Effect of Temperature, Relative Humidity, and Incubation Time on the Mycotoxin Production by Fusarium spp. Responsible for Dry Rot in Potato Tubers.

Potato is the fourth most consumed crop in the world. More than half of the crop is stored for three to nine months at cold temperatures (3-10 °C) for the fresh and seed market. One of the main causes of fresh potato waste in the retail supply chain is the processing of fungal and bacterial rots during storage. Dry rot is a fungal disease that mainly affects the potato crop during storage and is responsible for 1% of tuber losses in the UK. It is produced by Fusarium spp., such as Fusarium sambucinum and F. oxysporum, which can lead to the accumulation of mycotoxins in the potato tuber. Little is known about the impact of environmental factors on the accumulation of mycotoxins in potato tubers. Understanding the ecophysiology of these fungi is key to mitigating their occurrence under commercial storage conditions. Therefore, this work aimed to elucidate the effect of three different temperatures (5, 10, and 15 °C) and two different water activities (aw; 0.97, 0.99) on the ecophysiology and mycotoxin accumulation of F. sambucinum and F. oxysporum in a potato-based semi-synthetic medium. The mycotoxin accumulation was then studied in vivo, in potato tubers cultivated under organic farming conditions, stored for 40 days at 8.5 °C. Results showed that higher temperatures and aw enhanced fungal growth, lag time, and mycotoxin accumulation in vitro. Growth rate was 2 and 3.6 times higher when the temperature increased from 5 to 10 and 15 °C, respectively. Six different mycotoxins (T-2, HT-2, diacetoxyscirpenol, 15-acetoxyscirpenol, neosolaniol, and beauvericin) were detected in vitro and in vivo. T-2 was the most abundant mycotoxin detected in vitro, observing 106 ng of T-2/g media after 21 days of incubation at 10 °C and 0.99 aw. Due to the long period of time that potato tubers spend in storage, the fluctuations of environmental factors, such as temperature and relative humidity, could promote the development of fungal rot, as well as mycotoxin accumulation. This could result in important food and economic losses for the potato market and a threat to food safety.

First evidence on the occurrence of multi-mycotoxins and dietary risk exposure to AFB1 along the cassava value chain in Uganda.

This study investigated the occurrence and distribution of multiple mycotoxins (aflatoxin B1, B2, G1, G2, fumonisins B1, B2, ochratoxin A (OTA), deoxynivalenol (DON), zearalenone (ZEN), and citrinin (CIT)) in cassava products and as assessed the potential risk of aflatoxin B1 (AFB1) exposure among cassava consumers. A total of 192 samples of cassava products (96 flour and 96 chips, each with 48 samples from farmer and 48 from wholesaler) were analysed using LC/MS-MS. All positive samples irrespective of their origin (flour or chips) exhibited AFB1 levels exceeding the EU regulatory threshold of 5 µg/kg. The sum of fumonisins (FB1 + FB2), ZEN, and DON were significantly (P < 0.05) higher in cassava flour (14.3 µg/kg; 3.71 µg/kg; 25.1 µg/kg) compared to chips (6.54 µg/kg; 1.25 µg/kg; 0.25 µg/kg), respectively. Aflatoxins G2 was not detected in any of 192 samples. Cassava flour samples from farmers exhibited significantly (P < 0.05) higher mean concentrations of AFB1 (27.1 µg/kg), total aflatoxins (78.2 µg/kg), and ochratoxin A (79.6 µg/kg) in contrast to wholesalers, whose mean levels were notably lower at 8.91, 5.79 µg/kg, and 2.44 µg/kg, respectively, pointing the likely critical source of mycotoxin contamination. Cassava consumers in Northern Uganda are at a higher risk, with an estimated 2.06 cancer cases per 100,000 individuals per year compared to those in Eastern Uganda at 0.25. This study underscores the urgent need for interventions to manage aflatoxins in cassava flour, particularly at farm level in Northern Uganda. It accentuates a shift market to household-level sampling and the need for analytical methods targeting multiple mycotoxins.

Mycotoxin Accumulation in Dry Rot Potato Tubers from Algeria and Toxigenic Potential of Associated Isolates of Fusarium Genus.

The presence of different mycotoxins in 232 tuber samples exhibiting dry rot symptoms and their associated Fusarium strains from two production sites in Algeria was investigated. LC-MS/MS was used to simultaneously detect and quantify 14 mycotoxins, including trichothecenes and non-trichothecenes. A total of 49 tubers were contaminated with at least one mycotoxins, including T-2, HT-2, Diacetoxyscirpenol (DAS), 15-acetoxyscirpenol (15-AS) and Beauvericin (BEA). Positive samples from the Bouira region had a significantly higher level of toxin contamination compared to Ain Defla (56.34% and 5.59%, respectively). A total of 283 Fusarium strains were isolated: 155 from Bouira and 128 from Ain Defla. These strains were evaluated for their ability to produce the targeted mycotoxins. The results showed that 61.29% and 53.9% of strains originate from Bouira and Ain Defla regions were able to produce Nivalenol, Fusarenone-X, DAS, 15-AS, Neosolaniol, BEA and Zearalenone. The phylogenetic analysis of the conserved ribosomal internal transcribed spacer (ITS) sequences of 29 Fusarium strains, representative of the recorded mycotoxins profiles, was distributed into 5 Fusarium species complexes (SC): F. incarnatum-equiseti SC (FIESC), F. sambucinum SC (FSAMSC), F. oxysporum SC (FOSC), F. tricinctum SC (FTSC) and F. redolens SC (FRSC). This is the first study determining multiple occurrences of mycotoxins contamination associated to Fusarium dry rot of potato in Algeria and highlights fungal potential for producing trichothecene and non-trichothecens mycotoxins.

Reduction in Ochratoxin A Occurrence in Coffee: From Good Practices to Biocontrol Agents.

Ochratoxin A (OTA) is a mycotoxin mainly produced by Aspergillus section Circumdati and section Nigri across the coffee chain. OTA is nephrotoxic and is a threat to human health. This review summarizes current knowledge on how to reduce OTA concentration in coffee from farm to cup. After a brief introduction to the OTA occurrence in coffee, current good management practices are introduced. The core of this review focuses on biocontrol and microbial decontamination by lactic acid bacteria, yeasts and fungi, and their associated enzymes currently reported in the literature. Special attention is given to publications closest to in vivo applications of biocontrol agents and microbial OTA adsorption or degradation agents. Finally, this review provides an opinion on which future techniques to promote within the coffee supply chain.

Potential Impact of Current Agricultural Practices on Mycotoxin Occurrence and Mycotoxin Knowledge Along the Cassava Value Chain in Uganda.

Cassava is the second most important staple food crop for Uganda and is prone to contamination with mycotoxins. This study aimed at understanding the current agricultural practices, their potential influence on mycotoxin occurrence, as well as assessing mycotoxin knowledge among key cassava value chain actors, including farmers, wholesalers, and processors. Data were collected through individual interviews (210), key informant interviews (34), and 4 focus group discussions. The findings revealed that 51% of farmers peeled cassava directly on bare ground, resulting in direct contact with soil that potentially harbors mycotoxin-producing fungi, such as Aspergillus section Flavi. During postharvest handling, 51.6% of farmers dried cassava chips directly on bare ground. Nearly, all (95.2%) of wholesalers packed cassava chips in local gunny bags and placed them on ground instead of pallets. In the processing of cassava chips into flour, only one of the 14 processing machines was certified by the Uganda National Bureau of Standards. Additionally, there was only one processing machine available for every 180 (1:180) consumers bringing their cassava for processing. 50.8% of cassava consumers interviewed admitted to consuming cassava flour regardless of quality, while 73% blended cassava flour with flour from mycotoxin-susceptible crops mainly maize, millet, and sorghum. Most (96.2%) of the people along the cassava value chain did not understand what the term mycotoxins meant. However, 56% of interviewed respondents were familiar with the term aflatoxins. Of the cassava value chain actors aware of mycotoxins, 82.9% knew of methods for reducing aflatoxin contamination, but only 40.9% were putting such methods into practice. More farmers (47.9%) managed aflatoxins compared to wholesalers (33.3%) and processors (21.4%). Knowledge on aflatoxins was significantly associated with value chain actor (P = 0.026), head of household (P = 0.004), region (P = 0.033), age (P = 0.001), and experience (P = 0.001). This study highlights the critical areas of mycotoxin contamination within the cassava value chain in Uganda and underscores the need to improve the knowledge among value chain actors especially farmers.

The effect of the interactions of water activity, and temperature on OTA, OTB, and OTα produced by Penicillium verrucosum in a mini silo of natural and inoculated wheat using CO2 production as fungal activity sentinel.

Ochratoxin A (OTA) is a nephrotoxin that contaminates grains in storage. Moisture and temperature sensors give delayed responses due to their slow kinetic movement within the silo. This study examines if CO2 production could predict OTA contamination and identify storage conditions exceeding the maximum limit (5 µg/kg). The impact of water activity levels (0.70-0.90 aw), temperatures (15 and 20 °C), and storage duration on (a)Penicillium verrucosum population, (b)CO2 respiration rates (RR), and (c)ochratoxins concentrations in stored wheat was investigated. 96 samples were analysed for ochratoxins with LCMS-MS. RR was >7 times higher at wetter conditions than at drier aw levels. A positive correlation between CO2, OTA, OTB, and OTα was observed at the wettest conditions. OTA exceeded the limit at >0.80 aw (16% moisture content) with RR > 0.01 mg CO2 kg-1 h-1. The knowledge of the RR of stored grain would alert grain farmers/managers to improve grain storage management.

Plasmon-mediated dynamics and lasing of nanoemitters enhanced by dispersing nanorings.

We investigate the plasmon-mediated nonlinear dynamics and the optics of a laser emission of random nanoemitters (NEs) embedded in a two-dimensional (2D) lattice of conducting nanorings (NRs) enhanced by plasmon-polariton (PP) excitations. The interaction of quantum NEs with the PP field in the NRs perturbs the dynamics of the electronic populations in NEs, leading to a significant dependence of laser generation (dynamics) on the plasma frequency ωp of PP. This results in a strong coupling of NE field emission with the PP field and sharp variations of the average current in the NR lattice. The phase transition in the system was found when the macroscopic structures of PP fields are excited simultaneously in different regions of the system if ωp (control parameter) reaches critical value ωc. We have established the analytical dependence of the PP current I = I(ωp/ωc) on the plasma frequency, which is in excellent agreement with the results of numerical simulations. This effect may allow the design of new types of PP active devices with the use of conducting NRs in modern nanoelectronics.

The influence of different abiotic conditions on the concentrations of free and conjugated deoxynivalenol and zearalenone in stored wheat.

Environmental factors influence fungal growth and mycotoxin production in stored grains. However, the concentrations of free mycotoxins and their conjugates and how they are impacted by different interacting environment conditions have not been previously examined. The objectives of this study were to examine the impact of storage conditions (0.93-0.98 aw) and temperature (20-25 °C) on (a) the concentrations of deoxynivalenol and zearalenone and their respective glucosides/conjugates and (b) the concentrations of emerging mycotoxins in both naturally contaminated and irradiated wheat grains inoculated with Fusarium graminearum. Contaminated samples were analysed for multiple mycotoxins using Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS). Method validation was performed according to the acceptable performance criteria set and updated by the European Commission regulations No. 2021/808/EC. As an important conjugate of deoxynivalenol, the concentrations of deoxynivalenol-3-glucoside were significantly different from its precursor deoxynivalenol at 0.93 aw (22% moisture content- MC) at 25 °C in the naturally contaminated wheat with a ratio proportion of 56:44% respectively. The high concentrations of deoxynivalenol-3-glucoside could be influenced by the wheat's variety and/or harvested season/fungal strain type/location. Zeralenone-14-sulfate concentrations were surprisingly three times higher than Zearalenone in the naturally contaminated wheat at 0.98 aw (26% MC) at both temperatures. Emerging mycotoxins such as moniliformin increased with temperature rise with the highest concentrations at 0.95 aw and 25 °C. These findings highlight the influence and importance of storage aw x temperature conditions on the relative presence of free vs conjugated mycotoxins which can have implications for food safety.

Elucidating the impact of environmental factors on the growth of Colletotrichum coccodes strains isolated from potato tubers in Great Britain.

Black dot and silver scurf caused by Colletotrichum coccodes and Helminthosporium solani, respectively, are tuber blemish diseases affecting quality in the fresh and pre-pack potato industry. In the last 20 years, the importance of high-quality tuber appearance has increased considerably due to the growing demand for washed and pre-packed potatoes in the UK. Changing climate characterised by rising temperatures and wetter summers is a threat as this will favour the development of pathogens such as C. coccodes in the soil increasing the risk of food spoilage. Moreover, both diseases can develop not only in the field but also after harvest, with postharvest storage temperatures being a crucial factor in controlling fungal growth. Furthermore, anecdotal evidence showed differences on the aggressiveness of black dot depending on its origin (i.e. England and Scotland) on potato tubers. Silver scurf and black dot are difficult to differentiate as they present similar phenotypes characterised by silvery lesions making it challenging for managers to take the necessary corrective action during storage. Hence, the aim of this study was to give a general insight into the ecological conditions affecting the establishment of the causal agent of potato black dot in the field, and black dot and silver scurf during the supply chain. Therefore, invitro experiments were designed to study the growth rate and lag times simulating both scenarios respectively: on soil extract agar (SEA) media at different temperatures (4, 11, 15 °C) and matric potentials (control [unmodified] and - 1.4 MPa [modified]); and on natural potato dextrose agar (NPDA) for different temperatures (4, 11, 15 and 20 °C) at 99 % relative humidity (RH) for 25 days. When simulating the field environment, drier conditions (matric potential = -1.4 MPa) reduced fungal growth for both isolates by 0.1 cm day-1 at the temperature of 15 °C, suggesting temperature as the main limiting factor for the growth of C. coccodes in the soil. The causal agent of black dot exhibited a faster growth rate under retailer-like conditions (i.e., 15 °C) compared to H. solani. Understanding the environmental influence on both the pathogen and the crop is vital for proper disease management to help reduce food loss and waste.

Complex ADHD Challenging Case: Managing Co-Occurring Attention-Deficit Hyperactivity Disorder and Congenital Heart Disease with a Limited Medication Formulary: A Case from Mexico.

CASE: DL is an 8-year-old Mexican boy with a posterior atrial septal defect and partial anomalous pulmonary venous return of the right lower pulmonary vein with resultant right heart dilation with normal right ventricular systolic and diastolic function and no arrhythmias. Surgical repair was deferred, and DL's condition was being medically managed with furosemide 0.5 mg/kg BID and spironolactone 0.5 mg/kg BID.DL presents for developmental assessment due to poor performance in school following a lifting of COVID-19 pandemic restrictions and return to in-person classes. He has been attending full-time classes for 3 months without improvements in math, reading, and writing skills. Current attentional concerns at school include an inability to complete tasks without getting distracted by minimal stimuli and highly impulsive behavior.At the first assessment, DL was performing below grade expectations (e.g., reading by syllable without text comprehension, demonstrating preoperational addition and subtraction skills, inability to take dictation)-all of which was viewed as negatively impacted by attentional deficits. DL met DSM-5 criteria for ADHD, predominantly inattentive type. He was started on 10-mg immediate-release methylphenidate PO at 8 am with breakfast and a second dose of 10-mg immediate-release methylphenidate PO 4 hours after the first dose.After a month, at the first follow-up consultation, improvement in attention span, impulsivity, and school performance were observed, including reading skills and math proficiency. However, DL's mother raised concerns about circumoral cyanosis and acrocyanosis in the fingers of both hands after playing outside. These signs were not previously observed. During physical examination at the same visit, heart rate, blood pressure, and oximetry were within baseline ranges and his cardiac examination was unchanged. DL's dosage of methylphenidate was lowered to 10-mg immediate-release methylphenidate PO QD in the mornings with breakfast (8 am).DL did not return to clinic for another 2 months, having discontinued the medication after 2 months of treatment given financial limitations. His mother reported that DL's exertional circumoral cyanosis and acrocyanosis resolved while he was off medication. However, she observed an increase in inattentive symptoms and impulsivity and decline in his academic skills. She asked if our team was able continue the treatment despite the drug side effects, since she believed the benefits outweighed the disadvantages.Given these concerns, the team requested an updated cardiology assessment. The Cardiologist recommended discontinuation of methylphenidate and recommended follow-up with cardiothoracic surgery for reassessment of the surgical timeline.Given the limited treatment options in Mexico, what would you do next as the treating developmental-behavioral clinician…?

Impact of Environmental Conditions on the Concentrations of Trichothecenes, Their Glucosides, and Emerging Fusarium Toxins in Naturally Contaminated, Irradiated, and Fusarium langsethiae Inoculated Oats.

Trichothecenes produced by Fusarium species are commonly detected in oats. However, the ratios of the concentrations of free trichothecenes and their conjugates and how they are impacted by different interacting environmental conditions are not well documented. This study aims to examine the effect of water activity (0.95 and 0.98 aw) and temperature (20 and 25 °C) stress on the production of T-2 and HT-2 toxins, deoxynivalenol and their conjugates, as well as diacetoxyscirpenol (DAS). Multiple mycotoxins were detected using liquid chromatography-tandem mass spectrometry from 64 contaminated oat samples. The highest concentrations of HT-2-glucoside (HT-2-Glc) were observed at 0.98 aw and 20 °C, and were higher than other type A trichothecenes in the natural oats' treatments. However, no statistical differences were found between the mean concentrations of HT-2-Glc and HT-2 toxins in all storage conditions analysed. DAS concentrations were generally low and highest at 0.95 aw and 20 °C, while deoxynivalenol-3-glucoside levels were highest at 0.98 aw and 20 °C in the naturally contaminated oats. Emerging mycotoxins such as beauvericin, moniliformin, and enniatins mostly increased with a rise in water activity and temperature in the naturally contaminated oats treatment. This study reinforces the importance of storage aw and temperature conditions in the high risk of free and modified toxin contamination of small cereal grains.

Impact of predicted climate change environmental conditions on the growth of Fusarium asiaticum strains and mycotoxins production on a wheat-based matrix.

Fusarium asiaticum is a predominant fungal pathogen causing Fusarium Head Blight (FHB) in wheat and barley in China and is associated with approximately £201 million in annual losses due to grains contaminated with mycotoxins. F. asiaticum produces deoxynivalenol and zearalenone whose maximum limits in cereals and cereals-derived products have been established in different countries including the EU. Few studies are available on the ecophysiological behaviour of this fungal pathogen, but nothing is known about the impact of projected climate change scenarios on its growth and mycotoxin production. Therefore, this study aimed to examine the interacting effect of i) current and increased temperature (25 vs 30 °C), ii) drought stress variation (0.98 vs 0.95 water activity; aw) and iii) existing and predicted CO2 concentrations (400 vs 1000 ppm) on fungal growth and mycotoxin production (type B trichothecenes and zearalenone) by three F. asiaticum strains (CH024b, 82, 0982) on a wheat-based matrix after 10 days of incubation. The results showed that, when exposed to increased CO2 concentration (1000 ppm) there was a significant reduction of fungal growth compared to current concentration (400 ppm) both at 25 and 30 °C, especially at 0.95 aw. The multi-mycotoxin analysis performed by LC-MS/MS qTRAP showed a significant increase of deoxynivalenol and 15-acetyldeoxynivalenol production when the CH024b strain was exposed to elevated CO2 compared to current CO2 levels. Zearalenone production by the strain 0982 was significantly stimulated by mild water stress (0.95 aw) and increased CO2 concentration (1000 ppm) regardless of the temperature. Such results highlight that intraspecies variability exist among F. asiaticum strains with some mycotoxins likely to exceed current EU legislative limits under prospected climate change conditions.

Biocontrol activities of yeasts or lactic acid bacteria isolated from Robusta coffee against Aspergillus carbonarius growth and ochratoxin A production in vitro.

Biocontrol Agents (BCAs) can be an eco-friendly alternative to fungicides to reduce the contamination with mycotoxigenic fungi on coffee. In the present study, different strains of bacteria and yeasts were isolated from Ivorian Robusta coffee. Their ability to reduce fungal growth and Ochratoxin A (OTA) production during their confrontation against Aspergillus carbonarius was screened on solid media. Some strains were able to reduce growth and OTA production by 85 % and 90 % and were molecularly identified as two yeasts, Rhodosporidiobolus ruineniae and Meyerozyma caribbica. Subsequent tests on liquid media with A. carbonarius or solely with OTA revealed adhesion of R. ruineniae to the mycelium of A. carbonarius through Scanning Electron Microscopy, and an OTA adsorption efficiency of 50 %. For M. caribbica potential degradation of OTA after 24 h incubation was observed. Both yeasts could be potential BCAs good candidates for Ivorian Robusta coffee protection against A. carbonarius and OTA contamination.

X-Chromosome Association Study in Latin American Cohorts Identifies New Loci in Parkinson's Disease.

BACKGROUND: Sex differences in Parkinson's disease (PD) risk are well-known. However, the role of sex chromosomes in the development and progression of PD is still unclear. OBJECTIVE: The objective of this study was to perform the first X-chromosome-wide association study for PD risk in a Latin American cohort. METHODS: We used data from three admixed cohorts: (1) Latin American Research consortium on the Genetics of Parkinson's Disease (n = 1504) as discover cohort, and (2) Latino cohort from International Parkinson Disease Genomics Consortium (n = 155) and (3) Bambui Aging cohort (n = 1442) as replication cohorts. We also developed an X-chromosome framework specifically designed for admixed populations. RESULTS: We identified eight linkage disequilibrium regions associated with PD. We replicated one of these regions (top variant rs525496; discovery odds ratio [95% confidence interval]: 0.60 [0.478-0.77], P = 3.13 × 10-5 replication odds ratio: 0.60 [0.37-0.98], P = 0.04). rs5525496 is associated with multiple expression quantitative trait loci in brain and non-brain tissues, including RAB9B, H2BFM, TSMB15B, and GLRA4, but colocalization analysis suggests that rs5525496 may not mediate risk by expression of these genes. We also replicated a previous X-chromosome-wide association study finding (rs28602900), showing that this variant is associated with PD in non-European populations. CONCLUSIONS: Our results reinforce the importance of including X-chromosome and diverse populations in genetic studies. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Efectividad de la colecistectomía laparoscópica de puerto único asistida con imanes bajo anestesia espinal

Objetivo: Determinar la efectividad de la colecistectomía laparoscópica de puerto único asistida por imanes bajo anestesia espinal en el tratamiento quirúrgico de la colecistopatía litiásica crónica. Material y Métodos: Estudio prospectivo de cohorte en 51 pacientes entre octubre de 2019 y febrero de 2021. 17 pacientes fueron sometidos a colecistectomía laparoscópica de puerto único asistida por imanes y 34 a colecistectomía laparoscópica convencional por un mismo equipo quirúrgico. Se aplicó la técnica quirúrgica descrita por Dominguez et al y SAGES, bajo anestesia espinal. Se realizó estadística descriptiva e inferencial, analizando el dolor postoperatorio a las 3, 6, 12, 24 y 72 h y la satisfacción de los pacientes. Resultados: Se encontró diferencia significativa en el dolor postoperatorio en el grupo de estudio a las 6 h (p = 0,022), 12 h (p = 0,039), 24 h (p = 0,025) y 72 h (p < 0,001). En la satisfacción se encuentra un RR de 3 (p = 0,001), sin diferencia significativa en el tiempo operatorio y horas de hospitalización postquirúrgicas. Conclusiones: La colecistectomía laparoscópica de puerto único asistida por imanes, bajo anestesia espinal, ha demostrado efectividad en la reducción importante del dolor postoperatorio a partir de las 6 h, y en la superación de las expectativas en los intervenidos, sin aumento significativo de tiempo operatorio ni estancia hospitalaria.

Aim: To determine the effectiveness of magnet-assisted single-port laparoscopic cholecystectomy under spinal anesthesia in surgical treatment of chronic lithiasic cholecystopathy. Materials and Method: Prospective cohort study in 51 patients between October 2019 and February 2021. 17 patients underwent magnet-assisted single-port laparoscopic cholecystectomy and 34 underwent conventional laparoscopic cholecystectomy by the same surgical team. The surgical technique described by Dominguez and SAGES was used, under spinal anesthesia. Descriptive and inferential statistics were performed, analyzing postoperative pain at 3, 6, 12, 24 and 72 hours and patient satisfaction. Results: A significant difference in postoperative pain was found in the study group at 6 h (p = 0.022), 12 h (p = 0.039), 24 h (p = 0.025) and 72 h (p < 0.001). In satisfaction, there is an RR of 3 (p = 0.001), with no significant difference in operative time and postoperative hospitalization hours. Conclusions: Magnet-assisted single-port laparoscopic cholecystectomy under spinal anesthesia has shown effectiveness in significantly reducing postoperative pain after 6h, associated with significantly exceeding expectations in those operated on, without a significant increase in operative time or hospital stay.

Acclimatisation of Fusarium langsethiae, F. poae and F. sporotrichioides to elevated CO2: Impact on fungal growth and mycotoxin production on oat-based media.

Oats are highly susceptible to infection by Fusarium species, especially F. langsethiae, F. poae and F. sporotrichioides which contaminate the grain with mycotoxins. Climate change is expected to affect fungal colonisation and associated mycotoxin production. The objective of this study was to examine the effect of acclimatisation to elevated CO2 on the growth and mycotoxin production capacity of these fungal species. Strains of F. langsethiae (FL; seven strains), F. poae (FP; two strains) and F. sporotrichioides (FS; one strain) were acclimatised by sub-culturing for 10 generations at either 400 or 1000 ppm CO2 under diurnal temperature conditions. At each sub-culturing, the effect of acclimatisation to elevated CO2 on (a) lag phase prior to growth, (b) growth rate on oat-based media was assessed. Additionally, the production of type A trichothecenes and related toxic secondary metabolites of sub-cultures after 1, 7 and 10 generations were assessed using LC-MS/MS qTRAP. The results showed that Fusarium strains had an increased lag time and growth rate in response to the combined effect of sub-culturing and elevated CO2 levels. T-2 + HT-2 production was affected by elevated CO2 in strain FL4 (7.1-fold increase) and a decrease in strain FL1 (2.0-fold decrease) at the first sub-culturing and FS (1.3-fold decrease) after 7 sub-cultures compared to ambient conditions. The effect of sub-culturing on T-2 + HT-2 production varied depending on the fungal strain. For strain FL4, significantly less T-2 + HT-2 toxins were produced after 10 generations (4.4-fold decrease) as compared to that under elevated CO2 conditions after one sub-culture, and no change was observed under ambient conditions. The FS strain showed significant stimulation of T-2 + HT-2 toxin production after 10 sub-cultured generations (1.1-fold increase) compared to the initial sub-culture of this strain under elevated CO2 conditions. The production of other toxic secondary metabolites was generally not impacted by elevated CO2 conditions or by sub-culture for 10 generations, with the exceptions of FL1 and FP1. FL1 produced significantly more neosolaniol after 10 generations, when compared to those after 1 and 7, regardless of the CO2 conditions. For FP1, elevated CO2 significantly triggered beauvericin production after an initial sub-culture when compared to ambient conditions at the same sub-culture stage (29-fold). FP1 acclimatisation to elevated CO2 led to a decrease of beauvericin production after 10 generations when compared to 1 (6-fold). In contrast, sub-culturing for 10 generations compared to 1 under ambient CO2 conditions resulted in an increase in this toxin (12-fold).

X-Chromosome Association Study in Latin American Cohorts Identifies New Loci in Parkinson Disease.

Sex differences in Parkinson Disease (PD) risk are well-known. However, it is still unclear the role of sex chromosomes in the development and progression of PD. We performed the first X-chromosome Wide Association Study (XWAS) for PD risk in Latin American individuals. We used data from three admixed cohorts: (i) Latin American Research consortium on the GEnetics of Parkinson's Disease (n=1,504) as discover cohort and (ii) Latino cohort from International Parkinson Disease Genomics Consortium (n = 155) and (iii) Bambui Aging cohort (n= 1,442) as replication cohorts. After developing a X-chromosome framework specifically designed for admixed populations, we identified eight linkage disequilibrium regions associated with PD. We fully replicated one of these regions (top variant rs525496; discovery OR [95%CI]: 0.60 [0.478 - 0.77], p = 3.13 × 10 -5 ; replication OR: 0.60 [0.37-0.98], p = 0.04). rs525496 is an expression quantitative trait loci for several genes expressed in brain tissues, including RAB9B, H2BFM, TSMB15B and GLRA4 . We also replicated a previous XWAS finding (rs28602900), showing that this variant is associated with PD in non-European populations. Our results reinforce the importance of including X-chromosome and diverse populations in genetic studies.

Conocimientos, actitudes y prácticas sobre Leishmaniasis visceral en tres comunas de Neiva, Huila / Knowledge, attitudes and practices about Visceral leishmaniasis in three communes of Neiva, Huila

Introducción: La leishmaniasis visceral es una enfermedad zoonótica, transmitida por vectores del género Lutzomyia, de distribución en 98 países, incluyendo Colombia y que puede ocasionar un cuadro clínico grave, que en ausencia de tratamiento puede ser fatal. Objetivo: Determinar los conocimientos, actitudes y prácticas (CAP) adquiridas sobre vectores, reservorios y características de la Leishmaniasis visceral en las comunas 8, 9 y 10 de Neiva (Huila) en 2019. Materiales y métodos: Se realizó un estudio descriptivo de corte transversal en el período de junio a diciembre de 2019, en el que se muestrearon tres comunas (8, 9 y 10), en un total de 30 barrios de la ciudad de Neiva-Huila. Se aplicaron 385 encuestas tipo CAP, con un margen de error de 5 % y una confiabilidad de 95 %. Se incluyeron personas adultas de 18 años o más (267 mujeres y 117 hombres), que voluntariamente desearon participar, con previo consentimiento informado. Resultados: Según la información analizada, se determinó que 77 % de los encuestados no conoce la leishmaniasis visceral, 52 % no la identifican como una enfermedad zoonótica, 82 % no conocen el agente causal y 44 % no tienen claridad sobre los síntomas que se presentan en humanos. Conclusiones: Aunque se han realizado campañas preventivas en las comunas afectadas, el nivel de conocimiento sobre la enfermedad, el vector, el reservorio y las prácticas preventivas específicas para contrarrestar la leishmaniasis visceral son poco conocidos en la población de estudio, a pesar de que las prácticas y actitudes identificadas son positivas.

Introduction: Visceral leishmaniasis is a zoonotic disease transmitted by vectors of the Lutzomyia genus, distributed in 98 countries, including Colombia, which can cause a serious clinical picture that, in the absence of treatment, can be fatal. Objective: To determine the knowledge, attitudes, and practices (KAP) acquired on vectors and reservoirs, as well as the characteristics of visceral Leishmaniasis in communes 8, 9 and 10 of the city of Neiva in 2019. Material and Methods: A descriptive cross-sectional study was carried out from June to December 2019. Three communes (8, 9 y 10) were sampled from a total of 30 neighborhoods of the city of Neiva - Huila. In addition, 385 CAP-type surveys were applied, with a margin of error of 5% and a reliability of 95%. People aged 18 years or older (267 women and 117 men) who voluntarily wished to participate, with prior informed consent, were included. Results: According to the analyzed information, it was determined that the majority of the surveyed population did not know about visceral leishmaniasis (77%), did not identify it as a zoonotic disease (52%), nor did they know who the causative agent is (82%); furthermore, they were not clear about the symptoms that occur in humans, nor the treatment used to manage them. Conclusions: Although preventive campaigns have been carried out in the affected communes, the level of knowledge about the disease, the vector, the reservoir, and the specific preventive practices to counteract visceral leishmaniasis are little known in the study population, despite the fact that the identified practices and attitudes are positive.

Business intelligence for the visualization and data analysis of Telepharmacy activity indicators in a hospital pharmacy service scorecard.

OBJECTIVE: The consolidation of Telepharmacy during the COVID-19 pandemic  has raised the need for managing large volumes of real-time activity data  through data analysis. The aim of this project was to design a dynamic, user- friendly, customizable scorecard in a hospital pharmacy service for the  visualization and analysis of Telepharmacy activity indicators through the use  of advanced business intelligence technology. METHOD: The software tool was developed by a multidisciplinary team between  April and May 2021, driven from the hospital pharmacy service. Once the Telepharmacy indicators of interest were established,  datasets were extracted from raw databases (administrative databases,  Telepharmacy database, outpatient dispensing software, drug catalogues)  through data analysis. The different data sources were integrated in a  scorecard using PowerBI®. The criteria for processing missing and duplicated  data were defined, and data pre-processing, normalization and transformation were performed. Once the pilot scorecard was validated by  different profiles of users, the structure was designed for the panels to  automatically update as databases were updated. RESULTS: Design and implementation of a scorecard of Telepharmacy activity:  general descriptive panel (demographic profile of patients, count and delivery  conditions, program and medical service); geolocation of destination;  pharmacological profile; relative analysis of patients involved in the  Telepharmacy program with respect to the total of outpatients. In the last  updating as of January 2022, data from 16,000 dispensations to more than  4,000 patients had been collected. This means that 21.93% of outpatients had  benefited at some time point from the Telepharmacy service. Filters enable the  visualization of timeline progress and patient characterization, and  measure Telepharmacy activity by program. CONCLUSIONS: The processing of large Telemedicine datasets from various  sources through Business Intelligence in a hospital pharmacy service makes it  possible to synthesize information, generate customized reports, and visualize  information in a dynamic and attractive format. The application of this new  technology will help us improve strategic clinical and management decision  making.

OBJETIVO: La consolidación de la Telefarmacia en el contexto de la pandemia por la COVID-19 exige manejar a tiempo real un gran volumen de datos de actividad mediante análisis de datos. El objetivo de este trabajo fue diseñar un cuadro de mando ágil, personalizable y dinámico para la visualización y análisis de indicadores de actividad en Telefarmacia en un servicio de farmacia de hospital, mediante el empleo de herramientas  avanzadas de inteligencia empresarial (business intelligence).Método: Un equipo de trabajo multidisciplinar desarrolló una herramienta de  software entre abril y mayo de 2021 impulsado desde el servicio de farmacia  de hospital. Una vez consensuados los indicadores de interés en Telefarmacia,  se extrajeron los datos a partir de bases de datos brutas (base de datos de  Telefarmacia, programa de dispensación de pacientes externos, bases de datos  administrativas, catálogos de fármacos) mediante análisis de datos. La  integración de las diferentes fuentes de datos en el cuadro de mando se realizó mediante PowerBI®. Se definió el manejo de los datos perdidos y duplicados y  se aplicó preprocesamiento, normalización y transformación de los datos. Una  vez  validado el piloto por diferentes tipos de usuarios, se diseñó la estructura para actualización automática de los paneles con las sucesivas actualizaciones de las fuentes de datos. RESULTADOS: Diseño e implementación de un cuadro de mando de la actividad  en Telefarmacia: panel descriptivo general (perfil demográfico de pacientes,  recuento y condiciones de envíos, programa y servicio médico); geolocalización  de destino; perfil farmacológico; análisis relativo de los  pacientes beneficiarios de Telefarmacia respecto del total de pacientes  externos. En el último corte, a enero de 2022, se habían incluido datos de  16.000 dispensaciones con entrega informada a más de 4.000 pacientes, lo  que supone que el 21,93% de los pacientes externos han estado en algún momento en el programa de Telefarmacia. La aplicación de filtros permite  visualizar la evolución temporal, caracterizar grupos de pacientes y  dimensionar la actividad por programas. CONCLUSIONES: El procesamiento de paquetes de datos de Telemedicina, de  gran volumen, difícil manejo y procedentes de diversas fuentes relativas a Telefarmacia mediante inteligencia empresarial, en un servicio de farmacia  de hospital, permite sintetizar la información y proporcionar informes  personalizados y visualizaciones dinámicas y atractivas. La aplicación de estas  nuevas tecnologías puede ayudarnos a mejorar la toma de decisiones  estratégicas, tanto clínicas como de gestión.

May Measurement Month 2017-2019: an analysis of blood pressure screening results from Dominican Republic.

Arterial hypertension is the main risk factor that contributes to cardiovascular disease and represents a leading cause of morbidity and mortality globally. May Measurement Month (MMM) is a global screening campaign with the aim of improving awareness of hypertension at the individual and population level, an initiative that has been supported in the Dominican Republic (DR) since 2017. Adults (≥18 years) were recruited by sampling in different places in the DR, three blood pressure (BP) readings were performed per participant, and data on risk factors and comorbidities were collected. Hypertension was defined as systolic BP ≥140 mm Hg, diastolic BP ≥ 90 mm Hg (mean of second and third readings), and/or taking antihypertensive medication. Multiple imputation was used to estimate participants' mean BP when three readings were not available. Of 3693 participants, 2134 (57.8%) had hypertension, of whom 1646 (77.1%) were taking medication, but only 38.6% of those on treatment had their BP under control(<140/90 mmHg). The remaining 61.4% of the participants received inadequate treatment. A total of 66% of treated patients were taking a single antihypertensive drug. MMM provides an important platform for the standardized compilation of BP data and the creation of awareness of hypertension in the DR and other nations of the world. The data generated from the 2017-2019 MMM campaigns highlight the importance of adequate detection, knowledge, and control of BP.