Improving the management of open tibia fractures, Malawi

Objective To assess the impact of an open fracture intervention bundle on clinical management and patient outcomes of adults in Malawi with open tibia fractures. Methods We conducted a before-and-after implementation study in Malawi in 2021 and 2022 to assess the impact of an open fracture intervention bundle, including a national education course for clinical officers and management guidelines for open fractures. We recruited 287 patients with open tibia fractures. The primary outcome was a before-and-after comparison of the self-reported short musculoskeletal function assessment score, a measure of patient function. Secondary outcomes included clinical management; and clinician knowledge and implementation evaluation outcomes of 57 health-care providers attending the course. We also constructed multilevel regression models to investigate associations between clinical knowledge, patient function, and implementation evaluation before and after the intervention. Findings The median patient function score at 1 year was 6.8 (interquartile range, IQR: 1.5 to 14.5) before intervention and 8.4 (IQR: 3.8 to 23.2) after intervention. Compared with baseline scores, we found clinicians' open fracture knowledge scores improved 1 year after the intervention was implemented (mean posterior difference: 1.6, 95% highest density interval: 0.9 to 2.4). However, we found no difference in most aspects of clinicians' open fracture management practice. Conclusion Despite possible improvement in clinician knowledge and positive evaluation of the intervention implementation, our study showed that there was no overall improvement in clinical management, and weak evidence of worsening patient function 1 year after injury, after implementation of the open fracture intervention bundle.

New formulations of fermented milk drinks with fruit pulp added: Physicochemical characteristics during storage and nutritional profile

The aim of this study was to evaluate the nutritional profile and the physicochemical characteristics during storage of newly developed formulations of fermented milk drinks with added pineapple, mango and passion fruit pulp. The fermented drinks showed a high content of protein, iron, and calcium. The passion fruit milk drink had the lowest pH (4.13) and highest acidity (0.95%, expressed in % of lactic acid), which was significantly different (p<0.05) from the pineapple and mango drinks. As for syneresis and sedimentation, the pineapple milk drink had the highest rates at 14 days storage, with 34.33% and 6.50%, respectively and was significantly different (p≤0.05) when compared to the mango and passion fruit milk drinks. In conclusion, newly developed fermented milk drinks with added fruit pulp were a source of several nutrients. We observed physical-chemical characteristics suitable for a fermented milk product during storage.

El objetivo de este estudio fue el desarrollo de nuevas formulaciones de bebidas lácteas fermentadas adicionadas de piña, mango y maracuyá, para evaluar el perfil nutricional y las características fisicoquímicas durante el almacenamiento. Las bebidas fermentadas mostraron un alto contenido en proteínas, hierro y calcio. En cuanto a las características fisicoquímicas durante el almacenamiento, la bebida láctea de maracuyá presentó el pH más bajo (4,13) y la acidez más alta (0,95%, expresada en % de ácido láctico), con una diferencia significativa (p < 0,05), en comparación con las bebidas de piña y mango. En cuanto a sinéresis y sedimentación, la bebida láctea de piña presentó los mayores índices a los 14 días de almacenamiento, con 34,33% y 6,50%, respectivamente, y con diferencia significativa (p ≤ 0,05) al compararla con las bebidas lácteas de mango y maracuyá. En conclusión, las bebidas lácteas fermentadas con adición de pulpa de fruta son una fuente de varios nutrientes, y de características físico-químicas adecuadas para un producto lácteo fermentado durante el almacenamiento.

Glycosylation and charge distribution orchestrates the conformational ensembles of a biotechnologically promissory phytase in different pHs - a computational study.

Phytases [myo-inositol(1,2,3,4,5,6) hexakisphosphate phosphohydrolases] are phytate-specific phosphatases not present in monogastric animals. Nevertheless, they are an essential supplement to feeding such animals and for human special diets. It is crucial, hence, the biotechnological use of phytases with intrinsic stability and activity at the acid pHs from gastric environments. Here we use Metadynamics (METADY) simulations to probe the conformational space of the Aspergillus nidulans phytase and the differential effects of pH and glycosylation in this same space. The results suggest that strategic combinations of pH and glycosylation affect the stability of native-like conformations and alternate these structures from a metastable to a stable profile. Furthermore, the protein segments previously reported as more thermosensitive in phytases from this family present a pivotal role in the conformational changes at different conditions, especially H2, H5-7, L8, L10, L12, and L17. Also, the glycosylations and the pH-dependent charge balance modulate the mobility and interactions at these same regions, with consequences for the surface solvation and active site exposition. Finally, although the glycosylations have stabilized the native structure and improved the substrate docking at all the studied pHs, the data suggest a higher phytate receptivity at catalytic poses for the unglycosylated structure at pH 6.5 and the glycosylated one at pH 4.5. This behavior agrees with the exact change in optimum pH reported for this enzyme, expressed on low or high glycosylating systems. We hope the results and insights presented here will be helpful in future approaches for rational engineering of technologically promising phytases and intelligent planning of their heterologous expression systems and conditions for use.Communicated by Ramaswamy H. Sarma.

Biomarkers for immune checkpoint inhibitors in solid tumors.

The use of immune checkpoint inhibitors in solid organ malignancies has become widespread in the last decade. Accumulating evidence shows broad survival benefit as compared to traditional chemotherapies. At the same time, a need has emerged to stratify these drugs in various patient populations and histologies. Consequently, various immune biomarkers have been proposed to help in selecting patients for these therapies. Here, we review the evidence pertaining to biomarkers including programmed death-ligand 1, defective mismatch repair, tumor mutational burden, tumor-infiltrating lymphocytes, gene expression profiles, circulating blood cells, circulating DNA and the gut microbiome. The value of PD-L1 testing in certain malignancies, such as lung and urothelial cancer is highlighted as well as emerging data from trials such as GARNET and CheckMate142.

Metabolites in Conocarpus erectus leaves attenuate α-amylase activity by modulating amino acid residues of α-amylase: an in vitro and docking study / Los metabolitos en las hojas de Conocarpus erectus atenúan la actividad de la α-amilasa al modular los residuos de aminoácidos de la α-amilasa: un estudio in vitro y de acoplamiento

The antioxidant activity and the inhibitory potential of α-amylase of lyophilized hydroethanolic extracts of Conocarpus erectus leaves obtained by ultrasonication were determined. The most potent extract was subjected to ultra-high performance liquid chromatography system equipped with mass spectrometer for metabolite identification. The identified metabolites were docked in α-glucosidase to assess their binding mode. The results revealed that 60% ethanolic extract exhibited highest ferric reducing antioxidant power (4.08 ± 0.187 mg TE/g DE) and α-amylase inhibition (IC50 58.20 ± 1.25 µg/mL. The metabolites like ellagic acid, 3-O-methyl ellagic acid, ferujol, 5, 2 ́-dihydroxy-6,7,8-trimethyl flavone and kaempferol glucoside were identified in the extract and subjected to molecular docking studies regarding α-amylase inhibition. The comparison of binding affinities revealed 3-O-methyl ellagic acid as most effective inhibitor of α-amylase with binding energy of -14.5911 kcal/mol comparable to that of acarbose (-15.7815 kcal/mol). The secondary metabolites identified in the study may be extended further for functional food development with antidiabetic properties.

Se determinó la actividad antioxidante y el potencial inhibidor de la α-amilasa de extractos hidroetanólicos liofilizados de hojas de Conocarpus erectus obtenidos por ultrasónicación. El extracto más potente se sometió a un sistema de cromatografía líquida de ultra alto rendimiento equipado con un espectrómetro de masas para la identificación de metabolitos. Los metabolitos identificados se acoplaron en α-glucosidasa para evaluar su modo de unión. Los resultados revelaron que el extracto etanólico al 60% exhibió el mayor poder antioxidante reductor férrico (4.08 ± 0.187 mg TE/g DE) e inhibición de la α-amilasa (IC50 58.20 ± 1.25 µg/mL. Los metabolitos como el ácido elágico, 3-O-metil elágico ácido, ferujol, 5, 2 ́-dihidroxi-6,7,8-trimetil flavona y kaempferol glucósido se identificaron en el extracto y se sometieron a estudios de acoplamiento molecular con respecto a la inhibición de la α-amilasa. La comparación de las afinidades de unión reveló 3-O-metil El ácido elágico como inhibidor más eficaz de la α-amilasa con una energía de unión de -14,5911 kcal/mol comparable a la de la acarbosa (-15,7815 kcal/mol). Los metabolitos secundarios identificados en el estudio pueden ampliarse aún más para el desarrollo funcional de alimentos con propiedades antidiabéticas.

Soil contamination by Ancylostoma spp. and Toxocara spp. eggs in elementary school playgrounds in the extreme south of Brazil.

Millions of people worldwide, and especially schoolchildren, may be infected by geohelminths due to their exposure to a contaminated environment. The aim of this study was to evaluate soil contamination by Ancylostoma spp. and Toxocara spp. eggs in recreation areas at elementary schools in Pelotas, state of Rio Grande do Sul, Brazil. Sand samples were collected from 22 schools and were processed using the centrifugal flotation method. Helminth eggs with zoonotic potential were found in 12 out of the 22 schools (54.5%). Contamination by Ancylostoma spp. and Toxocara spp. was observed in 36.4% (8/22) and 27.3% (6/22) of the soil samples collected at these schools, respectively. These findings of eggs show that the school communities are exposed to risks of zoonotic transmission.

Soil contamination by Ancylostoma spp. and Toxocara spp. eggs in elementary school playgrounds in the extreme south of Brazil / Contaminação do solo de praças de recreação de escolas de ensino fundamental por ovos de Ancylostoma spp. e Toxocara spp. no extremo sul do Brasil

Abstract Millions of people worldwide, and especially schoolchildren, may be infected by geohelminths due to their exposure to a contaminated environment. The aim of this study was to evaluate soil contamination by Ancylostoma spp. and Toxocara spp. eggs in recreation areas at elementary schools in Pelotas, state of Rio Grande do Sul, Brazil. Sand samples were collected from 22 schools and were processed using the centrifugal flotation method. Helminth eggs with zoonotic potential were found in 12 out of the 22 schools (54.5%). Contamination by Ancylostoma spp. and Toxocara spp. was observed in 36.4% (8/22) and 27.3% (6/22) of the soil samples collected at these schools, respectively. These findings of eggs show that the school communities are exposed to risks of zoonotic transmission.

Resumo Milhões de pessoas podem ser acometidas por geohelmintos, especialmente crianças em idade escolar, devido a sua maior exposição a ambientes contaminados. O objetivo deste estudo foi avaliar a contaminação do solo por ovos de Ancylostoma spp. e Toxocara spp. em áreas de recreação de escolas de ensino fundamental da cidade de Pelotas, Rio Grande do Sul, Brasil. Foram colhidas amostras de areia de 22 escolas e processadas pelo método de centrífugo-flutuação. Em 54,5% (12/22) das escolas houve registro da presença de ovos de helmintos com potencial zoonótico. A contaminação por Ancylostoma spp. e Toxocara spp. foi observada em 36,4% (8/22) e 27,3% (6/22) das amostras de solo das escolas, respectivamente. Existe a presença de ovos de Ancylostoma spp. e Toxocara spp., havendo risco de transmissão de zoonoses à comunidade escolar.

Helminth eggs with zoonotic potential in the vicinity of public schools in southern Brazil.

The aim of this study was to evaluate environmental contamination by helminth eggs with zoonotic potential that were found in dog feces in the vicinity of elementary schools. Seventy-nine samples of dog feces were collected from 28 municipal schools located in five neighborhoods in Pelotas, Rio Grande do Sul (RS), Brazil. The samples were processed using the Willis-Mollay technique and analyzed using an optical microscope (40X), to identify any parasite eggs present. All neighborhoods were positive and 74.7% of the samples exhibited one or more helminth genera. The agent with the highest prevalence was Ancylostoma spp. (93.2%), followed by Trichuris spp. (18.6%), Toxocara spp. (11.9%) and Toxascaris (1.7%). These data show that there is a need for greater care towards controlling these helminths with zoonotic potential, including responsible pet ownership and daily activities to clean and collect dog feces in the vicinity of schools, because these are places where children play and study.

Elaboration, evaluation of nutritional information and physical-chemical stability of dairy fermented drink with caja-mango pulp / Elaboração, avaliação de informação nutricional e estabilidade físico-química de bebida láctea fermentada com polpa de cajá-manga

Whey is a by-product of the dairy industry of great importance due to its high nutritional value, and can be used for the manufacture of fermented dairy drinks which, combined with fruit, increase the nutritional value and add characteristic flavors. Therefore, a fermented dairy beverage with caja-mango pulp (Spondias dulcis) was elaborated and its nutritional information as well as the physical-chemical stability were evaluated during storage. The results showed that the nutritional information met the requirements stipulated by the Brazilian legislation. The physical-chemical stability of the dairy fermented drink in terms of pH, acidity, syneresis and sedimentation was influenced by the storage time, possibly associated with uncontrolled factors in this study, such as the initial and final dairy culture concentration of the processed product, protein biodegradation during storage and low solids contents. It is concluded that the elaborated drink constitutes a food source of several nutrients, and may complement the daily diet of children, adolescents and adults, supplying nutritional deficiencies.(AU)

O soro lácteo é um subproduto da indústria de laticínios de grande importância devido ao seu alto valor nutritivo, podendo ser utilizado para fabricação de bebida láctea fermentada que, associada a frutas, aumenta o valor nutricional e agrega sabores característicos. A partir disso, foi elaborada uma bebida láctea fermentada adicionada de polpa de cajá-manga (Spondias dulcis), sendo avaliada sua informação nutricional bem como a estabilidade físico-química, durante o armazenamento. Os resultados mostram que a informação nutricional atendeu os requisitos estipulados pela legislação brasileira. A estabilidade físico-química da bebida, quanto aos parâmetros analisados de pH, acidez, sinerese e sedimentação, sofreu influência pelo o tempo de armazenamento, possivelmente, associados a fatores não controlados neste estudo como a concentração de cultura láctea iniciadora e final do produto elaborado, a biodegradação de proteínas durante a estocagem e baixos teores de sólidos. Conclui-se que a bebida elaborada constitui um alimento fonte de diversos nutrientes, e poderá complementar a alimentação diária de crianças, adolescentes e adultos, suprindo as carências nutricionais.(AU)

Elaboration, evaluation of nutritional information and physical-chemical stability of dairy fermented drink with caja-mango pulp / Elaboração, avaliação de informação nutricional e estabilidade físico-química de bebida láctea fermentada com polpa de cajá-manga

ABSTRACT: Whey is a by-product of the dairy industry of great importance due to its high nutritional value, and can be used for the manufacture of fermented dairy drinks which, combined with fruit, increase the nutritional value and add characteristic flavors. Therefore, a fermented dairy beverage with caja-mango pulp (Spondias dulcis) was elaborated and its nutritional information as well as the physical-chemical stability were evaluated during storage. The results showed that the nutritional information met the requirements stipulated by the Brazilian legislation. The physical-chemical stability of the dairy fermented drink in terms of pH, acidity, syneresis and sedimentation was influenced by the storage time, possibly associated with uncontrolled factors in this study, such as the initial and final dairy culture concentration of the processed product, protein biodegradation during storage and low solids contents. It is concluded that the elaborated drink constitutes a food source of several nutrients, and may complement the daily diet of children, adolescents and adults, supplying nutritional deficiencies.

RESUMO: O soro lácteo é um subproduto da indústria de laticínios de grande importância devido ao seu alto valor nutritivo, podendo ser utilizado para fabricação de bebida láctea fermentada que, associada a frutas, aumenta o valor nutricional e agrega sabores característicos. A partir disso, foi elaborada uma bebida láctea fermentada adicionada de polpa de cajá-manga (Spondias dulcis), sendo avaliada sua informação nutricional bem como a estabilidade físico-química, durante o armazenamento. Os resultados mostram que a informação nutricional atendeu os requisitos estipulados pela legislação brasileira. A estabilidade físico-química da bebida, quanto aos parâmetros analisados de pH, acidez, sinerese e sedimentação, sofreu influência pelo o tempo de armazenamento, possivelmente, associados a fatores não controlados neste estudo como a concentração de cultura láctea iniciadora e final do produto elaborado, a biodegradação de proteínas durante a estocagem e baixos teores de sólidos. Conclui-se que a bebida elaborada constitui um alimento fonte de diversos nutrientes, e poderá complementar a alimentação diária de crianças, adolescentes e adultos, suprindo as carências nutricionais.

Helminth eggs with zoonotic potential in the vicinity of public schools in southern Brazil / Ovos de helmintos com potencial zoonótico nas proximidades de escolas públicas no extremo sul do Brasil

Abstract The aim of this study was to evaluate environmental contamination by helminth eggs with zoonotic potential that were found in dog feces in the vicinity of elementary schools. Seventy-nine samples of dog feces were collected from 28 municipal schools located in five neighborhoods in Pelotas, Rio Grande do Sul (RS), Brazil. The samples were processed using the Willis-Mollay technique and analyzed using an optical microscope (40X), to identify any parasite eggs present. All neighborhoods were positive and 74.7% of the samples exhibited one or more helminth genera. The agent with the highest prevalence was Ancylostoma spp. (93.2%), followed by Trichuris spp. (18.6%), Toxocara spp. (11.9%) and Toxascaris (1.7%). These data show that there is a need for greater care towards controlling these helminths with zoonotic potential, including responsible pet ownership and daily activities to clean and collect dog feces in the vicinity of schools, because these are places where children play and study.

Resumo O objetivo deste estudo foi avaliar a contaminação ambiental por ovos de helmintos com potencial zoonótico, diagnosticados em fezes caninas depositadas nas proximidades de escolas primárias. Setenta e nove amostras de fezes foram colhidas em 28 escolas municipais localizadas em cinco bairros da cidade de Pelotas, Rio Grande do Sul (RS), Brasil. As amostras foram processadas pela técnica de Willis-Mollay e analisadas em microscópio óptico (40X), para identificar quaisquer parasitos presentes. Todos os bairros foram positivos e 74,7% das amostras apresentaram um ou mais gêneros de helmintos. O agente com maior prevalência foi Ancylostoma spp. (93,2%), seguido por Trichuris spp. (18,6%), Toxocara spp. (11,9%) e Toxascaris (1,7%). Esses dados mostram que há necessidade de maior cuidado no controle desses helmintos com potencial zoonótico, incluindo a posse responsável dos animais e atividades diárias de limpeza e colheita de fezes de cães nas proximidades das escolas, porque esses são locais onde as crianças brincam e estudam.

Helminth eggs with zoonotic potential in the vicinity of public schools in southern Brazil / Ovos de helmintos com potencial zoonótico nas proximidades de escolas públicas no extremo sul do Brasil

The aim of this study was to evaluate environmental contamination by helminth eggs with zoonotic potential that were found in dog feces in the vicinity of elementary schools. Seventy-nine samples of dog feces were collected from 28 municipal schools located in five neighborhoods in Pelotas, Rio Grande do Sul (RS), Brazil. The samples were processed using the Willis-Mollay technique and analyzed using an optical microscope (40X), to identify any parasite eggs present. All neighborhoods were positive and 74.7% of the samples exhibited one or more helminth genera. The agent with the highest prevalence was Ancylostoma spp. (93.2%), followed by Trichuris spp. (18.6%), Toxocara spp. (11.9%) and Toxascaris (1.7%). These data show that there is a need for greater care towards controlling these helminths with zoonotic potential, including responsible pet ownership and daily activities to clean and collect dog feces in the vicinity of schools, because these are places where children play and study.(AU)

O objetivo deste estudo foi avaliar a contaminação ambiental por ovos de helmintos com potencial zoonótico, diagnosticados em fezes caninas depositadas nas proximidades de escolas primárias. Setenta e nove amostras de fezes foram colhidas em 28 escolas municipais localizadas em cinco bairros da cidade de Pelotas, Rio Grande do Sul (RS), Brasil. As amostras foram processadas pela técnica de Willis-Mollay e analisadas em microscópio óptico (40X), para identificar quaisquer parasitos presentes. Todos os bairros foram positivos e 74,7% das amostras apresentaram um ou mais gêneros de helmintos. O agente com maior prevalência foi Ancylostoma spp. (93,2%), seguido por Trichuris spp. (18,6%), Toxocara spp. (11,9%) e Toxascaris (1,7%). Esses dados mostram que há necessidade de maior cuidado no controle desses helmintos com potencial zoonótico, incluindo a posse responsável dos animais e atividades diárias de limpeza e colheita de fezes de cães nas proximidades das escolas, porque esses são locais onde as crianças brincam e estudam.(AU)

Oral gallic acid improves metabolic profile by modulating SIRT1 expression in obese mice brown adipose tissue: A molecular and bioinformatic approach.

AIMS: The aim of the presente study was to examine the effects of oral gallic acid (GA) administration on the brown adipose tissue of obese mice fed with high-fat diet. New mechanisms and interactions pathways in thermogenesis were accessed through bioinformatics analyses. MAIN METHODS: Swiss male mice were divided into four groups and fed during 60 days with: standard diet, standard diet combined with gallic acid, high-fat diet and high-fat diet combined with gallic acid. Body weight, food intake, and blood parameters (glucose tolerance test, total-cholesterol, high-density low-c, triglyceride and glucose levels) were evaluated. Brown and subcutaneous white adipose tissue histological analysis were performed. SIRT1 and PGC1-α mRNA expression in the brown adipose tissue were assessed. KEY FINDINGS: Our main findings showed that the gallic acid improved glucose tolerance and metabolic parameters. These results were accompanied by bioinformatics analyses that evidenced SIRT1 as main target in the thermogenesis process, confirmed as increased SIRT1 mRNA expression was evidenced in the brown adipose tissue. SIGNIFICANCE: Together, the data suggest that the gallic acid effect in brown adipose tissue may improve body metabolism, glucose homeostasis and increase thermogenesis.

Characterization of the Catalytic Structure of Plant Phytase, Protein Tyrosine Phosphatase-Like Phytase, and Histidine Acid Phytases and Their Biotechnological Applications.

Phytase plays a prominent role in monogastric animal nutrition due to its ability to improve phytic acid digestion in the gastrointestinal tract, releasing phosphorus and other micronutrients that are important for animal development. Moreover, phytase decreases the amounts of phytic acid and phosphate excreted in feces. Bioinformatics approaches can contribute to the understanding of the catalytic structure of phytase. Analysis of the catalytic structure can reveal enzymatic stability and the polarization and hydrophobicity of amino acids. One important aspect of this type of analysis is the estimation of the number of ß-sheets and α-helices in the enzymatic structure. Fermentative processes or genetic engineering methods are employed for phytase production in transgenic plants or microorganisms. To this end, phytase genes are inserted in transgenic crops to improve the bioavailability of phosphorus. This promising technology aims to improve agricultural efficiency and productivity. Thus, the aim of this review is to present the characterization of the catalytic structure of plant and microbial phytases, phytase genes used in transgenic plants and microorganisms, and their biotechnological applications in animal nutrition, which do not impact negatively on environmental degradation.

Change of Fate and Staminodial Laminarity as Potential Agents of Floral Diversification in the Zingiberales.

The evolution of floral morphology in the monocot order Zingiberales shows a trend in which androecial whorl organs are progressively modified into variously conspicuous "petaloid" structures with differing degrees of fertility. Petaloidy of androecial members results from extensive laminarization of an otherwise radially symmetric structure. The genetic basis of the laminarization of androecial members has been addressed through recent candidate gene studies focused on understanding the spatiotemporal expression patterns of genes known to be necessary to floral organ formation. Here, we explore the correlation between gene duplication events and floral and inflorescence morphological diversification across the Zingiberales by inferring ancestral character states and gene copy number using the most widely accepted phylogenetic hypotheses. Our results suggest that the duplication and differential loss of GLOBOSA (GLO) copies is correlated with a change in the degree of the laminarization of androecial members. We also find an association with increased diversification in most families. We hypothesize that retention of paralogs in flower development genes could have led to a developmental shift affecting androecial organs with potential adaptive consequences, thus favoring diversification in some lineages but not others.