High temperature and nib acidification during cacao-controlled fermentation improve cadmium transfer from nibs to testa and the liquor's flavor.

Migration of nib Cd to the testa during fermentation can be achieved with high temperatures (> 45 °C) and low nib pH values (< 5.0) using spontaneous fermentation. However, this low pH can lead to low flavor quality. This study used three controlled temperature fermentation treatments on three cacao genotypes (CCN 51, ICS 95, and TCS 01) to test its effects on the nib pH, the migration of nib Cd to the testa, and the liquor flavor quality. All treatments were effective in reducing the total nib Cd concentration. Nevertheless, the treatment with the higher mean temperature (44.25 °C) and acidification (pH 4.66) reached the highest mean nib Cd reductions throughout fermentation, a 1.37 factor in TCS 01, promoting the development of fine-flavor cocoa sensorial notes. In unfermented beans, the Cd concentration of nibs was higher than that of the testa, and the Cd migration proceeded down the total concentration gradient. However, Cd migration was observed against the concentration gradient (testa Cd > nib Cd) from the fourth day. Cd migration could increase by extensive fermentation until the sixth day in high temperatures and probably by the adsorbent capacity of the testa. Genotype-by-treatment interactions were present for the nib Cd reduction, and a universal percentage of decrease of Cd for each genotype with fermentation cannot be expected. Selecting genotypes with highly adsorbent testa combined with controlled temperatures would help reduce the Cd concentration in the cacao raw material, improving its safety and quality.

Racial disparities in complications following elective colon cancer resection: Impact of laparoscopic versus robotic approaches.

BACKGROUND: We sought to examine differences in outcomes for Black and White patients undergoing robotic or laparoscopic colectomy to assess the potential impact of technological advancement. METHODS: We queried the ACS-NSQIP database for elective robotic (RC) and laparoscopic (LC) colectomy for cancer from 2012 to 2020. Outcomes included 30-day mortality and complications. We analyzed the association between outcomes, operative approach, and race using multivariable logistic regression. RESULTS: We identified 64,460 patients, 80.9% laparoscopic and 19.1% robotic. RC patients were most frequently younger, male, and White, with fewer comorbidities (P â€‹< â€‹0.001). After adjustment, there was no difference in mortality by approach or race. Black patients who underwent LC had higher complications (OR 1.10, 95% CI 1.03-1.08, P â€‹= â€‹0.005) than their White LC counterparts and RC patients. CONCLUSIONS: Robotic colectomy was associated with lower rates of complications in minority patients. Further investigation is required to identify the causal pathway that leads to our finding.

Clinical outcomes of elective robotic vs laparoscopic surgery for colon cancer utilizing a large national database.

BACKGROUND: Prior studies have shown comparable outcomes between laparoscopic and robotic approaches across a range of surgeries; however, these have been limited in size. This study investigates differences in outcomes following robotic (RC) vs laparoscopic (LC) colectomy across several years utilizing a large national database. METHODS: We analyzed data from ACS NSQIP for patients who underwent elective minimally invasive colectomies for colon cancer from 2012 to 2020. Inverse probability weighting with regression adjustment (IPWRA) incorporating demographics, operative factors, and comorbidities was used. Outcomes included mortality, complications, return to the operating room (OR), post-operative length of stay (LOS), operative time, readmission, and anastomotic leak. Secondary analysis was performed to further assess anastomotic leak rate following right and left colectomies. RESULTS: We identified 83,841 patients who underwent elective minimally invasive colectomies: 14,122 (16.8%) RC and 69,719 (83.2%) LC. Patients who underwent RC were younger, more likely to be male, non-Hispanic White, with higher body mass index (BMI) and fewer comorbidities (for all, P < 0.05). After adjustment, there were no differences between RC and LC for 30-day mortality (0.8% vs 0.9% respectively, P = 0.457) or overall complications (16.9% vs 17.2%, P = 0.432). RC was associated with higher return to OR (5.1% vs 3.6%, P < 0.001), lower LOS (4.9 vs 5.1 days, P < 0.001), longer operative time (247 vs 184 min, P < 0.001), and higher rates of readmission (8.8% vs 7.2%, P < 0.001). Anastomotic leak rates were comparable for right-sided RC vs LC (2.1% vs 2.2%, P = 0.713), higher for left-sided LC (2.7%, P < 0.001), and highest for left-sided RC (3.4%, P < 0.001). CONCLUSIONS: Robotic approach for elective colon cancer resection has similar outcomes to its laparoscopic counterpart. There were no differences in mortality or overall complications, however anastomotic leaks were highest after left RC. Further investigation is imperative to better understand the potential impact of technological advancement such as robotic surgery on patient outcomes.

Antibiotic Adjuvant Activity Revealed in a Photoaffinity Approach to Determine the Molecular Target of Antipyocyanin Compounds.

Infections with Pseudomonas aeruginosa are a looming threat to public health. New treatment strategies are needed to combat this pathogen, for example, by blocking the production of virulence factors like pyocyanin. A photoaffinity analogue of an antipyocyanin compound was developed to interrogate the inhibitor's molecular mechanism of action. While we sought to develop antivirulence inhibitors, the proteomics results suggested that the compounds had antibiotic adjuvant activity. Unexpectedly, we found that these compounds amplify the bactericidal activity of colistin, a well-characterized antibiotic, suggesting they may represent a first-in-class antibiotic adjuvant therapy. Analogues have the potential not only to widen the therapeutic index of cationic antimicrobial peptides like colistin, but also to be effective against colistin-resistant strains, strengthening our arsenal to combat P. aeruginosa infections.

Periprocedural Outcomes in Patients on Chronic Anticoagulation Undergoing Fistulograms.

BACKGROUND: Management of antithrombotic therapy with warfarin in patients undergoing fistulograms and possible interventions is controversial and difficult because of lack of adequate outpatient bridging options. Our goal was to assess periprocedural outcomes in patients managed using different anticoagulation strategies. METHODS: A retrospective, single-institution analysis of all patients on chronic anticoagulation with warfarin undergoing fistulograms from 2011 to 2017 was performed. Anticoagulation management strategies were classified as suspended warfarin (SW), continued warfarin (CW), and a heparin bridge with suspended warfarin (HB). Periprocedural outcomes were analyzed. RESULTS: There were 87 patients on chronic anticoagulation with warfarin who underwent 175 fistulograms. Median age was 63 years, and 43.4% were women. Indications for warfarin included atrial fibrillation (53%), prior pulmonary embolism/deep vein thrombosis (29%), and hypercoagulable state (14%). Distribution was SW (60%), CW (26%), and HB (14%). Approximately half (53%) were same-day procedures, 30% occurred during access-related admissions, and 14% were performed during nonaccess-related admissions. Common indications for a fistulogram included difficulty with dialysis (63.4%), access thrombosis (20.6%), and poor maturation (10.3%). Interventions included angioplasty (82.9%), thrombectomy/embolectomy (20.6%), and stenting (8.6%). Thirty-day outcomes for SW versus CW versus HB were similar for bleeding complications (5.7%, 6.5%, 8.3%; P = 0.89), systemic thrombotic complications (3.8%, 2.2%, 0%; P = 0.569), access rethrombosis (7.6%, 13%, 12.5%; P = 0.517), and tunneled dialysis catheter placement (11.4%, 13%, 12.5%; P = 0.958). After excluding procedures performed during a nonaccess-related admission, length of stay (LOS) was highest among HB (9.6 ± 7.8 days) compared with SW (2.6 ± 5.9 days) and CW (1 ± 2.8 days), (P < 0.0001). CONCLUSIONS: CW therapy in patients undergoing fistulograms was not associated with increased morbidity and was associated with shorter LOS. Bridging with heparin is not associated with improved outcomes, warranting a thorough consideration of continuing warfarin is safe and may streamline preservation of dialysis accesses without significantly increasing resource utilization.

Aportes de Medicina Familiar en el desarrollo de las competencias profesionales de la carrera de Medicina de la Facultad de Ciencias Médicas de la Universidad Nacional de Córdoba / Contributions of Family Medicine in the development of professional competences of the medical career of the Faculty of Medicine of the National University of Córdoba

Medicina Familiar constituye un espacio de integración curricular en la Práctica Final de Medicina de la Universidad Nacional de Córdoba. Objetivo: identificar aportes de la asignatura para adquisición de competencias según resolución CONEAU N° 1314. Material y método: Estudio descriptivo cualicuantitativo, transversal. Período 2016 ­ 2017. Encuesta de autoevaluación y test de observación directa al inicio y al final del cursado. Se realizó análisis de contenido. Resultados: Autoevaluación inicial y final: competencias de alto impacto (investigación de la dolencia, búsqueda de opinión y acuerdo en tratamientos, investigación contexto). Competencias de bajo impacto (identificación motivo de consulta, explicación al paciente que se lo va a examinar, uso racional de métodos complementarios). Análisis cualitativo competencia "Búsqueda de acuerdo y consenso", categorías: explicar el problema, diagnóstico, alternativas de tratamiento; consultar comprensión del problema, dudas, preferencias. Competencia "Investigación contexto social, categorías: estructura familiar; condiciones laborales; contexto. Evaluación competencias pre y pos cursado (observación directa): impacto intermedio, valoraciones satisfactorias sin modificaciones significativas pre y post. Comparación percepción de los alumnos/ nivel de desarrollo de competencias: mayor divergencia ("organización de entrevista", "claridad para realizar examen físico", "precisión para definir los problemas", "selección de tratamientos según efectividad"). Conclusión: se logró el afianzamiento de competencias relacionadas con la entrevista y el abordaje integral (AU)

Family medicine constitutes a space of curricular integration in the final practice of the career of medicine of the National University of Córdoba.Objectives: to identify the contributions of the subject in the acquirement of competence according to CONEAU ́s resolution N° 1314.Material and methods: transversal descriptive cuali-cuantitative study. During the period of the years 2016-2017. Self-evaluation survey and a direct observation test in the begging and the end of the classes. Analysis of the data: SPSS statistics and analysis of the content.Results: Initial and final self- evaluation: High impact competences (inquiry of the disease, search for opinions and agreements about the treatments, investigation of the social and family context and support network). Low impact competences (identifying reason of the consultation, explaining to the patient that they were going to be examined, rational use of complementary methods). Qualitative competence analysis "Search for agreements and consensus", categories: to explain the problem, diagnosis, treatment alternatives; consultation about (consult of) the comprehension of the problem, doubts and preferences. Competence "Investigation of the social context", categories: family structure, working conditions, neighborhood context, family relationships. Evaluation of the competences pre and post taking classes (direct observation): intermediate impact: satisfactory evaluations without significant modification pre and post. Student perception and level of competence development comparison: grater divergence (" organization of the interview", "clarity to do a physical exam", "precision to define problems", "chose of treatments according to effectiveness"). Conclusion: Family medicine managed to secure professional ́s competences related to clinical interview and integral approach of the person (AU)

MAP1203 Promotes Mycobacterium avium Subspecies paratuberculosis Binding and Invasion to Bovine Epithelial Cells.

Mycobacterium avium subspecies paratuberculosis (MAP) is the causative agent of Johne's disease, chronic and ultimately fatal enteritis that affects ruminant populations worldwide. One mode of MAP transmission is oral when young animals ingest bacteria from the collostrum and milk of infected dams. The exposure to raw milk has a dramatic impact on MAP, resulting in a more invasive and virulent phenotype. The MAP1203 gene is upregulated over 28-fold after exposure of the bacterium to milk. In this study, the role of MAP1203 in binding and invasion of the bovine epithelial cells was investigated. By over-expressing the native MAP1203 gene and two clones of deletion mutant in the signal sequence and of missense mutations changing the integrin domain from RGD into RDE, we demonstrate that MAP1203 plays a role in increasing binding in more than 50% and invasion in 35% of bovine MDBK epithelial cells during early phase of infection. Furthermore, results obtained suggest that MAP1203 is a surface-exposed protein in MAP and the signal sequence is required for processing and expression of functional protein on the surface of the bacterium. Using the protein pull-down assay and far-Western blot, we also demonstrate that MAP1203 interacts with the host dihydropyrimidinase-related protein 2 and glyceraldehyde 3-phosphate dehydrogenase proteins, located on the membrane of epithelial cell and involved in the remodeling of the cytoskeleton. Our data suggests that MAP1203 plays a significant role in the initiation of MAP infection of the bovine epithelium.

Uso de almohadas de gel en recién nacidos de pretérmino se asocia a disminución de deformidad craneana / Using gel pillows in preterm infants is related to decreased cranial deformity

Introducción: la escafocefalia posicional, deformidad craneana típica del recién nacido prematuro, presumiblemente es debida a un inicio anticipado de presión sobre la calota, a un inadecuado control motor que determina un menor cambio de posición y un mayor tiempo de presión asimétrica sobre la calota. El descenso de la presión de puntos de apoyo asimétricos sobre el cráneo podría disminuir la escafocefalia. La superficie de gel puede bajar la presión localizada en el cráneo al disminuir la rigidez de la superficie de contacto. Los estudios existentes, escasos, no son concluyentes al respecto. Objetivo: Mostrar la relación entre el uso de almohadas de gel y la reducción de escafocefalia en recién nacidos de pretérmino. Método: Estudio longitudinal de pacientes prematuros hospitalizados en el servicios de neonatología de un hospital terciario, que utilizaron almohadas de gel por 5 semanas consecutivas, durante al menos el 90 por ciento del tiempo que permanecieron en decúbito. Se realizaron mediciones craneales, considerando el índice de deformidad craneana; la primera medición fue previo al uso de almohadas y luego semanalmente hasta completar 5 semanas. Resultados: 17 pacientes completaron las 5 semanas de protocolo. Edad promedio: 28,9 semanas de gestación (rango 28 a 34). Peso promedio: 1058 grs. (rango 720 a 2000). El índice de deformidad craneana varió desde 70,36 (DE 4,7) al inicio del estudio a 76,95 (DE 3,03) al término del estudio, con una diferencia significativa (p< 0,05). Conclusión: Este trabajo mostró una relación entre reducción del grado de escafocefalia, expresada en el IC, con el uso de almohadas de gel por un período de 5 semanas en RNPT.

Introduction: the positional scaphocephaly is the preterm infants’ typical cranial deformity. And probably is due to improper motor control, which determines minor change in position and longer asymmetric pressure on the skull. Decreasing the pressure of asymmetric support points on the skull, might decrease scaphocephaly. Gel’s surface may decrease localized pressure in the skull thus decreasing the stiffness of the contact surface. There are scarce reports about this issue and all are inconclusive. Objective: To show the relationship between the use of gel pillows and reduction of scaphocephaly in preterm infants. Method: Longitudinal study of preterm infants hospitalized in neonatology service of a tertiary hospital. They used gel pillows for 5 consecutive weeks, for at least 90 percent of the time in prone position. Cranial measurements were performed, considering the index of cranial deformity, the first measurement before to the use of pillows and then weekly until 5 weeks. Results: 17 patients completed the 5-week protocol. Average age 28.9 weeks of gestation (range 28-34), average weight 1058 g. (range 720-2000). The index of cranial deformity ranged from 70.36 (SD 4.7) at baseline to 76.95 (3.03) at the end of the study with a significant difference (p <0.05). Conclusions This study showed a relationship between the degree of reduction of scaphocephaly expressed in the IC, using gel pillows for a period of 5 weeks in preterm infants.

Injected phage-displayed-VP28 vaccine reduces shrimp Litopenaeus vannamei mortality by white spot syndrome virus infection.

White spot syndrome virus (WSSV) is the most important viral pathogen for the global shrimp industry causing mass mortalities with huge economic losses. Recombinant phages are capable of expressing foreign peptides on viral coat surface and act as antigenic peptide carriers bearing a phage-displayed vaccine. In this study, the full-length VP28 protein of WSSV, widely known as potential vaccine against infection in shrimp, was successfully cloned and expressed on M13 filamentous phage. The functionality and efficacy of this vaccine immunogen was demonstrated through immunoassay and in vivo challenge studies. In ELISA assay phage-displayed VP28 was bind to Litopenaeus vannamei immobilized hemocyte in contrast to wild-type M13 phage. Shrimps were injected with 2 × 10(10) cfu animal(-1) single dose of VP28-M13 and M13 once and 48 h later intramuscularly challenged with WSSV to test the efficacy of the vaccine against the infection. All dead challenged shrimps were PCR WSSV-positive. The accumulative mortality of the vaccinated and challenged shrimp groups was significantly lower (36.67%) than the unvaccinated group (66.67%). Individual phenoloxidase and superoxide dismutase activity was assayed on 8 and 48 h post-vaccination. No significant difference was found in those immunological parameters among groups at any sampled time evaluated. For the first time, phage display technology was used to express a recombinant vaccine for shrimp. The highest percentage of relative survival in vaccinated shrimp (RPS = 44.99%) suggest that the recombinant phage can be used successfully to display and deliver VP28 for farmed marine crustaceans.

First Report of Root Rot and Twigs Wilting of Olive Trees in Argentina Caused by Phytophthora nicotianae.

In Argentina, olives (Olea europaea) are planted on approximately 90,000 ha located primarily in the northwest continental regions. During a 2005 survey, root rot was recorded at several olive plantations in Catamarca, La Rioja, and San Juan provinces (3). Aboveground symptoms associated with root rot were twigs wilting with or without chlorosis, defoliation, and death. Symptoms were initiated on lateral branches and sometimes affected the entire crown. Even if young (5-year-old) trees displayed root rot, aerial symptoms may or may not be seen until years later. Disease incidence varied from 3 to 30%. Rotted rootlets were associated mainly with the infection of Phytophthora palmivora Butler and less frequently with another Phytophthora species. Isolates of this species were heterothallic, had a fluffy growth on carrot agar, and arachnoid growth on potato dextrose agar. Chlamydospores approximately 36 µm in diameter were also produced. The species developed prominent, papillate, noncaducous sporangia of different shapes ranging from ellipsoid to spherical when submerged in saline solution. Sporangia were 35 to 57 × 25 to 45 µm (average 44 × 33 µm), L:B ratio from 1.1 to 1.7. Isolates formed oogonia and amphyginous antheridia following mating type assays. On the basis of morphological features, these isolates were identified as P. nicotianae Breda de Haan. Identity was confirmed by sequencing the rDNA internal transcribed spacer (GenBank Accession No. FJ746693) (1). One-year-old O. europea seedlings were challenged with P. nicotianae (A1 isolates 306G and 339) through soil infestation assay in a growth chamber at 25°C. Infested and uninfested autoclaved millet grains moistened with V8 juice were used to inoculate 15 olive seedlings per isolate and controls, respectively. Fifty days after inoculation, seedlings showed foliar symptoms similar to those observed in the field and had an average of 50% reduction in the root system. Control plants remained healthy. P. nicotianae was always reisolated from symptomatic roots. P. nicotianae was reported on Citrus aurantium in Argentina in 1947 and is currently associated with several hosts (2). In 2002, the same species was reported associated with olive root rot in southern Italy (4). It is possible that P. nicotianae was recently introduced into Argentina through importation of Mediterranean olive varieties. The demonstrated pathogenicity of P. nicotianae on olive together with the recently reported detection of P. palmivora (3) presents a serious threat to olive cultivation in Argentina. References: (1) D. E. L. Cooke et al. Fungal Genet. Biol. 30:17, 2000. (2) M. J. Frezzi. Rev. Investig. Agric. 4:47, 1950. (3) G. Lucero et al. Plant Pathol. 56:728, 2007. (4) F. Nigro and A. Ippolito. Acta Hortic. 586:777, 2002.

Alternatively Spliced Genes as Biomarkers for Schizophrenia, Bipolar Disorder and Psychosis: A Blood-Based Spliceome-Profiling Exploratory Study.

OBJECTIVE: Transcriptomic biomarkers of psychiatric diseases obtained from a query of peripheral tissues that are clinically accessible (e.g., blood cells instead of post-mortem brain tissue) have substantial practical appeal to discern the molecular subtypes of common complex diseases such as major psychosis. To this end, spliceome-profiling is a new methodological approach that has considerable conceptual relevance for discovery and clinical translation of novel biomarkers for psychiatric illnesses. Advances in microarray technology now allow for improved sensitivity in measuring the transcriptome while simultaneously querying the "exome" (all exons) and "spliceome" (all alternatively spliced variants). The present study aimed to evaluate the feasibility of spliceome-profiling to discern transcriptomic biomarkers of psychosis. METHODS: We measured exome and spliceome expression in peripheral blood mononuclear cells from 13 schizophrenia patients, nine bipolar disorder patients, and eight healthy control subjects. Each diagnostic group was compared to each other, and the combined group of bipolar disorder and schizophrenia patients was also compared to the control group. Furthermore, we compared subjects with a history of psychosis to subjects without such history. RESULTS: After applying Bonferroni corrections for the 21,866 full-length gene transcripts analyzed, we found significant interactions between diagnostic group and exon identity, consistent with group differences in rates or types of alternative splicing. Relative to the control group, 18 genes in the bipolar disorder group, eight genes in the schizophrenia group, and 15 genes in the combined bipolar disorder and schizophrenia group appeared differentially spliced. Importantly, thirty-three genes showed differential splicing patterns between the bipolar disorder and schizophrenia groups. More frequent exon inclusion and/or over-expression was observed in psychosis. Finally, these observations are reconciled with an analysis of the ontologies, the pathways and the protein domains significantly over-represented among the alternatively spliced genes, several of which support prior discoveries. CONCLUSIONS: To our knowledge, this is the first blood-based spliceome-profiling study of schizophrenia and bipolar disorder to be reported. The battery of alternatively spliced genes and exons identified in this discovery-oriented exploratory study, if replicated, may have potential utility to discern the molecular subtypes of psychosis. Spliceome-profiling, as a new methodological approach in transcriptomics, warrants further work to evaluate its utility in personalized medicine. Potentially, this approach could also permit the future development of tissue-sampling methodologies in a form that is more acceptable to patients and thereby allow monitoring of dynamic and time-dependent plasticity in disease severity and response to therapeutic interventions in clinical psychiatry.

Nodal T cell blast crisis in chronic myeloid leukemia.

We report the case of a 54 year old male with an original diagnosis of chronic myeloid leukemia (CML) who developed a nodal T cell blast crisis (BC) while he was in a complete hematological remission (CR). We describe the clinical presentation and the histological, immunophenotypic and molecular characterization of the lymph node blast cells. Our case, together with other rare similar reports in the literature, argue that a T cell nodal blast crisis of CML resembles the presentation of a T-cell non-Hodgkin's lymphoma.

The hepatitis B virus posttranscriptional regulatory element is composed of two subelements.

The RNAs of the hepatitis B virus (HBV) contain a cis-acting regulatory element which facilitates the cytoplasmic localization of unspliced transcripts (J. Huang and T. J. Liang, Mol. Cell. Biol. 13:7476-7486, 1993, and Z. M. Huang and T. S. Yen, J. Virl. 68:3193-3199, 1994). Such localization is presumed to be mediated by cellular factors which interact with the element. The HBV posttranscriptional regulatory element (HBVPRE) can efficiently activate an RNA export reporter system in an orientation-dependent and position-independent manner. Deletion analysis reveals that the HBVPRE consists of two subelements which function synergistically. A synergistic effect was also observed when the 5' (PREalpha) or 3' (PREbeta) subelements were duplicated. The bipartite structure of the HBVPRE is reminiscent of reports that the high-affinity binding sites of the Rev-like proteins must be duplicated to function efficiently (M. Grone, E. Hoffmann, S. Berchtold, B.R. Cullen, and R. Grassmann, Virology 204:144-152, 1994; X. Huang, T.J. Hope, B.L. Bond, D. McDonald, K. Grahl, and T. G. Parslow, J. Virol. 65:2131-2134, 1991; and D. McDonald, T. J. Hope, and T. G. Parslow, J. Virol. 66:7232-7238, 1992).