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The gold-standard treatment for Parkinson's disease is levodopa (L-DOPA), which is taken orally and absorbed intestinally. L-DOPA must reach the brain intact to exert its clinical effect; peripheral metabolism by host and microbial enzymes is a clinical management issue. The gut microbiota is altered in PD, with one consistent and unexplained observation being an increase in Bifidobacterium abundance among patients. Recently, certain Bifidobacterium species were shown to have the ability to metabolize L-tyrosine, an L-DOPA structural analog. Using both clinical cohort data and in vitro experimentation, we investigated the potential for commensal Bifidobacteria to metabolize this drug. In PD patients, Bifidobacterium abundance was positively correlated with L-DOPA dose and negatively with serum tyrosine concentration. In vitro experiments revealed that certain species, including B. bifidum, B. breve, and B. longum, were able to metabolize this drug via deamination followed by reduction to the compound 3,4-dihydroxyphenyl lactic acid (DHPLA) using existing tyrosine-metabolising genes. DHPLA appears to be a waste product generated during regeneration of NAD +. This metabolism occurs at low levels in rich medium, but is significantly upregulated in nutrient-limited minimal medium. Discovery of this novel metabolism of L-DOPA to DHPLA by a common commensal may help inform medication management in PD.
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Bifidobacterium bifidum , Enfermedad de Parkinson , Humanos , Levodopa , Bifidobacterium/metabolismo , Bifidobacterium bifidum/metabolismoRESUMEN
BACKGROUND: Large-scale preclinical Alzheimer's disease study based on ß-amyloid positron emission tomography (PET) has not been conducted in China. OBJECTIVES: Establish a cohort on Alzheimer's disease spectrum, especially the preclinical stages, and determine the factors influencing the acceptance of ß-amyloid PET scan screening in China. DESIGN: Longitudinal. SETTING: Shanghai, China. PARTICIPANTS: A total of 4386 participants were screened and 2451 participants who met enrollment criteria were eventually included in this report. MEASUREMENTS: The multidimensional data was collected, including comprehensive assessments, PET and magnetic resonance imaging scans, genetics, and plasma biomarkers. RESULTS: There were 571 participants in the normal cognition group, 625 participants in the subjective cognitive decline group, 155 participants in the objectively defined subtle cognitive decline group, 501 participants in the mild cognitive impairment group, 471 participants in Alzheimer's disease group, and 128 participants with cognitive impairment from other known causes. Significant differences in demographics, florbetapir PET, APOE, and neuropsychological tests were found among the groups. Eight hundred and seventeen participants (33.3%) completed the florbetapir PET scanning. Non-demented individuals with higher age, lower education years, male, with a family history of dementia, and higher self-report depression prefer to undergo PET scans. Acceptance of PET scans did not correlate with objectively assessed cognitive impairment. CONCLUSIONS: The Chinese Preclinical Alzheimer's Disease Study was designed to establish a large-scale cohort with comprehensive data collection. Our findings may help to understand the factors affecting the acceptance of ß-amyloid PET in urban areas of China and help us address the low acceptance challenge.
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Enfermedad de Alzheimer , Péptidos beta-Amiloides , Tomografía de Emisión de Positrones , Humanos , Masculino , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/diagnóstico por imagen , Apolipoproteínas E , China , Pueblos del Este de Asia , Tomografía de Emisión de Positrones/métodosRESUMEN
Background/Aim: NovoSorbâ Biodegradable Temporizing Matrix (BTM) is a relatively novel, biodegradable polyurethane-based dermal regeneration template. The aim of this study was to evaluate the long-term scarring outcomes and safety of BTM in patients who underwent dermal reconstruction involving ≥5% of the total body surface area. Methods: This was a postmarket, multicenter, observational cohort study involving evaluation of long-term outcomes in patients treated with BTM. A total of 55 patients (35 from Royal Adelaide Hospital, South Australia, and 20 from Victoria Adult Burns Service, The Alfred, Victoria) who underwent dermal repair with BTM between 2011 and 2017 were screened for inclusion in this study. All patients had BTM implanted for ≥18 months. Results: Fifteen eligible patients with a mean (SD) age of 49.1 (14.3) years completed study assessments. These patients had a total of 39 areas treated with BTM. Using the Patient and Observer Scar Assessment Scale, scar quality was reported to be good by both observers and patients, with a mean (SD) observer score across all lesions of 3.6 (1.2) and mean (SD) overall opinion of 3.8 (1.2) as well as a mean (SD) patient score of 3.5 (1.2) and overall opinion of 5.0 (2.2). No adverse events or adverse device effects were reported or identified. Conclusion: The long-term scar quality is comparable to published studies. BTM is safe in the long term with no additional risks or adverse consequences being identified.
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Objective: This study is an exploration of the major stressors associated with the COVID-19 for students in higher education in Taiwan. Participants: The sample comprised 838 higher education students studying at various Taiwanese universities. Methods: A cross-sectional online survey was administered at different postsecondary institutions during the semi-lockdown period of COVID-19, which mandated online instruction. Machine learning was employed to determine the variables that most highly predicted students' mental health using R. Results: The findings revealed that COVID-19-related experiences, including social interactions, financial conditions, and educational experiences, were significantly associated with mental health outcomes. Particularly, loneliness are significantly related to social interactions and educational experiences. Conclusions: Findings revealed that Covid-19 impacted Taiwanese students' financial conditions, educational experiences, and social interactions, which were significant predictors of their mental health outcomes such as anxiety, loneliness and depression. The current study contributes to the gap in knowledge about mental health issues among postsecondary students during the pandemic.
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This study was an investigation of the relationship between past and present learning experiences of first-year college students and of how the psychological capital and academic self-efficacy they had accrued from past learning experiences were correlated with their current learning engagement. Longitudinal data were collected to examine how students' learning experiences in high school impacted their learning in college. Structural equation modeling (SEM) and bootstrapping techniques were employed in data analysis. Results indicated that psychological capital and academic self-efficacy functioned as mediators between students' past learning experience and present learning engagement. Overall, the findings highlight the importance of these two psychological constructs and suggest that postsecondary institutions should provide learning environments that support these factors to ensure student success.
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Aprendizaje , Autoeficacia , Humanos , Universidades , Estudiantes/psicología , Instituciones AcadémicasRESUMEN
â¢Omicron variant continues to progress in Senegal with the appearance of new contaminations.â¢IRESSEF detected the first positive case of the Omicron variant on Friday, December 3, 2021.â¢Since this date, the number of Omicron variant infections has increased over the weeks.â¢Molecular surveillance of the Omicron variant is carried out in real time to inform the medical authorities.
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Intimate partner violence (IPV) against pregnant women is a global public health problem. Yet, the trajectory of IPV during pregnancy and its association with health are unclear. This study set out to investigate the trajectory of IPV by categorizing pregnant women according to changes of IPV exposure before, during, and after pregnancy and to examine the predictive factors of these IPV-related categories. During 2016 and 2017, we conducted a longitudinal study with a sample of 1,083 pregnant women in Hong Kong. Pregnant women reported their IPV experiences, depression, and demographics in the baseline survey (at about 24-week gestation), and their IPV experiences, mental health outcomes, social support, and perceived father's involvement in the follow-up survey (around 4 weeks postpartum). We categorized pregnant women into four groups, including women with (a) sustaining abusive relationship (AR); (b) relationship with decreased violence over pregnancy (DVR); (c) relationship with stress-related violence (SVR); and (d) nonviolent relationship (NVR). Although we found an overall decline of IPV during pregnancy from 24.6% to 14.3%, there were still a considerable proportion of women reporting as a victim of IPV. We observed that a higher proportion of pregnant women were actually suffering from IPV during pregnancy and after childbirth continuously (22.3% of AR and SVR) than experiencing a termination of IPV due to pregnancy (11.4% of DVR). We also observed that more severe maternal depression, lower levels of father's involvement, and poorer social support were significantly associated with the categories that reflected greater severity of IPV over the course of pregnancy. Our findings reflected that the complexity of IPV related to pregnancy should never be overlooked. Mere reporting of prevalence in an aggregate might not sufficiently explain the problem. Father's involvement and social support are two important factors that might help reduce IPV related to pregnancy and childbirth.
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Violencia de Pareja , Mujeres Embarazadas , Formación de Concepto , Femenino , Humanos , Violencia de Pareja/psicología , Estudios Longitudinales , Embarazo , Mujeres Embarazadas/psicología , ViolenciaRESUMEN
OBJECTIVE: To study the impact of LT experience on the outcome of CLR for locally advanced hepatobiliary malignancy. SUMMARY OF BACKGROUND DATA: Despite evolution in LT knowledge and surgical techniques in the past decades, there is yet data to evaluate the significance of LT experience in performing CLR. METHODS: Postoperative outcome after CLR between 1995 and 2019 were reviewed and correlated with LT experience in a single center with both LT and CLR service. CLR was defined as hepatectomy with vasculobiliary reconstruction, or multivisceral resection, central bisectionectomy (S4/5/8), or associating liver partition and portal vein ligation for staged hepatectomy. Spearman rank correlation and receiver operating characteristic analysis were used to define the association between CLR-related outcomes and LT experience. RESULTS: With cumulative single-center experience of 1452 LT, 222 CLR were performed during the study period [hepatectomy with biliary (27.0%), or vascular (21.2%) reconstruction, with multivisceral resections (9.9%), with associating liver partition and portal vein ligation for staged hepatectomy (18.5%)] mainly for hepatocellular carcinoma (53.2%), and hilar cholangiocarcinoma (14%). Median tumor size was 7.0âcm. Other features include macrovascular invasion (23.4%), and juxta-visceral invasion (14%). Major postoperative complication rate was 25.2% and mortality rate was 6.3%. CLR-complication rate was inversely associated with LT experience (R = -0.88, P < 0.005). Receiver operator characteristic analysis revealed the cutoff for LT experience to have the greatest influence on CLR was 95 with a sensitivity of 100% and Youden index of 1. Multivariable analysis showed that blood transfusion, prolonged operating time, LT experience < /=95 were associated with major postoperative complications. CONCLUSION: LT experience was complimentary to CLR for locally advanced hepatobiliary malignancy with improved postoperative outcome.
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Neoplasias de los Conductos Biliares , Neoplasias Hepáticas , Trasplante de Hígado , Neoplasias Primarias Secundarias , Hepatectomía/métodos , Humanos , Ligadura/efectos adversos , Trasplante de Hígado/efectos adversos , Neoplasias Primarias Secundarias/patología , Vena Porta/patología , Vena Porta/cirugía , Complicaciones Posoperatorias/etiología , Resultado del TratamientoRESUMEN
INTRODUCTION: An emerging amount of literature emphasises the ever-growing shortage of burn surgeons worldwide. Despite burn surgery being a fundamental competency in the Australia and New Zealand plastic and reconstructive surgery training curriculum, a perceived lack of interest amongst trainees exists. The aim of this study was to investigate Australasian plastic surgery trainees' interest in burn surgery as a career and compare with the Brown and Mills survey in 2004. METHODS: An electronic survey was distributed to all Australian and New Zealand plastic and reconstructive surgery trainees during the March 2021 registrar trainee conference. This anonymous survey was adapted from the original survey conducted by Brown and Mills in 2004, with additional questions to determine the perceived importance of burns surgery as a subspecialty of plastic and reconstructive surgery, and to elicit possible solutions to the issue of workforce shortage. A reminder email was sent one month following the conference to improve the response rate. The survey was hosted by Survey Monkey (San Mateo, California, USA). RESULTS: The survey was distributed to all 121 trainees and 71 (58.7%) responded. An increase in interest amongst trainees in pursuing a career in burn surgery was found, with 34 trainees (48.6% of respondents) interested, mostly on a half time or sessional basis. The three most common barriers to practising burn surgery remain unchanged, and were nature of burn operations, nature of burn care and on-call commitments; inadequacy of exposure or training ranked fourth. We found a strong overall response that burn surgery and burn care remained an important component of plastic and reconstructive surgery. DISCUSSION: Inadequate exposure or training has evolved to present a bigger barrier in this study compared to a similar study conducted 17 years ago. Burn units and training bodies may offer additional job placements to address these feelings of insufficient exposure. Facilitating employment of burn surgeons on a half-time or sessional capacity is a sustainable model, and will arguably improve clinical service provision. Strong and early mentorship and allocation of commensurate resources and funding will help to address the high workload. CONCLUSIONS: Interest in burn surgery has improved over the last 17 years and the most common deterrents persist, namely nature of burn operations, nature of burn care and on-call commitments. However, many of these issues are modifiable or amenable to change. The opportunity exists for relevant stakeholders to address some of these concerns raised, and thereby addressing the issue of burn surgeon shortage.
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Quemaduras , Procedimientos de Cirugía Plástica , Cirujanos , Cirugía Plástica , Australia , Quemaduras/cirugía , Humanos , Nueva Zelanda , Cirugía Plástica/educación , Encuestas y CuestionariosRESUMEN
PURPOSE: With evolving evidence around the progression, assessment, and management of autosomal dominant polycystic kidney disease (ADPKD), care of the disease has become increasingly complex. Needs assessments in British Columbia (BC) described variability in knowledge and comfort with incorporating these new aspects of ADPKD care into clinical practice. Undercapture of early-stage ADPKD patients in existing renal databases was also identified as an unmet need. SOURCES OF INFORMATION: A multidisciplinary group of clinicians and patient partners with interest and expertise in ADPKD and/or multidisciplinary kidney care informed the project work. An existing provincial renal database was used to support the provincial ADPKD registry. METHODS: A formalized, comprehensive provincial ADPKD Network was created within the existing infrastructure of multidisciplinary kidney clinics (MDCs) in BC. The Network is coordinated provincially and implemented locally. It incorporates robust data collection, education, creation, and dissemination of dedicated clinical tools; collaboration between clinics and clinicians across the province; and ongoing evaluation and continuous quality improvement. KEY FINDINGS: Over the 5 years since its inception, the BC ADPKD Network has enabled increased and earlier identification of British Columbians living with ADPKD and a shift in practice toward increased and earlier enrollment of ADPKD patients into MDCs. A host of tailored ADPKD clinical tools have been created and implemented in all MDCs across the province to support existing MDC staff in the delivery of more standardized and specialized ADPKD care. A collaborative provincial clinician network founded on Local Clinical Champions has been established to support ongoing experience sharing between clinics. An evaluation framework has been established to evaluate outcomes and enable ongoing refinement of the Network. LIMITATIONS: The provincial ADPKD registry is undergoing enhancements to enable more comprehensive capture of APDKD-specific information such as total kidney volume and genetic results, but at present, this remains a limitation. It remains to be seen whether the activities of the ADPKD Network will improve long-term clinical outcomes and care experiences of patients living with ADPKD, and a long-term sustainability assessment of this model of care will be required. IMPLICATIONS: The structure, tools, and coordinated and collaborative clinician network established through this comprehensive provincial ADPKD Network may be valuable in addressing the variability and gaps in existing ADPKD care while allowing patients and families across BC to receive enhanced care locally, in their usual kidney care environments.
JUSTIFICATION: L'évolution des données entourant la progression, l'évaluation et la prise en charge de la polykystose autosomique dominante (ADPKD) complexifie de plus en plus son traitement. En Colombie-Britannique (C.-B.), une évaluation des besoins a décrit la variabilité des connaissances et le niveau de confort quant à l'intégration de ces nouveaux aspects des soins pour l'ADPKD dans la pratique clinique. La capture des patients atteints d'ADPKD à un stade précoce dans les bases de données rénales existantes a également été reconnue comme un besoin non satisfait. SOURCES: Les travaux ont été orientés par un groupe multidisciplinaire de cliniciens et de patients partenaires possédant une expertise dans le domaine de l'ADPKD ou dans les soins rénaux multidisciplinaires. Une base de données provinciale existante sur les maladies rénales a été utilisée en appui au registre provincial de l'ADPKD. MÉTHODOLOGIE: Un réseau provincial complet et structuré pour l'ADPKD a été créé au sein de l'infrastructure existante des cliniques rénales multidisciplinaires (CRM) de la Colombie-Britannique. Le réseau est coordonné à l'échelle provinciale et mis en Åuvre localement. Le réseau englobe une collecte rigoureuse des données, de l'éducation, la création et la diffusion d'outils cliniques dédiés, la collaboration entre les cliniques et les cliniciens de toute la province, de même que l'évaluation et l'amélioration continues de la qualité. PRINCIPAUX RÉSULTATS: Au cours des cinq années qui ont suivi sa création, le réseau ADPKD de la C.-B. a permis d'identifier en plus grand nombre et plus précocement les Britanno-Colombiens vivant avec l'ADPKD. On a également pu observer un virage dans la pratique vers une plus vaste et une plus précoce inclusion des patients atteints d'ADPKD dans les CRM. De plus, une foule d'outils cliniques sur mesure ont été créés et mis en Åuvre dans tous les CRM de la province afin d'appuyer le personnel des CRM existantes dans la prestation de soins normalisés et plus spécialisés pour l'ADPKD. Un réseau coopératif provincial de cliniciens, fondé sur les champions cliniques locaux, a été créé pour favoriser le partage continu de l'expérience entre les cliniques. Enfin, un cadre d'évaluation a été établi pour examiner les résultats et permettre l'amélioration continue du réseau. LIMITES: Le registre provincial de l'ADPKD fait présentement l'objet d'améliorations qui permettront une saisie plus complète de l'information spécifique à l'APDKD, notamment le volume rénal total et les résultats génétiques, mais à l'heure actuelle, ceci demeure une limite. Reste à voir si les activités du réseau ADPKD permettront d'améliorer les résultats cliniques à long terme et les expériences de soins des patients vivant avec l'ADPKD. Une évaluation à long terme de la durabilité de ce modèle de soins sera nécessaire. CONCLUSION: La structure, les outils et le réseau coordonné et collaboratif de cliniciens mis en place par le biais de ce réseau provincial sur l'APDKD peuvent être utiles pour rendre compte de la variabilité et combler les lacunes des soins existantes, tout en permettant aux patients et aux familles de la Colombie-Britannique de recevoir localement de meilleurs soins, soit dans leur milieu de soins rénaux habituel.
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A moderately halophilic and strictly aerobic bacterium was isolated from a human stool as part of a study on the diagnosis of childhood malnutrition in Mali. Strain Marseille-Q1616T is a Gram-stain-positive, rod-shaped, catalase-positive and oxidase-negative bacterium. It has a genome size of 3.91 Mbp with 39.79% G+C content, which contains 3954 protein-coding genes including genes encoding phosphomycin resistance and Listeria monocytogenes, 16 rRNA genes and 64 tRNA genes. Strain Marseille-Q1616T exhibited a 96.3% 16S rRNA gene sequence similarity and shared an OrthoANI value of 70.64% (the highest observed) with Virgibacillus kekensis, the phylogenetically closest validly published species. Based on phenotypic and phylogenetic evidence and genomic average nucleotide identity values, we suggest the creation of a new species within the Virgibacillus genus, named Virgibacillus doumboii sp. nov., type strain Marseille-Q1616T (= CSURQ1616).
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Using a culturomics approach, a strain was isolated, identified and characterised following the taxonogenomics concept. Neobacillus massiliamazoniensis sp. nov., strain LF1T (=CSURP1359) was isolated from human stool. The 16S rRNA gene sequence analysis of strain LF1T (accession number: LK021124) exhibits 98.32% similarity levels with Neobacillus bataviensis strain IDA1115 (accession number: NR_036766.1), the phylogenetically closest related species with standing in nomenclature. The draft genome size of strain LF1T (accession number: CVRB00000000) is 4.6 Mbp with a G+C content of 34.1 mol%. Analysis of phylogenic tree, genomic analysis and phenotypic criteria described here sufficiently prove that this bacterium is different from previously known bacterial species with standing in nomenclature and represents a new Neobacillus species belonging to Firmicutes phylum.
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Using the culturomics method, two strains were isolated, identified, and characterised following the taxonogenomics concept. Bacillus marasmi sp. nov. strain Marseille-P3556 (= CSURP3556) is isolated from a 13-month-old girl living in Niger. The phylogenetic tree, phenotypic criteria, and genomic analysis described here clearly show that this bacterium is different from previously known bacterial species withstanding in nomenclature and new members of Bacillus genus.
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In this communication, based upon a squeezed-state trial wave function, we have performed a simple variational study of the spectral collapse in the anisotropic two-photon Rabi model. Our analysis indicates that the light-matter interaction and the spin-flipping (together with the anisotropy) effectively constitute two competing impacts upon the radiation mode. Whilst the former tries to decrease the radiation mode frequency, the latter may counteract or reinforce it. The light-matter interaction appears to dominate the frequency modulation as its coupling strengths go beyond the critical values, leading to the emergence of the spectral collapse. However, at the critical couplings the dominance of the light-matter interaction is not complete, and incomplete spectral collapse appears. Accordingly, at the critical couplings the eigenenergy spectrum comprises both a set of discrete energy levels and a continuous energy spectrum. The discrete eigenenergy spectrum can be derived via a simple one-to-one mapping to the bound state problem of a particle of variable effective mass in a finite potential well, and the number of bound states available is determined by the energy difference between the two atomic levels. Each of these eigenenergies has a twofold degeneracy corresponding to the spin degree of freedom.
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In this communication, based upon a squeezed-state trial wave function, we have performed a simple variational study of the spectral collapse of the two-photon Rabi model. Our analysis indicates that the light-matter interaction and the spin-flipping effectively constitute two competing impacts upon the radiation mode. Whilst the former tries to decrease the radiation mode frequency, the latter may counteract or reinforce it, contingent upon the state of the atomic system. The light-matter interaction appears to dominate the frequency modulation as its coupling strength goes beyond the critical value, leading to the emergence of the spectral collapse. However, at the critical coupling the dominance of the light-matter interaction is not complete, and incomplete spectral collapse appears. The extent of incomplete spectral collapse is found to depend upon the energy difference between the two atomic levels as well.
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Strain Marseille-P3248Ñ is a new species from the order Actinomycetales that was isolated from the urine sample of a girl aged 20 months with rotavirus gastroenteritis. It is a facultative anaerobic Gram-positive rod-shaped bacterium. Strain Marseille-P3248Ñ exhibits 94.73% sequence similarity with Arcanobacterium pluranimalium strain M430/94/2, a phylogenetically related species with standing in nomenclature. Its genome size is 1 667 964 bp with 49.1% G + C content. Strain Marseille-P3248Ñ (= CSURP3248) is the type strain of the new species Arcanobacterium urinimassiliense sp. nov.
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Quasi-periodic moiré patterns and their effect on electronic properties of twisted bilayer graphene have been intensely studied. At small twist angle θ, due to atomic reconstruction, the moiré superlattice morphs into a network of narrow domain walls separating micron-scale AB and BA stacking regions. We use scanning probe photocurrent imaging to resolve nanoscale variations of the Seebeck coefficient occurring at these domain walls. The observed features become enhanced in a range of mid-infrared frequencies where the hexagonal boron nitride substrate is optically hyperbolic. Our results illustrate the capabilities of the nano-photocurrent technique for probing nanoscale electronic inhomogeneities in two-dimensional materials.