Prevalence of chronic postsurgical hypoparathyroidism not adequately controlled: an analysis of a nationwide cohort of 337 patients.

Purpose: The identification of patients with chronic hypoparathyroidism who are adequately (AC) or not adequately controlled (NAC) has clinical interest, since poor disease control is related to complications and mortality. We aimed to assess the prevalence of NAC patients in a cohort of subjects with postsurgical hypoparathyroidism. Methods: We performed a multicenter, retrospective, cohort study including patients from 16 Spanish hospitals with chronic hypoparathyroidism lasting ≥3 years. We analyzed disease control including biochemical profile and clinical wellness. For biochemical assessment we considered three criteria: criterion 1, normal serum calcium, phosphorus and calcium x phosphorus product; criterion 2, the above plus estimated glomerular filtration rate ≥60 ml/min/1.73 m2; and criterion 3, the above plus normal 24-hour urinary calcium excretion. A patient was considered AC if he or she met the biochemical criteria and was clinically well. Results: We included 337 patients with postsurgical hypoparathyroidism (84.3% women, median age 45[36-56] years, median time of follow-up 8.9[6.0-13.0] years). The proportions of NAC patients with criteria 1, 2 and 3 were, respectively, 45.9%, 49.2% and 63.1%. Patients who had dyslipidemia at the time of diagnosis presented a significantly higher risk of NAC disease (criterion 3; OR 7.05[1.44-34.45]; P=0.016). NAC patients (criterion 2) had a higher proportion of subjects with incident chronic kidney disease and eye disorders, and NAC patients (criterion 3) had a higher proportion of incident chronic kidney disease, nephrolithiasis and dyslipidemia than AC patients. Conclusion: The present study shows a strikingly high prevalence of NAC patients in the clinical practice of Spanish endocrinologists. Results suggest that NAC disease might be associated with some prevalent and incident comorbidities.

Preparation and application of polycaprolactone/ß-cyclodextrin/gamma-Decalactone nanofiber composites in citrus postharvest diseases.

Citrus fruits are highly susceptible to pathogenic fungal infections after harvesting, which causes serious economic losses. Therefore, it's necessary to develop new antifungal packaging. In this study, gamma-Decanolactone (DL) was successfully encapsulated in a polycaprolactone (PCL)/ß-cyclodextrin (ß-CD) composite system using electrostatic spinning technology. PCL/ß-CD was compounded in different ratios, the ratio was screened through other indicators such as fiber morphologies and mechanical properties. Then, antifungal mats were prepared by adding different concentrations of DL to the PCL/ß-CD solution. The results showed that when the mixture ratio of PCL/ß-CD was 6:1 and loaded with 6 % DL, the antifungal felt had strong mechanical, significantly inhibiting the growth of three citrus pathogens (P. digitatum, P. italicum and G. candidum), released DL for up to 204 h and effectively reduced the morbidity rate of citrus fruits. Therefore, the antifungal pad prepared in this study has great potential in the field of citrus disease control.

The Efficacy of Orange Terpene and Bacillus mycoides Strain BM103 on the Control of Periwinkle Leaf Yellowing Phytoplasma.

Phytoplasmas are obligate phytopathogenic bacteria belonging to the class Mollicutes. The pathogens, transmitted by insect vectors, associated with hundreds of plant diseases worldwide. Due to the regulation on banning use of antibiotics and limited efficacy of the traditional disease management manners, an eco-friendly alternative is needed. Given that terpene and probiotics have antibiotic activity and the ability to induce systemic resistance, in this study, the effectiveness of orange terpene and a Bacillus mycoides strain, BM103, was evaluated in periwinkle plants infected with periwinkle leaf yellowing (PLY) phytoplasma derived from a shoot-tip tissue culture system. Weekly drenching of 1,000 ppm diluted orange terpene emulsion or pre-activated strain BM103 liquid culture dilution exhibited the ability to inhibit PLY phytoplasma accumulation. The expression of the genes associated with plant defense response and flower development was upregulated after treatment. Moreover, pre-treatment of orange terpene or strain BM103 delayed PLY infection via cleft-grafting inoculation. While orange terpene did not suppress the symptoms, strain BM103 did result in a milder symptom expression that might partially attribute to its plant growth-promoting characteristics. Additionally, the pre-activation of strain BM103 may contribute to its efficacy. Taken together, this research indicates that orange terpene and B. mycoides BM103, with the ability to rapidly induce plant defense responses, could potentially be developed into biological control materials as preventive agents or biofertilizers.

Additive Effect of Blood and Tissue Eosinophilia on Chronic Rhinosinusitis With Nasal Polyps.

PURPOSE: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a highly heterogeneous disease with varied clinical features and treatment effects. This study aimed to investigate the additive effect of blood and tissue eosinophilia on patients with CRSwNP. METHODS: Based on the blood eosinophil (Beos) count and tissue eosinophil (Teos) count, we divided 144 CRSwNP patients into four groups, analysed their clinical features and histopathologic changes, and investigated their postoperative control. RESULTS: Patients in the Beos+Teos+ (blood eosinophil count > 0.3 × 109/L, tissue eosinophil count > 10/HPF) group had a higher incidence of allergic rhinitis (AR) and asthma. Lund-Mackay (LM) scores, hyposmia visual analogue scale (VAS) scores and Global Osteitis Scoring Scale (GOSS) scores were higher in the Beos+Teos+ group than those in the other groups. Tissue remodelling, such as connective tissue oedema and basement membrane thickening was more severe in the Beos+Teos+ group compared with other groups. There were more uncontrolled patients after surgery in Beos+Teos+, Beos+Teos- (blood eosinophil count > 0.3 × 109/L, tissue eosinophil count ≤ 10/HPF)and Beos-Teos+ (blood eosinophil count ≤ 0.3 × 109/L, tissue eosinophil count > 10/HPF)groups compared with the Beos-Teos- group. CONCLUSIONS: Eosinophilic inflammation both in blood and tissue was accompanied by more severe clinical features and tissue remodelling. Eosinophilia in blood or tissue indicated poorer disease control after surgery.

Invited Review: Improved control of Johne's disease in dairy cattle through advancements in diagnostics, testing and management of young stock.

Johne's disease (JD; paratuberculosis) control programs have been regionally implemented across the globe, but few have successfully eradicated the pathogen (Mycobacterium avium ssp. paratuberculosis (MAP)) causing this disease. The limited success may partly be attributed to excluding young stock (calves and replacement heifers or bulls) from testing strategies aimed at identifying MAP-infected cattle. Young stock can shed MAP in feces and can have detectable MAP-specific antibodies in blood, as confirmed in experimentally and naturally infected cattle. Furthermore, MAP transmission causes new infections in young stock. Calves and heifers are often included in JD management strategies on dairy farms but excluded from conventional diagnostic tests due to a presumed lag between infection and detection of MAP shedding and/or MAP-specific serum antibodies. We summarize evidence of MAP shedding early in the course of infection and discuss promising diagnostics, testing and management strategies to support inclusion of young stock in JD control programs. Improvements in fecal Polymerase Chain Reaction, interferon-gamma release assay (IGRA), and enzyme-linked immunosorbent assay (ELISA) enable earlier detection of MAP and specific early immune responses. Studies on IGRA and ELISA have focused on evaluation of new antigens and optimal age of testing. There are new diagnostics, including phage-based tests to detect viable MAP, and gene expression patterns and metabolomics to detect MAP-infected young stock. In addition, refinements in testing and management of calves and heifers may enable reductions in MAP prevalence. We provide recommendations for dairy farmers, researchers, veterinarians, and other stakeholders that may improve JD control programs with an objective to control and potentially eradicate JD. Additionally, we have identified the most pressing gaps in knowledge that currently hamper inclusion of young stock in JD prevention and control programs. In summary, transmission among young stock may cause new MAP infections, and appropriate use of new diagnostic tests, testing and management strategies for young stock may improve the efficacy of JD control programs.

Patulin inhibition of specific apple microbiome members uncovers Hanseniaspora uvarum as a potential biocontrol agent.

Penicillium expansum is a major postharvest pathogen of apples, causing loss in fruits through tissue damage, as well as in apple products due to contamination with the mycotoxin patulin. During infections, patulin is a cultivar-dependent virulence factor that facilitates apple lesion development. Patulin also has characterized antimicrobial activity and is important for inhibiting other competitive phytopathogens, but the role of this inhibitory activity has not been investigated in the context of the apple microbiome. In our current study, we isolated 68 apple microbiota and characterized their susceptibility to P. expansum extracts. We found Gram-negative bacteria and Basidiomycete yeast to demonstrate largely patulin-specific growth inhibition compared to Gram-positive and Ascomycete isolates. From co-cultures, we identified a Hanseniaspora and Gluconobacter pairing that reduced P. expansum biomass and found that Hanseniaspora uvarum alone is sufficient to reduce apple disease progression in vivo. We investigated possible mechanisms of H. uvarum biocontrol activity and found modest inhibition on apple puree plates, as well as a trend toward lower patulin levels at the wound site. Active biocontrol activity required live yeast, which also were effective in controlling Botrytis cinerea apple infections. Lastly, we explored the breadth of H. uvarum biocontrol activity with over 30 H. uvarum isolates and found consistent inhibition of P. expansum apple disease.

Pyriofenone Interacts with the Major Facilitator Superfamily Transporter of Phytopathogenic Fungi to Potentially Control Tea Leaf Spot Caused by Lasiodiplodia theobromae.

Tea leaf spot caused by Lasiodiplodia theobromae is a newly discovered fungal disease in southwest China. Due to a lack of knowledge of its epidemiology and control strategies, the disease has a marked impact on tea yield and quality. Pyriofenone is a new fungicide belonging to the aryl phenyl ketone fungicide group, which has shown marked efficacy in controlling various fungal diseases. However, its mechanism of action is not yet understood. This study found that pyriofenone exhibits strong in vitro inhibitory activity against various phytopathogenic fungi. Specifically, it showed strong inhibitory activity against L. theobromae, with a half-maximal effective concentration (EC50) value of 0.428 µg/ml determined by measuring mycelial growth rate. Morphological observations, using optical, scanning electron, and transmission electron microscopy, revealed that pyriofenone induces morphological abnormalities in L. theobromae hyphae. At lower doses, the hyphae became swollen, the distance between septa decreased, and the hyphal growth rate slowed. At higher doses and longer exposures, the hyphae collapsed. Transcriptomic and bioinformatic analyses indicated that pyriofenone can affect the expression of genes related to membrane transporters. Homology modeling suggested that pyriofenone may bind to a candidate target protein of the major facilitator superfamily (MFS) transporter, with a free binding energy of -7.1 kcal/mol. This study suggests that pyriofenone may potentially regulate the transport of metabolites in L. theobromae, thus affecting hyphal metabolism and interfering with hyphal growth. Pyriofenone exhibits in vitro inhibitory activity against various tea foliar pathogens and holds promise for future applications to the control of tea foliar diseases.

Differential Sources of Resistance from Lactuca serriola Against Three Races of Xanthomonas hortorum pathovar vitians (Brown, 1918) Morinière et al. 2020 Causing Bacterial Leaf Spot of Lettuce.

Bacterial leaf spot (BLS) of lettuce (Lactuca sativa L.) is caused by the bacterium Xanthomonas hortorum pv. vitians which is hypothesized to have at least three races of the pathogen present in North America as defined by their differential resistance phenotypes in lettuce cultivars/accessions. Though resistance to X. hortorum pv. vitians race 1 has been identified in cultivated lettuce, numerous other X. hortorum pv. vitians strains cause disease on cultivars carrying this resistance locus. Thus far, resistance to these 'additional' X. hortorum pv. vitians strains has not been adequately described in L. sativa or in any other wild Lactuca species sexually compatible with cultivated lettuce. We have performed an extensive screening of approximately 500 Lactuca accessions from L. sativa, L. serriola, L. saligna, L. virosa, L. aculeata, L. altaica, and L. perennis species to identify accessions resistant to these additional X. hortorum pv. vitians races. Following the initial screenings, greenhouse tests confirmed that X. hortorum pv. vitians race 2 and race 3 could be defined using Lactuca sativa accessions. Race 2 strain BS3217 had an incompatible response (hypersensitive response) on ten Lactuca serriola accessions including PI491114 and PI491108, while race 1 (BS0347) and race 3 (BS2861) strains of X. hortorum pv. vitians showed a compatible response (disease) on these genotypes. L. serriola accession ARM09-161 (and selections derived from it) was the only genotype resistant to the race 3 strain BS2861. L. serriola accessions identified in this study to be resistant to race 2 and race 3 of X. hortorum pv. vitians, together with race 1 resistant cultivars, can be used for pyramiding resistance loci against the three races of the BLS-causing pathogen.

Evaluation of the mpox surveillance system in Cameroon from 2018 to 2022: a laboratory cross-sectional study.

BACKGROUND: Formal assessment of a surveillance system's features and its ability to achieve objectives is crucial for disease control and prevention. Since the implementation of the mpox surveillance system in Cameroon, no evaluation has been conducted. METHODS: In a cross-sectional study, we assessed the performance of the mpox surveillance system in accordance with the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) guidelines. We collected mpox surveillance data from 2018 to 2022 and conducted a survey with key stakeholders of the surveillance program. The survey results were summarized. The rates of complete reporting and mpox detection, as well as the time lag between the different stages of surveillance were analyzed using R version 4.1. RESULTS: The mpox detection rate was 21.6% (29/134) over the five years under review. Surveillance indicators revealed that a combination of sample types, including vesicles, crust, and blood, was associated with higher case confirmation. Overall, the mpox surveillance system was effective. Weaknesses in terms of simplicity were identified. Most components of the assessed system failed to meet the timeliness and data quality goals, except for the laboratory component, which was commendable. The lack of a computerized shared database and the system's non-sustainability were a course of concern. CONCLUSIONS: Despite all identified bottlenecks in the mpox surveillance system in Cameroon, it was found to meet it stipulated goals. Recommendations are made for training on surveillance system features, particularly at the facility/field level. Therefore, there is a crucial need to globally improve the mpox surveillance system in Cameroon for better disease control.

Trauma Research Funding: An Emergency in Emergency Care.

INTRODUCTION: Trauma remains a significantly underfunded area of medical research despite its status as a leading cause of death and substantial economic burden in the United States. This study explores the disparity in trauma research funding, focusing on Oklahoma compared to neighboring and populous states. METHODS: Using data from the Centers for Disease Control and Prevention (CDC)'s Web-based Injury Statistics Query and Reporting System (WISQARS™) and the National Institutes of Health (NIH)'s RePORT databases, we analyzed age-adjusted years of potential life lost (YPLL) due to trauma and corresponding NIH funding across different states and nationally. Statistical analyses included bivariate comparisons and standardization of funding data per population and YPLL. RESULTS: From 2010 to 2020, NIH allocated approximately $124 billion nationally, with only 5% dedicated to trauma, amounting to $1,772.32 per age-adjusted YPLL. Oklahoma and Kansas exhibited the lowest NIH funding per YPLL compared to New York and California. Funding for the National Injury Prevention and Control, a subdivision of the CDC, has shown significant increases, ranking third in 2022. CONCLUSION: This study highlights the urgent need for enhanced trauma research funding to address its disproportionate impact on mortality and healthcare costs. Strategic allocation of resources is essential to advance trauma care and align research priorities with public health needs.

Evaluation of a Pharmacist-Led Multidisciplinary Approach to the Treatment of Latent Tuberculosis in Refugee Patients in the Primary Care Setting.

BACKGROUND: Treatment of latent tuberculosis infection (LTBI) is essential for refugee patients that have been relocated to the United States to prevent progression to active infection. OBJECTIVE: To determine the effectiveness of a multidisciplinary team approach, embedded within a primary care clinic, to treatment of LTBI in newly resettled refugee patients compared to a local health department. METHODS: This was a single-center, retrospective chart review of newly resettled refugee patients 18-89 years old with diagnosis of LTBI. The primary objective was completion rate of LTBI therapy within one year of resettlement. Secondary objectives were incidence of adverse events, regimen switches, and adherence rate. RESULTS: A total of 58 patients were included in the study; 14 individuals through the multidisciplinary clinic and 44 individuals with the local health department. Completion of therapy within 1 year of resettlement was seen in 71.4% (n=10) of patients in the multidisciplinary clinic compared to 72.7% (n= 32) at the health department. There were 7 patients who underwent a regimen switch, all of which were in the health department arm. Adverse effects occurred in 14.2% of patients in the multidisciplinary clinic and 15.9% of patients in the health department arm. Treatment adherence was 98.6% in the multidisciplinary clinic and 90.5% in the local health department arm. CONCLUSION: Use of a multidisciplinary team was successful in completion of LTBI treatment in refugee patients, helping to alleviate barriers to treatment completion by ensuring adherence and close follow-up.

Infectious Disease Physicians' Knowledge and Practices Regarding Wastewater Surveillance, United States, 2024.

A survey of US infectious disease physicians indicated that few regularly reviewed wastewater surveillance (WWS) data but many reported examples of how WWS has affected or could affect their clinical practice. WWS data can be useful for physicians, but increased communication between public health professionals and physicians regarding WWS could improve its utility.

Transient Expression of Nicotiana tabacum Silicon-Induced Histidine-Rich Defensins in Nicotiana benthamiana Limits Necrotic Lesion Development Caused by Phytopathogenic Fungi.

Silicon (Si) supplementation permits plants to better deter infection. Supplementing hydroponically-propagated Nicotiana tabacum with 1 mM potassium silicate (K2SiO3) reduced necrotic lesion development on detached leaves by both Botrytis cinerea and Sclerotinia sclerotiorum. Previously, a family of Si-induced genes was identified in N. tabacum. These genes were members of the Solanaceous Histidine-Rich Defensin (HRD) superfamily and were termed NtHRD1s (the first identified family of Nicotiana tabacum Histidine-Rich Defensins). Defensins were originally identified to participate in innate immunity. Thus, the NtHRD1s were tested for antimicrobial effects on plant pathogens. Transient expression of NtHRD1 genes within Nicotiana benthamiana leaves restricted the development of necrotic lesions caused by B. cinerea and S. sclerotiorum. Thus, the NtHRD1s may be an additional Si-responsive factor conferring beneficial effects on plants.

New Approaches to Plant Pathogen Detection and Disease Diagnosis.

Detecting plant pathogens and diagnosing diseases are critical components of successful pest management. These key areas have undergone significant advancements driven by breakthroughs in molecular biology and remote sensing technologies within the realm of precision agriculture. Notably, nucleic acid amplification techniques, with recent emphasis on sequencing procedures, particularly next-generation sequencing, have enabled improved DNA or RNA amplification detection protocols that now enable previously unthinkable strategies aimed at dissecting plant microbiota, including the disease-causing components. Simultaneously, the domain of remote sensing has seen the emergence of cutting-edge imaging sensor technologies and the integration of powerful computational tools, such as machine learning. These innovations enable spectral analysis of foliar symptoms and specific pathogen-induced alterations, making imaging spectroscopy and thermal imaging fundamental tools for large-scale disease surveillance and monitoring. These technologies contribute significantly to understanding the temporal and spatial dynamics of plant diseases.

Risk factors investigation for different outcomes between unilateral and bilateral chronic rhinosinusitis with nasal polyps patients.

BACKGROUND: Studies involving chronic rhinosinusitis with nasal polyps (CRSwNP) have mostly focused on bilateral cases, making unilateral CRSwNP inadequately recognized. This study examined the differences in clinical characteristics, outcomes, and risk factors for poor outcomes between unilateral and bilateral CRSwNP to facilitate a better assessment in the two groups. METHODS: Demographic information, tissue and blood cells, endoscopic scores, Lund-Mackay scores, recurrence rates, and disease control conditions were compared between 310 unilateral and 596 bilateral CRSwNP patients. Furthermore, the stepwise regression multivariate Cox proportional hazard models were performed to generate risk factors for poor outcomes in the two groups. RESULTS: Bilateral cases exhibited higher rates of smoking, AR, and asthma comorbidities, along with higher numbers of tissue eosinophils and blood inflammatory cells when compared to unilateral patients. Endoscopic nasal polyp score, total computed tomography (CT) score (with scores for each sinus cavity), and adjusted CT scores were significantly higher in the bilateral group, except for a markedly higher adjusted maxillary score in the unilateral group. Furthermore, significantly higher proportions of bilateral patients experienced nasal polyp recurrence, uncontrolled status, and most disease control-related symptoms at follow-up. The primary risk factors for poor outcomes were asthma, tissue eosinophils, and total CT score in the bilateral group and blood basophils in the unilateral group. CONCLUSIONS: Bilateral CRSwNP patients experience worse disease severity and outcomes than their unilateral counterparts. Primarily, asthma, tissue eosinophils, and total CT score were risk factors for poor outcomes in bilateral CRSwNP patients, with blood basophils in unilateral cases.

Efficacy and safety of PARPis combined with an ICIs for advanced or metastatic triple-negative breast cancer: a single-arm meta-analysis.

Although the intervention for triple-negative breast cancer (TNBC) patients has improved and survival time has increased, the combination of immune checkpoint inhibitors(ICIs) and PARP inhibitors (Poly ADP-Ribose Polymerase inhibitors, PARPis) is still controversial. Previous studies revealed that the combined use of ICIs and PARPis led to increased antitumor activity. However, most of these combined regimens are nonrandomized controlled trials with small sample sizes. The purpose of this meta-analysis was to evaluate the efficacy and safety of ICIs combined with PARPis in patients with advanced or metastatic TNBC. The PubMed, Embase, Cochrane Library and Web of Science databases were systematically searched. The results including the objective remission rate (ORR), disease control rate (DCR), progression-free survival (PFS) and adverse events (AEs), were subjected to further analysis. Four studies involving 110 subjects were included in this meta-analysis. The combined ORR and DCR were 23.6% and 53.6%, respectively; while the ORR and DCR of BRCAmut patients were 38.1% and 71.4%, respectively. The median PFS of the patients was 4.29 months. As for safety, the most common AEs were nausea (49.0%), anemia (44.3%) and fatigue (40.6%). Most of them were grade 1 or 2, and the incidence of adverse events ≥ III was obviously low. Except for anemia, the incidence of AEs ≥ III was < 10%. This meta-analysis revealed that the combination of ICIs and PARPis has good efficacy and safety for advanced or metastatic TNBC patients.