Since leprosy is both treated and controlled by multidrug therapy (MDT) it is important to monitor recurrent cases for drug resistance and to distinguish between relapse and reinfection as a means of ...assessing therapeutic efficacy. All three objectives can be reached with single nucleotide resolution using next generation sequencing and bioinformatics analysis of Mycobacterium leprae DNA present in human skin.
DNA was isolated by means of optimized extraction and enrichment methods from samples from three recurrent cases in leprosy patients participating in an open-label, randomized, controlled clinical trial of uniform MDT in Brazil (U-MDT/CT-BR). Genome-wide sequencing of M. leprae was performed and the resultant sequence assemblies analyzed in silico.
In all three cases, no mutations responsible for resistance to rifampicin, dapsone and ofloxacin were found, thus eliminating drug resistance as a possible cause of disease recurrence. However, sequence differences were detected between the strains from the first and second disease episodes in all three patients. In one case, clear evidence was obtained for reinfection with an unrelated strain whereas in the other two cases, relapse appeared more probable.
This is the first report of using M. leprae whole genome sequencing to reveal that treated and cured leprosy patients who remain in endemic areas can be reinfected by another strain. Next generation sequencing can be applied reliably to M. leprae DNA extracted from biopsies to discriminate between cases of relapse and reinfection, thereby providing a powerful tool for evaluating different outcomes of therapeutic regimens and for following disease transmission.
Interleukin 7 (IL-7) and its receptor, formed by IL-7Rα (encoded by IL7R) and γc, are essential for normal T-cell development and homeostasis. Here we show that IL7R is an oncogene mutated in T-cell ...acute lymphoblastic leukemia (T-ALL). We find that 9% of individuals with T-ALL have somatic gain-of-function IL7R exon 6 mutations. In most cases, these IL7R mutations introduce an unpaired cysteine in the extracellular juxtamembrane-transmembrane region and promote de novo formation of intermolecular disulfide bonds between mutant IL-7Rα subunits, thereby driving constitutive signaling via JAK1 and independently of IL-7, γc or JAK3. IL7R mutations induce a gene expression profile partially resembling that provoked by IL-7 and are enriched in the T-ALL subgroup comprising TLX3 rearranged and HOXA deregulated cases. Notably, IL7R mutations promote cell transformation and tumor formation. Overall, our findings indicate that IL7R mutational activation is involved in human T-cell leukemogenesis, paving the way for therapeutic targeting of IL-7R-mediated signaling in T-ALL.
Twin pregnancy was associated with significantly higher rates of adverse neonatal and perinatal outcomes, especially for the second twin. In addition, the maternal complications (potentially ...life-threatening conditions-PLTC, maternal near miss-MNM, and maternal mortality-MM) are directly related to twin pregnancy and independently associated with adverse perinatal outcome. The objective of the preset study is to evaluate perinatal outcomes associated with twin pregnancies, stratified by severe maternal morbidity and order of birth.
Secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS), a cross-sectional study implemented in 29 countries. Data from 8568 twin deliveries were compared with 308,127 singleton deliveries. The occurrence of adverse perinatal outcomes and maternal complications were assessed. Factors independently associated with adverse perinatal outcomes were reported with adjusted PR (Prevalence Ratio) and 95%CI.
The occurrence of severe maternal morbidity and maternal death was significantly higher among twin compared to singleton pregnancies in all regions. Twin deliveries were associated with higher rates of preterm delivery (37.1%), Apgar scores less than 7 at 5th minute (7.8 and 10.1% respectively for first and second twins), low birth weight (53.2% for the first and 61.1% for the second twin), stillbirth (3.6% for the first and 5.7% for the second twin), early neonatal death (3.5% for the first and 5.2% for the second twin), admission to NICU (23.6% for the first and 29.3% for the second twin) and any adverse perinatal outcomes (67% for the first twin and 72.3% for the second). Outcomes were consistently worse for the second twin across all outcomes. Poisson multiple regression analysis identified several factors independently associated with an adverse perinatal outcome, including both maternal complications and twin pregnancy.
Twin pregnancy is significantly associated with severe maternal morbidity and with worse perinatal outcomes, especially for the second twin.
Per- and polyfluoroalkyl substances (PFAS) are a class of highly persistent contaminants that have been linked to human health effects at low exposure concentrations. Public concerns exist that ...land-application of biosolids may result in the release of PFAS into terrestrial and aquatic ecosystems. The relative importance of inorganic constituents such as Fe and Al, which are known to impact PFAS retention/release behavior in soils, on PFAS release from wastewater residuals (WWRs, i.e., biosolids and sewage sludges) is not well understood. Here, we examine native concentrations and WWR-water partition coefficients of a range of PFAS in the context of WWRs characteristics including oxalate-extractable Fe and Al, organic matter (OM), dissolved organic carbon, and total protein content. Total PFAS concentrations, which included perfluoroalkyl carboxylates, perfluoroalkyl sulfonates, fluorotelomer sulfonates and some sulfonamides, ranged from ∼480 to 3500 μg PFAS kg−1 dry weight. PFAS WWR-water partition coefficients ranged from ∼10 to 20,000 L kg−1, consistent with the literature. PFAS partitioning was significantly correlated to oxalate extractable Al and Fe as well as bulk OM and protein content. These results have important implications for wastewater treatment facilities that recycle Al- and Fe-based drinking water treatment residuals in terms of both PFAS retention and loading.
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•PFAS partitioning correlated with organic matter and protein content.•However, PFAS partitioning also corelated with oxalate Fe and Al content.•Potential greater partitioning to biosolids in facilities recycling water treatment residuals.
To evaluate the surgical rehabilitation of cleft lip and/or palate by the Brazilian public health system.
Retrospective, analytical and comparative ecological study, with information on hospital ...procedures performed on individuals with cleft lip and/or palate in Centers authorized by the Brazilian public health system, between the years 2008 and 2020. The information was collected in databases Ministry of Health data.
Between 2008 and 2020, there was an increase of 8 (36.4%) qualified Centers in Brazil, currently having 30 Centers in 100% of the geographic regions. The surgical procedures performed totaled 68,716; with multiple surgeries being the most frequent. Complete cleft lip and palate was the most frequent type in hospital admissions. The public financial resources invested in the surgical rehabilitation of cleft lip and palate in the qualified Lip and Palate Malformation Treatment Centers were US$ 39,693 million, making an average value per procedure of US$ 577.64.
In Brazil, public health system performed and financed, over the years 2008 and 2020, an important volume of surgical procedures for cleft lip and/or palate, which presented a polarization in the Southeast region but with a slight tendency expansion to other regions of the country. The most performed surgical procedures were multiple surgeries and mostly for individuals with cleft lip and palate. The amounts paid showed a heretogeneous distribution in the national territory.
Level 5: Report containing program evaluation data.
Background and aims
Prescribed fire is a common management practice in native rangelands that can result in significant losses of C, N, and P from plant and soil. This study evaluated the short-term, ...fire-induced changes in C, N, and P stocks in subtropical native rangelands in Florida, USA.
Methods
Changes in C, N, and P stocks were quantified in aboveground biomass and soil (0-20 cm depth) in locations within native rangelands dominated by either saw-palmetto (
Serenoa repens
Bartr.; Saw-palmetto) or grasses (mixed C
4
grasses; Grass).
Results
Prescribed fire had no impact on soil temperature below 2.5 cm, but peak temperature at soil surface was greater in Saw-palmetto than Grass areas. Despite greater pre-fire aboveground biomass in Saw-palmetto (1115 g m
−2
) vs. Grass (689 g m
−2
), no difference in post-fire net loss (−660 g m
−2
) was observed between vegetation types. This occurred because 97% of biomass in Grass was combusted during fire vs. 65% in Saw-palmetto dominated areas. Similar responses were observed for aboveground C and P stocks. Fire-induced N loss was greater in Saw-palmetto (−6 g N m
−2
) than grass (−2.7 g N m
−2
). Soil C, N, and P stocks were not affected by prescribed fire. This was likely due to limited effects of prescribed fire on soil temperature. Although fire had no effect on soil respiration, ash addition increased soil potentially mineralizable C by 11%.
Conclusion
Prescribed fire reduces C, N, and P stocks in aboveground vegetation, but limited impacts are expected to occur in soil pools.
Abstract
Inflammatory states and body composition changes are associated with a poor prognosis in many diseases, but their role in coronavirus disease 2019 (COVID-19) is not fully understood. To ...assess the impact of low skeletal muscle radiodensity (SMD), high neutrophil-to-lymphocyte ratio (NLR) and a composite score based on both variables, on complications, use of ventilatory support, and survival in patients with COVID-19. Medical records of patients hospitalized between May 1, 2020, and July 31, 2020, with a laboratory diagnosis of COVID-19 who underwent computed tomography (CT) were retrospectively reviewed. CT-derived body composition measurements assessed at the first lumbar vertebra level, and laboratory tests performed at diagnosis, were used to calculate SMD and NLR. Prognostic values were estimated via univariate and multivariate logistic regression analyses and the Kaplan–Meier curve. The study was approved by the local Institutional Review Board (CAAE 36276620.2.0000.5404). A total of 200 patients were included. Among the patients assessed, median age was 59 years, 58% were men and 45% required ICU care. A total of 45 (22.5%) patients died. Multivariate logistic analysis demonstrated that a low SMD (OR 2.94; 95% CI 1.13–7.66,
P
= 0.027), high NLR (OR 3.96; 95% CI 1.24–12.69,
P
= 0.021) and both low SMD and high NLR (OR 25.58; 95% CI 2.37–276.71,
P
= 0.008) combined, were associated with an increased risk of death. Patients who had both low SMD and high NLR required more mechanical ventilation (
P
< 0.001) and were hospitalized for a longer period (
P
< 0.001). Low SMD, high NLR and the composite score can predict poor prognosis in patients with COVID-19, and can be used as a tool for early identification of patients at risk. Systemic inflammation and low muscle radiodensity are useful predictors of poor prognosis, and the assessment of these factors in clinical practice should be considered.
Removal of polycyclic aromatic hydrocarbons (PAHs) from petrochemical wastewater was investigated using various low-cost adsorbents of natural origin including sugar cane bagasse, green coconut ...shells, chitin, and chitosan. Adsorption experiments of mixtures of PAHs (5.0–15.0
mg/L) have been carried out at ambient temperature (28
±
2
°C) and pH 7.5. The adsorption isotherms of PAHs were in agreement with a Freundlich model, while the uptake capacity of PAHs followed the order: green coconut shells
>
sugar cane bagasse
>
chitin
>
chitosan. The adsorption properties of green coconut shells were comparable to those of some conventional adsorbents such as Amberlite T. The partition coefficients in acetone:water, the adsorption constants at equilibrium, and the molecular masses of the PAHs could be linearly correlated with octanol–water partition coefficients.
Pasture management can have important implications on the amounts and long-term stability of soil organic carbon (SOC). We investigated the short-term impacts of grazing intensity and nitrogen (N) ...fertilization levels on C dynamics into the various SOC pools in rotationally stocked ‘Tifton 85’ bermudagrass (Cynodon spp.) pastures. Treatments consisted of three grazing intensities (based on target postgraze stubble heights of 8, 16, and 24 cm) and three levels of N fertilization (50, 150, and 250 kg N ha−1 yr−1). Soil samples (0- to 20-cm depth) were taken prior to imposing treatments and at the end of the 2-yr study. Grazing intensity and N levels had no effect on bulk SOC and N concentration and content. Greater stubble height and rate of N fertilizer resulted in a linear increase in particulate organic carbon (POC) and C and N concentration in the <53-μm particle-size fraction. Grazing intensity and N fertilization showed significant effects on δ13C values and the relative amounts of C3-C vs. C4-C. The δ13C data indicated that readily decomposable C components (C4-derived C) were lost in response to more intensive grazing (stubble height of 8 cm). Results demonstrated that POC and C associated with <53 μm particle-size fraction were sensitive indicators of short-term impacts of pasture management strategies on SOC. Further studies are warranted to examine the long-term impacts of grassland management on SOC pools in sandy soils of subtropical regions.
► Soil organic C in grasslands is strongly influenced by management. ► Grazing intensity and N levels had no short-term effect on bulk soil carbon levels. ► Particulate organic carbon increased linearly as grazing intensity decrease. ► 13C data indicated that grazing intensity affects readily decomposable C. ► Pasture management can affect soil carbon fractions in as little as 2 yr.
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