DigiPatICS: Digital Pathology Transformation of the Catalan Health Institute Network of 8 Hospitals-Planification, Implementation, and Preliminary Results.

Complete digital pathology transformation for primary histopathological diagnosis is a challenging yet rewarding endeavor. Its advantages are clear with more efficient workflows, but there are many technical and functional difficulties to be faced. The Catalan Health Institute (ICS) has started its DigiPatICS project, aiming to deploy digital pathology in an integrative, holistic, and comprehensive way within a network of 8 hospitals, over 168 pathologists, and over 1 million slides each year. We describe the bidding process and the careful planning that was required, followed by swift implementation in stages. The purpose of the DigiPatICS project is to increase patient safety and quality of care, improving diagnosis and the efficiency of processes in the pathological anatomy departments of the ICS through process improvement, digital pathology, and artificial intelligence tools.

Successful and stable operation of anaerobic thermophilic co-digestion of sun-dried sugar beet pulp and cow manure under short hydraulic retention time.

This work consists of a long-term (621 days) experimental study about biogas production from sun dried sugar beet pulp and cow manure. Thermophilic (55 °C) anaerobic co-digestion was performed in semi-continuous reactors, testing ten hydraulic retention times (30-3 days) (HRTs) and organic loading rates (2-24 gVS/Lreactor∙d) (OLRs). Results showed that the best global system performance (regarding stability, biogas production, and organic matter removal) was achieved at an HRT as short as 5 days (OLR of 12.47 gVS/Lreactor∙d) with a biogas yield of 315 mL/gVSadded. The gradual OLR increase allowed system control and time-appropriate intervention, avoiding irreversible process disturbances and maintaining admissible acidity/alkalinity ratios (<0.8) for HRTs ranging from 30 to 4 days. The accumulation of acetic acid was the main cause of the process disturbance observed at short HRTs. It was deduced that for the HRT of 3 days, the methane productivity was mainly owing to the hydrogen-utilizing methanogens pathway. This research clearly shows how an adequate combination of agro-industrial wastes and livestock manure could be processed by anaerobic co-digestion in short HRTs with great efficiency and stability and deepens in the understanding of the start-up, stability and optimization of the co-digestion.

Glyphosate-based herbicide affects the composition of microbes associated with Colorado potato beetle (Leptinotarsa decemlineata).

Here, we examined whether glyphosate affects the microbiota of herbivores feeding on non-target plants. Colorado potato beetles (Leptinotarsa decemlineata) were reared on potato plants grown in pots containing untreated soil or soil treated with glyphosate-based herbicide (GBH). As per the manufacturer's safety recommendations, the GBH soil treatments were done 2 weeks prior to planting the potatoes. Later, 2-day-old larvae were introduced to the potato plants and then collected in two phases: fourth instar larvae and adults. The larvae's internal microbiota and the adults' intestinal microbiota were examined by 16S rRNA gene sequencing. The beetles' microbial composition was affected by the GBH treatment and the differences in microbial composition between the control and insects exposed to GBH were more pronounced in the adults. The GBH treatment increased the relative abundance of Agrobacterium in the larvae and the adults. This effect may be related to the tolerance of some Agrobacterium species to glyphosate or to glyphosate-mediated changes in potato plants. On the other hand, the relative abundances of Enterobacteriaceae, Rhodobacter, Rhizobium and Acidovorax in the adult beetles and Ochrobactrum in the larvae were reduced in GBH treatment. These results demonstrate that glyphosate can impact microbial communities associated with herbivores feeding on non-target crop plants.

Protein Supplements and Their Relation with Nutrition, Microbiota Composition and Health: Is More Protein Always Better for Sportspeople?

Sports nutrition products are developed and targeted mainly for athletes to improve their nutrient intake, performance, and muscle growth. The fastest growing consumer groups for these products are recreational sportspeople and lifestyle users. Although athletes may have elevated physiological protein requirements and they may benefit from dietary supplements, the evidence regarding the role of dietary protein and supplements in the nutrition of recreational sportspeople and sedentary populations is somewhat complex and contradictory. In high-protein diets, more undigested protein-derived constituents end up in the large intestine compared to moderate or low-protein diets, and hence, more bacterial amino acid metabolism takes place in the colon, having both positive and negative systemic and metabolic effects on the host. The aim of the present review is to summarize the impact of the high-protein products and diets on nutrition and health, in sportspeople and in sedentary consumers. We are opening the debate about the current protein intake recommendations, with an emphasis on evidence-based effects on intestinal microbiota and personalized guidelines regarding protein and amino acid supplementation in sportspeople and lifestyle consumers.

Mice gut microbiota programming by using the infant food profile. The effect on growth, gut microbiota and the immune system.

During the complementary feeding (CF) period, nutritional imbalances can have negative consequences not only on a child's health in the short term but also later in adulthood, as a phenomenon known as "nutritional programming" takes place. The aim of this study was to evaluate the possible changes in body growth, gut microbiota (GM) and the immune system in mice fed with two different commercial sterilized baby foods in jars (BFJs) for CF. Mice fed with different BFJs (A and B groups) showed an accelerated growth from the fifth week of life when compared with the control (C) group. Group A showed a higher BMI, post-weaning growth rate, and IL-10 levels and a decrease in the Lactobacillus group. Group B showed a significant decrease in the total bacterial count, Lactobacillus group, Enterococcus spp. and Bacteroidetes-Prevotella. The Bifidobacterium genus tended to be lower in groups A and B. Akkermansia muciniphila was more frequently detected in group C. The results obtained from groups A and B can be attributed to the BFJ fatty acid profile, rich in UFAs. This study demonstrates for the first time that the commercial BFJ composition during CF might be a "programming" factor for body growth, GM and the immune system.

Mice exposed to infant formula enriched with polyamines: impact on host transcriptome and microbiome.

Previous studies using a BALB/cOlaHsd model have shown the impact that the supplementation of infant formula with polyamines has on the modulation of microbial colonization and immune system development. To contribute to deciphering and identifying new complex interactions underlying the host response to polyamines, a systems biology approach integrating data from microbiota along the gastrointestinal tract, lymphocyte populations and immune system gene expression analysis of a lactating mice model fed different diets was carried out. The study design included four different dietary regimens including the following: mice fed by normal lactation; early weaned mice given commercial infant formula; and early weaned mice fed with infant formula enriched with two different concentrations of polyamines. Cluster analysis by principal component analysis and heat map demonstrated that the bacterial communities and immune system status differed between groups. The assessment of the relationship between immune system development, microbiota succession and polyamine supplementation in a global manner proved that the supplementation of infant formula with polyamines promotes similar microbial communities along the whole gastrointestinal tract, and results in similar lymphocyte populations and expression of immune related-genes to those with the normal lactated milk and the results differ from those with the infant formula without polyamines. Further studies should be conducted in human subjects to verify the current results, as the supplementation of polyamines may resemble the effect of natural breastfeeding practices in the gastrointestinal microbiota and immune system development in a mouse model.

Biomethanization of sugar beet byproduct by semi-continuous single digestion and co-digestion with cow manure.

Dried pellet of exhausted sugar beet cossettes were digested alone and combined with cow manure as co-substrate in a mesophilic semi-continuous anaerobic system. In single digestion assay, the stable biogas production and stable reactor operation was observed at the hydraulic retention time (HRT) of 20days (OLR: 3.26gVS/Lreactord) which was the minimum HRT tolerated by the system. However, co-digestion with cow manure allowed to decrease the HRT until 15days (OLR: 4.97gVS/Lreactord) with 32% higher biogas generation and efficient reactor operation. Propionic acid was the predominant VFA observed during single digestion assay failure, while acetic acid accumulation was observed in the co-digestion assay. In both single and co-digestion assays, the recovery of digesters was possible by ceasing the feeding and re-inoculation with a well-adapted inoculum.

Evaluation of methane generation and process stability from anaerobic co-digestion of sugar beet by-product and cow manure.

The effect of mesophilic anaerobic co-digestion of dried pellets of exhausted sugar beet cossettes (ESBC-DP) and cow manure (CM) on the enhancement of methane generation and process stability were studied with the aim to select the best substrate mixture ratio. A series of batch experiments was conducted using the following five mixture ratios of ESBC-DP:CM: 0:100; 25:75; 50:50; 75:25 and 100:0. Best results were obtained from mixture ratios with ESBC-DP proportions in the range of 25-50%. Mixture ratio of 50:50 showed a specific methane production (SMP) increase of 81.4% and 25.5%, respectively, in comparison with mono-digestion of ESBC-DP and CM. Evolution of the indirect parameter named acidogenic substrate as carbon (ASC) could be used to provide more insight about the process stability of anaerobic digestion. ASC accumulation was observed in reactors with higher ESBC-DP proportions leading to a delay in VFAs consumption and conversion into methane.

Semi-continuous anaerobic co-digestion of sugar beet byproduct and pig manure: Effect of the organic loading rate (OLR) on process performance.

Anaerobic co-digestion of dried pellet of exhausted sugar beet cossettes (ESBC-DP) with pig manure (PM) was investigated in a semi-continuous stirred tank reactor (SSTR) under mesophilic conditions. Seven hydraulic retention times (HRT) from 20 to 5 days were tested with the aim to evaluate the methane productivities and volatile solids (VS) removal. The corresponding organic loading rates (OLR) ranged from 4.2 to 12.8 gVS/L(reactor) d. The findings revealed that highest system efficiency was achieved at an OLR of 11.2 gVS/L(reactor) d (6 days-HRT) with a methane production rate (MPR) and volatile solids (VS) reduction of 2.91 LCH4/L(reactor) d and 57.5%, respectively. The HRT of 5 days was found critical for the studied process, which leads to volatile fatty acids (VFA) accumulation and sharp drop in pH. However, the increase of HRT permits the recovery of system.

The effect of tomato juice supplementation on biomarkers and gene expression related to lipid metabolism in rats with induced hepatic steatosis.

PURPOSE: Tomato products are a dietary source of natural antioxidants, especially lycopene, which accumulates in the liver, where it exerts biological effects. Taking into consideration this fact, the aim of the present study was to ascertain the effect of tomato consumption on biomarkers and gene expression related to lipid metabolism in rats with induced steatosis. METHODS: Adult male Sprague-Dawley rats (8 weeks old) were randomly grouped (n = 6 rats/group) in four experimental groups: NA (normal diet and water), NL (normal diet and tomato juice), HA (high fat diet and water) and HL (high fat diet and tomato juice). After 7 weeks, rats were euthanized, and plasma, urine, feces and liver were sampled to analyze the biomarkers related to lipid metabolism, inflammation and oxidative stress. RESULTS: The H diet induced steatosis (grade II) in the HA and HL groups, which was confirmed by the levels of alanine aminotransferase and aspartate aminotransferase, histological examination and the presence of dyslipidemia. The intake of tomato juice led to an accumulation of all-E and Z-lycopene and its metabolites in the livers of these animals; levels were higher in HL than in NL, apparently due to higher absorption (63.07 vs. 44.45%). A significant improvement in the plasma level of high-density lipoprotein was observed in the HL group compared with HA animals, as was an alleviation of oxidative stress through reduction of isoprostanes in the urine. In relation to fatty acid gene expression, an overexpression of several genes related to fatty acid transport, lipid hydrolysis and mitochondrial and peroxisomal ß-fatty acid oxidation was observed in the HL group. CONCLUSIONS: The consumption of tomato juice and tomato products reduced hallmarks of steatosis, plasmatic triglycerides and very low-density lipoproteins, and increased lipid metabolism by inducing an overexpression of genes involved in more efficient fatty acid oxidation.

Resembling breast milk: influence of polyamine-supplemented formula on neonatal BALB/cOlaHsd mouse microbiota.

Infant microbiota is influenced by numerous factors, such as delivery mode, environment, prematurity and diet (breast milk or formula). In addition to its nutritional value, breast milk contains bioactive substances that drive microbial colonisation and support immune system development, which are usually not present in infant formulas. Among these substances, polyamines have been described to be essential for intestinal and immune functions in newborns. However, their effect on the establishment of microbiota remains unclear. Therefore, the aim of the present study was to ascertain whether an infant formula supplemented with polyamines has an impact on microbial colonisation by modifying it to resemble that in breast-fed neonatal BALB/c mice. In a 4 d intervention, a total of sixty pups (14 d old) were randomly assigned to the following groups: (1) breast-fed group; (2) non-enriched infant formula-fed group; (3) three different groups fed an infant formula enriched with increasing concentrations of polyamines (mixture of putrescine, spermidine and spermine), following the proportions found in human milk. Microbial composition in the contents of the oral cavity, stomach and small and large intestines was analysed by quantitative PCR targeted at fourteen bacterial genera and species. Significantly different (P< 0·05) microbial colonisation patterns were observed in the entire gastrointestinal tract of the breast-fed and formula-fed mice. In addition, our findings demonstrate that supplementation of polyamines regulates the amounts of total bacteria, Akkermansia muciniphila, Lactobacillus, Bifidobacterium, Bacteroides-Prevotella and Clostridium groups to levels found in the breast-fed group. Such an effect requires further investigation in human infants, as supplementation of an infant formula with polyamines might contribute to healthy gastrointestinal tract development.

SUMO-1 gene transfer improves cardiac function in a large-animal model of heart failure.

Recently, the impact of small ubiquitin-related modifier 1 (SUMO-1) on the regulation and preservation of sarcoplasmic reticulum calcium adenosine triphosphatase (SERCA2a) function was discovered. The amount of myocardial SUMO-1 is decreased in failing hearts, and its knockdown results in severe heart failure (HF) in mice. In a previous study, we showed that SUMO-1 gene transfer substantially improved cardiac function in a murine model of pressure overload-induced HF. Toward clinical translation, we evaluated in this study the effects of SUMO-1 gene transfer in a swine model of ischemic HF. One month after balloon occlusion of the proximal left anterior descending artery followed by reperfusion, the animals were randomized to receive either SUMO-1 at two doses, SERCA2a, or both by adeno-associated vector type 1 (AAV1) gene transfer via antegrade coronary infusion. Control animals received saline infusions. After gene delivery, there was a significant increase in the maximum rate of pressure rise [dP/dt(max)] that was most pronounced in the group that received both SUMO-1 and SERCA2a. The left ventricular ejection fraction (LVEF) improved after high-dose SUMO-1 with or without SERCA2a gene delivery, whereas there was a decline in LVEF in the animals receiving saline. Furthermore, the dilatation of LV volumes was prevented in the treatment groups. SUMO-1 gene transfer therefore improved cardiac function and stabilized LV volumes in a large-animal model of HF. These results support the critical role of SUMO-1 in SERCA2a function and underline the therapeutic potential of SUMO-1 for HF patients.

[Improvements in oral anticoagulant therapy for atrial fibrillation]. / Avances en el tratamiento anticoagulante oral de la fibrilación auricular.

For the last decades vitamin K antagonists have been the most effective anticoagulant treatment of atrial fibrillation. New molecules are being designed, mainly due to the great amount of disadvantages in the management of conventional anticoagulation. Dabigatran, rivaroxaban and apixaban will soon be available as an alternative to warfarin/acenocumarol. All of them have demonstrated to be non-inferior to warfarin in preventing stroke and systemic embolism, with even dabigatran 150 mg bid and apixaban being superior. They have also a lower risk of bleeding, especially regarding severe/fatal and intracranial hemorrhages. This is a real revolution. The advance of these new anticoagulants will be limited only by the higher cost, and will progressively become the protagonists of oral anticoagulation in patients with nonvalvular atrial fibrillation.

Adeno-associated virus serotype 8 ApoA-I gene transfer reduces progression of atherosclerosis in ApoE-KO mice: comparison of intramuscular and intravenous administration.

Apolipoprotein A-I (ApoA-I)/high-density lipoprotein (HDL)-raising treatments are effective antiatherosclerotic strategies. We have compared the antiatherogenic effects of human ApoA-I (hApoA-I) overexpression by intraportal and intramuscular gene transfer in atherosclerotic ApoE-knockout mice. Atherosclerotic lesions were induced by atherogenic diet. After atherosclerosis induction, a group of animals was killed and served as atherosclerosis baseline-control group. The remaining animals were randomized into the following groups: (1) atherosclerosis-progression-control, (2) intraportal/vector administration, and (3) intramuscular/vector administration. Aortas and hearts were processed for atherosclerotic quantification by en face Sudan IV and Oil Red-O, respectively. Liver and muscle specimens were processed for protein/gene expression analysis. A sustained increase in hApoA-I/HDL plasma levels was observed in both transduced groups. hApoA-I overexpression abolished plaque progression versus progression-control group. hApoA-I overexpression significantly reduced lesion macrophage, feature indicative of plaque stabilization. Scavenger receptor class-B type I (SR-BI), but not ATP-binding cassette, sub-family A (ABCA), member 1 (ABCA-1), was significantly upregulated in treated groups versus progression-controls. The results of this study show a similar effect of hApoA-I/HDL overexpression on plaque progression/stabilization by 2 different routes of administration. Our results showing similar effects using either intramuscular administration and intraportal route of administration may have significant clinical implications, given the reduced medical risk to patient and cost of intramuscular injections.

Immunomodulatory effects of the intake of fermented milk with Lactobacillus casei DN114001 in lactating mothers and their children.

The healthy action of probiotics is not only due to their nutritional properties and their influence on the gastrointestinal environment, but also to their action on the immune system. The aim of the present study was to determine if 6 weeks of probiotic intake would be able to modulate the immune system in women who had recently delivered and were breast-feeding. The design consisted of a randomised, controlled and double-blind nutritional intervention study with parallel groups with a sample size of 104 women. The main variable is the T helper type 1/T helper type 2 (Th1/Th2) profile determined by measuring interferon-gamma (Th1) and IL-4 (Th2) values in peripheral blood by flow cytometry. The modifications of cytokines were evaluated in maternal milk by cytometric bead array in a flow cytometer and ELISA at three stages of breast-feeding: colostrum, early milk (10 d) and mature milk (45 d). Additionally, the anthropometry and infectious and allergic episodes in the newborn were followed up throughout the first 6 months of life. After the consumption of milk fermented with Lactobacillus casei during the puerperium, we observed a nonsignificant increase in T and B lymphocytes and a significant increase in natural killer cells. A decrease in the pro-inflammatory cytokine TNF-alpha in maternal milk and fewer gastrointestinal disturbances were also observed in the breast-fed child of the mothers who consumed L. casei. The intake of milk fermented with L. casei during the lactation period modestly contributes to the modulation of the mother's immunological response after delivery and decreases the incidence of gastrointestinal episodes in the breast-fed child.