250 research outputs found

    Evolutionary and functional history of the escherichia coli K1 capsule

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    Escherichia coli is a leading cause of invasive bacterial infections in humans. Capsule polysaccharide has an important role in bacterial pathogenesis, and the K1 capsule has been firmly established as one of the most potent capsule types in E. coli through its association with severe infections. However, little is known about its distribution, evolution and functions across the E. coli phylogeny, which is fundamental to elucidating its role in the expansion of successful lineages. Using systematic surveys of invasive E. coli isolates, we show that the K1-cps locus is present in a quarter of bloodstream infection isolates and has emerged in at least four different extraintestinal pathogenic E. coli (ExPEC) phylogroups independently in the last 500 years. Phenotypic assessment demonstrates that K1 capsule synthesis enhances E. coli survival in human serum independent of genetic background, and that therapeutic targeting of the K1 capsule re-sensitizes E. coli from distinct genetic backgrounds to human serum. Our study highlights that assessing the evolutionary and functional properties of bacterial virulence factors at population levels is important to better monitor and predict the emergence of virulent clones, and to also inform therapies and preventive medicine to effectively control bacterial infections whilst significantly lowering antibiotic usage

    Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19

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    Introduction: Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population. Methods: This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay. Results: Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity. Conclusions: AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes

    Influence of the pharmaceutical advice on the prevention and control of dengue in elderly adults served at the Botica My Health, Puerto Maldonado-Tambopata august-october ,2022

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    Se determinó que el nivel de conocimiento y prácticas de prevención y control del dengue fue de 19.0% (n = 19) en nivel bajo, el 76.0% (n = 76) medio y 5.0% (n = 5) alto. Se desarrolló la consejería en la Botica Mi Salud, Puerto Maldonado, en cuatro sesiones a las cuales asistieron todos los sujetos que constituyeron la muestra. El nivel de prevención y control del dengue mejoró en el post test en relación al pre test. Ya que disminuyó el nivel bajo de 19.0 a 0.0%, el medio disminuyó de 76.0 a 45.0% y el alto aumentó de 5.0 a 55.0%. se demostró que existen diferencias estadísticamente significativas entre los resultados obtenidos en el pre y el post test

    Patterns of oral anticoagulant use and outcomes in Asian patients with atrial fibrillation: a post-hoc analysis from the GLORIA-AF Registry

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    Background: Previous studies suggested potential ethnic differences in the management and outcomes of atrial fibrillation (AF). We aim to analyse oral anticoagulant (OAC) prescription, discontinuation, and risk of adverse outcomes in Asian patients with AF, using data from a global prospective cohort study. Methods: From the GLORIA-AF Registry Phase II-III (November 2011-December 2014 for Phase II, and January 2014-December 2016 for Phase III), we analysed patients according to their self-reported ethnicity (Asian vs. non-Asian), as well as according to Asian subgroups (Chinese, Japanese, Korean and other Asian). Logistic regression was used to analyse OAC prescription, while the risk of OAC discontinuation and adverse outcomes were analysed through Cox-regression model. Our primary outcome was the composite of all-cause death and major adverse cardiovascular events (MACE). The original studies were registered with ClinicalTrials.gov, NCT01468701, NCT01671007, and NCT01937377. Findings: 34,421 patients were included (70.0 ¬Ī 10.5 years, 45.1% females, 6900 (20.0%) Asian: 3829 (55.5%) Chinese, 814 (11.8%) Japanese, 1964 (28.5%) Korean and 293 (4.2%) other Asian). Most of the Asian patients were recruited in Asia (n = 6701, 97.1%), while non-Asian patients were mainly recruited in Europe (n = 15,449, 56.1%) and North America (n = 8378, 30.4%). Compared to non-Asian individuals, prescription of OAC and non-vitamin K antagonist oral anticoagulant (NOAC) was lower in Asian patients (Odds Ratio [OR] and 95% Confidence Intervals (CI): 0.23 [0.22-0.25] and 0.66 [0.61-0.71], respectively), but higher in the Japanese subgroup. Asian ethnicity was also associated with higher risk of OAC discontinuation (Hazard Ratio [HR] and [95% CI]: 1.79 [1.67-1.92]), and lower risk of the primary composite outcome (HR [95% CI]: 0.86 [0.76-0.96]). Among the exploratory secondary outcomes, Asian ethnicity was associated with higher risks of thromboembolism and intracranial haemorrhage, and lower risk of major bleeding. Interpretation: Our results showed that Asian patients with AF showed suboptimal thromboembolic risk management and a specific risk profile of adverse outcomes; these differences may also reflect differences in country-specific factors. Ensuring integrated and appropriate treatment of these patients is crucial to improve their prognosis. Funding: The GLORIA-AF Registry was funded by Boehringer Ingelheim GmbH

    Log√≠stica Inversa y Econom√≠a Circular de los A√Īos 2022 al 2023

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    Objective: Determine the review of reverse logistics and circular economy for the year 2022 - 2023. Methodology: to search for information, the Boolean operators AND, OR, and NOT were used, using an eight-step guide proposed by Okoli and Schabram (2010), 10 articles were recorded and exclusion and inclusion criteria were used for their selection. 6 articles were excluded and only 04 were included for the review. Databases were used: Redalyc, Scielo, Dialnet, Google Scholar, the PRISMA guidelines and documentary analysis were used as a technique, and Instruments were the articles mentioned.  Result: Shows that recycling, proper disposal, and the efficient implementation of reverse logistics require careful planning and effective supply chain management. It involves activities such as product collection, return transportation, temporary storage, disassembly, repair, recycling, and final disposal. Product Returns: When customers return defective, damaged, or incorrect products to manufacturers or distributors. This can include dangerous chemical products, expired medicines or contaminated products, especially electronics, for which it is necessary to understand the problem in order to propose a proposal that allows understanding the current context. Conclusion: That reverse logistics can provide various benefits, such as reducing production costs, improving corporate image and compliance with environmental regulations. In addition, it contributes to the circular economy by promoting the reuse and recycling of products and materials, properly the products, components or materials, thus promoting sustainability and the circular economy, for which the articles make a conceptual review, but especially in some cases seeks to propose a model based on linear programming and other related concepts.Metodolog√≠a: para la b√ļsqueda de la informaci√≥n se utiliz√≥ los operadores booleanos, AND,OR Y NOT, utilizando una gu√≠a de ocho pasos propuesta por Okoli y Schabram (2010) se consignaron 10 art√≠culos y para su selecci√≥n se utilizaron criterios de exclusi√≥n e inclusi√≥n se excluyeron 6 art√≠culos y solo 04 se incluyeron para la revisi√≥n se utilizaron base de datos: Redalyc, Scielo, Dialnet, Google Scholar, se utiliz√≥ como t√©cnica las directrices PRISMA y de an√°lisis documental, e Instrumentos los art√≠culos mencionados.  Resultado: muestra que el reciclaje, desecho adecuado, y la implementaci√≥n eficiente de la log√≠stica inversa requiere una planificaci√≥n cuidadosa y una gesti√≥n efectiva de la cadena de suministro. Implica actividades como la recolecci√≥n de productos, el transporte de retorno, el almacenamiento temporal, el desmontaje, la reparaci√≥n, el reciclaje y la disposici√≥n final. Devoluciones de productos: Cuando los clientes devuelven productos defectuosos, da√Īados o incorrectos a los fabricantes o distribuidores. Esto puede incluir productos qu√≠micos peligrosos, medicamentos caducados o productos contaminados especialmente electr√≥nico, para lo cual se requiere entender el problema para proponer una propuesta que permita entender el contexto actual.  Conclusi√≥n:  Que la log√≠stica inversa puede proporcionar diversos beneficios, como la reducci√≥n de costos de producci√≥n, la mejora de la imagen corporativa y el cumplimiento de las regulaciones ambientales. Adem√°s, contribuye a la econom√≠a circular al fomentar la reutilizaci√≥n y el reciclaje de productos y materiales, adecuadamente los productos, componentes o materiales, promoviendo as√≠ la sostenibilidad y la econom√≠a circular, por lo que los art√≠culos hacen una revisi√≥n conceptual, pero especialmente en algunos casos se busca proponer un modelo basado en programaci√≥n lineal y otros conceptos relacionados

    Evolutionary and functional history of the Escherichia coli K1 capsule

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    Escherichia coli is a leading cause of invasive bacterial infections in humans. Capsule polysaccharide has an important role in bacterial pathogenesis, and the K1 capsule has been firmly established as one of the most potent capsule types in E. coli through its association with severe infections. However, little is known about its distribution, evolution and functions across the E. coli phylogeny, which is fundamental to elucidating its role in the expansion of successful lineages. Using systematic surveys of invasive E. coli isolates, we show that the K1-cps locus is present in a quarter of bloodstream infection isolates and has emerged in at least four different extraintestinal pathogenic E. coli (ExPEC) phylogroups independently in the last 500 years. Phenotypic assessment demonstrates that K1 capsule synthesis enhances E. coli survival in human serum independent of genetic background, and that therapeutic targeting of the K1 capsule re-sensitizes E. coli from distinct genetic backgrounds to human serum. Our study highlights that assessing the evolutionary and functional properties of bacterial virulence factors at population levels is important to better monitor and predict the emergence of virulent clones, and to also inform therapies and preventive medicine to effectively control bacterial infections whilst significantly lowering antibiotic usage

    Coronal Heating as Determined by the Solar Flare Frequency Distribution Obtained by Aggregating Case Studies

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    Flare frequency distributions represent a key approach to addressing one of the largest problems in solar and stellar physics: determining the mechanism that counter-intuitively heats coronae to temperatures that are orders of magnitude hotter than the corresponding photospheres. It is widely accepted that the magnetic field is responsible for the heating, but there are two competing mechanisms that could explain it: nanoflares or Alfv\'en waves. To date, neither can be directly observed. Nanoflares are, by definition, extremely small, but their aggregate energy release could represent a substantial heating mechanism, presuming they are sufficiently abundant. One way to test this presumption is via the flare frequency distribution, which describes how often flares of various energies occur. If the slope of the power law fitting the flare frequency distribution is above a critical threshold, őĪ=2\alpha=2 as established in prior literature, then there should be a sufficient abundance of nanoflares to explain coronal heating. We performed >>600 case studies of solar flares, made possible by an unprecedented number of data analysts via three semesters of an undergraduate physics laboratory course. This allowed us to include two crucial, but nontrivial, analysis methods: pre-flare baseline subtraction and computation of the flare energy, which requires determining flare start and stop times. We aggregated the results of these analyses into a statistical study to determine that őĪ=1.63¬Ī0.03\alpha = 1.63 \pm 0.03. This is below the critical threshold, suggesting that Alfv\'en waves are an important driver of coronal heating.Comment: 1,002 authors, 14 pages, 4 figures, 3 tables, published by The Astrophysical Journal on 2023-05-09, volume 948, page 7

    Low-dose aspirin confers protection against acute cellular allograft rejection after primary liver transplantation.

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    OBJECTIVE To investigate the effect of low-dose aspirin in primary adult liver transplantation LT on acute cellular rejection ACR as well as arterial patency rates. BACKGROUND The use of low-dose aspirin after LT is practiced by many transplant centers to minimize the risk of hepatic artery thrombosis HAT, although solid recommendations do not exist. However, aspirin also possesses potent anti-inflammatory properties and might mitigate inflammatory processes after LT, such as rejection. Therefore, we hypothesized that the use of aspirin after liver transplantation has a protective effect against ACR. METHODS This is an international, multicenter cohort study of primary adult deceased donor LT. The study included 17 high-volume LT centers and covered the 3-year period from 2013 to 2015 to allow a minimum 5-year follow-up. RESULTS In this cohort of 2,365 patients, prophylactic antiplatelet therapy with low-dose aspirin was administered in 1,436 recipients 61%. One-year rejection-free survival rate was 89% in the aspirin group versus 82% in the no-aspirin group HR 0.77, 95% CI 0.63-0.94, p=0.01. One-year primary arterial patency rates were 99% in the aspirin and 96% in the no-aspirin group with a HR of 0.23 95% CI: 0.13-0.40; p<0.001. CONCLUSION Low-dose aspirin was associated with a lower risk of ACR and HAT after LT, especially in the first vulnerable year after transplantation. Therefore, low-dose aspirin use after primary LT should be evaluated to protect the liver graft from ACR and to maintain arterial patency

    Apolipoprotein B, Residual Cardiovascular Risk After Acute Coronary Syndrome, and Effects of Alirocumab.