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Aims: The purpose of this study was to investigate the bacterial community of wild Cordyceps cicadae and explore its effect on the production of N6‐(2‐hydroxyethyl)‐adenosine (HEA) and three nucleosides in C. cicadae. Methods and Results: Illumina high‐throughput sequencing technology was used to analyse the bacterial community in wild C. cicadae. After C. cicadae was isolated and bacteria were isolated from wild C. cicadae, we identified four bacterial strains that independently altered HEA and nucleoside production in a coculture with C. cicadae and four bacteria separately. After cocultivation, the HEA yield from C. cicadae increased markedly. The bacteria in wild C. cicadae did not produce HEA, and the levels of three nucleosides decreased significantly. Both 16S rRNA and community analyses showed close evolutionary relationships and high abundance ratios for the four selected bacterial strains. Conclusions: Some bacteria exist in wild C. cicadae and have a high abundance ratio. Moreover, the isolated bacteria inhibited the growth of C. cicadae and prevented the production of HEA in axenic cultures. Significance and Impact of the Study: We discuss the bacterial community in wild C. cicadae and provide a new way to increase HEA production in C. cicadae by coculture with bacterial strains isolated from wild C. cicadae. [ABSTRACT FROM AUTHOR]

Background Atopic dermatitis ( AD) assessment is more difficult in patients with skin of colour ( SOC). Objectives To compare the reliability of commonly used outcome measures for assessing AD in patients with SOC and to evaluate a novel greyscale in this population. Methods Twenty-five patients with AD each attended a 1-day scoring exercise based in either Sydney or Melbourne, Australia. Each patient was scored by the same five physicians using the Eczema Area and Severity Index ( EASI), objective Scoring Atopic Dermatitis ( oSCORAD), Investigator's Global Assessment ( IGA) and a novel greyscale. Patients also completed the Patient-Oriented Eczema Measure and quality-of-life measures. A Mexameter was used to measure baseline melanin indices. Ten random patients were rescored to test intrarater reliability. Results We included 11 light-skinned patients (melanin index ≤ 200) and 14 patients with SOC (melanin index > 200) in the cohort. The inter-rater intraclass correlation coefficients ( ICCs) were EASI 0·83 [95% confidence interval ( CI) 0·66-0·94] for light skin and 0·77 (95% CI 0·60-0·91) for SOC; oSCORAD 0·68 (95% CI 0·44-0·88) for light skin and 0·74 (95% CI 0·54-0·89) for SOC; and IGA 0·80 (95% CI 0·62-0·93) for light skin and 0·70 (95% CI 0·49-0·87) for SOC. The greyscale had an ICC of 0·78 (95% CI 0·60-0·91) when replacing the EASI's erythema scale for patients with SOC. All scores showed excellent intrarater reliability for all skin types. Erythema component analysis showed that erythema did not contribute to variability. Conclusions EASI showed excellent reliability for patients of all skin colours, and is recommended as the optimal core measure for patients with all skin colours. [ABSTRACT FROM AUTHOR]

Background There are multiple severity outcome measures for atopic dermatitis ( AD). There is a need to compare the reliability of these measures. Objectives To compare the inter-rater and intrarater reliability of the objective Scoring Atopic Dermatitis ( oSCORAD), Eczema Area and Severity Index ( EASI), Six Area, Six Sign Atopic Dermatitis ( SASSAD) and Three Item Severity index ( TIS); and to analyse the correlation between these outcome measures and the quality-of-life instruments Patient-Orientated Eczema Measurement, Dermatology Life Quality Index and Skindex-29. Methods Twelve patients with AD attended a 1-day scoring exercise by five trained dermatology clinicians. Inter-rater and intrarater reliability were assessed using the intraclass correlation coefficient ( ICC). Correlation between clinician-rated and patient-reported measures was analysed using Spearman's rho. Results Regarding inter-rater reliability, EASI and SASSAD showed good reliabilities, with ICCs of 0·730 [95% confidence interval ( CI) 0·500-0·900] and 0·680 (95% CI 0·440-0·880), respectively. However, the ICCs were poor for TIS and oSCORAD, with 0·497 (95% CI 0·233-0·785) and 0·498 (95% CI 0·234-0·785), respectively. Separate body surface area ( BSA) component analyses showed that the oSCORAD BSA component contributed to its inter-rater variations. Regarding intrarater reliability, EASI and TIS showed excellent ICCs of 0·886 (95% CI 0·744-0·952) and 0·820 (0·614-0·923), respectively, while SASSAD showed a good reliability with an ICC of 0·720 (95% CI 0·424-0·878). However, the intrarater ICC was poor for oSCORAD, with 0·446 (95% CI 0·037-0·730). Regarding correlation with patient-reported measures, only SASSAD demonstrated moderate correlation with Skindex-29 (ρ = 0·611, P = 0·035). Conclusions EASI demonstrated the highest inter-rater and intrarater reliability, supporting it as the optimal AD severity outcome measure. [ABSTRACT FROM AUTHOR]