Microbiome-preserving antibiotics for the treatment of Clostridioides difficile infection: a systematic review and meta-analysis.

BACKGROUND: Newer antibiotics that specifically target Clostridioides difficile while preserving the host microbiome have emerged to treat C. difficile infection (CDI): cadazolid, fidaxomicin, ridinilazole, and surotomycin. The aim of the present study was to perform a systematic review and meta-analysis of efficacy for each antibiotic. METHODS: Only randomized clinical trials of patients being treated for Clostridioides disease infection were included. Studies were sought in MEDLINE, EMBASE, the Cochrane Register of Controlled Trials, ClinicalTrials.gov, and the World Health Organization clinical trials register portal (up to December 9, 2022). Sustained clinical cure was the outcome of treatment comparison, defined as the resolution of diarrhea without recurrence. Vancomycin was the standard treatment comparator. Meta-analysis was performed for each antibiotic. The overall certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-classified as either high, moderate, low, or very low. RESULTS: Fourteen eligible studies were included in the meta-analysis with 4837 patients from 773 sites. Cadazolid did not increase sustained clinical cure relative to vancomycin (risk ratio (RR) 1.04, 95% confidence intervals (CI) 0.96-1.13; moderate-certainty evidence). Fidaxomicin demonstrated a significant increase (RR 1.14, 95% CI 1.07-1.21; low-certainty evidence). In one phase 2 study, ridinilazole demonstrated a significant increase in sustained clinical cure (RR 1.71, 95% CI 1.01-2.91; very low-quality evidence). Surotomycin did not show significant improvement (RR 1.05, 95% CI 0.96-1.14; moderate-certainty evidence). CONCLUSIONS: Fidaxomicin (in seven studies) demonstrated significant improvement in achieving sustained clinical cure. A limitation of this study may that more studies are needed to compare fidaxomicin with other antibiotics.

Proximity-enhanced magnetocaloric effect in ferromagnetic trilayers.

The demagnetization and associated magnetocaloric effect (MCE) in strong-weak-strong ferromagnetic trilayers, upon a reorientation of the strong ferromagnets from parallel to antiparallel (AP) magnetization, is simulated using atomistic spin dynamics. The simulations yield non-trivial spin distributions in the AP state, which in turn allows entropy to be calculated directly. The influence of longer-range spin-spin interactions and of variable strength of the external switching field are investigated. Finally, we find that the MCE in the system can be significantly improved by allowing the local exchange to vary through the spacer, which in practice can be implemented by spatially tailoring the spacer's magnetic dilution.

Correction to: Topical antimicrobial prophylaxis in colorectal surgery for the prevention of surgical wound infection: a systematic review and meta-analysis.

Unfortunately, an author name (Nuzhat Iqbal) was missed out in the original publication. The complete updated author list is given below.

Topical antimicrobial prophylaxis in colorectal surgery for the prevention of surgical wound infection: a systematic review and meta-analysis.

BACKGROUND: Among the techniques investigated to reduce the risk of surgical wound infection or surgical space infection (SSI) in patients having colorectal surgery are topical application of antimicrobials (antibiotics and antiseptics) to the open wound or immediately after closure. The aim of the present study was to perform a systematic review of the literature on those treatments, with the exception of antibiotic ointments applied to closed skin, which are adequately assessed elsewhere, and a meta-analysis. METHODS: Only randomized trials of patients having only colorectal surgery were included in this review. Studies were sought in MEDLINE, EMBASE, the Cochrane Register of Controlled Trials, Clinical Trials.gov, and the World Health Organization Internet clinical trials register portal. In addition, reference lists of included studies and other published reviews were screened. Meta-analysis was performed for all included studies and subgroup analyses done for each individual intervention. Risk of bias was assessed for each included study, paying particular attention to the preoperative antibiotic prophylaxis used in each study. Sensitivity analyses were done to investigate heterogeneity of the analyses, excluding those studies with a significant risk of bias issues. Absolute risk reduction (RR) was calculated. The overall quality of the evidence for each individual intervention was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, and was classified as high, moderate, low or very low. RESULTS: A total of 30 studies are included in this review with 5511 patients, 665 of whom had SSI. The interventions included: 10 studies of gentamicin impregnated sponge or beads wound inlays, 4 studies of chlorhexidine impregnated suture, 11 studies of direct wound lavage or powder application or injection of antibiotics before closure, 4 studies of ionized silver dressing applied to the closed skin, and 1 study of vitamin E oil applied to the open wound. All but one study used preoperative antibiotic prophylaxis in addition to topical procedures, although, in some studies, the systemic antibiotic prophylaxis was not the same between groups or varied significantly from the recommended guidelines. Use of gentamycin sponge did not decrease SSI (RR 0.93, 95% CI 0.75-1.16; low-quality evidence) even after including only the studies of abdominal wounds (RR 1.02, 95% CI 0.80-1.30; low-quality evidence). However, sensitivity analysis excluding studies at high risk of bias decreased the heterogeneity and increased the effect of the prophylaxis for all wounds (RR 0.5, 95% CI 0.33-0.78; low-quality evidence) and for abdominal wounds only (RR 0.38, 95% CI 0.20-0.72; moderate-quality evidence). Chlorhexidine impregnated suture showed no effect on SSI (RR 0.79, 95% CI 0.56-1.10; low-quality evidence) and an increased efficacy after sensitivity analysis (RR 0.42, 95% CI 0.22-0.79; low-quality evidence). Antibiotic lavage showed a significant decrease in SSI (RR 0.45, 95% CI 0.26-0.79; low-quality evidence) which increased after sensitivity analysis (RR 0.33, 95% CI 0.15-0.72; moderate-quality evidence). Application of silver dressing to the closed wound resulted in a decrease of SSI (RR 0.55, 95% CI 0.35-0.85; moderate-quality evidence). The one study of topical vitamin E oil applied to the open wound showed a significant risk reduction (RR 0.22, 95% CI 0.05-0.98; low-quality evidence). CONCLUSIONS: Each of these interventions appears to be effective in decreasing SSI, but the number of studies for each is small and the quality of evidence is very low to moderate. Within the various outcomes of GRADE assessment, even a moderate classification suggests that further studies may well have very different results.. No randomized trials exist of combinations of two or more of the above interventions to see if there is a combined effect. Future studies should make sure that the antibiotic used preoperatively is uniform within a study and is consistent with the current guidelines. Deviation from this leads to a significant heterogeneity and risk of bias.

Spin dynamics in a Curie-switch.

Ferromagnetic resonance properties of F1/f/F2/AF multilayers, where weakly ferromagnetic spacer f is sandwiched between strongly ferromagnetic layers F1 and F2, with F1 being magnetically soft and F2-magnetically hard due to exchange pinning to antiferromagnetic layer AF, are investigated. Spacer-mediated exchange coupling is shown to strongly affect the resonance fields of both F1 and F2 layers. Our theoretical calculations as well as measurements show that the key magnetic parameters of the spacer, which govern the ferromagnetic resonance in F1/f/F2/AF, are the magnetic exchange length (Λ), effective saturation magnetization at T = 0 (m0) and effective Curie temperature (T(C)(eff)). The values of these key parameters are deduced from the experimental data for multilayers with f = Ni(x)Cu(100-x), for the key ranges in the Ni-concentration (x = 54 ÷ 70 at. %) and spacer thickness (d = 3 ÷ 6 nm). The results obtained provide a deeper insight into thermally-controlled spin precession and switching in magnetic nanostructures, with potential applications in spin-based oscillators and memory devices.

[The effect of epigenetic polymorphism of corn seeds on their germination rate and resistance of seedlings under UV-C exposure].

The hypothesis on connection between various germination rates of seeds that are not in dormancy with their epigenetic polymorphism has been checked. It was shown that seedlings which were characterized with different germination rates had different methylation patterns of transcribed and satellite DNA. Different cytogenetic characteristics and their changes were observed under UV-C irradiation as well.

Rotatable magnetic anisotropy in Si/SiO2/(Co2Fe)(x)Ge(1-x) Heusler alloy films.

Polycrystalline (Co2Fe)(x)Ge(1-x) Heusler alloy films are fabricated by sputtering on amorphous substrates and shown to possess three types of magnetic anisotropy. The nearly stoichiometric composition of x = 50 m.f.% shows a rectangular hysteresis loop and isotropic coercive and ferromagnetic resonance fields when the film is field-magnetized along any in-plane direction, thus predominantly possessing rotatable in-plane magnetic anisotropy. Higher-x compositions show evidence of two- and fourfold in-plane anisotropy superposed on the rotatable one. A qualitative model of the observed anisotropic magnetic properties is proposed. The model explains the rotatable anisotropy by taking into account dry friction for the in-plane rotation of the magnetization direction in a fine-grained polycrystalline film with the magnetic grain size smaller than the correlation length of the inter-grain exchange interaction. The observed two- and fourfold magnetic anisotropy contributions are attributed to partial texturing of the fine-grained films, even though the films are grown on amorphous SiO2 substrates. These results should be valuable for understanding and controlling the magnetic behaviour of highly spin-polarized Heusler alloy films used in various magnetic nanodevices.

[Corn plant DNA methylation pattern changes upon fractional UV-C irradiation].

Relationship of changes of methylation pattern of functionally different parts of DNA and chromosomal aberration yield was studied at the conditions of the fractionating of UV-C irradiation. Combination of restriction analysis (Hpall, MspI, MboI enzymes) with the subsequent raising of PCR (internal transcribed space ITS1, 1TS4 and inter simple sequence repeat - ISSR, 14b primers) was used. The got results testify to the changes in methylation pattern of satellite and transcription active part of DNA atan irradiation in the mode of fractionating and depending on fraction time ranges. The role of the methylation DNA pattern change in development of radiation damage and induction of organism protective reactions was discussed.

[Fractionated UV-C irradiation effects on the changes of transcribed and satellite DNA methylation profile and unstable chromosomal aberration yield].

Interaction between changes of functionally different DNA methylation pattern and chromosomal aberration yield under fractionated UV-C exposure at the doses-of 6.2-9 kJ/m2 have been investigated. Two ways of meristematic tissue renewal after irradiation have been revealed on the grounds of statistical analysis. To estimate changes in the methylation pattern of transcribed and satellite DNA the restriction analysis was carried out. The restriction reaction was followed by PCR with ITS1(19b), ITS4(20b) and ISSR(14b) primers. The obtained data indicate specific changes in the methylation pattern of transcribed and satellite DNA parts under fractionated irradiation with different fraction ranges. Possible role of these changes in the progressing irradiation damage and inducible protection reactions is discussed.

[Changes in wheat DNA methylation pattern after chronic seed gamma-irradiation].

Alterations of DNA methylation patterns of wheat two varieties--Odessa' albatross and Donetsk 48 have been studied. Seeds were irradiated for 4 months with low dose rate (3 x 10(-7) Gy/s). Six restriction endonucleases were used in the experiments. Primary distinction in DNA methylation patterns of the studied varieties has been demonstrated. The chronic irradiation resulted in the increase of methylation level on the sites of recognition for Glul and Sou3Al and in the decline of this index for the sites of recognition of GlaI and HpaII. The meaningful increase of chromosome aberration levels was demonstrated at the same accumulated dose of chronic irradiation. The role of changes of DNA methylation patterns in development of radiation damage and organism protective reactions is discussed.

[Association of P-mobile element activity and DNA methylation pattern changes in the conditions of Drosophila melanogaster prolonged irradiation].

Association of the radiosensitivity and epigenetic pattern DNA changes at the conditions of prolonged irradiation was investigated. Two laboratory Drosophila melanogaster strains (Canton-S and ri) irradiated for 20 generations to low doses rate (1.2 x 10(-1), 0.8 x 10(-8) and 0.12 x 10(-8) Gy/s) were used as experimental objects. DNA for the analysis was extracted separately for the flies of males and females. Restriction endonucleases Glul, Glal were used. Restriction analysis has shown that there are different DNA methylated patterns for males and females as for control and exposed variants. At the chronic irradiation there was the decline of methylation level at the enzymes Glul, Glal sites recognition.

[Dynamics of gonadal dysgenesis frequency in Drosophila melanogaster under controlled conditions of chronic radiation exposure].

Two Drosophila melanogaster strains (Canton-S and ri-lines) for 20 generations were in the controlled terms of chronic irradiation with 3-dose rate (1,2 x 10(-8); 0,3 x 10(-8); 0,12 x 10(-8) Gy/c). The dynamics of hybrid dysgenesis frequency was explored for each generation of F1 descendants from Canton-S and ri-lines crossing. The gradual change of dose response of hybrid dispense depending on duration of irradiation of ancestors and dose rate was shown. The complex dynamics of hybrid dysgenesis frequency depending on irradiation duration of ancestors and dose rate was detected. The cumulative effect of the prolonged irradiation shows up as adaptation at the lowest dose rate and as exhaustion at the highest dose rate. Question comes into discussion about the features of transitional process and including of protective and adaptive reactions hierarchy at the conditions of radiation factor chronic action.

[The effects of the distance interaction of the exposed and unexposed plants].

The effects of the distance interaction between the irradiated and unirradiated corn plants in the conditions of water culture were investigated. The change of biological and radiobiological reactions (radioadaptation) is shown at the helped unexposed plants, and also oppressing, as compared to the exposed homogeneous culture, similar indexes at the exposed plants from mixed culture.

[The dynamics of P-mobile Drosophila melanogaster element activation in controlled terms of protracted irradiation].

Verification of hypothesis about mobile element activation radiosensitivity change in the conditions of the prolonged irradiation was the research goal. The estimation of orientation of these changes depending on the accumulated dose and their characteristic times were conducted. Two Drosophila melanogaster strains (Canton-S and P-lines) for 20 generations were in the controlled terms of chronic irradiation with 3-dose rate (1.2 x 10(-8), 0.6 x 10(-8) and 0.12 x 10(-8) Gy/c). The dynamics of hybrid dysgenese frequency was explored for each generation of F1 descendants from Canton-S and P-lines crossing. The gradual change of dose response of hybrid disgenesis depending on duration of irradiation of ancestors and dose rate was shown. The complex dynamics of hybrid dysgenese frequency depending on irradiation duration of ancestors and dose rate was shown. The cumulative effect of the prolonged irradiation shows up as adaptation at the lowest dose rate and as exhaustion at the highest dose rate. Question comes into discussion about the features of transitional process and including of protective and adaptive reactions hierarchy at the conditions of radiation factor chronic action.

[The dynamics of cytogenetic anomalies output in seedling merysteme at the chronic irradiation of seeds].

The dynamics of chromosomal aberrations in seedling root merysteme is explored in various terms of irradiation of two genotype corn dry seeds. The effects of chronic irradiation with low rate dose, with acute and with combined irradiation are explored in the different terms of seed storage. It is shown that the output of chromosomal aberrations and of the efficiency of irradiation (1/Gy) change depending on the accumulated dose of chronic irradiation and for both genotypes are described by unmonotonous functions. Efficiency of acute irradiation changes the dependence on the terms of seed storage. The efficiency of chronic irradiation considerably exceeds the efficiency of acute irradiation. Antagonistic effect of combined irradiation dry seeds of one of genotypes is marked.

Reconstruction and forecast of doses due to ingestion of 137Cs and 90Sr after the Chernobyl accident.

The assessment doses due to ingestion of (137)Cs and (90)Sr for the population suffering from the Chernobyl accident was performed on the basis of the new mechanistic ecological model for assessment of radiological consequences of agricultural lands contamination (EMARC). The EMARC model allows estimation of internal doses based on ecological factors influencing the contamination of foodstuff, for the post-accidental years in the countries of the former Soviet Union. The EMARC model allows estimation of all quantities required in radiation hygiene practice. For example, the proposed analytical method may be used for both retrospective dose reconstruction and prospective estimates of annual dose and integrated "life-time" dose, for different age intervals. According to the EMARC model, estimated reference "life-time" doses for adults are between 7 and 269 microSv kBq(-1) m(2) for (137)Cs, and between 25 and 235 microSv kBq(-1) m(2) for (90)Sr. Maximal doses were estimated for persons who were 3, 9 and 11 years old, at the time of the accident and these doses exceed those for adults by a factors of 1, 5 for (90)Sr, and 1.4 for (137)Cs.

[Diagnostics and treatment of patients with closed injuries of abdominal cavity organs in combination with craniocerebral trauma].

The article presents the results of the diagnostics and treatment of 114 patients with closed injuries of abdominal cavity organs combined with craniocerebral trauma. 34 (29.8%) of the patients developed injuries of two and more organs of abdominal cavity. The injured were subjected to complex examination methods including X-ray, ultrasonic diagnostics, endoscopy, laparocentesis, echoencephalography, spinal and pleural puncture, hemodynamic and hematological tests. All the injured were operated on. Infusion of autoblood was done to 32 (28%) of the patients. The analysis of the observation shows that rational use of common and informative diagnostic methods allows diagnosing timely patients with closed injuries of abdominal cavity organs in combination with craniocerebral trauma.

[Diagnosis and treatment of patients with closed injury of abdominal cavity organs in combination with craniocerebral trauma]. / Diagnostika i lechenie bol'nykh s zakrytym povrezhdeniem organov briushnoi polosti v sochetanii s cherepno-mozgovoi travmoi.

Results of diagnosis and treatment of 114 injured persons with closed abdominal trauma, combined with craniocerebral trauma were suggested. In 34 (29.8%) observations the injury of two or more organs of peritoneal cavity was diagnosed, the parenchymatous organs trauma--in 35 (30.7%) and the hole organs trauma--in 45 (39.5%). Cerebral concussion was established in 61 (53.5%) of injured persons, cerebral contusion--in 26 (22.8%), cerebral compression on the contusion background--in 16 (14%) and subdural hematoma--in 11 (9.7%). In all the injured persons the operative intervention was performed. In 32 (28%) the blood of their own was transfused. To reduce the endogenous intoxication severity there were performed the forced diuresis, hemosorption--in 10 (8.7%), the blood ultraviolet irradiation--in 41 (35.9%), intravenous laserotherapy--in 40 (35%). After the operation 14 (12.3%) of patients died. High mortality in combined cranioabdominal trauma is caused by the injury severity, the traumatic shock and mutual burden syndrome presence.

[Extracorporeal ultraviolet irradiation of blood in combined treatment of patients with peritonitis]. / Ekstrakorporal'noe ul'trafioletovoe obluchenie krovi v komplekse lecheniia bol'nykh s peritonitom.

Experience of application of extracorporeal ultraviolet irradiation of the blood (EUIB) in 60 patients with diffuse peritonitis of different etiology was presented. EUIB was conducted in 16-24 hours after performance of operation using apparatus MD--73 M "Izolda". The leukocytic index of intoxication after performance of the EUIB third procedure had reduced by 28.5%. Leukocytic index of shift had reduced after the first procedure performance--by 23.1%, after the third--by more than 50%. T-lymphocytes quantity in 22-24 hours after conduction of the first EUIB procedure had increased by 23.8% and after the third--by 63%. General postoperative mortality after complex treatment conduction using EUIB had constituted 3.3% and without EUIB--6.5%. Duration of treatment of the patients, in whom EUIB was applied, had shortened by 2.6 days.