Erythrocyte deformability correlates with systemic inflammation.

Recent evidence suggests that systemic conditions, particularly those associated with inflammation, can affect erythrocyte deformability in the absence of haematological conditions. In this exploratory study, we investigated the relationship between systemic inflammatory status and erythrocyte deformability (using osmotic gradient ektacytometry) in a heterogenous study population consisting of individuals with no medical concerns, chronic conditions, and acute illness, providing a wide range of systemic inflammation severity. 22 participants were included in a prospective observational study. Maximum Elongation Index (EImax) in ektacytometry served as the readout for erythrocyte deformability. Inflammatory status was assessed using C-reactive protein (CRP) and self-reported symptoms associated with inflammatory activation (Sickness Questionnaire Scores, SicknessQ). In a univariate linear regression, both CRP and SicknessQ scores significantly predicted EImax (CRP: F(1,20) = 7.751, p < 0.05 (0.011), R2 = 0.279; SicknessQ: F(1,18) = 4.831, p < 0.05 (0.041), R2 = 0.212). Sensitivity analyses with multivariable linear regression correcting for age showed concordant findings. Results suggest a linear relationship between erythrocyte deformability and biochemical and clinical markers of systemic inflammation. Replication of findings in a larger study, and mechanisms and clinical consequences need further in investigation.

Foliar inoculation of Phyllachora maydis into corn induces infection and local spread in field environments.

Tar spot of corn (Zea mays L.) is a significant disease in the United States and Canada caused by Phyllachora maydis, an obligate biotroph fungus. However, field research critical for understanding and managing the disease has been hindered by a need for methods to inoculate corn with P. maydis in field environments. In this study, we developed and demonstrated the efficacy of a method to initiate tar spot in field settings using inoculations of corn leaves with P. maydis inoculum that had been stored at -20 °C for 10 months. Stromata of P. maydis were observed 19 days after inoculations in two field experiments, and stromata resulting from secondary spread were initially observed 39 to 41 days after the initial inoculations. Tar spot was not present in the fields beyond the inoculated areas or localized spread area, signifying that the establishment of initial disease resulted solely from inoculations. This study enhances our understanding of inoculation and infection of corn with P. maydis and tar spot development in field environments. The results will aid new research into understanding the corn tar spot pathosystem and improving management strategies.

Trypanosoma cruzi heme responsive gene (TcHRG) plays a central role in orchestrating heme uptake in epimastigotes.

Trypanosoma cruzi, a heme auxotrophic parasite, can control intracellular heme content by modulating heme responsive gene (TcHRG) expression when a free heme source is added to an axenic culture. Herein, we explored the role of TcHRG protein in regulating the uptake of heme derived from hemoglobin in epimastigotes. We demonstrate that the endogenous TcHRG (protein and mRNA) responded similarly to bound (hemoglobin) and free (hemin) heme. Endogenous TcHRG was found in the flagellar pocket boundaries and partially overlapping with the mitochondrion. On the other hand, endocytic null parasites were able to develop and exhibited a similar heme content compared to wild-type when fed with hemoglobin, indicating that endocytosis is not the main entrance pathway for hemoglobin-derived heme in this parasite. Moreover, the overexpression of TcHRG led to an increase in heme content when hemoglobin was used as the heme source. Taken together, these results suggest that the uptake of hemoglobin-derived heme likely occurs through extracellular proteolysis of hemoglobin via the flagellar pocket, and this process is governed by TcHRG. In sum, T. cruzi epimastigotes control heme homeostasis by modulating TcHRG expression independently of the available source of heme.

SHP2 inhibitors maintain TGFß signalling through SMURF2 inhibition.

Despite the promising antitumor activity of SHP2 inhibitors in RAS-dependent tumours, overall responses have been limited by their narrow therapeutic window. Like with all MAPK pathway inhibitors, this is likely the result of compensatory pathway activation mechanisms. However, the underlying mechanisms of resistance to SHP2 inhibition remain unknown. The E3 ligase SMURF2 limits TGFß activity by ubiquitinating and targeting the TGFß receptor for proteosome degradation. Using a functional RNAi screen targeting all known phosphatases, we identify that the tyrosine phosphatase SHP2 is a critical regulator of TGFß activity. Specifically, SHP2 dephosphorylates two key residues on SMURF2, resulting in activation of the enzyme. Conversely, SHP2 depletion maintains SMURF2 in an inactive state, resulting in the maintenance of TGFß activity. Furthermore, we demonstrate that depleting SHP2 has significant implications on TGFß-mediated migration, senescence, and cell survival. These effects can be overcome through the use of TGFß-targeted therapies. Consequently, our findings provide a rationale for combining SHP2 and TGFß inhibitors to enhance tumour responses leading to improved patient outcomes.

TcHRG plays a central role in orchestrating heme uptake in Trypanosoma cruzi epimastigotes.

Trypanosoma cruzi, a heme auxotrophic parasite, can control intracellular heme content by modulating TcHRG expression when a free heme source is added to axenic culture. Herein, we explore the role of TcHRG protein in regulating the uptake of heme derived from hemoglobin in epimastigotes. It was found that the parasités endogenous TcHRG (protein and mRNA) responds similarly to bound (hemoglobin) and free (hemin) heme. Additionally, the overexpression of TcHRG leads to an increase in intracellular heme content. The localization of TcHRG is also not affected in parasites supplemented with hemoglobin as the sole heme source. Endocytic null epimastigotes do not show a significant difference in growth profile, intracellular heme content and TcHRG protein accumulation compared to WT when feeding with hemoglobin or hemin as a source of heme. These results suggest that the uptake of hemoglobin-derived heme likely occurs through extracellular proteolysis of hemoglobin via the flagellar pocket, and this process is governed by TcHRG. In sum, T. cruzi epimastigotes controls heme homeostasis by modulating TcHRG expression independently of the source of available heme.

First report of Curvularia leaf spot on Zea mays caused by Curvularia lunata in North Carolina.

In late July of 2022, corn leaves with spots were observed in a field at North Carolina State University's Vernon James Research and Extension Center (35.873294º N, 76.658599º W; Plymouth NC). The affected leaves contained small (two to three millimeters in diameter) tan-colored circular to oval lesions with reddish-brown margins and chlorotic haloes. The disease severity approached 50% on affected leaves. Leaf tissue from the margins of the lesions was excised and surface sterilized by soaking in 10 % bleach solution for two minutes followed by rinsing in distilled water. Next, leaf tissue was transferred to alkaline water agar amended with streptomycin (100 mgliter-1) and the plates were incubated at 27º C in dark. After one week, conidia were observed. Conidia were curved, light brown in color and contained three transverse septa. The size of the conidia (n= 30) ranged from 21-25 µm (average 24 µm) long by 7 to 10 µm wide (average 9 µm). These characteristics were typical of Curvularia lunata (Munkvold and White 2016). DNA from pure cultures was extracted, internal transcribed space region (ITS) was amplified using the primers ITS4 and ITS5 (White et al. 1990). Sequences were obtained and deposited into GenBank (accession no. OP998306). BLAST search indicated that the sequence was 100 % identical to C. lunata from Louisiana (MG 971305.1, Garcia- Aroca et al. 2018). Pathogenicity was confirmed on field corn cultivar 'Yellow dent' by inoculating two pots of two-week-old greenhouse-grown corn plants (6 plants per pot) by spraying conidial suspension with a concentration of 6 x 104 conidia /ml. The control plants (n= 6) were sprayed with distilled water and the plants were covered with a plastic bag for 24 hours. The plastic bags were removed and plants were moved to the greenhouse at 23º C. Four days after inoculation small round tan-colored lesions were observed and no symptoms on control plants. The experiment was repeated once and the pathogen was recovered from the symptomatic tissue. The morphology of the recovered isolate was similar to the original isolate. This is the first report of C. lunata causing leaf spot on corn in North Carolina. Although this disease has not been demonstrated to cause yield loss it has been detected more frequently in corn production areas of U.S. and should continue to be monitored going forward.

Anatomic Characteristics of the Adolescent Cricothyroid Membrane on Computed Tomography Scans.

BACKGROUND: The cricothyroid membrane (CTM) is the most important anatomic structure when performing emergency front-of-neck access (FONA) procedures. Adolescence is a period of rapid morphologic change in laryngeal structures, including the CTM. We hypothesized that the adolescent CTM would be sufficiently different from pediatric or adult anatomy to merit special consideration in FONA. OBJECTIVE: The aim of the study was to define the procedurally relevant CTM anatomy in an adolescent population. METHODS: This was a retrospective, multicenter cohort study composed of patients who underwent a diagnostic computed tomography scan during routine clinical care. Inclusion criteria were ages 16 to 19 years and a computed tomography of the neck with or without contrast. The primary outcome was CTM height measured in the midsagittal plane using electronic calipers. RESULTS: One hundred thirty-four imaging studies met inclusion criteria. The average CTM height was strongly associated with age and ranged between 5.4 and 6.2 mm in male adolescents and 4.6 and 5.8 mm in female adolescents. We predicted that standard cuffed endotracheal and tracheostomy tubes recommended for FONA procedures (5.0- and 6.0-mm devices) could potentially fail for most patients in our cohort. CONCLUSIONS: The adolescent CTM is smaller than previously recognized. We recommend having a variety of equipment sizes readily available at any site where airway management in adolescents may occur.

The Functional Characterization of TcMyoF Implicates a Family of Cytostome-Cytopharynx Targeted Myosins as Integral to the Endocytic Machinery of Trypanosoma cruzi.

Of the pathogenic trypanosomatids, Trypanosoma cruzi alone retains an ancient feeding apparatus known as the cytostome-cytopharynx complex (SPC) that it uses as its primary mode of endocytosis in a manner akin to its free-living kinetoplastid relatives who capture and eat bacterial prey via this endocytic organelle. In a recent report, we began the process of dissecting how this organelle functions by identifying the first SPC-specific proteins in T. cruzi Here, we continued these studies and report on the identification of the first enzymatic component of the SPC, a previously identified orphan myosin motor (MyoF) specifically targeted to the SPC. We overexpressed MyoF as a dominant-negative mutant, resulting in parasites that, although viable, were completely deficient in measurable endocytosis in vitro To our surprise, however, a full deletion of MyoF demonstrated only a decrease in the overall rate of endocytosis, potentially indicative of redundant myosin motors at work. Thereupon, we identified three additional orphan myosin motors, two of which (MyoB and MyoE) were targeted to the preoral ridge region adjacent to the cytostome entrance and another (MyoC) which was targeted to the cytopharynx tubular structure similar to that of MyoF. Additionally, we show that the C-terminal tails of each myosin are sufficient for targeting a fluorescent reporter to SPC subregions. This work highlights a potential mechanism used by the SPC to drive the inward flow of material for digestion and unveils a new level of overlapping complexity in this system with four distinct myosin isoforms targeted to this feeding structure.IMPORTANCE The parasite Trypanosoma cruzi is the etiological agent of Chagas disease and chronically infects upwards of 7 million people in the Americas. Current diagnostics and treatments remain grossly inadequate due, in part, to our general lack of understanding of this parasite's basic biology. One aspect that has resisted detailed scrutiny is the mechanism employed by this parasite to extract nutrient resources from the radically different environments that it encounters as it transitions between its invertebrate and mammalian hosts. These parasites engulf food via a tubular invagination of its membrane, a strategy used by many protozoan species, but how this structure is formed or functions mechanistically remains a complete mystery. The significance of our research is in the identification of the mechanistic underpinnings of this feeding organelle that may bring to light new potential therapeutic targets to impede parasite feeding and thus halt the spread of this deadly human pathogen.

Identification and Localization of the First Known Proteins of the Trypanosoma cruzi Cytostome Cytopharynx Endocytic Complex.

The etiological agent of Chagas disease, Trypanosoma cruzi, is an obligate intracellular parasite that infects an estimated 7 million people in the Americas, with an at-risk population of 70 million. Despite its recognition as the highest impact parasitic infection of the Americas, Chagas disease continues to receive insufficient attention and resources in order to be effectively combatted. Unlike the other parasitic trypanosomatids that infect humans (Trypanosoma brucei and Leishmania spp.), T. cruzi retains an ancestral mode of phagotrophic feeding via an endocytic organelle known as the cytostome-cytopharynx complex (SPC). How this tubular invagination of the plasma membrane functions to bring in nutrients is poorly understood at a mechanistic level, partially due to a lack of knowledge of the protein machinery specifically targeted to this structure. Using a combination of CRISPR/Cas9 mediated endogenous tagging, fluorescently labeled overexpression constructs and endocytic assays, we have identified the first known SPC targeted protein (CP1). The CP1 labeled structure co-localizes with endocytosed protein and undergoes disassembly in infectious forms and reconstitution in replicative forms. Additionally, through the use of immunoprecipitation and mass spectrometry techniques, we have identified two additional CP1-associated proteins (CP2 and CP3) that also target to this endocytic organelle. Our localization studies using fluorescently tagged proteins and surface lectin staining have also allowed us, for the first time, to specifically define the location of the intriguing pre-oral ridge (POR) surface prominence at the SPC entrance through the use of super-resolution light microscopy. This work is a first glimpse into the proteome of the SPC and provides the tools for further characterization of this enigmatic endocytic organelle. A better understanding of how this deadly pathogen acquires nutrients from its host will potentially direct us toward new therapeutic targets to combat infection.

Unique Challenges to the Approach and Management of Pediatric Headscarf Pin Aspiration.

BACKGROUND: Headscarf use is becoming more common throughout the world. Many articles describe the problem of aspirated headscarf pins but few if any give technical details for retrieval or innovative methods of removal if traditional bronchoscopy fails particularly in the pediatric population. Herein, we describe our method of deep sedation with laryngeal mask airway (LMA) and flexible bronchoscopy (FB) and retrieval with a stepwise algorithm if traditional FB fails. METHODS: A retrospective review of pediatric patients with aspirated headscarf pins was performed. Patient demographics, symptomatology, procedure specifics, and outcomes were recorded. RESULTS: Fifty-six patients had pins removed at our institution between January 2010 and May 2017. Ninety-one percent were female. Each had a history of aspiration of a needle confirmed by a chest X-ray. The most common presenting symptom was cough in 48%. Only a small minority had physical exam findings (9% either wheezing or decreased air entry). FB via LMA under deep sedation was used as a primary intervention and was successful in 52 of 56 cases (93%). Fluoroscopy was added to aid the FB in 3 cases and was successful in 2 of the 3 patients. Two patients underwent mini-thoracotomy for removal. All pins were removed successfully and none of the patients had any postprocedural complications. CONCLUSION: Surgeons caring for pediatric patients throughout the world should be knowledgeable in a common problem often facing girls wearing headscarves. Given the majority of the needles are in segmental bronchi in teenage girls, we recommend FB as the primary modality with the addition of fluoroscopy to guide if needed and video-assisted thoracoscopy or mini thoracotomy if less invasive methods fail.

Dengue: a continuing global threat.

Dengue fever and dengue haemorrhagic fever are important arthropod-borne viral diseases. Each year, there are ∼50 million dengue infections and ∼500,000 individuals are hospitalized with dengue haemorrhagic fever, mainly in Southeast Asia, the Pacific and the Americas. Illness is produced by any of the four dengue virus serotypes. A global strategy aimed at increasing the capacity for surveillance and outbreak response, changing behaviours and reducing the disease burden using integrated vector management in conjunction with early and accurate diagnosis has been advocated. Antiviral drugs and vaccines that are currently under development could also make an important contribution to dengue control in the future.

Dengue vector-control services: how do they work? A systematic literature review and country case studies.

The increasing incidence and geographic expansion of dengue suggest limitations of vector-control operations. We undertook an analysis of services with two methods: a systematic literature review; and case studies (stakeholder interviews, questionnaires) in Brazil, Guatemala, The Philippines and Viet Nam. In the systematic literature review there were only a few studies (strict criteria, 9 studies; less strict criteria, a further 16 studies and 3 guidelines). Of the 9 studies, 3 showed little change of control operations over time but did show strategic changes (decentralisation, intersectoral collaboration). Staffing levels, capacity building, management and organisation, funding and community engagement were insufficient. The case studies confirmed most of this information: (1) a lack of personnel (entomologists, social scientists, operational vector-control staff); (2) a lack of technical expertise at decentralised levels of services; (3) insufficient budgets; (4) inadequate geographical coverage; (5) interventions relying mostly on insecticides; (6) difficulties in engaging communities; (7) little capacity building; (8) almost no monitoring and evaluation. Stakeholders' doubts about service effectiveness were widespread, but interventions were assumed to be effective with increased resources. The analysis underlined the need for: operational standards; evidence-based selection/delivery of combinations of interventions; development/application of monitoring and evaluation tools; needs-driven capacity building.

Six months of Aedes aegypti control with a novel controlled-release formulation of pyriproxyfen in domestic water storage containers in Cambodia.

A field evaluation of a novel, 5% controlled-release formulation of pyriproxyfen was carried out in 400-500 liter concrete water storage jars, the most common and important larval habitat of the dengue vector, Aedes aegypti, in Cambodia. The formulation consisted of cylindrical resin strands, 3 mm in diameter and 40 mm in length. Pyriproxyfen was applied to 100 jars at a target dose of 0.03-0.04 mg of active ingredient (a.i.) per liter (30-40 ppb) in households in Phum Thmei, a village near the capital city of Phnom Penh, in April 2005. Inhibition of adult emergence (IE) in field populations ofAe. aegypti was measured every 2 weeks for 34 weeks. IE in treated jars exceeded 90% for 20 weeks, and remained above 80% until the end of the study. In 25 untreated jars, failure of pupae to metamorphose into viable adults remained below 4%. No alteration of taste or other undesirable effects of the treatment were reported by householders. This single treatment provided control of Ae. aegypti in water jars for the length of the main dengue transmission season in Cambodia that normally extends from May to November.

Community-based use of the larvivorous fish Poecilia reticulata to control the dengue vector Aedes aegypti in domestic water storage containers in rural Cambodia.

A community-based study of the distribution of larvivorous fish, Poecilia reticulata (common name: guppy), in water storage containers for dengue control was undertaken in 14 villages and approximately 1,000 households in Cambodia. Community volunteers reared guppies and distributed them in water jars and tanks in households for which they were responsible. A nearby control area received no intervention. One year after project commencement, 56.9% of eligible containers contained guppies and there was a 79.0% reduction in Aedes infestation in the intervention community compared with the control. Smaller or discarded containers unsuitable for guppy distribution in the intervention area also had 51% less infestation than those in the control area, suggesting a "community-wide" protective effect. In addition, there was less infestation in villages with higher rates of fish uptake, suggesting that the presence of fish was responsible for a reduction in Aedes infestation. This applied vector control model was well-accepted, effective, efficient, and shows promise as a sustainable community-based, non-insecticidal intervention for dengue vector control in large domestic water storage containers in rural Cambodia and elsewhere.

Resurgence of chikungunya.

Chikungunya, an arboviral disease transmitted by Aedes mosquitoes, has recently increased dramatically in incidence and geographic extent. Large outbreaks have affected islands of the Indian Ocean, India and other parts of South and Southeast Asia, Africa and most recently Italy. International travellers have disseminated new strains of the virus, some into regions from which chikungunya has hitherto been absent. In parallel, over the past 30 years international trade has resulted in the spread of A. albopictus from its original range in Asia, to all continents but Antarctica, thereby extending the geographic area over which transmission can occur.

The effect of long-lasting insecticidal water container covers on field populations of Aedes aegypti (L.) mosquitoes in Cambodia.

Dengue in Cambodia is mainly transmitted by Aedes aegypti (L.) mosquitoes that primarily breed in large, concrete jars (> or =200 liters) used for the storage of water for domestic use. Following a preliminary risk assessment, long-lasting insecticidal netting (LN) treated with deltamethrin was incorporated into the design of the covers for these jars. Their effect on immature and adult female populations of Ae. aegypti in six villages in a peri-urban area of Cambodia were compared with populations in six nearby control villages before and for 22 weeks after distribution of the jar covers. There were significantly fewer pupae per house in intervention villages than in control villages (6.6 and 31.9, respectively, p<0.01). Fewer pupae were recovered from intervention houses than from control houses at every post-intervention assessment. Two weeks after the intervention, the average number of indoor resting female Ae. aegypti per house in the intervention villages had declined approximately three-fold, whereas in the controls there was only a slight reduction (16%). The magnitude of the difference between the two areas diminished over time, which contact bioassays confirmed was likely due to a gradual reduction of insecticidal effect of the jar covers. In the study area, insecticide-treated covers for large concrete water storage jars were efficacious for controlling Ae. aegypti in the protected water jars and with a demonstrable effect on adult densities and survival. Further studies of this targeted container strategy in Cambodia, and elsewhere, are recommended. However, improvements in technology that would extend the duration of insecticidal effectiveness of LN materials may be needed for the development of cost-effective public health applications.

Cost-effectiveness of annual targeted larviciding campaigns in Cambodia against the dengue vector Aedes aegypti.

OBJECTIVE: To assess the cost-effectiveness (CE) of annual targeted larviciding campaigns from 2001 to 2005 against the dengue vector Aedes aegypti in two urban areas of Cambodia with a population of 2.9 million people. METHODS: The intervention under analysis consisted of annual larviciding campaigns targeting medium to large water storage containers in households and other premises. The CE compared the intervention against the hypothetical alternative of no intervention. The CE was calculated as the ratio of disability adjusted life years (DALYs) saved to the net cost of the intervention (in 2005 US dollars) by year. A sensitivity analysis explored the range of study parameters. RESULTS: The intervention reduced the number of dengue cases and deaths by 53%. It averted an annual average of 2980 dengue hospitalizations, 11,921 dengue ambulatory cases and 23 dengue deaths, resulting in a saving of 997 DALYs per year. The gross cost of the intervention was US $567,800 per year, or US $0.20 per person covered. As the intervention averted considerable medical care, the annual net cost of the intervention was US $312,214 (US $0.11 per person covered) from a public sector perspective and US $37,137 (US $0.01 per person covered) from a societal perspective. The resulting CE ratios were: US $313/DALY gained from the public perspective and US $37/DALY gained from the societal perspective. Even under the most conservative assumption, the intervention remained cost effective from both perspectives. CONCLUSIONS: Annual, targeted larviciding campaigns appear to have been effective and cost-effective medium-term interventions to reduce the epidemiologic and economic burden of dengue in urban areas of Cambodia.

Inhibition of adult emergence of Aedes aegypti in simulated domestic water-storage containers by using a controlled-release formulation of pyriproxyfen.

Concrete domestic water-storage jars are a common larval habitat of the dengue vector Aedes aegypti in countries of Southeast Asia. The efficacy of a novel controlled-release formulation of the insect growth regulator pyriproxyfen, designed to inhibit adult emergence for 6 months (the approximate duration of the main dengue transmission season in many endemic countries) was tested in Cambodia against a local strain of Ae. aegypti in 200-liter jars. The resin-based formulation contained 4.8% active ingredient (AI). At target dosages of 18, 27, and 36 ppb of AI, inhibition of adult emergence remained above 95% for at least 2 months. After 3 months at 18 ppb AI, the residual efficacy was significantly lower than for the higher dosages (P < 0.05). At the higher dosages, inhibition of adult emergence was > or = 87% for 6 months. At a dosage of 27 ppb AI, monthly removal and replacement of two thirds of the water did not reduce efficacy (P > 0.05). Potential operational advantages and challenges of using the formulation are discussed. Larger-scale efficacy studies are recommended in community settings.