Novel species of microfungi described in the present study include the following from Australia: Phytophthora amnicola from still water, Gnomoniopsis smithogilvyi from Castanea sp., Pseudoplagiostoma ...corymbiae from Corymbia sp., Diaporthe eucalyptorum
from Eucalyptus sp., Sporisorium andrewmitchellii from Enneapogon aff. lindleyanus, Myrmecridium banksiae from Banksia, and Pilidiella wangiensis from Eucalyptus sp. Several species are also described from South Africa, namely: Gondwanamyces
wingfieldii from Protea caffra, Montagnula aloes from Aloe sp., Diaporthe canthii from Canthium inerne, Phyllosticta ericarum from Erica gracilis, Coleophoma proteae from Protea caffra, Toxicocladosporium strelitziae from Strelitzia reginae,
and Devriesia agapanthi from Agapanthus africanus. Other species include Phytophthora asparagi from Asparagus officinalis (USA), and Diaporthe passiflorae from Passiflora edulis (South America). Furthermore, novel genera of coelomycetes include Chrysocrypta
corymbiae from Corymbia sp. (Australia), Trinosporium guianense, isolated as a contaminant (French Guiana), and Xenosonderhenia syzygii, from Syzygium cordatum (South Africa). Pseudopenidiella piceae from Picea abies (Czech Republic),
and Phaeocercospora colophospermi from Colophospermum mopane (South Africa) represent novel genera of hyphomycetes. Morphological and culture characteristics along with ITS DNA barcodes are provided for all taxa.
Although we have learned much about how the brain fuels its functions over the last decades, there remains much still to discover in an organ that is so complex. This article lays out major gaps in ...our knowledge of interrelationships between brain metabolism and brain function, including biochemical, cellular, and subcellular aspects of functional metabolism and its imaging in adult brain, as well as during development, aging, and disease. The focus is on unknowns in metabolism of major brain substrates and associated transporters, the roles of insulin and of lipid droplets, the emerging role of metabolism in microglia, mysteries about the major brain cofactor and signaling molecule NAD
, as well as unsolved problems underlying brain metabolism in pathologies such as traumatic brain injury, epilepsy, and metabolic downregulation during hibernation. It describes our current level of understanding of these facets of brain energy metabolism as well as a roadmap for future research.
Abstract
Background
Only 13% of IBD teams across the UK have a specialist pharmacist within the MDT (1). Pharmacists have a crucial role in safe and effective medication prescribing and monitoring ...(2). Studies have shown that pharmacist led clinics are acceptable to clinicians and patients (2). At our trust we set up a pharmacist led biologic switch clinic where a specialist pharmacist counselled regarding biologic therapy switch from intravenous (IV) to subcutaneous (SC) medication and assessed disease burden at baseline and follow up. We set up thiopurine clinic where the specialist pharmacist arranges monitoring and facilitates pre-emptive switch of stable patients to shared care prescribing with the GP, in line with the national commitment of providing convenient and easy access to services. We analysed patient feedback, biologic and shared care prescribing data to assess the impact of our pharmacist-led clinics.
Methods
Patients who had been scheduled in thiopurine and biologic switch clinic were sent with questionnaires either by post or email. Both paper and electronic data were collected and analysed using Microsoft ExCel. Biologic therapy and thiopurine prescribing and monitoring databases were setup and data were captured and analysed retrospectively.
Results
112 patients were switched from IV biologic therapy to SC therapy of which 8 patients needed to be switched back to IV due to either an adverse reaction or uncontrolled IBD. By reducing drug cost and increasing hospital CIU capacity, the biologic switch clinic has generated significant financial savings to the organisation (estimated £333,666 per annum).
In thiopurine clinic, 80 patients were identified as suitable candidates for shared care agreement with primary care. 88% patients have been successfully transferred to primary care and the remaining 12% remained under secondary care because the GP opted-out.
88% of patients who had been scheduled in pharmacist led clinic were happy with the service and the remainder had a neutral opinion regarding the service (see chart). Some patients fed-back that the telephone consultation did not happen at scheduled time or they preferred face to face clinic.
Conclusion
Pharmacist led clinic led to significant cost savings, increased accessibility to thiopurines and was acceptable to patients. In response to patient feedback we amended our appointment letters to clarify appointment time frames and give pharmacist contact details for further patient queries. We have also set up face to face clinics for patients preferring this option.
References:
1 Burns, Corrinne. Only 13% of IBD teams meet standards for pharmacist. London: Pharmaceutical journal, 2021
2 IBDUK. The hidden cost and a vision for change. London: Crohn's and Colitis care in the UK, 2021
Abstract
Background
The process of commencing IBD patients on biologic therapy is logistically complex. Most biologic therapy is administered via a subcutaneous or intravenous route, so in addition ...to a negative pre-biologic screen, patients must be educated on subcutaneous self-administration or booked into an infusion’s clinic. A delay of over, 40 days in starting biologic therapy results in statistically worse self reported GI symptoms and endoscopic appearances at one year1. Therefore, reducing the time between the decision to initiate biologic treatment and the administration of the first dose is a key factor in improving outcomes.
Methods
A retrospective review of clinic letters, appointment dates and email exchanges was performed for all IBD patients commenced on outpatient biologic therapy (Adalimumab, Infliximab, Vedolizumab, Ustekinumab, Golimumab and Tofacitinib) by the Gastroenterology team at Lancashire Teaching Hospitals NHS Trust between February, 2019 and September 2021.
The length of time between the decision to initiate biologic therapy and the administration of the first dose was recorded in days. For cases where this time period was greater than, 28 days, the reason for the delay was categorised into either patient factors; logistical; outstanding biologic screen; outstanding clinical question; homecare delay or no single factor.
A tracking spreadsheet and generic referral email address were introduced in March, 2021 and the impact of these interventions was assessed via run chart.
Results
The median time period from the decision to initiate biologic therapy to administration of the first dose was, 35 days at the start of the study period, with, 67% of patients waiting over, 28 days.
Following the interventions in March, 2021, despite twice the number of patients, the median wait time was reduced to, 20 days with only, 23% of patients waiting over, 28 days.
Outstanding biologic screens and logistical factors such as delays in letter typing were the most common reasons for delays. Only, 17% of cases where communication was via email had a wait time of over, 28 days, compared to, 75% of cases where communication was via letter.
Conclusion
Simple adjustments such as a dedicated tracking spreadsheet and switching to email communication have a big impact on streamlining the process of initiating biologic therapy, almost halving the time taken from decision to initiate therapy to administration of the first dose.
1 System delays have real consequences: Impact of timing of biologic commencement on inflammatory bowel disease patient response A McCulloch, Journal of Crohn’s and Colitis, Volume, 13, Issue Supplement_1, March, 2019, Page S176
Since the cognitive turn in metaphor studies in the late 1970s, metaphor has been seen as a cognitive phenomenon reflecting how we think, alongside its classic role as a powerful literary device. ...This ‘cognitive turn’ in metaphor studies makes it possible to investigate metaphor in two facets: the cognitive one and the linguistic one. In this tenet, the notion of metaphor features two intertwined parts: conceptual metaphors which resemble mental connections between different knowledge packets (e.g., LIFE IS A BOOK), and their linguistic manifestations known as metaphorical expressions or linguistic metaphors (e.g., They are starting a new chapter of their life). This opens a window for metaphor translation research, for it allows researchers to examine metaphor translation from the two complementary facets. Building on conceptual metaphor theory (Lakoff and Johnson 1980, 2003) and conceptual blending theory (Fauconnier and Turner 2002), our case study discusses the translation of cognitive and linguistic metaphors identified in source and target texts. Metaphorical expressions were handpicked from seven popular cosmological articles published in Scientific American between 2017 and 2018, and their official Chinese translations published in Huanqiukexue (‘global science,’ Beijing) and Kexueren (‘science person,’ Taipei). The findings lend support to the joint application of two metaphor theories to descriptive translation studies, for it not only facilitates the analysis of translation examples but also enhances the feasibility of comparing metaphor translation research across languages pinned by metaphor parameters waiting to be explored.
Biosynthesis of aromatic amino acids in plants, many bacteria, and microbes relies on the enzyme 5-enolpyruvylshikimate 3-phosphate (EPSP) synthase, a prime target for drugs and herbicides. We have ...identified the interaction of EPSP synthase with one of its two substrates (shikimate 3-phosphate) and with the widely used herbicide glyphosate by x-ray crystallography. The two-domain enzyme closes on ligand binding, thereby forming the active site in the interdomain cleft. Glyphosate appears to occupy the binding site of the second substrate of EPSP synthase (phosphoenol pyruvate), mimicking an intermediate state of the ternary enzyme·substrates complex. The elucidation of the active site of EPSP synthase and especially of the binding pattern of glyphosate provides a valuable roadmap for engineering new herbicides and herbicide-resistant crops, as well as new antibiotic and antiparasitic drugs.
Across the globe coastal wetlands have been lost and degraded due to agriculture. Here we test hypotheses that there are differences in vegetation structure of the mangrove
Avicennia marina
at ...locations with or without cattle in the lower Shoalhaven River Estuary in New South Wales, Australia. We sampled the pneumatophores, seedlings, saplings, and trees within the mangrove forest and landward of the forest where cattle are most active. Areas with cattle had fewer trees, and their lowest branches were more than 2 m above the ground, giving trees an umbrella-shaped morphology. Although abundances of saplings and seedlings were highly variable among locations, plants at both stages were shortest along the landward side of the forest in the presence of cattle and seedlings were bushier, suggesting consumption of the apical shoots. A reduction in pneumatophore density and the highest proportion of branched pneumatophores occurred along the landward side of the forest in the presence of cattle, indicating impacts of trampling. Prospects for regeneration of the mangroves in the presence of cattle appear limited due to grazing, physical disturbance and trampling across multiple life history stages. Livestock paddocks should be fenced to exclude cattle and prevent degradation of these coastal intertidal habitats.
Apathy is a common and impairing sequela of traumatic brain injury (TBI). Yet, little is known about the neural mechanisms determining in which patients apathy does or does not develop post-TBI. We ...aimed to elucidate the impact of TBI on motivational neural circuits and how this shapes apathy over the course of TBI recovery. Resting-state functional magnetic resonance imaging data were collected in patients with subacute mild TBI (
= 44), chronic mild-to-moderate TBI (
= 26), and nonbrain-injured control participants (CTRL;
= 28). We measured ventromedial prefrontal cortex (vmPFC) functional connectivity (FC) as a function of apathy, using an
vmPFC seed adopted from a motivated decision-making study in an independent TBI study cohort. Patients reported apathy using a well-validated tool for assaying apathy in TBI. The vmPFC-to-wholebrain FC was contrasted between groups, and we fit regression models with apathy predicting vmPFC FC. Subacute and chronic TBI caused increased apathy relative to CTRL, replicating previous work suggesting that apathy has an enduring impact in TBI. The vmPFC was functionally connected to the canonical default network, and this architecture did not differ between subacute TBI, chronic TBI, and CTRL groups. Critically, in TBI, increased apathy scores predicted decreased vmPFC-dorsal anterior cingulate cortex (dACC) FC. Last, we subdivided the TBI group based on patients above versus below the threshold for "clinically significant apathy," finding that TBI patients with clinically significant apathy demonstrated comparable vmPFC-dACC FC to CTRLs, whereas TBI patients with subthreshold apathy scores demonstrated vmPFC-dACC hyperconnectivity relative to both CTRLs and patients with clinically significant apathy. Post-TBI vmPFC-dACC hyperconnectivity may represent an adaptive compensatory response, helping to maintain motivation and enabling resilience to the development of apathy after neurotrauma. Given the role of vmPFC-dACC circuits in value-based decision making, rehabilitation strategies designed to improve this ability may help to reduce apathy and improve functional outcomes in TBI.
Abstract
Age-related macular degeneration (AMD) is a complex neurodegenerative eye disease with behavioral and genetic etiology and is the leading cause of irreversible vision loss among elderly ...Caucasians. Functionally significant genetic variants in the alternative pathway of complement have been strongly linked to disease. More recently, a rare variant in the terminal pathway of complement has been associated with increased risk, Complement component 9 (C9) P167S. To assess the functional consequence of this variant, C9 levels were measured in two independent cohorts of AMD patients. In both cohorts, it was demonstrated that the P167S variant was associated with low C9 plasma levels. Further analysis showed that patients with advanced AMD had elevated sC5b-9 compared to those with non-advanced AMD, although this was not associated with the P167S polymorphism. Electron microscopy of membrane attack complexes (MACs) generated using recombinantly produced wild type or P167S C9 demonstrated identical MAC ring structures. In functional assays, the P167S variant displayed a higher propensity to polymerize and a small increase in its ability to induce hemolysis of sheep erythrocytes when added to C9-depleted serum. The demonstration that this C9 P167S AMD risk polymorphism displays increased polymerization and functional activity provides a rationale for the gene therapy trials of sCD59 to inhibit the terminal pathway of complement in AMD that are underway.
The objective of this study was to investigate players of club level Rugby Union (hereafter rugby) over one rugby season, for signs of residual cognitive dysfunction due to repeated concussive events ...incurred during long-term participation in the sport. Adult male players of club level rugby, without a diagnosis of a concussion during the season (n = 20), were compared with non-contact club level sports participants (n = 22) of equivalent sex, age, education, and estimated IQ at pre-, mid-, and post-season intervals. Measures included the ImPACT Verbal Memory, Visual Memory, Visual Motor Speed and Reaction Time composites, and the Purdue Pegboard test. Statistical group comparisons revealed consistently poorer performance for rugby players compared with controls for ImPACT Visual Motor Speed and Reaction Time composites at all test intervals, and for the Purdue Pegboard tasks at the first two test intervals. Repeat measures comparisons across the three test intervals demonstrated differential learning patterns between groups on ImPACT Visual Memory, ImPACT Reaction Time, and Purdue Both tasks, suggestive of cognitive vulnerability in the rugby group. Overall, the results reveal deleterious cognitive performance in adult club level rugby players relative to equivalent noncontact sports controls. The finding serves to endorse indications from other studies that demonstrate persistent brain injury effects in association with long-term participation in a contact sport. Recommendations for further research and management of concussion in rugby players are discussed.
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