Genomic and Experimental Analysis of the Insecticidal Factors Secreted by the Entomopathogenic Fungus Beauveria pseudobassiana RGM 2184.

The entomopathogenic fungus Beauveria pseudobassiana strain RGM 2184 can reach a maximum efficacy of 80% against the quarantine pest Lobesia botrana in field assays. In this study, the RGM 2184 genome was sequenced, and genome mining analyses were performed to predict the factors involved in its insecticidal activity. Additionally, the metabolic profiling of the RMG 2184 culture's supernatants was analyzed by mass spectrometry, and the insecticidal activity from one of these extracts was evaluated in Galleria mellonella larvae. The genome analysis resulted in 114 genes encoding for extracellular enzymes, four biosynthetic gene clusters reported as producers of insecticidal and bactericidal factors (oosporein, beauvericin, desmethylbassianin, and beauveriolide), 20 toxins, and at least 40 undescribed potential biocontrol factors (polyketides and nonribosomal peptides). Comparative genomic analysis revealed that 65-95% of these genes are Beauveria genus-specific. Metabolic profiling of supernatant extracts from RGM 2184 cultures exhibited secondary metabolites such as beauveriolide, oosporein, inflatin C, and bassiatin. However, a number of detected metabolites still remain undescribed. The metabolite extract caused 79% mortality of Galleria mellonella larvae at 28 days. The results of this research lay the groundwork for the study of new insecticidal molecules.

Factores de insatisfacción al alta de un servicio de Clínica Médica del Paraguay / Factors of dissatisfaction upon discharge from a Medical Clinic service of Paraguay

Introducción: los factores que influyen en la insatisfacción de los pacientes son diversos y varían con cada país y tipo de hospital. Objetivos: hallar la frecuencia y factores asociados a la insatisfacción en la atención referida por los pacientes. Materiales y métodos: se realizó una investigación cuantitativa con el cuestionario SERVQUAL aplicado al alta de los pacientes adultos del Servicio de Clínica Médica del Hospital Nacional durante los años 2018 y 2019. Con el cuestionario de recogieron variables demográficas, clínicas y las respuestas a 22 preguntas que evaluaron cinco dimensiones relacionadas a la satisfacción con el servicio. Todos los sujetos encuestados firmaron el consentimiento informado. Resultados: se encuestaron 224 pacientes, siendo 48% del sexo masculino y 52% del femenino. La edad media fue 44±17 años. La frecuencia de insatisfacción con la atención recibida fue 59%. La dimensión del cuestionario SERVQUAL con peor puntuación fue la tangibilidad. Los factores de riesgo asociados estadísticamente a la insatisfacción fueron el sexo masculino, la procedencia rural, el estado civil soltero y la presencia de comorbilidades. Conclusiones: la frecuencia de insatisfacción fue 59%. El perfil del paciente insatisfecho es un varón, de procedencia rural, soltero y con comorbilidades.

Introduction: the factors that influence patient dissatisfaction are diverse and vary with each country and type of hospital. Objectives: to find the frequency and factors associated with dissatisfaction in the care referred by the patients. Materials and methods: a quantitative investigation was carried out with the SERVQUAL questionnaire applied to the discharge of adult patients from the Medical Clinic Service of the National Hospital during the years 2018 and 2019. With the questionnaire we collected demographic, clinical variables and responses to 22 questions that evaluated five dimensions related to satisfaction with the service. All the subjects surveyed signed the informed consent. Results: 224 patients were surveyed, 48% being male and 52% female. The average age was 44 ± 17 years. The frequency of dissatisfaction with the care received was 59%. The dimension of the SERVQUAL questionnaire with the worst score was tangibility. The risk factors statistically associated with dissatisfaction were male sex, rural origin, single marital status and the presence of comorbidities. Conclusions: the frequency of dissatisfaction was 59%. The profile of the dissatisfied patient is a male, of rural origin, single and with comorbidities.

Tres casos consecutivos de gangrena seca en invierno / Three consecutive cases of dry gangrene in winter

Se presentan tres casos de gangrena seca ocurridos en el invierno austral del 2018. El primero corresponde a un varón de 37 años, portador de vasculitis por crioglobulinemia y enfermedad celiaca silente, que desarrolla gangrena seca en manos y pies. El segundo es una mujer de 40 años que consulta por gangrena seca de manos y pies, sin etiología demostrable. El tercero es un varón de 38 años que ingresa por choque séptico de origen neumónico que requiere tratamiento con vasopresores desarrollando gangrena seca de manos y pies. A pesar que los tres casos tienen etiología diferente, coincidieron con temperaturas muy frías (media 6° C), inusuales para el clima tropical del Paraguay.

We present three cases of dry gangrene occurred in the southern winter of 2018. The first corresponds to a 37-year-old man, carrier of vasculitis due to cryoglobulinemia and silent celiac disease, which develops dry gangrene in hands and feet. The second is a 40-year-old woman who consults for dry gangrene of hands and feet, without demonstrable etiology. The third is a 38-year-old male admitted for septic shock of pulmonary origin that requires treatment with vasopressors developing dry gangrene of the hands and feet. Although the three cases have a different etiology, they coincided with very cold temperatures (average 6 °C), unusual for the tropical climate of Paraguay.

Present status of Accelerator-Based BNCT.

AIM: This work aims at giving an updated report of the worldwide status of Accelerator-Based BNCT (AB-BNCT). BACKGROUND: There is a generalized perception that the availability of accelerators installed in hospitals, as neutron sources, may be crucial for the advancement of BNCT. Accordingly, in recent years a significant effort has started to develop such machines. MATERIALS AND METHODS: A variety of possible charged-particle induced nuclear reactions and the characteristics of the resulting neutron spectra are discussed along with the worldwide activity in suitable accelerator development. RESULTS: Endothermic (7)Li(p,n)(7)Be and (9)Be(p,n)(9)B and exothermic (9)Be(d,n)(10)B are compared. In addition to having much better thermo-mechanical properties than Li, Be as a target leads to stable products. This is a significant advantage for a hospital-based facility. (9)Be(p,n)(9)B needs at least 4-5 MeV bombarding energy to have a sufficient yield, while (9)Be(d,n)(10)B can be utilized at about 1.4 MeV, implying the smallest possible accelerator. This reaction operating with a thin target can produce a sufficiently soft spectrum to be viable for AB-BNCT. The machines considered are electrostatic single ended or tandem accelerators or radiofrequency quadrupoles plus drift tube Linacs. CONCLUSIONS: (7)Li(p,n)(7)Be provides one of the best solutions for the production of epithermal neutron beams for deep-seated tumors. However, a Li-based target poses significant technological challenges. Hence, Be has been considered as an alternative target, both in combination with (p,n) and (d,n) reactions. (9)Be(d,n)(10)B at 1.4 MeV, with a thin target has been shown to be a realistic option for the treatment of deep-seated lesions.