It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants' perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened

Short communication. Secondary dormancy in Diplotaxis erucoides: a possible adaptative strategy as an annual weed

The germination of stored Diplotaxis erucoides seed was studied under controlled conditions of temperature and light by conducting germination tests over three years after collection. The D. erucoides seed was not dormant at harvest, but secondary dormancy appeared during storage as indicated by reduced germination 12 months after collection (from 92% down to 39%). This could be overcome by prolonged storage or by the use of gibberellic acid. Such shifts between dormancy and non-dormancy can be interpreted in terms of the soil seed bank dynamics in relation to intraspecific competition and/or with its adaptation as an annual weed in periodically disturbed soil in cultivated areas.Se estudió la evolución de la germinación/dormición de semillas de Diplotaxis erucoides mediante ensayos periódicos en condiciones controladas (temperatura y luz), durante tres años desde el momento de su recolección. Las semillas recién recolectadas no presentaron dormición, pero a los 12 meses apareció una dormición secundaria (la germinación disminuyó de un 92% a un 32%), desapareciendo posteriormente durante el almacenamiento o mediante aplicaciones exógenas de ácido giberélico. Los cambios entre estado no durmiente y durmiente de las semillas se interpretan como una dinámica de las semillas en el banco del suelo, como posible estrategia relacionada con la competición intraespecífica y su adaptación como mala hierba anual

Short communication. Secondary dormancy in Diplotaxis erucoides: a possible adaptative strategy as an annual weed

The germination of stored Diplotaxis erucoides seed was studied under controlled conditions of temperature and light by conducting germination tests over three years after collection. The D. erucoides seed was not dormant at harvest, but secondary dormancy appeared during storage as indicated by reduced germination 12 months after collection (from 92% down to 39%). This could be overcome by prolonged storage or by the use of gibberellic acid. Such shifts between dormancy and non-dormancy can be interpreted in terms of the soil seed bank dynamics in relation to intraspecific competition and/or with its adaptation as an annual weed in periodically disturbed soil in cultivated areas.Se estudió la evolución de la germinación/dormición de semillas de Diplotaxis erucoides mediante ensayos periódicos en condiciones controladas (temperatura y luz), durante tres años desde el momento de su recolección. Las semillas recién recolectadas no presentaron dormición, pero a los 12 meses apareció una dormición secundaria (la germinación disminuyó de un 92% a un 32%), desapareciendo posteriormente durante el almacenamiento o mediante aplicaciones exógenas de ácido giberélico. Los cambios entre estado no durmiente y durmiente de las semillas se interpretan como una dinámica de las semillas en el banco del suelo, como posible estrategia relacionada con la competición intraespecífica y su adaptación como mala hierba anual

Genome-wide association study identifies a functional SIDT2 variant associated with HDL-C (High-Density Lipoprotein Cholesterol) levels and premature coronary artery disease

OBJECTIVE: Low HDL-C (high-density lipoprotein cholesterol) is the most frequent dyslipidemia in Mexicans, but few studies have examined the underlying genetic basis. Our purpose was to identify genetic variants associated with HDL-C levels and cardiovascular risk in the Mexican population. - APPROACH & RESULTS:A genome-wide association studies for HDL-C levels in 2335 Mexicans, identified four loci associated with genome-wide significance: CETP, ABCA1, LIPC, and SIDT2. The SIDT2 missense Val636Ile variant was associated with HDL-C levels and was replicated in 3 independent cohorts (P=5.9×10−18 in the conjoint analysis). The SIDT2/Val636Ile variant is more frequent in Native American and derived populations than in other ethnic groups. This variant was also associated with increased ApoA1 and glycerophospholipid serum levels, decreased LDL-C (low-density lipoprotein cholesterol) and ApoB levels, and a lower risk of premature CAD. Because SIDT2 was previously identified as a protein involved in sterol transport, we tested whether the SIDT2/Ile636 protein affected this function using an in vitro site-directed mutagenesis approach. The SIDT2/Ile636 protein showed increased uptake of the cholesterol analog dehydroergosterol, suggesting this variant affects function. Finally, liver transcriptome data from humans and the Hybrid Mouse Diversity Panel are consistent with the involvement of SIDT2 in lipid and lipoprotein metabolism. - CONCLUSIONS:This is the first genome-wide association study for HDL-C levels seeking associations with coronary artery disease in the Mexican population. Our findings provide new insight into the genetic architecture of HDL-C and highlight SIDT2 as a new player in cholesterol and lipoprotein metabolism in humans

Trimethylamine N-oxide levels are associated with NASH in obese subjects with type 2 diabetes.

AIMS: Trimethylamine N-oxide (TMAO), choline and betaine serum levels have been associated with metabolic diseases including type 2 diabetes (T2D) and non-alcoholic fatty liver disease (NAFLD). These associations could be mediated by insulin resistance. However, the relationships among these metabolites, insulin resistance and NAFLD have not been thoroughly investigated. Moreover, it has recently been suggested that TMAO could play a role in NAFLD by altering bile acid metabolism. We examined the association between circulating TMAO, choline and betaine levels and NAFLD in obese subjects. METHODS: Serum TMAO, choline, betaine and bile acid levels were measured in 357 Mexican obese patients with different grades of NAFLD as determined by liver histology. Associations of NAFLD with TMAO, choline and betaine levels were tested. Moreover, association of TMAO levels with non-alcoholic steatohepatitis (NASH) was tested separately in patients with and without T2D. RESULTS: TMAO and choline levels were significantly associated with NAFLD histologic features and NASH risk. While increased serum TMAO levels were significantly associated with NASH in patients with T2D, in non-T2D subjects this association lost significance after adjusting for sex, BMI and HOMA2-IR. Moreover, circulating secondary bile acids were associated both with increased TMAO levels and NASH. CONCLUSIONS: In obese patients, circulating TMAO levels were associated with NASH mainly in the presence of T2D. Functional studies are required to evaluate the role of insulin resistance and T2D in this association, both highly prevalent in NASH patients