Search

Abstract Klebsiella pneumoniae multidrug-resistant (MDR) high-risk clones drive the spread of antimicrobial resistance (AMR) associated infections, resulting in limited therapeutic options. This study described the genomic characteristics of K. pneumoniae MDR high-risk clones in Gauteng, South Africa. Representative carbapenem-resistant [K. pneumoniae carbapenemase (KPC)-2, New-Delhi metallo-beta (β)-lactamase (NDM)-1, oxacillinase (OXA)-181, OXA-232, OXA-48, Verona integron-encoded metallo-β-lactamase (VIM)-1] K. pneumoniae isolates (n = 22) obtained from inpatient and outpatient’s urine (n = 9) and inpatients rectal carriage (n = 13) were selected for short-read whole genome sequencing. Klebsiella pneumoniae population include sequence type (ST)-307 (n = 3), ST2497 (n = 5) and ST17 (n = 4). The ST17 strains were exclusively obtained from rectal screening. Ten isolates co-harboured carbapenemase genes including β-lactamase gene encoding KPC-2 + OXA-181, NDM-1 + OXA-48 and NDM-1 + OXA-181. One ST307 isolate (UP-KT-73CKP) co-harboured three carbapenemase genes (bla NDM-1 + bla OXA-48 + bla OXA-181), while all the ST2497 strains co-harboured (bla NDM-1 + bla OXA-232). Phenotypically, hypermucoviscosity was observed in a single ST307 isolate. The ST307 isolate UP-KT-151UKP harboured colibactin genotoxins. The following mobile genetic elements were detected: plasmids [incompatibility group (Inc)-FIB(K), IncX3], and bacteriophages [e.g. Klebsi_ST16_OXA48phi5.4_NC_049450, Klebsi_3LV2017_NC_047817(36)]. The study highlights the importance of local genomic surveillance systems to characterise K. pneumoniae MDR high-risk clones. This data will aid in designing infection and prevention measures for limiting the spread of carbapenemase-producing K. pneumoniae in Gauteng, South Africa.

BackgroundThis study investigates the cross-sectional and prospective associations between accelerometer-measured sedentary behavior and body composition from adolescence to early adulthood.MethodsData from the Santiago Longitudinal Study were analyzed (n = 212). Sedentary time was measured at age 16 years, and body composition (body mass index [BMI], waist circumference, waist-to-height ratio [WHtR], fat mass percentage, and lean mass percentage) was examined at both age 16 and 23 years. Adjusted linear regression models estimated associations between sedentary time, sedentary bout duration, and body composition, overall and by sex.ResultsIn all analyses, mean sedentary bout duration was not associated with body composition. In cross-sectional analyses, more sedentary time during adolescence was significantly associated with lower BMI, waist circumference, WHtR, fat mass percentage, and higher lean mass percentage (p

Este artículo busca brindar una síntesis de la experiencia argentina en el desarrollo de la vacuna ARVAC Cecilia Grierson como respuesta a la COVID-19. Su desarrollo reúne elementos singulares que permiten elaborar un interesante caso de estudio para valorar las fortalezas, las debilidades y los desafíos del sistema de ciencia, tecnología e innovación de la Argentina. A partir de su análisis surgensiete aprendizajes que podrían enriquecer el debate sobre cómo recuperar el papel que la ciencia y la tecnología deben tener en el desarrollo de nuestro país.

El trabajo a distancia ha planteado que las empresas y colaboradores expongan cuestionamientos sobre su efectividad y desarrollo. Por ello, el objetivo de esta investigación es responder la pregunta: ¿cuál es el impacto del trabajo a distancia en las organizaciones? Con esa finalidad, se desarrolla una investigación sistemática utilizando el método Prisma, el cual ha permitido encontrar, seleccionar y analizar diferentes artículos en reconocidas bases de datos como Scopus y Web of Science. En la primera búsqueda, se hallaron 54 003 artículos, los cuales fueron filtrados según diversos criterios, de manera que quedaron 30 artículos finales. Los resultados muestran que el trabajo a distancia puede tener un impacto positivo en la satisfacción laboral, el equilibrio entre el trabajo y la vida personal, la productividad y la innovación. Sin embargo, también se encontraron algunos impactos negativos, como el aumento de la fatiga, el aislamiento social y la falta de comunicación.

Lactofen is a chiral restricted-use herbicide, classified as toxicity class I by the Environmental Protection Agency (EPA), commonly used to control broadleaved weeds. While the observed herbicidal activity mostly derives from the (S)-(+)-enantiomer, formulations have been manufactured as a mixture of both enantiomers. In this work, we present a quantitative method for the enantiomeric determination of lactofen in commercial formulations based on the development of a second-order calibration to assist the selectivity of chiral separation under reversed-phase liquid chromatographic mode coupled to diode array detection. Chromatographic conditions were aimed to minimize analysis time and solvent consumption. This approach is feasible because second-order calibration allows for the quantification of overlapping bands and analytes in the presence of interferences. Chromatographic-spectral matrices were processed by unfolded partial least-squares coupled to residual bilinearization. The proposed methodology was evaluated through validation samples, achieving relative errors of predictions of 2–4 %. Finally, commercial formulations were subjected to minimal sample treatment and analyzed, and figures of merit for real samples were determined. The described methodology results suitable for the determination of enantiomeric purity and quality control in commercial lactofen formulations.

Abstract Scientific research of artificial intelligence (AI) in dermatology has increased exponentially. The objective of this study was to perform a systematic review and meta-analysis to evaluate the performance of AI algorithms for skin cancer classification in comparison to clinicians with different levels of expertise. Based on PRISMA guidelines, 3 electronic databases (PubMed, Embase, and Cochrane Library) were screened for relevant articles up to August 2022. The quality of the studies was assessed using QUADAS-2. A meta-analysis of sensitivity and specificity was performed for the accuracy of AI and clinicians. Fifty-three studies were included in the systematic review, and 19 met the inclusion criteria for the meta-analysis. Considering all studies and all subgroups of clinicians, we found a sensitivity (Sn) and specificity (Sp) of 87.0% and 77.1% for AI algorithms, respectively, and a Sn of 79.78% and Sp of 73.6% for all clinicians (overall); differences were statistically significant for both Sn and Sp. The difference between AI performance (Sn 92.5%, Sp 66.5%) vs. generalists (Sn 64.6%, Sp 72.8%), was greater, when compared with expert clinicians. Performance between AI algorithms (Sn 86.3%, Sp 78.4%) vs expert dermatologists (Sn 84.2%, Sp 74.4%) was clinically comparable. Limitations of AI algorithms in clinical practice should be considered, and future studies should focus on real-world settings, and towards AI-assistance.

Abstract Background Skin cancer is the most frequent cancer worldwide and the most frequent periocular tumor. Keratinocyte Carcinomas (KC) located in periorificial areas, such as periocular tumors, are considered high-risk tumors. Mohs Micrographic Surgery (MMS) is considered the first line for the treatment of high-risk KC, providing a lower recurrence rate than conventional wide excision. Objective To describe the clinical-pathological features of periocular KC treated with MMS in a tertiary university center in Chile. Methods A single-center, retrospective study of patients with KC located on the periocular area, that underwent MMS between 2017‒2022. MMS details were recorded. Results One hundred thirteen patients with periocular carcinomas were included. The mean age was 59 ± 13 years; 52% were women. The most frequent location was the medial canthus (53%), followed by the lower eyelid (30.1%). The most frequent BCC histology was the nodular variant (59.3%). Regarding MMS, the average number of stages was 1.5 ± 0.7, and 54% of the cases required only 1 stage to achieve clear margins. To date, no recurrence has been reported. Tumors larger than 8.5 mm in largest diameter or 43.5 mm2 were more likely to require complex reconstruction. Study limitations Retrospective design and a relatively low number of patients in the SCC group. Possible selection bias, as larger or more complex cases, may have been referred to oculoplastic surgeons directly. Conclusion The present study confirms the role of MMS for the treatment of periocular KCs. Periocular KCs larger than 8.5 mm might require complex reconstruction. These results can be used to counsel patients during pre-surgical visits.

La reseña traza un recorrido por la publicación Poner en Común. Sistematizaciones de experiencias de extensión universitaria. Desde la experiencia de formación universitaria en el profesorado de ciencias naturales y exactas se destaca la propuesta del libro de integrar, reformular y/o producir conocimientos con una perspectiva multidisciplinar, en relación con la propia experiencia de la autora a lo largo de la cursada de la carrera y el paso por talleres y proyectos de extensión. Finalmente se evalúa el aporte del libro y se invita a su lectura para estimular nuevas voces y experiencias con las que continuar reflexionando sobre la extensión y su producción de conocimientos.

Introduction: Studies focused on dermoscopic aspects of pigmented Bowen disease (pBD) in Latin American population are scarce and limited to only case reports or small series. Objectives: To report dermoscopic findings in a large series of 147 pBD diagnosed in Ibero-Latin American population. Methods: We conducted a multicentric, retrospective study on 147 histologically proven pBD under the auspices of the Dermoscopy Chapter of the Ibero-Latin American College of Dermatology. Results: The study population consisted of 77 females (52%) and 70 males (48%) with a mean age of 68.6 years. 70.1% of patients had skin phototype 3, 15.6% to skin phototype 2, and 14.3% to skin phototype 4. On clinical examination, near 60% of pBD were flat, 70% presented with scales, and 90% were asymmetric. Under dermoscopy, structureless hypopigmented areas, dots brown and pink color were the most frequently observed. Regarding specific dermoscopic clues to pBD, the most prevalent were structureless hypopigmented areas, vessels arranged in linear fashion at the periphery, and pigmented lines or pigmented dots distributed in a linear fashion. Clustered, coiled, and dotted vessels were observed in 55.8%, 45.6%, and 45.6% of the cases, respectively. Conclusions: We report a large series of cases of pBD in Latin American patients, with most patients being skin phototype 3 and 4. Distinctively in our study, the pigmented structures and the clues derived from the presence of melanin were much more frequent than in previous reports in fair skin.

Summary: Urinary tract infections (UTIs) commonly afflict people with diabetes. To better understand the mechanisms that predispose diabetics to UTIs, we employ diabetic mouse models and altered insulin signaling to show that insulin receptor (IR) shapes UTI defenses. Our findings are validated in human biosamples. We report that diabetic mice have suppressed IR expression and are more susceptible to UTIs caused by uropathogenic Escherichia coli (UPEC). Systemic IR inhibition increases UPEC susceptibility, while IR activation reduces UTIs. Localized IR deletion in bladder urothelium promotes UTI by increasing barrier permeability and suppressing antimicrobial peptides. Mechanistically, IR deletion reduces nuclear factor κB (NF-κB)-dependent programming that co-regulates urothelial tight junction integrity and antimicrobial peptides. Exfoliated urothelial cells or urine samples from diabetic youths show suppressed expression of IR, barrier genes, and antimicrobial peptides. These observations demonstrate that urothelial insulin signaling has a role in UTI prevention and link IR to urothelial barrier maintenance and antimicrobial peptide expression.

This paper offers a survey of the uses of Iasian marbles and their relationships with other stones. In the 6th century, these marbles were used for wall cladding and flooring, with an aim to alternate with or frame lighter marbles, as was the case in Iasos, in the Agora Basilica. Similar combinations were attested in the cladding of synthronoi of the basilicas A and C of Nea Anchialos. In the latter, the sides of the presbytery were framed with red cipollino slabs of different lengths and widths. In the prostoon, verde antico was added to red and white veined marbles.Other examples seem to demonstrate the use of the red cipollino to mark thresholds and passageways, as was the case of the solea of Hagia Sophia and the presbytery of the basilica of St. John in Ephesos. There, the templon stylobate and bases made of Iasian marble supported columns of verde antico and gray marbles; some slabs would have been of the openwork type; thus, the variety of marbles, their textures and workmanship must have contributed to the deep impact of the arrangement.

Introduction: The risk of pulmonary thromboembolism (PTE) in hospitalized patients is well known, but SARS-COV-2 (COVID-19) pandemic has increased its incidence, with varying evidence describing a prevalence of PTE of 3-8%. Methodology: Description of non-concurrent longitudinal cohort of hospitalized patients for SARS-COV2 infection with PTE in a tertiary complexity hospital. Clinical and epidemiological features were analyzed. Results: 151 patients were recruited with PTE and COVID-19 diagnosis, 3.4% of all hospitalized COVID patients. The median age was 67 years, 63% male patients, median length-of-stay (LOS) 20 days, and median time between COVID-19 to PTE diagnosis 13 days. Mortality at 30 days was PTE 17%, in-hospital mortality 23.1%. Mean PESI 107, Mean PESI of the deceased 116. Invasive mechanical ventilation prevalence was 31%. Discussion: 3.4% incidence of PTE in the cohort is in the lower incidence described in other centers, considering that there was no systematic search strategy for PTE. The increased risk of in-hospital mortality and overall mortality is an alert on the possible clinical impact and may indicate the need for closer surveillance in this population.

ABSTRACT IncF plasmids are commonly found in extra-intestinal pathogenic Escherichia coli (ExPEC) strains, serving as reservoirs for antimicrobial resistance (AMR) genes and virulence factors, persistently coexisting with ExPEC lineages. Multidrug-resistant (MDR) high-risk ExPEC clones, particularly ST131, ST1193, and ST410, have acquired diverse IncF plasmids over time, containing various AMR determinants, contributing significantly to their global success. However, the broader roles of these IncF plasmids in the success of MDR ExPEC clones, beyond AMR, remain elusive. In this study, we employed a novel clustered regularly interspaced short palindromic repeats–CRISPR-associated protein-9 nuclease (CRISPR-Cas9)-mediated pCasCure plasmid-curing system to precisely remove specific IncF plasmids among ExPEC clones (ST1193, ST131, and ST410). Antibiotic-resistant parent strains reverted to antibiotic-susceptible states post-curing; however, IncF plasmid curing did not show significant impact on bacterial in vitro growth and had little impact on other in vitro phenotypes, including survival in water, dry environment and biofilm production. In addition, IncF plasmid curing did not affect the conjugation frequency of KPC-producing pKpQIL plasmid. This study represents a pivotal initial step in understanding the precise roles of IncF plasmids in the success of ExPEC. Future research will be crucial in investigating their influence on cell invasion and in vivo fitness, thereby providing a more comprehensive perspective on the functions of IncF plasmids in MDR ExPEC clones. IMPORTANCE Understanding the role of IncF plasmids in the success of drug-resistant bacteria has far-reaching implications for tackling antibiotic resistance. The study's use of a novel CRISPR-Cas9-mediated plasmid-curing system provides a precision tool for dissecting the specific impact of IncF plasmids on ExPEC clones, especially high-risk, multidrug-resistant strains like ST131, ST1193, and ST410. The study offers a crucial stepping stone for future research into understanding how these plasmids influence more complex aspects of bacterial behavior, such as cell invasion and in vivo fitness.

The incidence of melanoma has been dramatically increasing over the last decades. Melanoma is considered to have a high metastatic potential and it can progress due to hematogenous metastasis or via lymphatic vessels. Different patterns of recurrence have been described, namely, local, satellite, and in transit metastasis (LCIT), lymphatic, and systemic metastasis. With a more advanced melanoma stage at diagnosis, there is a higher risk for systemic metastasis in comparison to LCIT; in contrast, early-stage melanoma tends to recur more frequently as LCIT and less commonly as systematic metastasis. The aim of this review was to summarize the patterns of recurrence of cutaneous melanoma, giving the clinician a practical summary for diagnosis, prognosis, and surveillance. There is a knowledge gap of the common patterns of recurrence that needs to be addressed to better identify patients at high risk of disease recurrence and personalize surveillance strategies as well as patient counseling.