Fitness cost of tet(A) type I variant-mediated tigecycline resistance in Klebsiella pneumoniae.

OBJECTIVE: The aim of the present study is to explore the impact of the tet(A) type I variant (tetA-v1) on its fitness effect in Klebsiella pneumoniae. METHODS: Clinical K. pneumoniae strains were utilized as parental strains to generate strains carrying only the plasmid vector (pBBR1MCS-5) or the tetA-v1 recombinant plasmid (ptetA-v1). Antimicrobial susceptibility testing was conducted to estimate the contribution of tetA-v1 to drug resistance. Plasmid stability was evaluated by serial passage over 10 consecutive days in the absence of tigecycline. Biological fitness was examined through growth curve analysis, in vitro competition assays and a neutropenic mouse thigh infection model. RESULTS: A 2-4-fold increase in tigecycline MIC was observed following the acquisition of tetA-v1. Without tigecycline treatment, the stability of ptetA-v1 plasmids has been decreasing since day 1. The ptetA-v1 plasmid in Kp89, Kp91, and Kp93 exhibited a decrease of about 20% compared to the pBBR1MCS-5 plasmid. The acquisition of the tetA-v1 gene could inhibit the growth ability of K. pneumoniae strains both in vitro and in vivo. tetA-v1 gene imposed a fitness cost in K. pneumoniae, particularly in the CRKP strain Kp51, with a W value of approximately 0.56. CONCLUSION: The presence of tetA-v1 is associated with a significant fitness cost in K. pneumoniae in the absence of tigecycline, both in vitro and in vivo.

Comparative Assessment of Habitat Suitability and Niche Overlap of Three Cytospora Species in China.

The plant pathogenic fungus Cytospora is notoriously known for causing woody plant canker diseases, resulting in substantial economic losses to biological forests and fruit trees worldwide. Despite their strong negative ecological impact, the existing and prospective distribution patterns of these plant pathogens in China, according to climate change, have received little attention. In this study, we chose three widely dispersed and seriously damaging species, namely, Cytospora chrysosperma, Cytospora mali, and Cytospora nivea, which are the most common species that damage the Juglans regia, Malus domestica, Eucalyptus, Pyrus sinkiangensis, Populus spp., and Salix spp. in China. We utilized ecological niche modeling to forecast their regional distribution in China under four climate change scenarios (present, SSP 126, SSP 370, and SSP 585). The results show that temperature-related climate factors limit the current distribution ranges of the three species. Currently, the three studied species are highly suitable for northeast, northwest, north, and southwest China. Under future climate scenarios, the distribution ranges of the three species are projected to increase, and the centers of the adequate distribution areas of the three species are expected to shift to high-latitude regions. The three species coexist in China, primarily in the northwest and north regions. The ecological niches of C. chrysosperma and C. nivea are more similar. The distribution range of C. mali can reach the warmer and wetter eastern region, whereas C. chrysosperma and C. nivea are primarily found in drought-prone areas with little rainfall. Our findings can help farmers and planners develop methods to avoid the spread of Cytospora spp. and calculate the costs of applying pesticides to reduce contamination and boost yields.

Sensitivity of Puccinia triticina f. sp. tritici from China to Triadimefon and Resistance Risk Assessment.

Wheat leaf rust, caused by Puccinia triticina f. sp. tritici (Pt), is distributed widely in wheat-producing areas and results in serious yield losses worldwide. In China, leaf rust has been largely controlled with a demethylation inhibitor (DMI) fungicide, triadimefon. Although high levels of fungicide resistance in pathogens have been reported, no field failure of wheat leaf rust to DMI fungicides has been reported in China. A resistance risk assessment of triadimefon to Pt was investigated in the present study. The sensitivity of 197 Pt isolates across the country to triadimefon was determined, and the density distribution of EC50 values (concentration at which mycelial growth is inhibited by 50%) showed a continuous multimodal curve because of the extensive use of this fungicide in wheat production, with a mean value of 0.46 µg/ml. The majority of the tested Pt isolates were sensitive to triadimefon, whereas 10.2% developed varying degrees of resistance. Characterization of parasitic fitness revealed that the triadimefon-resistant isolates exhibited strong adaptive traits in urediniospore germination rate, latent period, sporulation intensity, and lesion expansion rate. No correlation was observed between triadimefon and tebuconazole and hexaconazole, which have the similar mode of action, or pyraclostrobin and flubeneteram, which have different modes of action. Overexpression of the target gene Cyp51 led to the triadimefon resistance of Pt. The risk of resistance to triadimefon in Pt may be low to moderate. This study provided important data for fungicide resistance risk management against wheat leaf rust.

Cell-Based Biomaterials for Coronavirus Disease 2019 Prevention and Therapy.

Coronavirus disease 2019 (COVID-19) continues to threaten human health, economic development, and national security. Although many vaccines and drugs have been explored to fight against the major pandemic, their efficacy and safety still need to be improved. Cell-based biomaterials, especially living cells, extracellular vesicles, and cell membranes, offer great potential in preventing and treating COVID-19 owing to their versatility and unique biological functions. In this review, the characteristics and functions of cell-based biomaterials and their biological applications in COVID-19 prevention and therapy are described. First the pathological features of COVID-19 are summarized, providing enlightenment on how to fight against COVID-19. Next, the classification, organization structure, characteristics, and functions of cell-based biomaterials are focused on. Finally, the progress of cell-based biomaterials in overcoming COVID-19 in different aspects, including the prevention of viral infection, inhibition of viral proliferation, anti-inflammation, tissue repair, and alleviation of lymphopenia are comprehensively described. At the end of this review, a look forward to the challenges of this aspect is presented.

Effect of evaluation timing and duration of anxiety-like behaviors induced by conditioned fear in rats: Assessment using the triple test.

The fear conditioning-based models of anxiety disorders have been widely used for assessing anxiolytic action. The triple test is an evaluation method for anxiety-like behaviors that integrates the open field, elevated plus maze, and light/dark box, which can comprehensively reflect the anxiety-like behaviors state of animals. However, there are many factors that can affect the evaluation results of anxiety-like behaviors, especially the time of day (morning or afternoon), which are often ignored by most experimental studies. Accordingly, in the present study, we first measured the anxiety-like behavior in the fear conditioning-based model rats by using the triple test in the morning and afternoon, respectively (experiment 1). In experiment 2, the anxiety-like behaviors were evaluated on the 1st, 7th, 10th and 14th day after experiencing foot shock for 4 consecutive days, respectively. The fear-conditioned rats exhibited increased anxiety-like behaviors only in the afternoon and prolonged freezing times either in the morning and afternoon. Furthermore, model rats exhibit increased anxiety-like behaviors in open field, elevated plus maze, and light/dark box on the 1st day; in open field and light/dark box on the 7th day; in elevated plus maze on the 10th day; and in light/dark box on the 14th day after the final foot shock. The results suggested that the time of day had a significant effect on anxiety-like behaviors caused by conditioned fear, and increased in the afternoon vs morning. Moreover, the lasting increased in anxiety-like behavior for 14 days was appropriated to explore the effects of long-term administration of anxiolytics.

Geriatric Nutritional Risk Index assessment in elderly patients during the COVID-19 outbreak.

Background and Aims: Globally, coronavirus disease-2019 (COVID-19) is persistent in many countries and presents a major threat to public health. Critically, elderly individuals, especially those with underlying disease, poor nutritional and immune functions, are highly susceptible. Therefore, we analyzed the epidemiological features in elderly COVID-19 patients. Methods: In total, 126 patients were recruited in the Fifth Affiliated Hospital of Sun Yat-sen University, China from January 2020 to March 2020 (including 103 confirmed COVID-19 patients and 23 elderly suspected cases). Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. We assessed nutritional risks in elderly patients by calculating the Geriatric Nutritional Risk Index (GNRI). Results: When compared with young patients, elderly patients were more likely to have underlying comorbidities and received nutritional support and intensive care unit treatment. Elderly patients had significantly lower levels of the following: lymphocyte percentages, red blood cell counts, hemoglobin levels, and serum albumin values. When compared with suspected COVID-19 elderly cases, elderly patients had significantly lower red blood cell counts and hemoglobin levels. The average GNRI of suspected cases and confirmed patients indicated no nutritional risk. There were no marked differences in GNRI values between groups. Conclusion: Nutritional risk assessments may provide valuable information for predicting a COVID-19 prognosis, especially in elderly patients. Anemia prevention and management should be actively and timely provided. GNRI is a potentially prognostic factor for hospitalized elderly patients. Moreover, it is also important to follow up discharged patients for continuous nutritional observations.

Sensitivity and Resistance Risk Assessment of Puccinia striiformis f. sp. tritici to Triadimefon in China.

Wheat stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), is a destructive disease of wheat that seriously threatens production safety in wheat-producing areas worldwide. In China, the disease has been largely controlled with the fungicide triadimefon. Although high levels of fungicide resistance in other fungal pathogens have been reported, failure to control Pst with any fungicides has seldomly been reported, and fungicide sensitivity of Pst has not been evaluated in China. The distribution of triadimefon-resistant Pst isolates was investigated in the present study. The baseline sensitivity of 446 Pst isolates across the country to triadimefon was determined, and the concentration for 50% of maximal effect showed a unimodal distribution curve, with a mean value of 0.19 µg ml-1. The results indicated a wide range of sensitivity to triadimefon, with more insensitive isolates collected from Pst winter-increasing areas and northwest oversummering areas, whereas more sensitive isolates were collected from southwest oversummering areas and epidemic areas of Xinjiang and Tibet. The majority of the tested Pst isolates were sensitive to triadimefon; only 6.79% had developed varying degrees of resistance. Characterization of parasitic fitness revealed that the triadimefon-resistant isolates exhibited strong adaptive traits in the urediniospore germination rate, latent period, sporulation intensity, and lesion expansion rate. Positive cross-resistance was observed between triadimefon and tebuconazole or hexaconazole, but not between pyraclostrobin or flubeneteram. The point mutation Y134F in the 14α-demethylase enzyme (CYP51) was detected in triadimefon-resistant isolates. A molecular method (kompetitive allele-specific PCR) was established for the rapid detection of Y134F mutants in the Pst population. Two genotypes with one point mutation Y134F conferred resistance to triadimefon in Pst. The risk of resistance to triadimefon in Pst may be low to moderate. This study provided important data for establishment of high throughput molecular detection methods, fungicide resistance risk management, and the development of new target fungicides.

Rehabilitation psychological experience of the elderly within 6 months of initial disability: a qualitative study.

PURPOSE: To explore the rehabilitation psychological experience of the Chinese elderly within 6 months of initial disability, understand and analyse their real feelings and thoughts to help caregivers in providing support. MATERIALS AND METHODS: We adopted the descriptive phenomenology method to purposefully select elderly with initial disability within 6 months from neurorehabilitation departments of 2 hospitals in China, who were able to cooperate with researchers to conduct interviews. The data were collected from semi-structured interviews and analysed using Colaizzi's analysis method. RESULTS: fifteen participants with an average age of 73.7(±9.0) years and an average disability time of 3.2 (±1.5) months were interviewed. Four themes were identified: (1) the discomfort of losing the sense of self; (2) feeling trapped over unmet needs; (3) ambivalence towards rehabilitation; (4) expectations and hopelessness for the future. Traditional Chinese thoughts such as family concepts played an important role in the generation of complex emotions. CONCLUSION: The elderly had the desire and motivation to recover and return to the families and society. However, due to personal, family and social factors, they still felt ambivalence towards rehabilitation, self-worth and life, which hindered rehabilitation. Therefore, carers should focus on the elderly's psychological states, taking corresponding measures to satisfy their complex demands and motivate long-term recovery.IMPLICATIONS FOR REHABILITATIONChinese elderly with initial disability often had a strong sense of ambivalence towards self-worth, rehabilitation and life, among which the influence of the traditional Chinese family concept counts.Health care personnel should improve the positive coping ability of the elderly to promote their harmonious coexistence with disability, rebuild their personal values, develop their rehabilitation potential.Health care departments need to provide support to the elderly and their families to maximize the positive role of the family in the rehabilitation process of the elderly.In order to alleviate the discomfort of disabled elderly in rehabilitation and enhance compliance, there is a need to improve the hard environment (rehabilitation technologies, etc.) and soft environment (rehabilitation concept and service quality, etc.).

Predictors and correlations of phthalate metabolite concentrations in urine and seminal plasma among reproductive-aged men.

BACKGROUND: Certain phthalates are suspected to be endocrine disruptors that are adversely associated with male reproductive health. However, the predictors and correlations of phthalate metabolite concentrations in urine and seminal plasma among reproductive-aged men have not been thoroughly studied. OBJECTIVE: To investigate the predictors and correlations of phthalate metabolite concentrations in urine and seminal plasma among adult Chinese males. METHOD: We measured mono-n-butyl phthalate (MBP), monobenzyl phthalate (MBzP), monomethyl phthalate (MMP), monoethyl phthalate (MEP), mono-n-octyl phthalate (MOP), mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) concentrations in seminal plasma and repeated spot-urine samples from 687 men who visited a reproductive center. Mixed-effect models were used to examine the associations of sociodemographic, lifestyle and medical factors with urinary metabolite concentrations. Linear regression models were used to identify predictors of metabolite concentrations in seminal plasma and correlations between metabolite concentrations in spot urine samples and seminal plasma. RESULTS: Measurements taken from spot urine samples poorly predicted same-day seminal plasma concentrations (all R2<0.10). Inverse associations were observed between education level and urinary MBP and MEOHP and between household income and urinary MMP; receiving intravenous infusion therapy was associated with increased urinary MBP, MEHHP and MEOHP, use of facial cleanser/cream was associated with increased MEP, and smoking was associated with increased MEHP. The predictors of metabolite concentrations in seminal plasma differed from those in urine, except for the association of intravenous infusion therapy with MBP. BMI was associated with increased seminal plasma MBP, MEHP and MEOHP, smoking was associated with increased MEP, and contact with plastics was associated with increased MEOHP. CONCLUSIONS: Phthalate metabolite concentrations in adult men varied in accordance with sociodemographic variables, lifestyle factors and intravenous therapy. Measures of metabolite levels in urine may not directly reflect the exposure status of the male reproductive system.

Management of persistent caesarean scar pregnancy after curettage treatment failure.

BACKGROUND: Caesarean scar pregnancy (CSP) is a late serious complication of caesarean section. The incidence of CSP has increased worldwide in recent years. Early diagnosis and prompt therapy are crucial to avoid catastrophic complications. There are various strategies for CSP treatment, but there is no consensus on the best management for CSP. Dilation and curettage (D&C) and hysteroscopy are common and effective treatments with their advantages and disadvantages. No in-depth study of the clinical effects of hysteroscopic management of CSP after D&C treatment failure has been conducted. The purpose of this study is to evaluate the effectiveness and safety of hysteroscopic removal of residual CSP tissue (persistent CSP) as a rescue after failed D&C management. METHODS: This is a retrospective clinical research study. Forty-five patients underwent operative hysteroscopy to remove the residual gestational tissue in the caesarean scar after failed D&C treatment. The clinical characteristics and outcomes of hysteroscopic surgeries of 45 CSP cases were investigated. All data analyses were conducted with SPSS 17.0. RESULTS: Forty-three CSP cases after unsuccessful curettage treatment were successfully treated by operative hysteroscopy. The estimated intraoperative blood loss was 20.00 (10.00-500.00) mL, the hysteroscopic operating time was 20.00 (15.00-45.00) min, the decline of serum ß-hCG the day after surgery was 71.91 ± 14.05%, the total hospitalisation time was 7.87 ± 2.26 days, the medical cost was 13,682.71 ± 3553.77 China Yuan (CNY), the time of bleeding after surgery was 7.42 ± 2.48 days, and the time of serum ß-hCG resolution after surgery was 13.84 ± 9.83 days. Follow-up after discharge demonstrated that there were no severe complications for any patients. CONCLUSIONS: Hysteroscopy therapy could treat persistent CSP effectively and safely after curettage treatment failure. Therapy should be individualised, and the risks and cost of the hysteroscopy procedure and anaesthesia must be considered and fully discussed with the patients before surgery.

A Systematic Review of Application and Effectiveness of mHealth Interventions for Obesity and Diabetes Treatment and Self-Management.

The use of mobile and wireless technologies and wearable devices for improving health care processes and outcomes (mHealth) is promising for health promotion among patients with chronic diseases such as obesity and diabetes. This study comprehensively examined published mHealth intervention studies for obesity and diabetes treatment and management to assess their effectiveness and provide recommendations for future research. We systematically searched PubMed for mHealth-related studies on diabetes and obesity treatment and management published during 2000-2016. Relevant information was extracted and analyzed. Twenty-four studies met inclusion criteria and varied in terms of sample size, ethnicity, gender, and age of the participating patients and length of follow-up. The mHealth interventions were categorized into 3 types: mobile phone text messaging, wearable or portable monitoring devices, and applications running on smartphones. Primary outcomes included weight loss (an average loss ranging from -1.97 kg in 16 wk to -7.1 kg in 5 wk) or maintenance and blood glucose reduction (an average decrease of glycated hemoglobin ranging from -0.4% in 10 mo to -1.9% in 12 mo); main secondary outcomes included behavior changes and patient perceptions such as self-efficacy and acceptability of the intervention programs. More than 50% of studies reported positive effects of interventions based on primary outcomes. The duration or length of intervention ranged from 1 wk to 24 mo. However, most studies included small samples and short intervention periods and did not use rigorous data collection or analytic approaches. Although some studies suggest that mHealth interventions are effective and promising, most are pilot studies or have limitations in their study designs. There is an essential need for future studies that use larger study samples, longer intervention (≥ 6 mo) and follow-up periods (≥ 6 mo), and integrative and personalized innovative mobile technologies to provide comprehensive and sustainable support for patients and health service providers.

Simple and rapid chemiluminescence aptasensor for Hg2+ in contaminated samples: A new signal amplification mechanism.

Detection of ultralow concentration of heavy metal ion Hg2+ is important for human health protection and environment monitoring because of the gradual accumulation in environmental and biological fields. Herein, we report a convenient chemiluminescence (CL) biosensing platform for ultrasensitive Hg2+ detection by signal amplification mechanism from positively charged gold nanoparticles ((+)AuNPs). It is based on (+)AuNPs charge effect and aptamer conformation change induced by target to stimulate the generation of CL in the presence of H2O2 and luminol without high salt medium. Notably particularly, the typical problem of the high salt medium from (-) AuNPs system, like influencing aptamers' bind with target and hindering CL reaction can be effectively addressed through the direct introduction of (+)AuNPs. Therefore, the proposed biosensing exhibits a high sensitivity toward target Hg2+ with a detection limit of 16 pM, which is far below the limit (10nM) defined by the U.S. Environmental Protection Agency in drinkable water, and is about 10-fold lower than the previously reported aptamer-based assays for Hg2+. This sensing platform provides a simple, rapid, and cost-effective approach for label-free sensitive detection of Hg2+. Moreover, it is universal for the detection of other targets. Undoubtedly, such a direct utilizing of (+)AuNPs' charge effect will provide a new signal amplification way for label-free aptamer-based CL analysis.

[Comparison of ultrasound plus radiography versus computed tomography in the diagnosis of ectopic intrauterine devices].

OBJECTIVE: To compare the effectiveness of ultrasound plus radiography versus computed tomography (CT) in the diagnosis of ectopic intrauterine device (IUD) and analyze the ratio of cost and effectiveness (C/E) so as to provide scientific rationales for the selection of appropriate diagnostic methods. METHODS: A total of 70 cases were recruited from two major Chinese hospitals in 2009. They were examined with ultrasound plus radiography and CT respectively. The gold diagnostic criterion was postoperative diagnosis to compare the sensitivity, specificity, diagnostic index (DI), accuracy and C/E for different diagnostic methods. The SPSS 13.0 statistical analysis software was employed for data analysis. RESULTS: The data of 65 subjects were collected and analyzed. For ultrasound plus radiography, the sensitivity, specificity, DI, accuracy and C/E were 82.1%, 88.9%, 171.0%, 83.1% and 137.3 respectively. As for CT, the above indices were 96.4%, 55.6%, 152.0%, 90.8% and 170.7 respectively. CONCLUSION: Considering the higher levels of specificity and DI and a lower C/E, ultrasound plus radiography is superior to CT so that the former modality shall become a first-choice in the diagnosis of ectopic IUD, especially at the grass-root family planning service stations.

[18F-FDG imaging by coincidence circuit SPECT with low-dose CT in preoperative assessment of pulmonary lesions].

OBJECTIVE: To assess the clinical diagnostic value of 18F-FDG imaging by coincidence circuit SPECT with low-dose CT in differential diagnosis of pulmonary lesions and mediastinal lymph node involvement, which can not be definitely diagnosed based on regular CT image in patients with non-small-cell lung cancer (NSCLC). METHODS: By using GE-Millennium VG with Hawkeye, 18F-FDG imaging was carried out in 48 patients with suspected lung cancer. Clinical value of 18F-FDG imaging for diagnosing malignancy was evaluated through comparison with the final pathological results. Mediastinal lymph node involvement was also assessed through lesion-by-lesion comparison with pathologic results in 74 lymph node regions from 24 patients. RESULTS: Final pathologic diagnoses of these patients were 36 malignancies consisting of 20 adenocarcinomas, 12 squamous cell carcinomas, 3 small cell carcinomas and I large cell carcinoma; 12 benign tumors including 6 pneumonias, 2 tuberculosis, 2 hamatomas, 1 cyst and 1 neurofibroma. Of 48 patients, uptake of 18F-FDG in the chest was found to be abnormal in 40. Correct diagnosis were made in 34 malignancies and 6 false positive lesions were excluded based on morphology and 18F-FDG uptake status of the lesion. There were 6 false positive and 2 false negative cases. Furthermore, extrathoracic metastases which were not showed on previous CT image in 4 patients including one in the adrenal gland and 3 in the bone were detected by 18F-FDG imaging. The sensitivity, specificity and accuracy of the 18F-FDG imaging for differentiating malignant tumor from benign was 94.4%, 50.0% and 83.3%, respectively. Squamous cell carcinoma was found to uptake more FDG than adenocarcinoma. For determination of mediastinal lymph node involvement, the sensitivity, specificity and accuracy of 18F-FDG imaging was 57.9% , 90.9% and 82.4%, respectively through lesion-by-lesion comparison; whereas, which was 61.5%, 81.8% and 70.8%, respectively, based on case-by-case comparison. CONCLUSION: 18F-FDG imaging by coincidence circuit SPECT with low-dose CT is quite helpful in differential diagnosis for patient with undetermined lesion on regular CT image, but it is limited for staging of lung cancer in the patients with non-small cell lung cancer.

Bad but bold: Ambivalent attitudes toward men predict gender inequality in 16 nations.

A 16-nation study involving 8,360 participants revealed that hostile and benevolent attitudes toward men, assessed by the Ambivalence Toward Men Inventory (P. Click & S.T. Fiske, 1999), were (a) reliably measured across cultures, (b) positively correlated (for men and women, within samples and across nations) with each other and with hostile and benevolent sexism toward women (Ambivalent Sexism Inventory, P. Click & S.T. Fiske, 1996), and (c) negatively correlated with gender equality in cross-national comparisons. Stereotype measures indicated that men were viewed as having less positively valenced but more powerful traits than women. The authors argue that hostile as well as benevolent attitudes toward men reflect and support gender inequality by characterizing men as being designed for dominance.