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Thrombocytopenia could appear during pregnancy, in up to 8–10% of the cases, where 3–5% is related to an autoimmune process so-called immune thrombocytopenia (ITP). We present a 34-year-old woman debuted at 13 weeks gestation, with a platelet count of 19 × 109/L and petechiae. She did not respond to initial treatment with corticosteroids and intravenous immunoglobulin. At this point, considering the limited treatment options due to toxicity and/or teratogenesis of other drugs proven to be effective against ITP like azathioprine, rituximab, cyclophosphamide, etc. and the risk of bleeding symptoms, either from mother or fetus, we decided to begin treatment with Romiplostim (thrombopoietin receptor agonist). On reviewing the literature at this matter, only eight cases with ITP were treated during pregnancy with Romiplostim and only one of those, the ITP, was refractory to Romiplostim. In a retrospective study, Romiplostim used as a bridge to surgery in 47 patients stated a platelet count increment higher than 100 × 109/L in 79% cases after two doses of Romiplostim. According to bibliography, we decided to start Romiplostim to our patient at 35 weeks of gestation with a spectacular platelet count recovery of 158 × 109/L within 1 week of treatment, at 36th week, and after induced labor, she had on the very next day an eutocic vaginal childbearing without major bleeding complications.

The function of project risk management (PRM) is to understand the uncertainty that surrounds a project and to identify the potential threats than can affect it as well as to know how to handle these risks in an appropriate way. Then, the measurement of the performance of PRM becomes an important concern, an issue that has not yet been addressed in the research literature. It is necessary to know how successful the application of the PRM process is and how capable is the process within the organization. Regarding construction projects, it is essential to know whether the selected responses to mitigate or eliminate identified risks were suitable and well implemented after the execution of the project. This paper presents a critical analysis of the relevance of measuring the performance of PRM and the benefits of doing so. Additionally, it presents a preliminary and pioneering methodology to measure the performance of PRM through the evaluation of the adequacy of responses applied to mitigate risks as well as to evaluate the resulting impacts as indicators of the effectiveness of these actions at the end of the project. This knowledge will allow construction companies to incorporate good practices, generate lessons learned, and thereby to promote a continuous improvement of the whole PRM process.

A lo largo del proceso de aprendizaje de una lengua, el alumno va completando diferentes etapas que pueden ser definidas por la riqueza, el control y el alcance del vocabulario. La relevancia de estos parámetros en la determinación del nivel competencial del estudiante es el principal motivo de este trabajo, cuyo objetivo general es analizar con detalle el vocabulario que conoce un grupo de 52 alumnos taiwaneses con un nivel A1 de español. Para ello, hemos aplicado un test de disponibilidad léxica conforme a la metodología practicada por los estudios que surgieron en Francia dentro del marco del Centre d’étude du français élémentaire a mediados del siglo XX. El análisis de los resultados del test servirá como punto de partida para enfrentar futuras investigaciones que aborden la suficiencia o insuficiencia del léxico de los alumnos, así como la eficacia o ineficacia de los materiales de aprendizaje e, incluso, de la metodología de enseñanza seguida en el aula.

En este trabajo se ha realizado una encuesta online a más de 500 usuarios de Facebook en España y Portugal con el objetivo de identificar qué variables influyen en mayor medida en la intención de usar esta red social para sus decisiones de compra. Los resultados de este estudio indican que la intención de uso de Facebook en las decisiones de compra está influenciada por variables como la utilidad percibida, la influencia social y la actitud hacia Facebook, mientras que la facilidad de uso percibida no parece tener una influencia directa sobre dicha intención de uso. Además, este estudio identifica que el disfrute percibido podría jugar un rol esencial, incluso superior a la utilidad percibida, en la determinación de la actitud del individuo hacia Facebook como herramienta para la búsqueda de información sobre el producto a comprar.

Bicellar systems are lipid nanostructures formed by long- and short-chained phospholipids dispersed in aqueous solution. The morphological transitions of bicellar aggregates due to temperature, composition and time variations have been revised in this work. To this end, two bicellar systems have been considered; one formed by dimyristoyl-phosphatidylcholine (DMPC) and dihexanoyl- phosphatidylcholine (DHPC) and another formed by dipalmitoyl-phosphatidylcholine (DPPC) and DHPC. The relationship between the magnetic alignment, the morphology of the aggregates and the phase transition temperature (Tm) of lipids is discussed. In general terms, the non-alignable samples present rounded objects at temperature below the Tm. Above this temperature, an increase of viscosity is followed by the formation of large elongated aggregates. Alignable samples presented discoidal objects below the Tm. The best alignment was achieved above this temperature with large areas of lamellar stacked bilayers and some multilamellar vesicles. The effect of the inclusion of ceramides with different chain lengths in the structure of bicelles is also revised in the present article. A number of physical techniques show that the bicellar structures are affected by both the concentration and the type of ceramide. Systems are able to incorporate 10% mol of ceramides that probably are organized forming domains. The addition of 20% mol of ceramides promotes destabilization of bicelles, promoting the formation of mixed systems that include large structures. Bicellar systems have demonstrated to be morphologically stable with time, able to encapsulate different actives and to induce specific effects on the skin. These facts make bicellar systems good candidates as colloidal carriers for dermal delivery. However, water dilution induces structural changes and formation of vesicular structures in the systems; stabilization strategies have been been explored in recent works and are also updated here.

Reproductive activity was studied in two populations of Anolis mariarum duringrainy and dry season months in the Antioquia department of Colombia. Minimumsize at maturity was comparable at the two sites for both males (37-39 mm SVL) andfemales (44 mm SVL). At the population level, reproduction was continuous, with themajority of adult males and females reproductively active even during the dry seasonmonths. Juvenile size distributions also were uniform across seasons, consistent withthe conclusion that recruitment is not pulsed in these populations. However, therewas some evidence that certain females may lower their reproductive rates during thedry season, especially at the site receiving the least total annual precipitation (1700mm). These results further support accumulating evidence that populations of Anolisspecies inhabiting the climatic equator region, where the annual precipitation regimeis bimodal, are capable of maintaining continuous reproduction even when annualprecipitation amounts are relatively low. In contrast, Anolis populations in areasreceiving comparable amounts of annual precipitation during a single rainy seasontend to cease reproductive activity during the longer dry season each year.

Growing broiler chickens of the Cobb500 strain were used to determine the effects on intestinal microbiota composition of a protein-free (PF) diet as compared to a diet based in casein (CAS) as the only protein source. CAS was formulated to contain the same amount of protein (190 g kg -1 ) as a commercial Maize-soy diet which was used as a practical reference. The ileal AA flow (g kg -1 dry matter intake) was significantly higher (P < 0.001) than PF in birds fed protein containing diets (CAS or Maize-soy). Taken as a whole (discriminant and ANOSIM analysis), the intestinal (ileal and caecal contents and ileal tissue) microbiota composition of PF and CAS were significantly (P < 0.001) different from Maize-soy and not different from each other in some cases. RT-qPCR and sequencing analysis of the ileal and caecal microbiota revealed significant (P < 0.05) differences in a number of bacterial groups between broilers fed PF, CAS or Maize-soy diets. The main result was that the lack of protein in the intestinal medium of PF birds resulted in a drop of Lactobacillus spp. counts (on average, 43 in PF vs 1,734 in the Maize-soy diet) and increased Enterobacteriaceae (on average, 419 in PF vs 172 in the Maize-soy diet) and other potentially pathogenic bacterial groups (in both intestinal contents and tissue). Thus, the lack of protein in the intestinal medium of PF birds resulted in a microbiota composition compatible with a pro-inflammatory state, and this effect was somewhat less marked in birds fed CAS. The results reported here suggest that the adverse effects on microbiota composition in broilers fed CAS were less marked than in those fed PF, which would be in line with a preferential use of a highly digestible protein containing diet to determine endogenous AA excretion instead of a PF diet., Competing Interests: DISCLOSURES Authors declare no conflict of interest, (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

HLA-DQA1*05:115 shows an alanine at position 59 not described previously., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Characterisation of HLA-DQA1*01:02:01:30, HLA-DQA1*01:03:01:14, HLA-DQA1*03:03:01:20, HLA-DQA1*04:01:01:13, HLA-DQA1*05:05:01:40 alleles in Spanish individuals., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Long-term follow-up of cerebral aneurysms treated with the Silk Vista Baby (SVB) flow diverter is lacking. This study aimed to assess the technical success, procedural safety, and efficacy of the SVB (Balt, Montmorency, France) for the treatment of intracranial aneurysms in small cerebral vessels over a mid-to long-term follow-up., Methods: We retrospectively analyzed a prospectively maintained database of patients treated with the SVB between September 2018 and June 2021. Data regarding patient demographics, aneurysm characteristics, and technical procedures were also collected. Angiographic and clinical findings were recorded during the procedure and over a period of at least 12 months., Results: Angiographic and clinical follow-up data were available for 50 patients/50 aneurysms. The procedural complication rate was 8%. At 12 months, the final results showed a technical success rate of 100%, the re rupture rate was 0%, neuromorbidity and mortality rates of 4 and 0%, respectively, and an almost complete occlusion rate of 94%., Conclusion: Treatment of complex intracranial aneurysms with the SVB was safe and effective. Long-term results showed high rates of adequate and stable occlusions., 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. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Rodríguez-Fernández, Ruiz-Garcia, Garcia-Sanchez, Manrique-Zegarra, Toledano-Illán, Escartin, Vences, Rubio, Luttich and Pumar.)

Characterization of HLA-DQB1*02:02:01:18, -DQB1*02:02:01:19, -DQB1*03:02:01:20 and -DQB1*05:03:01:10 alleles in Spanish individuals., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Shifts toward increased proteolytic fermentation, such as, for example, in athlete and high-protein weight loss diets, may alter the relative abundance of microbial species in the gut and generate bioactive, potentially deleterious metabolic products. In the current investigation, intestinal (caecal) microbiota composition was studied in rats fed diets differing only in their constituent proteins: milk (casein (CAS), lactalbumin (LA)) or legume ( Cicer arietinum, Lupinus angustifolius ) protein isolates (chickpea protein isolate (CPI), lupin protein isolate (LI)). ANOSIM and Discriminant Analysis showed significant ( p < 0.05) differences at both family and genus levels in both microbiota composition and functionality as a consequence of feeding the different proteins. Differences were also significant ( p < 0.05) for predicted functionality parameters as determined by PICRUSt analysis. LA induced a generally healthier microbiota composition than CAS, and higher amounts of Methanobrevibacter spp. and Methanogenic&#95;PWY were found in the LI group. LEfSe analysis of bacterial composition and functional activities revealed a number of groups/functions able to explain the different effects found with milk and legume protein isolates. In conclusion, the mostly beneficial modulation of intestinal microbiota generally found with legume-based diets is likely to be due, at least in part, to their constituent proteins.

Characterization of HLA-B*40:01:02:61, -B*48:01:01:14, and -C*01:02:01:69 alleles in Spanish individuals., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Characterization of HLA-DQB1*06:472, -DQB1*06:02:01:34 and -DQB1*06:04:01:06 alleles in Spanish individuals., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Three novel HLA Class I alleles, -A*02:1092, -A*29:01:01:11 and -B*44:03:01:58, characterized in Spanish individuals., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Four novel HLA Class II alleles, HLA-DPA1*01:03:01:68, -DPA1*01:03:01:71, -DQA1*02:01:01:06, and -DQB1*06:03:01:19, characterized in Spanish individuals., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Four novel HLA-DQA1 alleles, -DQA1*01:01:02:04, -DQA1*01:04:01:05, -DQA1*03:03:01:19 and -DQA1*05:01:01:08, characterized in Spanish individuals., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Three novel HLA Class I alleles, -B*15:640, -B*18:01:01:71 and -C*05:275, characterized in Spanish individuals., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The DQA1*05:01:11 allele shows the TAA (UAA) stop codon instead of the common DQA1 TGA (UGA) stop codon., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Infection with Borrelia miyamotoi in California, USA, has been suggested by serologic studies. We diagnosed B. miyamotoi infection in an immunocompromised man in California. Diagnosis was aided by plasma microbial cell-free DNA sequencing. We conclude that the infection was acquired in California.

Three novel HLA Class II alleles, -DQA1*02:28, -DQA1*05:01:08:02 and -DQB1*03:02:01:13, characterized in Spanish individuals., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Four novel HLA-DPA1 alleles, -DPA1*01:03:01:59, -DPA1*01:03:01:60, -DPA1*02:01:01:30, and -DPA1*02:01:01:31, characterized in Spanish individuals., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Identification of the novel DQA1*03:31, DQB1*05:01:01:19, DPA1*02:01:01:20 and DPA1*02:01:01:28 alleles by NGS., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Four novel HLA-DQB1 alleles, -DQB1*02:02:01:08, -DQB1*02:01:01:11, -DQB1*03:01:01:30 and -DQB1*03:01:01:36, characterized in Spanish individuals., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Pandemics and epidemics have represented public health emergencies with severe consequences at a global level. Primary care teams have played a crucial role in disease surveillance and monitoring during the COVID-19 pandemic through early detection, contact tracing, and isolation of positive cases. The objective of this study was to explore the impact of the COVID-19 pandemic on primary care teams regarding their internal dynamics and their professional performance., Methods: Qualitative study carried out between July and December 2020 in two large central and southern Spanish regions (Castilla la Mancha and Madrid). Semi-structured interviews and focus groups were conducted with primary care workers. Data was analysed using thematic content analysis. Participants were accessed using purposive sampling., Results: A total of 53 primary care workers participated in the study, of which 38 were individually interviewed, and 15 participated in three focus groups.The analysis of their experiences revealed two main themes regarding the impact of the COVID-19 pandemic on primary care teams: 1) The need to reorganise traditional roles: Primary care settings closed their doors to the public and their workers restructured their roles to ensure the delivery of essential services; 2) The need to implement a new primary care delivery model: Each primary care team had to self-organise, making sure their reference population was cared for and developing resource optimisation strategies., Conclusions: Primary care teams have quickly adapted their roles and internal dynamics to respond to the demands generated by COVID-19. In the new delivery model, some positive aspects could be highlighted - such as increased communication between professionals and the use of telemedicine for some cases. However, it is important to address the negative impact that the COVID-19 crisis has had on of the main functions of primary care. These measures are necessary to promote well-being in primary care teams, and to provide quality care that addresses the complex and individual needs of each person and reduces inequalities in healthcare delivery., (© 2022. The Author(s).)

The characterization of the expression profile of HLA questionable alleles (Q) is clinically relevant in allogeneic hematopoietic stem cell transplantation (HSTC) because an aberrant expression of these alleles could lead to transplantation-related complications. HLA-DQB1*03:01:01:21Q shows a substitution at the donor splice site of intron 3 that potentially could affect the expression of this allele. In order to determine their expression profile at RNA and protein level, we analyzed the presence of the HLA-DQ7 molecule by complement-dependent cytotoxicity test (CDC) and flow cytometry, and their RNA processing by cDNA analyses and sequencing by Sanger methods. Our results reveal that HLA-DQ7 is not detectable by serological methods, this is confirmed by cDNA methods demonstrating the absence of specific HLA-DQB1*03:01:01:21Q mRNA, probably due to an intron 3 retention that creates a premature TGA stop codon, leading to mRNA degradation via nonsense-mediated decay (NMD). These findings demonstrate that the HLA-DQB1*03:01:01:21Q allele is nonexpressed, thus it has been renamed as DQB1*03:01:01:21N., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

A single nucleotide substitution in exon 3 of HLA-DQB1*06:03:01 results in a new allele, HLA-DQB1*06:03:27., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Four novel HLA alleles, HLA-B*40:02:01:26, HLA-DQB1*03:01:01:29, HLA-DQB1*04:02:01:12 and HLA-DPB1*1195:01, detected in Spanish individuals., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

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.

Four novel HLA class I alleles, -A*01:01:01:76, -B*15:03:12, -B*49:01:01:14, and -C*04:01:01:115, detected in Spanish individuals., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Three novel HLA class I alleles, HLA-A*03:01:93, -C*07:18:08, and -C*03:03:01:41, detected in Spanish individuals., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Importance: Latinx individuals, particularly immigrants, are at higher risk than non-Latinx White individuals of contracting and dying from coronavirus disease 2019 (COVID-19). Little is known about Latinx experiences with COVID-19 infection and treatment., Objective: To describe the experiences of Latinx individuals who were hospitalized with and survived COVID-19., Design, Setting, and Participants: The qualitative study used semistructured phone interviews of 60 Latinx adults who survived a COVID-19 hospitalization in public hospitals in San Francisco, California, and Denver, Colorado, from March 2020 to July 2020. Transcripts were analyzed using qualitative thematic analysis. Data analysis was conducted from May 2020 to September 2020., Main Outcomes and Measures: Themes and subthemes that reflected patient experiences., Results: Sixty people (24 women and 36 men; mean [SD] age, 48 [12] years) participated. All lived in low-income areas, 47 participants (78%) had more than 4 people in the home, and most (44 participants [73%]) were essential workers. Four participants (9%) could work from home, 12 (20%) had paid sick leave, and 21 (35%) lost their job because of COVID-19. We identified 5 themes (and subthemes) with public health and clinical care implications: COVID-19 was a distant and secondary threat (invincibility, misinformation and disbelief, ingrained social norms); COVID-19 was a compounder of disadvantage (fear of unemployment and eviction, lack of safeguards for undocumented immigrants, inability to protect self from COVID-19, and high-density housing); reluctance to seek medical care (worry about health care costs, concerned about ability to access care if uninsured or undocumented, undocumented immigrants fear deportation); health care system interactions (social isolation and change in hospital procedures, appreciation for clinicians and language access, and discharge with insufficient resources or clinical information); and faith and community resiliency (spirituality, Latinx COVID-19 advocates)., Conclusions and Relevance: In interviews, Latinx patients with COVID-19 who survived hospitalization described initial disease misinformation and economic and immigration fears as having driven exposure and delays in presentation. To confront COVID-19 as a compounder of social disadvantage, public health authorities should mitigate COVID-19-related misinformation, immigration fears, and challenges to health care access, as well as create policies that provide work protection and address economic disadvantages.

Background: Rapid coronavirus disease 2019 (COVID-19) diagnosis and isolation of infectious persons are critical to stopping forward transmission, and the care cascade framework can identify gaps in the COVID-19 response., Methods: We described a COVID-19 symptom to isolation cascade and barriers among symptomatic persons who tested polymerase chain reaction positive for severe acute respiratory disease coronavirus 2 (SARS-CoV-2) at a low-barrier testing site serving a low-income Latinx community in San Francisco. Steps in the cascade are defined as days from symptom onset to test, test to result, and result to counseling on self-isolation. We examined SARS-CoV-2 cycle threshold (Ct) values to assess the likelihood of infectiousness on the day of testing and during missed isolation days., Results: Among 145 persons, 97% were Latinx and 81% had an income of <$50   000. The median time from symptom onset to isolation (interquartile range [IQR]) was 7 (5-10) days, leaving a median (IQR) of 3 (0-6) days of isolation. Eighty-three percent had moderate to high levels of virus (Ct <33), but by disclosure 23% were out of their isolation period. The longest intervals were symptom onset to test (median [IQR], 4 [2-9] days) and test to results notification (median [IQR], 3 [2-4] days). Access to a test site was the most common barrier to testing, and food and income loss was the most common barrier to isolation., Conclusions: Over half of the 10-day isolation period passed by the time of disclosure, and over a fifth of people were likely outside the window of infectiousness by the time they received results. Improvements in test access and turnaround time, plus support for isolation, are needed for epidemic control of SARS-CoV-2 in highly impacted communities., (© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Background: Differences in the composition of the intestinal microbiota and energetic metabolism between lean and obese populations have been described. Legume consumption has been reported to modulate intestinal microbiota composition. However, to the best of our knowledge, no information can be found in the literature on the effects of consumption of diets containing extruded legume plus cereal mixes on the intestinal microbiota composition of rats. Our purpose was to evaluate the effects on lipids profile (see the accompanying paper) and intestinal microbiota composition (current paper) of incorporating this new food ingredient in normocaloric and obesogenic diets., Results: Intestinal and fecal qPCR-based microbial composition of rats fed the extruded legumes plus cereal mixes differed (P < 0.05) from controls. Obesogenic diets did not affect bacterial counts. However, the inclusion of the extruded mixes reduced (P < 0.05) log 10 counts in some bacterial groups and increased (P < 0.05) counts of Lactobacilli, while others remained unaffected. PCoA at the genus level grouped together Lactobacillus reuteri, Akkermansia miciniphila and species from Parabacteroides, Prevotella, Rikenellaceae, and Lactobacillus with extruded legume plus cereal diets. Feeding on extruded legumes plus cereal mixes was associated with increased mRNA expression of the cytokines IL6 and TNF-α and decreased expression of TLR4., Conclusions: Our results show that the inclusion in the feed of limited amounts of extruded legumes plus cereal mix, providing a diet that is closer to a normal human one, did modulate the intestinal microbiota composition. Taken together, these results point to the protective, health-promoting properties of extruded legume plus cereal mixes., (© 2020 Society of Chemical Industry.)

Three new HLA-B*08:254, -DQB1*02:172, and -DPB1*1101:01 alleles detected in Spanish individuals., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Most data on the clinical presentation, diagnostics, and outcomes of patients with COVID-19 have been presented as case series without comparison to patients with other acute respiratory illnesses., Methods: We examined emergency department patients between February 3 and March 31, 2020 with an acute respiratory illness who were tested for SARS-CoV-2. We determined COVID-19 status by PCR and metagenomic next generation sequencing (mNGS). We compared clinical presentation, diagnostics, treatment, and outcomes., Findings: Among 316 patients, 33 tested positive for SARS-CoV-2; 31 without COVID-19 tested positive for another respiratory virus. Among patients with additional viral testing (27/33), no SARS-CoV-2 co-infections were identified. Compared to those who tested negative, patients with COVID-19 reported longer symptoms duration (median 7d vs. 3d, p  < 0.001). Patients with COVID-19 were more often hospitalized (79% vs. 56%, p  = 0.014). When hospitalized, patients with COVID-19 had longer hospitalizations (median 10.7d vs. 4.7d, p  < 0.001) and more often developed ARDS (23% vs. 3%, p  < 0.001). Most comorbidities, medications, symptoms, vital signs, laboratories, treatments, and outcomes did not differ by COVID-19 status., Interpretation: While we found differences in clinical features of COVID-19 compared to other acute respiratory illnesses, there was significant overlap in presentation and comorbidities. Patients with COVID-19 were more likely to be admitted to the hospital, have longer hospitalizations and develop ARDS, and were unlikely to have co-existent viral infections., Funding: National Center for Advancing Translational Sciences, National Heart Lung Blood Institute, National Institute of Allergy and Infectious Diseases, Chan Zuckerberg Biohub, Chan Zuckerberg Initiative., Competing Interests: Dr. Prasad reports personal fees from EpiExcellence, LLC, outside the submitted work. Dr. Chiu reports grants from National Institutes of Health/NHLBI, grants from National Institutes of Health/NIAID, during the conduct of the study. Dr. Peluso reports grants from Gilead Sciences, outside the submitted work. Dr. Deng has a patent 62/667,344 pending. All other authors have nothing to disclose., (© 2020 The Author(s).)

Lactate can be produced by many gut bacteria, but in adults its accumulation in the colon is often an indicator of microbiota perturbation. Using continuous culture anaerobic fermentor systems, we found that lactate concentrations remained low in communities of human colonic bacteria maintained at pH 6.5, even when dl-lactate was infused at 10 or 20 mM. In contrast, lower pH (5.5) led to periodic lactate accumulation following lactate infusion in three fecal microbial communities examined. Lactate accumulation was concomitant with greatly reduced butyrate and propionate production and major shifts in microbiota composition, with Bacteroidetes and anaerobic Firmicutes being replaced by Actinobacteria , lactobacilli, and Proteobacteria Pure-culture experiments confirmed that Bacteroides and Firmicutes isolates were susceptible to growth inhibition by relevant concentrations of lactate and acetate, whereas the lactate-producer Bifidobacterium adolescentis was resistant. To investigate system behavior further, we used a mathematical model (microPop) based on 10 microbial functional groups. By incorporating differential growth inhibition, our model reproduced the chaotic behavior of the system, including the potential for lactate infusion both to promote and to rescue the perturbed system. The modeling revealed that system behavior is critically dependent on the proportion of the community able to convert lactate into butyrate or propionate. Communities with low numbers of lactate-utilizing bacteria are inherently less stable and more prone to lactate-induced perturbations. These findings can help us to understand the consequences of interindividual microbiota variation for dietary responses and microbiota changes associated with disease states. IMPORTANCE Lactate is formed by many species of colonic bacteria, and can accumulate to high levels in the colons of inflammatory bowel disease subjects. Conversely, in healthy colons lactate is metabolized by lactate-utilizing species to the short-chain fatty acids butyrate and propionate, which are beneficial for the host. Here, we investigated the impact of continuous lactate infusions (up to 20 mM) at two pH values (6.5 and 5.5) on human colonic microbiota responsiveness and metabolic outputs. At pH 5.5 in particular, lactate tended to accumulate in tandem with decreases in butyrate and propionate and with corresponding changes in microbial composition. Moreover, microbial communities with low numbers of lactate-utilizing bacteria were inherently less stable and therefore more prone to lactate-induced perturbations. These investigations provide clear evidence of the important role these lactate utilizers may play in health maintenance. These should therefore be considered as potential new therapeutic probiotics to combat microbiota perturbations., (Copyright © 2020 Wang et al.)

Legume consumption has been reported to induce beneficial effects on obesity-associated metabolic disorders, but the underlying mechanisms have not been fully clarified. In the current work, pea ( Pisum sativum L.) seed meal proteins (albumins, legumins and vicilins) were isolated, submitted to a simulated gastrointestinal digestion, and the effects of their hydrolysates (pea albumins hydrolysates (PAH), pea legumins hydrolysates (PLH) and pea vicilin hydrolysates (PVH), respectively) on 3T3-L1 murine pre-adipocytes were investigated. The pea vicilin hydrolysate (PVH), but not native pea vicilins, increased lipid accumulation during adipocyte differentiation. PVH also increased the mRNA expression levels of the adipocyte fatty acid-binding protein (aP2) and decreased that of pre-adipocyte factor-1 (Pref-1) (a pre-adipocyte marker gene), suggesting that PVH promotes adipocyte differentiation. Moreover, PVH induced adiponectin and insulin-responsive glucose transporter 4 (GLUT4) and stimulated glucose uptake. The expression levels of peroxisome proliferator-activated receptor γ (PPARγ), a key regulator of adipocyte differentiation, were up-regulated in 3T3-L1 cells treated with PVH during adipocyte differentiation. Finally, PVH exhibited PPARγ ligand activity. Lactalbumin or other pea hydrolysates (PAH, PLH) did not exhibit such effects. These findings show that PVH stimulates adipocyte differentiation via, at least in part, the up-regulation of PPARγ expression levels and ligand activity. These effects of PVH might be relevant in the context of the beneficial health effects of legume consumption in obesity-associated metabolic disorders., Competing Interests: The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Overweight and obesity are regarded as world epidemics and are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases, and cancer. Two new highly palatable extruded mixes based on rice and pea ( Pisum sativum ) or kidney bean ( Phaseolus vulgaris ) meals were incorporated into normocaloric or obesogenic diets for rats at a low inclusion level (25%). Our purpose was to evaluate the effects of dietary incorporation of this new food ingredient on lipid profile. Organs (heart, liver, kidneys, spleen, stomach, small intestine, colon, cecum) and visceral fat relative weights were different ( p < 0.01) from controls for animals fed the obesogenic diets and in rats fed extruded diets with respect to controls. Faecal excretion of bile acids was higher ( p < 0.01) for rats fed extruded mixes compared with controls. The inclusion of extruded mixes replacing part of the casein in the control diet lowered liver cholesterol and triglycerides ( p < 0.001) and plasma low-density lipoprotein (LDL; p < 0.01) values, although plasma high-density lipoprotein (HDL) was unaltered. Both the inclusion of extruded mixes and the use of obesogenic diets resulted in significantly ( p < 0.001) different long chain fatty acid (LCFA) profiles in liver and visceral fat. Incorporating extruded legume plus cereal mixes beneficially influenced lipid metabolism, and would therefore deserve closer attention in human intervention studies, particularly with adolescents. To our knowledge, this is the first report on the nutritional and physiological effects of extruded legume plus cereal mixes.

The new HLA-A*02:01:01:126, B*35:01:01:40, and B*44:02:01:37 alleles characterized in Spanish individuals., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

HLA-DQB1*03:01:01:21Q differs from HLA-DQB1*03:01:01:03 by a single-nucleotide substitution (G → A) at position 1 of intron 3., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The strong selection in search for a higher growth rate in broilers has resulted in adverse effects such as metabolic disorders, low responsiveness of the immune system, and decreased resistance to pathogens. On the other hand, newly hatched chicks rely mostly on innate immune responses until their gut gets colonized with microbiota. In consequence, early access to active substances or bacteria (pre- and post-hatch) is particularly relevant here because in broilers much of the immune system development occurs early in life. Therefore, early stimulation of beneficial microflora is critical, as it affects, to a great extent, the entire life-span of an individual, and also because the nutritional manipulations of the gastrointestinal tract (GIT) microbiome to enhance productivity and health are rather limited by the resilience of the ecosystem once established in the chicken´s gut. Early life or developmental programming is based on the assumption that the development of diseases later in life can be modulated by perturbations or environmental exposures during critical pre- or early post-natal life. Substances such as plant derivatives, Na butyrate, pre- and probiotics, and β-glucans have been shown to induce beneficial microbiological and immunological changes within the GIT, and therefore are potential candidates to be used as tools to manipulate GIT functionality in the young chicken. Accordingly, substances as these might represent promising candidates to study intestinal microbiota/immune system modulation in broilers´ early stages of breeding. In ovo-delivered prebiotics and synbiotics have been shown to have no adverse effect on the development of the immune system in exposed chickens, while being able to affect lymphoid-organs' morphology in chickens. In ovo procedures have also been proposed as means of promoting a healthy microflora in embryonic guts and stimulating maturation of the cellular and humoral immune responses in central and peripheral immune organs, including those in the GIT. The purpose of this presentation is to discuss the potential usefulness of the instruments currently available to induce early life programming in broilers., (© 2018 Poultry Science Association Inc.)