Microbial plankton communities do not always respond to inorganic nutrient additions in coastal waters off NW Spain. However, enhanced growth of phytoplankton and heterotrophic bacteria has been ...observed when exposed to both inorganic (nitrate, ammonium and phosphate) and organic (amino acids and glucose) nutrient amendments, suggesting the existence of a coupling between both microbial compartments. The aim of this paper was to assess the role of the phytoplankton-bacterioplankton coupling in the response of primary producers to nutrient additions. Changes in bacterial production (BP), primary production, and chlorophyll a concentration were measured after different nutrient addition treatments on natural microbial communities where bacterial activity was blocked with antibiotics. The results obtained in this study show that phytoplankton biomass and production respond only to the nutrient inputs when heterotrophic bacteria are active. The response of coastal microbial plankton to nutrient inputs might thus be eventually dependent on the BP of secondary metabolites necessary for phytoplankton growth (e.g. B-12 vitamin).
Maternal obesity is associated with complications of pregnancy and increases the infant’s risk of developing obesity, diabetes and cardiovascular disease later in life. The placenta has an important ...role in determining the pregnancy outcome, and the syncytiotrophoblast (ST) is the main component of the placenta that supports the relationship between the mother and fetus. The differentiation of the cytotrophoblast (CT) into the ST is accompanied by changes in mitochondrial functions and dynamics. The objective of the present study was to investigate the effects of maternal obesity (without gestational diabetes) on the in vitro differentiation capacities of human CT isolated from term placenta by focusing on mitochondrial status. We found that, during human CT differentiation process, maternal obesity is associated with (i) a lower progesterone secretion, (ii) a transient impairment in the ST’s fusion potential (via syncytin-2 and its receptor), (iii) a lower mitochondrial content, and (iv) weaker mRNA expression of oestrogen-related receptor-gamma (a key mitobiogenesis gene). Moreover, maternal obesity altered the time course of ATP and reactive oxygen species production throughout CT differentiation. The mitochondrial dysfunctions observed in isolated human CTs of obese women might explain the observed decrease in progesterone production. Our results demonstrated that obesity in pregnancy is associated with a functional impairment of the ST which might alter the foetal-maternal dialogue.
Decades of pharmacogenetic research have revealed genetic biomarkers of clinical response to antipsychotics. Genetic variants in antipsychotic targets, dopamine and serotonin receptors in particular, ...and in metabolic enzymes have been associated with the efficacy and toxicity of antipsychotic treatments. However, genetic prediction of antipsychotic response based on these biomarkers is far from accurate. Despite the clinical validity of these findings, the clinical utility remains unclear. Nevertheless, genetic information on CYP metabolic enzymes responsible for the biotransformation of most commercially available antipsychotics has proven to be effective for the personalisation of clinical dosing, resulting in a reduction of induced side effects and in an increase in efficacy. However, pharmacogenetic information is rarely used in psychiatric settings as a prescription aid. Lack of studies on cost-effectiveness, absence of clinical guidelines based on pharmacogenetic biomarkers for several commonly used antipsychotics, the cost of genetic testing and the delay in results delivery hamper the implementation of pharmacogenetic interventions in clinical settings. This narrative review will comment on the existing pharmacogenetic information, the clinical utility of pharmacogenetic findings, and their current and future implementations.
We report the emergence of an isolate belonging to the sequence type (ST)131-
high-risk clone with ceftazidime-avibactam resistance recovered from a patient with bacteremia in 2019. Antimicrobial ...susceptibility was determined and whole genome sequencing (Illumina-NovaSeq6000) and cloning experiments were performed to investigate its resistance phenotype. A KPC-3-producing
isolate susceptible to ceftazidime-avibactam (MIC = 0.5/4 mg/L) and with non-wild type MIC of meropenem (8 mg/L) was detected in a blood culture performed at hospital admission. Following 10-days of standard ceftazidime-avibactam dose treatment, a second KPC-producing
isolate with a phenotype resembling an extended-spectrum β-lactamase (ESBL) producer (meropenem 0.5 mg/L, piperacillin-tazobactam 16/8 mg/L) but resistant to ceftazidime-avibactam (16/4 mg/L) was recovered. Both
isolates belonged to ST131, serotype O25:H4 and sublineage H30R1. Genomics analysis showed a
genome of 5,203,887 base pair with an evolutionary distance of 6 single nucleotide polymorphisms. A high content of resistance and virulence genes was detected in both isolates. The novel KPC-49 variant, an Arg-163-Ser mutant of
, was detected in the isolate with resistance to ceftazidime-avibactam. Cloning experiments revealed that
gene increases ceftazidime-avibactam MIC and decreases carbapenem MICs when using a porin deficient
strain as a host. Both
and
genes were located on the transposon Tn
a as a part of an IncF F1:A2:B20 plasmid. The emergence of novel
genes conferring decreased susceptibility to ceftazidime-avibactam and resembling ESBL production in the epidemic ST131-H30R1-
high-risk clone presents a new challenge in clinical practice.
The purpose of this study was to develop, build, and implement a virtual platform equipped with practical tools, relevant contents, and communication rooms, with the aim of facilitating patients' ...self-management of type 1 diabetes mellitus (T1DM).
The design of the platform was based on the suggestions of T1DM patients who were being managed at two reference hospitals. Patients' needs and preferences were identified in group discussion sessions. Before having access to the platform, patients underwent a baseline assessment, which included physical examination and the administration of validated questionnaires for evaluation of clinical background, quality of life, treatment satisfaction, and well-being.
A total of 33 patients were included in the study; 54.5% of them were men, their median age was 34 (18-50) years, the median duration of diabetes was 15 (1-38) years, and the median A1C was 7.4% (6%-12.6%). Based on their suggestions and requests, the online platform EncoDiab was built and organized into four domains: a personal domain, two domains shared by the patients and the staff of each of the two participating hospitals, and one domain that was accessible to all participants. The platform included practical tools (a body mass index calculator, a carbohydrate counting tool, and an insulin-dose calculator), a library with relevant information (documents on prevention and treatment of acute complications, nutrition, exercise, etc), and a chat room.
Although the study is still ongoing, our current results demonstrate the feasibility of building and implementing an online platform for helping T1DM patients in the self-management of their disease in the public health setting.
To evaluate the influence of conventional rehabilitation combined with virtual reality on improving quality of life related to post-stroke health.
Randomized controlled trial.
Rehabilitation and ...neurology departments of a general hospital (Talavera de la Reina, Spain).
A total of 43 participants with subacute stroke.
Participants were randomized into experimental group (conventional treatment + virtual reality) and control (conventional treatment).
Health-related quality of life as measured by the EuroQoL-5 dimensions instrument (EQ-5D-5L) and EuroQoL visual analog scale (EQ-VAS).
A total of 23 patients in the experimental group (62.6 ± 13.5 years) and 20 in the control (63.6 ± 12.2 years) completed the study. In the experimental group, EQ-VAS score was 29.1 ± 12.8 at baseline, 86.5 ± 7.1 post-intervention, and 78.3 ± 10.3 at the three-month follow-up. The control group obtained scores of 25.5 ± 5.1, 57.0 ± 4.7, and 58.5 ± 5.9, respectively. We identified significant differences at the post-intervention and follow-up timepoints (
= 0.000) and a partial η
of 0.647. In EQ-5D-5L, the severity of issues decreased after intervention in the experimental group, while pain and anxiety dimensions increased between post-intervention and follow-up.
The conventional rehabilitative approach combined with virtual reality appears to be more effective for improving the perceived health-related quality of life in stroke survivors.
There are several position statements and clinical practice guidelines (CPG) for diagnosing dementia.
Our aims were to evaluate the adherence to CPG among specialists in the 7 memory clinics included ...in the Registry of Dementias of Girona (ReDeGi), and to compare the results between 2007-2011 and 2012-2015. We also determined the time and number of visits required to achieve a diagnosis, the supplementary tests ordered, and the drugs prescribed according to dementia subtypes.
Medical charts of a stratified random sample of 475 ReDeGi cases were reviewed. Basic dementia work-up was evaluated using as a reference evidence-based CPG. An Index of Adherence (AI) was calculated using the following items in the medical chart: cognitive symptomatology; functional disability evaluation; physical examination; neurological examination; psychiatric examination; brief cognitive examination; activities of daily living performance examination; blood test; structural neuroimaging (CT-scan or MRI).
The mean AI to CPG among specialists was of 8.2 points, and it improved from 7.9 points in 2007-2011 to 8.5 points in 2012-2015 (Cohen's d = 0.46). A lower adherence was detected in the most severe cases. A dementia diagnosis required 3.5 visits, regardless of the subtype of dementia, although milder cases required more time, more visits, and more supplementary tests than severe cases.
The adherence to CPG in the catchment area of the ReDeGi is high, and an epidemiological surveillance system such as the ReDeGi may help in improving it. Dementia guidelines should establish procedures adapted to clinical practice, with simplified recommendations for most severe cases.
Human endogenous retroviruses (HERVs) make up 8% of the human genome. The HERV-K (HML-2) family is the most recent group of these viruses to have inserted into the genome, and we have detected the ...activation of HERV-K (HML-2) proviruses in the blood of patients with HIV-1 infection. We report that HIV-1 infection activates expression of a novel HERV-K (HML-2) provirus, termed K111, present in multiple copies in the centromeres of chromosomes throughout the human genome yet not annotated in the most recent human genome assembly. Infection with HIV-1 or stimulation with the HIV-1 Tat protein leads to the activation of K111 proviruses. K111 is present as a single copy in the genome of the chimpanzee, yet K111 is not found in the genomes of other primates. Remarkably, K111 proviruses appear in the genomes of the extinct Neanderthal and Denisovan, while modern humans have at least 100 K111 proviruses spread across the centromeres of 15 chromosomes. Our studies suggest that the progenitor K111 integrated before the Homo-Pan divergence and expanded in copy number during the evolution of hominins, perhaps by recombination. The expansion of K111 provides sequence evidence suggesting that recombination between the centromeres of various chromosomes took place during the evolution of humans. K111 proviruses show significant sequence variations in each individual centromere, which may serve as markers in future efforts to annotate human centromere sequences. Further, this work is an example of the potential to discover previously unknown genomic sequences through the analysis of nucleic acids found in the blood of patients.
The continued spread of rabies in Indonesia poses a risk to human and animal populations in the remaining free islands, as well as the neighbouring rabies-free countries of Timor Leste, Papua New ...Guinea and Australia. Here we describe the development of a generic risk assessment tool which can be used to rapidly determine the vulnerability of rabies-free islands, so that scarce resources can be targeted to surveillance activities and the sensitivity of surveillance systems increased. The tool was developed by integrating information on the historical spread of rabies, anthropological studies, and the opinions of local animal health experts. The resulting tool is based on eight critical parameters that can be estimated from the literature, expert opinion, observational studies and information generated from routine surveillance. In the case study presented, results generated by this tool were most sensitive to the probability that dogs are present on private and fishing boats and it was predicted that rabies-infection (one infected case) might occur in a rabies-free island (upper 95% prediction interval) with a volume of 1000 boats movements. With 25,000 boat movements, the median of the probability distribution would be equal to one infected case, with an upper 95% prediction interval of six infected cases. This tool could also be used at the national-level to guide control and eradication plans. An initial recommendation from this study is to develop a surveillance programme to determine the likelihood that boats transport dogs, for example by port surveillance or regularly conducted surveys of fisherman and passenger ferries. However, the illegal nature of dog transportation from rabies-infected to rabies-free islands is a challenge for developing such surveillance.
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