Klotho, the elusive kidney-derived anti-ageing factor

Chronic kidney disease (CKD) is one of the fastest growing causes of death worldwide. Only early diagnosis will allow prevention of both CKD progression and the negative impact of CKD on all-cause and cardiovascular mortality. Klotho is a protein produced by the kidneys that has anti-ageing and phosphaturic properties, preventing excess positive phosphate balance. There is evidence that Klotho downregulation is one of the earliest consequences of kidney injury. Thus the development of reliable assays to monitor Klotho levels may allow an early diagnosis of CKD and monitoring the impact of therapies aimed at preserving Klotho expression or at preventing CKD progression. However, the performance of Klotho assays has been suboptimal so far. In this issue of Clinical Kidney Journal, Neyra et al. explore methods to improve the reliability of Klotho assays.The authors were supported by FIS PI16/02057, PI18/01366, PI19/ 00588, PI19/00815, ERA-PerMed-JTC2018 (KIDNEY ATTACK AC18/00064 and PERSTIGAN AC18/00071), DTS18/00032, ISCIIIRETIC REDinREN RD016/0009 Fondos FEDER, Sociedad Española de Nefrología, Comunidad de Madrid B2017/BMD-3686 CIFRA2- CM and Miguel Servet MS14/00133 to MDS

Training future childhood education teachers in University and a school collaboration

Los cambios que ha experimentado nuestra sociedad en los últimos años, han repercutido notablemente en el ámbito educativo, y por tanto, en sus profesionales, de tal modo que parece necesaria una revisión y transformación de su formación, para poder dar respuestas a las demandas y a las necesidades educativas de hoy. Desde nuestro punto de vista, la formación inicial constituye uno de los ejes vertebradores de toda formación, por ello, en este trabajo presentamos dos actividades desarrolladas en 1º del Grado de Educación Infantil, que forman parte de nuestra propuesta académica. Propuesta basada en un modelo de aprendizaje que supone la creación de un espacio educativo abierto, caracterizado por el desarrollo de competencias, en un ambiente participativo y de colaboración, donde la práctica y la teoría están en constante interacción. Nuestro alumnado tuvo que enfrentarse al reto de diseñar, planificar, organizar, realizar y evaluar una actividad con un grupo de niños del segundo ciclo de Educación Infantil, así como colaborar y participar en unas Jornadas educativas organizadas por diferentes colegios de la provincia. Tras evaluar la experiencia los resultados han sido muy satisfactorios, podemos afirmar que nuestro alumnado ha empezado a desarrollar un profesionalismo práctico, que da sentido al conocimiento teórico aprendido y hemos conseguido una integración absoluta entre la teoría y la práctica educativa, consiguiendo un mayor acercamiento entre la universidad y la escuela.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Correction: New knowledge on the antiglycoxidative mechanism of chlorogenic acid

Correction for 'New knowledge on the antiglycoxidative mechanism of chlorogenic acid' by Beatriz Fernandez-Gomez et al., Food Funct., 2015, DOI: 10.1039/c5fo00194c

Metagenomic sequencing, molecular characterization, and Bayesian phylogenetics of imported type 2 vaccine-derived poliovirus, Spain, 2021

Introduction: In 2021, a type 2 vaccine-derived poliovirus (VDPV2) was isolated from the stool of a patient with acute flaccid paralysis (AFP) admitted to Spain from Senegal. A virological investigation was conducted to characterize and trace the origin of VDPV2. Methods: We used an unbiased metagenomic approach for the whole-genome sequencing of VDPV2 from the stool (pre-treated with chloroform) and from the poliovirus-positive supernatant. Phylogenetic analyses and molecular epidemiological analyses relying on the Bayesian Markov Chain Monte Carlo methodology were used to determine the geographical origin and estimate the date of the initiating dose of the oral poliovirus vaccine for the imported VDPV2. Results: We obtained a high percentage of viral reads per total reads mapped to the poliovirus genome (69.5% for pre-treated stool and 75.8% for isolate) with a great depth of sequencing coverage (5,931 and 11,581, respectively) and complete genome coverage (100%). The two key attenuating mutations in the Sabin 2 strain had reverted (A481G in the 5'UTR and Ile143Thr in VP1). In addition, the genome had a recombinant structure between type-2 poliovirus and an unidentified non-polio enterovirus-C (NPEV-C) strain with a crossover point in the protease-2A genomic region. VP1 phylogenetic analysis revealed that this strain is closely related to VDPV2 strains circulating in Senegal in 2021. According to Bayesian phylogenetics, the most recent common ancestor of the imported VDPV2 could date back 2.6 years (95% HPD: 1.7-3.7) in Senegal. We suggest that all VDPV2s circulating in 2020-21 in Senegal, Guinea, Gambia, and Mauritania have an ancestral origin in Senegal estimated around 2015. All 50 stool samples from healthy case contacts collected in Spain (n = 25) and Senegal (n = 25) and four wastewater samples collected in Spain were poliovirus negative. Discussion: By using a whole-genome sequencing protocol with unbiased metagenomics from the clinical sample and viral isolate with high sequence coverage, efficiency, and throughput, we confirmed the classification of VDPV as a circulating type. The close genomic linkage with strains from Senegal was consistent with their classification as imported. Given the scarce number of complete genome sequences for NPEV-C in public databases, this protocol could help expand poliovirus and NPEV-C sequencing capacity worldwide.This study was partially supported by two grants from the Instituto de Salud Carlos III [grant numbers PI18CIII/00017 and PI20CIII/00005].S

Proyecto de aprendizaje-servicio para la formación inicial del maestro/a de educación infantil desde contextos reales

En este trabajo se presentan los principales elementos de un Proyecto de Coordinación Docente desarrollado en el curso académico 2016/17, en 1º curso del Grado de Maestro/a de Educación Infantil de la Facultad de Ciencias de la Educación de la Universidad de Málaga. En él se han unificado principios y prácticas de las asignaturas de “Hacia una escuela inclusiva: modelos y prácticas”, “Organización Escolar en la Educación Infantil” y “Didáctica aplicada a la Educación Infantil”. La finalidad ha sido provocar en el alumnado el conocimiento, a través de la experiencia de su práctica real, desde una perspectiva multidisciplinar y reflexiva partiendo de los contenidos de las tres disciplinas. Como eje conductor, el aprendizaje han pivotado sobre un Proyecto de Aprendizaje-Servicio a la comunidad, en este caso, la mejora del Patio de Recreo de una Escuela de Infantil de la localidad, procurando convertirlo en un patio lúdico y educativo, donde cada una y cada uno de los niños vea facilitado su derecho al juego. Dicho proyecto ha posibilitado que nuestro alumnado pueda construir una visión de las asignaturas como recursos para dar respuestas a una única realidad, que es a lo que se enfrentarán en su futuro profesional. Igualmente, ha facilitado el aprendizaje a partir de otros tiempos y espacios didácticos más abiertos e integrales, mediante el trabajo colaborativo de docentes y alumnado y centrando la enseñanza en el aprendizaje. La evaluación del proyecto continúa abierta, aunque en este trabajo ya se aportan algunas conclusiones.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Shotgun metagenomics to investigate unknown viral etiologies of pediatric meningoencephalitis

Introduction: Meningoencephalitis in children poses a diagnostic challenge, as etiology remains unknown for most of patients. Viral metagenomics by shotgun sequencing represents a powerful tool for investigating unknown viral infections related to these cases. Patients and methods: In a two-year, reference-centre, retrospective study, we investigated the usefulness of viral metagenomics of cerebrospinal fluid (CSF) for the diagnosis of viral infectious meningoencephalitis in forty seven pediatric patients, forty of them previously tested negative with a routine neurologic panel of viral targets that included herpesvirus 1-3 and enterovirus. We enhanced the detection by targeting viral sequences by hybrid capture. Raw sequence data was analysed using three bioinformatics pipelines. Results: Out of forty remaining children with meningoencephalitis of unknown viral etiology, a significant detection of viral nucleic acid by shotgun sequencing was found in twenty one, which was confirmed in ten of them by specific PCR: seven human endogenous retrovirus K113 (HER K113), one parechovirus 3, one human herpesvirus 5 (HHV5); one enterovirus B (Echovirus 9). The remaining eleven CSF were not confirmed by PCR: three rotavirus, one human herpesvirus 7 (HHV7), one influenza A, one mastadenovirus C, one sindbis virus, one torque teno virus, one human immunodeficiency virus 1 (HIV-1), one human alphaherpesvirus 3 (HHV3), one human alphaherpesvirus 2 (HHV2). Conclusions: Underutilization of currently available meningitis-encephalitis diagnostic techniques such as BioFire® FilmArray® is the main cause of undiagnosed cases of meningoencephalitis. However, in this study we detected uncommon viruses that should be considered, including virus, rotavirus, sindbis virus, influenza A virus and HHV7. No other viral sequences that could be readily linked to CNS inflammation were detected. Some findings may stem from reagent or sample contamination, as seen with papillomavirus; for others, the clinical relevance of the virus remains uncertain and should be substantiated by further studies, as is the case with endogenous retrovirus K113 virus. Online bioinformatics pipeline CZID represents a valuable tool for analysing shotgun sequencing data in cases of neurological conditions with unknown etiology. Altogether, this study highlights the potential of shotgun sequencing in identifying previously unknown viral neuropathogens and sheds light on the interpretation issues related to its application in clinical microbiology.This work was supported by a grant from Instituto de Salud Carlos III. Project code MPY434/2021. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.S

Evaluation of a novel digital environment for learning medical parasitology.

open access articleEukaryotic parasites represent a serious human health threat requiring health professionals with parasitology skills to counteract this threat. However, recent surveys highlight an erosion of teaching of parasitology in medical and veterinary schools, despite reports of increasing instances of food and water borne parasitic infections. To address this we developed a web-based resource, DMU e-Parasitology®, to facilitate the teaching and learning of parasitology, comprising four sections: theoretical; virtual laboratory; virtual microscopy; virtual clinical case studies. Testing the package was performed using a questionnaire given to ninety-five Pharmacy students in 2017/18 to assess effectiveness of the package as a teaching and learning tool. 89.5% of students reported appropriate acquisition of knowledge of the pathology, prevention and treatment of some parasitic diseases. 82.1% also welcomed the clinical specialism of the package as it helped them to acquire basic diagnostic skills, through learning infective features/morphology of the parasites

Phosphate, microbiota and ckd

Phosphate is a key uremic toxin associated with adverse outcomes. As chronic kidney disease (CKD) progresses, the kidney capacity to excrete excess dietary phosphate decreases, triggering compensatory endocrine responses that drive CKD-mineral and bone disorder (CKD-MBD). Eventu-ally, hyperphosphatemia develops, and low phosphate diet and phosphate binders are prescribed. Recent data have identified a potential role of the gut microbiota in mineral bone disorders. Thus, parathyroid hormone (PTH) only caused bone loss in mice whose microbiota was enriched in the Th17 cell-inducing taxa segmented filamentous bacteria. Furthermore, the microbiota was required for PTH to stimulate bone formation and increase bone mass, and this was dependent on bacterial production of the short-chain fatty acid butyrate. We review current knowledge on the relationship between phosphate, microbiota and CKD-MBD. Topics include microbial bioactive compounds of special interest in CKD, the impact of dietary phosphate and phosphate binders on the gut microbiota, the modulation of CKD-MBD by the microbiota and the potential therapeutic use of microbiota to treat CKD-MBD through the clinical translation of concepts from other fields of science such as the optimization of phosphorus utilization and the use of phosphate-accumulating organisms.This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 860329, FIS/Fondos FEDER (PI18/01366, PI20/00744, PI19/00815, DTS18/00032, ERA-PerMed-JTC2018 (KIDNEY ATTACK AC18/00064 and PERSTIGAN AC18/00071, ISCIII-RETIC REDinREN RD016/0009), Sociedad Española de Nefrología, FRIAT, Comunidad de Madrid en Biomedicina B2017/BMD-3686 CIFRA2-C

Prophylactic incisional negative pressure wound therapy for gynaecologic malignancies

Wound complications are an important cause of postoperative morbidity among patients with gynaecologic malignancies. We evaluated whether the placement of closed-incisional negative pressure therapy (ciNPT) at the time of laparotomy for gynaecologic cancer surgery reduced wound complication rates. A retrospective cohort study with primary wound closure performed by a gynaecologic oncologist was carried out. We evaluated two cohorts of patients who underwent surgery in 2017 with standard closure and patients who underwent surgery in 2019 with the placement of prophylactic ciNPT. Postoperative outcomes were examined. A total of 143 patients were included, 85 (59.4%) vs 58 (40.6%) with standard closure and ciNPT, respectively. The total complication rate in our sample was 38.71%. The rate of surgical complications in patients treated with ciNPT was 6.9% compared with 31.8% (P = .000) in patients treated with standard closure. In the analysis of complications, a significant reduction in infections (17.1%), seromas (15.4%), and wound dehiscence (17.1%) were observed when ciNPT was applied. The median hospital stay was 8 vs 6 days in the standard closure vs ciNPT groups (P = .048). The use of the prophylactic ciNPT following a laparotomy may decrease wound complications and hospital stays in oncological patients. ciNPT could be considered as part of clinical practice in patients at high risk of wound complications, such as patients with gynaecological malignancies