Effects of essential oils from Cymbopogon spp. and Cinnamomum verum on biofilm and virulence properties of Escherichia coli O157:H7

Every year, the pharmaceutical and food industries produce over 1000 tons of essential oils (EOs) exploitable in different fields as the development of eco-friendly and safe antimicrobial inhibitors. In this work we investigated the potential of some EOs, namely Cinnamomum verum, Cymbopogon martini, Cymbopogoncitratus and Cymbopogon flexuosus, on the growth, biofilm formation and gene expression in four strains of enterohemorrhagic Escherichia coli O157:H7. All EOs were analyzed by gas chromatography-mass spectrometry (GC-MS). The antimicrobial activity was performed by using dilutions of EOs ranging from 0.001 to 1.2% (v/v). Subinhibitory doses were used for biofilm inhibition assay. The expression profiles were obtained by RT-PCR. E. coli O157:H7 virulence was evaluated in vivo in the nematode Caenorhabditis elegans. All EOs showed minimal inhibitory concentrations (MICs) ranging from 0.0075 to 0.3% (v/v). Cinnamomum verum bark EO had the best activity (MIC of 0.0075% (v/v) in all strains) while the C. verum leaf EO had an intermediate efficacy with MIC of 0.175% (v/v) in almost all strains. The Cymbopogon spp. showed the more variable MICs (ranging from 0.075 to 0.3% (v/v)) depending on the strain used. Transcriptional analysis showed that C. martini EO repressed several genes involved in biofilm formation, virulence, zinc homeostasis and encoding some membrane proteins. All EOs affected zinc homeostasis, reducing ykgM and zinT expression, and reduced the ability of E. coli O157:H7 to infect the nematode C. elegans. In conclusion, we demonstrated that these EOs, affecting E. coli O157:H7 infectivity, have a great potential to be used against infections caused by microorganisms

Deformation heterogeneity study of a 6061-T6 aluminum alloy processed by equal channel angular pressing

Among the severe plastic deformation techniques, the equal channel angular pressing (ECAP) has drastically improved the mechanical properties of the processed alloys. However, information regarding friction phenomenon, which modifies the deformation at the surface and the heterogeneity microstrain state produced by the process itself, is still scarce. In the present work, the deformation heterogeneity and the friction effect, at the surface in the bulk material of the 6061-T6 aluminum alloy processed by ECAP, is presented and discussed. The residual stress (RS) measurements were performed by means of X-Ray diffraction. By means of synchrotron diffraction, volumetric sections of the ECAPed samples were characterized. Finite element analysis showed a good agreement with the experimentally obtained residual stress and microhardness mapping results. The study also showed that the highest deformation zones were located at the outer parts of the deformed samples (top and bottom), while the inner zone showed strain oscillations of up to 49±2 MPa.Peer ReviewedPostprint (author's final draft

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Microbiological analysis of bacterial plaque on three different threads in oral surgery

BACKGROUND: Suture is the final act of most oral surgery procedures. The quality of healing after the operation depends on its efficiency. Sutures must not cause inflammation \u2014 neither directly nor indirectly. The objective of this study is to compare the bacterial colonization on different suture materials after a third molar extraction. METHODS: Thirty patients were randomly selected among people going under third molar extraction; they were divided into 3 groups and one suture type was used on each group. After 7 days distal stitches were removed by a single operator, placed in physiologic solution and analyzed after 2 or 3 hours. Patients followed the same postsurgical protocols; materials used were: Ethicon Silk\uae 4/0, B. Braun Dafilon\uae 4/0, and B. Braun Safil\uae 4/0. RESULTS: The amount of cocci and bacilli on the sutures analyzed shows that silk (Ethicon Silk) is the higher level of retention material where monofilament (B. Braun Dafilon) is the lower. There is a difference between monofilament and polyglycolide (B. Braun Safil), as the former is less retentive than the latter, although not significantly so. CONCLUSIONS: A less plaque retention, and consequently a fewer bacterial presence, is crucial to minimize the inflammatory process and allow a better tissue healing. Since the capability of brushing and, of course, the final personal hygiene depends on multiple variables, we must use surgical protocols able to minimize the effect of improper cleaning on the healing process: this statement implies the use of low plaque retention materials. The use of monofilament or polyglycolide threads in sutures can help reducing bacterial concentration and therefore promotes a faster and better healing

Early triggering of natural killer and dendritic cell during antitumor therapeutic response induced by TNFa tumor vessel delivery and melphalan

PURPOSE: A systemic administration of L19mTNFa selectively targets the tumor vasculature, and in combination with melphalan is able to induce a long-lasting therapeutic response and immune T cell memory in two tumor mice models: WEHI-164 fibrosarcoma, that respond well to the therapy (85%), and C51 colon carcinoma, low cured which showed a poor response to therapy (30%). The combined treatment was exploited to determine the role of NK, DC and macrophages in WEHI-164 and C51 tumors. METHODS: The induced-immune responses were investigated by flow cytometry, intracellular immunostaining, chromium release cytotoxicity and FACS cell sorting. RESULTS: We found that 40h after L19TNFa/melphalan treatment in the WEHI-164, tumor-derived lymph nodes (TDLN) display an increased number of mature CD40+CD86+ DC, functional NK cells, CD4+ and CD8+ T cells as compared to LN of untreated mice. In the spleens of treated WEHI-164-bearing mice, we also observed TH1 cell polarization, CD8+ T cell activation and an increase in cytotoxic NK cells. With L19TNFa/melphalan treatment, increased mature DC were found among the immune cells infiltrating the tumors in conjunction with NK, CD4 and CD8 T cells, as compared to control mice early on after the combined treatment. Otherwise, in the TDLN of treated C51 tumor-bearing mice, neither a significant influx of mature DC, nor activation of NK cells was observed. In the spleens there was no activation of NK cells and a high MDSC population. Interestingly in both tumor models, a significant decrease of infiltrating M2-type macrophages was detected after the treatment. DISCUSSION AND CONCLUSIONS: These results strongly suggest that the success of L19TNFa/melphalan is related, in addition to the previous reported T cell responses, to the early activation and polarization of NK and DC. BIBLIOGRAPHY: L. Mortara, et al., Cancer Med. 2013. L. Mortara, et al., Eur. J. Immunol. 2007. L. Mortara, et al., Clin. Cancer Res. 2006