Search

Previous evidence has shown that the consumption of fruit-derived anthocyanins may have exercise benefits. This review aimed to summarize the effects of fruit-derived anthocyanins on cycling-induced responses and cycling performance. Medline, Science Direct, Cochrane Library, and SPORTDiscus online databases were searched. Nineteen articles met the inclusion criteria. The fruit-derived anthocyanins used in these studies were from cherry (n = 6), blackcurrant (n = 8), pomegranate (n = 2), açai (n = 1), and juçara fruit (n = 2), and were offered in juice, pulp, powder, freeze-dried powder, and extract form. The supplementation time ranged from acute consumption to 20 days, and the amount of anthocyanins administered in the studies ranged from 18 to 552 mg/day. The studies addressed effects on oxidative stress (n = 5), inflammation (n = 4), muscle damage (n = 3), fatigue (n = 2), nitric oxide biomarkers (n = 2), vascular function (n = 2), muscle oxygenation (n = 2), performance (n = 14), substrate oxidation (n = 6), and cardiometabolic markers (n = 3). The potential ergogenic effect of anthocyanin supplementation on cycling-induced responses seems to be related to lower oxidative stress, inflammation, muscle damage, and fatigue, and increased production of nitric oxide, with subsequent improvements in vascular function and muscle oxygenation leading to improved performance. In addition, the observed increase in fat oxidation can direct nutritional strategies to change the use of substrate and improve performance.

This work aims to evaluate the tranquilization, the hematological and the physiological parameters of domestic cats undergoing pharmacupuncture with acepromazine maleate. Seven animals received 5% of the dose of the drug indicated for this species in acupoint Yintang (GI) and seven (GII) received the same dose intramuscularly. The reassurance was assessed using a scale adapted from Dobbins et al. (2002). The GI group demonstrated that 71.43% of the animals presented drowsiness and projection of the third eyelid and 28.47% were less active. In GII group, 14.28% of cats were less active and 85.72% demonstrated were unchanged. About the hematologicals changing, the two groups demonstrated a slight increase of leukocytes, in GI decreased hematocrit and erythrocytes. According to physiological parameters, GI presented decrease rectal temperature and increase in respiratory rate. There were no significant changes on the heart rate and systolic blood pressure in any cat. In GII, occurred a decrease in diastolic blood pressure. The pharmacupunture showed effectiveness in cats tranquilization, besides clinical safety

This work aims to evaluate the tranquilization, the hematological and the physiological parameters of domestic cats undergoing pharmacupuncture with acepromazine maleate. Seven animals received 5% of the dose of the drug indicated for this species in acupoint Yintang (GI) and seven (GII) received the same dose intramuscularly. The reassurance was assessed using a scale adapted from Dobbins et al. (2002). The GI group demonstrated that 71.43% of the animals presented drowsiness and projection of the third eyelid and 28.47% were less active. In GII group, 14.28% of cats were less active and 85.72% demonstrated were unchanged. About the hematologicals changing, the two groups demonstrated a slight increase of leukocytes, in GI decreased hematocrit and erythrocytes. According to physiological parameters, GI presented decrease rectal temperature and increase in respiratory rate. There were no significant changes on the heart rate and systolic blood pressure in any cat. In GII, occurred a decrease in diastolic blood pressure. The pharmacupunture showed effectiveness in cats tranquilization, besides clinical safety.

Objetivo: traçar uma proposta de sistematização da assistência de enfermagem para uma idosa com lesão medular, usuária de uma unidade de saúde de natal/rn. Métodos: estudo de caso utilizando três instrumentos para coleta de informações relacionadas ao grau de dependência e às condições de autocuidado da paciente sob estudo para elaboração do planejamento da assistência. Resultados: quatro diagnósticos de enfermagem foram elaborados com base na nanda e teoria do déficit de autocuidado: mobilidade física prejudicada, padrão de sono prejudicado, manutenção do lar prejudicada e déficit de autocuidado para vestir-se e arrumar-se. quatro intervenções correspondentes foram traçadas, formulando um plano assistencial. Conclusão: propõe-se o uso dos instrumentos que avaliam a dependência e o autocuidado das pessoas para a condução da sistematização da assistência ao cuidar de idosos como lesão medular na residência como contribuição para a prática de enfermagem com essa população. Descritores: Processos de enfermagem, Idoso, Traumatismos da medula espinhal.

We report on the detection, from observations obtained with the Apache Point Observatory Galactic Evolution Experiment spectroscopic survey, of a metal-poor ([Fe/H] = −1.3 dex) field giant star with an extreme Mg–Al abundance ratio ([Mg/Fe] = −0.31 dex; [Al/Fe] = 1.49 dex). Such low Mg/Al ratios are seen only among the second-generation population of globular clusters (GCs) and are not present among Galactic disk field stars. The light-element abundances of this star, 2M16011638-1201525, suggest that it could have been born in a GC. We explore several origin scenarios, studying the orbit of the star in particular to check the probability of its being kinematically related to known GCs. We performed simple orbital integrations assuming the estimated distance of 2M16011638-1201525 and the available six-dimensional phase-space coordinates of 63 GCs, looking for close encounters in the past with a minimum distance approach within the tidal radius of each cluster. We found a very low probability that 2M16011638-1201525 was ejected from most GCs; however, we note that the best progenitor candidate to host this star is GC ω Centauri (NGC 5139). Our dynamical investigation demonstrates that 2M16011638-1201525 reaches a distance from the Galactic plane and minimum and maximum approaches to the Galactic center of Rmin < 0.62 kpc and Rmax < 7.26 kpc in an eccentric (e ∼ 0.53) and retrograde orbit. Since the extreme chemical anomaly of 2M16011638-1201525 has also been observed in halo field stars, this object could also be considered a halo contaminant, likely to have been ejected into the Milky Way disk from the halo. We conclude that 2M16011638-20152 is also kinematically consistent with the disk but chemically consistent with halo field stars. [ABSTRACT FROM AUTHOR]

Psychodinae (Diptera: Psychodidae), commonly known as "drain flies", are a subfamily of insects adapted to environments modified by humans. While often regarded as harmless, it has been reported that they may carry pathogenic microorganisms, contributing to hospital environmental contamination and potentially playing a role in healthcare-associated infections. This study aimed to investigate drain flies in a hospital setting to assess their role in carrying microbial pathogens. Twenty-six drain flies were collected from a tertiary hospital using sterile tubes and processed within two hours. The insects were identified as Clogmia albipunctata (Williston, 1893). Whole-body macerates were cultured on EMB media, and fungal isolates were identified using MALDI-TOF MS and ITS region sequencing. The emergent pathogen Trichosporon asahii was isolated, highlighting the potential role of C. albipunctata as a mechanical vector of fungal pathogens associated with HAIs. These findings underscore the importance of monitoring drain flies as part of infection prevention and control strategies in healthcare settings.

This study aims to enhance understanding of probiotic lactic acid bacteria (LAB) survival in high-hopped beer formulations and their interactions with different yeasts and highlights the fermentation processes, microbial metabolism, and production of distinctive beer flavors. For this, this research used Lacticaseibacillus paracasei F19 (F19), Saccharomycodes ludwigii, and Saccharomyces cerevisiae strains US-05 (US-05) and Kveik (Kveik) for brewing. Bacterial and yeast cultures were prepared, fermented in wort, and analyzed in different hop concentrations (International Bitterness Units - IBU 0, 20, 40). Methods included physicochemical analysis, yeast and bacterial counts, RT-qPCR for gene expression, statistical analysis, and sensory evaluation by sommeliers following BJCP guidelines. Physicochemical analysis showed efficient fermentation across all hop concentrations (IBU 0, 20, 40), with decreasing SG and pH over time due to lactic acid bacteria and yeast metabolism. Higher hop levels (IBU 20 and 40) resulted in less acidic beer, indicating hop interference with bacterial activity. Yeast populations remained stable regardless of hop content, with Saccharomyces cerevisiae and Saccharomycodes ludwigii performing well. Probiotic strain F19 exhibited robust viability in all formulations. Sensory analysis favored higher hop content beers, suggesting consumer acceptance and potential health benefits of probiotic, high-hop beers. Higher hop content hindered sour beer production as only hop-free beers reached low pH levels. Probiotic strain F19 remained viable under high IBU formulations (20 and 40), with these being preferred by sommeliers using BJCP methodology. All yeast strains supported F19 survival. Further studies are needed on gastrointestinal resistance and clinical benefits., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: Immunocompromised individuals, such as those diagnosed with cancer, are at a significantly higher risk for severe illness and mortality when infected with SARS-CoV-2 (COVID-19) than the general population. Two oral antiviral treatments are approved for COVID-19: Paxlovid® (nirmatrelvir/ritonavir) and Lagevrio® (molnupiravir). There is a paucity of data regarding the benefit from these antivirals among immunocompromised patients with cancer, and recent studies have questioned their efficacy among vaccinated patients, even those with risk factors for severe COVID-19., Methods: We evaluated the efficacy and safety of nirmatrelvir/ritonavir and molnupiravir in preventing severe illness and death using our database of 457 patients with cancer and COVID-19 from Brown University-affiliated hospitals., Results: Sixty-seven patients received nirmatrelvir/ritonavir or molnupiravir and were compared to 45 concurrent controls who received no antiviral treatment despite being eligible to receive it. Administration of nirmatrelvir/ritonavir or molnupiravir was associated with improved survival and lower 90-day all-cause and COVID-19-attributed mortality (p < 0.05) and with lower peak O 2 requirements (ordinal odds ratio [OR] 1.52, 95% confidence interval [CI] 0.92-2.56)., Conclusion: Acknowledging the small size of our sample as a limitation, we concluded that early antiviral treatment might be beneficial to immunocompromised individuals, particularly those with cancer, when infected with SARS-CoV-2. Larger-scale, well-stratified studies are needed in this patient population., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: COVID-19 can have a particularly detrimental effect on patients with cancer, but no studies to date have examined if the presence, or site, of metastatic cancer is related to COVID-19 outcomes., Methods: Using the COVID-19 and Cancer Consortium (CCC19) registry, the authors identified 10,065 patients with COVID-19 and cancer (2325 with and 7740 without metastasis at the time of COVID-19 diagnosis). The primary ordinal outcome was COVID-19 severity: not hospitalized, hospitalized but did not receive supplemental O 2 , hospitalized and received supplemental O 2 , admitted to an intensive care unit, received mechanical ventilation, or died from any cause. The authors used ordinal logistic regression models to compare COVID-19 severity by presence and specific site of metastatic cancer. They used logistic regression models to assess 30-day all-cause mortality., Results: Compared to patients without metastasis, patients with metastases have increased hospitalization rates (59% vs. 49%) and higher 30 day mortality (18% vs. 9%). Patients with metastasis to bone, lung, liver, lymph nodes, and brain have significantly higher COVID-19 severity (adjusted odds ratios [ORs], 1.38, 1.59, 1.38, 1.00, and 2.21) compared to patients without metastases at those sites. Patients with metastasis to the lung have significantly higher odds of 30-day mortality (adjusted OR, 1.53; 95% confidence interval, 1.17-2.00) when adjusting for COVID-19 severity., Conclusions: Patients with metastatic cancer, especially with metastasis to the brain, are more likely to have severe outcomes after COVID-19 whereas patients with metastasis to the lung, compared to patients with cancer metastasis to other sites, have the highest 30-day mortality after COVID-19., (© 2024 American Cancer Society.)

Objective: To analyze the effects of transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) on the cognitive function of individuals with Alzheimer's disease (AD)., Methods: This systematic review with meta-analysis and meta-regression included randomized clinical trials published until 05/2022. We included studies conducted with individuals with AD of both sexes, aged between 55 and 85 years, treated with tDCS, TMS, or both., Results: Twenty-one studies were included in the systematic review and sixteen in the meta-analysis. Meta-regression suggested a significant influence of anodic tDCS with current intensity of 1.5 mA on cognitive function. Significant results were found with treatment frequencies of three and five days a week for two weeks. Subgroup analysis found that anodic tDCS influences cognitive function, regardless of AD stage. Similar was observed for TMS using a frequency of 20 Hz and current intensity of 90% of the resting motor threshold., Discussion: Anodal tDCS and 20 Hz TMS have demonstrated the ability to improve cognitive function in AD by modulating neural activity. These therapies are safe and well-tolerated, offering promise as adjuncts to available pharmacological treatments. Studies with greater methodological rigor and parameter standardization are warranted. Comprehensive investigations involving neuroimaging techniques may provide a better understanding of the interaction between induced electrical fields and the complex neural networks affected in AD, paving the way for more personalized and effective neurostimulation approaches.

Background and Objective: Reduced functional capacity, dyspnea, fatigue, and changes in body composition are common in patients with post-COVID-19 syndrome (PCS), and cardiopulmonary rehabilitation may improve these parameters. Thus, the present study verified the effects of cardiopulmonary rehabilitation (respiratory, aerobic, and resistance muscle training) on submaximal exercise tolerance, dyspnea, fatigue, and body composition., Methods: This controlled and randomized clinical trial applied a six-week outpatient intervention protocol in individuals over 18 years old (n = 33) with a diagnosis of COVID-19 confirmed by polymerase chain reaction. These individuals were allocated to cardiopulmonary rehabilitation (n = 17) or control groups (i.e., educational lectures; n = 16). The cardiopulmonary rehabilitation group performed respiratory, aerobic, and resistance muscle training. Submaximal exercise tolerance, dyspnea, fatigue, and body composition were assessed before and after the protocol., Results: After 6 weeks, the cardiopulmonary rehabilitation group increased the tolerance to submaximal exercise, with a difference of 100.46 m (95% confidence interval [CI]: 7.40-193 m) in the distance walked on the six-minute walk test, reduced dyspnea (-1.45, 95% CI: -1.98--0.92) in the modified Medical Research Council, and increased 0.63 kg (95% CI: 0.09-1.18 kg) of muscle mass in the upper limbs compared with the control group., Conclusion: The six-week cardiopulmonary rehabilitation protocol improved functional capacity, reduced dyspnea, and increased muscle mass in the upper limbs in individuals with PCS. Thus, these results supported the protocol use in this population and encourage further studies to assess its effectiveness in a large sample., (© 2024 John Wiley & Sons Ltd.)

The Viracor CMV-T-cell immunity Panel (TCIP) measures %CMV-specific CD4 + and CD8 + T-cells. In this blinded clinical study, we evaluated the performance of the TCIP in predicting CMV events. Prospectively enrolled donor or recipient CMV-seropositive kidney transplant recipients (KTR) were evaluated with monthly TCIP testing until either discontinuation of valganciclovir prophylaxis or CMV DNAemia prompting treatment initiation. Also, prospectively enrolled KTR with low-level untreated DNAemia or after completion of treatment were evaluated for progression or relapse of CMV infection. Among 46 KTR, those with CMV events had significantly lower %CMV-specific CD8 + T-cells (p = 0.024), and the CMV protection ROC AUC was significant (AUC 0.78, p = 0.026). The positive predictive values of CD4 + and CD8 + T-cell positivity >0.2 % for CMV protection were: 96.3 % for CMV DNAemia prompting treatment initiation, 92.6 % for any DNAemia, 100 % for DNAemia >1000 IU/mL. The TCIP could be a useful adjunct tool in individualized management of CMV infection., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dimitrios Farmakiotis reports financial support was provided by Eurofins Viracor BioPharma Services. Dimitrios Farmakiotis reports a relationship with Eurofins Viracor BioPharma Services that includes: consulting or advisory. Dimitrios Farmakiotis reports a relationship with Merck & Co Inc that includes: funding grants., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Patients with cancer have many comorbidities that increase their risk of death from Coronavirus disease 2019 (COVID-19). Anti-spike monoclonal antibodies (mAbs) reduce the risk of hospitalization or death from COVID-19 in the general population. To our knowledge, no studies have focused on the clinical efficacy of mAbs compared to no outpatient treatment exclusively among patients with solid tumors and hematologic malignancies, who are often excluded from clinical trials. We studied patients with cancer who had COVID-19 between 11.9.2020 and 7.21.2022 and received mAbs in an outpatient setting. We compared hospitalization and mortality rates to those of patients with cancer concurrently diagnosed with COVID-19, who were eligible for mAbs, but did not receive any outpatient treatment. 63 patients received mAbs and 89 no outpatient treatment. Administration of mAbs was associated with lower 90-day hospitalization (20.6% vs. 60.7%, p <0.001), all-cause (6.3% vs. 19.1%, p 0.025) and COVID-19-attributed (3.2% vs. 14.6%, p 0.019) mortality rates, and lower peak O 2 requirements (ordinal Odds Ratio [OR] = 0.33, 95% Confidence Intervals [CI] = 0.20-0.53). Administration of mAbs (aHR 0.21, p <0.001), age (≥ 60 years, adjusted Hazard Ratio [aHR] 1.86, p=0.033), and metastases (aHR 0.41, p 0.007) were independently associated with hospitalization. mAb treatment remained significantly associated with all-cause (aHR 0.27, p 0.019) and COVID-19-attributed (aHR 0.19, p 0.031) mortality, after adjustment for other factors. mAb administration was associated with improved clinical outcomes among vulnerable patients with cancer and COVID-19. With no mAbs approved currently for treatment against the prevalent circulating variants, the development of new mAbs should be a research priority., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Communicable diseases represent a huge economic burden for healthcare systems and for society. Sexually transmitted infections (STIs) are a concerning issue, especially in developing and underdeveloped countries, in which environmental factors and other determinants of health play a role in contributing to its fast spread. In light of this situation, machine learning techniques have been explored to assess the incidence of syphilis and contribute to the epidemiological surveillance in this scenario., Objective: The main goal of this work is to evaluate the performance of different machine learning models on predicting undesirable outcomes of congenital syphilis in order to assist resources allocation and optimize the healthcare actions, especially in a constrained health environment., Method: We use clinical and sociodemographic data from pregnant women that were assisted by a social program in Pernambuco, Brazil, named Mãe Coruja Pernambucana Program (PMCP). Based on a rigorous methodology, we propose six experiments using three feature selection techniques to select the most relevant attributes, pre-process and clean the data, apply hyperparameter optimization to tune the machine learning models, and train and test models to have a fair evaluation and discussion., Results: The AdaBoost-BODS-Expert model, an Adaptive Boosting (AdaBoost) model that used attributes selected by health experts, presented the best results in terms of evaluation metrics and acceptance by health experts from PMCP. By using this model, the results are more reliable and allows adoption on a daily usage to classify possible outcomes of congenital syphilis using clinical and sociodemographic data., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Teixeira et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Organ transplant recipients (OTRs) are less protected from vaccination than immunocompetent hosts. Additional vaccine doses have shown increased immunogenicity. Few studies have assessed their clinical efficacy, particularly against Omicron variants, as most included patients from earlier phases of the pandemic, with higher base mortality rates., Methods: We studied adult OTRs who had coronavirus disease 2019 (COVID-19) between 12/15/21 and 5/25/22. We compared clinical outcomes between those who had received 2 or ≥3 doses of an mRNA vaccine and concurrent unvaccinated controls., Results: Among 103 OTRs, vaccination was associated with lower 90-day mortality (unvaccinated vs 2 vs ≥3 doses: 25% vs 7% vs 3%; P = .003), hospital (unvaccinated vs 2 vs ≥3 doses: 56% vs 37% vs 27%; P = .018) and intensive care unit (ICU; unvaccinated vs 2 vs ≥3 doses: 25% vs 15% vs 3%; P = .001) admission rates, and peak O 2 requirements (ordinal scale Kendall's tau b = -0.309 [lower scores, ie, O 2 requirements with more vaccine doses]; P = .003). Age (age >60 years: adjusted hazard ratio [aHR], 7.73; P = .016; administration of antispike monoclonal antibody: aHR, 0.17; P = .042) and vaccination, especially with ≥3 doses (aHR, 0.105; P = .01), were independently associated with 90-day mortality. Black ( P = .021) and Hispanic ( P = .016) OTRs were underrepresented among the vaccinated, especially in the ≥3-dose group., Conclusions: Despite lower mRNA vaccine efficacy in OTRs and against Omicron variants, vaccination protects this vulnerable patient population from severe COVID-19 and death. Ethnic and racial disparities in health care have been exacerbated by the COVID-19 pandemic and warrant better community outreach efforts., Competing Interests: Potential conflicts of interest. D.F. has received research support from Viracor, Astellas, and Merck and a consultant fee from Viracor. All other authors have nothing to disclose. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

This study assessed the efficacy of a pulmonary rehabilitation (PR) on pulmonary and respiratory muscle function and thickness of quadriceps femoris and diaphragm of patients with post-COVID-19 syndrome. This series of cases followed nine patients who performed PR twice a week for six weeks. Patients received the following PR program: lung expansion therapy; respiratory muscle training; upper limb strength exercises; aerobic exercises on a treadmill. After the program, we observed increased peak expiratory flow (26.03%), forced vital capacity (FVC) (7.14%), forced expiratory volume in the first second (FEV1) (9.55%), and ratio between FEV1/FVC (6.19%). All parameters of respiratory muscle strength and endurance were improved. Diaphragmatic thickening fraction and thickness of quadriceps femoris also improved, whereas echo intensity of quadriceps reduced. Thus, RP protocol improved pulmonary function, respiratory muscle strength and endurance, and thickness of diaphragm and quadriceps femoris, and reduced echo intensity of quadriceps in patients with post-COVID-19 syndrome.

Background: The effect of COVID-19 on immunosuppressant drug levels in organ transplant recipients (OTRs) has not been adequately studied., Objective: To study the effect of COVID-19 on tacrolimus trough levels (primary outcome) in OTRs and the association of the later with acute kidney injury, bacterial infection, and oxygen requirements., Methods: We studied adult (>18-year-old) hospitalized OTRs with COVID-19, who were receiving tacrolimus between 3/1 and 12/16/2020., Results: Among 30 OTRs, 67% were men, 90% had a kidney transplant. Median age was 60.5 (interquartile range [IQR]: 45-68) years, median time from transplant 36 (IQR: 20-84) months. Tacrolimus troughs were higher on admission for COVID-19 than baseline (average over 6 months prior) ( P = .001). Eighteen patients (60%) had admission tacrolimus trough >10, 5 (17%) >20 ng/mL. Patients with diarrhea had borderline higher tacrolimus troughs, compared to those without diarrhea ( P = .09). Organ transplant recipients with a tacrolimus trough >10 ng/mL were more likely to have elevated aspartate aminotransferase on admission ( P = .01) and require supplemental oxygen. ( P = .026)., Conclusion and Relevance: Tacrolimus trough levels were elevated in most OTRs with COVID-19 at the time of hospital admission, compared to baseline. Potential mechanisms are diarrhea and hepatic involvement in COVID-19. In OTRs with COVID-19, including outpatients, immunosuppressant drug levels should be closely followed; management of immunosuppression should be individualized.

Background: The frequency of coinfections and their association with outcomes have not been adequately studied among patients with cancer and coronavirus disease 2019 (COVID-19), a high-risk group for coinfection., Methods: We included adult (≥18 years) patients with active or prior hematologic or invasive solid malignancies and laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection, using data from the COVID-19 and Cancer Consortium (CCC19, NCT04354701). We captured coinfections within ±2 weeks from diagnosis of COVID-19, identified factors cross-sectionally associated with risk of coinfection, and quantified the association of coinfections with 30-day mortality., Results: Among 8765 patients (hospitalized or not; median age, 65 years; 47.4% male), 16.6% developed coinfections: 12.1% bacterial, 2.1% viral, 0.9% fungal. An additional 6.4% only had clinical diagnosis of a coinfection. The adjusted risk of any coinfection was positively associated with age >50 years, male sex, cardiovascular, pulmonary, and renal comorbidities, diabetes, hematologic malignancy, multiple malignancies, Eastern Cooperative Oncology Group Performance Status, progressing cancer, recent cytotoxic chemotherapy, and baseline corticosteroids; the adjusted risk of superinfection was positively associated with tocilizumab administration. Among hospitalized patients, high neutrophil count and C-reactive protein were positively associated with bacterial coinfection risk, and high or low neutrophil count with fungal coinfection risk. Adjusted mortality rates were significantly higher among patients with bacterial (odds ratio [OR], 1.61; 95% CI, 1.33-1.95) and fungal (OR, 2.20; 95% CI, 1.28-3.76) coinfections., Conclusions: Viral and fungal coinfections are infrequent among patients with cancer and COVID-19, with the latter associated with very high mortality rates. Clinical and laboratory parameters can be used to guide early empiric antimicrobial therapy, which may improve clinical outcomes., (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Organ transplant recipients may not mount an adequate immune response to COVID-19 infection and therefore may benefit greatly from passive immunization with anti-spike monoclonal antibodies (mAbs), which have been shown to decrease hospitalization rates in the general outpatient population. We evaluated the efficacy of mAb therapy in decreasing hospitalizations or emergency room (ER) visits among kidney transplant recipients (KTR) with COVID-19. We identified KTR with COVID-19 between March 1, 2020 and April 30, 2021. Patients were excluded if they had multi-organ transplant or hospital-acquired COVID-19. We studied 95 KTR; 20 received mAb. mAb administration was associated with a significant decrease in hospitalizations or ER visits (15% vs. 76%, p < 0.001). This association remained significant after adjustment for potential confounders, and analysis of mAb administration as a time-dependent variable, with day of symptom onset as day 1 (adjusted HR 0.216, p = 0.04). Black or Hispanic patients were less likely to receive mAb and more likely to be admitted to the hospital or visit the ER. In our KTR population, mAb therapy for COVID-19 may have helped decrease hospitalizations and ER visits. Healthcare inequities, including access to investigational treatments, have been exacerbated by the COVID-19 pandemic. Antiviral mAbs are a promising therapeutic modality, especially for immunocompromised patients., (© 2021 The American Society of Transplantation and the American Society of Transplant Surgeons.)

Patterned cell death is a common feature of many neurodegenerative diseases. In patients with autosomal-recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) and mouse models of ARSACS, it has been observed that Purkinje cells in anterior cerebellar vermis are vulnerable to degeneration while those in posterior vermis are resilient. Purkinje cells are known to express certain molecules in a highly stereotyped, patterned manner across the cerebellum. One patterned molecule is zebrin, which is expressed in distinctive stripes across the cerebellar cortex. The different zones delineated by the expression pattern of zebrin and other patterned molecules have been implicated in the patterning of Purkinje cell death, raising the question of whether they contribute to cell death in ARSACS. We found that zebrin patterning appears normal prior to disease onset in Sacs -/- mice, suggesting that zebrin-positive and -negative Purkinje cell zones develop normally. We next observed that zebrin-negative Purkinje cells in anterior lobule III were preferentially susceptible to cell death, while anterior zebrin-positive cells and posterior zebrin-negative and -positive cells remained resilient even at late disease stages. The patterning of Purkinje cell innervation to the target neurons in the cerebellar nuclei (CN) showed a similar pattern of loss: neurons in the anterior CN, where inputs are predominantly zebrin-negative, displayed a loss of Purkinje cell innervation. In contrast, neurons in the posterior CN, which is innervated by both zebrin-negative and -positive puncta, had normal innervation. These results suggest that the location and the molecular identity of Purkinje cells determine their susceptibility to cell death in ARSACS., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Toscano Márquez, Cook, Rice, Smileski, Vieira-Lomasney, Charron, McKinney and Watt.)

Introduction: Observational studies suggest that low-dose valganciclovir prophylaxis (450 mg daily for normal renal function) is as effective as and perhaps safer than standard-dose valganciclovir (900 mg daily) in preventing CMV infection among kidney transplant recipients. However, this practice is not supported by current guidelines due to concerns for breakthrough infection from resistant CMV, mainly in high-risk CMV donor-seropositive/recipient-seronegative kidney transplant recipients. Standard-dose valganciclovir is costly and possibly associated with higher incidence of neutropenia and BKV DNAemia. Our institution adopted low-dose valganciclovir prophylaxis for intermediate-risk (seropositive) kidney transplant recipients in January 2018. Research Question: To analyze the efficacy (CMV DNAemia), safety (BK virus DNAemia, neutropenia, graft loss, and death), and cost savings associated with this change. Design: We retrospectively compared the above outcomes between CMV-seropositive kidney transplant recipients who received low-dose and standard-dose valganciclovir, transplanted within our institution, between 1/19/2014 and 7/15/2019, using propensity score-adjusted competing risk analyses. We also compared cost estimates between the two dosing regimens, for 3 months of prophylaxis, and for different percentage of patient-weeks with normal renal function, using the current average wholesale price of valganciclovir. Results: We studied 179 CMV-seropositive kidney transplant recipients, of whom 55 received low-dose and 124 standard-dose valganciclovir. The majority received nonlymphocyte depleting induction (basiliximab). Low-dose valganciclovir was at least as effective and safe as, and more cost-saving than standard-dose valganciclovir. Conclusion: This single-center study contributes to mounting evidence for future guidelines to be adjusted in favor of low-dose valganciclovir prophylaxis in CMV-seropositive kidney transplant recipients.

In order to provide favorable conditions for bone regeneration, a lot of biomaterials have been developed and evaluated, worldwide. Composite biomaterials have gained notoriety, as they combine desirable properties of each isolated material. Thus, in this research, bone repair capacity of three developed formulations of ceramic scaffolds were evaluated histomorphometrically, after implantation. Scaffolds were based on wollastonite (W) and β -tricalcium phosphate ( β -TCP) composites in three different ratios (wt.%). Thirty Wistar rats were randomly assigned to three experimental groups: W-20 (20 W/80 β -TCP wt.%), W-60 (60 W/40 β -TCP wt.%), and W-80 (80 W/20 β -TCP wt.%), evaluated by optical microscopy at biological tests after 15 and 45 days of implantation. Throughout the study, the histological results evidenced that the scaffolds remained at the implantation site, were biocompatible and presented osteogenic potential. The percentage of neoformed mineralized tissue was more evident in the W-20 group (51%), at 45 days. The composite of the W-80 group showed more evident biodegradation than the biomaterials of the W-20 and W-60 groups. Thus, it is concluded that the scaffold containing 20 W/80 β -TCP (wt.%) promoted more evident bone formation, but all composites evaluated in this study showed notorious bioactivity and promising characteristics for clinical application., (© 2021 IOP Publishing Ltd.)

Background: Kidney transplant recipients (KTR) are considered high-risk for morbidity and mortality from coronavirus disease 2019 (COVID-19). However, some studies did not show worse outcomes compared to non-transplant patients and there is little data about immunosuppressant drug levels and secondary infections in KTR with COVID-19. Herein, we describe our single-center experience with COVID-19 in KTR., Methods: We captured KTR diagnosed with COVID-19 between March 1, 2020 and May 18, 2020. After exclusion of KTR on hemodialysis and off immunosuppression, we compared the clinical course of COVID-19 between hospitalized KTR and non-transplant patients, matched by age and sex (controls)., Results: Eleven KTR were hospitalized and matched with 44 controls. One KTR and 4 controls died (case fatality rate: 9.1%). There were no significant differences in length of stay or clinical outcomes between KTR and controls. Tacrolimus or sirolimus levels were >10 ng/mL in 6 out of 9 KTR (67%). Bacterial infections were more frequent in KTR (36.3%), compared with controls (6.8%, P = .02)., Conclusions: In our small case series, unlike earlier reports from the pandemic epicenters, the clinical outcomes of KTR with COVID-19 were comparable to those of non-transplant patients. Calcineurin or mammalian target of rapamycin inhibitor (mTOR) levels were high. Bacterial infections were more common in KTR, compared with controls., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objectives: Observational and experimental studies suggest that the use of antibiotics close to administration of immune checkpoint inhibitors (ICI) can have a negative effect on tumour response and patient survival, due to microbiome dysbiosis and the resultant suppression of host immune response against neoplastic cells., Methods: A systematic search of PUBMED and EMBASE was undertaken for studies published between 1 January 2017 and 1 June 2020, evaluating the association between the use of antibiotics and clinical outcomes in patients with cancer treated with ICIs. A meta-analysis of the association between the use of antibiotics and clinical outcomes was also performed., Results: Forty-eight studies met the inclusion criteria (12,794 patients). Use of antibiotics was associated with shorter overall survival [hazard ratio (HR) 1.88, 95% confidence interval (CI) 1.59-2.22; adjusted HR 1.87, 95% CI 1.55-2.25] and progression-free survival (HR 1.52, 95% CI 1.36-1.70; adjusted HR 1.93, 95% CI 1.59-2.36), decreased response rate [odds ratio (OR) 0.54, 95% CI 0.34-0.86] and more disease progression (OR 2.00, 95% CI 1.27-3.14). The negative association between the use of antibiotics and progression-free survival was stronger in patients with renal cell carcinoma or melanoma compared with lung cancer. Only antibiotic administration >1 month prior to ICI initiation was associated with increased disease progression. Heterogeneity was substantial for all outcomes., Conclusions: Recent use of antibiotics in patients with cancer treated with ICIs was associated with worse clinical outcomes. Such patients may benefit from dedicated antimicrobial stewardship programmes., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in patients undergoing induction chemotherapy for acute myeloid leukemia (AML). In this patient population, antifungal prophylaxis (AP) has been associated with decreased incidence of IFIs and better survival. However, some centers have not adopted AP during induction chemotherapy for AML, as it is unclear whether AP improves outcomes in settings where the incidence of invasive mold infections is low. We retrospectively assessed the differences in clinical outcomes and resource utilization in patients undergoing 7 + 3 induction chemotherapy for AML, after implementing a policy of AP as part of a dedicated inpatient malignant hematology service (HS) at Rhode Island Hospital. Between January 1, 2007 and April 1, 2019, 56 patients with AML received AP during 7 + 3 induction chemotherapy and 52 patients did not, without significant differences in their baseline characteristics. Use of AP was associated with less proven or probable IFI (0% vs. 6%, P = 0.1) and lower all-cause in-hospital mortality (7% vs. 21%, P < 0.05), without significant increases in resource utilization or toxicities. Empiric and targeted antifungal therapies were more frequently started in the non-AP group (69%) than changed in the AP group (41%, P < 0.005). Having a dedicated inpatient malignant hematology service was also associated with improved outcomes. However, use of AP was associated with better survival (30-day post-induction survival log-rank P < 0.05), prior to the implementation of this clinical service as well, which is suggestive of an independent benefit from AP.

Functional insect vector colonies are essential for the study of their biology, evolution, behavior as well as control strategies of these organisms that transmit pathogens of medical and veterinary importance. In addition to the establishment, improvement and adaptation of pre-established protocols in the maintenance of a colony is important, as it may result in higher production of insects. Stomoxys calcitrans or stable fly causes important economic losses in production of beef and milk, besides mechanically transmitting a great variety of pathogens to cattle. In order to generate flies under laboratory conditions, a colony of S. calcitrans was established at our laboratory considering local environment geographical characteristics. Adults collected in UFRRJ campus were kept in the laboratory and maintained with daily feeding on anticoagulant-containing bovine blood offered in disposable sanitary napkins. Immature forms were maintained on diets rich in organic matter. The colony temperature and relative humidity were daily monitored as well as the development of insects. The monthly measured biological parameters included the development of eggs into pupae, of pupae into F1 adults and the comparison of the number of flies collected in the field with the number of F1 flies emerged in the laboratory. The data presented here was obtained from March to November 2019. In that period, the average per month of flies collected in the field was 604.2, of generated eggs was 2694.3, of generated pupae was 349.5 and of generated F1 flies in the laboratory was 205.9. Fluctuations of abiotic and biological factors contributed to an uneven production of flies in the colony throughout the months. This is the first report with numerical quantification of S. calcitrans flies production in a laboratory in Brazil. Some methodologies used in the colony shall be reevaluated and modified with the goal of obtaining higher numbers of flies generated in the laboratory over time., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Despite significant advances in transplantation of HIV-infected individuals, little is known about HIV coinfected patients with hepatitis C virus (HCV) genotypes other than genotype 1, especially when receiving HCV-infected organs with a different genotype. We describe the first case of kidney transplantation in a man coinfected with hepatitis C and HIV in our state. To our knowledge, this is also the first report of an HIV/HCV/HBV tri-infected patient with non-1 (2a) HCV genotype who received an HCV-infected kidney graft with the discordant genotype (1a), to which he converted after transplant. Our case study highlights the following: (1) transplant centers need to monitor wait times for an HCV-infected organ and regularly assess the risk of delaying HCV antiviral treatment for HCV-infected transplant candidates in anticipation of the transplant from an HCV-infected donor; (2) closer monitoring of tacrolimus levels during the early phases of anti-HCV protease inhibitor introduction and discontinuation may be indicated; (3) donor genotype transmission can occur; (4) HIV/HCV coinfected transplant candidates require a holistic approach with emphasis on the cardiovascular risk profile and low threshold for cardiac catheterization as part of their pretransplant evaluation., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Dimitrios Farmakiotis et al.)

Background: Cytomegalovirus (CMV) infection is one of the most common opportunistic infections following organ transplantation, despite administration of CMV prophylaxis. CMV-specific T-cell immunity (TCI) has been associated with reduced rates of CMV infection. We describe for the first time clinical experience using the CMV T-Cell Immunity Panel (CMV-TCIP), a commercially available assay which measures CMV-specific CD4+ and CD8+ T-cell responses, to predict clinically significant CMV events., Methods: Adult (> 18-year-old) patients with CMV-TCIP results and ≥ 1 subsequent assessment for CMV DNAemia were included at Brown University and the University of Maryland Medical Center-affiliated hospitals between 4/2017 and 5/2019. A clinically significant CMV event was defined as CMV DNAemia prompting initiation of treatment. We excluded indeterminate results, mostly due to background positivity, allogeneic hematopoetic cell transplant (HCT) recipients, or patients who were continued on antiviral therapy against CMV irrespective of the CMV-TCIP result, because ongoing antiviral therapy could prevent a CMV event., Results: We analyzed 44 samples from 37 patients: 31 were solid organ transplant recipients, 4 had hematologic malignancies, 2 had autoimmune disorders. The CMV-protection receiver operating characteristic (ROC) area under the curve (AUC) was significant for %CMV-specific CD4+ (AUC: 0.78, P < 0.001) and borderline for CD8+ (AUC: 0.66, P = 0.064) T-cells. At a cut-off value of 0.22% CMV-specific CD4+ T-cells, positive predictive value (PPV) for protection against CMV was 85% (95%CI 65-96%), and negative predictive value (NPV) was 67% (95%CI 41-87%)., Conclusions: The CMV-TCIP, in particular %CMV-specific CD4+ T-cells, showed good diagnostic performance to predict CMV events. The CMV-TCIP may be a useful test in clinical practice, and merits further validation in larger prospective studies.

We explore the origins of the young B-type stars found by Casetti-Dinescu et al. (2014) at the outskirts of the Milky-Way disk in the sky region of Leading Arm of the Magellanic Stream. High-resolution spectroscopic observations made with the MIKE instrument on the Magellan Clay 6.5m telescope for nine stars are added to the previous sample analyzed by Zhang et al. (2017). We compile a sample of fifteen young stars with well-determined stellar types, ages, abundances and kinematics. With proper motions from Gaia DR2 we also derive orbits in a realistic Milky-Way potential. We find that our previous radial-velocity selected LA candidates have substantial orbital angular momentum. The substantial amount of rotational component for these stars is in contrast with the near-polar Magellanic orbit, thus rendering these stars unlikely members of the LA. There are four large orbital-energy stars in our sample. The highest orbital-energy one has an age shorter than the time to disk crossing, with a birthplace z = 2.5 kpc and R GC ~ 28 kpc. Therefore, the origin of this star is uncertain. The remaining three stars have disk runaway origin with birthplaces between 12 and 25 kpc from the Galactic center. Also, the most energetic stars are more metal poor ([Mg/H] =-0.50 ± 0.07) and with larger He scatter ( σ [He/H] = 0.72) than the inner disk ones ([Mg/H] = 0.12 ± 0.36, σ [He/H] = 0.15). While the former group's abundance is compatible with that of the Large Magellanic Cloud, it could also reflect the metallicity gradient of the MW disk and their runaway status via different runaway mechanisms.

We explore the Gaia data release 2 (DR2) proper motions of six young, main-sequence stars, members of the Large Magellanic Cloud (LMC) reported by Moni Bidin et al. These stars are located in the outskirts of the disk, between 7° and 13° from the LMC's center where there is very low H I content. Gaia DR2 proper motions confirm that four stars formed locally, in situ, while two are consistent with being expelled via dynamical interactions from inner, more gas-rich regions of the LMC. This finding establishes that recent star formation occurred in the periphery of the LMC, where thus far only old populations were known.

Arhgap21 is a member of the Rho GTPase activating protein (RhoGAP) family, which function as negative regulators of Rho GTPases. Arhgap21 has been implicated in adhesion and migration of cancer cells. However, the role of Arhgap21 has never been investigated in hematopoietic cells. Herein, we evaluated functional aspects of hematopoietic stem and progenitor cells (HSPC) using a haploinsufficient (Arhgap21 +/- ) mouse. Our results show that Arhgap21 +/- mice have an increased frequency of phenotypic HSC, impaired ability to form progenitor colonies in vitro and decreased hematopoietic engraftment in vivo, along with a decrease in LSK cell frequency during serial bone marrow transplantation. Arhgap21 +/- hematopoietic progenitor cells have impaired adhesion and enhanced mobilization of immature LSK and myeloid progenitors. Arhgap21 +/- mice also exhibit reduced erythroid commitment and differentiation, which was recapitulated in human primary cells, in which knockdown of ARHGAP21 in CMP and MEP resulted in decreased erythroid commitment. Finally, we observed enhanced RhoC activity in the bone marrow cells of Arhgap21 +/- mice, indicating that Arhgap21 functions in hematopoiesis may be at least partially mediated by RhoC inactivation., (Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.)

This paper presents and discusses the results of an intervention research conducted in Ouro Preto, Brazil from August 2014 to March 2016. The main objective was to contribute to the development of an intersectoral and interdisciplinary network to face psychosocial vulnerabilities of children and teenagers, especially related to sexual violence and drug use. To achieve this, we identified the difficulties faced by the Sistema de Garantia de Direitos Humanos da Criança e do Adolescente (SGDHCA) implemented by the municipality which take care of this population. We also identified protective and promotion factors accomplished to empower them. The methodology used combines Deleuze and Guattari Cartography, Institutional Analysis and the Cross Training. This latter methodology was developed by a group of researchers of Douglas Institute, in Montreal, which we met through scientific co-operation with our laboratory. On account of the practical-theoric and co-participative activities with the professional network of Ouro Preto, we produced a detailed diagnosis of the SGDHCA and a document proposing short, medium and long-term strategies. As final result, we intend to help the local collective-the Forum Intersetorial da Infância e Juventude-to develop a work plan from the proposed actions. In this paper we will concentrate the potential of the methodology used by presenting outcome from two important moments of the research: the discussions of successful and unsuccessful cases that elucidate the network operation and the potential and difficulties arising from the Rotation Positional, important technical of the Cross Training.