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Background: Sulphotransferase (SOT) enzyme (encoded by a conserved family of SOT genes) is involved in sulphonation of a variety of compounds, through transfer of a sulphuryl moiety from 3'phosphoadenosine- 5'phosphosulphate (PAPS) to a variety of secondary metabolites. The PAPS itself is derived from 3'adenosine-5'phosphosulphate (APS) that is formed after uptake of sulphate ions from the soil. The process provides tolerance against abiotic stresses like drought and heat in plants. Therefore, a knowledge of SOT genes in any crop may help in designing molecular breeding methods for improvement of tolerance for drought and heat. Methods: Sequences of rice SOT genes and SOT domain (PF00685) of corresponding proteins were both used for identification of SOT genes in wheat and six related species (T. urartu, Ae. tauschii, T. turgidum, Z. mays, B. distachyon and Hordeum vulgare), although detailed analysis was conducted only in wheat. The wheat genes were mapped on individual chromosomes and also subjected to synteny and collinearity analysis. The proteins encoded by these genes were examined for the presence of a complete SOT domain using 'Conserved Domain Database' (CDD) search tool at NCBI. Results: In wheat, 107 TaSOT genes, ranging in length from 969 bp to 7636 bp, were identified and mapped onto individual chromosomes. SSRs (simple sequence repeats), microRNAs, long non-coding RNAs (lncRNAs) and their target sites were also identified in wheat SOT genes. SOT proteins were also studied in detail. An expression assay of TaSOT genes via wheat RNA-seq data suggested engagement of these genes in growth, development and responses to various hormones and biotic/abiotic stresses. Conclusions: The results of the present study should help in further functional characterization of SOT genes in wheat and other related crops. [ABSTRACT FROM AUTHOR]

The Internet of Medical Things (IoMTs) is a network of connected medical equipment such as pacemakers, prosthetics, and smartwatches. Utilizing the IoMT-based system, a huge amount of data is generated, offering experts a valuable resource for tasks such as prediction, real-time monitoring, and diagnosis. To do so, the patient's health data must be transferred to database storage for processing because of the limitations of the storage and computation capabilities of IoMT devices. Consequently, concerns regarding security and privacy can arise due to the limited control over the transmitted information and reliance on wireless transmission, which leaves the network vulnerable to several kinds of attacks. Motivated by this, in this study, we aim to build and improve an efficient intrusion detection system (IDS) for IoMT networks. The proposed IDS leverages tree-based machine learning classifiers combined with filter-based feature selection techniques to enhance detection accuracy and efficiency. The proposed model is used for monitoring and identifying unauthorized or malicious activities within medical devices and networks. To optimize performance and minimize computation costs, we utilize Mutual Information (MI) and XGBoost as filter-based feature selection methods. Then, to reduce the number of the chosen features selected, we apply a mathematical set (intersection) to extract the common features. The proposed method can detect intruders while data are being transferred, allowing for the accurate and efficient analysis of healthcare data at the network's edge. The system's performance is assessed using the CICIDS2017 dataset. We evaluate the proposed model in terms of accuracy, F1 score, recall, precision, true positive rate, and false positive rate. The proposed model achieves 98.79% accuracy and a low false alarm rate 0.007 FAR on the CICIDS2017 dataset according to the experimental results. While this study focuses on binary classification for intrusion detection, we are planning to build a multi-classification approach for future work which will be able to not only detect the attacks but also categorize them. Additionally, we will consider using our proposed feature selection technique for different ML classifiers and evaluate the model's performance empirically in real-world IoMT scenarios. [ABSTRACT FROM AUTHOR]

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Novel biomarkers reflecting the degree of immunosuppression in transplant patients are required to ensure eventual personalized equilibrium between rejection and infection risks. With the above aim, Torque Teno Virus (TTV) viremia was precisely examined in a large cohort of transplanted immunocompromised patients (192 hematological and 60 solid organ transplant recipients) being monitored for Cytomegalovirus reactivation. TTV load was measured in 2612 plasma samples from 448 patients. The results revealed a significant increase in TTV viral load approximately 14 days following CMV reactivation/infection in solid organ transplant (SOT) patients. No recognizable difference in TTV load was noted among hematological patients during the entire timeframe analyzed. Furthermore, a temporal gap of approximately 30 days was noted between the viral load peaks reached by the two viruses, with Cytomegalovirus (CMV) preceding TTV. It was not possible to establish a correlation between CMV reactivation/infection and TTV viremia in hematological patients. On the other hand, the SOT patient cohort allowed us to analyze viral kinetics and draw intriguing conclusions. Taken together, the data suggest, to our knowledge for the first time, that CMV infection itself could potentially cause an increase in TTV load in the peripheral blood of patients undergoing immunosuppressive therapy. [ABSTRACT FROM AUTHOR]

Balancing the immune response after solid organ transplantation (SOT) and vascularized composite allotransplantation (VCA) remains an ongoing clinical challenge. While immunosuppressants can effectively reduce acute rejection rates following transplant surgery, some patients still experience recurrent acute rejection episodes, which in turn may progress to chronic rejection. Furthermore, these immunosuppressive regimens are associated with an increased risk of malignancies and metabolic disorders. Despite significant advancements in the field, these IS related side effects persist as clinical hurdles, emphasizing the need for innovative therapeutic strategies to improve transplant survival and longevity. Cellular therapy, a novel therapeutic approach, has emerged as a potential pathway to promote immune tolerance while minimizing systemic side-effects of standard IS regiments. Various cell types, including chimeric antigen receptor T cells (CAR-T), mesenchymal stromal cells (MSCs), regulatory myeloid cells (RMCs) and regulatory T cells (Tregs), offer unique immunomodulatory properties that may help achieve improved outcomes in transplant patients. This review aims to elucidate the role of cellular therapies, particularly MSCs, T cells, Tregs, RMCs, macrophages, and dendritic cells in SOT and VCA. We explore the immunological features of each cell type, their capacity for immune regulation, and the prospective advantages and obstacles linked to their application in transplant patients. An in-depth outline of the current state of the technology may help SOT and VCA providers refine their perioperative treatment strategies while laying the foundation for further trials that investigate cellular therapeutics in transplantation surgery. [ABSTRACT FROM AUTHOR]

The Internet of Medical Things (IoMTs) is a network of connected medical equipment such as pacemakers, prosthetics, and smartwatches. Utilizing the IoMT-based system, a huge amount of data is generated, offering experts a valuable resource for tasks such as prediction, real-time monitoring, and diagnosis. To do so, the patient’s health data must be transferred to database storage for processing because of the limitations of the storage and computation capabilities of IoMT devices. Consequently, concerns regarding security and privacy can arise due to the limited control over the transmitted information and reliance on wireless transmission, which leaves the network vulnerable to several kinds of attacks. Motivated by this, in this study, we aim to build and improve an efficient intrusion detection system (IDS) for IoMT networks. The proposed IDS leverages tree-based machine learning classifiers combined with filter-based feature selection techniques to enhance detection accuracy and efficiency. The proposed model is used for monitoring and identifying unauthorized or malicious activities within medical devices and networks. To optimize performance and minimize computation costs, we utilize Mutual Information (MI) and XGBoost as filter-based feature selection methods. Then, to reduce the number of the chosen features selected, we apply a mathematical set (intersection) to extract the common features. The proposed method can detect intruders while data are being transferred, allowing for the accurate and efficient analysis of healthcare data at the network’s edge. The system’s performance is assessed using the CICIDS2017 dataset. We evaluate the proposed model in terms of accuracy, F1 score, recall, precision, true positive rate, and false positive rate. The proposed model achieves 98.79% accuracy and a low false alarm rate 0.007 FAR on the CICIDS2017 dataset according to the experimental results. While this study focuses on binary classification for intrusion detection, we are planning to build a multi-classification approach for future work which will be able to not only detect the attacks but also categorize them. Additionally, we will consider using our proposed feature selection technique for different ML classifiers and evaluate the model’s performance empirically in real-world IoMT scenarios.

An increasing body of randomized controlled trials suggests the safety of engaging in moderate to vigorous intensity exercise training following solid organ transplantation. Fueled by emerging sport events designed for transplant recipients and the ever-growing body of research highlighting the diverse health benefits of physical activity, transplant recipients are now increasingly participating in strenuous and occasionally competitive physical endeavors that largely surpass those evaluated in controlled research settings. This viewpoint article adopts a cautionary stance to counterbalance the prevalent one-sided optimistic perspective regarding posttransplant physical activity. While discussing methodological limitations, we explore plausible adverse impacts on the cardiovascular, immunological, and musculoskeletal systems. We also examine the physiological consequences of exercising in the heat, at high altitude, and in areas with high air pollution. Risks associated with employing performance-enhancing strategies and the conceivable psychological implications regarding physical activity as a tribute to the 'gift of life' are discussed. With a deliberate focus on the potential adverse outcomes of strenuous posttransplant physical activity, this viewpoint aims to restore a balanced dialogue on our comprehension of both beneficial and potentially detrimental outcomes of physical activity that ultimately underscores the imperative of well-informed decision-making and tailored exercise regimens in the realm of posttransplant care. [ABSTRACT FROM AUTHOR]

Whether trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis prevents nocardiosis in solid organ transplant (SOT) recipients is controversial. To assess the effect of TMP-SMX in the prevention of nocardiosis after SOT, its dose-response relationship, its effect on preventing disseminated nocardiosis, and the risk of TMP-SMX resistance in case of breakthrough infection. A systematic review and individual patient data meta-analysis. MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science Core Collection, and Scopus up to 19 September 2023. (a) Risk of nocardiosis between SOT recipients with and without TMP-SMX prophylaxis, or (b) sufficient details to determine the rate of TMP-SMX resistance in breakthrough nocardiosis. SOT recipients. TMP-SMX prophylaxis versus no prophylaxis. Risk Of Bias In Non-randomized Studies-of Exposure (ROBINS-E) for comparative studies; dedicated tool for non-comparative studies. For our primary outcome (i.e. to determine the effect of TMP-SMX on the risk of nocardiosis), a one-step mixed-effects regression model was used to estimate the association between the outcome and the exposure. Univariate and multivariable unconditional regression models were used to adjust for the potential confounding effects. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Individual data from three case-control studies were obtained (260 SOT recipients with nocardiosis and 519 uninfected controls). TMP-SMX prophylaxis was independently associated with a significantly decreased risk of nocardiosis (adjusted OR = 0.3, 95% CI 0.18–0.52, moderate certainty of evidence). Variables independently associated with an increased risk of nocardiosis were older age, current use of corticosteroids, high calcineurin inhibitor concentration, recent acute rejection, lower lymphocyte count, and heart transplant. Breakthrough infections (66/260, 25%) were generally susceptible to TMP-SMX (pooled proportion 98%, 95% CI 92–100). In SOT recipients, TMP-SMX prophylaxis likely reduces the risk of nocardiosis. Resistance appears uncommon in case of breakthrough infection. [Display omitted] [ABSTRACT FROM AUTHOR]

Narrative: DeJarnette was a researcher, author, teacher and developer of the SOT systems method of Chiropractic. DeJarnette stated in his 1967 book Philosophy, Science and Art of SOT that: 'Man is a segmental unit of a great many diversified structures and chemical elements, blended into one cooperative functional unit by the nervous system. This total segmental being is made to function through his muscular system's response to stimuli. The framework is held together by ligaments, and all revolve around the central spinal column. Let this central column fail in any respect and the total is out of harmony and balance Here I describe the pain and spinal patterns that clinically indicate an SOT Category Three and offer treatment approaches which I have found effective in practice to deliver predictable outcomes. [ABSTRACT FROM AUTHOR]

Balancing the immune response after solid organ transplantation (SOT) and vascularized composite allotransplantation (VCA) remains an ongoing clinical challenge. While immunosuppressants can effectively reduce acute rejection rates following transplant surgery, some patients still experience recurrent acute rejection episodes, which in turn may progress to chronic rejection. Furthermore, these immunosuppressive regimens are associated with an increased risk of malignancies and metabolic disorders. Despite significant advancements in the field, these IS related side effects persist as clinical hurdles, emphasizing the need for innovative therapeutic strategies to improve transplant survival and longevity. Cellular therapy, a novel therapeutic approach, has emerged as a potential pathway to promote immune tolerance while minimizing systemic side-effects of standard IS regiments. Various cell types, including chimeric antigen receptor T cells (CAR-T), mesenchymal stromal cells (MSCs), regulatory myeloid cells (RMCs) and regulatory T cells (Tregs), offer unique immunomodulatory properties that may help achieve improved outcomes in transplant patients. This review aims to elucidate the role of cellular therapies, particularly MSCs, T cells, Tregs, RMCs, macrophages, and dendritic cells in SOT and VCA. We explore the immunological features of each cell type, their capacity for immune regulation, and the prospective advantages and obstacles linked to their application in transplant patients. An in-depth outline of the current state of the technology may help SOT and VCA providers refine their perioperative treatment strategies while laying the foundation for further trials that investigate cellular therapeutics in transplantation surgery.

ABSTRACT: Objectives: Underlying immunodeficiency has been associated with worse clinical presentation and increased mortality in patients with COVID-19. We evaluated the mortality of solid organ transplant (SOT) recipients (SOTR) hospitalized in Spain due to COVID-19. Methods: Nationwide, retrospective, observational analysis of all adults hospitalized because of COVID-19 in Spain during 2020. Stratification was made according to SOT status. The National Registry of Hospital Discharges was used, using the International Classification of Diseases, 10th revision coding list. Results: Of the 117,694 adults hospitalized during this period, 491 were SOTR: kidney 390 (79.4%), liver 59 (12%), lung 27 (5.5%), and heart 19 (3.9%). Overall, the mortality of SOTR was 13.8%. After adjustment for baseline characteristics, SOTR was not associated with higher mortality risk (odds ratio [OR] = 0.79, 95% confidence interval [CI] 0.60-1.03). However, lung transplantation was an independent factor related to mortality (OR = 3.26, 95% CI 1.33-7.43), while kidney, liver, and heart transplantation were not. Being a lung transplant recipient was the strongest prognostic factor in SOT patients (OR = 5.12, 95% CI 1.88-13.98). Conclusion: This nationwide study supports that the COVID-19 mortality rate in SOTR in Spain during 2020 did not differ from the general population, except for lung transplant recipients, who presented worse outcomes. Efforts should be focused on the optimal management of lung transplant recipients with COVID-19.

Sulfotransferases (SOTs) (EC 2.8.2.-) are sulfate regulatory proteins in a variety of organisms that have been previously shown to be involved in regulating a variety of physiological and biological processes, such as growth, development, adaptation to land, stomatal closure, drought tolerance, and response to pathogen infection. However, there is a lack of comprehensive identification and systematic analysis of SOT in cotton, especially in G. barbadense. In this study, we used bioinformatics methods to analyze the structural characteristics, phylogenetic relationships, gene structure, expression patterns, evolutionary relationships, selection pressure and stress response of SOT gene family members in G. barbadense. In this study, a total of 241 SOT genes were identified in four cotton species, among which 74 SOT gene members were found in G. barbadense. According to the phylogenetic tree, 241 SOT protein sequences were divided into five distinct subfamilies. We also mapped the physical locations of these genes on chromosomes and visualized the structural information of SOT genes in G. barbadense. We also predicted the cis-acting elements of the SOT gene in G. barbadense, and we identified the repetitive types and collinearity analysis of SOT genes in four cotton species. We calculated the Ka/Ks ratio between homologous gene pairs to elucidate the selective pressure between SOT genes. Transcriptome data were used to explore the expression patterns of SOT genes, and then qRT-PCR was used to detect the expression patterns of GBSOT4, GBSOT17 and GBSOT33 under FOV stress. WGCNA (weighted gene co-expression network analysis) showed that GB_A01G0479 (GBSOT4) belonged to the MEblue module, which may regulate the resistance mechanism of G. barbadense to FOV through plant hormones, signal transduction and glutathione metabolism. In addition, we conducted a VIGS (virus-induced gene silencing) experiment on GBSOT4, and the results showed that after FOV inoculation, the plants with a silenced target gene had more serious leaf wilting, drying and cracking than the control group, and the disease index of the plants with the silenced target gene was significantly higher than that of the control group. This suggests that GBSOT4 may be involved in protecting the production of G. barbadense from FOV infection. Subsequent metabolomics analysis showed that some flavonoid metabolites, such as Eupatorin-5-methylether (3′-hydroxy-5,6,7,4′-tetramethoxyflavone, were accumulated in cotton plants in response to FOV infection. [ABSTRACT FROM AUTHOR]

Introduction: Sacro occipital technique (SOT) uses occipital fibre analysis and treatment (OFT) to find regions of the body that have interrelationships through direct musculoskeletal and/or indirect reflex to the occipital region, spinal segments, and possibly to visceral referred pain pathways used with chiropractic manipulative reflex technique (CMRT). The purpose of this pilot study was to determine if experienced SOT doctors could palpate occipital fibres on canines and if it could be determined that certain fibres were more prominent on one side or the other. Methods and Intervention: Three canines occipital fibres were palpated by 11 experienced SOT doctors that had no knowledge of each dog. The doctor would palpate subject one, two, and three without anyone else in the room, except for the canine's owner and the doctor gathering answers to survey questions. Results: All doctors in this study reported that they could palpate occipital fibres on the three canines, however the number of fibres palpated was inconsistent, with the number 7 being the most common finding (6 of 11 doctors). Conclusion: This study is the first attempt to demonstrate palpable occipital fibres on a canine. Future study is needed to better address the questions asked as well as determine how to gain clearer data. Since there have been no other studies to date published on the palpation of OFT in animals, this pilot study is an important first step. [ABSTRACT FROM AUTHOR]

Background: A 63-year-old female presented for care with primary concerns of balance issues, brain fog and difficulty walking. Secondary concerns included tendonitis and digestive issues. Management: The patient commenced a course of subluxation-based chiropractic care during which numerous techniques were used. These included Sacro-occipital technique, Torque Release Technique, Thompson, Diversified, and Toggle Recoil. Outcomes: At the conclusion of her care plan, the patient reported significant improvements in all symptomatology, concomitant with reductions in subluxation findings and other objective tests. Additionally, mental clarity, mood, and energy were all improved. [ABSTRACT FROM AUTHOR]

A 30-year-old female patient presented for care at a chiropractic clinic with a primary complaint of decreased strength. Further examination revealed more specific symptoms of low back pain, neck pain, stiffness, fatigue, eczema and low energy. Management: The patient commenced a course of subluxation-based chiropractic care during utilising Torque Release Technique, Toggle Recoil, Thompson, Gonstead and Sacro-Occipital Technique with pelvic/sacral blocks. Outcomes: At the conclusion of her care plan, the patient reported improved mood, menstrual health, and gut function, reduced eczema and better sleep and energy. This was concomitant with a reduction in subluxation findings, and improvements in objective measurements (Heart rate variability and sEMG). [ABSTRACT FROM AUTHOR]

Introduction: The intention of this paper is to present a cranial bone adjustment method that can be primarily used for all three Sacro Occipital Technique (SOT) categories, and to share a three-part cranial indicator analysis that specifies the needed side for the adjustment. To help build a substantive rational for this intervention a retrospective analysis of 85 patients was undertaken. Also shared is a five-part cranial adjusting procedure that can be used for all three SOT categories. Methods: A retrospective review of the records of 85 patients was performed to assess the three-part cranial indicator analysis to help determine the optimal side for the cranial adjusting of the zygoma. Results: A consistency was found between analysis of craniofacial range of motion (ROM) testing and head tilt. These results helped guide the side and location to focus the craniofacial adjustments. Conclusion: This retrospective study of 85 patients yielded interesting correlative findings for the indicators of lateral head tilt, zygomatic ROM, and facial analysis to determine optimal side of zygomatic adjustment. [ABSTRACT FROM AUTHOR]

• Solid organ transplant recipients had similar mortality to other patients. • Age, male gender, and lymphoma were risk factors for mortality among solid organ transplant recipients. • Lung transplant recipients presented more respiratory insufficiency and mortality. • Efforts should be focused on the management of COVID-19 in lung transplant recipients. Underlying immunodeficiency has been associated with worse clinical presentation and increased mortality in patients with COVID-19. We evaluated the mortality of solid organ transplant (SOT) recipients (SOTR) hospitalized in Spain due to COVID-19. Nationwide, retrospective, observational analysis of all adults hospitalized because of COVID-19 in Spain during 2020. Stratification was made according to SOT status. The National Registry of Hospital Discharges was used, using the International Classification of Diseases, 10th revision coding list. Of the 117,694 adults hospitalized during this period, 491 were SOTR: kidney 390 (79.4%), liver 59 (12%), lung 27 (5.5%), and heart 19 (3.9%). Overall, the mortality of SOTR was 13.8%. After adjustment for baseline characteristics, SOTR was not associated with higher mortality risk (odds ratio [OR] = 0.79, 95% confidence interval [CI] 0.60-1.03). However, lung transplantation was an independent factor related to mortality (OR = 3.26, 95% CI 1.33-7.43), while kidney, liver, and heart transplantation were not. Being a lung transplant recipient was the strongest prognostic factor in SOT patients (OR = 5.12, 95% CI 1.88-13.98). This nationwide study supports that the COVID-19 mortality rate in SOTR in Spain during 2020 did not differ from the general population, except for lung transplant recipients, who presented worse outcomes. Efforts should be focused on the optimal management of lung transplant recipients with COVID-19. [ABSTRACT FROM AUTHOR]

This study examines the prevalence of respiratory viral infections (RVIs) in transplant recipients during the COVID-19 pandemic. Patients were admitted to a regional haematology unit (RHU) in England which provides a tertiary referral service for haematological malignancy, stem cell transplantation, CAR-T therapy, thrombosis, haemostasis and haemoglobinopathies. Weekly screening for RVIs was conducted on all inpatients in the RHU wards, and data were collected retrospectively for all admissions from August 2018 to February 2021. There was a significant drop in the circulation of non-SARS-CoV-2 RVIs in transplant recipients during the COVID-19 pandemic. The most common viral pathogen in the transplant cohort was rhinovirus, followed by parainfluenza 3, adenovirus, and RSV. The study also highlights the importance of infection prevention and control measures to reduce the risk of nosocomial transmission of RVIs and SARS-CoV-2 in transplant recipients. Further studies are needed to observe whether this effect is pronounced in multiple transplant centres.

Background This is a systematic review and meta-analysis of diagnostic test accuracy studies to assess the predictive value of both tuberculin skin test (TST) and interferon-gamma release assays (IGRA) for active tuberculosis (TB) among solid organ transplantation (SOT) recipients. Methods Medline, Embase, and the CENTRAL databases were searched from 1946 until June 30, 2022. Two independent assessors extracted data from studies. Sensitivity analyses were performed to investigate the effect of studies with high or low risk of bias. Methodological quality of each publication was assessed using QUADAS-2. Results A total of 43 studies (36 403 patients) with patients who were screened for latent TB infection (LTBI) and who underwent SOT were included: 18 were comparative and 25 noncomparative (19 TST, 6 QuantiFERON-TB Gold In-Tube [QFT-GIT]). For IGRA tests taken together, positive predictive value (PPV) and negative predictive value (NPV) were 1.2% and 99.6%, respectively. For TST, PPV was 2.13% and NPV was 95.5%. Overall, PPV is higher when TB burden is higher, regardless of test type, although still low in absolute terms. Incidence of active TB was similar between studies using LTBI prophylaxis (mean incidence 1.22%; 95% confidence interval [CI],.2179–2.221) and those not using prophylaxis (mean incidence 1.045%; 95% CI, 0.2731–1.817; P =.7717). Strengths of this study include the large number of studies available from multiple different countries; limitations include absence of gold standard for diagnosis of latent TB and low incidence of active TB. Conclusions We found both TST and IGRA had a low PPV and high NPV for the development of active TB posttransplant. Further studies are needed to better understand how to prevent active TB in the SOT population. [ABSTRACT FROM AUTHOR]

Background: Management of infections due to carbapenemase‐resistant Enterobacterales (CRE) in solid organ transplant (SOT) recipients remains a difficult challenge. The INCREMENT‐SOT‐CPE score has been specifically developed from SOT recipients to stratify mortality risk, but an external validation is lacking. Methods: Multicenter retrospective cohort study of liver transplant (LT) recipients colonized with CRE infection who developed infection after transplant over 7‐year period. Primary endpoint was all‐cause 30‐day mortality from infection onset. A comparison between INCREMENT‐SOT‐CPE and other selected scores was performed. A two‐level mixed effects logistic regression model with random effects for the center was fitted. Performance characteristics at optimal cut‐point were calculated. Multivariable Cox regression analysis of risk factors for all‐cause 30‐day mortality was carried out. Results: Overall, 250 CRE carriers developed infection after LT and were analyzed. The median age was 55 years (interquartile range [IQR]: 46–62) and 157 were males (62.8%). All‐cause 30‐day mortality was 35.6%. A sequential organ failure assessment (SOFA) score ≥ 11 showed a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 69.7%, 76.4%, 62.0%, 82.0%, and 74.0%, respectively. An INCREMENT‐SOT‐CPE ≥ 11 reported a sensitivity, specificity, PPV, NPV, and accuracy of 73.0%, 62.1%, 51.6%, 80.6% and 66.0%, respectively. At multivariable analysis acute renal failure, prolonged mechanical ventilation, INCREMENT‐SOT‐CPE score ≥ 11 and SOFA score ≥ 11 were independently associated with all‐cause 30‐day mortality, while a tigecycline‐based targeted regimen was found to be protective. Conclusions: Both INCREMENT‐SOT‐CPE ≥ 11 and SOFA ≥ 11 were identified as strong predictors of all‐cause 30‐day mortality in a large cohort of CRE carriers developing infection after LT. [ABSTRACT FROM AUTHOR]

Phaeohyphomycosis comprises a variety of infections caused by pigmented fungi. Solid organ transplant (SOT) recipients are particularly at risk of invasive infections due to their prolonged immunosuppression. Here, we describe three cases of phaeohyphomycosis in SOT recipients who were successfully treated with surgical excision and/or antifungal therapy. We additionally carried out a narrative review of the literature on phaeohyphomycosis in 94 SOT recipients from 66 published studies describing 40 different species of fungi. The most reported fungus was Alternaria (21%). The median time from transplant to diagnosis was 18 months (IQR 8.25-48), and kidney transplants were the most reported. Antifungal regimens were not homogeneous, though there was a prevalence of itraconazole- and voriconazole-based treatments. Clinical outcomes included recovery in 81% and death in 5% of infected SOT recipients. Susceptibility testing was done in 26.6% of the cases, with heterogeneous results due to the variety of species isolated. While the wide diversity of dematiaceous fungi and their host range make it difficult to offer a uniform approach for phaeohyphomycosis, an early diagnosis and therapy are critical in preventing the dissemination of disease in the immunocompromised host. [ABSTRACT FROM AUTHOR]

Purpose of Review: The goal of our manuscript is to address the diagnostic challenges in coccidioidomycosis related infections among solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients. We hope to answer the utility of different methods in reaching the diagnosis and tackle each test's limitation in SOT and HSCT recipients. Recent Findings: Multiple testing modalities including serology, antigen, PCR, and β-d-glucan (BDG) tests are performed during the evaluation process of SOT/HSCT recipients with coccidioidomycosis. We have highlighted recent literature discussing the sensitivity and specificity of these tests in SOT/HSCT recipients. Summary: We have found that the best approach to diagnosing transplant patients with suspected coccidioidomycosis, is to utilize multiple testing modalities including serology, antigen, PCR, and BDG tests, which can lead to earlier and improved test sensitivities. This approach is important as there is a high risk for the transplant patients who may not mount appropriate immune responses for the serology tests to become positive, resulting in the progression of undiagnosed and untreated infections. Future testing is required to further evaluate and validate newer diagnostic testing such as PCR in the diagnosis of coccidioidiomycosis. [ABSTRACT FROM AUTHOR]

The sensory organization test (SOT) is an established and effective method for assessing postural stability and determining fall risk. SOT equilibrium scores are derived from the relationship between an individual's peak sway amplitude and a standard, theoretically-derived normal limits of stability (tLOS). Determining an individual's postural stability and fall risk based on this one-size-fits-all tLOS may overestimate functional equilibrium scores and underestimate fall risk when personal stability limits (pLOS) are reduced. The purpose of this study is to investigate whether LOS measured from a group of healthy adults is different from the tLOS, and whether SOT equilibrium scores are significantly different when calculated using pLOS versus the standard tLOS. Sixty healthy volunteers were recruited into three age-groups: young (18−39), middle-aged (40−64), and elderly (65−80), with 10 males and 10 females in each age-group. Outcome measures included SOT and LOS. Additional measures o balance perception and functional mobility were obtained including the Activities Balance Confidence (ABC) scale and the timed-up-and-go test (TUG). The tLOS and pLOS were used to calculate standard (tSOT) and personalized (pSOT) equilibrium scores. The mean pLOS from the group of healthy adults was significantly lower than the tLOS. Consequently, the pSOT equilibrium scores were significantly lower than the standard SOT scores derived using the tLOS. Individual measures of LOS are significantly lower than theoretical estimates of the LOS in healthy adults. This suggests that use of tLOS in the calculation of SOT equilibrium scores often overestimates postural stability and may have implications for the determination of fall risk. • The contribution of LOS to postural stability on SOT should be taken into account. • Interplay between LOS and postural sway is the cornerstone of the study SOT method. • The standard SOT measure of equilibrium can overestimate postural stability. [ABSTRACT FROM AUTHOR]

As the habitat areas of Tibetan antelopes usually exhibit poaching and unpredictable risks, combining target recognition and tracking with intelligent Unmanned Aerial Vehicle (UAV) technology is necessary to obtain the real-time location of injured Tibetan antelopes to better protect and rescue them. (1) Background: The most common way to track an object is to detect each frame of it, and it is not necessary to run the object tracker and classifier at the same rate, because the speed for them to change class is slower than objects move. Especially in the edge reasoning scene, UAV real-time monitoring requires to seek a balance between the frame rate, latency, and accuracy. (2) Methods: A backtracking tracker is proposed to recognize Tibetan antelopes which generates motion vectors through stored optical flow, achieving faster target detection. The lightweight You Only Look Once X (YOLOX) is selected as the baseline model to reduce the dependence on hardware configuration and calculation cost while ensuring detection accuracy. Region-of-Interest (ROI)-to-centroid tracking technology is employed to reduce the processing cost of motion interpolation, and the overall processing frame rate is smoothed by pre-calculating the motions of different objects recognized. The On-Line Object Tracking (OLOT) system with adaptive search area selection is adopted to dynamically adjust the frame rate to reduce energy waste. (3) Results: using YOLOX to trace back in the native Darkenet can reduce latency by 3.75 times, and the latency is only 2.82 ms after about 10 frame hops, with the accuracy being higher than YOLOv3. Compared with traditional algorithms, the proposed algorithm can reduce the tracking latency of UAVs by 50%. By running and comparing in the onboard computer, although the proposed tracker is inferior to KCF in FPS, it is significantly higher than other trackers and is obviously superior to KCF in accuracy. (4) Conclusion: A UAV equipped with the proposed tracker effectively reduces reasoning latency in monitoring Tibetan antelopes, achieving high recognition accuracy. Therefore, it is expected to help better protection of Tibetan antelopes. [ABSTRACT FROM AUTHOR]

Background. Nocardia is a group of ubiquitous bacteria known to cause opportunistic infections in immunocompromised hosts, including those affected by malignancies and solid-organ or hematopoietic stem cell transplants. Pulmonary involvement, occurring in two-thirds of cases, is the most frequent presentation. Diagnosis might be challenging both because of microbiological technical issues, but also because of the variability of organ involvement and mimicry. Methods. We describe four cases of disseminated nocardiosis caused by N. farcinica observed between September 2021 and November 2021 in immune-compromised hosts presenting with nodular cutaneous lesions that had raised a high degree of clinical suspect and led to microbiological identification through MALDI-TOF MS. Results. Cutaneous involvement is typically reported in immunocompetent hosts with primary cutaneous nocardiosis with multiple forms of manifestation; nonetheless, disseminated nocardiosis rarely involves the skin and subcutaneous tissues, and this occurs as a result of metastatic spread. Our cases were disseminated nocardiosis in which the metastatic cutaneous involvement, even if rare, provided a clue for the diagnosis. Conclusions. The pathomorphosis of disseminated nocardiosis may have changed in the current years with more rapid spread due to advanced immunosuppression. For this reason, after clinical suspicion, the prompt start of an active targeted therapy based on rapid microbiological identification might potentially open the way to hopeful results, even in the most immune-compromised patients. [ABSTRACT FROM AUTHOR]

In this study, current-induced partial magnetization-based switching was realized through the spin–orbit torque (SOT) in single-layer L10 FePt with a perpendicular anisotropy (Ku⊥) of 1.19 × 107 erg·cm−3 (1 erg·cm−3 = 0.1 J·m−3), and its corresponding SOT efficiency (βDL) was 8 × 10−6 Oe·(A·cm−2)−1 (1 Oe = 79.57747 A·m−1), which is several times higher than that of the traditional Ta/CoFeB/MgO structure reported in past work. The SOT in the FePt films originated from the structural inversion asymmetry in the FePt films since the dislocations and defects were inhomogeneously distributed within the samples. Furthermore, the FePt grown on MgO with a granular structure had a larger effective SOT field and efficiency than that grown on SrTiO3 (STO) with a continuous structure. The SOT efficiency was found to be considerably dependent on not only the sputtering temperature-induced chemical ordering but also the lattice mismatch-induced evolution of the microstructure. Our findings can provide a useful means of efficiently electrically controlling a magnetic bit that is highly thermally stable via SOT.

Background: Although many studies have reported cases of COVID-19 infection in transplant recipients, most of them only involve a small number of patients and narrow geographic areas. This study aims to investigate the clinical characteristics, morbidity, severity, and mortality of COVID-19 infection among solid organ transplant (SOT) recipients by meta-analysis. Method: We performed a literature search using the databases PubMed, Web of Science, and Google Scholar as of November 26, 2020. We included randomized controlled trials and cohort studies, excluding case reports and small case series (n

Cytomegalovirus (CMV) infection remains a significant challenge in solid organ transplantation (SOT). The last international consensus guidelines on the management of CMV in SOT were published in 2018, highlighting the need for revision to incorporate recent advances, notably in cell-mediated immunity monitoring, which could alter the current standard of care. A working group including members from the Group for the Study of Infection in Transplantation and the Immunocompromised Host (GESITRA-IC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Society of Transplantation (SET), developed consensus-based recommendations for managing CMV infection in SOT recipients. Recommendations were classified based on evidence strength and quality using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The final recommendations were endorsed through a consensus meeting and approved by the expert panel. • Monitoring CMV-CMI is recommended to optimize the preventive strategy. • Letermovir is the alternative for D+/R- kidney transplant recipients with leukopenia during prophylaxis. • More data is needed to extend the use of letermovir to other organs. • Maribavir should be used as the first therapeutic option in treating refractory/resistant disease. [ABSTRACT FROM AUTHOR]

Sulfotransferases (SOTs) (EC 2.8.2.-) are sulfate regulatory proteins in a variety of organisms that have been previously shown to be involved in regulating a variety of physiological and biological processes, such as growth, development, adaptation to land, stomatal closure, drought tolerance, and response to pathogen infection. However, there is a lack of comprehensive identification and systematic analysis of SOT in cotton, especially in G. barbadense. In this study, we used bioinformatics methods to analyze the structural characteristics, phylogenetic relationships, gene structure, expression patterns, evolutionary relationships, selection pressure and stress response of SOT gene family members in G. barbadense. In this study, a total of 241 SOT genes were identified in four cotton species, among which 74 SOT gene members were found in G. barbadense. According to the phylogenetic tree, 241 SOT protein sequences were divided into five distinct subfamilies. We also mapped the physical locations of these genes on chromosomes and visualized the structural information of SOT genes in G. barbadense. We also predicted the cis-acting elements of the SOT gene in G. barbadense, and we identified the repetitive types and collinearity analysis of SOT genes in four cotton species. We calculated the Ka/Ks ratio between homologous gene pairs to elucidate the selective pressure between SOT genes. Transcriptome data were used to explore the expression patterns of SOT genes, and then qRT-PCR was used to detect the expression patterns of GBSOT4, GBSOT17 and GBSOT33 under FOV stress. WGCNA (weighted gene co-expression network analysis) showed that GB_A01G0479 (GBSOT4) belonged to the MEblue module, which may regulate the resistance mechanism of G. barbadense to FOV through plant hormones, signal transduction and glutathione metabolism. In addition, we conducted a VIGS (virus-induced gene silencing) experiment on GBSOT4, and the results showed that after FOV inoculation, the plants with a silenced target gene had more serious leaf wilting, drying and cracking than the control group, and the disease index of the plants with the silenced target gene was significantly higher than that of the control group. This suggests that GBSOT4 may be involved in protecting the production of G. barbadense from FOV infection. Subsequent metabolomics analysis showed that some flavonoid metabolites, such as Eupatorin-5-methylether (3′-hydroxy-5,6,7,4′-tetramethoxyflavone, were accumulated in cotton plants in response to FOV infection.

Background: Solid organ transplant (SOT) recipients can benefit from traditional antimicrobial stewardship (AMS) activities directed to improve judicious perioperative prescribing and management, but evidence is lacking. The aim of this expert opinion review is to provide an update on the current landscape of application of AMS practices for optimization of perioperative prophylaxis (PP). Methods: We reviewed the available literature on early postoperative infectious complications in SOT and PP management, on modified perioperative approaches in case of infection or colonization in recipients and donors and on AMS in transplantation PP. Results: SOT recipients are at high risk for early postoperative infectious complications due to the complexity of surgical procedures, severity of end stage organ disease, net state of immunosuppression in the posttransplant period and to the high risk for multidrug resistant organism. Moreover, SOT may be exposed to preservation fluid infections and expected or unexpected donor‐derived infections. We summarize main factors to take into account when prescribing transplant PP. Conclusion: Creating personalized PP to avoid unwanted consequences of antimicrobials while improving outcomes is an emerging and critical aspect in SOT setting. Further studies are needed to offer best PP tailored to SOT type and to evaluate interventions efficacy and safety. [ABSTRACT FROM AUTHOR]

Back in 2012 Integrated Operating System known as SOT (Sistem Operasi Terpadu) was started to implement in order to conduct reporting Oil and Gas Production to all stakeholders such as related Government and Ministry, House of Representatives and Supervisory Agency. The program is always being improved to have better quality on both data, infrastructure, people and process to address some problem in regards with data completeness, accuracy and timeliness. In order to address the issue arises the study has been conducted to see the problem by discussing with multi parties, study of literatures and discuss the propose framework with SME's. The well-known standard such as COBIT and DMM also support to mapping and having insight of the observed gaps. At the end this study come up with the plan of action on how the data quality is improved from many perspectives on how the policy and principle, culture and behavior, information and communication, skill of people and competencies, to management commitment and infrastructure. [ABSTRACT FROM AUTHOR]

Kaposi sarcoma herpesvirus/human herpesvirus-8 (HHV-8) neoplastic and non-neoplastic disease in solid organ transplant (SOT) recipients can be life-threatening. We evaluated the seroprevalence of HHV-8 infection among donors (D) and recipients (R), the incidence of HHV-8 transmission/reactivation, and the clinical characteristics, management, and outcomes of HHV-8-related diseases, including Kaposi sarcoma herpesvirus-associated inflammatory cytokine syndrome (KICS), in consecutive SOT patients from 2011 to 2023. HHV-8 seroprevalence was 3.3% in 1349 donors and 8.4% in 1856 recipients screened (p<0.0001). Among the D+/R- group (n=49), 13 patients developed HHV-8-related diseases: 7 liver recipients had KICS, and 1 lung recipient had Kaposi sarcoma (KS) with subsequent KICS. Four KICS patients treated with rituximab survived, while the 3 patients not treated with rituximab died. Within the D-/R- group, out of 5 (0.3%) patients with non-donor-derived primary HHV-8 infection, 3 liver recipients developed KICS. In the R+ patients (n=155), 3 developed KS. In our cohort, 25/944 (2.6%) liver transplant recipients had a primary HHV-8 infection, and 10 of them (40%) developed KICS; 40% (4/10) of HHV-8 seropositive heart transplant recipients developed reactivation and 2 of them (50%) had fatal KS. Serologic screening and molecular surveillance of D+/R- patient groups facilitate early recognition and effective therapy of KICS., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmissible through lung transplantation, and outcomes among infected organ recipients may be severe. Transmission risk to extrapulmonary organ recipients and recent (within 30 days of transplantation) SARS-CoV-2–infected recipient outcomes are unclear. Methods During March 2020–March 2021, potential SARS-CoV-2 transmissions through solid organ transplantation were investigated. Assessments included SARS-CoV-2 testing, medical record review, determination of likely transmission route, and recent recipient outcomes. Results During March 2020–March 2021, approximately 42 740 organs were transplanted in the United States. Forty donors, who donated 140 organs to 125 recipients, were investigated. Nine (23%) donors and 25 (20%) recipients were SARS-CoV-2 positive by nucleic acid amplification test (NAAT). Most (22/25 [88%]) SARS-CoV-2–infected recipients had healthcare or community exposures. Nine SARS-CoV-2–infected donors donated 21 organs to 19 recipients. Of these, 3 lung recipients acquired SARS-CoV-2 infections from donors with negative SARS-CoV-2 testing of pretransplant upper respiratory tract specimens but from whom posttransplant lower respiratory tract (LRT) specimens were SARS-CoV-2 positive. Sixteen recipients of extrapulmonary organs from SARS-CoV-2–infected donors had no evidence of posttransplant COVID-19. All-cause mortality within 45 days after transplantation was 6-fold higher among SARS-CoV-2–infected recipients (9/25 [36%]) than those without (6/100 [6%]). Conclusions Transplant-transmission of SARS-CoV-2 is uncommon. Pretransplant NAAT of lung donor LRT specimens may prevent transmission of SARS-CoV-2 through transplantation. Extrapulmonary organs from SARS-CoV-2–infected donors may be safely usable, although further study is needed. Reducing recent recipient exposures to SARS-CoV-2 should remain a focus of prevention. [ABSTRACT FROM AUTHOR]

Simple Summary: Post-transplant lymphoproliferative disease (PTLD) is a well-recognized complication after transplant. We developed and validated a risk score to predict PTLD among solid organ transplant (SOT) recipients. This work presents the first risk score developed and externally validated to predict risk of PTLD among SOT recipients. PTLD is a potentially severe complication after solid organ transplantation, and the best clinical strategy would be to detect the disease at early stages and prevent progression to fulminant lymphoma or even better to predict the risk of a patient developing PTLD prior to onset of disease. Our score had a strong similar discriminatory ability in both derivation and validation cohorts. Post-transplant lymphoproliferative disease (PTLD) is a well-recognized complication after transplant. This study aimed to develop and validate a risk score to predict PTLD among solid organ transplant (SOT) recipients. Poisson regression identified predictors of PTLD with the best fitting model selected for the risk score. The derivation cohort consisted of 2546 SOT recipients transpanted at Rigshospitalet, Copenhagen between 2004 and 2019; 57 developed PTLD. Predictors of PTLD were high-risk pre-transplant Epstein–Barr Virus (EBV), IgG donor/recipient serostatus, and current positive plasma EBV DNA, abnormal hemoglobin and C-reactive protein levels. Individuals in the high-risk group had almost 7 times higher incidence of PTLD (incidence rate ratio (IRR) 6.75; 95% CI: 4.00–11.41) compared to the low-risk group. In the validation cohort of 1611 SOT recipients from the University Hospital of Zürich, 24 developed PTLD. A similar 7 times higher risk of PTLD was observed in the high-risk group compared to the low-risk group (IRR 7.17, 95% CI: 3.05–16.82). The discriminatory ability was also similar in derivation (Harrell's C-statistic of 0.82 95% CI (0.76–0.88) and validation (0.82, 95% CI:0.72–0.92) cohorts. The risk score had a good discriminatory ability in both cohorts and helped to identify patients with higher risk of developing PTLD. [ABSTRACT FROM AUTHOR]

Nocardia is primarily considered an opportunistic pathogen and affects patients with impaired immune systems, solid-organ transplant recipients (SOTRs), and patients with haematologic malignancies. We present the cases of six patients diagnosed with nocardiosis at our center in the last two years, describing the various predisposing conditions alongside the clinical manifestation, the diagnostic workup, and the treatment course. Moreover, we propose a brief literature review on Nocardia infections in the immunocompromised host, focusing on SOTRs and haematopoietic stem cell transplantation recipients and highlighting risk factors, clinical presentations, the diagnostic tools available, and current treatment and prophylaxis guidelines. [ABSTRACT FROM AUTHOR]

Abstract Background Recently, chronic hepatitis E virus (HEV) infections gained increasing attention as a possible cause for elevated liver enzymes of unknown origin and liver cirrhosis in solid organ transplant recipients. Reduction of immunosuppressive therapy and/or use of antiviral drug ribavirin have been established as possible treatment strategies. Methods The efficacy of dose reduction of mycophenolic acid (MPA) and ribavirin therapy was retrospectively analyzed in eight renal transplant patients of our outpatient clinic who were diagnosed with HEV infection by detection of specific antibodies (immunoglobulin M and immunoglobulin G) and/or positive RNA in blood and stool. In four patients serial HEV viral loads in blood were measured. Results Only one patient reached HEV clearance after reduction of immunosuppressive therapy (predominantly reduction of MPA daily dose) alone, whereas six patients were treated with ribavirin after reduction of immunosuppressive therapy due to persistent virus replication. Four of six patients reached HEV clearance after 3 months of ribavirin therapy. HEV clearance was observed after 34–42 days. Two patients, both treated with rituximab within the last 12 months before diagnosis of HEV infection, needed prolonged ribavirin therapy due to persistent viral replication. Conclusion Reduction of daily dose of MPA therapy alone in transplant patients with chronic HEV infection may not be sufficient to control viral replication. HEV clearance under ribavirin therapy shows interindividual variability. Therefore, serial viral monitoring may be useful to personalize treatment duration. Rituximab therapy is a risk factor for complicated‐to‐treat chronic HEV infection.

Background: We studied factors related to humoral response in solid organ transplant (SOT) recipients following a three-dose regimen of an mRNA-based SARS-CoV-2 vaccine. Method: This was a prospective study of SOT recipients who received a third homologous dose of the BNT162b2 (Pfizer–BioNTech) vaccine. The anti-spike S1 IgG response was measured using the SARS-CoV-2 IgG II Quant assay (Abbott Laboratories) with a cut-off of 7.1 BAU/mL. Multiple logistic regression was used to determine the factors associated with humoral response. Results: In total, 395 SOT recipients were included. Anti-spike IgG was detected in 195/395 (49.4%) patients after the second dose and 261/335 (77.9%) patients after the third dose. The overall mean increase in antibody concentration after the third dose was 831.0 BAU/mL (95% confidence interval (CI) 687.4–974.5) and 159 (47.5%) participants had at least a 10-fold increase in antibody concentration after the third dose. The increase in antibody concentration was significantly higher among patients with detectable antibodies after the second dose than those without. Cumulative time from transplantation and liver recipients was positively associated with an antibody response, whereas older age, administration of prednisolone, and proliferation inhibitors were associated with diminished antibody response. Conclusion: Although the third dose of the BNT162b2 vaccine improved humoral responses among SOT non-responders following the second dose, the overall response remained low, and 22.1% did not develop any response. Patients at risk of a diminished vaccine response require repeated booster doses and alternative treatment approaches. [ABSTRACT FROM AUTHOR]

Background: Tocilizumab was studied to reduce cytokine syndrome in patients with severe COVID‐19 pneumonia in solid organ transplant (SOT) recipients with conflicting results. We aim to study the early use of tocilizumab in SOT with COVID‐19 pneumonia on low flow oxygen. Methods: This is a retrospective cohort study that was conducted in two transplant centers in Saudi Arabia among 46 SOT with COVID‐19 comparing 21 patients who received tocilizumab to 25 patients who received standard of care. Their clinical characteristics and outcomes were described. Results: Compared to patients who received standard of care, patients in the tocilizumab group were older (60.2 ± 12.8 vs. 48.6 ± 12.3, p =.003), had higher ferritin (862.1 ± 919.1 vs. 414 ± 447.3, p =.025) and C‐reactive protein (CRP) (85 ± 83.1 vs. 42.9 ± 57.3, p =.012). More patients in the tocilizumab group required high flow oxygen (38.1% vs. 8.0%, p =.028) compared to patients on standard of care. There were no differences in mortality or mechanical ventilation requirement. Hospital stay was significantly shorter in the tocilizumab group than the standard of care group (9.6 ± 7.4 vs. 20.7 ± 11.7, p <.001). Conclusions: Early use of tocilizumab in SOT was associated with a shorter hospital stay. There was no difference in mortality rate and the requirement for mechanical ventilation in both groups. [ABSTRACT FROM AUTHOR]

Abstract Background Tocilizumab was studied to reduce cytokine syndrome in patients with severe COVID‐19 pneumonia in solid organ transplant (SOT) recipients with conflicting results. We aim to study the early use of tocilizumab in SOT with COVID‐19 pneumonia on low flow oxygen. Methods This is a retrospective cohort study that was conducted in two transplant centers in Saudi Arabia among 46 SOT with COVID‐19 comparing 21 patients who received tocilizumab to 25 patients who received standard of care. Their clinical characteristics and outcomes were described. Results Compared to patients who received standard of care, patients in the tocilizumab group were older (60.2 ± 12.8 vs. 48.6 ± 12.3, p = .003), had higher ferritin (862.1 ± 919.1 vs. 414 ± 447.3, p = .025) and C‐reactive protein (CRP) (85 ± 83.1 vs. 42.9 ± 57.3, p = .012). More patients in the tocilizumab group required high flow oxygen (38.1% vs. 8.0%, p = .028) compared to patients on standard of care. There were no differences in mortality or mechanical ventilation requirement. Hospital stay was significantly shorter in the tocilizumab group than the standard of care group (9.6 ± 7.4 vs. 20.7 ± 11.7, p

Accurately estimating mean survival after solid organ transplant (SOT) is crucial for efficient healthcare resource allocation decisions. However, registry-based post-transplant recipient survival estimates vary greatly and are incomplete. Often, the methods used in lifetime survival extrapolation may not fit complex transplant data and therefore alternative methods are required. We aimed to explore the flexible cubic spline methodology as a meaningful alternative for estimating lifetime survival following SOT. Survival analyses were conducted in kidney, liver, heart, and lung transplant recipients. Mean survival was estimated using flexible cubic splines on the hazard scale fitted with three knots, based on where hazards changed direction, clinical advice, and best-fit curve using Akaike and Bayesian information criterion. The tail was extrapolated when data were no longer available. Extrapolation tails were compared with general population mortality, using age-matched life table hazards, and the highest hazards were taken at all times. We found that mean survival post-transplant was longest for kidney transplants (US: 22.79 years; UK: 26.58 years), followed by liver (US: 20.90 years; UK: 20.38 years), heart (US: 14.82 years; UK: 15.85 years), and lung (US: 9.28 years; UK: 9.21 years). A sensitivity analysis using two knots found differences in survival ranging from −1.30 to +4.83 years across SOTs examined. This study does not represent individual patient survival, survival by age groups, multiple-organ transplants, or assess factors that may impact overall or organ survival. Our study estimates reflect real-world survival following SOTs and demonstrate the importance of including long-term hazards in survival estimations. These lifetime survival estimates can be used by decision-makers in situations where means are preferred over medians (e.g. population projections, budgetary estimates, and cost-effectiveness models) and can thus offer a meaningful alternative to the estimates used and accepted in current practice. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has highlighted genetic vaccination as a powerful and cost-effective tool to counteract infectious diseases. Invasive fungal infections (IFI) remain a major challenge among immune compromised patients, particularly those undergoing allogeneic hematopoietic bone marrow transplantation (HSCT) or solid organ transplant (SOT) both presenting high morbidity and mortality rates. Candidiasis and Aspergillosis are the major fungal infections among these patients and the failure of current antifungal therapies call for new therapeutic aids. Vaccination represents a valid alternative, and proof of concept of the efficacy of this approach has been provided at clinical level. This review will analyze current understanding of antifungal immunology, with a particular focus on genetic vaccination as a suitable strategy to counteract these diseases. [ABSTRACT FROM AUTHOR]

Write asymmetry, the significantly different write current for high-to-low and low-to-high resistance switching because of natural stochastic behaviors of magnetization, is a fundamental issue in magnetic random-access memory (MRAM). For high-performance spin transfer torque (STT) MRAM, it can be eliminated by precisely controlling atomically thin magnetic multilayers or by introducing compensation techniques in circuit-level designs, while for spin-orbit torque (SOT) MRAM, it has not been addressed. Here we systematically investigated the write asymmetry of SOT-MRAM as a function of applied magnetic fields (H) and demonstrated that the write currents are intrinsically asymmetric due to different SOT efficiencies for high-to-low and low-to-high switching. Furthermore, we found that the SOT efficiency is very sensitive to the tilt angle between H and write current, which can be tuned through H to achieve symmetric SOT switching. These results provide an additional guideline for designing SOT devices and suggest that the write asymmetry can be eliminated by adjusting the introduced effective magnetic fields within a field-free SOT-MRAM architecture. [ABSTRACT FROM AUTHOR]

Herpes virus infections is not uncommon in solid organ transplantation patients. We report 3 cases with primary Herpes simplex virus type-1 (HSV1) infection with acute liver failure (ALF). This is a rare and potentially fatal entity that could be a donor-derived infection. Although the initial clinical presentation is non-specific, it should be considered as a differential diagnosis in HSV-negative serology patients with liver failure and empirical treatment must be started in combination with a drastic reduction of immunosuppression. A strategy of HSV prophylaxis for pre-transplant HSV seronegative patients must be stablished in order to reduce the risk of clinical disease.

Phaeohyphomycosis comprises a variety of infections caused by pigmented fungi. Solid organ transplant (SOT) recipients are particularly at risk of invasive infections due to their prolonged immunosuppression. Here, we describe three cases of phaeohyphomycosis in SOT recipients who were successfully treated with surgical excision and/or antifungal therapy. We additionally carried out a narrative review of the literature on phaeohyphomycosis in 94 SOT recipients from 66 published studies describing 40 different species of fungi. The most reported fungus was Alternaria (21%). The median time from transplant to diagnosis was 18 months (IQR 8.25–48), and kidney transplants were the most reported. Antifungal regimens were not homogeneous, though there was a prevalence of itraconazole- and voriconazole-based treatments. Clinical outcomes included recovery in 81% and death in 5% of infected SOT recipients. Susceptibility testing was done in 26.6% of the cases, with heterogeneous results due to the variety of species isolated. While the wide diversity of dematiaceous fungi and their host range make it difficult to offer a uniform approach for phaeohyphomycosis, an early diagnosis and therapy are critical in preventing the dissemination of disease in the immunocompromised host.