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Our previous study showed that OmpA-deficient Salmonella Typhimurium (STM) failed to retain LAMP-1, quit Salmonella-containing vacuole (SCV) and escaped to the host cytosol. Here we show that the cytosolic population of STM ΔompA sequestered autophagic markers, syntaxin17 and LC3B in a sseL-dependent manner and initiated lysosomal fusion. Moreover, inhibition of autophagy using bafilomycinA1 restored its intracellular proliferation. Ectopic overexpression of OmpA in STM ΔsifA restored its vacuolar niche and increased interaction of LAMP-1, suggesting a sifA-independent role of OmpA in maintaining an intact SCV. The OmpA extracellular loops impaired the LAMP-1 recruitment to SCV and caused bacterial release into the cytosol of macrophages, but unlike STM ΔompA, they retained their outer membrane stability and didn't activate the lysosomal degradation pathway aiding in their intra-macrophage survival. Finally, OmpA extracellular loop mutations protected the cytosolic STM ΔsifA from the lysosomal surveillance, revealing a unique OmpA-dependent strategy of STM for its intracellular survival.
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To control human-to-human mpox transmission during the 2022 outbreak, European Union (EU)/European Economic Area (EEA) countries conducted case investigation and contact tracing (CT). We aimed to provide an overview of CT activities, describe CT data collection practices, and identify related facilitators, barriers, and potential opportunities for improvement. Between April 03, 2023 and May 12, 2023, a survey was distributed to CT stakeholders in 30 EU/EEA countries, asking about mpox CT activities and data collection and requesting to rank enablers, barriers, and improvements for CT on a five-point Likert scale. The 139 respondents from 27 countries indicated having performed case investigations (96%, n = 133), backward CT (88%, n = 122), forward CT (87%, n = 121), and follow-up on contacts' outcomes (77%, n = 107). Sixty percent (n = 80/134) used standardized data collection forms and 73% (n = 91/124) used databases. The highest-rated enablers were clear guidelines (mean = 3.9), quick access to laboratory results (3.6), and sufficient expertise (3.6). Highly rated barriers were inability to contact contacts (3.0) or cases (2.5) and lack of staff (2.4). The most needed improvements were availability of staff (3.5), expertise on affected populations (3.4) and data reporting tools and systems (3.3). To improve CT of mpox and diseases with similar transmission patterns, EU/EEA countries should increase workforce capacity in public and sexual health, offer training on CT operations and communication with affected communities, and use common CT data collection tools and systems.
Assuntos
Busca de Comunicante , Mpox , Humanos , União Europeia , Coleta de Dados , Surtos de Doenças/prevenção & controleRESUMO
Mobile organisms like seabirds can provide important nutrient flows between ecosystems, but this connectivity has been interrupted by the degradation of island ecosystems. Island restoration (via invasive species eradications and the restoration of native vegetation) can reestablish seabird populations and their nutrient transfers between their foraging areas, breeding colonies, and adjacent nearshore habitats. Its diverse benefits are making island restoration increasingly common and scalable to larger islands and whole archipelagos. We identified the factors that influence breeding seabird abundances throughout the Chagos Archipelago in the Indian Ocean and conducted predictive modeling to estimate the abundances of seabirds that the archipelago could support under invasive predator eradication and native vegetation restoration scenarios. We explored whether the prey base exists to support restored seabird populations across the archipelago, calculated the nitrogen that restored populations of seabirds might produce via their guano, and modeled the cascading conservation gains that island restoration could provide. Restoration was predicted to increase breeding pairs of seabirds to over 280,000, and prey was predicted to be ample to support the revived seabird populations. Restored nutrient fluxes were predicted to result in increases in coral growth rates, reef fish biomasses, and parrotfish grazing and bioerosion rates. Given these potential cross-ecosystem benefits, our results support island restoration as a conservation priority that could enhance resilience to climatic change effects, such as sea-level rise and coral bleaching. We encourage the incorporation of our estimates of cross-ecosystem benefits in prioritization exercises for island restoration.
Restauración en islas para reconstruir las poblaciones de aves marinas y amplificar la funcionalidad de los arrecifes de coral Resumen Los organismos móviles como las aves marinas pueden proporcionar flujos importantes de nutrientes entre los ecosistemas, aunque esta conectividad ha sido interrumpida por la degradación de los ecosistemas isleñas. La restauración de islas (por medio de la erradicación de especies invasoras y la restauración de la vegetación nativa) puede reestablecer las poblaciones de aves marinas y su transferencia de nutrientes entre las áreas de forrajeo, las colonias reproductoras y los hábitats adyacentes a la costa. Los diferentes beneficios de la restauración de islas hacen que sea cada vez más común y escalable a islas más grandes y archipiélagos completos. Identificamos los factores que influyen sobre la abundancia de aves reproductoras en todo el archipiélago de Chagos en el Océano Índico y realizamos un modelo predictivo para estimar la abundancia de aves que podría soportar el archipiélago bajo escenarios de la erradicación de un depredador invasor y la restauración de la vegetación nativa. Exploramos si existe la base de presas para soportar las poblaciones restauradas de aves marinas en el archipiélago, calculamos el nitrógeno que las poblaciones restauradas podrían producir mediante el guano y modelamos la conservación en cascada que podría proporcionar la restauración de la isla. Se pronosticó que la restauración incrementaría las parejas reproductoras a más de 280,000 y que las presas serían las suficientes para soportar las poblaciones restauradas de aves marinas. También se pronosticó que los flujos restaurados de nutrientes resultarían en un incremento de la tasa de crecimiento de los corales, la biomasa de los peces del arrecife y las tasas de bioerosión y de alimentación de los peces loro. Dados estos beneficios potenciales entre los ecosistemas, nuestros resultados respaldan a la restauración de islas como una prioridad de conservación que podría incrementar la resiliencia a los efectos del cambio climático, como el incremento en el nivel del mar y el blanqueamiento de los corales. Promovemos que se incorporen nuestras estimaciones de los beneficios transecosistémicos dentro de los ejercicios de priorización para la restauración de islas.
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This perspective summarises and explains the long-term surveillance framework 2021-2027 for infectious diseases in the European Union/European Economic Area (EU/EEA) published in April 2023. It shows how shortcomings in the areas of public health focus, vigilance and resilience will be addressed through specific strategies in the coming years and how these strategies will lead to stronger surveillance systems for early detection and monitoring of public health threats as well as informing their effective prevention and control. A sharper public health focus is expected from a more targeted list of notifiable diseases, strictly public-health-objective-driven surveillance standards, and consequently, leaner surveillance systems. Vigilance should improve through mandatory event reporting, more automated epidemic intelligence processing and increased use of genomic surveillance. Finally, EU/EEA surveillance systems should become more resilient by modernising the underlying information technology infrastructure, expanding the influenza sentinel surveillance system to other respiratory viruses for better pandemic preparedness, and increasingly exploiting potentially more robust alternative data sources, such as electronic health records and wastewater surveillance. Continued close collaboration across EU/EEA countries will be key to ensuring the full implementation of this surveillance framework and more effective disease prevention and control.
Assuntos
Doenças Transmissíveis , União Europeia , Saúde Pública , Humanos , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/diagnóstico , Vigilância da População , Europa (Continente)/epidemiologia , Surtos de Doenças/prevenção & controle , Vigilância de Evento Sentinela , Controle de Doenças Transmissíveis/métodos , Vigilância em Saúde Pública/métodosRESUMO
Approximately five million Ukrainians were displaced to the EU/EEA following the Russian invasion of Ukraine. While tuberculosis (TB) notification rates per 100,000 Ukrainians in the EU/EEA remained stable, the number of notified TB cases in Ukrainians increased almost fourfold (mean 2019-2021: 201; 2022: 780). In 2022, 71% cases were notified in three countries, and almost 20% of drug-resistant TB cases were of Ukrainian origin. Targeted healthcare services for Ukrainians are vital for early diagnosis and treatment, and preventing transmission.
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Tuberculose Resistente a Múltiplos Medicamentos , Tuberculose , Humanos , União Europeia , Vigilância da População , Tuberculose/diagnóstico , Tuberculose/epidemiologia , População do Leste EuropeuRESUMO
PURPOSE: In surgical practice during endoscopic endonasal approach (EEA), Growth Hormone-secreting Pituitary Neuroendocrine Tumors (GH-secreting PitNET) patients show morphologic differences in the nasal cavities and sinuses, leading to a narrower surgical field and a carotid prominence and potentially increasing the complexity of the surgical and the risk of complications. The aim of the study is to evaluate the anatomical differences of the sphenoid sinus between patients with GH-secreting PitNETs and patients with non-functioning Pituitary Neuroendocrine Tumors (NF-PitNET) underwent EEA. METHODS: This is a monocentric retrospective study conducted at author's institution. The minimum intercarotid distance (ICS), the largest diameter of the sphenoid sinus (DSS) and the distance between vomer and clivus (VCD) were collected and compared. Presence, localization and course of intersphenoid sinus septum (ISS) were also evaluated. RESULTS: 100 consecutive patients were identified: 57 males (57%) and 43 females (43%), with a mean age of 55 years. 60 patients had NF-PitNET (60%) and 40 had GH-secreting PitNET (40%). GH-secreting PitNET group presented inferior values of ICD (16.8±3.94 mm vs. 20.4±3.94 mm, p<0.001), DSS (32.5±9.81 mm vs. 38.6±11.03 mm, p=0.006) and VCD (25.5±6.96 mm vs. 29.6±8.47 mm, p=0.012) compared to NF-PitNET group. ISS showed no differences between the two groups. CONCLUSION: ICD, DSS and VCD resulted smaller in acromegalic patients, confirming that patients with GH-secreting PitNETs have a narrower surgical field. A meticulous anatomical preoperative planning and neuronavigation are important to recognize the sphenoid anatomical landmarks in order to reduce the risk of complications, especially in acromegalic patients.
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Background: The petroclival area is a technically challenging region to operate owing to the proximity of the internal carotid artery (ICA) and the need to obtain gross total excision of tumors in this area as they are often resistant to radiotherapy. Objective: We present our experience with the endonasal endoscopic transpterygoid approach in managing tumors of the petroclival region and discuss various operative nuances for safer resection. Materials and Methods: A retrospective study of all consecutive cases of lesions occupying the petroclival region that were operated via endonasal endoscopic transpterygoid approach at our center between January 2016 and December 2021 was performed. Results: The study included 14 cases of lesions occupying the petroclival region. Gross total resection by intraoperative observation was achieved in 10 patients, near total decompression was performed in two patients, and the remaining two patients underwent marsupialization of lesion. Postoperatively, one patient had right Lower motor neuron (LMN) facial nerve palsy and one patient required surgery for Cerebrospinal fluid (CSF) rhinorrhea on postoperative day 8. The mean duration of follow-up was 13.8 ± 16.6 months (range: 2-59 months). Four of six patients with visual symptoms on presentation reported improvement in vision, and the other two patients had a stable vision on follow-up. Two patients received radiotherapy postsurgery. No mortality was noted. Conclusion: The extended endonasal endoscopic transpterygoid approach can be safely and efficiently used for petroclival lesions. Very sound knowledge of anatomical relationship, use of intraoperative image guidance to avoid injury to ICA, and multilayer reconstruction with a vascularized nasoseptal flap are required to optimize the clinical outcome.
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Rinorreia de Líquido Cefalorraquidiano , Neoplasias da Base do Crânio , Humanos , Estudos Retrospectivos , Endoscopia/métodos , Nariz , Neoplasias da Base do Crânio/diagnóstico por imagem , Neoplasias da Base do Crânio/cirurgia , Neoplasias da Base do Crânio/patologia , Procedimentos Neurocirúrgicos/métodos , Rinorreia de Líquido Cefalorraquidiano/cirurgiaRESUMO
Apresentamos os que emergem do processo de desenvolvimento da comunicação mãe-bebê nas interações do tipo face a face. Este processo é concebido como compondo um sistema dinâmico em constante transformação e construção. Os padrões de organização descrevem as fases de maior estabilidade desse sistema, propostas pelo modelo EEA como constituindo três padrões que se sucedem: um estabelecimento inicial, seguido de um período de extensão e, finalmente, um período de abreviação das trocas comunicativas. Analisamos os dados longitudinais das trocas comunicativas do tipo face a face de cinco díades mãe-bebê, descrevendo o processo através do qual esses padrões se organizam. Identificamos uma tendência geral de manutenção da mesma sequência de aparecimento e dominância desses três padrões nas cinco díades, tal como proposto pelo modelo EEA. Todavia, cada díade difere na idade de aparecimento, de dominância e na duração de cada um dos padrões referidos.
We present the patterns of organization that emerge from the developmental process of mother-infant communication in face-to-face exchanges. This process is conceived as creating a dynamic system in constant transformation and construction. The patterns of organization describe the periods of stability of this system, proposed by the EEA model as corresponding to three successive patterns, starting by an initial establishment, followed by a period of extension, and finally by an abbreviation of the dyadic exchanges. We analyzed the longitudinal mother-infant face-to-face exchanges from five dyads, describing the process of organization of these patterns. We identified a general tendency toward maintenance of the sequence of emergence and dominance of these three patterns in all five dyads, according to the proposals of the EEA model. However, each dyad differs in terms of age of appearance, dominance and duration of each of these patterns.
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Humanos , Feminino , Adulto , Comunicação , Desenvolvimento Humano , Relações Mãe-FilhoRESUMO
Comparamos duas abordagens teórico-metodológicas distintas e investigamos a concepção que mães apresentam acerca do processo de desenvolvimento da comunicação mãe-bebê. Lyra e colaboradores propõem o modelo EEA, que integra uma seqüência de três padrões de organização do desenvolvimento da comunicação, denominados estabelecimento, extensão e abreviação (EEA). Esse modelo está baseado na observação longitudinal e na análise microgenética de estudos de caso a partir da perspectiva dos sistemas dinâmicos. Utilizando o procedimento de classificação múltipla, investigamos como esses três períodos do desenvolvimento da comunicação (EEA) são conceituados pelas mães. Foram pesquisadas 48 mães pertencentes a dois níveis sócio-econômicos. Os resultados encontrados fortalecem o modelo EEA, confirmando: a distinção entre as trocas face-a-face e aquelas mediadas pelo objeto (MOB); a diferenciação dos três períodos do desenvolvimento da comunicação (EEA) em ambas as trocas; e a distribuição ordenada (axial) desses três períodos, exceto, nesse último caso, para as trocas MOB, quando analisadas separadamente.
Two theoretical-methodological distinct perspectives are compared in order to study mother's conceptualization of the process of mother-infant development of communication. Based on dynamic systems perspective and relying on longitudinal microanalysis of case studies observations, Lyra and collaborators propose the EEA model for studying this process of development. This model integrates a sequence of three periods of development of this process, conceived as developmental patterns of organization: establishment, extension and abbreviation (EEA). Using a 'multiple sorting procedure', we investigated mothers' conceptualization of these three periods of development. We examined 48 mothers, from two socioeconomic levels. The results support the EEA model confirming: the distinction between face-to-face and the exchanges mediated by the object (MOB); the differentiation among the three periods of communication development (EEA) in both type of exchanges; and, an order distribution (axial) of these three periods, except for the specific analysis of the MOB type of exchanges.