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Abstract Purpose Arbuscular mycorrhizal fungi (AMF) play a key role in medicinal plant species, besides their ecological role in shaping plant communities. Knowledge about the diversity and structure of AMF communities associated with the endangered Prunus africana is valuable in the conservation and domestication of the species for its medicinal products. Methods We investigated the diversity and structure of AMF species communities in the rhizosphere soils of P. africana trees occurring in four fragmented Afromontane forests found in Cameroon (Mount Cameroon and Mount Manengouba) and Kenya (Chuka and Malava) using Illumina Miseq sequencing of 18S rRNA gene amplicons. Results A total of 64 virtual taxa (VT) belonging to eight genera were detected, namely Glomus (43 VT), Claroideoglomus (6 VT), Paraglomus (5 VT), Acaulospora (4 VT), Diversispora (3 VT), and Archaeospora, Pacispora, and Scutellospora with 1 VT each. Scutellospora heterogama VTX00286 was the most abundant and common species in all four sites (49.62%). Glomeraceae and Gigasporaceae were the most abundant families found across the sites, while Acaulosporaceae, Pacisporaceae, and Archaeosporaceae were rare, represented by

Abstract Grain size is a key agronomic trait that contributes to grain yield in hexaploid wheat. Grain length and width were evaluated in an international collection of 157 wheat accessions. These accessions were genetically characterized using a genotyping-by-sequencing (GBS) protocol that produced 73,784 single nucleotide polymorphism (SNP) markers. GBS-derived genotype calls obtained on Chinese Spring proved extremely accurate when compared to the reference (> 99.9%) and showed > 95% agreement with calls made at SNP loci shared with the 90 K SNP array on a subset of 71 Canadian wheat accessions for which both types of data were available. This indicates that GBS can yield a large amount of highly accurate SNP data in hexaploid wheat. The genetic diversity analysis performed using this set of SNP markers revealed the presence of six distinct groups within this collection. A GWAS was conducted to uncover genomic regions controlling variation for grain length and width. In total, seven SNPs were found to be associated with one or both traits, identifying three quantitative trait loci (QTLs) located on chromosomes 1D, 2D and 4A. In the vicinity of the peak SNP on chromosome 2D, we found a promising candidate gene (TraesCS2D01G331100), whose rice ortholog (D11) had previously been reported to be involved in the regulation of grain size. These markers will be useful in breeding for enhanced wheat productivity.

Abstract Background Burkholderia cenocepacia is a human opportunistic pathogen causing devastating symptoms in patients suffering from immunodeficiency and cystic fibrosis. Out of the 303 B. cenocepacia strains with available genomes, the large majority were isolated from a clinical context. However, several isolates originate from other environmental sources ranging from aerosols to plant endosphere. Plants can represent reservoirs for human infections as some pathogens can survive and sometimes proliferate in the rhizosphere. We therefore investigated if B. cenocepacia had the same potential. Results We selected genome sequences from 31 different strains, representative of the diversity of ecological niches of B. cenocepacia, and conducted comparative genomic analyses in the aim of finding specific niche or host-related genetic determinants. Phylogenetic analyses and whole genome average nucleotide identity suggest that strains, registered as B. cenocepacia, belong to at least two different species. Core-genome analyses show that the clade enriched in environmental isolates lacks multiple key virulence factors, which are conserved in the sister clade where most clinical isolates fall, including the highly virulent ET12 lineage. Similarly, several plant associated genes display an opposite distribution between the two clades. Finally, we suggest that B. cenocepacia underwent a host jump from plants/environment to animals, as supported by the phylogenetic analysis. We eventually propose a name for the new species that lacks several genetic traits involved in human virulence. Conclusion Regardless of the method used, our studies resulted in a disunited perspective of the B. cenocepacia species. Strains currently affiliated to this taxon belong to at least two distinct species, one having lost several determining animal virulence factors.

The nutritional evaluation of quality protein maize (QPM) in feeding trials has proved its nutritional superiority over non-QPM varieties for human and livestock consumption. The present paper reviews some of the most recent achievements in development of QPM varieties using both conventional and molecular breeding under stressed and non-stressed environments. It is evident that numerous QPM varieties have been developed and released around the world over the past few decades. While the review points out some gaps in information or research efforts, challenges associated with adoption QPM varieties are highlighted and suggestions to overcome them are presented. The adoption of released varieties and challenges facing QPM production at the farmer level are also mentioned. Several breeding methods have been conventionally used to develop QPM varieties in stressed (drought, low soil nitrogen, resistance to grey leaf spot, Turcicum leaf blight, ear rot, and Striga) and non-stressed environments. At least three genetic loci have been found to be implicated in controlling the levels of a protein synthesis factor correlated with lysine. They have been mapped on chromosomes 2, 4, and 7. While the use of molecular approaches will improve the efficiency and speed of variety development, the cost implications might limit the use of these technologies in the developing world. More emphasis should be given to breeding QPM for tolerance to environmental stresses, such as low soil pH, heat, and combined heat and drought stress. The post-harvest attack of QPM grains should also be considered. The adoption of QPM genotypes by farmers has been found to be limited mainly due to the minimal collaboration between maize breeders, farmers, agricultural extension workers, and other relevant stakeholders, as well as the need for isolating QPM varieties from normal maize. Therefore, there is need to use participatory plant breeding (PPB) and/or participatory variety selection (PVS) to enhance and improve the adoption of QPM varieties.

La sociedad humana se ha construido a sí misma con el pasar de los años. A cada nueva revolución de pensamiento, los modelos sociales se han modificado; como resultado, los procesos que tenían como finalidad establecer los cimientos de una red de relaciones de todo ámbito desembocaron en aquello que los seres humanos percibimos en la actualidad como nuestro entorno. Sin embargo, no sólo se ha construido aquello que se aprecia a simple vista, sino también otras complejas abstracciones que han pasado desapercibidas pero que dan sentido de manera tácita a numerosos elementos del vivir cotidiano. A nuestro alrededor, miles de signos son interpretados a velocidades inimaginables. Sobre esos sistemas de significación se reescriben las convenciones en una eterna actualización de códigos. Es así como llama la atención en particular el caso de la música como discurso que genera una interpretación. Desde la óptica del estudio del significado, la música despierta una respuesta en la dimensión encargada de comprenderla, pero el cómo se genera esa respuesta sigue siendo objeto de acaloradas y apasionadas discusiones entre los teóricos. La intrincada relación de conceptos generados y reforzados en el tiempo por medio de la interacción social construyen nuestra interpretación musical. Por ello, y para comprender en su totalidad el proceso, repasaremos estudios como el de “Social Constructionism”, enfoques cognitivos, Generativismo, Social Representation o Interaccionismo Simbólico para enmarcarlos en el campo de la experiencia de la música y acercarnos a la comprensión del fenómeno del imaginario colectivo musical.

This study aims to develop an interactive Sparkol VideoScribe learning video integrated with the case method in the Pancasila course, which will enablestudents to understand the Pancasila material better. The problem is the lack of interactive learning media that students can access, especially when learning Pancasila. This research uses the type of research development (Research and Development) with the 4-D development model with the stages of defining, designing, developing and dissemination. The development stages are integrated in the activities of 1) Integration of Pancasila material, namely the History of Pancasila Formulation, Pancasila as an Ethical System and Pancasila as the Basis for Science and Technology Development; 2) Integrating the material that has been developed into the Sparkol VideoScribe application; 3) Development of Sparkol VideoScribe Interactive Video integrated with Case Method; 4) Preparation of validation instruments and validation of Sparkol VideoScribe Interactive Video Integratedwith Case Method by material experts and media experts; 5) Implementing videos that have been developed to students while reflecting and evaluating; 6) Disseminating research products to students. The results of thisstudy arebased on the results of material expert validation obtained a result of 85% with the category "Very Valid". In addition, based on the assessment of media experts, the result is 75% with the category "Valid".Based on the assessment results from material and media expert validators, the interactive video learning media Sparkol VideoScribe is suitable for use in the Pancasila learning process.

IntroductionUrinary tract infection (UTI) is one of the most common medical complaints in the emergency department (ED). The aim of this study was to assess the real indication of an initial broad-spectrum treatment administered in the ED for hospitalized patients with a diagnosis of community-acquired UTI (CAUTI).Materials and methodsThis is a monocentric observational retrospective study conducted in the ED of one of the largest tertiary care centers in Lebanon, on a two-year period, including adult patients admitted to the hospital for a CAUTI. The primary outcome was to evaluate the need of downgrading empirical antibiotherapy started in the ED. Secondary outcomes included a description of CAUTIs characteristics: prevalence and risk factors for (extended spectrum beta lactamases) ESBL-related infection, complicated and uncomplicated UTIs, empirical and targeted treatment, and finally the rate of adherence to local guidelines.ResultsThe most isolated strains on urine cultures were gram negative bacilli (GNB) with 29.1% producing ESBL; 69.4% of patients received an ESBL-targeting empirical treatment in the ED, in agreement with local guidelines, 46% of which needed a downgrade. Amikacin adjunction was only indicated in 42.8% of the cases. Patients who received antibiotics in the last 6 months had a 2.36 times higher risk of developing an ESBL-related infection.ConclusionThis study showed a high adherence rate to local recommendations suggesting the use of empirical ESBL-targeting antibiotherapy even in uncomplicated UTIs. However, the frequent need of de-escalation highlights the importance of establishing an efficient multi-drug resistant (MDR) bacteria surveillance system in the community in order to elaborate a stewardship program with more solid local guidelines.

The province of Alberta has been implementing a new hospital based electronic medical record (EMR) over the past several years based on the Epic system. With this implementation comes challenges related to consistent mapping of data to ensure consistency of data over time before and after implementation, even for standardized and routinely used elements. In a research study evaluating potential disparities in access to Emergency Department (ED) care, particularly in wait times and patient boarding (the time spent in the ED awaiting transfer to an inpatient bed), between mental health (MH) and non-MH patients during the COVID-19 pandemic. An interrupted time series analysis was used to evaluate the impact of the pandemic on boarding time. While there initially appeared to be a large decrease in boarding time near the start of the pandemic, it was later determined to be a data quality issue corresponding to the rollout of the new EMR at one hospital, despite the data coming from a secondary standardized dataset that is used for provincial and national reporting and expected to be reliable. This presentation will highlight how the issue was identified, what steps were taken to confirm the underlying cause, and how it was corrected to ensure accurate results in this research study.

Abstract Background The high utilization of acute care services, particularly emergency departments (ED), continues to be a significant concern for healthcare providers. Numerous approaches have been studied to meet the care needs of patients who frequently seek care in the ED; however, there is no comprehensive review of the current literature base. As such, a current understanding of the interventions initiated within the ED to address the needs of frequent users is required. This mapping review had three objectives: identify the characteristics associated with the need to frequently seek care in the ED; identify interventions implemented to address the needs of this population; and identify gaps in the current evidence base. Methods A knowledge map was created by scoping the literature to identify characteristics associated with frequent ED use and interventions implemented to address frequent use. Then, a literature search was conducted to determine what has been implemented by EDs to reduce frequent ED use. The literature was searched from 2013 to January 2023. MeSH terms and keywords were used to identify relevant studies. Studies implementing an intervention for those with characteristics associated with frequent ED use and reporting on ED use were included. Results Twenty-three (23) controlled trials and 35 observational studies were included. The most common populations were older adults, those with chronic conditions, and generic “frequent users”. No studies assessed Indigenous Peoples or racial minorities, and few assessed patients with a disability or patients experiencing homelessness. The most common interventions were referrals, care plans, case management, care coordination, and follow-up phone calls. Most studies reported ED revisits, hospitalization, costs, length-of-stay, or outpatient utilization. Few assessed patient or staff perspectives. About one-third of studies (n = 24) reported significant reductions in ED revisits. Conclusions Similar interventions, mainly focused on care coordination and planning, have been implemented to address frequent use of the ED. There are still significant gaps in the populations that have been studied. Efforts now must be undertaken to study more diverse populations whose care needs are not being met elsewhere and thus frequent the ED often.

Introduction This study describes the protocol for a systematic review. The systematic review will address experiences of managing methamphetamine intoxication, specifically violence and agitation related to intoxication, in the emergency department (ED).Methods and analysis This study uses the Grading of Recommendations Assessment, Development and Evaluation system to guide the methods in this section. The primary objective of the review is to identify experimental studies assessing the effectiveness of both pharmacological and non-pharmacological strategies to manage acute methamphetamine intoxication in patients presenting violently in the ED. Our secondary objectives will be to assess the impact of specific strategies on the time it takes to achieve de-escalation and/or sedation, the length of stay in the ED, frequency of admission, mortality and provider satisfaction with the intervention.Ethics and dissemination Ethics approval has been obtained from the Conjoint Health Research Ethics Board REB21-1387. Results will be published in a peer-reviewed journal and presented at healthcare conferences in Canada.Trial registration number The protocol is registered through the International Prospective Register of Systematic Reviews (identification number: CRD42020157938) and will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extensions for systematic review protocols.

Objetivo: evaluar el control glucémico entre pacientes con diabetes mellitus (DM) atendidos en consulta presencial y por teleconsulta, e identificar factores asociados a variaciones de hemoglobina glicosilada (HbA1c). Materiales y métodos: Se realizó un estudio de cohortes retrospectivo, que incluyó a pacientes > 18 años evaluados en consulta presencial o teleconsulta por DM en el Hospital Nacional Alberto Sabogal Sologuren, durante junio 2021. Se recolectaron datos clínicos de las historias clínica electrónicas, entre ellos los niveles de HbA1c inicial y al seguimiento a 11 meses. Utilizamos regresiones de Poisson con varianza robusta para calcular riesgos relativos (RR) y sus intervalos de confianza del 95% (IC 95%), con el fin de identificar factores asociados a variaciones de HbA1C ≥ 0,5 durante el seguimiento. Resultados: se incluyeron 416 pacientes, la mediana de edad fue de 62 años, el 57,2% eran mujeres y el 68,5% se atendieron por teleconsulta. El porcentaje de pacientes con HbA1C < 7% aumentó del 21,7 al 27,4% durante el seguimiento, mientras que aquellos con HbA1C ≥ 10% disminuyó del 38,2 al 19,1%. Entre los pacientes con HbA1C basal ≥ 7%, tener una HbA1C basal ≥ 10% se asoció con una disminución de la HbA1C ≥ 0,5% (RR ajustado: 2,97; IC 95 %: 1,61-5,50). El tipo de consulta (presencial o teleconsulta) no se asoció con variaciones significativas de HbA1C. Conclusiones: la quinta parte de los pacientes tuvo un control glucémico óptimo al inicio, cifra que aumentó en el seguimiento. Aquellos con HbA1C basal ≥ 10% tuvieron mayor incidencia de reducción de HbA1C, aunque el tipo de consulta (presencial o teleconsulta) no se asoció con variación en el nivel de HbA1C.

Abstract Background Despite constituting 14% of the general population, older adults make up almost a quarter of all emergency department (ED) visits. These visits often do not adequately address patient needs, with nearly 80% of older patients discharged from the ED carrying at least one unattended health concern. Many interventions have been implemented and tested in the ED to care for older adults, which have not been recently synthesized. Methods A systematic review was conducted to identify interventions initiated in the ED to address the needs of older adults. Embase, MEDLINE, CINAHL, Cochrane CENTRAL, the Cochrane Database of Systematic Reviews, and grey literature were searched from January 2013 to January 18, 2023. Comparative studies assessing interventions for older adults in the ED were included. The quality of controlled trials was assessed with the Cochrane risk-of-bias tool for randomized trials, and the quality of observational studies was assessed with the risk of bias in non-randomized studies of interventions tool. Due to heterogeneity, meta-analysis was not possible. Results Sixteen studies were included, assessing 12 different types of interventions. Overall study quality was low to moderate: 10 studies had a high risk of bias, 5 had a moderate risk of bias, and only 1 had a low risk of bias. Follow-up telephone calls, referrals, geriatric assessment, pharmacist-led interventions, physical therapy services, care plans, education, case management, home visits, care transition interventions, a geriatric ED, and care coordination were assessed, many of which were combined to create multi-faceted interventions. Care coordination with additional support and early assessment and intervention were the only two interventions that consistently reported improved outcomes. Most studies did not report significant improvements in ED revisits, hospitalization, time spent in the ED, costs, or outpatient utilization. Two studies reported on patient perspectives. Conclusion Few interventions demonstrate promise in reducing ED revisits for older adults, and this review identified significant gaps in understanding other outcomes, patient perspectives, and the effectiveness in addressing underlying health needs. This could suggest, therefore, that most revisits in this population are unavoidable manifestations of frailty and disease trajectory. Efforts to improve older patients’ needs should focus on interventions initiated outside the ED.

Abstract Background Long-term care (LTC) was overwhelmingly impacted by COVID-19 and unnecessary transfer to emergency departments (ED) can have negative health outcomes. This study aimed to explore how the COVID-19 pandemic impacted LTC to ED transfers and hospitalizations, utilization of community paramedics and facilitated conversations between LTC and ED physicians during the first four waves of the pandemic in Alberta, Canada. Methods In this retrospective population-based study, administrative databases were linked to identify episodes of care for LTC residents who resided in facilities in Alberta, Canada. This study included data from January 1, 2018 to December 31, 2021 to capture outcomes prior to the onset of the pandemic and across the first four waves. Individuals were included if they visited an emergency department, received care from a community paramedic or whose care involved a facilitated conversation between LTC and ED physicians during this time period. Results Transfers to ED and hospitalizations from LTC have been gradually declining since 2018 with a sharp decline seen during wave 1 of the pandemic that was greatest in the lowest-priority triage classification (CTAS 5). Community paramedic visits were highest during the first two waves of the pandemic before declining in subsequent waves; facilitated calls between LTC and ED physicians increased during the waves. Conclusions There was a reduction in number of transfers from LTC to EDs and in hospitalizations during the first four waves of the pandemic. This was supported by increased conversations between LTC and ED physicians, but was not associated with increased community paramedic visits. Additional work is needed to explore how programs such as community paramedics and facilitated conversations between LTC and ED providers can help to reduce unnecessary transfers to hospital.

The development of an on-line automated SPE-HPLC--ESI-MS method is described for targeted metabolomic analysis of urinary modified nucleoside levels. The setup comprises a boronate affinity column as a trapping device, a hydrophilic interaction chromatography (HILIC) separation and information-dependent MS detection modes. The system was optimized using standards and tested on biological samples, detecting a number of modified nucleosides. Other urinary biomarkers could also be analyzed by the system developed: for example, the urinary nucleobases were also available for analysis. A simultaneous creatinine-monitoring experiment was also demonstrated to be viable when utilizing the method, which is of benefit as creatinine is a urinary normalizing factor.

Urinary modified nucleosides have a potential role as cancer biomarkers, and most of the methods used in their study have utilized low-pressure phenylboronate affinity chromatography materials for the purification of the cisdiol-containing nucleosides. In this study, a boronate HPLC column was surprisingly shown not to trap the nucleosides as would be expected from experience with the classic Affigel 601 resin but showed only partial selectivity toward cis-diol groups while other groups exhibited better retention. In aprotic conditions, trapping of nucleosides was possible; however, the selectivity toward cis-diol-containing compounds was lost with the Lewis basicity of available nitrogens being the main determinant of retention. The experimental findings are compared to and confirmed by DFT calculations.