Characteristic Metabolic Changes in Skeletal Muscle Due to Vibrio vulnificus Infection in a Wound Infection Model.

Vibrio vulnificus is a bacterium that inhabits warm seawater or brackish water environments and causes foodborne diseases and wound infections. In severe cases, V. vulnificus invades the skeletal muscle tissue, where bacterial proliferation leads to septicemia and necrotizing fasciitis with high mortality. Despite this characteristic, information on metabolic changes in tissue infected with V. vulnificus is not available. Here, we elucidated the metabolic changes in V. vulnificus-infected mouse skeletal muscle using capillary electrophoresis time-of-flight mass spectrometry (CE-TOFMS). Metabolome analysis revealed changes in muscle catabolites and energy metabolites during V. vulnificus infection. In particular, succinic acid accumulated but fumaric acid decreased in the infected muscle. However, the virulence factor deletion mutant revealed that changes in metabolites and bacterial proliferation were abolished in skeletal muscle infected with a multifunctional-autoprocessing repeats-in-toxin (MARTX) mutant. On the other hand, mice that were immunosuppressed via cyclophosphamide (CPA) treatment exhibited a similar level of bacterial counts and metabolites between the wild type and MARTX mutant. Therefore, our data indicate that V. vulnificus induces metabolic changes in mouse skeletal muscle and proliferates by using the MARTX toxin to evade the host immune system. This study indicates a new correlation between V. vulnificus infections and metabolic changes that lead to severe reactions or damage to host skeletal muscle. IMPORTANCE V. vulnificus causes necrotizing skin and soft tissue infections (NSSTIs) in severe cases, with high mortality and sign of rapid deterioration. Despite the severity of the infection, the dysfunction of the host metabolism in skeletal muscle triggered by V. vulnificus is poorly understood. In this study, by using a mouse wound infection model, we revealed characteristic changes in muscle catabolism and energy metabolism in skeletal muscle associated with bacterial proliferation in the infected tissues. Understanding such metabolic changes in V. vulnificus-infected tissue may provide crucial information to identify the mechanism via which V. vulnificus induces severe infections. Moreover, our metabolite data may be useful for the recognition, identification, or detection of V. vulnificus infections in clinical studies.

Location of Hamstring Injuries Based on Magnetic Resonance Imaging: A Systematic Review.

CONTEXT: Hamstring muscle injury location using magnetic resonance imaging (MRI) is not so well described in the literature. OBJECTIVE: To describe the location of hamstring injuries using MRI. DATA SOURCES: PubMed, Web of Science, Scopus, SPORTDiscus, Cochrane Library. STUDY SELECTION: The full text of studies, in English, had to be available. Case reports and reviews were excluded. Included studies must report the location of hamstring injuries using MRI within 8 days of the acute injury. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 4. DATA EXTRACTION: A first screening was conducted based on title and abstract of the articles. In the second screening, the full text of the remaining articles was evaluated for the fulfillment of the inclusion criteria. RESULTS: From the 2788 references initially found in 5 databases, we included 34 studies, reporting a total of 2761 acute hamstring injuries. The most frequent muscle head involved was the long head of the biceps femoris (BFLH) (70%), followed by the semitendinosus (ST) (15%), generally associated with BFLH. The most frequent tissue affected was the myotendinous junction (MTJ) accounting for half the cases (52%). Among all lesions, the distribution between proximal, central, and distal lesions looked homogenous, with 34.0%, 33.4% and 32.6%, respectively. The stretching mechanism, while only reported in 2 articles, represented 3% of all reported mechanisms, appears responsible for a specific lesion involving the proximal tendon of the semimembranosus (SM), and leading to a longer time out from sport. CONCLUSION: BFLH was the most often affected hamstring injuries and MTJ was the most affected tissue. In addition, the distal, central, and proximal locations were homogeneously distributed. We also noted that MRI descriptions of hamstring injuries are often poor and did not take full advantage of the MRI strengths. SYSTEMATIC REVIEW REGISTRATION: Before study initiation, the study was registered in the PROSPERO International prospective register of systematic reviews (registration number CRD42018107580).

Ice-templated synthesis of tungsten oxide nanosheets and their application in arsenite oxidation.

Tungsten oxide (WO3) nanosheets were prepared as catalysts to activate hydrogen peroxide (H2O2) in arsenite (As(III)) oxidation. Ice particles were employed as templates to synthesize the WO3 nanosheets, enabling easy template removal via melting. Transmission electron microscopy and atomic force microscopy revealed that the obtained WO3 nanosheets were plate-like, with lateral sizes ranging from dozens of nanometers to hundreds of nanometers and thicknesses of <10 nm. Compared to that of the WO3 nanoparticle/H2O2 system, a higher efficiency of As(III) oxidation was observed in the WO3 nanosheet/H2O2 system. Electron spin resonance spectroscopy, radical quenching studies, and As(III) oxidation experiments under anoxic conditions suggested that the hydroperoxyl radical (HO2●) acted as the primary oxidant. The WO3 nanosheets possessed numerous surface hydroxyl groups and electrophilic metal centers, enhancing the production of HO2● via H2O2 activation. Various anions commonly present in As(III)-contaminated water exhibited little effect on As(III) oxidation in the WO3 nanosheet/H2O2 system. The high oxidation efficiency was maintained by adding H2O2 when it was depleted, suggesting that the catalytic activity of the WO3 nanosheets did not deteriorate after multiple catalytic cycles.

Effect of smartphone-based stress management programs on depression and anxiety of hospital nurses in Vietnam: a three-arm randomized controlled trial.

There are growing concerns on stress among nurses in low- and middle-income countries (LMICs) in South-East Asia. It is important to improve mental health among nurses in these countries. The objective of this study was to examine the efficacy of two types of newly developed smartphone-based stress management programs in improving depressive and anxiety symptoms among hospital nurses in Vietnam. This study was a three-arm (including two intervention groups and one control group) randomized trial. Participants were recruited from nurses in a large general hospital in Hanoi, Vietnam. Two types (free-choice and fixed sequential order) of smartphone-based stress management programs were developed. Participants were randomly allocated to Program A (a free-choice, multimodule stress management), Program B (a fixed-order, internet cognitive behavioral therapy, iCBT), or a control group (treatment as usual). The depressive and anxiety symptoms were measured by using the Depression Anxiety and Stress Scales at baseline, 3-, and 7-month follow-up surveys. 951 participants were randomly allocated to each of the three groups. Program B showed a statistically significant effect on improving depressive symptoms at 3-month (p = 0.048), but not at 7-month (p = 0.92); Cohen's d was - 0.18 (95% CI - 0.34 to - 0.02) and 0.03 (95% CI - 1.00 to 1.05), respectively. Program A failed to show a significant intervention effect on any of the outcomes at 3- or 7-month follow-up (p > 0.05). Despite the small effect size, the present fixed-order iCBT program seems effective in improving depression of hospital nurses in Vietnam. A public health impact of the intervention can be scalable, when considering its accessibility and minimal cost.Trial registration number: The study protocol is registered at the UMIN Clinical Trials Registry (UMINCTR; ID = UMIN000033139). Registered date of the protocol is 1st Jul. 2018. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037796.

Reductive transformation of hexavalent chromium by ferrous ions in a frozen environment: Mechanism, kinetics, and environmental implications.

The transformation between hexavalent chromium (Cr6+) and trivalent chromium (Cr3+) has a significant impact on ecosystems, as Cr6+ has higher levels of toxicity than Cr3+. In this regard, a variety of Cr6+ reduction processes occurring in natural environments have been studied extensively. In this work, we investigate the reductive transformation of Cr6+ by ferrous ions (Fe2+) in ice at -20 °C, and compare the same process in water at 25 °C. The Fe2+-mediated reduction of Cr6+ occurred much faster in ice than it did in water. The accelerated reduction of Cr6+ in ice is primarily ascribed to the accumulation of Cr6+, Fe2+, and protons in the grain boundaries formed during freezing, which constitutes favorable conditions for redox reactions between Cr6+ and Fe2+. This freeze concentration phenomenon was verified using UV-visible spectroscopy with o-cresolsulfonephthalein (as a pH indicator) and confocal Raman spectroscopy. The reductive transformation of Cr6+ (20 µM) by Fe2+ in ice proceeded rapidly under various Fe2+ concentrations (20-140 µM), pH values (2.0-5.0), and freezing temperatures (-10 to -30 °C) with a constant molar ratio of oxidized Fe2+ to reduced Cr6+ (3:1). This result implies that the proposed mechanism (i.e., the redox reaction between Cr6+ and Fe2+ in ice) can significantly contribute to the natural conversion of Cr6+ in cold regions. The Fe2+-mediated Cr6+ reduction kinetics in frozen Cr6+-contaminated wastewater was similar to that in frozen Cr6+ solution. This indicates that the variety of substrates typically present in electroplating wastewater have a negligible effect on the redox reaction between Cr6+ and Fe2+ in ice; it also proposes that the Fe2+/freezing process can be used for the treatment of Cr6+-contaminated wastewater.

Freezing-Induced Simultaneous Reduction of Chromate and Production of Molecular Iodine: Mechanism, Kinetics, and Practical Implications.

A new method for the concurrent treatment of Cr(VI)-contaminated wastewater and production of the useful I2 chemical was developed. The method is based on the redox reaction between Cr(VI) and I- that occurs when an aqueous wastewater solution containing Cr(VI) and I- is frozen, producing I2 and allowing for the effective removal of Cr. The redox reaction occurs primarily because of the accumulation of Cr(VI), I-, and protons in the ice grain boundaries formed during freezing (i.e., the freeze concentration effect). This effect was verified by confocal Raman spectroscopy and the experiments varying I- concentration and pH. The reduction of Cr(VI) (20 µM) was near complete after freezing at I- concentrations ≥ 100 µM, pH ≤ 3.0, and temperatures ≤ -10 °C. The freezing method (liquid cooling vs air cooling) had little effect on the final Cr(VI) reduction efficiency but had a significant effect on the Cr(VI) reduction rate. The freezing method was also tested with Cr(VI)-contaminated electroplating wastewater samples, and simultaneous Cr(VI) reduction and I2 production proceeded rapidly in a frozen solution but was not observed in an aqueous solution. Additionally, other substances in electroplating wastewater did not reduce the rate and final efficiency of Cr(VI) reduction and I2 production. Therefore, the freezing/Cr(VI)/I- system can be considered a feasible approach to water-energy nexus technology for simultaneous I2 production and Cr(VI)-contaminated wastewater treatment.

Percutaneous Ultrasound-Guided Access to the Superior Ophthalmic Vein for Embolization of a Cavernous Sinus Dural Arteriovenous Fistula.

The treatment of symptomatic cavernous sinus dural arteriovenous fistula, an unusually occluded cavernous sinus, is by a transvenous approach through the inferior petrosal sinus and superior ophthalmic vein. If these two modes of conventional transvenous access are not possible, surgical exposure and/or direct puncture access to the superior ophthalmic vein or cavernous sinus have been previously described. In a patient with progressive ophthalmological problems, the goal of treatment is to not only cure the ophthalmic symptoms but also to conserve or improve visual acuity, so treatment is needed as soon as possible. We report a 68-year-old woman suffering a Barrow type D cavernous sinus dural arteriovenous fistula. In this case, inadequate, inferior petrosal sinus embolization and lack of access for superior ophthalmic vein via a facial vein preceded percutaneous puncture under sonographic guidance of the superior ophthalmic vein. This permitted venous occlusion without complications and symptom-free for 11 months.

Type III Secretion Effector VopQ of Vibrio parahaemolyticus Modulates Central Carbon Metabolism in Epithelial Cells.

Vibrio parahaemolyticus is a Gram-negative halophilic pathogen that frequently causes acute gastroenteritis and occasional wound infection. V. parahaemolyticus contains several virulence factors, including type III secretion systems (T3SSs) and thermostable direct hemolysin (TDH). In particular, T3SS1 is a potent cytotoxic inducer, and T3SS2 is essential for causing acute gastroenteritis. Although much is known about manipulation of host signaling transductions by the V. parahaemolyticus effector, little is known about the host metabolomic changes modulated by V. parahaemolyticus To address this knowledge gap, we performed a metabolomic analysis of the epithelial cells during V. parahaemolyticus infection using capillary electrophoresis-time of flight mass spectrometry (CE-TOF/MS). Our results revealed significant metabolomic perturbations upon V. parahaemolyticus infection. Moreover, we identified that T3SS1's VopQ effector was responsible for inducing the significant metabolic changes in the infected cells. The VopQ effector dramatically altered the host cell's glycolytic, tricarboxylic acid cycle (TCA), and amino acid metabolisms. VopQ effector disrupted host cell redox homeostasis by depleting cellular glutathione and subsequently increasing the level of reactive oxygen species (ROS) production.IMPORTANCE The metabolic response of host cells upon infection is pathogen specific, and infection-induced host metabolic reprogramming may have beneficial effects on the proliferation of pathogens. V. parahaemolyticus contains a range of virulence factors to manipulate host signaling pathways and metabolic processes. In this study, we identified that the T3SS1 VopQ effector rewrites host metabolism in conjunction with the inflammation and cell death processes. Understanding how VopQ reprograms host cell metabolism during the infection could help us to identify novel therapeutic strategies to enhance the survival of host cells during V. parahaemolyticus infection.

Prevalence and associated factors of overweight and obesity among schoolchildren in Hanoi, Vietnam.

BACKGROUND: The prevalence of overweight and obesity (OW/OB) has increased rapidly in Vietnam. This study aimed to elucidate the factors influencing OW/OB among secondary schoolchildren. METHOD: A survey was conducted in January 2014 in four randomly selected state schools in two Hanoi urban districts, and 821 students in grade six (11-12 years old) participated. Definitions of OW/OB followed the World Health Organization standard cut-offs. RESULTS: Overall, 4.1% of children were underweight, 59.7% were normal weight, 17.1% were overweight, and 19.1% were obese. The odds of OW/OB were lowest among children whose parents had college/university degrees [father (aOR =0.65, 95% CI: 0.42-1.00); mother (aOR =0.63, 95% CI: 0.41-0.97)] compared with those whose parents had only a primary education. Children with an OW/OB family history had an increased risk of OW/OB. Other associated factors include parental OW/OB and birth weight (BW). The odds of OW/OB were highest among children with parents with OW/OB [father (aOR =2.022, 95% CI: 1.34-3.04); mother (aOR =2.83, 95% CI: 1.51-5.30)] compared with those with normal-weight parents. Children with both parents having OW/OB [both parents (aOR =6.59, 95% CI: 1.28-33.87) had the highest risk, followed by one parent (aOR =2.22, 95% CI: 1.50-3.27)] and then neither parent having OW/OB. Moreover, high-birth-weight children [BW ≥ 3500 g (aOR =1.52, 95% CI: 1.07-2.15)] had greater odds than did normal-birth-weight children. Children who slept 11 h per day [8-11 h (aOR =0.57, 95% CI: 0.40-0.81) or more (aOR =0.44, 95% CI: 0.22-0.87)] had lower OW/OB odds than those who slept 8 h or less. Children with specific positive lifestyle behaviours had lower risk of OW/OB than those who did not engage in positive lifestyle behaviours. The odds were lower among children who exercised for weight reduction (OR = 0.16, 95% CI: 0.11-0.23), lowered food intake (aOR = 0.12, 95% CI: 0.09-0.17), and added vegetables to their diet (aOR = 0.26, 95% CI: 0.19-0.35). CONCLUSION: The results suggest that parents and children with OW/OB parents or a high BW should be educated to prevent OW/OB at an early stage. Positive lifestyle behaviours should be adopted by the students.

Effects of two types of smartphone-based stress management programmes on depressive and anxiety symptoms among hospital nurses in Vietnam: a protocol for three-arm randomised controlled trial.

INTRODUCTION: Due to an increasing demand for healthcare in low-income and middle-income countries in Asia, it is important to develop a strategy to manage work-related stress in healthcare settings, particularly among nurses in these countries. The purpose of this three-arm randomised controlled trial (RCT) is to examine the effects of a newly developed smartphone-based multimodule stress management programme on reducing severity of depressive and anxiety symptoms as primary outcomes at 3-month and 7-month follow-ups among hospital nurses in Vietnam. METHODS AND ANALYSIS: The target study population will be registered nurses working in a large general hospital (which employs approximately about 2000 nurses) in Vietnam. They will be invited to participate in this study. Participants who fulfil the eligibility criteria will be randomly allocated to the free-choice, multimodule stress management (intervention group A, n=360), the internet cognitive behavioural therapy (iCBT), that is, fixed-order stress management (intervention group B, n=360), or a treatment as usual control group (n=360). Two types (free-choice and fixed sequential order) of smartphone-based six-module stress management programmes will be developed. Participants in the intervention groups will be required to complete one of the programmes within 10 weeks after the baseline survey. The primary outcomes are depressive and anxiety symptoms, measured by using the Depression Anxiety and Stress Scales (DASS) at 3-month and 7 month follow-ups. ETHICS AND DISSEMINATION: The study procedures have been approved by the Research Ethics Review Board of Graduate School of Medicine/Faculty of Medicine, the University of Tokyo (no 11991) and the Ethical Review Board for Biomedical Research of Hanoi University of Public Health (no 346/2018/YTCC-HD3). If a significant effect of the intervention programmes will be found in the RCT, the programmes will be made available to all nurses in the hospital including the control group. If the positive effects are found in this RCT, the e-stress management programmes will be disseminated to all nurses in Vietnam. TRIAL REGISTRATION NUMBER: UMIN000033139; Pre-results.

Host cellular unfolded protein response signaling regulates Campylobacter jejuni invasion.

Campylobacter jejuni is a major cause of bacterial foodborne illness in humans worldwide. Bacterial entry into a host eukaryotic cell involves the initial steps of adherence and invasion, which generally activate several cell-signaling pathways that induce the activation of innate defense systems, which leads to the release of proinflammatory cytokines and induction of apoptosis. Recent studies have reported that the unfolded protein response (UPR), a system to clear unfolded proteins from the endoplasmic reticulum (ER), also participates in the activation of cellular defense mechanisms in response to bacterial infection. However, no study has yet investigated the role of UPR in C. jejuni infection. Hence, the aim of this study was to deduce the role of UPR signaling via induction of ER stress in the process of C. jejuni infection. The results suggest that C. jejuni infection suppresses global protein translation. Also, 12 h of C. jejuni infection induced activation of the eIF2α pathway and expression of the transcription factor CHOP. Interestingly, bacterial invasion was facilitated by knockdown of UPR-associated signaling factors and treatment with the ER stress inducers, thapsigargin and tunicamycin, decreased the invasive ability of C. jejuni. An investigation into the mechanism of UPR-mediated inhibition of C. jejuni invasion showed that UPR signaling did not affect bacterial adhesion to or survival in the host cells. Further, Salmonella Enteritidis or FITC-dextran intake were not regulated by UPR signaling. These results indicated that the effect of UPR on intracellular intake was specifically found in C. jejuni infection. These findings are the first to describe the role of UPR in C. jejuni infection and revealed the participation of a new signaling pathway in C. jejuni invasion. UPR signaling is involved in defense against the early step of C. jejuni invasion and thus presents a potential therapeutic target for the treatment of C. jejuni infection.

Cystic Fibrosis Transmembrane Conductance Regulator Reduces Microtubule-Dependent Campylobacter jejuni Invasion.

Campylobacterjejuni is a foodborne pathogen that induces gastroenteritis. Invasion and adhesion are essential in the process of C. jejuni infection leading to gastroenteritis. The mucosal layer plays a key role in the system of defense against efficient invasion and adhesion by bacteria, which is modulated by several ion channels and transporters mediated by water flux in the intestine. The cystic fibrosis transmembrane conductance regulator (CFTR) plays the main role in water flux in the intestine, and it is closely associated with bacterial clearance. We previously reported that C. jejuni infection suppresses CFTR channel activity in intestinal epithelial cells; however, the mechanism and importance of this suppression are unclear. This study sought to elucidate the role of CFTR in C. jejuni infection. Using HEK293 cells that stably express wild-type and mutated CFTR, we found that CFTR attenuated C. jejuni invasion and that it was not involved in bacterial adhesion or intracellular survival but was associated with microtubule-dependent intracellular transport. Moreover, we revealed that CFTR attenuated the function of the microtubule motor protein, which caused inhibition of C. jejuni invasion, but did not affect microtubule stability. Meanwhile, the CFTR mutant G551D-CFTR, which had defects in channel activity, suppressed C. jejuni invasion, whereas the ΔF508-CFTR mutant, which had defects in maturation, did not suppress C. jejuni invasion, suggesting that CFTR suppression of C. jejuni invasion is related to CFTR maturation but not channel activity. When these findings are taken together, it may be seen that mature CFTR inhibits C. jejuni invasion by regulating microtubule-mediated pathways. We suggest that CFTR plays a critical role in cellular defenses against C. jejuni invasion and that suppression of CFTR may be an initial step in promoting cell invasion during C. jejuni infection.