Multispacer typing of Rickettsia isolates from humans and ticks in Tunisia revealing new genotypes

BACKGROUND: Rickettsioses are important remerging vector born infections. In Tunisia, many species have been described in humans and vectors. Genotyping is important for tracking pathogen movement between hosts and vectors. In this study, we characterized Rickettsia species detected in patients and vectors using multispacer typing (MST), proposed by Founier et al. and based on three intergenic spacers (dksA-xerC, rmpE- tRNA(fMet), mppA-pruC) sequencing. METHODS: Our study included 25 patients hospitalized during 2009. Ticks and fleas were collected in the vicinity of confirmed cases. Serology was performed on serum samples by microimmunofluorescence using Rickettsia conorii and Rickettsia typhi antigens. To detect and identify Rickettsia species, PCR targeting ompA, ompB and gltA genes followed by sequencing was performed on 18 obtained skin biopsies and on all collected vectors. Rickettsia positive samples were further characterized using primers targeting three intergenic spacers (dksA-xerC, rmpE- tRNA(fMet) and mppA-purC). RESULTS: A rickettsial infection was confirmed in 15 cases (60%). Serology was positive in 13 cases (52%). PCR detected Rickettsia DNA in four biopsies (16%) allowing the identification of R. conorii subsp israelensis in three cases and R. conorii subsp conorii in one case. Among 380 collected ticks, nine presented positive PCR (2.4%) allowing the identification of six R. conorii subsp israelensis, two R. massiliae and one R. conorii subsp conorii. Among 322 collected fleas, only one was positive for R. felis. R. conorii subsp israelensis strains detected in humans and vectors clustered together and showed a new MST genotype. Similarly, R. conorii subsp conorii strains detected in a skin biopsy and a tick were genetically related and presented a new MST genotype. CONCLUSIONS: New Rickettsia spotted fever strain genotypes were found in Tunisia. Isolates detected in humans and vectors were genetically homogenous despite location differences in their original isolation suggesting epidemiologic circulation of these strains

How Much FBMC/OQAM Is Better than FBMC/QAM? A Tentative Response Using the POPS Paradigm

A major trend of the current research in 5G is to find well time and frequency localized waveforms, dedicated to non-orthogonal wireless multi-carrier systems. The ping-pong optimized pulse shaping (POPS) paradigm was proposed as a powerful technique to generate a family of waveforms, ensuring an optimal signal to interference plus noise ratio (SINR) at the receiver. In this paper, we derive, for the first time, the analytical expression of the SINR for FBMC/OQAM systems. We then adopt the POPS algorithm in the design of optimum transmit and receive waveforms for FBMC/OQAM, with respect to the SINR criterion. For relatively high dispersions, numerical results show that the optimized waveforms provide a gain of 7 dB, in terms of SINR, compared to the PHYDYAS waveform. They also show that the obtained waveforms offer better out-of-band (OOB) emissions with regard to those of the IOTA waveform. Furthermore, we notice that FBMC/OQAM systems present a gain of 4 dB in SINR, compared to FBMC/QAM systems, when both operate at their time-frequency lattice critical densities. However, FBMC/QAM systems can guarantee, with a reduced computational complexity, a comparable performance to FBMC/OQAM systems, in terms of SINR, when their spectral efficiency is relatively reduced by less than 5%

On the Joint Use of Time Reversal and POPS-OFDM for 5G Systems

International audience—This paper investigates the efficiency of the combination of the Ping-pong Optimized Pulse Shaping-Orthogonal Frequency Division Multiplexing (POPS-OFDM) algorithm with the Time Reversal (TR) technique. This algorithm optimizes the transmit and receive OFDM waveforms with a significant reduction in the system Inter-Carrier Interference (ICI)/Inter-Symbol Interference (ISI) and guarantees maximal Signal to Interference plus Noise Ratio (SINR) for realistic mobile radio channels in 5G Systems. To this end, we characterize the scattering function of the TR channel and we derive the closed-form expression of the SINR as a Generalized Rayleigh Quotient. Numerical analysis reveals a significant gain in SINR and Out-Of-Band (OOB) emissions, brought by the proposed TR-POPS-OFDM approach

Ivabradine in patients with heart failure: a systematic literature review

ABSTRACTBackground: Heart failure is a chronic disease linked with significant morbidity and mortality, and uncontrolled resting heart rate is a risk factor for adverse outcomes. This systematic literature review aimed to assess the efficacy, safety, and patient-reported outcomes (PROs) of ivabradine in patients with heart failure (HF) with reduced ejection fraction (HFrEF) in randomized controlled trials (RCTs) and observational studies.Methods: We searched electronic databases from their inception to July 2021 to include studies that reported on efficacy, safety, or PROs of ivabradine in patients with HFrEF.Results: Of 1947 records screened, 51 RCTs and 6 observational studies were identified. Ivabradine on top of background therapy demonstrated a significant reduction in composite outcomes including hospitalization for HF or cardiovascular death. In addition, observational studies suggested that ivabradine was associated with a significant reduction in mortality. Across all studies, ivabradine use on top of background therapy was associated with greater reductions in heart rate, improved EF, and improved health-related quality of life (QoL) and comparable risk of total adverse events compared to those treated with background therapy alone.Conclusions: Ivabradine on top of background therapy is beneficial for heart rate, hospitalization risk for HF, mortality, EF, and patients’ QoL. Moreover, these benefits were achieved with no significant increase in the overall risk of total adverse events

Additional file 1: Table S1. of First molecular detection and characterization of zoonotic Bartonella species in fleas infesting domestic animals in Tunisia

Distribution of Bartonella species by bioclimatic zones, site, flea species and animal host and partial sequencing analysis of gltA gene and the ITS region. (PDF 23 kb

Plasma oxysterols: Altered level of plasma 24-hydroxycholesterol in patients with bipolar disorder

International audienceCholesterol and its oxygenated metabolites, including oxysterols, are intensively investigated as potential players in the pathophysiology of brain disorders. Altered oxysterol levels have been described in patients with numerous neuropsychiatric disorders. Recent studies have shown that Bipolar disorder (BD) is associated with the disruption of cholesterol metabolism. The present study was aimed at investigating the profile of oxysterols in plasma, their ratio to total cholesterol and their association with clinical parameters in patients with BD. Thirty three men diagnosed with BD and forty healthy controls matched for age and sex were included in the study. Oxysterol levels were measured by isotope-dilution ultra-performance liquid chromatography-tandem mass spectrometry. Significantly higher levels were observed for cholestane-3β,5α,6β-triol, 27-hydroxycholesterol (27-OHC) and Cholestanol in patients with BD. The concentration of 24-hydroxycholesterol (24-OHC) was significantly lower in patients compared to controls. 24-OHC was also negatively correlated to MAS subscale score (r =-0.343; p = 0.049). In patients, 24-OHC was inversely correlated with age (r = -0.240; p = 0.045). Multivariate analysis found that BD acute decompensation was independently related to the rise in plasma 24-OHC (p = 0.002; OR = 0.966, 95 % CI [0.945 - 0.987]). However, the 24-OHC assay relevance as a biomarker of this disease deserves further investigation in other studies

Building Oncofertility Core Competency in Developing Countries: Experience From Egypt, Tunisia, Brazil, Peru, and Panama

Purpose: Little is known about oncofertility practice in developing countries that usually suffer from a shortage of health services, especially those related to cancer care. Materials and Methods: To learn more about oncofertility practice in developing countries, we generated a survey to explore the barriers and opportunities associated with oncofertility practice in five developing countries from Africa and Latin America within our Oncofertility Consortium Global Partners Network. Responses from Egypt, Tunisia, Brazil, Peru, and Panama were collected, reviewed, and discussed. Results: Common barriers were identified by each country, including financial barriers (lack of insurance coverage and high out-of-pocket costs for patients), lack of awareness among providers and patients, cultural and religious constraints, and lack of funding to help to support oncofertility programs. Conclusion: Despite barriers to care, many opportunities exist to grow the field of oncofertility in these five developing countries. It is important to continue to engage stakeholders in developing countries and use powerful networks in the United States and other developed countries to aid in the acceptance of oncofertility on a global level

Molecular diagnosis of Rickettsia infection in patients from Tunisia

International audienceDiagnosis of rickettsioses had largely benefited from the development of molecular techniques. Unfortunately, in Tunisia, despite the large number of rickettsia( cases registered every year, the Rickettsia species remain unidentified. In this study, we aimed to detect the Rickettsia species in clinical samples using molecular tests. A study was established to analyze skin biopsies, cutaneous swabs, and cerebrospinal fluid samples taken from clinically suspected patients to have rickettsial infection. Two molecular techniques were used to detect Rickettsia DNA: quantitative real time PCR (qPCR) and reverse line blot test (RLB). An analysis of the RLB hybridization assay results revealed the presence of Rickettsia DNA in skin biopsies (40.6%) and swabs (46.7%). Rickettsia conorii was the most prevalent identified species among tested samples. Other species of interest include Rickettsia typhi and Rickettsia massiliae. Using qPCR positivity rates in skin biopsies was 63.7% against 80% in swabs. R. conorii was the most frequently detected species, followed by R typhi. The agreement between the two techniques was 68.6% (kappa = 0.33). Molecular tests, especially using specific probes qPCR, allow for a rapid, better and confident diagnosis in clinical practice. They improve the survey of Mediterranean spotted fever which is considered to be the most important rickettsial infection in humans in Tunisia. (C) 2016 Elsevier GmbH. All rights reserved

Comparison of Two Quantitative Real Time PCR Assays for <i>Rickettsia</i> Detection in Patients from Tunisia

<div><p>Background and objectives</p><p>Quantitative real time PCR (qPCR) offers rapid diagnosis of rickettsial infections. Thus, successful treatment could be initiated to avoid unfavorable outcome. Our aim was to compare two qPCR assays for <i>Rickettsia</i> detection and to evaluate their contribution in early diagnosis of rickettsial infection in Tunisian patients.</p><p>Patients and methods</p><p>Included patients were hospitalized in different hospitals in Tunisia from 2007 to 2012. Serology was performed by microimmunofluorescence assay using <i>R. conorii</i> and <i>R. typhi</i> antigens. Two duplex qPCRs, previously reported, were performed on collected skin biopsies and whole blood samples. The first duplex amplified all <i>Rickettsia</i> species (PanRick) and <i>Rickettsia typhi</i> DNA (Rtt). The second duplex detected spotted fever group <i>Rickettsiae</i> (RC00338) and typhus group <i>Rickettsiae</i> DNA (Rp278).</p><p>Results</p><p>Diagnosis of rickettsiosis was confirmed in 82 cases (57.7%). Among 44 skin biopsies obtained from patients with confirmed diagnosis, the first duplex was positive in 24 samples (54.5%), with three patients positive by Rtt qPCR. Using the second duplex, positivity was noted in 21 samples (47.7%), with two patients positive by Rp278 qPCR. Among79 whole blood samples obtained from patients with confirmed diagnosis, panRick qPCR was positive in 5 cases (6.3%) among which two were positive by Rtt qPCR. Using the second set of qPCRs, positivity was noted in four cases (5%) with one sample positive by Rp278 qPCR. Positivity rates of the two duplex qPCRs were significantly higher among patients presenting with negative first serum than those with already detectable antibodies.</p><p>Conclusions</p><p>Using qPCR offers a rapid diagnosis. The PanRick qPCR showed a higher sensitivity. Our study showed that this qPCR could offer a prompt diagnosis at the early stage of the disease. However, its implementation in routine needs cost/effectiveness evaluation.</p></div

Positivity of qPCR according to serologic status among patients with confirmed diagnosis.

<p>Positivity of qPCR according to serologic status among patients with confirmed diagnosis.</p