Design and Calibration of an Organic Diffusive Probe to Extend the Diffusion Gradient Technique to Organic Pollutants

The objective of this study was to develop a method for measuring the mobility of persistent organic pollutants in the solid phase of soils within the context of environmental pollution risk assessment. A new diffusive probe, purposely designed by adapting the diffusive gradient technique method, measures labile organic species by immobilizing them after diffusion through a thin deionized water layer. The measure of the mass accumulated is used to calculate the flow of pollutant from solid phase to pore water. Naphthalene was chosen as a model persistent organic pollutant. The probe was calibrated at different temperatures and was then tested in several microcosms at different porosity and reactivities with naphthalene (one clay soil, two sandy soils and one natural soil). The probe response showed good agreement with the expected different abilities of the solid phases in restoring the solution phase. The concentration of naphthalene in the pore water was well buffered by rapid equilibria with the solid phase in the investigated natural soil. In contrast, pore water concentration in the sandy soils decreased rapidly and the flow was slackened, especially for the sandy soil with finer particles. In clay, only a fraction of the total naphthalene content was present in the labile fraction, while the remaining was tightly bound and was not released to the pore water. Therefore, this first stage of testing points out that the diffusive gradient technique, if optimized, can properly quantify the mobility of organic pollutants in soil

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Molecular mechanisms of quinolone resistance in clinical isolates of Aeromonas caviae and Aeromonas veronii bv. sobria

Mutations in quinolone targets were studied together with quinolone efflux pump activation and plasmid-mediated quinolone resistance determinants in nalidixic-acid-resistant isolates of Aeromonas caviae and Aeromonas veronii. Among 135 clinical Aeromonas spp. isolated from stools of patients with gastrointestinal symptoms, 40 nalidixic acid-resistant strains belonging to A. caviae and A. veronii were selected and their susceptibility to different quinolones (ciprofloxacin, norfloxacin, ofloxacin) further evaluated. Susceptibility to nalidixic acid and ciprofloxacin in the presence/absence of Phe- Arg-β-naphthylamide was also determined. The 16 nalidixic-acid-resistant strains identified as A. caviae were more resistant than the 24 A. veronii bv. sobria strains to ciprofloxacin, norfloxacin, and ofloxacin. All strains showed a mutation (single or double) at position 83 of the QRDR sequence of gyrA, with Ser-83 → Ile as the most frequent substitution. By contrast, no mutations were found at position 87 of gyrA. Double substitutions (GyrA-ParC) were detected in 50% of A. veronii bv. sobria isolates and in 43.75% of A. caviae strains. Both species showed decreases in the MICs of ciprofloxacin. A qnrS gene was found in an A. caviae strain. Thus, in the two species of nalidixic-acid-resistant Aeromonas isolates examined, resistance mediated by efflux pumps contributed only slightly to ciprofloxacin resistance. While two isolates were positive for the aac(6′)-Ib gene, no -cr variants were detected. [Int Microbiol 2010; 13(3):135-141

Influencia del transporte fluvial de sedimentos sobre la evolución de una laguna costera

Mexican shores have about 130 lagoon systems. The main economical activities in these systems are relate to the shrimp fisheries. Such activities have been suffered from an improper watershed management, that have resulted, among others, in an increase in the sediment rate within the lagoons. As a point to start in watershed mangement studies, is the knowledgement of the erosion-sedimentation processes within the basin and the lagoon. Such knowledgement is here presented for the Sontecomapan system. The rate of erosion within watershed was estimated using the Universe Equation, while the sedimentation in the lagoon was estimated by field measurements.El litoral mexicano cuenta con más de 130 sistemas lagunares costeros con una dinámica marítima-continental. Estos sistemas albergan especies pesqueras comerciales, sobre las que se desarrolla gran parte de la actividad económica. En los últimos años, las lagunas costeras han padecido procesos de azolvamiento, debido a erosión-transporte-sedimentación, derivado del cambio en el uso del suelo y a la inducción de prácticas agrícolas inadecuadas en las cuencas de aporte. El manejo de cuencas hidrológicas es una técnica que permite equilibrar la producción agrícola, las capacidades de la cuenca y los impactos fuera de ella; cuantifica los recursos suelo, agua y planta, para determinar la dinámica interelacional entre recursos. La modelación numérica realiza las cuantificaciones requeridas y permite extrapolar las condiciones en las cuales una cuenca entra en crisis o afecta a los sistemas subsecuentes. En este trabajo se realizó la simulación numérica del proceso erosión-sedimentación entre la cuenca de aporte y su laguna costera de recepción, como un primer elemento para establecer el manejo, conservación y restauración del sistema lagunar. Los resultados muestran un fuerte dependencia entre los procesos físicos que padece la cuenca y el azolvamiento de la laguna, la predominancia de las condiciones continentales sobre las marítimas y por consiguiente, el manejo de la cuenca como alternativa de recuperación

Current and historical factors drive variation of reproductive traits in unisexual mosses in Europe : A case study

Unisexual bryophytes provide excellent models to study the mechanisms that regulate the frequency of sexual versus asexual reproduction in plants, and their ecological and evolutionary implications. Here, we determined sex expression, phenotypic sex ratio, and individual shoot traits in 242 populations of the cosmopolitan moss Pseudoscleropodium purum spanning its whole distributional range. We tested whether niche differentiation, sex-specific differences in shoot size, and biogeographical history explained the spatial variation of reproductive traits. We observed high levels of sex expression and predominantly female-biased populations, although both traits showed high intraspecific variation among populations. Sex expression and sex ratio were partly explained by current macroscale environmental variation, with male shoots being less frequent at the higher end of the environmental gradients defined by the current distribution of the species. Female bias in population sex ratio was significantly lower in areas recolonized after the last glacial maximum (recent populations) than in glacial refugia (long-term persistent populations). We demonstrated that reproductive trait variation in perennial unisexual mosses is partially driven by macroscale and historical environmental variation. Based on our results, we hypothesize that sexual dimorphism in environmental tolerance and vegetative growth contribute to sex ratio bias over time, constraining the chances of sexual reproduction, especially in long-term persistent populations. Further studies combining genetic analyses and population monitoring should improve our understanding of the implications of the intraspecific variation in the frequency of sexual versus asexual reproduction in bryophyte population fitness and eco-evolutionary dynamics

Antimicrobial resistance phenotypes and genotypes of methicillin-resistant Staphylococcus aureus CC398 isolates from Spanish hospitals

Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) of lineage CC398 is an emerging clone causing human infections but is mostly found in pigs. The aim of this study was to characterize the antimicrobial resistance phenotypes/genotypes of a collection of 137 MRSA CC398 isolates obtained in a previous study from 17 Spanish hospitals, using tetracycline resistance as marker for selection. A multidrug-resistant (MDR) phenotype was present in 79% of analysed isolates, with 17% of them resistant to at least six different antimicrobial families. All tetracycline-resistant isolates (n=137) carried the tetM gene and 75% also carried the tetK gene. Almost 50% of MRSA CC398 isolates showed macrolide and/or lincosamide resistance: a) 39% of isolates were ERYR-CLIR (all with constitutive phenotype), with 87% of them carrying the ermC gene, followed by msrA (25%), ermB (21%), vgaA (17%), ermA (6%), lsaB (4%), linA (2%), linB (2%), and ermT (2%, this isolate with the new spa-type t18071); and b) 9% of MRSA CC398 isolates showed the dissociated ERYS-CLIR phenotype carrying the linA, linB, lsaB and vgaA genes. Other antimicrobial resistance phenotypes in these MRSA CC398 isolates included resistance to ciprofloxacin (67%), aminoglycosides (21%), mupirocin (6%), chloramphenicol (4%) or fusidic acid (2%). The more common resistance genes detected for some of these antimicrobials were: aac(6’)-Ie-aph(2’’)-Ia (16%) and ant(4’)-Ia (12%) for aminoglycosides, and fexA (3%) for chloramphenicol. The high rate of MDR phenotypes with a wide range of antimicrobial resistance genes shown in this study reduce the potential therapeutic options in case of infections.This work was supported by the Agencia Estatal de Investigación (AEI) of Spain (project SAF2016-76571-R), the Fondo Europeo de Desarrollo Regional (FEDER) of the EU, and the Sociedad de Enfermedades Infecciosas del Norte (SEINORTE). Sara Ceballos and Laura Ruiz-Ripa had predoctoral fellowships of the University of La Rioja (Spain) during the experimental part of the study