Risk factors for recurrence in patients with Clostridium difficile infection due to 027 and non-027 ribotypes

Objectives: Our objective was to evaluate factors associated with recurrence in patients with 027+ and 027– Clostridium difficile infection (CDI). Methods: Patients with CDI observed between January and December 2014 in six hospitals were consecutively included in the study. The 027 ribotype was deduced by the presence of tcdB, tcdB, cdt genes and the deletion Δ117 in tcdC (Xpert® C. difficile/Epi). Recurrence was defined as a positive laboratory test result for C. difficile more than 14 days but within 8 weeks after the initial diagnosis date with reappearance of symptoms. To identify factors associated with recurrence in 027+ and 027– CDI, a multivariate analysis was performed in each patient group. Subdistributional hazard ratios (sHRs) and 95% confidence intervals (95%CIs) were calculated. Results: Overall, 238 patients with 027+ CDI and 267 with 027– CDI were analysed. On multivariate analysis metronidazole monotherapy (sHR 2.380, 95%CI 1.549–3.60, p <0.001) and immunosuppressive treatment (sHR 3.116, 95%CI 1.906–5.090, p <0.001) were factors associated with recurrence in patients with 027+ CDI. In this patient group, metronidazole monotherapy was independently associated with recurrence in both mild/moderate (sHR 1.894, 95%CI 1.051–3.410, p 0.033) and severe CDI (sHR 2.476, 95%CI 1.281–4.790, p 0.007). Conversely, non-severe disease (sHR 3.704, 95%CI 1.437–9.524, p 0.007) and absence of chronic renal failure (sHR 16.129, 95%CI 2.155–125.000, p 0.007) were associated with recurrence in 027– CDI. Conclusions: Compared to vancomycin, metronidazole monotherapy appears less effective in curing CDI without relapse in the 027+ patient group, independently of disease severity

Early-onset epileptic encephalopathy caused by a reduced sensitivity of Kv7.2 potassium channels to phosphatidylinositol 4,5-bisphosphate

Kv7.2 and Kv7.3 subunits underlie the M-current, a neuronal K(+) current characterized by an absolute functional requirement for phosphatidylinositol 4,5-bisphosphate (PIP(2)). Kv7.2 gene mutations cause early-onset neonatal seizures with heterogeneous clinical outcomes, ranging from self-limiting benign familial neonatal seizures to severe early-onset epileptic encephalopathy (Kv7.2-EE). In this study, the biochemical and functional consequences prompted by a recurrent variant (R325G) found independently in four individuals with severe forms of neonatal-onset EE have been investigated. Upon heterologous expression, homomeric Kv7.2 R325G channels were non-functional, despite biotin-capture in Western blots revealed normal plasma membrane subunit expression. Mutant subunits exerted dominant-negative effects when incorporated into heteromeric channels with Kv7.2 and/or Kv7.3 subunits. Increasing cellular PIP(2) levels by co-expression of type 1γ PI(4)P5-kinase (PIP5K) partially recovered homomeric Kv7.2 R325G channel function. Currents carried by heteromeric channels incorporating Kv7.2 R325G subunits were more readily inhibited than wild-type channels upon activation of a voltage-sensitive phosphatase (VSP), and recovered more slowly upon VSP switch-off. These results reveal for the first time that a mutation-induced decrease in current sensitivity to PIP(2) is the primary molecular defect responsible for Kv7.2-EE in individuals carrying the R325G variant, further expanding the range of pathogenetic mechanisms exploitable for personalized treatment of Kv7.2-related epilepsies

Improved Constraints on Northern Extratropical CO₂ Fluxes Obtained by Combining Surface-Based and Space-Based Atmospheric CO₂ Measurements

Top‐down estimates of CO₂ fluxes are typically constrained by either surface‐based or space‐based CO₂ observations. Both of these measurement types have spatial and temporal gaps in observational coverage that can lead to differences in inferred fluxes. Assimilating both surface‐based and space‐based measurements concurrently in a flux inversion framework improves observational coverage and reduces sampling related artifacts. This study examines the consistency of flux constraints provided by these different observations and the potential to combine them by performing a series of 6‐year (2010–2015) CO₂ flux inversions. Flux inversions are performed assimilating surface‐based measurements from the in situ and flask network, measurements from the Total Carbon Column Observing Network (TCCON), and space‐based measurements from the Greenhouse Gases Observing Satellite (GOSAT), or all three data sets combined. Combining the data sets results in more precise flux estimates for subcontinental regions relative to any of the data sets alone. Combining the data sets also improves the accuracy of the posterior fluxes, based on reduced root‐mean‐square differences between posterior flux‐simulated CO₂ and aircraft‐based CO₂ over midlatitude regions (0.33–0.56 ppm) in comparison to GOSAT (0.37–0.61 ppm), TCCON (0.50–0.68 ppm), or in situ and flask measurements (0.46–0.56 ppm) alone. These results suggest that surface‐based and GOSAT measurements give complementary constraints on CO₂ fluxes in the northern extratropics and can be combined in flux inversions to improve constraints on regional fluxes. This stands in contrast with many earlier attempts to combine these data sets and suggests that improvements in the NASA Atmospheric CO₂ Observations from Space (ACOS) retrieval algorithm have significantly improved the consistency of space‐based and surface‐based flux constraints

Improved Constraints on Northern Extratropical CO₂ Fluxes Obtained by Combining Surface-Based and Space-Based Atmospheric CO₂ Measurements

Top‐down estimates of CO₂ fluxes are typically constrained by either surface‐based or space‐based CO₂ observations. Both of these measurement types have spatial and temporal gaps in observational coverage that can lead to differences in inferred fluxes. Assimilating both surface‐based and space‐based measurements concurrently in a flux inversion framework improves observational coverage and reduces sampling related artifacts. This study examines the consistency of flux constraints provided by these different observations and the potential to combine them by performing a series of 6‐year (2010–2015) CO₂ flux inversions. Flux inversions are performed assimilating surface‐based measurements from the in situ and flask network, measurements from the Total Carbon Column Observing Network (TCCON), and space‐based measurements from the Greenhouse Gases Observing Satellite (GOSAT), or all three data sets combined. Combining the data sets results in more precise flux estimates for subcontinental regions relative to any of the data sets alone. Combining the data sets also improves the accuracy of the posterior fluxes, based on reduced root‐mean‐square differences between posterior flux‐simulated CO₂ and aircraft‐based CO₂ over midlatitude regions (0.33–0.56 ppm) in comparison to GOSAT (0.37–0.61 ppm), TCCON (0.50–0.68 ppm), or in situ and flask measurements (0.46–0.56 ppm) alone. These results suggest that surface‐based and GOSAT measurements give complementary constraints on CO₂ fluxes in the northern extratropics and can be combined in flux inversions to improve constraints on regional fluxes. This stands in contrast with many earlier attempts to combine these data sets and suggests that improvements in the NASA Atmospheric CO₂ Observations from Space (ACOS) retrieval algorithm have significantly improved the consistency of space‐based and surface‐based flux constraints

Improved Constraints on Northern Extratropical CO2 Fluxes Obtained by Combining Surface-Based and Space-Based Atmospheric CO2 Measurements

Abstract Top-down estimates of CO2 fluxes are typically constrained by either surface-based or space-based CO2 observations. Both of these measurement types have spatial and temporal gaps in observational coverage that can lead to differences in inferred fluxes. Assimilating both surface-based and space-based measurements concurrently in a flux inversion framework improves observational coverage and reduces sampling related artifacts. This study examines the consistency of flux constraints provided by these different observations and the potential to combine them by performing a series of 6-year (2010?2015) CO2 flux inversions. Flux inversions are performed assimilating surface-based measurements from the in situ and flask network, measurements from the Total Carbon Column Observing Network (TCCON), and space-based measurements from the Greenhouse Gases Observing Satellite (GOSAT), or all three data sets combined. Combining the data sets results in more precise flux estimates for subcontinental regions relative to any of the data sets alone. Combining the data sets also improves the accuracy of the posterior fluxes, based on reduced root-mean-square differences between posterior flux-simulated CO2 and aircraft-based CO2 over midlatitude regions (0.33?0.56?ppm) in comparison to GOSAT (0.37?0.61?ppm), TCCON (0.50?0.68?ppm), or in situ and flask measurements (0.46?0.56?ppm) alone. These results suggest that surface-based and GOSAT measurements give complementary constraints on CO2 fluxes in the northern extratropics and can be combined in flux inversions to improve constraints on regional fluxes. This stands in contrast with many earlier attempts to combine these data sets and suggests that improvements in the NASA Atmospheric CO2 Observations from Space (ACOS) retrieval algorithm have significantly improved the consistency of space-based and surface-based flux constraints

Improved Constraints on Northern Extratropical CO2 Fluxes Obtained by Combining Surface-Based and Space-Based Atmospheric CO2 Measurements

© 2020. The Authors. Top-down estimates of CO2 fluxes are typically constrained by either surface-based or space-based CO2 observations. Both of these measurement types have spatial and temporal gaps in observational coverage that can lead to differences in inferred fluxes. Assimilating both surface-based and space-based measurements concurrently in a flux inversion framework improves observational coverage and reduces sampling related artifacts. This study examines the consistency of flux constraints provided by these different observations and the potential to combine them by performing a series of 6-year (2010–2015) CO2 flux inversions. Flux inversions are performed assimilating surface-based measurements from the in situ and flask network, measurements from the Total Carbon Column Observing Network (TCCON), and space-based measurements from the Greenhouse Gases Observing Satellite (GOSAT), or all three data sets combined. Combining the data sets results in more precise flux estimates for subcontinental regions relative to any of the data sets alone. Combining the data sets also improves the accuracy of the posterior fluxes, based on reduced root-mean-square differences between posterior flux-simulated CO2 and aircraft-based CO2 over midlatitude regions (0.33–0.56 ppm) in comparison to GOSAT (0.37–0.61 ppm), TCCON (0.50–0.68 ppm), or in situ and flask measurements (0.46–0.56 ppm) alone. These results suggest that surface-based and GOSAT measurements give complementary constraints on CO2 fluxes in the northern extratropics and can be combined in flux inversions to improve constraints on regional fluxes. This stands in contrast with many earlier attempts to combine these data sets and suggests that improvements in the NASA Atmospheric CO2 Observations from Space (ACOS) retrieval algorithm have significantly improved the consistency of space-based and surface-based flux constraints

SIRT1 Promotes N-Myc Oncogenesis through a Positive Feedback Loop Involving the Effects of MKP3 and ERK on N-Myc Protein Stability

The N-Myc oncoprotein is a critical factor in neuroblastoma tumorigenesis which requires additional mechanisms converting a low-level to a high-level N-Myc expression. N-Myc protein is stabilized when phosphorylated at Serine 62 by phosphorylated ERK protein. Here we describe a novel positive feedback loop whereby N-Myc directly induced the transcription of the class III histone deacetylase SIRT1, which in turn increased N-Myc protein stability. SIRT1 binds to Myc Box I domain of N-Myc protein to form a novel transcriptional repressor complex at gene promoter of mitogen-activated protein kinase phosphatase 3 (MKP3), leading to transcriptional repression of MKP3, ERK protein phosphorylation, N-Myc protein phosphorylation at Serine 62, and N-Myc protein stabilization. Importantly, SIRT1 was up-regulated, MKP3 down-regulated, in pre-cancerous cells, and preventative treatment with the SIRT1 inhibitor Cambinol reduced tumorigenesis in TH-MYCN transgenic mice. Our data demonstrate the important roles of SIRT1 in N-Myc oncogenesis and SIRT1 inhibitors in the prevention and therapy of N-Myc–induced neuroblastoma