Prevention and control of antimicrobial resistant healthcare-associated infections: The microbiology laboratory rocks!

In Europe, each year, more than four milion patients acquire a healthcare-associated infection (HAI) and almost 40 thousand die as a direct consequence of it. Regardless of many stategies to prevent and control HAIs, they remain an important cause of morbidity and mortality worldwide with a significant economic impact: a recent estimate places it at the ten billion dollars/year. The control of HAIs requires a prompt and efficient identification of the etiological agent and a rapid communication with the clinician. The Microbiology Laboratory has a significant role in the prevention and control of these infections and is a key element of any Infection Control Program. The work of the Microbiology Laboratory covers microbial isolation and identification, determination of antimicrobial susceptibility patterns, epidemiological surveillance and outbreak detection, education, and report of quality assured results. In this paper we address the role and importance of the Microbiology Laboratory in the prevention and control of HAI and in Antibiotic Stewardship Programs and how it can be leveraged when combined with the use of information systems. Additionally, we critically review some challenges that the Microbiology Laboratory has to deal with, including the selection of analytic methods and the proper use of communication channels with other healthcare services.publishersversionpublishe

Major adverse cardiovascular events (MACE) in patients with severe COVID-19 registered in the ISARIC WHO clinical characterization protocol:A prospective, multinational, observational study

Purpose To determine its cumulative incidence, identify the risk factors associated with Major Adverse Cardiovascular Events (MACE) development, and its impact clinical outcomes. Materials and methods This multinational, multicentre, prospective cohort study from the ISARIC database. We used bivariate and multivariate logistic regressions to explore the risk factors related to MACE development and determine its impact on 28-day and 90-day mortality. Results 49,479 patients were included. Most were male 63.5% (31,441/49,479) and from high-income countries (84.4% [42,774/49,479]); however, >6000 patients were registered in low-and-middle-income countries. MACE cumulative incidence during their hospital stay was 17.8% (8829/49,479). The main risk factors independently associated with the development of MACE were older age, chronic kidney disease or cardiovascular disease, smoking history, and requirement of vasopressors or invasive mechanical ventilation at admission. The overall 28-day and 90-day mortality were higher among patients who developed MACE than those who did not (63.1% [5573/8829] vs. 35.6% [14,487/40,650] p < 0.001; 69.9% [6169/8829] vs. 37.8% [15,372/40,650] p < 0.001, respectively). After adjusting for confounders, MACE remained independently associated with higher 28-day and 90-day mortality (Odds Ratio [95% CI], 1.36 [1.33–1.39];1.47 [1.43–1.50], respectively). Conclusions Patients with severe COVID-19 frequently develop MACE, which is independently associated with worse clinical outcomes

Effect of in vitro gastrointestinal digestion on the total phenolic contents and antioxidant activity of wild Mediterranean edible plant extracts

The recent interest in wild edible plants is associated with their health benefits, which are mainly due to their richness in antioxidant compounds, particularly phenolics. Nevertheless, some of these compounds are metabolized after ingestion, being transformed into metabolites frequently with lower antioxidant activity. The aim of the present study was to evaluate the influence of the digestive process on the total phenolic contents and antioxidant activity of extracts from four wild edible plants used in the Mediterranean diet (Beta maritima L., Plantago major L., Oxalis pes-caprae L. and Scolymus hispanicus L.). HPLC-DAD analysis revealed that S. hispanicus is characterized by the presence of caffeoylquinic acids, dicaffeoylquinic acids and flavonol derivatives, P. major by high amounts of verbascoside, B. maritima possesses 2,4-dihydroxybenzoic acid, 5-O-caffeoylquinic acid, quercetin derivatives and kaempferol-3-O-rutinoside, and O. pes-caprae extract contains hydroxycinnamic acids and flavone derivatives. Total phenolic contents were determined by Folin-Ciocalteu assay, and antioxidant activity by the ABTS, DPPH, ORAC and FRAP assays. Phenolic contents of P. major and S. hispanicus extracts were not affected by digestion, but they significantly decreased in B. maritima after both phases of digestion process and in O. pes-caprae after the gastric phase. The antioxidant activity results varied with the extract and the method used to evaluate the activity. Results showed that P. major extract has the highest total phenolic contents and antioxidant activity, with considerable values even after digestion, reinforcing the health benefits of this species.European Union (FEDER funds through COMPETE)European Union (EU)European Union (FEDER)European Union (EU)Programa de Cooperacion Interreg V-A Espana - Portugal (POCTEP) 2014-2020 [0377_IBERPHENOL_6_E]project INTERREG - MD. Net: When Brand Meets PeopleFCT Portuguese Foundation for Science and Technolog

Freshwater mussels (Bivalvia: Unionidae) from the rising sun (Far East Asia): phylogeny, systematics, and distribution

Freshwater mussels (Bivalvia: Unionidae) is a diverse family with around 700 species being widespread in the Northern Hemisphere and Africa. These animals fulfill key ecological functions and provide important services to humans. Unfortunately, populations have declined dramatically over the last century, rendering Unionidae one of the world’s most imperiled taxonomic groups. In Far East Asia (comprising Japan, Korea, and Eastern Russia), conservation actions have been hindered by a lack of basic information on the number, identity, distribution and phylogenetic relationships of species. Available knowledge is restricted to studies on national and sub-national levels. The present study aims to resolve the diversity, biogeography and evolutionary relationships of the Far East Asian Unionidae in a globally comprehensive phylogenetic and systematic context.We reassessed the systematics of all Unionidae species in the region, including newly collected specimens from across Japan, South Korea, and Russia, based on molecular (including molecular species delineation and a COI + 28S phylogeny) and comparative morphological analyses. Biogeographical patterns were then assessed based on available species distribution data from the authors and previous reference works.We revealed that Unionidae species richness in Far East Asia is 30% higher than previously assumed, counting 43 species (41 native + 2 alien) within two Unionidae subfamilies, the Unioninae (32 + 1) and Gonideinae (9 + 1). Four of these species are new to science, i.e. Beringiana gosannensis sp. nov., Beringiana fukuharai sp. nov., Buldowskia kamiyai sp. nov., and Koreosolenaia sitgyensis gen. & sp. nov. We also propose a replacement name for Nodularia sinulata, i.e. Nodularia breviconcha nom. nov. and describe a new tribe (Middendorffinaiini tribe nov.) within the Unioninae subfamily. Biogeographical patterns indicate that this fauna is related to that from China south to Vietnam until the Mekong River basin. The Japanese islands of Honshu, Shikoku, Kyushu, Hokkaido, and the Korean Peninsula were identified as areas of particularly high conservation value, owing to high rates of endemism, diversity and habitat loss. The genetically unique species within the genera Amuranodonta, Obovalis, Koreosolenaia gen. nov., and Middendorffinaia are of high conservation concern

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

Ecogeographical determinants of investment in chemical defences in pines

Understanding the ecological and environmental correlates of tree defences has value for understanding forest susceptibility to pests and pathogens in a time of global change. In the present work, we assessed how life-history attributes and biogeography are related to chemical defences of pine trees in Palaearctic and Nearctic forests. We studied adult trees of ten pine species in forests of Portugal and Eastern North America. We measured total phenols (using gallic acid as a standard) and condensed tannins (as catechin hydrate equivalents) in the phloem of pine branches. Pine trees in forests of Eastern North America presented higher levels of total phenolic content in their phloem tissues than pine trees in forests in Portugal. Higher values of precipitation were correlated with higher phenolic content and higher temperatures were associated with higher levels of condensed tannins. A few life-history traits—the maximum height reached by each pine species, the age at which they start reproducing, and the size of seeds—were positively related with defences. The present work points to interactions between life-history attributes, climate, and geographic location as predictors of defensive investment in pines. The results are useful for understanding differences within and among pine forests in susceptibility to pests and pathogens.info:eu-repo/semantics/acceptedVersio

Effective medium theory based modeling of the thermoelectric properties of composites: comparison between predictions and experiments in the glass-crystal composite system Si10As15Te75–Bi0.4Sb1.6Te3

International audienceWe report on the theoretical predictions of the effective medium theory (EMT) and its generalized version taking into account percolation theory (GEMT) on the thermoelectric properties of composites based on Landauer and Sonntag’s equations. The results were tested experimentally on composites composed of the glassy phase Si10As15Te75 and the crystalline phase Bi0.4Sb1.7Te3. The evolution of the electrical resistivity and thermal conductivity with the fraction of crystalline phase matches very well the experimental data, although the GEMT model fails to predict the thermopower. A better agreement between theory and experiment could be obtained by combining the principles of the GEMT and theWebman–Jortner–Cohen models. Despite the fact that the GEMT model originally predicts the possibility to optimize the dimensionless figure of merit ZT of composites by adjusting the fraction and the values of the transport properties of each phase, the new model developed rules out any beneficial influence on the ZT values. These results confirm within a different framework the early conclusions of Bergman regarding the impossibility of improving the ZT values using multi-phased materials

A História da Ciência, a psicogênese e a resolução de problemas na construção do conhecimento em sala de aula

O Grupo de Pesquisa em didática de Ciências e Matemática da Faculdade de Educação da Universidade de São Paulo é um grupo interdisciplinar, constituído por professores de primeiro, segundo e terceiro graus, que trabalham com o ensino de física, química, matemática, biologia e formação de professores. Inicialmente o grupo teve como proposta estudar como as crianças e adolescentes constroem os conceitos de ciências (psicogênese dos conceitos) tendo por hipótese que esse conhecimento seria uma variável importante na construção do ensino desenvolvido na escola de primeiro e segundo graus ( Coll, 1985, 1990). Vários trabalhos foram feitos nessa linha de investigação. Procuramos conhecer a evolução dos conceitos de aceleração, quantidade de movimento, velocidade angular, transformação de matéria, centro de massa, campo de força, semelhança de figuras geométricas e o conceito de decomposição da matéria

Mitogenomic phylogeny and fossil-calibrated mutation rates for all F- And M-type mtDNA genes of the largest freshwater mussel family, the Unionidae (Bivalvia)

The Unionidae represent an excellent model taxon for unravelling the drivers of freshwater diversity, but, phylogeographic studies on Southeast Asian taxa are hampered by lack of a comprehensive phylogeny and mutation rates for this fauna. We present complete female- (F) and male-type (M) mitogenomes of four genera of the Southeast Asian clade Contradentini+Rectidentini. We calculate substitution rates for the mitogenome, the 13 protein-coding genes, the two ribosomal units and three commonly used fragments (co1, nd1 and 16S) of both F- and M-mtDNA, based on a fossil-calibrated, mitogenomic phylogeny of the Unionidae. Phylogenetic analyses, including an M+F concatenated dataset, consistently recovers a monophyletic Gonideinae. Subfamily-level topology is congruent with that of a previous nuclear genomic study and with patterns in mitochondrial gene order, suggesting Unionidae F-type 2 as a synapomorphy of the Gonideinae. Our phylogeny indicates that the clades Contradentini+Rectidentini and Lamprotulini+Pseudodontini+Gonideini split in the early Cretaceous (~125 Mya), and that the crown group of Contradentini+Rectidentini originated in the late Cretaceous (~79 Mya). Most gonideine tribes originated during the early Palaeogene. Substitution rates were comparable to those previously published for F-type co1 and 16S for certain Unionidae and Margaritiferidae species (pairs).This research was developed under ConBiomics: the missing approach for the Conservation of Freshwater Bivalves Project No. NORTE-01-0145-FEDER-030286, co-financed by COMPETE 2020, Portugal 2020, and the European Union through the ERDF, and by the Portuguese Foundation for Science and Technology (FCT) through national funds, and Strategic Funding UIDB/04423/2020 and UIDP/04423/2020. FCT also supported A.G.S. (SFRH/BD/137935/2018) and S.V. (UID/AGR/04033/2019). A.Z.was supported by an Anne McLaren Research Fellowship from the University of Nottingham. I.N.B. was supported by the Ministry of Science and Higher Education of Russia (Project No. AAAA-A18-118012390161-9 and Project No. FSRU 2020-0007) and the Russian Scientific Fund (Project No. 19-04-00066)

Microcondylaea bonellii, a testimonial for neglected endangered species

Although biodiversity is considered a value to be protected to avoid the degradation of ecosystem functions, conservation practices ignore the role of many species. Species are not protected according to their degree of risk, but according to their degree of attractiveness. The so-called iconic species are used as flag species to convince the public of the need to protect all species to safeguard biodiversity. In reality, the iconic species gain protection, but it all ends there. The protection of biodiversity is a slogan that does not correspond to reality. In truth, species are protected by following the criteria underlying zoos, where the choice is based on emotional and economic components. Since we need safeguard biodiversity to prevent ecosystems degradation, it is crucial to identify, and possibly correct, the errors of the “conservation system.” Tracing the history that brought a species to the brink of extinction serves to identify the weaknesses. Microcondylaea bonellii was chosen as an example since its conservation status was incorrectly assessed and this resulted in a lack of adequate legislative protection. Ironically, the species is protected against the only threat that does not seem to have any importance at all (exploitation), but it receives no protection against real threats (habitat degradation, fragmentation, pollution). The European legislative instrument for the protection of species, the Habitats Directive, grants adequate protection only to a few “priority” species, the others are left to their fate. This is in contrast to the declared aims: the ecological principles that promoted the formulation of the Habitats Directive are not translated into practice. There is a wide debate on this issue to avoid repeating these flaws/errors in the new and ambitious EU’s biodiversity strategy for 2030. The contribution of this chapter is to provide evidence of the current malfunction, because learning from past mistakes is necessary to progress.This publication is based upon work from COST Action CA18239, supported by COST (European Cooperation in Science and Technology). Microcondylaea bonellii rescue Project is financed by the Mohamed bin Zayed Conservation Fund. The authors acknowledge all the people that voluntarily contributed to Microcondylaea bonellii surveys (Monica May, Sheila Rinaldi, Angela Boggero); people and organizations that are supporting Microcondylaea bonellii rescuing through dissemination activities (the President, Luisa Erba, and the Soroptimist Association of Pavia; Giuseppe Camerini and the Liceo Taramelli, Pavia students involved in the website construction)