Altered Ecology of the Respiratory Tract Microbiome and Nosocomial Pneumonia

10 p.Nosocomial pneumonia is one of the most frequent infections in critical patients. It is primarily associated with mechanical ventilation leading to severe illness, high mortality, and prolonged hospitalization. The risk of mortality has increased over time due to the rise in multidrug-resistant (MDR) bacterial infections, which represent a global public health threat. Respiratory tract microbiome (RTM) research is growing, and recent studies suggest that a healthy RTM positively stimulates the immune system and, like the gut microbiome, can protect against pathogen infection through colonization resistance (CR). Physiological conditions of critical patients and interventions as antibiotics administration and mechanical ventilation dramatically alter the RTM, leading to dysbiosis. The dysbiosis of the RTM of ICU patients favors the colonization by opportunistic and resistant pathogens that can be part of the microbiota or acquired from the hospital environments (biotic or built ones). Despite recent evidence demonstrating the significance of RTM in nosocomial infections, most of the host-RTM interactions remain unknown. In this context, we present our perspective regarding research in RTM altered ecology in the clinical environment, particularly as a risk for acquisition of nosocomial pneumonia. We also reflect on the gaps in the field and suggest future research directions. Moreover, expected microbiome-based interventions together with the tools to study the RTM highlighting the "omics" approaches are discussed.Comunidad de MadridFundación Ramón ArecesInstituto de Salud Carlos IIIFondo Europeo de Desarrollo RegionalCIBERON

Electron density contour maps via Rietveld-MEM analysis using HR-XRD for the polycrystalline ferroelectric BCZT

The maximum entropy method in combination with the Rietveld refinement method applied to the analysis (Rietveld-MEM analysis) of high-resolution x-ray diffraction (HR-XRD) is an important tool to elucidate the electron density distribution and chemical bonding nature of materials. In this work, we present the comparison of electron density distribution obtained from the Rietveld-MEM analysis for polycrystalline perovskite BaTiO3 (reference sample) and Ba0.9Ca0.2Ti0.9Zr0.1O3 (BCZT). To perform this task, HR-XRD patterns using synchrotron radiation were acquired. Tetragonal phase with P4mm (No.99) space group and pseudo-Voigt function were considered to model the HR-XRD peaks by the Rietveld method using the profile fitting Fullprof suite program. VESTA software was used to visualize 3D, 2D electron density distribution maps and line profiled to monitor the chemical bonding nature between Ba-O and Ti-O interactions and to visualize the off-center displacement of Ti cations by the incorporation of Zr and Ca cations. The interaction between Ti contours with O contours in the electron density distribution and the minimum electron density values revealed the enhancement of covalent nature and predominant ionic nature between barium and oxygen ions in the BCZT. To monitor the ferroelectric hysteresis behavior, polarization versus electric field curves complement the characterization of these samples

Influence of excesses of volatile elements on structure and composition of solution derived lead-free (Bi0.50Na0.50)1xBaxTiO3 thin films

The preparation of (Bi0.50Na0.50)1−xBaxTiO3 films requires a compositional/structural control, as they determine the functionality of these materials. We report a systematic compositional and structural analysis on (Bi0.50Na0.50)1−xBaxTiO3 films fabricated by chemical solution deposition. The effects of incorporating Na(I) and Bi(III) excesses are analyzed through the comparison of the compositional depth profiles of stoichiometric films (BNBT) and films containing excesses (BNBTxs). Heterogeneous compositional profiles with larger bismuth content close to the substrate and thicker film-substrate interfaces are observed in BNBTxs, unlike stoichiometric films, which show atomic concentrations that correspond to the nominal composition of the precursor solution. Excesses induce structural differences in depth, observing a shift of the region of coexistence of rhombohedral and tetragonal phases (morphotropic phase boundary) toward higher x values and the formation of thick film-substrate interfaces. In contrast, stoichiometric films have homogeneous compositional and structural profiles with the MPB placed close to that described for bulk ceramics.This work was financed by Spanish Project MAT2013-40489-P. D. Pérez-Mezcua acknowledges the financial support of the FPU Spanish program (AP2012-0639). A portion of this research was carried out at the Stanford Synchrotron Radiation Lightsource, a national user facility operated by Stanford University. D. Chateigner acknowledges the Conseil Régional de Basse Normandie for its partial financial of the four-circles X-ray diffractometer.Peer reviewe

Metagenomics for Bacteriology

The study of bacteria, or bacteriology, has gone through transformative waves since its inception in the 1600s. It all started by the visualization of bacteria using light microscopy by Antonie van Leeuwenhoek, when he first described “animalcules.” Direct cellular observation then evolved into utilizing different wavelengths on novel platforms such as electron, fluorescence, and even near-infrared microscopy. Understanding the link between microbes and disease (pathogenicity) began with the ability to isolate and cultivate organisms through aseptic methodologies starting in the 1700s. These techniques became more prevalent in the following centuries with the work of famous scientists such as Louis Pasteur and Robert Koch, and many others since then. The relationship between bacteria and the host’s immune system was first inferred in the 1800s, and to date is continuing to unveil its mysteries. During the last century, researchers initiated the era of molecular genetics. The discovery of the first-generation sequencing technology, the Sanger method, and, later, the polymerase chain reaction technology propelled the molecular genetics field by exponentially expanding the knowledge of relationship between gene structure and function. The rise of commercially available next-generation sequencing methodologies, in the beginning of this century, is drastically allowing larger amount of information to be acquired, in a manner open to the democratization of the approach

Host diet mediates a negative relationship between abundance and diversity of <i>Drosophila</i> gut microbiota.

Nutrient supply to ecosystems has major effects on ecological diversity, but it is unclear to what degree the shape of this relationship is general versus dependent on the specific environment or community. Although the diet composition in terms of the source or proportions of different nutrient types is known to affect gut microbiota composition, the relationship between the quantity of nutrients supplied and the abundance and diversity of the intestinal microbial community remains to be elucidated. Here, we address this relationship using replicate populations of &lt;i&gt;Drosophila melanogaster&lt;/i&gt; maintained over multiple generations on three diets differing in the concentration of yeast (the only source of most nutrients). While a 6.5-fold increase in yeast concentration led to a 100-fold increase in the total abundance of gut microbes, it caused a major decrease in their alpha diversity (by 45-60% depending on the diversity measure). This was accompanied by only minor shifts in the taxonomic affiliation of the most common operational taxonomic units (OTUs). Thus, nutrient concentration in host diet mediates a strong negative relationship between the nutrient abundance and microbial diversity in the &lt;i&gt;Drosophila&lt;/i&gt; gut ecosystem

Guidance to 2018 good practice : ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma

AimsMobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurred by the disease and to improve the digital transformation of health and care. The ultimate goal is to change the management strategy in chronic diseases.MethodsMASK implements ICT technologies for individualized and predictive medicine to develop novel care pathways by a multi-disciplinary group centred around the patients.StakeholdersInclude patients, health care professionals (pharmacists and physicians), authorities, patient's associations, private and public sectors.ResultsMASK is deployed in 23 countries and 17 languages. 26,000 users have registered.EU grants (2018)MASK is participating in EU projects (POLLAR: impact of air POLLution in Asthma and Rhinitis, EIT Health, DigitalHealthEurope, Euriphi and Vigour).Lessons learnt(i) Adherence to treatment is the major problem of allergic disease, (ii) Self-management strategies should be considerably expanded (behavioural), (iii) Change management is essential in allergic diseases, (iv) Education strategies should be reconsidered using a patient-centred approach and (v) Lessons learnt for allergic diseases can be expanded to chronic diseases.Peer reviewe

Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air (R) App

Background In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. Methods All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated. Results A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures. Conclusions VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.Peer reviewe

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe