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A new species in the southern hemisphere, genusClasmatocoleais described for New Zealand asC. bisexualis, with superficial similarities toC. verrucosaandC. strongylophylla.Clasmatocolea bisexualishas dome-like tuberculae very similar in size and shape to those ofC. verrucosabut only on the abaxial leaf surface. It differs fromC. strongylophyllain having a single large tuberculum per cell rather than many low papillae over each leaf cell that tend to be elongated or striate, and in having a smooth rather than papillose stem surface. A new subgenus is described for the species,Clasmatocoleasubg.Bisexuales.Clasmatocolea verrucosais also reported for the first time from New Zealand from two sites in Fiordland and one in Western Nelson. A revised key to New Zealand species ofClasmatocoleais provided. [ABSTRACT FROM AUTHOR]

Objectives: IL-1α/β and TNF are closely linked to the pathology of severe COVID-19 and sepsis. The soluble forms of their receptors, functioning as decoy receptors, exhibit inhibitory effects. However, little is known about their regulation in severe bacterial and viral infections, which we aimed to investigate in this study., Methods: The circulating soluble receptors of TNF (sTNFR1 and sTNFR2) and IL-1α/β (sIL-1R1, sIL-1R2) were evaluated in the plasma of patients with COVID-19, severe bacterial infections, and sepsis and compared with healthy controls. Additionally, IL1R1, IL1R2, TNFRSF1A, and TNFRSF1B expression was evaluated at the single cell level in PBMCs derived from COVID-19 or sepsis patients., Results: Plasma concentrations of sIL-1R1, sTNFR1, and sTNFR2 were significantly higher in COVID-19 patients compared to healthy subjects. Notably, sIL-1R1 levels were particularly elevated in ICU COVID-19 patients, and transcriptome analysis indicated heightened IL1R1 expression in PBMCs from severe COVID-19 patients. In severe bacterial infections, only sTNFR1 and sTNFR2 exhibited increased levels compared to healthy controls. Sepsis patients had decreased sIL-1R1 plasma concentrations but elevated sIL-1R2, sTNFR1, and sTNFR2 levels compared to healthy individuals, reflecting the heightened expression due to the increased numbers of monocytes present in sepsis. Finally, elevated concentrations of sIL-1R2, sTNFR1, and sTNFR2 were moderately associated with reduced 28-day survival in sepsis patients., Conclusion: Our study reveals distinct regulation of plasma concentrations of soluble IL-1 receptors in COVID-19 and sepsis. Moreover, soluble TNF receptors 1 and 2 consistently rise in all conditions and show a positive correlation with disease severity in sepsis., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: M.G.N. is a scientific founder of TTxD, Biotrip and Lemba (none of these entities are involved in sepsis or COVID-19 fields). E. J. Giamarellos-Bourboulis has received honoraria from Abbott CH, bioMérieux, Brahms GmbH, GSK, InflaRx GmbH, Sobi and Xbiotech Inc; independent educational grants from Abbott CH, bioMérieux Inc, InflaRx GmbH, Johnson & Johnson, MSD, Sobi and Xbiotech Inc. All other authors report no potential conflicts., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

While several effective therapies for critically ill patients with COVID-19 have been identified in large, well-conducted trials, the mechanisms underlying these therapies have not been investigated in depth. Our aim is to investigate the association between various immunosuppressive therapies (corticosteroids, tocilizumab and anakinra) and the change in endothelial host response over time in critically ill COVID-19 patients. We conducted a pre-specified multicenter post-hoc analysis in a Dutch cohort of COVID-19 patients admitted to the ICU between March 2020 and September 2021 due to hypoxemic respiratory failure. A panel of 18 immune response biomarkers in the complement, coagulation and endothelial function domains were measured using ELISA or Luminex. Biomarkers were measured on day 0-1, day 2-4 and day 6-8 after start of COVID-19 treatment. Patients were categorized into four treatment groups: no immunomodulatory treatment, corticosteroids, anakinra plus corticosteroids, or tocilizumab plus corticosteroids. The association between treatment group and the change in concentrations of biomarkers was estimated with linear mixed-effects models, using no immunomodulatory treatment as reference group. 109 patients with a median age of 62 years [IQR 54-70] of whom 72% (n = 78) was male, were included in this analysis. Both anakinra plus corticosteroids (n = 22) and tocilizumab plus corticosteroids (n = 38) were associated with an increase in angiopoietin-1 compared to no immune modulator (n = 23) (beta of 0.033 [0.002-0.064] and 0.041 [0.013-0.070] per day, respectively). These treatments, as well as corticosteroids alone (n = 26), were further associated with a decrease in the ratio of angiopoietin-2/angiopoietin-1 (beta of 0.071 [0.034-0.107], 0.060 [0.030-0.091] and 0.043 [0.001-0.085] per day, respectively). Anakinra plus corticosteroids and tocilizumab plus corticosteroids were associated with a decrease in concentrations of complement complex 5b-9 compared to no immunomodulatory treatment (0.038 [0.006-0.071] and 0.023 [0.000-0.047], respectively). Currently established treatments for critically ill COVID-19 patients are associated with a change in biomarkers of the angiopoietin and complement pathways, possibly indicating a role for stability of the endothelium. These results increase the understanding of the mechanisms of interventions and are possibly useful for stratification of patients with other inflammatory conditions which may potentially benefit from these treatments., (© 2024. The Author(s).)

Background: Dexamethasone improves the survival of COVID-19 patients in need of supplemental oxygen therapy. Although its broad immunosuppressive effects are well-described, the immunological mechanisms modulated by dexamethasone in patients hospitalized with COVID-19 remain to be elucidated., Objective: We combined functional immunological assays and an omics-based approach to investigate the in vitro and in vivo effects of dexamethasone in the plasma and peripheral blood mononuclear cells (PBMCs) of COVID-19 patients., Methods: Hospitalized COVID-19 patients eligible for dexamethasone therapy were recruited from the general care ward between February and July, 2021. Whole blood transcriptomic and targeted plasma proteomic analyses were performed before and after starting dexamethasone treatment. PBMCs were isolated from healthy individuals and COVID-19 patients and stimulated with inactivated SARS-CoV-2 ex vivo in the presence or absence of dexamethasone and transcriptome and cytokine responses were assessed., Results: Dexamethasone efficiently inhibited SARS-CoV-2-induced in vitro expression of chemokines and cytokines in PBMCs at the transcriptional and protein level. Dexamethasone treatment in COVID-19 patients resulted in down-regulation of genes related to type I and II interferon (IFN) signaling in whole blood immune cells. In addition, dexamethasone attenuated circulating concentrations of secreted interferon-stimulating gene 15 (ISG15) and pro-inflammatory cytokines and chemokines correlating with disease severity and lethal outcomes, such as tumor necrosis factor (TNF), interleukin-6 (IL-6), chemokine ligand 2 (CCL2), C-X-C motif ligand 8 (CXCL8), and C-X-C motif chemokine ligand 10 (CXCL10). In PBMCs from COVID-19 patients that were stimulated ex vivo with multiple pathogens or Toll-like receptor (TLR) ligands, dexamethasone efficiently inhibited cytokine responses., Conclusion: We describe the anti-inflammatory impact of dexamethasone on the pathways contributing to cytokine hyperresponsiveness observed in severe manifestations of COVID-19, including type I/II IFN signaling. Dexamethasone could have adverse effects in COVID-19 patients with mild symptoms by inhibiting IFN responses in early stages of the disease, whereas it exhibits beneficial effects in patients with severe clinical phenotypes by efficiently diminishing cytokine hyperresponsiveness., 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 © 2023 Engel, van der Made, Keur, Setiabudiawan, Röring, Damoraki, Dijkstra, Lemmers, Ioannou, Poulakou, van der Meer, Giamarellos-Bourboulis, Kumar, van de Veerdonk, Netea and Ziogas.)

Since the discovery of the human electroencephalogram (EEG), neurophysiology techniques have become indispensable tools in our armamentarium to localize epileptic seizures. New signal analysis techniques and the prospects of artificial intelligence and big data will offer unprecedented opportunities to further advance the field in the near future, ultimately resulting in improved quality of life for many patients with drug-resistant epilepsy. This article summarizes selected presentations from Day 1 of the two-day symposium "Neurophysiology, Neuropsychology, Epilepsy, 2022: Hills We Have Climbed and the Hills Ahead". Day 1 was dedicated to highlighting and honoring the work of Dr. Jean Gotman, a pioneer in EEG, intracranial EEG, simultaneous EEG/ functional magnetic resonance imaging, and signal analysis of epilepsy. The program focused on two main research directions of Dr. Gotman, and was dedicated to "High-frequency oscillations, a new biomarker of epilepsy" and "Probing the epileptic focus from inside and outside". All talks were presented by colleagues and former trainees of Dr. Gotman. The extended summaries provide an overview of historical and current work in the neurophysiology of epilepsy with emphasis on novel EEG biomarkers of epilepsy and source imaging and concluded with an outlook on the future of epilepsy research, and what is needed to bring the field to the next level., 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 © 2023 Elsevier Inc. All rights reserved.)

Immune dysregulation is an important component of the pathophysiology of COVID-19. A large body of literature has reported the effect of immune-based therapies in patients with COVID-19, with some remarkable successes such as the use of steroids or anti-cytokine therapies. However, challenges in clinical decision-making arise from the complexity of the disease phenotypes and patient heterogeneity, as well as the variable quality of evidence from immunotherapy studies. This Review aims to support clinical decision-making by providing an overview of the evidence generated by major clinical trials of host-directed therapy. We discuss patient stratification and propose an algorithm to guide the use of immunotherapy strategies in the clinic. This will not only help guide treatment decisions, but may also help to design future trials that investigate immunotherapy in other severe infections., (© 2022. Springer Nature America, Inc.)

Non-typhoidalSalmonellae (NTS) are virulent bacteria that commonly cause gastroenteritis. However, less than 5% of patients infected with NTS develop bacteraemia and metastatic foci of infection. Mortality remains high, despite appropriate use of antibiotic therapy. We present three cases to demonstrate that immunodeficiency - and T-cell dysfunction in particular - is a major risk factor for NTS bacteraemia. All three patients presented with fever and general malaise, while none of them had symptoms of gastroenteritis. Blood cultures revealed the presence of Salmonella enteritidis, but stool cultures were negative. All three patients were diagnosed with vascular infection, for which they were treated with a combination of surgery and antibiotics. The efficiency of NTS clearance depends greatly on successful antigen presentation to T-cells. T-cell dysfunction contributes to the development of bacteraemia. These cases emphasise the importance of recognising extraintestinal complications of NTS infection in immunocompromised patients, particularly those associated with T-cell dysfunction.

A working checklist of accepted taxa worldwide is vital in achieving the goal of developing an online flora of all known plants by 2020 as part of the Global Strategy for Plant Conservation. We here present the first-ever worldwide checklist for liverworts (Marchantiophyta) and hornworts (Anthocerotophyta) that includes 7486 species in 398 genera representing 92 families from the two phyla. The checklist has far reaching implications and applications, including providing a valuable tool for taxonomists and systematists, analyzing phytogeographic and diversity patterns, aiding in the assessment of floristic and taxonomic knowledge, and identifying geographical gaps in our understanding of the global liverwort and hornwort flora. The checklist is derived from a working data set centralizing nomenclature, taxonomy and geography on a global scale. Prior to this effort a lack of centralization has been a major impediment for the study and analysis of species richness, conservation and systematic research at both regional and global scales. The success of this checklist, initiated in 2008, has been underpinned by its community approach involving taxonomic specialists working towards a consensus on taxonomy, nomenclature and distribution.

Brevianthus is a distinctive genus of leafy liverwort in its succubously inserted, entire leaves, lack of underleaves, restriction of sexual organs to lateral-intercalary branches, scattered rhizoids and dense leaf-surface ornamentation. The sole species, Brevianthusflavus, is divided into two subspecies, one in Tasmania the other in New Zealand. A second species, Brevianthushypocanthidium, is described as new and is the first record of the genus for New Caledonia. Among its distinguishing characters are its shallowly bilobed leaves, and triangular underleaves present on small to medium-sized shoot sectors, the lack of a hyaline leaf margin, and the crenulate leaf margin formed by heavily thickened external cell walls. The most unusual features of the new species are the presence of underleaves between lateral leaf insertion lines that reach the ventral stem mid-line, and the absence of underleaves from larger shoots. To explain these features we propose a competitive model of shoot formation wherein the ventral merophyte progressively loses vigor as its relative stature decreases, and its derivative cells become discontinuous and isolated along the ventral stem surface, with intervening areas occupied by derivatives of the more vigorous lateral merophytes.

The postictal state is the abnormal condition occurring between the end of an epileptic seizure and return to baseline condition. Applying this definition operationally can be difficult, especially for complex partial seizures, where cognitive and sensorimotor impairments merge imperceptibly into the postictal state. Many patients are unaware of even having had a seizure. Electroencephalography sometimes helps to distinguish ictal from postictal periods, but may demonstrate focal slowing both during and after a seizure. Epileptiform electroencephalographic changes do not always correspond precisely to behavioral changes, especially with scalp recordings. The postictal state ends at the interictal state, but this too can be ambiguous. Interictal spikes and spike-waves can be associated with cognitive and behavioral impairments, suggesting that they may represent fragments of ictal episodes. Except where boundaries are clear, it is better to describe a sequence of behaviors and electroencephalographic changes, without labeling arbitrary stages as being ictal or postictal., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Eighty-four crossbred gilts were used to evaluate the effects of dietary choice white grease (CWG) or poultry fat (PF) on growth performance, carcass characteristics, and quality characteristics of longissimus muscle (LM), belly, and bacon of growing-finishing pigs. Pigs (initially 60 kg) were fed a control diet with no added fat or diets containing 2, 4, or 6% CWG or PF. Diets were fed from 60 to 110 kg and contained 2.26 g lysine/Mcal ME. Data were analyzed as a 2 x 3 factorial plus a control with main effects of fat source (CWG and PF) and fat level (2, 4, and 6%). Pigs fed the control diet, 2% fat, and 4% fat had greater (P < 0.05) ADFI than pigs fed 6% fat. Pigs fed 6% fat had greater (P < 0.05) gain/feed (G/F) than pigs fed the control diet or other fat levels. Subcutaneous fat over the longissimus muscle from pigs fed CWG had more (P < 0.05) moisture than that from pigs fed PF. Feeding dietary fat (regardless of source or level) reduced (P < 0.05) the amount of saturated fats present in the LM. Similarly, 4 or 6% fat decreased (P < 0.05) the amount of saturated fats and increased unsaturated fats present in the bacon. No differences (P > 0.05) were observed for ADG, dressing percentage, leaf fat weight, LM pH, backfat depth, LM area, percentage lean, LM visual evaluation, LM waterholding capacity, Warner-Bratzler shear and sensory evaluation of the LM and bacon, fat color and firmness measurements, or bacon processing characteristics. Adding dietary fat improved G/F and altered the fatty acid profiles of the LM and bacon, but differences in growth rate, carcass characteristics, and quality and sensory characteristics of the LM and bacon were minimal. Dietary additions of up to 6% CWG or PF can be made with little effect on quality of pork LM, belly, or bacon.

This paper reviews the standards of practice, regulations, and guidelines that govern gastrointestinal endoscopy and their effect on space and equipment, staff and physician quality of care, and educational programs. It also examines how all these considerations have affected the growth of an endoscopy center and describes the processes that have been instituted to ensure compliance with all relevant standards, regulations, and guidelines.

The urines of 3,270 asymptomatic girls were screened at annual physical examinations. The urines were collected in Dixie Cups without prior preparation of the perineum and cultured on 5% sheep cell agar. Less than 2 per cent of the specimens showed significant growth, thus requiring no follow-up visits by 98 per cent of the patients. Slightly less that 1/2 of one per cent were found to have asymptomatic urinary tract infections. The procedure was found to be practical, economically feasible and reliable, and was well accepted by both the parents and patients.

Two cases of jaundice are reported that were secondary to obstruction of the common bile duct by metastatic carcinoma of the breast and relieved by pallieative surgery. In one case, obstructive jaundice was the first evidence of spread beyond regional lymph nodes, in the other patient it was a late manifestation of the disease. In patients with prior history of carcinoma of the breast, jaundice may be secondary to obstruction of the common bile duct, and, because it is amenable to palliation, this possibility should be investigated before concluding that extensive hepatic involvement is the cause of jaundice.

Alcohol intakes and dietary habits of 304 alcoholic, hospitalized patients were evaluated. There were 195 patients with hepatic cirrhosis, 40 precirrhotics, and 69 noncirrhotics. Alcohol contributed 50% to 58% of total calories. Two thirds of the patients drank excessively for more than 20 years. There were no statistically significant differences between the three groups in the duration or degree of alcohol excess. Dietary intakes were assessed for a period of at least two years before the presenting illness. Noncirrhotics had higher food caloric intakes and higher protein intakes than the cirrhotics (P less than .05). The findings suggest that dietary factors may be involved in the pathogenesis of the disease.

A patient developed cholestatic hepatitis while being treated with nitrofurantoin. A second episode of jaundice followed the intravaginal administration of a mixture of furazolidone and nifuroxime. It is important to consider possible cross-sensitivity of chemically related compounds even when they are administered by different routes.

Most operations performed for peptic ulcer disease in the United States include vagotomy as part of the surgical procedure. This paper reviews the complications associated specifically with or increased in frequency and severity by this procedure. Included in this review are technical complications, gastric retention, recurrent ulceration, postvagotomy diarrhea, postvagotomy dysphagia and achalasia, postvagotomy biliary disease and nutritional problems. The frequency of these complications, their pathophysiology and therapeutic modalities available are reviewed. The main emphasis is on postvagotomy syndrome that can be treated medically and on the various treatment forms that have been suggested.

Extracolonic manifestations of inflammatory bowel disease have attracted considerable attention. We present two young men with ulcerative colitis who also developed pleurisy. While this association has not been reported previously, the temporal relationship and absence of another cause suggest that the pleuritis could be a systemic manifestation of inflammatory bowel disease.