Background
Awake prone positioning has been widely used in patients with COVID‐19 respiratory failure to avoid intubation despite limited evidence. Our objective was to evaluate if prone positioning ...is associated with a reduced intubation rate when compared to usual care.
Methods
This was a retrospective cohort study in the emergency department of a large quaternary hospital in Sao Paulo. We retrieved data from all admitted patients in need of oxygen supplementation (>3 L/min) and tachypnea (>24 ipm) from March 1 to April 30, 2020, excluding those who had any contraindication to the prone position or who had an immediate need for intubation. The primary endpoint was endotracheal intubation up to 15 days. Secondary outcomes included a 6‐point clinical outcome ordinal scale, mechanical ventilation–free days, admission to the intensive care unit, and need of hemodialysis and of vasoactive drugs, all assessed at or up to 15 days. We analyzed unadjusted and adjusted effect estimates with Cox proportional hazards models, logistic regression, quantile regression, and sensitivity analyses using propensity score models.
Results
Of 925 suspected COVID‐19 patients admitted off mechanical ventilation, 166 patients fulfilled inclusion and exclusion criteria: 57 were exposed to prone positioning and 109 to usual care. In the intervention group, 33 (58%) were intubated versus 53 (49%) in the control group. We observed no difference in intubation rates in the univariate analysis (hazard ratio = 1.21, 95% confidence interval CI = 0.78 to 1.88, p = 0.39) nor in the adjusted analysis (hazard ratio = 0.90, 95% CI = 0.55 to 1.49, p = 0.69). Results were robust to the sensitivity analyses. Secondary outcomes did not differ between groups.
Conclusions
Awake prone positioning was not associated with lower intubation rates. Caution is necessary before widespread adoption of this technique, pending results of clinical trials.
Animal-induced galls are considered extended phenotypes of their inducers, and therefore plant morphogenesis and metabolism may vary according to the species of gall inducers. The alterations in ...vacuolar and apoplastic polyphenols, carotenoids, chlorophyll fluorescence rates, PSII quantum yield, and phospholipid peroxidation were studied in galls induced by Ditylenchus gallaeformans (Nematoda) on Miconia albicans and M. ibaguensis (Melastomataceae), and by an unidentified Eriophyidae (Acarina) on M. ibaguensis. The focus currently addressed is gall metabolism as the extended phenotype of the gall inducers, and the neglected determination of gall functionalities over host plant peculiarities. Galls induced by D. gallaeformans on M. albicans and by the Eriophyidae on M. ibaguensis have increased accumulation of apoplastic and vacuolar phenolics, which is related to the control of phospholipid peroxidation and photoprotection. The galls induced by D. gallaeformans on M. ibaguensis have higher carotenoid and vacuolar polyphenol contents, which are related to excessive sunlight energy dissipation as heat, and photoprotection. Accordingly, antioxidant strategies varied according to the gall-inducing species and to the host plant species. The distinctive investments in carotenoid and/or in polyphenol concentrations in the studied galls seemed to be peculiar mechanisms to maintain oxidative homeostasis. These mechanisms were determined both by the stimuli of the gall-inducing organism and by the intrinsic physiological features of the host plant species. Therefore, the roles of both associated organisms in host plant-galling organisms systems over gall metabolism is attested.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This study evaluated the role of dung beetle species alone or associated under different species on nitrous oxide (N
O) emission, ammonia volatilization, and the performance of pearl millet ...Pennisetum glaucum (L.). There were seven treatments, including two controls (soil and soil + dung without beetles), single species of Onthophagus taurus Shreber, 1759 (1), Digitonthophagus gazella Fabricius, 1787 (2), or Phanaeus vindex MacLeay, 1819 (3); and their assemblages (1 + 2 and 1 + 2 + 3). Nitrous oxide emission was estimated for 24 days, when pearl millet was planted in sequence to assess growth, nitrogen yield (NY), and dung beetle activity. Dung beetle species presented greater N
O flow of dung on the 6th day (80 g N
O-N ha
day
) compared to soil and dung (2.6 g N
O-N ha
day
). Ammonia emissions varied with the presence of dung beetles (P < 0.05), and D. gazella had less NH
N on days 1, 6, and 12 with averages of 2061, 1526, and 1048 g ha
day
, respectively. The soil N content increased with dung + beetle application. Dung application affected pearl millet herbage accumulation (HA) regardless of dung beetle presence, and averages ranged from 5 to 8 g DM bucket
. A PCA analysis was applied to analyze variation and correlation to each variable, but it indicated a low principal component explanation (less than 80%), not enough to explain the variation in findings. Despite the greater dung removal, the largest species, P. vindex and their species combination, need to be more studied to get a better understanding about their contribution on greenhouse gases. The presence of dung beetles prior to planting improved pearl millet production by enhancing N cycling, although assemblages with the three beetle species enhanced N losses to the environment via denitrification.
Zika virus infection during pregnancy can cause congenital abnormities or fetal demise. The persistence of Zika virus in the male reproductive system poses a risk of sexual transmission. Here we ...demonstrate that live-attenuated Zika virus vaccine candidates containing deletions in the 3' untranslated region of the Zika virus genome (ZIKV-3'UTR-LAV) prevent viral transmission during pregnancy and testis damage in mice, as well as infection of nonhuman primates. After a single-dose vaccination, pregnant mice challenged with Zika virus at embryonic day 6 and evaluated at embryonic day 13 show markedly diminished levels of viral RNA in maternal, placental, and fetal tissues. Vaccinated male mice challenged with Zika virus were protected against testis infection, injury, and oligospermia. A single immunization of rhesus macaques elicited a rapid and robust antibody response, conferring complete protection upon challenge. Furthermore, the ZIKV-3'UTR-LAV vaccine candidates have a desirable safety profile. These results suggest that further development of ZIKV-3'UTR-LAV is warranted for humans.Zika virus infection can result in congenital disorders and cause disease in adults, and there is currently no approved vaccine. Here Shan et al. show that a single dose of a live-attenuated Zika vaccine prevents infection, testis damage and transmission to the fetus during pregnancy in different animal models.
Beef cattle producers seldom use fertilizers for their pastures in tropical regions of Brazil. Slowly, this is changing but because of the need for repeated applications, N fertilizer is rarely ...applied. The introduction of a forage legume is an appropriate solution for this problem, but until recently adoption has been very low as the legumes generally have not persisted in the sward. We report research on how grazing management can affect the persistence of stoloniferous legumes in pastures of Brachiaria spp. and the problems of establishing and maintaining crown‐forming legumes such as Stylosanthes spp. With suitable management, milk or bovine carcass yields can be equal or greater from mixed than from grass‐alone pastures fertilized with 120 or 150 kg Nha‐1 year−1. In addition to savings in CO2 emissions from fossil fuels for the production and distribution of N fertilizers, nitrous oxide emissions from cattle excreta and legume residues are lower than those from N‐fertilized brachiaria grass monocultures. Other studies indicate that enteric methane emissions from cattle may be mitigated when forage legumes are included in their diet. The use of forage legumes in mixed pastures for tropical regions is emerging as a feasible strategy to keep meat and milk production at acceptable levels with reduced greenhouse gas emission rates.
Plants deploy various immune receptors to recognize pathogens and defend themselves. Crosstalk may happen among receptor-mediated signal transduction pathways in the same host during simultaneous ...infection of different pathogens. However, the related function of the receptor-like kinases (RLKs) in thwarting different pathogens remains elusive. Here, we report that NIK1, which positively regulates plant antiviral immunity, acts as an important negative regulator of antibacterial immunity. nik1 plants exhibit dwarfed morphology, enhanced disease resistance to bacteria and increased PAMP-triggered immunity (PTI) responses, which are restored by NIK1 reintroduction. Additionally, NIK1 negatively regulates the formation of the FLS2/BAK1 complex. The interaction between NIK1 and FLS2/BAK1 is enhanced upon flg22 perception, revealing a novel PTI regulatory mechanism by an RLK. Furthermore, flg22 perception induces NIK1 and RPL10A phosphorylation in vivo, activating antiviral signalling. The NIK1-mediated inverse modulation of antiviral and antibacterial immunity may allow bacteria and viruses to activate host immune responses against each other.
The increasing demand for water, food and energy poses challenges for the world´s sustainability. Tropical palm oil is currently the major source of vegetable oil worldwide with a production that ...exceeds 55 million tons per year, while generating over 200 million tons of palm oil mill effluent (POME). It could potentially be used as a substrate for production of microalgal biomass though. In this study, the microalgal strain Chlamydomonas biconvexa Embrapa|LBA40, originally isolated from a sugarcane vinasse stabilization pond, was selected among 17 strains tested for growth in POME retrieved from anaerobic ponds of a palm oil industrial plant located within the Amazon rainforest region. During cultivation in POME, C. biconvexa Embrapa|LBA40 biomass productivity reached 190.60 mgDW • L-1 • d-1 using 15L airlift flat plate photobioreactors. Carbohydrates comprised the major fraction of algal biomass (31.96%), while the lipidic fraction reached up to 11.3% of dry mass. Reductions of 99% in ammonium and nitrite, as well as 98% reduction in phosphate present in POME were detected after 5 days of algal cultivation. This suggests that the aerobic pond stage, usually used in palm oil industrial plants to reduce POME inorganic load, could be substituted by high rate photobioreactors, significantly reducing the time and area requirements for wastewater treatment. In addition, the complete mitochondrial genome of C. biconvexa Embrapa|LBA40 strain was sequenced, revealing a compact mitogenome, with 15.98 kb in size, a total of 14 genes, of which 9 are protein coding genes. Phylogenetic analysis confirmed the strain taxonomic status within the Chlamydomonas genus, opening up opportunities for future genetic modification and molecular breeding programs in these species.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Two experiments were designed to evaluate the effects of different probiotic combinations on rumen fermentation characteristics, performance, and carcass characteristics of feedlot Bos ...indicus beef bulls offered a high-concentrate diet. In experiment 1, 30 rumen-fistulated Nellore steers were blocked by initial body weight (BW = 350 ± 35.0 kg) and within blocks (n = 10), animals were randomly assigned to receive: 1) high-concentrate diet without probiotic supplementation (n = 10; CONT), 2) CONT plus 1 g per head of a probiotic mixture containing three strains of Enterococcus faecium and one strain of Saccharomyces cerevisiae (3.5 × 109 CFU/g; n = 10; EFSC), and 3) CONT plus 2 g per head of a probiotic mixture containing Bacillus licheniformis and Bacillus subtilis (3.2 × 109 CFU/g; n = 10; BLBS). The experimental period lasted 35 d, being 28 d of adaptation and 7 d of sampling. From day 34 to day 35 of the experimental period, ruminal fluid and fecal samples were collected every 3 h, starting immediately before feeding (0 h) for rumen fermentation characteristics and apparent nutrient digestibility analysis, respectively. In experiment 2, 240 Nellore bulls were ranked by initial shrunk BW (375 ± 35.1 kg), assigned to pens (n = 4 bulls per pen), and pens randomly assigned to receive the same treatments as in experiment 1 (n = 20 pens per treatment). Regardless of treatment, all bulls received the same step-up and finishing diets throughout the experimental period, which lasted 115 d. In both experiments, data were analyzed as orthogonal contrasts to partition-specific treatment effects: 1) probiotic effect: CONT vs. PROB and 2) probiotic type: EFSC vs. BLBS (SAS Software Inc.). In experiment 1, no contrast effects were observed on nutrient intake, overall nutrient digestibility, and rumen fermentation analyses (P ≥ 0.13). Nonetheless, supplementation of probiotics, regardless of type (P = 0.59), reduced mean acetate:propionate ratio and rumen ammonia-N concentration vs. CONT (P ≤ 0.05). In experiment 2, no significant effects were observed for final BW and dry matter intake (P ≥ 0.12), but average daily gain and feed efficiency tended to improve (P ≤ 0.10) when probiotics were offered to the animals. Probiotic supplementation or type of probiotic did not affect carcass traits (P ≥ 0.22). In summary, supplementation of probiotics containing a mixture of E. faecium and S. cerevisiae or a mixture of B. licheniformis and B. subtilis reduced rumen acetate:propionate ratio and rumen ammonia-N levels and tended to improve the performance of feedlot cattle offered a high-concentrate diet.
Contaminated duodenoscopes caused several hospital outbreaks. Despite efforts to reduce contamination rates, 15% of patient-ready duodenoscopes are still contaminated with gastrointestinal ...microorganisms. This study aimed to provide an overview of duodenoscope contamination over time, identify risk factors and study the effects of implemented interventions.
Duodenoscope culture sets between March 2015 and June 2022 at a Dutch tertiary care centre were analysed. Contamination was defined as (1) the presence of microorganisms of oral or gastrointestinal origin (MGO) or (2) any other microorganism with ≥20 colony-forming units/20 mL (AM20). A logistic mixed effects model was used to identify risk factors and assess the effect of interventions, such as using duodenoscopes with disposable caps, replacing automated endoscope reprocessors (AER) and conducting audits in the endoscopy department.
A total of 404 culture sets were analysed. The yearly contamination rate with MGO showed great variation, ranging from 14.3% to 47.5%. Contamination with AM20 increased up to 94.7% by 2022. For both MGO and AM20, the biopsy and suction channels were the most frequently contaminated duodenoscope components. The studied interventions, including audits, AER replacement and implementation of duodenoscopes with disposable caps, did not show a clear association with contamination rates.
Duodenoscope contamination remains a significant problem, with high contamination rates despite several interventions. Reprocessing the biopsy and suction channels is especially challenging. Changes in the design of reusable duodenoscopes, such as enabling sterilisation or easily replaceable channels, are necessary to facilitate effective duodenoscope reprocessing and to eliminate the risk of duodenoscope-associated infections.
Duodenoscope-associated infections (DAIs) are exogenous infections resulting from the use of contaminated duodenoscopes. Though numerous outbreaks of DAI have involved multidrug-resistant ...micro-organisms (MDROs), outbreaks involving non-MDROs are also likely to occur. Detection challenges arise as these infections often resolve before culture or because causative strains are not retained for comparison with duodenoscope strains.
To identify and analyse DAIs spanning a seven-year period in a tertiary care medical centre.
This was a retrospective observational study. Duodenoscope cultures positive for gastrointestinal flora between March 2015 and September 2022 were paired with duodenoscope usage data to identify patients exposed to contaminated duodenoscopes. Analysis encompassed patients treated after a positive duodenoscope culture and those treated within the interval from a negative to a positive culture. Patient identification numbers were cross-referenced with a clinical culture database to identify patients developing infections with matching micro-organisms within one year of their procedure. A ‘pair’ was established upon a species-level match between duodenoscope and patient cultures. Pairs were further analysed via antibiogram comparison, and by whole-genome sequencing (WGS) to determine genetic relatedness.
Sixty-eight pairs were identified; of these, 21 exhibited matching antibiograms which underwent WGS, uncovering two genetically closely related pairs categorized as DAIs. Infection onset occurred up to two months post procedure. Both causative agents were non-MDROs.
This study provides crucial insights into DAIs caused by non-MDROs and it highlights the challenge of DAI recognition in daily practice. Importantly, the delayed manifestation of the described DAIs suggests a current underestimation of DAI risk.
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