Uncovering the Microbial Diversity of Two Exotic Calcareous Sponges.

Sponges-associated microorganisms play important roles in their health and ecology; consequently, they may be crucial in the successful adaptation of exotic species to novel environments. However, few studies have focused on the microbial diversity of exotic sponges, especially those with calcium carbonate spicules (class Calcarea). Therefore, this is the first in situ characterization of the microbiota of the exotic calcareous sponges Sycettusa hastifera and Paraleucilla magna. Our results suggest that S. hastifera has a more stable microbiota than P. magna, as there were no differences in its beta diversity among sampling sites. Conversely, P. magna showed significant differences in its microbial communities, perhaps related to its adhesion to artificial substrate and/or shellfish mariculture activities. Each sponge species presented a single dominant proteobacterial OTU potentially active in the nitrogen cycle, which could help sponge detoxification, especially in polluted areas where exotic species usually establish. Our results show the importance of assessing the microbial diversity to unveil host-microorganism relationships and suggest that these associated nitrogen-cycling microorganisms could favor the success of exotic sponges in new environments.

The Complexity of Transferring Remote Monitoring and Virtual Care Technology Between Countries: Lessons From an International Workshop.

International deployment of remote monitoring and virtual care (RMVC) technologies would efficiently harness their positive impact on outcomes. Since Canada and the United Kingdom have similar populations, health care systems, and digital health landscapes, transferring digital health innovations between them should be relatively straightforward. Yet examples of successful attempts are scarce. In a workshop, we identified 6 differences that may complicate RMVC transfer between Canada and the United Kingdom and provided recommendations for addressing them. These key differences include (1) minority groups, (2) physical geography, (3) clinical pathways, (4) value propositions, (5) governmental priorities and support for digital innovation, and (6) regulatory pathways. We detail 4 broad recommendations to plan for sustainability, including the need to formally consider how highlighted country-specific recommendations may impact RMVC and contingency planning to overcome challenges; the need to map which pathways are available as an innovator to support cross-country transfer; the need to report on and apply learnings from regulatory barriers and facilitators so that everyone may benefit; and the need to explore existing guidance to successfully transfer digital health solutions while developing further guidance (eg, extending the nonadoption, abandonment, scale-up, spread, sustainability framework for cross-country transfer). Finally, we present an ecosystem readiness checklist. Considering these recommendations will contribute to successful international deployment and an increased positive impact of RMVC technologies. Future directions should consider characterizing additional complexities associated with global transfer.

Pelvic floor dysfunction after vaginal delivery: MOODS-a prospective study.

INTRODUCTION AND HYPOTHESIS: Labor is a known risk factor for pelvic floor dysfunction (PFD); however, the impact of operative vaginal delivery (OVD), particularly spatulas, remains unclear. The aim of this study was to compare postpartum PFD symptoms in women undergoing spontaneous vaginal delivery (SVD) and those undergoing OVD. METHODS: An observational prospective study (MOODS: Maternal-neonatal Outcomes in Operative Vaginal Delivery) was enrolled at Hospital de Braga from February to October 2018. All singleton term OVD (Thierry spatulas and vacuum extractor) and a convenience SVD sample were recruited, in a 2:1 ratio. To assess PFD symptoms Pelvic Floor Distress Inventory-20 (PFDI-20) was applied at 3, 6, and 12 months postpartum. The questionnaire is divided into three subscales: Urinary (UDI), Colorectal-Anal (CRADI), and Pelvic Organ Prolapse Distress Inventory (POPDI). RESULTS: Of the 304 women recruited, 207 were included, 34.3% with SVD and 65.7% with OVD. Thierry spatulas were used in 53.7% of women undergoing OVD. Frequency of nulliparous (p < 0.001), episiotomy (p < 0.001), neuraxial anesthesia (p < 0.001), postpartum pain (p = 0.001) and occiput-posterior fetal position (p < 0.001) were significantly higher in OVD. Second phase of labor duration was longer in OVD (p = 0.001). At 3 months postpartum, women undergoing OVD and spatula-assisted delivery had higher UDI score, POPDI score, and global score, with no differences at 6 months and 1 year. After controlling for confounding variables, OVD and spatulas were still associated with greater POPDI scores at 3 months postpartum. CONCLUSIONS: Operative vaginal delivery, particularly with spatulas, seems to be associated with a higher prevalence of early PFD symptoms, mainly regarding pelvic organ prolapse.

Impact of detection criteria on coronal and root caries estimates in adults with and without type 2 diabetes mellitus.

OBJECTIVE: To compare caries prevalence and extent in adults with or without diabetes mellitus (DM) according to different caries detection criteria (WHO, ICDAS, and Nyvad). MATERIALS AND METHODS: A cross-sectional study was carried out including 122 individuals, 44 without DM and 78 with type 2 DM. Trained and calibrated examiners performed a visual-tactile inspection to record coronal and root caries lesions (weighted kappa > 0.7). Caries prevalence and extent were calculated according to the WHO (only cavitated lesions, missing and filled surfaces), ICDAS (all non-cavitated and cavitated lesions, missing and filled surfaces), and Nyvad (only active lesions, non-cavitated and cavitated). For root caries, lesions were classified as active or inactive. RESULTS: A significantly higher overall caries experience (DMF-S) was observed among patients with DM when the WHO (RR = 1.37; 95% CI = 1.09-1.71) and the ICDAS (RR = 1.32; 95% CI = 1.07-1.62) criteria were adopted. No difference between groups was found when the Nyvad criterion was used, although a low study power was observed in this comparison. Estimates for root caries showed a higher prevalence (PR = 2.65; 95% CI = 1.05-6.70) and risk (RR = 6.02, 95% CI = 1.81-20.00) of total D-S among diabetic patients. CONCLUSIONS: DM can predispose individuals to a higher number of root caries lesions, independently of their past caries experience. Missing teeth can overestimate caries extent in individuals with DM. CLINICAL RELEVANCE: Individuals with DM should be monitored for the prevention and control of root caries. It is recommended to splitting missing teeth from the caries estimates in studies involving adults, particularly diabetic ones.

Functional Impact of BeKm-1, a High-Affinity hERG Blocker, on Cardiomyocytes Derived from Human-Induced Pluripotent Stem Cells.

IKr current, a major component of cardiac repolarization, is mediated by human Ether-à-go-go-Related Gene (hERG, Kv11.1) potassium channels. The blockage of these channels by pharmacological compounds is associated to drug-induced long QT syndrome (LQTS), which is a life-threatening disorder characterized by ventricular arrhythmias and defects in cardiac repolarization that can be illustrated using cardiomyocytes derived from human-induced pluripotent stem cells (hiPS-CMs). This study was meant to assess the modification in hiPS-CMs excitability and contractile properties by BeKm-1, a natural scorpion venom peptide that selectively interacts with the extracellular face of hERG, by opposition to reference compounds that act onto the intracellular face. Using an automated patch-clamp system, we compared the affinity of BeKm-1 for hERG channels with some reference compounds. We fully assessed its effects on the electrophysiological, calcium handling, and beating properties of hiPS-CMs. By delaying cardiomyocyte repolarization, the peptide induces early afterdepolarizations and reduces spontaneous action potentials, calcium transients, and contraction frequencies, therefore recapitulating several of the critical phenotype features associated with arrhythmic risk in drug-induced LQTS. BeKm-1 exemplifies an interesting reference compound in the integrated hiPS-CMs cell model for all drugs that may block the hERG channel from the outer face. Being a peptide that is easily modifiable, it will serve as an ideal molecular platform for the design of new hERG modulators displaying additional functionalities.

Private and public values of innovation: A patent analysis of synthetic biology.

Emerging science and technology fields are increasingly expected to provide solutions to societal grand challenges. The promise of such solutions frequently underwrites claims for the public funding of research. In parallel, universities, public research organizations and, in particular, private enterprises draw on such research to actively secure property rights over potential applications through patenting. Patents represent a claim to garner financial returns from the novel outcomes of science and technology. This is justified by the potential social value promised by patents as they encourage information sharing, further R&D investment, and the useful application of new knowledge. Indeed, the value of patents has generated longstanding academic interest in innovation studies with many scholars investigating its determinants based on econometric models. Yet, this research has largely focused on evaluating factors that influence the market value of patents and the gains from exclusivity rights granted to inventions, which reflect the private value of a patent. However, the patent system is a socially shaped enterprise where private and public concerns intersect. Despite the notion of the social utility of inventions as a patenting condition, and evidence of disconnection between societal needs and the goals of private actors, less attention has been paid to other interpretations of patent value. This paper investigates the various articulations of value delineated by patents in an emerging science and technology domain. As a pilot study, we analyse patents in synthetic biology, contributing a new analytical framework and classification of private and public values at the intersections of science, economy, and society. After considering the legal, business, social and political dimensions of patenting, we undertake a qualitative and systematic examination of patent content in synthetic biology. Our analysis probes the private and public value propositions that are framed in these patents in terms of the potential private and public benefits of research and innovation. Based on this framework, we shed light on questions of what values are being nurtured in inventions in synthetic biology and discuss how attention to public as well as private values opens up promising avenues of research in science, technology and innovation policy.

Anticipating governance challenges in synthetic biology: Insights from biosynthetic menthol.

This paper advances an anticipatory governance framework to investigate and prepare for the potential implications of an emerging technology. Within the growing domain of synthetic biology, we draw on an end-to-end assessment of biosynthetic menthol that incorporates consideration of multiple dimensions of production and use. Based on documentary analysis, available data, and interviews, our approach unfolds in three steps. First, we map the sociotechnical transition in menthol production, comparing existing agricultural and chemical production methods with new biosynthetic processes - or what we call the biological (bio) turn. Second, we explore the rationales, promises and expectations of menthol's bio-turn and explore the drivers of transition so as to clarify which goals and values innovation is addressing. Third, we reflect on the opportunities and challenges of such a transition to put forward an agenda for responsible innovation and anticipatory governance. The bio-turn in menthol is analysed through five responsible innovation dimensions: the potential distribution of benefits and burdens; social resilience; environmental sustainability; infrastructure and business models; and public perception and public interest. We consider the implications of our analysis both for the responsible development and application of synthetic biology for menthol and for the broader assessment and sociotechnical construction of emerging technologies.

Rhodoliths holobionts in a changing ocean: host-microbes interactions mediate coralline algae resilience under ocean acidification.

BACKGROUND: Life in the ocean will increasingly have to contend with a complex matrix of concurrent shifts in environmental properties that impact their physiology and control their life histories. Rhodoliths are coralline red algae (Corallinales, Rhodophyta) that are photosynthesizers, calcifiers, and ecosystem engineers and therefore represent important targets for ocean acidification (OA) research. Here, we exposed live rhodoliths to near-future OA conditions to investigate responses in their photosynthetic capacity, calcium carbonate production, and associated microbiome using carbon uptake, decalcification assays, and whole genome shotgun sequencing metagenomic analysis, respectively. The results from our live rhodolith assays were compared to similar manipulations on dead rhodolith (calcareous skeleton) biofilms and water column microbial communities, thereby enabling the assessment of host-microbiome interaction under climate-driven environmental perturbations. RESULTS: Under high pCO2 conditions, live rhodoliths exhibited positive physiological responses, i.e. increased photosynthetic activity, and no calcium carbonate biomass loss over time. Further, whereas the microbiome associated with live rhodoliths remained stable and resembled a healthy holobiont, the microbial community associated with the water column changed after exposure to elevated pCO2. CONCLUSIONS: Our results suggest that a tightly regulated microbial-host interaction, as evidenced by the stability of the rhodolith microbiome recorded here under OA-like conditions, is important for host resilience to environmental stress. This study extends the scarce comprehension of microbes associated with rhodolith beds and their reaction to increased pCO2, providing a more comprehensive approach to OA studies by assessing the host holobiont.

Use of etonogestrel implant beyond approved duration: prolonged contraceptive effectiveness.

BACKGROUND: The subdermal etonogestrel contraceptive implant has a current approved duration of 3 years. There is, however, recent and strong evidence of its effectiveness for 2 additional years during which no pregnancies were documented. CASE: We report a case of a 28-year-old woman who had an etonogestrel implant inserted 4 years earlier and wished to get pregnant. The implant was, however, deep in the triceps muscle and could not easily be removed. Her serum levels of etonogestrel remained positive even 6 years after insertion. As infertility investigation revealed endometriosis and bilateral tubal obstruction she was referred for assisted reproduction. Despite obtaining oocytes during an ovarian stimulation cycle, the endometrium was never above 4 mm, precluding embryo transfer. It was decided to remove the implant in order to improve endometrial conditions, after which the patient achieved pregnancy. CONCLUSION: This case report suggests that the etonogestrel implant is effective for even longer than the most recent studies have shown.

A Mobilising Concept? Unpacking Academic Representations of Responsible Research and Innovation.

This paper makes a plea for more reflexive attempts to develop and anchor the emerging concept of responsible research and innovation (RRI). RRI has recently emerged as a buzzword in science policy, becoming a focus of concerted experimentation in many academic circles. Its performative capacity means that it is able to mobilise resources and spaces despite no common understanding of what it is or should be 'made of'. In order to support reflection and practice amongst those who are interested in and using the concept, this paper unpacks understandings of RRI across a multi-disciplinary body of peer-reviewed literature. Our analysis focuses on three key dimensions of RRI (motivations, theoretical conceptualisations and translations into practice) that remain particularly opaque. A total of 48 publications were selected through a systematic literature search and their content was qualitatively analysed. Across the literature, RRI is portrayed as a concept that embeds numerous features of existing approaches to govern and assess emerging technologies. Our analysis suggests that its greatest potential may be in its ability to unify and provide political momentum to a wide range of long-articulated ethical and policy issues. At the same time, RRI's dynamism and resulting complexity may represent its greatest challenge. Further clarification on what RRI has to offer in practice-beyond what has been offered to date-is still needed, as well as more explicit engagement with research and institutional cultures of responsibility. Such work may help to realise the high political expectations that are attached to nascent RRI.

Ambiguity of care in the experience of drug consumers. / Ambiguidade do cuidado na vivência do consumidor de drogas.

OBJECTIVE: To understand the perception of users of a Psychosocial Care Center about care in the context of drug use. METHODS: Study based on the Phenomenology of Maurice Merleau-Ponty, developed in the Center for Psychosocial Care Alcohol and Other Drugs. The data has been submitted to the Analytical Technique of Ambiguity. RESULTS: The drug use sometimes provides the consumer with pleasurable feelings, sometimes contributing to the occurrence of biopsychosocial harm and/or new possibilities for relationship with the drug. CONCLUSIONS: The drug use is an ambiguous process, which corresponds to the perception of different care profiles in the relationship between the consumer and the drug. It is up to the health professionals to recognize the diverse possibilities of care and to favor the construction of therapeutic projects based on listening and respecting the needs of drug users.

Crystallographic orientation and concentric layers in spicules of calcareous sponges.

In this work, the crystallography of calcareous sponges (Porifera) spicules and the organization pattern of the concentric layers present in their inner structure were investigated in 10 species of the subclass Calcaronea and three species of the subclass Calcinea. Polished spicules had specific concentric patterns that varied depending on the plane in which the spicules were sectioned. A 3D model of the concentric layers was created to interpret these patterns and the biomineralization process of the triactine spicules. The morphology of the spicules was compared with the crystallographic orientation of the calcite crystals by analyzing the Kikuchi diffraction patterns using a scanning electron microscope. Triactine spicules from the subclass Calcinea had actines (rays) elongated in the 〈210〉 direction, which is perpendicular to the c-axis. The scale spicules of the hypercalcified species Murrayona phanolepis presented the c-axis perpendicular to the plane of the scale, which is in accordance with the crystallography of all other Calcinea. The triactine spicules of the calcaronean species had approximately the same crystallographic orientation with the unpaired actine elongated in the ∼[211] direction. Only one Calcaronea species, whose triactine was regular, had a different orientation. Three different crystallographic orientations were found in diactines. Spicules with different morphologies, dimensions and positions in the sponge body had similar crystallographic directions suggesting that the crystallographic orientation of spicules in calcareous sponges is conserved through evolution.

Integrating social and value dimensions into sustainability assessment of lignocellulosic biofuels.

The paper clarifies the social and value dimensions for integrated sustainability assessments of lignocellulosic biofuels. We develop a responsible innovation approach, looking at technology impacts and implementation challenges, assumptions and value conflicts influencing how impacts are identified and assessed, and different visions for future development. We identify three distinct value-based visions. From a techno-economic perspective, lignocellulosic biofuels can contribute to energy security with improved GHG implications and fewer sustainability problems than fossil fuels and first-generation biofuels, especially when biomass is domestically sourced. From socio-economic and cultural-economic perspectives, there are concerns about the capacity to support UK-sourced feedstocks in a global agri-economy, difficulties monitoring large-scale supply chains and their potential for distributing impacts unfairly, and tensions between domestic sourcing and established legacies of farming. To respond to these concerns, we identify the potential for moving away from a one-size-fits-all biofuel/biorefinery model to regionally-tailored bioenergy configurations that might lower large-scale uses of land for meat, reduce monocultures and fossil-energy needs of farming and diversify business models. These configurations could explore ways of reconciling some conflicts between food, fuel and feed (by mixing feed crops with lignocellulosic material for fuel, combining livestock grazing with energy crops, or using crops such as miscanthus to manage land that is no longer arable); different bioenergy applications (with on-farm use of feedstocks for heat and power and for commercial biofuel production); and climate change objectives and pressures on farming. Findings are based on stakeholder interviews, literature synthesis and discussions with an expert advisory group.

Calcareous sponges can synthesize their skeleton under short-term ocean acidification.

Calcifying organisms are considered as threatened by ocean acidification, because of their calcium carbonate skeleton. This study investigated if a calcareous sponge could synthesize its skeleton (i.e. spicules) under ocean-acidification conditions. Sponge cell aggregates that have the potential to develop into a functional sponge, called primmorphs, were submitted to a 5-day experiment, with two treatments: control (pH 8.1) and acidified conditions (pH 7.6). Primmorphs of the calcareous sponge Paraleucilla magna were able to synthesize a skeleton, even under low pH, and to develop into functional sponges. The spicules had the same shape in both conditions, although the spicules synthesized in low pH were slightly thinner than those in the control. These results suggest that P. magna may be able to survive near-future ocean-acidification conditions.

The Beauty and the Beast: Bariatric Surgery and a Case of Oxalate Nephropathy.

Oxalate nephropathy is a rare cause of kidney failure. Roux-en-Y gastric bypass surgery is a technique used for surgical treatment of obesity as well as for the treatment of gastric carcinoma. We report the case of a 46-year-old male who was admitted to the nephrology department due to kidney dysfunction eight months after bariatric surgery.

Greater Impact of Living Donation Than HLA Mismatching in Short-Term Renal Allograft Survival.

INTRODUCTION: Living donor kidney transplantation (LDKT) is accepted as first-line treatment for patients with end-stage kidney disease with advantages over deceased donor kidney transplantation (DDKT). Still, how the known detrimental effect of HLA mismatch (MM) may hamper these advantages remains unsettled. We sought to determine the effect of the degree of HLA MM, separately in deceased and living donor renal allograft outcomes. METHODS: We evaluated all adults submitted to LDKT and DDKT at our center between 2006 and 2018. Their HLA MM was classified according to the British Society of Transplantation system in low mismatch (LM) (level 1-2) and high mismatch (HM) (level 3-4). Acute rejection (AR) and global or censored graft survival were the outcomes of interest. Recipients were followed up from transplant until death, graft failure or the end of 2020.  Results: One thousand sixty-eight kidney transplant recipients were analyzed, 815 (76%) received a DDKT whereas 253 (24%) received an LDKT. From those submitted to DDKT, 95 (12%) had an LM and 720 (88%) had an HM, whereas in LDKT 32 (13%) had an LM and 221 (87%) had an HM. The AR at one year was 9% in the full cohort. Significant risk factors for AR were HM DDKT (OR:2.3, P=0.047) or HM LDKT (OR:5.6, P=0.003) (LM DDKT as reference), calculated panel-reactive antibody (cPRA) ≥5% (OR:1.9, P=0.040) and delayed graft function (DGF), (OR:3.2, P<0.001). Censored graft survival (CGS) at five years was 96% in the full cohort. Independent predictors for censored graft failure (CGF) were HM LDKT (HR:0.2, P=0.046) (LM DDKT as reference), AR (HR:2.7, P=0.008) and DGF (HR:2.2, P=0.017). Global graft survival (GGS) at five years was 91% in the full cohort. Independent predictors for global graft failure (GGF) were HM LDKT (HR:0.2, P=0.042) (LM DDKT as reference), recipient age (HR:1.8, P<0.001) and DGF (HR:1.8, P=0.006). No AR, CGF or GGF episodes were observed in the LM LDKT group. CONCLUSIONS: In our cohort, the level of HLA MM increased the risk of AR independently of donor type. Considering short graft survival, our results support the advantage of living donor vs deceased donor even with an increased HLA MM. However, its effect on long-term graft survival remains to be settled, emphasizing the need for further studies on this matter.

Two-Hit Kidney Allograft Injury by SARS-CoV-2.

Coronavirus disease 2019 (COVID-19) has been associated with acute kidney injury in kidney transplant recipients by several mechanisms. The authors report a case of acute kidney allograft dysfunction in a 48-year-old patient who presented in the emergency room with anasarca and nephrotic syndrome close after mild COVID-19 and no other clinical condition. Histopathology of the allograft biopsy revealed two distinct and simultaneous kidney lesions, collapsing glomerulopathy and thrombotic microangiopathy. Renal function persistently deteriorated, and definitive dialysis was initiated. After excluding other plausible causes for the findings, this case strengthens the hypothesis that the kidney allograft is also a target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Species-specific relationships between deep sea sponges and their symbiotic Nitrosopumilaceae.

Sponges thrive in the deep, dark and nutrient-depleted ocean and may rely on microbial symbionts for carbon acquisition and energy generation. However, these symbiotic relationships remain largely unexplored. In this study, we analyze the microbiome of deep-sea sponges and show that ammonia-oxidizing archaea (AOA) of the family Nitrosopumilaceae make up at least 75% of the microbial communities of the sponges Aphrocallistes sp., Farrea sp. and Paratimea sp.. Given the known autotrophic metabolism of AOAs, this implies that these sponge holobionts can have the capacity for primary production in the deep-sea. We also show that specific AOA lineages are highly specific towards their hosts, hinting towards an unprecedent vertical transmission of these symbionts in deep-sea sponges. Our results show that the ecology and evolution of symbiotic relationships in deep-sea sponge is distinct from that of their shallow-water counterparts.

Bilateral Renal Artery Thrombosis: A Case of Successful Kidney Recovery After Prolonged Anuria.

Anuria suggests complete urinary tract obstruction, acute cortical necrosis, or massive vascular occlusion. We report a case of bilateral renal artery thrombosis in an 87-year-old woman admitted to the emergency department with abdominal pain, diarrhea, and anuria in the last 24 hours. Serum creatinine at admission was 5.87 mg/dl and urea was 100 mg/dl. Computed tomography showed renal artery thrombosis and partial splenic infarction. A conservative approach was performed with anticoagulation with warfarin. The patient recovered renal function and urine output months later.