A Synopsis of Hepatitis C Virus Treatments and Future Perspectives.

Hepatitis C virus (HCV) infection is a worldwide public health problem. Chronic infection with HCV can lead to liver cirrhosis or cancer. Although some immune-competent individuals can clear the virus, others develop chronic HCV disease due to viral mutations or an impaired immune response. IFNs type I and III and the signal transduction induced by them are essential for a proper antiviral effect. Research on the viral cycle and immune escape mechanisms has formed the basis of therapeutic strategies to achieve a sustained virological response (SVR). The first therapies were based on IFNα; then, IFNα plus ribavirin (IFN-RBV); and then, pegylated-IFNα-RBV (PEGIFNα-RIV) to improve cytokine pharmacokinetics. However, the maximum SVR was 60%, and several significant side effects were observed, decreasing patients' treatment adherence. The development of direct-acting antivirals (DAAs) significantly enhanced the SVR (>90%), and the compounds were able to inhibit HCV replication without significant side effects, even in paediatric populations. The management of coinfected HBV-HCV and HCV-HIV patients has also improved based on DAA and PEG-IFNα-RBV (HBV-HCV). CD4 cells are crucial for an effective antiviral response. The IFNλ3, IL28B, TNF-α, IL-10, TLR-3, and TLR-9 gene polymorphisms are involved in viral clearance, therapeutic responses, and hepatic pathologies. Future research should focus on searching for strategies to circumvent resistance-associated substitution (RAS) to DAAs, develop new therapeutic schemes for different medical conditions, including organ transplant, and develop vaccines for long-lasting cellular and humoral responses with cross-protection against different HCV genotypes. The goal is to minimise the probability of HCV infection, HCV chronicity and hepatic carcinoma.

Genotypic and phenotypic diversity among Lactobacillus plantarum and Lactobacillus pentosus isolated from industrial scale cucumber fermentations.

The Lactobacillus plantarum and Lactobacillus pentosus genotypes existing in industrial-scale cucumber fermentations were defined using rep-PCR-(GTG)5. The ability of each genotype to ferment cucumbers under various conditions was evaluated. Rep-PCR-(GTG)5 was the technique capable of illustrating the most intraspecies discrimination compared to the sequencing of housekeeping genes (recA, dnaK, pheS and rpoA), MLST and RAPD with primers LP1, OPL5, M14 and COC. Ten genotypic clusters were defined for the 199 L. pentosus tested and three for the 17 L. plantarum clones. The ability of the 216 clones genotyped and 37 additional cucumber fermentation isolates, of the same species, to rapidly decrease the pH of cucumber juice medium under various combinations of sodium chloride (0 or 6%), initial pH (4.0 or 5.2) and temperatures (15 or 30 °C) was determined using a fractional factorial screening design. A reduced fermentation ability was observed for the L. plantarum strains as compared to L. pentosus, except for clone 3.2.8, which had a ropy phenotype and aligned to genotypic cluster A. L. pentosus strains belonging to three genotypic clusters (B, D and J) were more efficient in cucumber juice fermentation as compared to most L. plantarum strains. This research identified three genetically diverse L. pentosus strains and one L. plantarum as candidates for starter cultures for commercial cucumber fermentations.

"Everyone Has Their Story": Intergroup Dialogue's Potential to Cultivate Connection Through the Sharing of Migration Narratives.

Immigrant-origin (I-O) youth face increasing anti-immigrant rhetoric in the USA, including in their schools. School-based intergroup dialogue programming may help I-O youth and their peers build a more inclusionary culture. We qualitatively examined how I-O youth and their peers experienced a week-long school-wide intergroup dialogue program that aimed to foster connection among participants at a Northeastern high school. Participants' (N=159) experience in the program were analyzed using post-program reflections. Participants were 53% female and 74% underclassmen; 59% Latinx, 14% Black, 13% multiracial, 9% White, and 5% Asian and Middle Eastern; generationally, 54% identified as second-generation immigrants, 38% as non-immigrant origin, and 8% as first-generation. Participation in the program produced mixed results. For many, participation led to a greater sense of connection; youth reported that they learned about their peers, the immigrant experience, and sometimes, themselves. Connection was especially fostered among the dominant demographic groups in the school: second-generation and Latinx youth. Learning about others was less likely to cultivate connections when participants could not relate their own experiences, and at times even made participants feel more different from their peers. Intergroup dialogue has the potential to foster connection when participants are able to relate across experiences.

CO2-mediated bloater defect can be induced by the uncontrolled growth of Enterobacteriaceae in cucumber fermentation.

Enterobacteriaceae are known to proliferate in cucumber juice, deriving energy from the fermentation of sugars to organic acids and ethanol, and theoretically generating carbon dioxide (CO2). We hypothesized that the CO2 produced by the indigenous Enterobacteriaceae in the early stage of cucumber fermentation accumulates in the fermenting fruits causing bloater defect. The ability of seven Enterobacteriaceae, indigenous to cucumber, to grow and produce CO2 in cucumber juice medium (CJM), a sterile model system for cucumber fermentation, was characterized. The induction of bloater defect in cucumber fermentation conducted with pasteurized and acidified fruits was also evaluated. The generation times of the seven Enterobacteriaceae in CJM ranged between 0.25 and 8.20 h and resulted in carbon dioxide (CO2) production to estimated amounts of 7.22-171.5 mM. Enterobacter cancerogenus and Enterobacter nimipressuralis were among the bacteria that produced the most and the least CO2 in CJM, respectively, at estimated mM concentrations of 171.58 ± 42.96 and 16.85 ± 6.53. Inoculation of E. cancerogenus and E. nimipressuralis in acidified and pasteurized cucumbers resulted in the production of 138 and 27 mM CO2, respectively. Such Enterobacteriaceae produced 2% hydrogen in the model cucumber fermentations. A bloater index of 25.4 and 17.4 was calculated from the cucumbers fermented by E. cancerogenus and E. nimipressuralis, respectively, whereas no defect was observed in the fruits collected from uninoculated control fermentation jars. It is concluded that the metabolic activity of the Enterobacteriaceae indigenous to cucumber can produce sufficient CO2 in cucumber fermentations to induce bloater defect.

Tracheal stenosis as a complication of prolonged intubation in coronavirus disease 2019 (COVID-19) patients: a Peruvian cohort.

Background: Tracheal stenosis (TS) is associated with prolonged intubation and inflammation due to coronavirus disease 2019 (COVID-19) infection. Because of the COVID-19 pandemic, longer times of mechanical ventilation have been required, and different tracheostomies beyond 10 to 12 days have been made. All of these have increased the number of cases and complexity of tracheal pathology in patients with severe COVID-19 infection. Methods: A retrospective, chart review, from patients who were managed in the Service of Thoracic Surgery of Guillermo Almenara Irigoyen National Hospital, Lima, Peru, with a diagnosis of TS, tracheo-esophageal fistula and tracheomalacia between June 2020 until May 2021. Results: Sixty-three patients were diagnosed with TS because of prolonged intubation due to COVID-19 infection. Mean hospitalization time in the intensive care unit (ICU) was 30 days. Mean mechanical ventilation time was 25 days. The most frequent anatomical localization of TS was upper and middle third (55.6%), upper third (44.4%). Fifty-three patients (84.1%) had TS between 1-4 cm, and ten patients (15.9%) had TS longer than 4 cm. Most patients with TS were classified with Cotton-Myer grade III (88.9%). Conclusions: We report a retrospective study of 63 patients with a diagnosis of TS, in whom corrective surgery was performed: cervical tracheoplasty, Montgomery T tube, or tracheostomy.

Growth of ɣ-Proteobacteria in Low Salt Cucumber Fermentation Is Prevented by Lactobacilli and the Cover Brine Ingredients.

This study investigated the ability of É£-proteobacteria, indigenous to fresh cucumber, to grow in the expressed fruit juice (CJM) and fermentation. It was hypothesized that fresh cucumbers can support prolific growth of É£-proteobacteria but that the cover brine composition and acid production by the competing lactobacilli in the fermentation of the fruit act as inhibitory agents. The É£-proteobacteria proliferated in CJM with an average maximum growth rate (µmax) of 0.3895 ± 0.0929 and doubling time (Td) of 1.885 ± 0.465/h. A significant difference was found between the É£-proteobacteria µmax and Td relative to Lactiplantibacillus pentosus LA0445 (0.2319 ± 0.019; 2.89/h) and Levilactobacillus brevis 7.2.43 (0.221 ± 0.015; 3.35/h) but not Lactiplantibacillus plantarum 3.2.8 (0.412 ± 0.119; 1.87/h). While inoculation level insignificantly altered the µmax and Td of the bacteria tested; it impacted the length of lag and stationary phases for the lactobacilli. Unlike the lactobacilli, the É£-proteobacteria were inhibited in CJM supplemented with a low salt fermentation cover brine containing calcium chloride, acetic acid and potassium sorbate. The É£-proteobacteria, P. agglomerans, was unable to proliferate in cucumber fermentations brined with calcium chloride at a pH of 6.0 ± 0.1 and the population of Enterobacteriaceae was outcompeted by the lactobacilli within 36 h. Together these observations demonstrate that the prolific growth of É£-proteobacteria in CJM is not replicated in cucumber fermentation. While the É£-proteobacteria growth rate is faster that most lactobacilli in CJM, their growth in cucumber fermentation is prevented by the cover brine and the acid produced by the indigenous lactobacilli. Thus, the lactobacilli indigenous to cucumber and cover brine composition influence the safety and quality of fermented cucumbers. IMPORTANCE While the abundance of specific É£-proteobacteria species varies among vegetable type, several harbor Enterobacteriaceae and Pseudomonadaceae that benefit the plant system. It is documented that such bacterial populations decrease in density early in vegetable fermentations. Consequently, it is assumed that they do not contribute to the quality of finished products. This study explored the viability of É£-proteobacteria in CJM, used as a model system, CJM supplemented with fermentation cover brine and cucumber fermentation, which are characterized by an extremely acidic endpoint pH (3.23 ± 0.17; n = 391). The data presented demonstrates that fresh cucumbers provide the nutrients needed by É£-proteobacteria to proliferate and reduce pH to 4.47 ± 0.12. However, É£-proteobacteria are unable to proliferate in cucumber fermentation. Control of É£-proteobacteria in fermentations depends on the cover brine constituents and the indigenous competing lactobacilli. This knowledge is of importance when developing guidelines for the safe fermentation of vegetables, particularly with low salt.

Vegetable fermentations brined with low salt for reclaiming food waste.

Fermentation of eight vegetables was studied as an alternative for reclamation of surplus volumes. Fermentation performance was predicted by comparing the amounts of acid that could be produced from the intrinsic sugar content with that buffered by the fresh vegetable matrices prior to reaching an inhibitory pH for fermentative microbes (3.30). Native fermentations were brined with 345.0 mM sodium chloride, 40.0 mM calcium chloride, 6.0 mM potassium sorbate, and vinegar to adjust the initial pH to 4.70. High-performance liquid chromatography analysis, pH, and carbon dioxide measurements and spiral plating on selective media were employed to monitor the progress of fermentations. The average colony counts for yeast and/or molds and Enterobacteriaceae declined to undetectable levels from 3.6 ± 1.5 log CFU/ml within 7 days of fermentation. The fermentation of sugars produced lactic, acetic, succinic, and/or malic acids, and ethanol. As predicted, the fermentation of vegetables with low sugar content, such as broccoli, green leaf lettuce, and green pea proceeded to completion. The fermentation of vegetables with a moderate sugar content, such as green bell pepper, red ripened tomato, and green bean were incomplete at pH 3.1 ± 0.2. The fermentation of high sugar vegetables including sweet potato and corn were expected and observed to be incomplete. It is concluded that the intrinsic sugar content and buffer capacity of surplus vegetables are relevant parameters in obtaining complete fermentations. PRACTICAL APPLICATION: Vegetables are the second most wasted commodity in the United States and a substantial constituent of the global food waste. Development of fermentation to reclaim surplus vegetables from farms, grocery stores, and farmer's markets offers opportunities to ameliorate economic losses and environmental impact and add value to waste. The research described here suggests that a fraction of vegetables could be fermented in cover brines while others, with high sugar content, need specialized handling. Evidently, optimization of vegetable fermentation with starter cultures and added buffers represent an opportunity to stimulate complete bioconversions useful for reclaiming surplus volumes.

Eating Habits Associated with Nutrition-Related Knowledge among University Students Enrolled in Academic Programs Related to Nutrition and Culinary Arts in Puerto Rico.

University students frequently develop unhealthy eating habits. However, it is unknown if students enrolled in academic programs related to nutrition and culinary arts have healthier eating habits. We evaluated the relationship of eating habits and nutritional status of students in academic programs with knowledge on nutrition, as well as cooking methods and techniques. A descriptive cross-sectional study was conducted in spring of 2019, while we completed a survey measuring eating habits and knowledge on nutrition, as well as cooking methods and techniques. Anthropometric measurements were collected for nutritional status estimation. The non-probabilistic convenience sample comprised 93 students pursuing degrees at Universidad Ana G. Mendez, Puerto Rico. Inadequate body mass index (BMI) was observed in 59% of the students. Eating habits, knowledge on nutrition, and knowledge on cooking methods and techniques were inadequate in 86%, 68%, and 41% of the population, respectively. Eating habits were associated with knowledge on nutrition and academic program, but not with knowledge on cooking methods and techniques. Most students reported having inadequate eating habits and BMI. Nutrition and dietetics students had the best knowledge on nutrition compared to culinary management students, a majority of whom had inadequate knowledge. We can conclude that there are other factors inherent to students' life that may have a stronger influence on eating habits.

El cine durante la cuarentena: Una herramienta pedagógica de bioética en estudiantes de posgrado en salud / The Cinema During the Quarantine: a Pedagogical Tool of Bioethics in Postgraduate Health Students

La bioética estudia la conducta humana en los campos de las ciencias biológicas y de la atención de la salud. Es imprescindible que el contenido programático de las facultades de ciencias de la salud divulgue su significado e importancia. Todo aquel que pretenda una práctica profesional en la cual interaccione directamente con la vida, debe adquirir competencias desde el campo de la bioética con fundamentos arraigados en los principios éticos de no maleficencia, beneficencia, autonomía y justicia. De tal forma que desarrollen capacidad de reflexión crítica sobre los conflictos éticos provocados por los avances de la ciencia de la vida y la medicina. Cada día se propone más el uso de herramientas audiovisuales en la docencia, para facilitar el abordaje de dilemas éticos, crear espacios de análisis, discusión, que ayudan a la comprensión, memoria e interpretación de este tema entre los estudiantes. En este artículo se pretende divulgar la experiencia a través de una estrategia pedagógica que involucra el cineforo como medio de aprendizaje en bioética en un grupo de estudiantes posgrado en salud. (AU)

Bioethics studies human behavior in the field of biological sciences and health care. It is essential that the programmatic content of the faculties of health sciences disclose its meaning and importance. Anyone who intends a professional practice, in which they interact directly with life, must acquire skills from the field of bioethics with foundations rooted in the ethical principles of non-maleficence, beneficence, autonomy and justice. In such a way that they develop the capacity for critical reflection on the ethical conflicts caused by advances in the science of life and medicine. Every day, the use of audiovisual tools in teaching is proposed more, to make it easier for students to approach ethical dilemmas and create spaces for analysis, discussion, help understanding, memory and interpretation of this topic. This article aims to disseminate the experience through the implementation of a pedagogical strategy that involves cinema and commercial films as a means of learning bioethics in a group of postgraduate health students. (AU)