Holotranscobalamin Is a Useful Marker of Vitamin B12 Deficiency in Alcoholics

Background. Measurement of serum cobalamin (Cbl) levels is the standard investigation for assessing vitamin B12 deficiency. Falsely increased values of Cbl can be caused by alcoholic liver disease. Measurement of total vitamin B12 serum levels might be misleading in alcoholics, because a tissue metabolic deficiency is possible even with normal serum Cbl levels. Holotranscobalamin (HoloTC), the Cbl metabolically active fraction, is considered as a better index of vitamin B12 deficiency. Methods. For assessing vitamin B12 status, we evaluated 22 adult alcoholic male patients by measuring in parallel serum Cbl, serum folate and red blood cell folate levels, HoloTC levels by the AxSYM assay. Results. HoloTC values were reduced in 3 alcoholics with borderline-low Cbl values. Significant positive correlations were found between serum Cbl and HoloTC levels, serum Cbl and gamma-glutamyl transpeptidase (GGT). Conclusion. HoloTC measurement is a useful option for assessing vitamin B12 status in alcoholics, particularly in the subjects with borderline Cbl values and may be considered an early marker of vitamin B12 deficiency

Ophthalmic complications of Lemierre syndrome

PURPOSE: Lemierre syndrome is a life-threatening condition characterized by head/neck bacterial infection, local suppurative thrombophlebitis and septic embolic complications in a range of sites of distant organs. No prior study focused on the course and characteristics of ophthalmic complications of Lemierre syndrome. METHODS: We analysed data of 27 patients with ophthalmic complications from a large cohort of 712 cases with Lemierre syndrome reported globally between 2000 and 2017. We focused on initial manifestations, early (in-hospital) course and long-term ophthalmic deficits at the time of hospital discharge or during postdischarge follow-up. The study protocol was registered in the International Prospective Register of Systematic Reviews PROSPERO (CRD42016052572). RESULTS: Nine (33%) patients were women; the median age was 20 (Q1-Q3: 15-33) years. Fusobacterium spp. was involved in 56% of cases. The most prevalent initial manifestations were decreased vision (35%) and periocular oedema (38%), followed by impaired eye movements/nerve palsy (28%) and proptosis (28%). Venous involvement, notably cerebral vein thrombosis (70%) and ophthalmic vein thrombosis (55%), explained the symptomatology in most cases. Septic embolism (7%), orbital abscesses (2%) and carotid stenosis (14%) were also present. Ophthalmic sequelae were reported in 9 (33%) patients, often consisting of blindness or reduced visual acuity, and nerve paralysis/paresis. CONCLUSION: Ophthalmic complications represent a severe manifestation of Lemierre syndrome, often reflecting an underlying cerebral vein thrombosis. Visual acuity loss and long-term severe complications are frequent. We call for an interdisciplinary approach to the management of patients with Lemierre syndrome and the routine involvement of ophthalmologists

The adrenal capsule is a signaling center controlling cell renewal and zonation through <i>Rspo3</i>

Adrenal glands are zonated endocrine organs that are essential in controlling body homeostasis. How zonation is induced and maintained and how renewal of the adrenal cortex is ensured remain a mystery. Here we show that capsular RSPO3 signals to the underlying steroidogenic compartment to induce β-catenin signaling and imprint glomerulosa cell fate. Deletion of RSPO3 leads to loss of SHH signaling and impaired organ growth. Importantly, Rspo3 function remains essential in adult life to ensure replenishment of lost cells and maintain the properties of the zona glomerulosa. Thus, the adrenal capsule acts as a central signaling center that ensures replacement of damaged cells and is required to maintain zonation throughout life

Diversity and genetic architecture of agro-morphological traits in a core collection of European traditional tomato

European traditional tomato varieties have been selected by farmers given their consistent performance and adaptation to local growing conditions. Here we developed a multipurpose core collection, comprising 226 accessions representative of the genotypic, phenotypic, and geographical diversity present in European traditional tomatoes, to investigate the basis of their phenotypic variation, gene×environment interactions, and stability for 33 agro-morphological traits. Comparison of the traditional varieties with a modern reference panel revealed that some traditional varieties displayed excellent agronomic performance and high trait stability, as good as or better than that of their modern counterparts. We conducted genome-wide association and genome-wide environment interaction studies and detected 141 quantitative trait loci (QTLs). Out of those, 47 QTLs were associated with the phenotype mean (meanQTLs), 41 with stability (stbQTLs), and 53 QTL-by-environment interactions (QTIs). Most QTLs displayed additive gene actions, with the exception of stbQTLs, which were mostly recessive and overdominant QTLs. Both common and specific loci controlled the phenotype mean and stability variation in traditional tomato; however, a larger proportion of specific QTLs was observed, indicating that the stability gene regulatory model is the predominant one. Developmental genes tended to map close to meanQTLs, while genes involved in stress response, hormone metabolism, and signalling were found within regions affecting stability. A total of 137 marker–trait associations for phenotypic means and stability were novel, and therefore our study enhances the understanding of the genetic basis of valuable agronomic traits and opens up a new avenue for an exploitation of the allelic diversity available within European traditional tomato germplasmThis work was supported by European Commission H2020 research and innovation program through TRADITOM grant agreement no. 634561, G2P-SOL, grant agreement no. 677379, and HARNESSTOM grant agreement no. 101000716. Networking activities were funded by COST Actions “EUROCAROTEN CA15136 and ‘RoxyCOST’ CA18210 ‘RoxyCOSTPostprint (published version

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Materialidad como portadora de sentido

Abstract en inglés: This project is the continuation of the previous project PIACyT 34/0534. Its basis, like the previous one, continues to be the need of deepening the learning path of students and teachers of the subject Applied Sciences to the Arts of Fire, since we feel that in the face of the new challenges presented by the insertion of Fire Arts in the field of contemporary artistic practices, we need to develop new specific methodological devices. Our proposal as teaching team, refers to specific issues when defining the materiality of the ceramic object and the use of raw materials. The results obtained far exceed the practice understood only as the production of objects or results of samples collections, and open possibilities of relationships that positively influence the growth of one's own field. During the research period 2018-2019 we have fulfilled much of the work of collecting, correcting, nominating and organizing with logical criteria: documents, photos, videos, objects and ceramic products. This work covers the curses dictated from the beginning of the subject in 2001 to the present day. We must continue compiling and cataloguing students ‘research reports and their practical results. We are convinced that the availability of this information will serve to significantly increase local and regional raw materials and ceramic products usage, as well as the discourse of the Visual Arts, especially that of the Fire Arts, enhancing its possibilities by adapting them to the aesthetic purpose. The publication of the reports and results will make visible the work done by students as a source of information for other students, teachers, researchers, artists, artisans, interested in making ceramics. In addition, it will facilitate the localization of foreign experiences, adapting them to local materials and technological resources, since all the works were done using Argentinean or locally available materials, and processed with easily accessible technology. In this new stage of the project, to generate a data model that is extensible over time (since students will continue to provide documentation), is accessible with different search criteria, and in the future allows access from the web, we will define the type of digital platform to be used, its structure and implementation rules. Prior to the assembly of the platform and its eventual publication, we must adapt and homogenize the formats of the different documents, images and videos that exist, so that they are suitable for the platform.El presente proyecto es continuación del proyecto anterior PIACyT 34/0534. Su fundamentado, al igual que el anterior, continúa siendo la necesidad de seguir profundizando el trayecto recorrido por los estudiantes y docentes de la asignatura Ciencias Aplicadas a las Artes del Fuego, ya que sentimos que frente a los nuevos desafíos que hoy presenta la inserción de las Artes del Fuego en el ámbito de las prácticas artísticas contemporáneas nos es necesario desarrollar nuevos dispositivos metodológicos de la especificidad. Nuestra propuesta como equipo docente refiere a cuestiones concretas a la hora de definir la materialidad del objeto cerámico y el uso de materias primas, cuyos resultados superan ampliamente la práctica entendida tan solo como producción de objetos o muestrarios con resultados, y abren posibilidades de relaciones que influyen positivamente en el crecimiento del campo propio. Durante el período de la investigación 2018-2019 hemos cumplido con gran parte del trabajo de recopilación, corrección, nominación y organización con criterios lógicos: documentos, fotos, videos, objetos y productos cerámicos. Este trabajo abarca el recorrido realizado por la asignatura desde que comenzó a dictarse en el 2001 hasta el día de hoy. Debemos continuar la tarea de compilación y catalogación de los informes de investigaciones y sus resultados prácticos realizados por los estudiantes. Estamos convencidos que la disponibilidad de esta información servirá para acrecentar significativamente tanto el aprovechamiento de materias primas y productos cerámicos locales y regionales, como el discurso de las Artes Visuales, en especial el de las Artes del Fuego, potenciando sus posibilidades al adecuarlos al fin estético. La publicación de los informes y resultados visibilizará los trabajos realizados por los estudiantes como fuente de información para otros estudiantes, docentes, investigadores, artistas, artesanos, interesados en el hacer cerámico. Además, facilitará la localización de experiencias foráneas, adaptándolas a materiales y tecnologías locales, ya que todos los trabajos fueron realizados con materiales argentinos, o que se consiguen localmente, y procesados con tecnología fácilmente accesible. En esta nueva etapa del proyecto, a fin de generar un modelo de datos que sea extensible en el tiempo (dado que los estudiantes continuaran aportando documentación), accesible con distintos criterios de búsqueda, y que en el futuro permita el acceso desde la web, definiremos el tipo de plataforma digital a utilizar, su estructura y reglas de implementación. Previo al armado de la plataforma y su eventual publicación, deberemos, además de finalizar la tarea de compilación y catalogación, adecuar y homogeneizar los formatos de los distintos documentos, imágenes y videos existentes, para que sean aptos para la plataforma

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Caracterización de cepas de Staphylococcus aureus asociadas a infecciones transitorias y persistentes en la glándula mamaria bovina: estudios inmunológicos, moleculares y de infección intramamaria en bovinos.

El objetivo general de este trabajo fue estudiar diferentes aspectos de la compleja interacción entre genotipos bacterianos definidos y caracterizados como de alta y baja adaptación a la glándula mamaria (GM) con el hospedador, para poder comprender en parte, el establecimiento y cronicidad de las infecciones intramamarias (IIM) causadas por Staphylococcus aureus en bovinos. Se seleccionó la cepa 806 transitoria (T), cap8, icaACD, agrII, fuerte productora de biofilm, pulsotipo D, ST350 y poco invasiva en células epiteliales mamarias (MAC-T); y la cepa 5011 persistente (P), cap5, icaACD, agrI, blaZ, débil productora de biofilm, pulsotipo O, CC188 y altamente invasiva. La cepa P presentó mayor sobrevida intracelular en MAC-T y macrófagos. MAC-T infectadas con ambas cepas murieron por apoptosis, induciendo la cepa P mayores porcentajes de muerte. Los macrófagos infectados con la cepa P mostraron mayor capacidad fagocítica. La producción de especies reactivas de oxígeno y de óxido nítrico (ON) fue similar para ambas cepas. Los resultados de la IIM experimental difirieron entre ambas cepas, la T indujo aumento del recuento de células somáticas (RCS), ON, IL-1β, IL-6 e IgG total en leche a las 48 hs post-infección (pi); en sangre, indujo una disminución de los monocitos, linfocitos T y CD8. La cepa P, indujo un aumento del RCS a los 7 días pi y del ON 14 días pi. La combinación de factores de virulencia de S. aureus podría determinar el inicio de la interacción patógeno-hospedador e influenciar la respuesta inmune de la GM y la evolución del proceso infeccioso.Fil: Sacco, Sofía Clara. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Ciencias Veterinarias del Litoral. Universidad Nacional del Litoral. Facultad de Ciencias Veterinarias. Instituto de Ciencias Veterinarias del Litoral; Argentin

Cheating, inequality aversion, and appealing to social norms

We conduct a field experiment involving 143, 9-years old children in their classrooms. Children are requested to flip a coin in private and receive a big or a small prize depending on the outcome they report. Comparing the actual and theoretical distribution of reported wins, we find evidence of cheating at the aggregate level. By using behavioral data gathered on previous and subsequent meetings with the same children, we are able to explore the relationship between cheating behavior, other regarding preferences, and the tendency to appeal to social norms in judging unfair behaviors. Children who are classified as concerned about inequality are less likely to cheat. Similarly, children who are more likely to appeal to social norms in judging unfair behaviors are also less likely to cheat. We find no significant relationship between inequality concern and social norms sensitivity, suggesting that these mechanisms work differently interacting with children moral behavior