New Zein Protein Composites with High Performance in Phosphate Removal, Intrinsic Antibacterial, and Drug Delivery Capabilities.

Herein, poly(N-(4-aminophenyl)methacrylamide)-carbon nano-onions [abbreviated as PAPMA-CNOs (f-CNOs)] integrated gallic acid cross-linked zein composite fibers (ZG/f-CNOs) were developed for the removal/recovery of phosphate from wastewater along with controlled drug delivery and intrinsic antibacterial characteristics. The composite fibers were produced by Forcespinning followed by a heat-pressure technique. The obtained ZG/f-CNOs composite fibers presented several favorable characteristics of nanoadsorbents and drug carriers. The composite fibers exhibited excellent adsorption capabilities for phosphate ions. The adsorption assessment demonstrated that composite fibers process highly selective sequestration of phosphate ions from polluted water, even in the presence of competing anions. The ZG/f-CNOs composite fibers presented a maximum phosphate adsorption capacity (qmax) of 2500 mg/g at pH 7.0. This represents the most efficient phosphate adsorption system among all of the reported nanocomposites to date. The isotherm studies and adsorption kinetics of the adsorbent showed that the adsorption experiments followed the pseudo-second-order and Langmuir isotherm model (R2 = 0.9999). After 13 adsorption/desorption cycles, the adsorbent could still maintain its adsorption efficiency of 96-98% at pH 7.0 while maintaining stability under thermal and chemical conditions. The results mark significant progress in the design of composite fibers for removing phosphates from wastewater, potentially aiding in alleviating eutrophication effects. Owing to the f-CNOs incorporation, ZG/f-CNOs composite fibers exhibited controlled drug delivery. An antibiotic azithromycin drug-encapsulated composite fibers presented a pH-mediated drug release in a controlled manner over 18 days. Furthermore, the composite fibers displayed excellent antibacterial efficiency against Gram-positive and Gram-negative bacteria without causing resistance. In addition, zein composite fibers showed augmented mechanical properties due to the presence of f-CNOs within the zein matrix. Nonetheless, the robust zein composite fibers with inherent stimuli-responsive drug delivery, antibacterial properties, and phosphate adsorption properties can be considered promising multifunctional composites for biomedical applications and environmental remediation.

Longitudinal anti-SARS-CoV-2 antibody immune response in acute and convalescent patients.

Despite global efforts to assess the early response and persistence of SARS-CoV-2 antibodies in patients infected with or recovered from COVID-19, our understanding of the factors affecting its dynamics remains limited. This work aimed to evaluate the early and convalescent immunity of outpatients infected with SARS-CoV-2 and to determine the factors that affect the dynamics and persistence of the IgM and IgG antibody response. Seropositivity of volunteers from Mexico City and the State of Mexico, Mexico, was evaluated by ELISA using the recombinant receptor-binding domain (RBD) of the SARS-CoV-2 Spike protein for 90 days, at different time points (1, 15, 45, 60, and 90 days) after molecular diagnosis (RT-qPCR). Gender, age range, body mass index (BMI), comorbidities, and clinical spectrum of disease were analyzed to determine associations with the dynamics of anti-SARS-CoV-2 antibodies. On 90 days post-infection, individuals with moderate and asymptomatic disease presented the lowest levels of IgM, while for IgG, at the same time, the highest levels occurred with mild and moderate disease. The IgM and IgG levels were related to the clinical spectrum of disease, BMI, and the presence/absence of comorbidities through regression trees. The results suggest that the dynamics of anti-SARS-CoV-2 IgM and IgG antibodies in outpatients could be influenced by the clinical spectrum of the disease. In addition, the persistence of antibodies against SARS-CoV-2 could be related to the clinical spectrum of the disease, BMI, and the presence/absence of comorbidities.

Amoebiasis: Advances in Diagnosis, Treatment, Immunology Features and the Interaction with the Intestinal Ecosystem.

This review of human amoebiasis is based on the most current knowledge of pathogenesis, diagnosis, treatment, and Entamoeba/microbiota interactions. The most relevant findings during this last decade about the Entamoeba parasite and the disease are related to the possibility of culturing trophozoites of different isolates from infected individuals that allowed the characterization of the multiple pathogenic mechanisms of the parasite and the understanding of the host-parasite relationship in the human. Second, the considerable advances in molecular biology and genetics help us to analyze the genome of Entamoeba, their genetic diversity, and the association of specific genotypes with the different amoebic forms of human amoebiasis. Based on this knowledge, culture and/or molecular diagnostic strategies are now available to determine the Entamoeba species and genotype responsible for invasive intestinal or extraintestinal amoebiasis cases. Likewise, the extensive knowledge of the immune response in amoebiasis with the appearance of new technologies made it possible to design diagnostic tools now available worldwide. Finally, the understanding of the interaction between the Entamoeba species and the intestinal microbiota aids the understanding of the ecology of this parasite in the human environment. These relevant findings will be discussed in this review.

Squaramide-Immobilized Carbon Nanoparticles for Rapid and High-Efficiency Elimination of Anthropogenic Mercury Ions from Aquatic Systems.

Water pollution due to environmental remediation and poor waste administration in certain areas of the globe signifies a serious problem in acquiring safe and clean drinking water. This problem is especially critical in rural areas, where advanced water purification techniques are deficient, and it remains a daunting task for ecosystem and public health protection. This critical task can be addressed herein by developing scalable poly squaramide-phenyl methacrylamide (PSQ)-functionalized carbon nanoparticles (CNPs) (PSQ-CNPs) with densely populated chelating sites with strong Hg2+-binding capacity. The PSQ-CNPs have shown high efficiency in removing Hg2+ from aqueous solution, providing a Hg2+ capacity of 2840 mg g-1, surpassing all the amine and thiol-based adsorbents reported hitherto. More significantly, the adsorbent reveals the largest distribution coefficient value (Kd) of 9.09 × 1010 mL g-1, which allows it to reduce Hg2+ content from 10 ppm to less than 0.011 ppb, well below the United States Environmental Protection Agency (EPA) limits for drinking water standards (2 ppb). The adsorption measurements of the adsorbent followed the Langmuir isotherm model and pseudo-second order. The practical applicability of PSQ-CNPs was verified with the real samples (the lake, river, and industrial wastewater) and has been proven to be excellent. The adsorbent could still retain its Hg2+ removal efficacy even after 12 sorption cycles. It is attributed that the remarkable performance of PSQ-CNPs arises from the high-density chelating sites and pores on the surface of CNPs. The present work shows a new benchmark for Hg2+-removal adsorbents and presents a novel practical approach for decontaminating Hg2+ and other heavy metal ions from wastewater.

Survival after curative pancreaticoduodenectomy for ampullary adenocarcinoma in a South American population: A retrospective cohort study.

BACKGROUND: Ampullary adenocarcinoma (AAC) is a rare neoplasm that accounts for only 0.2% of all gastrointestinal cancers. Its incidence rate is lower than 6 cases per million people. Different prognostic factors have been described for AAC and are associated with a wide range of survival rates. However, these studies have been exclusively conducted in patients originating from Asian, European, and North American countries. AIM: To evaluate the histopathologic predictors of overall survival (OS) in South American patients with AAC treated with curative pancreaticoduodenectomy (PD). METHODS: We analyzed retrospective data from 83 AAC patients who underwent curative (R0) PD at the National Cancer Institute of Peru between January 2010 and October 2020 to identify histopathologic predictors of OS. RESULTS: Sixty-nine percent of patients had developed intestinal-type AAC (69%), 23% had pancreatobiliary-type AAC, and 8% had other subtypes. Forty-one percent of patients were classified as Stage I, according to the AJCC 8th Edition. Recurrence occurred primarily in the liver (n = 8), peritoneum (n = 4), and lung (n = 4). Statistical analyses indicated that T3 tumour stage [hazard ratio (HR) of 6.4, 95% confidence interval (CI) of 2.5-16.3, P < 0.001], lymph node metastasis (HR: 4.5, 95%CI: 1.8-11.3, P = 0.001), and pancreatobiliary type (HR: 2.7, 95%CI: 1.2-6.2, P = 0.025) were independent predictors of OS. CONCLUSION: Extended tumour stage (T3), pancreatobiliary type, and positive lymph node metastasis represent independent predictors of a lower OS rate in South American AAC patients who underwent curative PD.

COVID-19 in hospitalized patients in 4 hospitals in San Isidro, Buenos Aires, Argentina

In December 2019, a novel illness called coronavirus disease 2019 (COVID-19) was described in China and became pandemic in a few months. The first case was detected in Argentina on March 3, 2020. A multicentre prospective observational cohort study on hospitalized patients with COVID- 19 was conducted in 4 hospitals in San Isidro district from March 1, 2020 to October 31. Data was obtained by the attendant physician. 668 patients were included, the median age was 54 years, and 42.7% were female. Male sex and older age were associated with COVID-19 disease and more strongly with severity. Most frequent symptoms were fever and cough followed by dyspnoea, myalgia, odynophagia, headache, anosmia, and diarrhoea. Non-severe patients had more upper respiratory symptoms while severe patients had mainly lower respiratory symptoms on admission. Most common comorbidities were arterial hypertension, diabetes, and cardiovascular disease. A great proportion of patients had normal thorax X-ray and ground-glass opacity in tomography. In severe patients, radiography and tomography had a predominant ground - glass pattern, but normal radiography and tomography on presentation were present in 22% and 5.9%, respectively. The absence of fever and normal radiology on admission neither excluded the disease nor further severity. PCR elevation was related with COVID-19 disease and with severity, while lymphopenia was more related with the disease and leukocytosis and thrombocytopenia with severity. 8, 4% of patients were health care workers. The mortality rate was 12.4%, 32.7% in severe patients and 61.2% in ventilated patients. Mortality was higher in the public hospital, probably associated with patients with older age and more comorbidities. All these observations can contribute to the knowledge of this disease in terms of diagnosis and prognosis.

Design, fabrication and drug release potential of dual stimuli-responsive composite hydrogel nanoparticle interfaces.

Nanocomposite hydrogel particles grasp considerable attention in nanotechnology and nanomedicine as one of the potential drug delivery platforms. However, prevail a coveted drug delivery strategy with sustain and stimuli-drug release is still challenging. Herein, poly (N-(4-aminophenyl) methacrylamide))-carbon nano-onions (PAPMA-CNOs = f-CNOs)/diclofenac-complex integrated chitosan (CS) nanocomposite hydrogel nanoparticles (CNPs) were fabricated using an ionic gelation strategy. CNPs possess several conducive physicochemical properties, including spherical morphology and uniform particle distribution.In vitro drug release from CNPs was vetted in different pHs of gastrointestinal (GI) tract environment at a temperature range of 37-55 °C and found dual (pH and thermo)-responsive controlled drug release. Under pH 7.4, CNPs exhibited the highest drug release at 55 °C in 15 days. The drug release results disclose that the structure of CNPs was disassembled at 55 °C to release the encapsulated drug molecules in a controlled fashion. The CNPs also displayed good cell viability against human fibroblast cells. Thus, all the results together unveil that CNPs would thrive as a promising pH and temperature-triggered drug delivery platform for the GI tract and colon targeted drug delivery.

Covalently Functionalized Carbon Nano-Onions Integrated Gelatin Methacryloyl Nanocomposite Hydrogel Containing γ-Cyclodextrin as Drug Carrier for High-Performance pH-Triggered Drug Release.

Herein, poly (n-(4-aminophenyl) methacrylamide)) carbon nano-onions (PAPMA-CNOs = f-CNOs) and γ-cyclodextrin/DOX-complex (CD) reinforced gelatin methacryloyl (GelMA)/f-CNOs/CD supramolecular hydrogel interfaces were fabricated using the photo-crosslinking technique. The physicochemical properties, morphology, biodegradation, and swelling properties of hydrogels were investigated. The composite hydrogels demonstrated enriched drug release under the acidic conditions (pH 4.5 = 99%, and pH 6.0 = 82%) over 18 days. Owing to the f-CNOs inclusion, GelMA/f-CNOs/CD supramolecular hydrogels presented augmented tensile strength (σult = 356.1 ± 3.4 MPa), toughness (K = 51.5 ± 0.24 Jg-1), and Young's modulus (E = 41.8 ± 1.4 GPa). The strengthening of GelMA/f-CNOs/CD hydrogel systems indicates its good dispersion and the degree of polymer enveloping of f-CNOs within GelMA matrixes. Furthermore, the obtained hydrogels showed improved cell viability with human fibroblast cells. Nevertheless, the primed supramolecular hydrogels would pave the way for the controlled delivery systems for future drug delivery.

Engineering of carbon nano-onion bioconjugates for biomedical applications.

Engineered stimuli-responsive drug delivery strategies grasp enormous potential in biomedical applications for disease treatment due to their exploited therapeutic efficiency. In the current study, we developed poly 4-hydroxyphenyl methacrylate-carbon nano-onions (PHPMA-CNOs = f-CNOs) embedded bovine serum albumin (BSA) nanocomposite fibers by Forcespinning® (FS) technology for stimuli-responsive release of cargo, using doxorubicin (DOX) as a model drug. Nanocomposite fiber system showed thermosensitive drug release and exhibited around 72 and 95% of drug release at 37 and 43 °C, respectively. A slow and prolonged DOX release was observed over a 15-day study. The amount of drug released was determined by the concentration of the DOX payload, incubation temperature, and pH of the released medium. Owing to the f-CNOs incorporation, the mechanical strength (18.23 MPa) of hybrid BSA nanocomposite fibers was enhanced significantly. Besides, in vitro degradation, water contact angles, and thermal properties of nanocomposite fibers have augmented. During the in vitro cytotoxicity assessment, nanocomposite fibers exhibited improved cell viability against human fibroblast cells. Nonetheless, the external-stimuli-dependent and sustained DOX release perhaps reduces its circumventing side effects and show potential applications in biomedical research.

Carbon Nano-Onions Reinforced Multilayered Thin Film System for Stimuli-Responsive Drug Release.

Herein, poly (N-(4-aminophenyl) methacrylamide))-carbon nano-onions (PAPMA-CNOs = f-CNOs) and anilinated-poly (ether ether ketone) (AN-PEEK) have synthesized, and AN-PEEK/f-CNOs composite thin films were primed via layer-by-layer (LbL) self-assembly for stimuli-responsive drug release. The obtained thin films exhibited pH-responsive drug release in a controlled manner; pH 4.5 = 99.2% and pH 6.5 = 59.3% of doxorubicin (DOX) release was observed over 15 days. Supramolecular π-π stacking interactions between f-CNOs and DOX played a critical role in controlling drug release from thin films. Cell viability was studied with human osteoblast cells and augmented viability was perceived. Moreover, the thin films presented 891.4 ± 8.2 MPa of the tensile strength (σult), 43.2 ± 1.1 GPa of Young's modulus (E), and 164.5 ± 1.7 Jg-1 of toughness (K). Quantitative scrutiny revealed that the well-ordered aligned nanofibers provide critical interphase, and this could be responsible for augmented tensile properties. Nonetheless, a pH-responsive and mechanically robust biocompatible thin-film system may show potential applications in the biomedical field.

Prevention of severe COVID-19 in the elderly by early high-titer plasma

BackgroundTherapies to interrupt progression of early COVID-19 remain elusive. Among them, convalescent plasma in hospitalized patients was unsuccessful, perhaps because antibody should be administered earlier. We advanced plasma infusions to the first 72 hours of symptoms to arrest COVID-19 progression. MethodsA randomized, double-blind, placebo-controlled trial of convalescent plasma with high IgG titers against SARS-CoV2 in elderly subjects within 72 hours of mild COVID-19 symptoms. The primary endpoint was severe respiratory disease defined as a respiratory rate [≥]30 and/or an O2 sat<93% in room air. The study was interrupted at 76% of its projected sample size, because cases in the region decreased considerably and steady enrollment of study subjects became virtually impossible. Results160 patients underwent randomization. In the intention-to-treat analysis (ITT), 13/80(16.2%) patients receiving plasma vs. 25/80(31.2%) receiving placebo experienced severe respiratory disease [RR(95%CI)= 0.52(0.29,0.94); p=0.026)] with an RRR=48%. A modified ITT analysis, excluding six subjects who experienced the primary endpoint before infusion, showed a larger effect size [RR(95%CI) = 0.40(0.20, 0.81), p=0.007]. High- and low-titer donor analyses, based on a median IgG titer=1:3,200, evidenced a dose-dependent response with an RRR=73.3% for recipients of high-titer plasma (p=0.016) and a number needed to treat (NNT)=4.4. All secondary endpoints exhibited trends towards protection. No solicited adverse events were observed. ConclusionsEarly administration of high-titer convalescent plasma against SARS-CoV2 to mildly ill infected seniors reduced COVID-19 progression. This safe, inexpensive, outpatient intervention facilitates access to treatment from industrialized to LMIC, can decompress demands on hospitals, and may contribute to save lives. Funded by The Bill & Melinda Gates Foundation and The Fundacion INFANT Pandemic Fund. Registered in the Direccion de Sangre y Medicina Transfusional del Ministerio de Salud (PAEPCC19), Plataforma PRIISA (1421), and clinicaltrials.gov (NCT04479163). All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; RL, GPM, DW and FPP are investigators in a phase 3 SARS CoV2 trial from Pfizer; no other relationships or activities that could appear to have influenced the submitted work.

Monosegmental ALPPS: a long-term survival alternative to liver transplant in PRETEXT IV hepatoblastoma.

A 3-year-old female was treated with neoadjuvant chemotherapy (NACT) for a PRETEXT IV hepatoblastoma. POST-TEXT IV findings merited a liver transplant (LT), but multiple limitations precluded it. The initial future liver remnant (FLR) was small (21.3%). Monosegment 6 ALPPS was a rational approach given that the inferior right hepatic vein (IRHV) provided adequate outflow. Therefore, the procedure was performed after parental informed consent. On PO15 of the first stage, FLR had reached 32.6% and then the second-stage was carried out. The patient was discharged on POD 31, and she is about to reach the 5-year disease-free survival milestone.

Case report: Cutaneous amebiasis: the importance of molecular diagnosis of an emerging parasitic disease.

Cutaneous amebiasis is the least common clinical form of human amebiasis in Mexico, sexual amebiasis was only occasionally observed before the late 1980s. However, in the last few decades, most of the documented cases of cutaneous amebiasis from around the world are sexually transmitted. We present two cases of sexually transmitted genital amebiasis. The molecular characterization of the Entamoeba species in the affected tissues underlines the importance of an etiological diagnosis using specific and sensitive techniques that avoid the rapid destruction of tissues and the irreversible sequelae to the anatomy and function of the affected organs. In addition, for those interested in the study of the human-amoebic disease relationship and its epidemiology, the detection of a new, mixed infection in an invasive case of amebiasis reveals new perspectives in the study of the extraordinarily complex host-parasite relationship in amebiasis.

Novelties on amoebiasis: a neglected tropical disease.

In accordance with the 1997 documents of the World Health Organization (WHO), amoebiasis is defined as the infection by the protozoan parasite Entamoeba histolytica with or without clinical manifestations. The only known natural host of E. histolytica is the human with the large intestine as major target organ. This parasite has a very simple life cycle in which the infective form is the cyst, considered a resistant form of parasite: The asymptomatic cyst passers and the intestinal amoebiasis patients are the transmitters; they excrete cysts in their feces, which can contaminate food and water sources. E. histolytica sensu stricto is the potentially pathogenic species and E. dispar is a commensal non-pathogenic Entamoeba. Both species are biochemical, immunological and genetically distinct. The knowledge of both species with different pathogenic phenotypes comes from a large scientific debate during the second half of the 20(th) century, which gave place to the rapid development of diagnostics technology based on molecular and immunological strategies. During the last ten years, knowledge of the new epidemiology of amoebiasis in different geographic endemic and non-endemic areas has been obtained by applying mostly molecular techniques. In the present work we highlight novelties on human infection and the disease that can help the general physician from both endemic and non-endemic countries in their medical practice, particularly, now that emigration is undoubtedly a global phenomenon that is modifying the previous geography of infectious diseases worldwide.

Infection by human immunodeficiency virus-1 is not a risk factor for amebiasis.

The purpose of this study was to determine whether HIV-1 infected patients in our community were more susceptible to Entamoeba histolytica and Entamoeba dispar infection than non-HIV-infected individuals. The prevalence and frequency of invasive amebiasis was determined in 203 HIV+/AIDS subjects and 140 close relatives or sexual partners, all of whom were HIV-. Anti-E. histolytica antibodies (IgG, IgA) were assessed as indicators of E. histolytica invasive infection. Polymerase chain reaction (PCR) was used for the characterization of the Entamoeba species. The prevalence estimated with PCR data showed that E. histolytica infection was more common in the HIV+/AIDS group (25.32%), than in HIV- contacts (18.46%). E. histolytica + E. dispar infection was more frequent in HIV+/AIDS patients (13.3%), than in HIV- contacts (0.7%). E. histolytica and/or E. dispar infection was highly prevalent in HIV+/AIDS patients (34.1%) without evidence of recent or current invasive disease. Contacts of HIV+/AIDS patients who were infected with E. histolytica were asymptomatic cyst passers. Our results suggest that E. histolytica strains prevalent in the studied community appear to be of low pathogenic potential.

High prevalence rate of Entamoeba histolytica asymptomatic infection in a rural Mexican community.

The frequency of Entamoeba histolytica and Entamoeba dispar infection was analyzed in a rural community in the state of Morelos, Mexico, using polymerase chain reaction (PCR). Sociodemographic variables as risk factors for the infection were assessed. Results highlighted the number of individuals with intestinal parasites (43.1%) in the community, indicating extensive fecalism. A high frequency of E. histolytica asymptomatic infection, higher than E. dispar infection (13.8% versus 9.6%), was detected by PCR. Anti-amebic antibody levels (IgG) in serum and saliva (IgA) samples were not associated with E. histolytica intestinal infection. These findings suggest a predominant distribution of E. histolytica strains of low invasive potential in this community.

Entamoeba histolytica and Entamoeba dispar: prevalence infection in a rural Mexican community.

The frequency of Entamoeba histolytica and Entamoeba dispar infection was analyzed in a rural community in the state of Morelos, Mexico, through PCR technique by using specie specific primer. The E. histolytica specie was detected in 33 of 290 analyzed stool samples (11.4%), E. dispar specie was observed in 21 samples (7.2%) and both species of Entamoeba were detected in seven samples (2.4%). So a higher E. histolytica than E. dispar frequency infection was detected (13.8 versus 9.6%). Even though in our design we did not considered the follow-up of included individuals, the absence of invasive amebiasis cases in the studied population during our stay in town was unexpected.

Entamoeba histolytica and/or Entamoeba dispar: infection frequency in HIV+/AIDS patients in Mexico city.

The objective of this work was to evaluate the frequency of Entamoeba histolytica/Entamoeba dispar intestinal infection in HIV+/AIDS subjects and their HIV- close relatives or sexual partners. Enteric parasites were investigated in stool samples by microscopic examination and E. histolytica and E. dispar were identified by PCR. We found by microscopic analysis in HIV+/AIDS group that the E. histolytica/E. dispar complex was present in 5.9% of the members, while in the HIV- group was 2.9%. With PCR we found that the E. histolytica prevalence was 25.3% in the HIV+/AIDS group and 18.5% in the HIV-group. The difference in the results obtained with the microscopic and PCR is due to the different sensibility of the procedures. Besides, we found patients who were infected with E. histolytica in both groups were asymptomatic cyst passers. Our results suggest that E. histolytica strains prevalent in the studied community appear to be of low pathogenic potential.