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Tick-borne diseases (TBDs) can sometimes cause severe symptoms and lead to hospitalisation, but they often go unnoticed in the Emergency Department (ED). The aim of this study was twofold: (i) to describe the profile of patients hospitalised by TBDs; and (ii) to evaluate the data collected in the medical records from the ED in order to analyse their potential clinical consequences. A total of 84 cases that included all TBD diagnoses registered in the ED records were identified and analysed. These corresponded to all the hospitalisations by TBDs in the last 10 years (2009–2019) in two tertiary hospitals in Granada, Spain. Statistical analyses were made using RStudio. Coinciding with the absence of patient's report of exposure to ticks, 64.3% of TBDs were not suspected in the ED. Intensive care unit admission was required in 8.3% of cases, and the mortality rate was 2.4%. Non-suspected cases showed longer hospital stay (P < 0.001), treatment duration (P = 0.02) and delay in the initiation of antibiotic treatment (P < 0.001). Our findings indicate that symptoms associated with TBDs are highly non-specific. In the absence of explicit information related to potential tick exposure, TBDs are not initially suspected. As a consequence, elective treatment administration is delayed and hospitalisation time is prolonged. In conclusion, our results highlight the importance of addressing potential exposure to ticks during the ED contact with patients presenting with febrile syndrome.
The Hooks et al. review of microbiota-gut-brain (MGB) literature provides a constructive criticism of the general approaches encompassing MGB research. This commentary extends their review by: (a) highlighting capabilities of advanced systems-biology “-omics” techniques for microbiome research and (b) recommending that combining these high-resolution techniques with intervention-based experimental design may be the path forward for future MGB research.
We have monitored tributyltin (TBT) pollution in Galicia (NW Spain) for more than a decade by means of assessing gastropod imposex in populations of Nucella lapillus (N ≥ 34) and Tritia reticulata (N ≥ 18) at regular intervals. Several thousand specimens were processed to obtain their shell height (SH), penis length (PL) and vas deferens sequence (VDS); imposex indices (including the VDS index, VDSI) were subsequently calculated. The regional mean SH of both females and males has not changed significantly in either species throughout the study. This also applies to the mean male PL in N. lapillus, but male T. reticulata penises surprisingly enlarged. On the contrary, the regional mean female PL (MFPL) and all imposex indices significantly decreased in both snails. Results confirm previous conclusions based on the chemical analyses of tissues and partial imposex observations. In addition, the close correlations between MFPL and VDSI show some potential applications to TBT biomonitoring.
This article presents experimental measurements involving immersed collisions between a rigid impactor and a deformable target for a wide range of Reynolds and Stokes numbers. Three aluminium alloys are used as solid targets submerged in seven different fluids covering a wide range of viscosity and density. The collision and rebound velocities as well as the depth and diameter of the crater produced by the collisions are measured with high resolution. Most of the experiments in this study occur at velocities for which the deformation is within the elastic–plastic regime. Results of the experiments in air are analysed by elastic, plastic and elastic–plastic theories, and demonstrate the complexities of modelling elastic–plastic collisions. For collisions in a liquid, the measurements show that the size of the crater is independent of the fluid characteristics if the Stokes number is beyond a critical value. The normal coefficient of restitution can be estimated by including both viscous losses and plasticity effects and assuming that the collision time scale is significantly shorter than the hydrodynamic time scale. The results of the crater dimensions are also used to develop an analytical expression for the volume of deformation of the material as a function of material properties and the impact and critical Stokes numbers.
Neglected tropical diseases (NTDs) share certain traits: they are parasitic infections, prevailing in tropical environments and affecting marginalized sectors of the population. Six NTDs – ascariasis, cysticercosis, echinococcosis, hookworm infection, onchocerciasis and trichuriasis – all of them endemic in Latin America and the Caribbean (LAC), are analysed in this work. This review aims to discuss key information on the function of excretory/secretory (E/S) proteins from these parasites in their infectivity, pathogeny and diagnosis. The modulation of the host immune system to favour the permanence and survival of the parasite is also discussed. An updated knowledge on the function of E/S molecules in endemic parasitoses in LAC may lead to new approaches for the clinical management and diagnosis of these diseases. In turn, this could allow us to optimize their treatment and make it more affordable – a relevant goal given the economic constraints that the region is facing.
The disease caused by the influenza virus is a global public health problem due to its high rates of morbidity and mortality. Thus, analysis of the information generated by epidemiological surveillance systems has vital importance for health decision making. A retrospective analysis was performed using data generated by the four molecular diagnostic laboratories of the Mexican Social Security Institute between 2010 and 2016. Demographics, influenza positivity, seasonality, treatment choices and vaccination status analyses were performed for the vaccine according to its composition for each season. In all cases, both the different influenza subtypes and different age groups were considered separately. The circulation of A/H1N1pdm09 (48.7%), influenza A/H3N2 (21.1%), influenza B (12.6%), influenza A not subtyped (11%) and influenza A/H1N1 (6.6%) exhibited well-defined annual seasonality between November and March, and there were significant increases in the number of cases every 2 years. An inadequate use of oseltamivir was determined in 38% of cases, and the vaccination status in general varied between 12.1 and 18.5% depending on the season. Our results provide current information about influenza in Mexico and demonstrate the need to update both operational case definitions and medical practice guidelines to reduce the inappropriate use of antibiotics and antivirals.
The coffee berry borer, Hypothenemus hampei (Ferrari), can survive in residual coffee berries during the inter-harvest period, while new fructification only appears 2–3 months after the last harvest. The dispersal of colonizing females is an adaptation that enables the life cycle of the species to go ahead whenever his flight aptitude allows. This paper focuses on accurately determining the rate of inseminated females ready to reproduce when emerging from residuals berries to colonize new ones, which constitutes a characteristic of the live cycle far from common in Curculionidae. We dissected females caught in traps baited with a mixture of alcohols during the inter-harvest season, females from infested residual berries collected from branches, and virgin females obtained from pupae reared individually in the laboratory. After microscopic preparation with Giemsa stain, spermathecae were observed to identify the physiological status of each specimen. Out of the females found in the traps, 98.4% displayed recent and abundant insemination and 1.6% sporadic insemination. In contrast, in residual berries, most of females were recently inseminated (84.5%), followed by virgin females (10.5%) and older inseminated females (5%). In addition, the flight tests of the virgin females were negative. These results indicate that all colonizing females were inseminated, ready for flying and oviposition, females inside residual berries showed different physiological status, and virgin females could not migrate since they could not flight. The large number of inseminated females inside the residual berries, and the capacity of migrating females to colonize and reproduce, suggest that it is necessary to control residual berries and use traps to stop the dispersal and reproduction of this pest.
Composites from carbon nanotubes and polymers have been synthesized and studied. The composites were obtained joining carbon nanotubes with polymethyl methacrylate, nylon-6 and polystyrene. The materials were observed through scanning electron microscopy to evaluate the carbon nanotubes dispersion in the polymeric matrices. FTIR and Raman spectroscopies were used to analyze the interactions among functionalized and non-functionalized multiwalled carbon nanotubes and polymers, demonstrating affinity and peculiar spectra behaviors for each composite with different carbon nanotubes loads.
PA6 and PMMA polymers with different MWCNTs addition (5, 7 and 9 wt %) were synthetized through casting solution, resulting in improvement properties in contrast to pristine polymers. SEM images showed the MWCNTs embedded into polymeric matrices. D, G and G´ bands of MWCNTs were confirmed by Raman spectroscopy and functional groups observed in both nanocomposites by FTIR demonstrated a strong interaction. A significant increasing in electrical conductivity and microhardness was observed in all the nanocomposites. Major microhardness values were obtained in MWCNTs/PA6 (50 HV) however the MWCNTs/PMMA nanocomposites showed the highest electrical conductivity value (6.4×10-4 S/cm).
Individuals with schizophrenia have deficits in social cognition that are associated with poor functional outcome. Unfortunately, current treatments result in only modest improvement in social cognition. Oxytocin, a neuropeptide with pro-social effects, has significant benefits for social cognition in the general population. However, studies examining the efficacy of oxytocin in schizophrenia have yielded inconsistent results. One reason for inconsistency may be that oxytocin has typically not been combined with psychosocial interventions. It may be necessary for individuals with schizophrenia to receive concurrent psychosocial treatment while taking oxytocin to have the context needed to make gains in social cognitive skills.
The current study tested this hypothesis in a 24-week (48 session) double-blind, placebo-controlled trial that combined oxytocin and Cognitive-Behavioral Social Skills Training (CBSST), which included elements from Social Cognition and Interaction Training (SCIT). Participants included 62 outpatients diagnosed with schizophrenia (placebo n = 31; oxytocin n = 31) who received 36 IU BID, with supervised administration 45 min prior to sessions on CBSST group therapy days. Participants completed a battery of measures administered at 0, 12, and 24 weeks that assessed social cognition.
CBSST generally failed to enhance social cognition from baseline to end of study, and there was no additive benefit of oxytocin beyond the effects of CBSST alone.
Findings suggest that combined CBSST and oxytocin had minimal benefit for social cognition, adding to the growing literature indicating null effects of oxytocin in multi-dose trials. Methodological and biological factors may contribute to inconsistent results across studies.
The control of Anastrepha obliqua includes the sterilization of mass-reared insects grown in isolation in a constantly controlled environment. Through time, laboratory mass-reared colonies may produce flies with lower field performance. To recover the genetic variation and aptitude of mass-reared populations, wild insects are introduced into mass-reared colonies. Our aim in this study was to determine whether the host species from two localities influence the life history traits of A. obliqua. We collected flies as larvae from infested fruits of Spondias purpurea, S. mombin, Mangifera indica cv. ‘piña’, and M. indica cv. ‘coche’ from two localities in Chiapas, Mexico. There were significant differences in the mating competitiveness of males collected from mango cv. ‘coche’ compared with mass-reared males. There were no differences in the mating propensity between flies from the two localities, even in the number of matings, when weight was considered as a covariable. The mass-reared strain showed the earliest age at first oviposition. The locality affected the longevity and oviposition period, and these influenced the birth rate, intrinsic rate of increase, finite rate of population increase, mean generation time, and doubling time. According to the demographic parameters, the population of S. mombin would allow artificial colonization in less time, considering that it has a high reproduction rate starting at an early age. Even in the propensity test, it had the highest number of matings. However, males with greater sexual competitiveness and longevity for colonization corresponded to those collected from S. purpurea.
Wave loading on marine structures is the major external force to be considered in the design of such structures. The accurate prediction of the nonlinear high-order components of the wave loading has been an unresolved challenging problem. In this paper, the nonlinear harmonic components of hydrodynamic forces on a bottom-mounted vertical cylinder are investigated experimentally. A large number of experiments were conducted in the Danish Hydraulic Institute shallow water wave basin on the cylinder, both on a flat bed and a sloping bed, as part of a European collaborative research project. High-quality data sets for focused wave groups have been collected for a wide range of wave conditions. The high-order harmonic force components are separated by applying the ‘phase-inversion’ method to the measured force time histories for a crest focused wave group and the same wave group inverted. This separation method is found to work well even for locally violent nearly-breaking waves formed from bidirectional wave pairs. It is also found that the
th-harmonic force scales with the
th power of the envelope of both the linear undisturbed free-surface elevation and the linear force component in both time variation and amplitude. This allows estimation of the higher-order harmonic shapes and time histories from knowledge of the linear component alone. The experiments also show that the harmonic structure of the wave loading on the cylinder is virtually unaltered by the introduction of a sloping bed, depending only on the local wave properties at the cylinder. Furthermore, our new experimental results reveal that for certain wave cases the linear loading is actually less than 40 % of the total wave loading and the high-order harmonics contribute more than 60 % of the loading. The significance of this striking new result is that it reveals the importance of high-order nonlinear wave loading on offshore structures and means that such loading should be considered in their design.
OBJECTIVES/SPECIFIC AIMS: “Cure Quest” is an adventure quest game for mobile tablets that aims to teach the player about the complexities of discovery and development of new medicines. The game instills a sense of wonderment into the learning process, taking the player to a world of magic where a mysterious condition has affected the land and they must follow the steps of the discovery and development process to find a treatment. METHODS/STUDY POPULATION: The game is being developed through a collaboration between faculty and students at ISMMS and the Games and Simulation Arts and Science Program at Rensselaer Polytechnic Institute. The first target audience is 2nd–3rd year medical students, with the future goal of adapting the game to a broader population. RESULTS/ANTICIPATED RESULTS: The game is currently in development, but the project has yielded insight into the design process for serious games in medicine. We found that for a game of this type it is essential not just to have both designers and subject matter experts, but to enable cross-pollination of modes of thinking. Through multiple design iterations and focus groups, we found that a game design approach rooted in narrative and allegorical abstraction would have a better ability to engage the target audience than one focused only on realistic simulation. When complete, we anticipate that the game will improve understanding of the core concepts in drug discovery. DISCUSSION/SIGNIFICANCE OF IMPACT: If successful, the game-based learning approach can help fill key gaps in current formal medical and scientific training, as well as gaps in understanding among the general public. The design process serves as an informative model of evolving collaborative team science.
Anastrepha fraterculus (Wiedemann), a pest of great economic importance in South America, needs urgently to be controlled by environmentally friendly methods such as the sterile insect technique for which mass rearing of insects is required. Because oogenesis takes place during the adult stage, mass-rearing facilities should provide the females a diet that maximizes egg production at the lowest cost. Accordingly, we investigated the effect of artificial protein sources in the adult diet (yeast derivatives of different cost but with similar amino acids profiles, and the addition of wheat germ) on fecundity. Additionally, we evaluated different ratios of yeast derivatives or wheat germ on ovary maturation, fecundity, and fertility as well as their association with the nutrient content of females. Females fed hydrolyzed yeast and yeast extract attained the highest fecundity level, and those fed brewer's yeast the lowest. Reducing the amount of hydrolyzed yeast, an expensive protein source, in the diet negatively affected fecundity and ovary maturation. Increasing the amount of brewer's yeast, a low-cost protein source, did not favor fecundity. The addition of wheat germ in the adult diet improved fecundity regardless of the yeast derivate considered. Percentage of egg hatch was not affected by the diet. Nutrient content of A. fraterculus females varied according to the adult diet provided and mating status. Our findings provide novel baseline information to understand the role of nutrition on reproductive performance of A. fraterculus females and are discussed in the context of resource allocation. They also provide valuable advances in the search for cost-effective adult diets at fruit fly mass rearing facilities.
To compare the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP) and to examine the differences in clinical characteristics and outcome between BSIs caused by isolates with CTX-M versus other ESBL genotypes
As part of the INCREMENT project, 33 tertiary hospitals in 12 countries retrospectively collected data on adult patients diagnosed with ESBL-EC BSI or ESBL-KP BSI between 2004 and 2013. Risk factors for ESBL-EC versus ESBL-KP BSI and for 30-day mortality were examined by bivariate analysis followed by multivariable logistic regression.
The study included 909 patients: 687 with ESBL-EC BSI and 222 with ESBL-KP BSI. ESBL genotype by polymerase chain reaction amplification of 286 isolates was available. ESBL-KP BSI was associated with intensive care unit admission, cardiovascular and neurological comorbidities, length of stay to bacteremia >14 days from admission, and a nonurinary source. Overall, 30-day mortality was significantly higher in patients with ESBL-KP BSI than ESBL-EC BSI (33.7% vs 17.4%; odds ratio, 1.64; P=.016). CTX-M was the most prevalent ESBL subtype identified (218 of 286 polymerase chain reaction-tested isolates, 76%). No differences in clinical characteristics or in mortality between CTX-M and non–CTX-M ESBLs were detected.
Clinical characteristics and risk of mortality differ significantly between ESBL-EC and ESBL-KP BSI. Therefore, all ESBL-producing Enterobacteriaceae should not be considered a homogeneous group. No differences in outcomes between genotypes were detected.
The main objective of our study was to describe the epidemiological and microbiological features of an oligoclonal hospital-wide outbreak caused by OXA-48-producing Enterobacteriaceae (OXA-48-PE). OXA-48 is a carbapenemase belonging to Ambler class D beta-lactamases, identified frequently in the Mediterranean and Southern European countries, and associated with several Enterobacteriaceae species. An outbreak of OXA-48-PE with a complex epidemic pattern was detected in January 2011. Initial control measures included contact precautions and the reinforcement of infection control practices, but despite all efforts made, the epidemiological situation hardly changed and new measures were implemented during 2013. An observational retrospective study was performed to describe the main features of the outbreak and to analyse the cumulative incidence (CI) trends. Eight hundred and 16 patients colonised or infected by OXA-48-PE were identified during the 2-year period (January 2013–December 2014), female 46%, mean age (s.d.), 71.6 (15.2). The samples isolated in the incident cases were rectal swabs (80%), urine samples (10.7%), blood samples (2.8%) and other clinical samples (6.6%). The most frequent OXA-48-PE was Klebsiella pneumoniae. Eleven different clones were identified, but K. pneumoniae sequence types 11 and 405 were predominant: ST11 (64.2%) and ST405 (29.3%). OXA-48-PE CI trend suffered a statistically significant change in August 2013, which continued the following months. Though we could not eradicate the outbreak, we observed a statistically significant drop in CI after an intervention for OXA-48-PE control, based on patient cohort, active surveillance, electronic alerts and reinforcement of infection control measures in a tertiary hospital.
A major challenge in nanofabrication is the manipulation and exact placement of nano-objects on a specific template. Artificial DNA nanostructures such as DNA origami have garnered significant interest as templates for incorporating nanomaterials at precise sites while the structures are self-assembled. This work shows the usage of the DNA origami technique in the design and fabrication of nanostructures with the shapes of a circle and a triangle using the third part of the M13 virus genome, named mini-M13, as a scaffold. These DNA origami templates were modified to have DNA binding sites with a uniquely coded sequence. This method is used to attach 5 nm gold nanoparticles functionalized with the complementary DNA sequence. Two new metallic nanostructures with different nanoparticle arrays having minimum size but recognizable morphology are provided. The formation and dimensions of the nanostructures were verified using AFM and agarose gel electrophoresis.
The aim of this research is to ameliorate the dispersion of pristine and functionalized Carbon Nanotubes (CNTs) into polystyrene with hydroxyl end groups (PSOH) matrices using low magnetic fields. The Multi-Walled Carbon Nanotubes (MWCNTs) were synthesized by chemical vapor deposition (CVD) using benzene as carbon source; to produce CNTs with and without functional groups two catalysts were used (stainless steel and ferrocene). The obtained nanotubes contained iron nanoparticles inside. PSOH were synthesized using styrene as monomer, azobisisobutyronitrile as initiator and 2-MeOH as chain transfer agent. The MWCNTs-PSOH matrices were formed using 1.6 wt % of carbon nanotubes into PSOH and ultrasonic mixing for 30 min. The mixing materials were poured into containers and dry at room temperature. While the material was drying, constant magnetic fields of 0.24 T were being applied for 50 min. The MWCNTs-PSOH composites were analysed by SEM, FTIR and Raman spectroscopy. SEM micrographs showed that MWCNTs without functional groups were incorporated in the middle of PSOH. The MWCNTs functionalized perform differently; a better dispersion through the entire polymer matrix was achieved, because the polymer embedded the CNTs. FTIR and Raman spectroscopy showed chemical interaction between PSOH and MWCNTs functionalized. The CNTs dispersion into PSOH was ameliorated through the use of low magnetic fields and functionalization.
The diffusive strip method (DSM) is a near-exact numerical method for mixing computations initially developed in two dimensions (Meunier & Villermaux, J. Fluid Mech., vol. 662, 2010, pp. 134–172). The method, which consists of following stretched material lines to compute the resulting scalar field a posteriori, is extended here to three-dimensional flows. We describe the procedure and its three-dimensional peculiarity, which relies on the Lagrangian advection of a triangulated surface from which the stretching rate is extracted to infer the scalar field. The method is first validated at moderate Péclet number against a classical pseudospectral method solving the advection–diffusion equation for a Batchelor vortex, and then applied to a simple Taylor–Couette experimental configuration with non-rotating boundary conditions at the top-end disk, bottom-end disk and outer cylinder. This motion, producing an elaborate although controlled steady three-dimensional flow, relies on Ekman pumping arising from the rotation of the inner cylinder. A recurrent two-cell structure is separated by the horizontal mid-plane and formed by stream tubes shaped as nested tori under laminar flow conditions. A scalar blob in the flow experiences a Lagrangian oscillating dynamics undergoing stretchings and compressions, driving the mixing process. The DSM enables the calculation of the blob elongation and scalar concentration distributions through a single variable computation along the advected blob surface, capturing the rich evolution observed in the experiments. Interestingly, the mixing process in this axisymmetric and steady three-dimensional flow leads to a linear growth of surfaces in time similar to the one obtained in a two-dimensional shear. The potentialities, limits and extension of the method to more general flows are finally discussed.
Two metal fillers with TiC nanoparticles (TiC NPs) of less than 100 nm for the overlay process is an alternative to hardfacing for treating surfaces subjected to severe wear. In this work, the effect of tribological behavior for TiC NPs addition on two Co-based filler materials, as well as the dilutions, was studied. Mixtures of Co-based filler metals without and with 0.5% and 2% TiC NPs were deposited onto D2 steel plates using PTA (Plasma Transferred Arc). The BET surface area was 0.17 m2 g-1 and 0.31 m2 g-1, respectively, for Stellite 6 and 12. The distribution of ca 23% macroporous for Stellite 6 was sufficient to get inside the TiC NPs, as well as in the case of Stellite 12, with a pore distribution of ca 13%. Stellite 12 has an increase in the dilutions (70%) and enthalpies showed endothermic reactions. Stellite 6 with NPs was determined to be most effective in increasing the wear resistance.