Subgingival microbiome in periodontal health, gingivitis and different stages of periodontitis.

AIM: To characterize the subgingival microbiome in subjects with different periodontal health statuses. MATERIALS AND METHODS: In this cross-sectional observational study, subgingival samples were harvested from Spanish subjects with different periodontal health statuses, based on the 2018 Classification of Periodontal and Peri-Implant Diseases and Conditions. Samples were processed using high-throughput sequencing technologies (Illumina MiSeq). Taxa differentially abundant were identified using Analysis of Compositions of Microbiomes with Bias Correction (ANCOM-BC). α- and ß-diversity metrics were calculated using q2-diversity in QIIME2. The analyses were adjusted for age, gender and smoking status. RESULTS: The identified subgingival microbiome showed statistically significant differences among subjects, categorized into periodontal health, gingivitis and stages I-II and III-IV periodontitis (p < .05). In patients with severe (stages III-IV) periodontitis, the genera Filifactor and Fretibacterium were detected 24 times more frequently than in periodontally healthy subjects. Similarly, the genera Porphyromonas, Prevotella and Tannerella were detected four times more frequently (p < .05). The genera Granulicatella, Streptococcus, Paracoccus, Pseudomonas, Haemophilus, Actinobacteria, Bergeyella and Capnocytophaga were significantly associated with healthier periodontal status (p < .05). CONCLUSIONS: Significant differences were detected in the subgingival microbiome among periodontal health, gingivitis and stages I-II or III-IV periodontitis, suggesting overlapping, yet distinguishable microbial profiles.

An experimental look at trust, bargaining, and public goods in fishing communities.

Pro-social behavior is crucial to the sustainable governance of common-pool resources such as fisheries. Here, we investigate how key socioeconomic characteristics influence fishers' pro-social and bargaining behavior in three types of experimental economic games (public goods, trust, and trade) conducted in fishing associations in Chile. Our games revealed high levels of cooperation in the public goods game, a high degree of trust, and that sellers rather than buyers had more bargaining power, yet these results were strongly influenced by participants' socioeconomic characteristics. Specifically, gender, having a secondary income source, age, and being the main income provider for the household all had a relationship to multiple game outcomes. Our results highlight that engagement in pro-social behaviors such as trust and cooperation can be influenced by people's socioeconomic context.

Deletion of a Pathogenic Mutation-Containing Exon of COL7A1 Allows Clonal Gene Editing Correction of RDEB Patient Epidermal Stem Cells.

Recessive dystrophic epidermolysis bullosa is a severe skin fragility disease caused by loss of functional type VII collagen at the dermal-epidermal junction. A frameshift mutation in exon 80 of COL7A1 gene, c.6527insC, is highly prevalent in the Spanish patient population. We have implemented gene-editing strategies for COL7A1 frame restoration by NHEJ-induced indels in epidermal stem cells from patients carrying this mutation. TALEN nucleases designed to cut within the COL7A1 exon 80 sequence were delivered to primary patient keratinocyte cultures by non-integrating viral vectors. After genotyping a large collection of vector-transduced patient keratinocyte clones with high proliferative potential, we identified a significant percentage of clones with COL7A1 reading frame recovery and Collagen VII protein expression. Skin equivalents generated with cells from a clone lacking exon 80 entirely were able to regenerate phenotypically normal human skin upon their grafting onto immunodeficient mice. These patient-derived human skin grafts showed Collagen VII deposition at the basement membrane zone, formation of anchoring fibrils, and structural integrity when analyzed 12 weeks after grafting. Our data provide a proof-of-principle for recessive dystrophic epidermolysis bullosa treatment through ex vivo gene editing based on removal of pathogenic mutation-containing, functionally expendable COL7A1 exons in patient epidermal stem cells.

19. Adaptación transcultural y validación del instrumento Self Care of Heart Failure Index 6.2 para su uso en Uruguay

Antecedentes: el tratamiento de la IC es complejo por los múltiples fármacos a utilizar y las medidas no farmacológicas requeridas, por ello es importante que el paciente implemente su autocuidado adecuadamente. Autocuidado es el proceso de toma de decisiones del paciente con elección de comportamientos que mantienen la estabilidad fisiológica y la respuesta a los síntomas cuando ocurren y existen instrumentos para su evaluación. El Self Care of Heart Failure Index 6.2 (SCHFI 6.2), desarrollado en Estados Unidos, ayuda a los profesionales de la salud a identificar la adhesión (o no adhesión) al autocuidado, auxiliando en el redimensionamiento de orientaciones y conductas, pero para su utilización es necesario una adaptación transcultural. Objetivo: adaptar y validar el SCHFI 6.2 para pacientes uruguayos con IC. Material y método: estudio metodológico desarrollado en cuatro fases: traducción de la versión original (inglés) al español por dos traductores oficiales uruguayos; síntesis de las dos traducciones; retrotraducción y evaluación por la autora original; evaluación por el comité de expertos. Se invitó a ocho expertos en IC para evaluar cada ítem del cuestionario, en relación con la equivalencia semántica, idiomática, experimental y conceptual, a través de una escala Likert de cuatro puntos. Los datos fueron tabulados por Microsoft Excel 2013 y evaluados a través del índice de validez de contenido (IVC). El estudio se realizó entre los meses de julio y setiembre de 2017, con la aprobación del comité de ética. Resultados: de los 53 puntos evaluados, cinco presentaron IVC por debajo de 0,75, fueron reformulados y reenviados al comité de expertos para nueva evaluación, obteniéndose la versión final del SCHFI 6.2 español / Uruguay. Conclusiones: los instrumentos para evaluar el autocuidado son herramientas importantes y de bajo costo para el seguimiento de pacientes con IC. Se pretende dar seguimiento al estudio a través de la validación clínica y, con ello, poner a disposición la escala para uso de los profesionales de salud uruguayos, lo que podrá auxiliar en el direccionamiento de las orientaciones a estos pacientes.

Gene Editing for the Efficient Correction of a Recurrent COL7A1 Mutation in Recessive Dystrophic Epidermolysis Bullosa Keratinocytes.

Clonal gene therapy protocols based on the precise manipulation of epidermal stem cells require highly efficient gene-editing molecular tools. We have combined adeno-associated virus (AAV)-mediated delivery of donor template DNA with transcription activator-like nucleases (TALE) expressed by adenoviral vectors to address the correction of the c.6527insC mutation in the COL7A1 gene, causing recessive dystrophic epidermolysis bullosa in a high percentage of Spanish patients. After transduction with these viral vectors, high frequencies of homology-directed repair were found in clones of keratinocytes derived from a recessive dystrophic epidermolysis bullosa (RDEB) patient homozygous for the c.6527insC mutation. Gene-edited clones recovered the expression of the COL7A1 transcript and collagen VII protein at physiological levels. In addition, treatment of patient keratinocytes with TALE nucleases in the absence of a donor template DNA resulted in nonhomologous end joining (NHEJ)-mediated indel generation in the vicinity of the c.6527insC mutation site in a large proportion of keratinocyte clones. A subset of these indels restored the reading frame of COL7A1 and resulted in abundant, supraphysiological expression levels of mutant or truncated collagen VII protein. Keratinocyte clones corrected both by homology-directed repair (HDR) or NHEJ were used to regenerate skin displaying collagen VII in the dermo-epidermal junction.

Allergens Induce the Release of Lactoferrin by Neutrophils from Asthmatic Patients.

BACKGROUND: Despite the evidence that Lactoferrin (Lf) is involved in allergic asthma processes, it is unknown whether neutrophils can be one of the main cellular sources of this key inflammatory mediator directly in response of an IgE mediated stimulus. The present study was undertaken to analyze this question. METHODS: Neutrophils from healthy subjects (n = 34) and neutrophils from allergic asthmatic patients (n = 102) were challenged in vitro with specific allergens to which the patients were sensitized, PAF, or agonist mAbs against IgE-receptors, and the levels of Lf were measured in the culture supernatant. The levels of serum IgE together with the severity of symptoms were also analyzed. RESULTS: Lf was released into the culture supernatant of neutrophils from allergic asthmatic patients in response to allergens and PAF. This response was highly allergen-specific, and did not happen in neutrophils from healthy donors. Allergen effect was mimicked by Abs against FcεRI and galectin-3 but not by FcεRII. The levels of released Lf correlated well with the levels of serum specific IgE and severity of asthma symptoms. These observations represent a novel view of neutrophils as an important source of Lf in allergic asthma. Importantly, the levels of released Lf by neutrophils could therefore be used to evaluate disease severity in allergic asthmatic patients.

Immunotherapy reduces allergen-mediated CD66b expression and myeloperoxidase levels on human neutrophils from allergic patients.

UNLABELLED: CD66b is a member of the carcinoembryonic antigen family, which mediates the adhesion between neutrophils and to endothelial cells. Allergen-specific immunotherapy is widely used to treat allergic diseases, and the molecular mechanisms underlying this therapy are poorly understood. The present work was undertaken to analyze A) the in vitro effect of allergens and immunotherapy on cell-surface CD66b expression of neutrophils from patients with allergic asthma and rhinitis and B) the in vivo effect of immunotherapy on cell-surface CD66b expression of neutrophils from nasal lavage fluid during the spring season. Myeloperoxidase expression and activity was also analyzed in nasal lavage fluid as a general marker of neutrophil activation. RESULTS: CD66b cell-surface expression is upregulated in vitro in response to allergens, and significantly reduced by immunotherapy (p<0.001). Myeloperoxidase activity in nasal lavage fluid was also significantly reduced by immunotherapy, as were the neutrophil cell-surface expression of CD66b and myeloperoxidase (p<0.001). Interestingly, CD66b expression was higher in neutrophils from nasal lavage fluid than those from peripheral blood, and immunotherapy reduced the number of CD66+MPO+ cells in nasal lavage fluid. Thus, immunotherapy positive effects might, at least in part, be mediated by the negative regulation of the CD66b and myeloperoxidase activity in human neutrophils.

Allergen immunotherapy decreases LPS-induced NF-κB activation in neutrophils from allergic patients.

BACKGROUND: Allergen-specific immunotherapy (IT) is widely used to treat allergic diseases. The molecular mechanisms have not been clarified yet completely. The present work was undertaken to analyze the effect of IT in the activation of NF-κB. METHODS: Neutrophils from 15 pollen-allergic IT-treated patients, 10 untreated pollen-allergic patients, and 10 healthy donors were in vitro stimulated with LPS. NF-κB activation (p65/p52) was measured in their nuclear extracts by enzyme-linked immunosorbent assay (ELISA). IκBα phosphorylation, NF-κB-repressing factor (NRF) activation, and thromboxane A2 (TXA2 ) and Interleukin-8 (IL-8) release were measured by ELISA. RESULTS: There was a positive correlation between the score of symptoms and NF-κB activation in human neutrophils. IT significantly decreased NF-κB activation levels in neutrophils compared with neutrophils from untreated patients. IκBα phosphorylation and NRF activation levels were, respectively, significantly lower and higher in neutrophils from IT-treated patients than from untreated patients. IL-8 and TXA2 release were significantly lower in neutrophils from IT-treated patients than from untreated patients. CONCLUSIONS: IT positive effects are at least in part mediated by the negative regulation of NF-κB activation in human neutrophils. These observations represent a novel view of neutrophils as possible cell target to treat IgE-dependent diseases through NF-κB downmodulation.

Nivel de conocimiento de la enfermedad en una cohorte de pacientes con insuficiencia cardíaca / Level of disease awareness in a cohort of patients with heart failure

La causa más frecuente de reingresos por insuficiencia cardíaca es el mal cumplimiento terapéutico del paciente. Ello puede atribuirse a falta de conocimiento, a la complejidad del tratamiento, a deterioro cognitivo, a depresión o a una comunicación poco efectiva o inadecuada para el paciente por parte del equipo asistencial. Estudios previos muestran altos porcentajes de inadecuado conocimiento de la enfermedad en estos pacientes. En Uruguay no hay estudios que verifiquen esta situación. En el presente trabajo se analizó el conocimiento acerca de su enfermedad entre los pacientes controlados en una unidad especializada de insuficiencia cardíaca utilizando el método de encuesta mediante cuestionario autogestionado diseñado por los investigadores. Un elevado número de pacientes no conocen el diagnóstico de su enfermedad ni sus características, los factores de riesgo para enfermar y/o los factores de riesgo de descompensación. Esto debe obligar a otros análisis en cuanto a barreras de comunicación médico-paciente y/o a instrumentar planes educativos que puedan ser evaluados.

The most common cause of readmission for heart failure is poor patient compliance. This can be attributed to lack of knowledge, the complexity of treatment, cognitive impairment, depression or to an ineffective or inadequate communication to the patient by the healthcare team. Previous studies show a high percentage of inadequate knowledge about the disease in these patients. In Uruguay there are no studies that verify this. In this paper we analyzed the knowledge about their disease among the patients managed in a specialist heart failure unit using the survey method through self-administered questionnaire designed by the researchers.
A large number of patients do not know the diagnosis of the disease or the characteristics of the same, the risk factors for disease and / or risk factors of decompensation This should force other barriers analysis for doctor-patient communication and/or implement educational plans can be evaluated.

Keratinocyte cell lines derived from severe generalized recessive epidermolysis bullosa patients carrying a highly recurrent COL7A1 homozygous mutation: models to assess cell and gene therapies in vitro and in vivo.

Recessive dystrophic epidermolysis bullosa (RDEB) is caused by deficiency of type VII collagen due to COL7A1 mutations such as c.6527insC, recurrently found in the Spanish RDEB population. Assessment of clonal correction-based therapeutic approaches for RDEB requires large expansions of cells, exceeding the replication capacity of human primary keratinocytes. Thus, immortalized RDEB cells with enhanced proliferative abilities would be valuable. Using either the SV40 large T antigen or papillomavirus HPV16-derived E6-E7 proteins, we immortalized and cloned RDEB keratinocytes carrying the c.6527insC mutation. Clones exhibited high proliferative and colony-forming features. Cytogenetic analysis revealed important differences between T antigen-driven and E6-E7-driven immortalization. Immortalized cells responded to differentiation stimuli and were competent for epidermal regeneration and recapitulation of the blistering RDEB phenotype in vivo. These features make these cell lines useful to test novel therapeutic approaches including those aimed at editing mutant COL7A1.

Position coding effects in a 2D scenario: the case of musical notation.

How does the cognitive system encode the location of objects in a visual scene? In the past decade, this question has attracted much attention in the field of visual-word recognition (e.g., "jugde" is perceptually very close to "judge"). Letter transposition effects have been explained in terms of perceptual uncertainty or shared "open bigrams". In the present study, we focus on note position coding in music reading (i.e., a 2D scenario). The usual way to display music is the staff (i.e., a set of 5 horizontal lines and their resultant 4 spaces). When reading musical notation, it is critical to identify not only each note (temporal duration), but also its pitch (y-axis) and its temporal sequence (x-axis). To examine note position coding, we employed a same-different task in which two briefly and consecutively presented staves contained four notes. The experiment was conducted with experts (musicians) and non-experts (non-musicians). For the "different" trials, the critical conditions involved staves in which two internal notes that were switched vertically, horizontally, or fully transposed--as well as the appropriate control conditions. Results revealed that note position coding was only approximate at the early stages of processing and that this encoding process was modulated by expertise. We examine the implications of these findings for models of object position encoding.

Letter position coding across modalities: the case of Braille readers.

BACKGROUND: The question of how the brain encodes letter position in written words has attracted increasing attention in recent years. A number of models have recently been proposed to accommodate the fact that transposed-letter stimuli like jugde or caniso are perceptually very close to their base words. METHODOLOGY: Here we examined how letter position coding is attained in the tactile modality via Braille reading. The idea is that Braille word recognition may provide more serial processing than the visual modality, and this may produce differences in the input coding schemes employed to encode letters in written words. To that end, we conducted a lexical decision experiment with adult Braille readers in which the pseudowords were created by transposing/replacing two letters. PRINCIPAL FINDINGS: We found a word-frequency effect for words. In addition, unlike parallel experiments in the visual modality, we failed to find any clear signs of transposed-letter confusability effects. This dissociation highlights the differences between modalities. CONCLUSIONS: The present data argue against models of letter position coding that assume that transposed-letter effects (in the visual modality) occur at a relatively late, abstract locus.

Enhancing membrane disruption by targeting and multivalent presentation of antimicrobial peptides.

In order to enhance the membrane disruption of antimicrobial peptides both targeting and multivalent presentation approaches were explored. The antimicrobial peptides anoplin and temporin L were conjugated via click chemistry to vancomycin and to di- and tetravalent dendrimers. The vancomycin unit led to enhanced membrane disruption of large unilamellar vesicles (LUVs) displaying the vancomycin target lipid II, but only for temporin L and not for anoplin. The multivalent presentation led to enhanced LUV membrane disruption in the case of anoplin but not for temporin L.

A general approach for the non-stop solid phase synthesis of TAC-scaffolded loops towards protein mimics containing discontinuous epitopes.

In this Communication, the access to three different peptide loops attached to a small triazacyclophane (TAC) scaffold molecule for the mimicry of discontinuous epitopes present in, for example, antibodies is described for the first time.

Comunicación interna en el equipo de enfermería / Internal communication in the Nursing team

Introducción: en el proceso de interacción entre el nivel de supervisión y elpersonal de Enfermería surgen diariamente barreras en la divulgación de lainformación que pueden llegar a influir en el buen funcionamiento de lapráctica asistencial.Objetivos: conocer la motivación de los profesionales enfermeros y los canalesde comunicación existentes.Metodología: estudio descriptivo transversal. Población: enfermeras delHospital Ramón y Cajal (Madrid) del área de hospitalización. Instrumento:cuestionario autodiseñado de 22 preguntas cerradas y una abierta. Variablesanalizadas: socio-demográficas, laborales, motivación en la comunicación,canales de comunicación y propuestas de mejora.Resultados: 107 contestados (82,9%). Las enfermeras consideran muy importanterecibir información relacionada con su práctica profesional. Dentrode los canales de difusión, el tablón de anuncios es el más usado. Tienenmás dificultades para recibir información a través de los canalesinformáticos y mucha se recibe a través de rumores. Proponen aumentarlas reuniones y dejar toda la información por escrito.Conclusiones: los gestores son la pieza clave en el manejo de la información,para que su uso sea lo más eficiente que se pueda (AU)

Introduction: every day new obstacles arise in the exchange of informationthat takes place in the interaction process between supervisors and nursingstaff, which may negatively affect good clinical practice.Objectives: to learn about the motivation of nursing professionals and existingcommunication channels.Methodology: cross-sectional descriptive study. Population: Ramón y CajalHospital (Madrid) nurses from the hospitalization area. Instrument:Self-designed questionnaire comprised of 22 closed questions and one openquestion. Analyzed variables: sociodemographic, work-related, motivationin communication, communication channels and improvement proposals.Results: 107 questionnaires were completed (82,9%). Nurses consider receivinginformation related to their professional practice very important. Thebulletin board is the most frequently used information exhange channel.Nurses claim it is harder to receive information through computer channels(computerised data) and that a lot of information arrives in the formof rumours or worse still gossip. Nurses suggest increasing the number ofmeetings and having all the information conveyed in writing.Conclusions: managers are key to information management so communicationcan be as efficient as possible (AU)

A novel strategy to mimic discontinuous protective epitopes using a synthetic scaffold.

Although vaccines have been used for a long time and different types of vaccines have been developed, as yet no fully synthetic vaccines have been produced. The production of fully synthetic vaccines has probably not been realized so far due to the structural limitations of linear synthetic peptides to mimic the native shape of protein fragments which is often needed to induce protective antibodies. In this report we used the Bordetella pertussis protein pertactin as a model and show that a novel synthetic scaffold can be used to mimic structurally defined epitopes by confined presentation of several different peptide arms. Guided by modelling a construct was synthesized that induced protective antibodies directed towards a discontinuous epitope. This approach opens up the possibility to the design of new and fully synthetic vaccines that can induce protective antibodies.

Improving the antiviral efficacy and selectivity of HIV-1 reverse transcriptase inhibitor TSAO-T by the introduction of functional groups at the N-3 position.

Novel derivatives of the anti-HIV-1 agent, TSAO-T, bearing at the N-3 position a variety of polar, lipophilic, or aromatic groups linked to that position through flexible polymethylene linkers of different length, were prepared and evaluated for their anti-HIV activity. Several compounds (within the series of polar bearing groups) exhibited a 2-6-fold improved antiviral potency with regard to the lead compound, TSAO-T. Moreover, some of the most active N-3 TSAO derivatives retain antiviral activity against the TSAO-T-resistant HIV-1 strain (Glu138 --> Lys). Interestingly, the N-methylcarboxamide derivative 17 was 5- to 6-fold more active (IC50: 0.56 microM) against recombinant HIV-1 reverse transcriptase than the lead compound, thus becoming the most active TSAO derivative synthesized so far. On the other hand, the N-3 methylcarboxamide TSAO derivative 12 turned out to have the highest selectivity index yet reported for this class of compounds (around > or =12 000).

Synthesis of novel Bi-, Tri-, and tetracyclic nucleosides by reaction of a common cyclic enamine derived from TSAO-T with nucleophiles.

We report here the efficient regio- and stereoselective synthesis of new polycyclic nucleosides using a common cyclic enamine (7) as the starting material. In fact, the reaction of 7, easily prepared by reaction of 5'-O-Tosyl TSAO-T under basic nonnucleophilic conditions (potassium carbonate), with different classes of nucleophiles, for example, nitrogen-, oxygen-, sulfur-, and carbon-based nucleophiles, or with amino acids afforded, with total regio- and stereoselectivity, new bi-, tri-, and tetracyclic nucleosides. This straighforward route represents an original and unambiguously regio- and stereoselective pathway to these compounds. Some of these polycyclic nucleosides may be useful intermediates for a second series of reactions that may lead to the generation of structurally new nucleosides.

Structure-activity relationship studies on a novel family of specific HIV-1 reverse transcriptase inhibitors.

We have previously reported the discovery and preliminary structure-activity relationships of a new class of specific HIV-1 reverse transcriptase (RT) inhibitors whose prototype compound is the 1-[2',5'-bis-O-(tert-butyldimethylsilyl)-beta-D-ribofuranosyl]-3-N-[(carboxy) methyl]-thymine. In an attempt to increase the inhibitory efficacy against HIV-1 RT of this new class of nucleosides, and to further explore the structural features required for anti-HIV-1 activity, different types of modifications have been carried out on the prototype compound. These include substitution of the tert-butyldimethylsilyl groups by other liphophilic groups, replacement of the carboxy group at the N-3 position of the nucleobase by other functional groups, change in the length of the spacer between the thymine and the carboxylic acid residue and substitution of the thymine moiety by other pyrimidine (uracil, 5-ethyluracil) or purine (hypoxanthine) nucleobases. In addition, the most salient structural features of this new class of HIV-1-specific nucleosides have been incorporated into classical HIV RT nucleoside inhibitors such as ddl, AZT, d4T. Our studies demonstrate that both the carboxymethyl moiety at the nucleobase and tert-butyldimethylsilyl groups at the sugar are important structural components since deletion of either of them is detrimental to the antiviral activity.

Approaches to the solid phase of a cyclotriveratrylene scaffold-based tripodal library as potential artificial receptors.

Two versatile tripodal cyclotriveratrylene (CTV)-based scaffolds (7 and 9) have been prepared for the solid phase construction of libraries of tripodal artificial synthetic receptors. A 2197-member library of CTV-based tripodal receptor molecules, 20[1-13,1-13,1-13], was prepared on the solid phase using split-mix synthesis. The CTV-based receptors contain three peptide arms; one of them is attached to the solid phase and is different from the other two identical peptide arms.