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Abstract Background The diagnosis of healthcare-associated ventriculitis and meningitis (HCAVM) can be complex because multiple factors confound the interpretation of cerebrospinal fluid (CSF) tests. The cell index (CI) may help in the diagnosis of HCAVM. It does not incur additional medical cost and it avoids delays from the turnaround time of CSF cultures. It is derived by calculating the ratio of CSF white blood cell (WBC) and red blood cell (RBC) divided by the ratio of peripheral WBC and RBC. This study aimed to evaluate the diagnostic utility of this parameter. Methods An analytic, observational, cross-sectional study was conducted at the University of the Philippines – Philippine General Hospital. All admitted pediatric and adult patients from 2015 to 2022 who underwent external ventricular drain (EVD) insertion for hydrocephalus secondary to intracranial hemorrhage (ICH), acute ischemic stroke, intracranial neoplasms, traumatic brain injury, or congenital hydrocephalus were screened. Records of patients fulfilling the inclusion criteria were then reviewed. Results A total of 363 patients underwent EVD insertion from 2015 to 2022. Of these, 161 were included in the study. Two-thirds (66.5%) were adults ≥ 19 years old whereas the remaining were pediatric patients 1 to

Architecture can be very influential in enabling health and wellbeing in the residential built environment. In arid regions, health-supportive design would consider major environmental hazards, such as heat and dust, as well as social and cultural factors that influence household size and composition. Under current and projected conditions, the effects of climate change will increase, presenting opportunities and challenges to architects to demonstrate and deliver best practice in climate-appropriate and culturally appropriate housing design. This paper brings together a multidisciplinary team of researchers to identify the current and future needs for tropical semi-arid zone design with a focus on Indigenous communities in northern Central Australia. In a narrative review of the literature and exploratory fieldwork, current and projected impacts of climate change on housing, health, energy systems and behavioural practices are explored in a holistic way. Our findings demonstrate the growing awareness of climate-related issues for remote Indigenous housing but also the lack of place-based studies that might inform adaptation strategies. Overwhelmingly, there is limited understanding of local lived experiences that may be highly significant for developing resilience in a changing climate. Consideration of the beliefs, values and practices of Indigenous people will be integral to design solutions.

Amylase and protease are two of the most commonly used enzymes in the pharmaceutical industry. Particularly, Bacillus spp. is widely regarded as a “factory” of these enzymes. In this study, a total of 40 isolates were collected from four soil samples from different metropolitan sites namely, near Chemicals and Energy Division (CED), and National Metrology Laboratory (NML) oil tankers parking lot inside the Department of Science and Technology (DOST) Compound in Taguig City, and two metropolitan-volcanic sites in Clark Freeport Zone, Pampanga (CRK1, CRK2). Of these, 33 isolates were deemed putative Bacillus spp. via phenotypic assays and were screened for the production of amylase and protease. Results showed that 26 of the screened isolates were able to produce protease and 12 were positive for amylase production. Molecular identification revealed that the enzyme-producing isolates were Bacillus spp., B. cereus, B. aryabhattai, B. amyloliquefaciens, B. firmus, B. velezensis, and Fictibacillus sp. No isolate was able to produce amylase alone. These results show the potential of Bacillus spp. from metropolitan soil as sources of pharmaceutically-important enzymes.

Summary: For several decades, a plant‐based expression system has been proposed as an alternative platform for the production of biopharmaceuticals including therapeutic monoclonal antibodies (mAbs), but the immunogenicity concerns associated with plant‐specific N‐glycans attached in plant‐based biopharmaceuticals has not been completely solved. To eliminate all plant‐specific N‐glycan structure, eight genes involved in plant‐specific N‐glycosylation were mutated in rice (Oryza sativa) using the CRISPR/Cas9 system. The glycoengineered cell lines, PhytoRice®, contained a predominant GnGn (G0) glycoform. The gene for codon‐optimized trastuzumab (TMab) was then introduced into PhytoRice® through Agrobacterium co‐cultivation. Selected cell lines were suspension cultured, and TMab secreted from cells was purified from the cultured media. The amino acid sequence of the TMab produced by PhytoRice® (P‐TMab) was identical to that of TMab. The inhibitory effect of P‐TMab on the proliferation of the BT‐474 cancer cell line was significantly enhanced at concentrations above 1 μg/mL (****P < 0.0001). P‐TMab bound to a FcγRIIIa variant, FcγRIIIa‐F158, more than 2.7 times more effectively than TMab. The ADCC efficacy of P‐TMab against Jurkat cells was 2.6 times higher than that of TMab in an in vitro ADCC assay. Furthermore, P‐TMab demonstrated efficient tumour uptake with less liver uptake compared to TMab in a xenograft assay using the BT‐474 mouse model. These results suggest that the glycoengineered PhytoRice® could be an alternative platform for mAb production compared to current CHO cells, and P‐TMab has a novel and enhanced efficacy compared to TMab. [ABSTRACT FROM AUTHOR]

The heat generated by high-level radioactive waste can pose numerical and physical challenges to subsurface flow and transport simulators if the liquid water content in a region near the waste package approaches residual saturation due to evaporation. Here, residual saturation is the fraction of the pore space occupied by liquid water when the hydraulic connectivity through a porous medium is lost, preventing the flow of liquid water. While conventional capillary pressure models represent residual saturation using asymptotically large values of capillary pressure, here, residual saturation is effectively modeled as a tortuosity effect alone. Treating the residual fluid as primarily dead-end pores and adsorbed films, relative permeability is independent of capillary pressure below residual saturation. To test this approach, PFLOTRAN is then used to simulate thermal-hydrological conditions resulting from direct disposal of a dual-purpose canister in unsaturated alluvium using both conventional asymptotic and revised, smooth models. While the two models have comparable results over 100 000 years, the number of flow steps required is reduced by approximately 94%. [ABSTRACT FROM AUTHOR]

The Mycobacterial growth inhibition assay (MGIA) is an ex-vivo assay used to measure the overall functional immune response elicited by infection or vaccination. In tuberculosis (TB) vaccine development, MGIA is a potentially important tool for preclinical evaluation of early-stage vaccine candidates to complement existing assays, and to potentially reduce the need for lengthy and costly pathogenic Mycobacterium tuberculosis (Mtb) animal challenge experiments. The conventional method of MGIA in mice entails directly infecting mixed cell cultures, most commonly splenocytes, from immunised mice with mycobacteria. However, this direct infection of mixed cell populations may yield unreliable results and lacks sufficient sensitivity to discriminate well between different vaccines due to the low number of mycobacteria-permissive cells. Here, we modified the assay by inclusion of mycobacteria-infected congenic murine macrophage cell lines as the target cells, and by measuring the total number of killed cells rather than the relative reduction between different groups. Thus, using splenocytes from Mycobacterium bovis BCG immunised mice, and J774 and MH-S (BALB/c background) or BL/6-M (C57Bl/6 background) macrophage cell lines, we demonstrated that the modified assay resulted in at least 26-fold greater mycobacterial killing per set quantity of splenocytes as compared to the conventional method. This increased sensitivity of measuring mycobacterial killing was confirmed using both the standard culture forming unit (CFU) assay and luminescence readings of luciferase-tagged virulent and avirulent mycobacteria. We propose that the modified MGIA can be used as a highly calibrated tool for quantitating the killing capacity of immune cells in preclinical evaluation of vaccine candidates for TB. [ABSTRACT FROM AUTHOR]

Dysregulated epigenetic states are a hallmark of cancer and often arise from genetic alterations in epigenetic regulators. This includes missense mutations in histones, which, together with associated DNA, form nucleosome core particles. However, the oncogenic mechanisms of most histone mutations are unknown. Here, we demonstrate that cancer-associated histone mutations at arginines in the histone H3 N-terminal tail disrupt repressive chromatin domains, alter gene regulation, and dysregulate differentiation. We find that histone H3R2C and R26C mutants reduce transcriptionally repressive H3K27me3. While H3K27me3 depletion in cells expressing these mutants is exclusively observed on the minor fraction of histone tails harboring the mutations, the same mutants recurrently disrupt broad H3K27me3 domains in the chromatin context, including near developmentally regulated promoters. H3K27me3 loss leads to de-repression of differentiation pathways, with concordant effects between H3R2 and H3R26 mutants despite different proximity to the PRC2 substrate, H3K27. Functionally, H3R26C-expressing mesenchymal progenitor cells and murine embryonic stem cell-derived teratomas demonstrate impaired differentiation. Collectively, these data show that cancer-associated H3 N-terminal arginine mutations reduce PRC2 activity and disrupt chromatin-dependent developmental functions, a cancer-relevant phenotype. Missense mutations in histones can drive oncogenesis and disrupt chromatin, but the associated mechanisms for many such mutations remain poorly understood. Here, the authors show that cancer-associated histone mutations at arginines in the H3 N-terminal tail disrupt repressive chromatin domains, alter gene expression, and in one case impair differentiation via reduction of PRC2 function. [ABSTRACT FROM AUTHOR]

Therapeutic plasma exchange (TPE) is an effective and affordable treatment option in most parts of Southeast Asia (SEA). In 2018, the SEA TPE Consortium (SEATPEC) was established, consisting of regional neurologists working to improve outcome of various autoimmune neurological diseases. We proposed an immunotherapeutic guideline prioritizing TPE for this region. We reviewed disease burden, evidence-based treatment options, and major guidelines for common autoimmune neurological disorders seen in SEA. A modified treatment algorithm based on consensus agreement by key-opinion leaders was proposed. Autoimmune antibody diagnostic testing through collaboration with accredited laboratories was established. Choice of first-line immunotherapies (IVIg/corticosteroid/TPE) is based on available evidence, clinicians’ experience, contraindications, local availability, and affordability. TPE could be chosen as first-line therapy for GBS, CIDP, MG (acute/short term), IgG, A paraproteinemic neuropathy, and NMDAR encephalitis. Treatment is stopped for acute monophasic conditions such as GBS and ADEM following satisfactory outcome. For chronic immune disorders, a therapy taper or long-term maintenance therapy is recommended depending on the defined clinical state. TPE as second-line treatment is indicated for IVIg or corticosteroids refractory cases of ADEM, NMOSD (acute), MG, and NMDAR/LGI1/CASPR2/Hashimoto’s encephalitis. With better diagnosis, treatment initiation with TPE is a sustainable and effective immunotherapy for autoimmune neurological diseases in SEA.

Summary: Immunoglobulin G (IgG)‐based fusion proteins have been widely exploited as a potential vaccine delivery platform but in the absence of exogenous adjuvants, the lack of robust immunity remains an obstacle. Here, we report on a key modification that overcomes that obstacle. Thus, we constructed an IgG‐Fc vaccine platform for dengue, termed D‐PCF, which in addition to a dengue antigen incorporates the cholera toxin non‐toxic B subunit (CTB) as a molecular adjuvant, with all three proteins expressed as a single polypeptide. Following expression in Nicotiana benthamiana plants, the D‐PCF assembled as polymeric structures of similar size to human IgM, a process driven by the pentamerization of CTB. A marked improvement of functional properties in vitro and immunogenicity in vivo over a previous iteration of the Fc‐fusion protein without CTB [1] was demonstrated. These include enhanced antigen presenting cell binding, internalization and activation, complement activation, epithelial cell interactions and ganglioside binding, as well as more efficient polymerization within the expression host. Following immunization of mice with D‐PCF by a combination of systemic and mucosal (intranasal) routes, we observed robust systemic and mucosal immune responses, as well as systemic T cell responses, significantly higher than those induced by a related Fc‐fusion protein but without CTB. The induced antibodies could bind to the domain III of the dengue virus envelope protein from all four dengue serotypes. Finally, we also demonstrated feasibility of aerosolization of D‐PCF as a prerequisite for vaccine delivery by the respiratory route. [ABSTRACT FROM AUTHOR]