Surgeon-led 7-INCut Antibiotic Stewardship Intervention Decreases Duration of Treatment and Carbapenem Use in a General Surgery Service

Agents antibacterians; Ús terapèutic; Administració d'antimicrobians; Cirurgia general; EstàndardsAgentes antibacterianos; Uso terapéutico; Administración de antimicrobianos; Cirugía general; NormasAnti-bacterial agents; Therapeutic use; Antimicrobial stewardship; General surgery; StandardsAntibiotic stewardship programs optimize the use of antimicrobials to prevent the development of resistance and improve patient outcomes. In this prospective interventional study, a multidisciplinary team led by surgeons implemented a program aimed at shortening the duration of antibiotic treatment <7 days. The impact of the intervention on antibiotic consumption adjusted to bed-days and discharges, and the isolation of multiresistant bacteria (MRB) was also studied. Furthermore, the surgeons were surveyed regarding their beliefs and feelings about the program. Out of 1409 patients, 40.7% received antibiotic therapy. Treatment continued for over 7 days in 21.5% of cases, and, as can be expected, source control was achieved in only 48.8% of these cases. The recommendations were followed in 90.2% of cases, the most frequent being to withdraw the treatment (55.6%). During the first 16 months of the intervention, a sharp decrease in the percentage of extended treatments, with R2 = 0.111 was observed. The program was very well accepted by surgeons, and achieved a decrease in both the consumption of carbapenems and in the number of MRB isolations. Multidisciplinary stewardship teams led by surgeons seem to be well received and able to better manage antibiotic prescription in surgery

Age- and season-dependent pattern of flavonol glycosides in Cabernet Sauvignon grapevine leaves

Flavonols play key roles in many plant defense mechanisms, consequently they are frequently investigated as stress sensitive factors in relation to several oxidative processes. It is well known that grapevine (Vitis vinifera L.) can synthesize various flavonol glycosides in the leaves, however, very little information is available regarding their distribution along the cane at different leaf levels. In this work, taking into consideration of leaf position, the main flavonol glycosides of a red grapevine cultivar (Cabernet Sauvignon) were profiled and quantified by HPLC–DAD analysis. It was found that amount of four flavonol glycosides, namely, quercetin-3-O-galactoside, quercetin-3-O-glucoside, kaempferol-3-O-glucoside and kaempferol-3-O-glucuronide decreased towards the shoot tip. Since leaf age also decreases towards the shoot tip, the obtained results suggest that these compounds continuously formed by leaf aging, resulting in their accumulation in the older leaves. In contrast, quercetin-3-O-glucuronide (predominant form) and quercetin-3-O-rutinoside were not accumulated significantly by aging. We also pointed out that grapevine boosted the flavonol biosynthesis in September, and flavonol profile differed significantly in the two seasons. Our results contribute to the better understanding of the role of flavonols in the antioxidant defense system of grapevine

Small shrubs with large importance? Smaller deer may increase the moose-forestry conflict through feeding competition over Vaccinium shrubs in the field layer

The moose (Alces alces) is a dominant large mammalian herbivore in the world’s boreal zones. Moose exert significant browsing impacts on forest vegetation and are therefore often at the centre of wildlife-forestry conflicts. Consequently, understanding the drivers of their foraging behaviour is crucial for mitigating such conflicts. Management of moose in large parts of its range currently largely ignores the fact that moose foraging is influenced by increasing populations of sympatric deer species. In such multispecies systems, resource partitioning may be driven by foraging height and bite size. Feeding competition with smaller species might replace larger species from the field layer and drive them towards higher foraging strata offering larger bites. This bite size hypothesis has been well documented for African ungulate communities. Based on a large diet DNA metabarcoding dataset we suggest that feeding competition from three smaller deer species (red deer Cervus elaphus, fallow deer Dama dama, and roe deer Capreolus capreolus) over Vaccinium shrubs in the forest field layer might drive moose towards increasing consumption of Scots pine (Pinus sylvestris) in Sweden. We found that in areas of high deer density, moose diets consistently contained less Vaccinium and higher proportions of pine over three spring periods. Utilization of these food items by the smaller deer species was either unaffected by deer density or, for Vaccinium showed the opposite pattern to moose, i.e., increases of proportions in the diet of roe and red deer with increasing deer density. Availability of pine and Vaccinium, measured as proportion of available bites, did not explain the observed patterns. Our results suggest that managing key food items like Vaccinium and the populations of smaller deer may play an important role in controlling browsing impacts of moose on pine

Impaired phosphocreatine metabolism in white adipocytes promotes inflammation.

The mechanisms promoting disturbed white adipocyte function in obesity remain largely unclear. Herein, we integrate white adipose tissue (WAT) metabolomic and transcriptomic data from clinical cohorts and find that the WAT phosphocreatine/creatine ratio is increased and creatine kinase-B expression and activity is decreased in the obese state. In human in vitro and murine in vivo models, we demonstrate that decreased phosphocreatine metabolism in white adipocytes alters adenosine monophosphate-activated protein kinase activity via effects on adenosine triphosphate/adenosine diphosphate levels, independently of WAT beigeing. This disturbance promotes a pro-inflammatory profile characterized, in part, by increased chemokine (C-C motif) ligand 2 (CCL2) production. These data suggest that the phosphocreatine/creatine system links cellular energy shuttling with pro-inflammatory responses in human and murine white adipocytes. Our findings provide unexpected perspectives on the mechanisms driving WAT inflammation in obesity and may present avenues to target adipocyte dysfunction