the clinical workforce in IC&P. Here, we describe the network, how we built it, and its early outcomes.

METHODS

We began by codesigning the mission, vision, objectives, and values. We then established the structure for leadership and network management to provide a functional uniformity and sustainability. Virtual meetings with network members and strategic in-person gatherings optimized the use of the time and resources of the network.

RESULTS

The network has seen good participation by members and candidates for membership, who have provided feedback on case-based learning. Members have attended training sessions on quality improvement, research in human subjects, and IC&P in pediatric oncology at national and regional meetings and workshops. Network members have presented their work at regional and global meetings, and publications are beginning to emerge from this community. A direct effect of the Prevencionistas e Infectólogos para Cáncer Pediátrico en América Latina network has been the creation of a similar network for the Asia Pacific region, and a third network is being planned.

CONCLUSION

We have demonstrated the power of a discipline-specific network structure to facilitate sharing of evidence-based information that enhances the quality-of-care delivery in pediatric oncology.
Comparison of PIK3CA Mutation Prevalence in Breast Cancer Across Predicted Ancestry Populations
Authors: Chen Jessica W. , Murugesan Karthikeyan , Newberg Justin Y. , Sokol Ethan S. , Savage Heidi M. , Stout Thomas J. , Maund Sophia L. , Hutchinson Katherine E.
Published: November 2022

PURPOSE

Understanding the differences in biomarker prevalence that may exist among diverse populations is invaluable to accurately forecast biomarker-driven clinical trial enrollment metrics and to advance inclusive research and health equity. This study evaluated the frequency and types of PIK3CA mutations ( PIK3CAmut) detected in predicted genetic ancestry subgroups across breast cancer (BC) subtypes.

METHODS

Analyses were conducted using real-world genomic data from adult patients with BC treated in an academic or community setting in the United States and whose tumor tissue was submitted for comprehensive genomic profiling.

RESULTS

Of 36,151 patients with BC (median age, 58 years; 99% female), the breakdown by predicted genetic ancestry was 75% European, 14% African, 6% Central/South American, 3% East Asian, and 1% South Asian. We demonstrated that patients of African ancestry are less likely to have tumors that harbor PIK3CAmut compared with patients of European ancestry with estrogen receptor–positive/human epidermal growth factor receptor 2–negative (ER+/HER2–) BC (37% [949/2,593] v 44% [7,706/17,637]; q = 4.39E-11) and triple-negative breast cancer (8% [179/2,199] v 14% [991/7,072]; q = 6.07E-13). Moreover, we found that PIK3CAmut were predominantly composed of hotspot mutations, of which mutations at H1047 were the most prevalent across BC subtypes (35%-41% ER+/HER2– BC; 43%-61% HER2+ BC; 40%-59% triple-negative breast cancer).

CONCLUSION

This analysis established that tumor PIK3CAmut prevalence can differ among predicted genetic ancestries across BC subtypes on the basis of the largest comprehensive genomic profiling data set of patients with cancer treated in the United States. This study highlights the need for equitable representation in research studies, which is imperative to ensuring better health outcomes for all.