Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Induction of resistance to tobacco necrosis virus in bean plants by certain microbial isolates

Four rhizosphere microorganisms (Bacillus globisporus, Candida glabrata, Pseudomonas fluorescens, and Streptomyces gibsonii) were isolated, identified, and tested for their capacity to protect Phaseolus vulgaris plants from tobacco necrosis virus (TNV) symptoms. Foliage treatment by the culture filtrate of each one of the four microbial isolates highly reduced the number of local lesions, while soil treatment by the same four microbial isolates showed lesser effects. Concerning foliage treatment, both Pseudomonas fluorescens and Streptomyces gibsonii culture filtrates showed the highest inhibitory effect to TNV infection (91.5 % and 97.2%, respectively). A number of de-novo synthesized proteins (induced proteins) was detected by Polyacrylamide-gel electrophoretic analysis in the culture-filtrate-treated bean leaves relative to the (water-treated) control. The determination of â-1,3-glucanase and peroxidase enzymatic activities in the extracted proteins showed high â-1,3-glucanase and peroxidase activities in the leaves treated with Pseudomonas fluorescens and Bacillus globisporus culture filtrates respectively, in contrast to the Candida glabrata culture-filtrate-treated leaves. However, Streptomyces gibsonii culture-filtrate-treated leaves showed the same enzymatic activities as that of the control. These results show that filtrates of the four rhizosphere microbial isolates reduced TNV incidence in bean plants through a process termed induced resistance (IR). However each microbial isolate could induce resistance by a distinct mechanism that was different from classic induced resistance against viral infection. KEY WORDS: Induced resistance, Viral infection, TNV, Rhizosphere microbial isolates. Egyptian Journal of Botany Vol.5 2003: 10-1

Purification and biochemical characterization of taxadiene synthase from bacillus koreensis and stenotrophomonas maltophilia

Taxadiene synthase (TDS) is the rate-limiting enzyme of Taxol biosynthesis that cyclizes the geranylgeranyl pyrophosphate into taxadiene. Attenuating Taxol productivity by fungi is the main challenge impeding its industrial application; it is possible that silencing the expression of TDS is the most noticeable genomic feature associated with Taxol-biosynthetic abolishing in fungi. As such, the characterization of TDS with unique biochemical properties and autonomous expression that is independent of transcriptional factors from the host is the main challenge. Thus, the objective of this study was to kinetically characterize TDS from endophytic bacteria isolated from different plants harboring Taxol-producing endophytic fungi. Among the recovered 23 isolates, Bacillus koreensis and Stenotrophomonas maltophilia achieved the highest TDS activity. Upon using the Plackett–Burman design, the TDS productivity achieved by B. koreensis (18.1 µmol/mg/min) and S. maltophilia (14.6 µmol/mg/min) increased by ~2.2-fold over the control. The enzyme was purified by gel-filtration and ion-exchange chromatography with ~15 overall folds and with molecular subunit structure 65 and 80 kDa from B. koreensis and S. maltophilia, respectively. The chemical identity of taxadiene was authenticated from the GC-MS analyses, which provided the same mass fragmentation pattern of authentic taxadiene. The tds gene was screened by PCR with nested primers of the conservative active site domains, and the amplicons were sequenced, displaying a higher similarity with tds from T. baccata and T. brevifolia. The highest TDS activity by both bacterial isolates was recorded at 37–40 °C. The Apo-TDSs retained ~50% of its initial holoenzyme activities, ensuring their metalloproteinic identity. The activity of purified TDS was completely restored upon the addition of Mg2+, confirming the identity of Mg2+ as a cofactor. The TDS activity was dramatically reduced upon the addition of DTNB and MBTH, ensuring the implementation of cysteine-reactive thiols and ammonia groups on their active site domains. This is the first report exploring the autonomous robust expression TDS from B. koreensis and S. maltophilia with a higher affinity to cyclize GGPP into taxadiene, which could be a novel platform for taxadiene production as intermediary metabolites of Taxol biosynthesis

Biotransformation of soy flour isoflavones by <i>Aspergillus niger</i> NRRL 3122 β-glucosidase enzyme

<p>β-glucosidase enzyme produced from <i>Aspergillus niger</i> NRRL 3122 has been partially purified and characterised. Its molecular weight was 180 KDa. The optimal pH and temperature were 3.98 and 55 °C, respectively. It promoted the hydrolysis of soy flour isoflavone glycosides to their aglycone. Two-level Plackett–Burman design was applied and effective variables for genistein production were determined. Reaction time had a significant positive effect, and pH had a significant negative effect. They were further evaluated using Box–Behnken model. Accordingly, the optimal combination of the major reaction affecting factors was reaction time, 5 h and pH, 4. The concentration of genistein increased by 11.73 folds using this optimal combination. The antioxidant activity of the non-biotransformed and biotransformed soy flour extracts was determined by DPPH method. It was found that biotransformation increased the antioxidant activity by four folds.</p

A Novel Early Diagnosis System for Mild Cognitive Impairment Based on Local Region Analysis: A Pilot Study

Alzheimer's disease (AD) is an irreversible neurodegenerative disorder that accounts for 60–70% of cases of dementia in the elderly. An early diagnosis of AD is usually hampered for many reasons including the variable clinical and pathological features exhibited among affected individuals. This paper presents a computer-aided diagnosis (CAD) system with the primary goal of improving the accuracy, specificity, and sensitivity of diagnosis. In this system, PiB-PET scans, which were obtained from the ADNI database, underwent five essential stages. First, the scans were standardized and de-noised. Second, an Automated Anatomical Labeling (AAL) atlas was utilized to partition the brain into 116 regions or labels that served for local (region-based) diagnosis. Third, scale-invariant Laplacian of Gaussian (LoG) was used, per brain label, to detect the discriminant features. Fourth, the regions' features were analyzed using a general linear model in the form of a two-sample t-test. Fifth, the support vector machines (SVM) and their probabilistic variant (pSVM) were constructed to provide local, followed by global diagnosis. The system was evaluated on scans of normal control (NC) vs. mild cognitive impairment (MCI) (19 NC and 65 MCI scans). The proposed system showed superior accuracy, specificity, and sensitivity as compared to other related work

Synergistic Plant-Microbe Interactions between Endophytic Actinobacteria and Their Role in Plant Growth Promotion and Biological Control of Cotton under Salt Stress

Bacterial endophytes are well-acknowledged inoculants to promote plant growth and enhance their resistance toward various pathogens and environmental stresses. In the present study, 71 endophytic strains associated with the medicinal plant Thymus roseus were screened for their plant growth promotion (PGP), and the applicability of potent strains as bioinoculant has been evaluated. Regarding PGP traits, the percentage of strains were positive for the siderophore production (84%), auxin synthesis (69%), diazotrophs (76%), phosphate solubilization (79%), and production of lytic enzymes (i.e., cellulase (64%), lipase (62%), protease (61%), chitinase (34%), and displayed antagonistic activity against Verticillium dahliae (74%) in vitro. The inoculation of strain XIEG05 and XIEG12 enhanced plant tolerance to salt stress significantly (p V. dahliae at all tested salt concentrations. The GC-MS analysis showed that many compounds are known to have antimicrobial and antifungal activity. Our findings provide valuable information for applying strains XIEG05 and XIEG12 as bioinoculant fertilizers and biological control agent of cotton under saline soil conditions