Investigating the Use of Impedance Flow Cytometry for Classifying the Viability State of E. coli.

Bacteria detection, counting and analysis is of great importance in several fields. When viability plays a major role in decision making, the counting of colony-forming units grown on agar plates remains the gold standard. However, because plate counts depend on the growth of the bacteria, it is a slow procedure and only works with culturable species. Impedance flow cytometry (IFC) is a promising technology for particle detection, counting and characterization. It relies on the perturbation of an electric field by particles flowing through a microfluidic channel. The perturbation is directly related to the electrical properties of the particles, and therefore provides information about their composition and structure. In this work we investigate whether IFC can be used to differentiate viable cells from inactivated cells. Our findings demonstrate that the specific viability state of the bacteria has to be considered, but that with proper characterization thresholds, IFC can be used to classify bacterial viability states. By using three different inactivation methods-ethanol, heat and autoclavation-we have been able to show that the impedance response of Escherichia coli depends on its viability state, but that the specific response depends on the inactivation method. With these findings we expect to be able to optimize IFC for more reliable bacteria detection and counting in the future.

A genetically engineered H5 protein expressed in insect cells confers protection against different clades of H5N1 highly pathogenic avian influenza viruses in chickens.

The evolution of highly pathogenic H5N1 avian influenza viruses (HPAI-H5N1) has resulted in the appearance of a number of diverse groups of HPAI-H5N1 based on the presence of genetically similar clusters of their haemagglutinin sequences (clades). An H5 antigen encoded by a recombinant baculovirus and expressed in insect cells was used for oil-emulsion-based vaccine prototypes. In several experiments, vaccination was performed at 10 days of age, followed by challenge infection on day 21 post vaccination (PV) with HPAI-H5N1 clades 2.2, 2.2.1, and 2.3.2. A further challenge infection with HPAI-H5N1 clade 2.2.1 was performed at day 42 PV. High haemagglutination inhibition titres were observed for the recH5 vaccine antigen, and lower haemagglutination inhibition titres for the challenge virus antigens. Nevertheless, the rate of protection from mortality and clinical signs was 100% when challenged at 21 days PV and 42 days PV, indicating protection over the entire broiler chicken rearing period without a second vaccination. The unvaccinated control chickens mostly died between two and five days after challenge infection. A low level of viral RNA was detected by reverse transcription followed by a quantitative polymerase chain reaction in a limited number of birds for a short period after challenge infection, indicating a limited spread of HPAI-H5N1 at flock level. Furthermore, it was observed that the vaccine can be used in a differentiation infected from vaccinated animals (DIVA) approach, based on the detection of nucleoprotein antibodies in vaccinated/challenged chickens. The vaccine fulfilled all expectations of an inactivated vaccine after one vaccination against challenge with different clades of H5N1-HPAI and is suitable for a DIVA approach.

Consumer usage and reasons for using dietary supplements: report of a series of surveys.

OBJECTIVE: Consumer usage of dietary supplements is prevalent in the United States, and total usage is higher than reported in recent National Health and Nutrition Examination Surveys (NHANES), because these surveys capture usage only in the 30 days prior to the respondent's interview and do not capture occasional and seasonal use throughout the year. We report data from a series of consumer surveys on the full extent of dietary supplement use, on the reasons for supplement use, and on the products most commonly taken, as well as other health habits of supplement users. METHODS: The Council for Responsible Nutrition (CRN), a trade association of the dietary supplement industry, has contracted with Ipsos Public Affairs to conduct consumer surveys annually since 2000. The surveys have been administered online since 2007 to about 2000 subjects each year. We report 5 years of data (2007 to 2011) on the prevalence of dietary supplement use, as well as more detailed data from the 2011 survey on the products used, the reasons for using supplements, and other health habits of supplement users. RESULTS: The prevalence of supplement use fluctuated within the range of 64% to 69% from 2007 to 2011, and the prevalence of regular supplement use ranged from 48% to 53%, with no statistically significant differences from year to year. Over the 5-year period, the percentage of respondents who said that they regularly used a variety of supplements increased from 28% to 36%, and the increase from 2010 to 2011 was statistically significant. The percentage of respondents who said that they regularly used only a multivitamin, as opposed to a variety of supplements, declined from 24% to 17%, and the decrease from 2007 to 2008 was statistically significant. Detailed results from the 2011 survey confirm that supplement use increases with age and is higher in women than in men. Vitamin or mineral supplements were used by 67% of all respondents in 2011, specialty supplements by 35%, botanicals by 23%, and sports supplements by 17%. Among supplement users, multivitamins were the most commonly used supplement (71%), followed by omega-3 or fish oil (33%), calcium (32%), vitamin D (32%), and vitamin C (32%). The reasons most often cited for supplement use were for overall health and wellness (58%) and to fill nutrient gaps in the diet (42%). Supplement users were significantly more likely than nonusers to say that they try to eat a balanced diet, visit their doctor regularly, get a good night's sleep, exercise regularly, and maintain a healthy weight. CONCLUSIONS: Annual consumer surveys over a period of 5 years show that dietary supplement use is somewhat more prevalent in the United States than has been reported in the NHANES surveys, when occasional and seasonal use are taken into account, in addition to regular use. Most dietary supplement users take a multivitamin, and many take a variety of products. The primary reasons given for supplement use are for overall health and wellness or to fill nutrient gaps. Users of dietary supplements are more likely than nonusers to adopt a variety of healthy habits, indicating that supplement use is part of an overall approach to living healthy.

Telenursing: The view of care professionals in selected EU countries. A pilot study.

Background: With the growth of digital nursing, several studies have focused on recording patients' views on remote care, or specialised nurse staffing aspects. This is the first international survey on telenursing focused exclusively on clinical nurses that analyses the dimensions of usefulness, acceptability, and appropriateness of telenursing from the staff point of view. Methods: A previously validated structured questionnaire including demographic variables, 18 responses with a Likert-5 scale, three dichotomous questions, and one overall percentual estimation of holistic nursing care susceptible to being undertaken by telenursing, was administered (from 1 September to 30 November 2022) to 225 clinical and community nurses from three selected EU countries. Data analysis: descriptive data, classical and Rasch testing. Results: The results show adequacy of the model for measurement of the domains of usefulness, acceptability, and appropriateness of telenursing (overall Cronbach's alpha 0.945, Kaiser-Meyer-Olkin 0.952 and Bartlett's p < 0.001). Answers in favour of telenursing ranked 4 out of 5 in Likert scale, both globally and by the three domains. Rasch: reliability coefficient 0.94, Warm's main weighted likelihood estimate reliability 0.95. In the ANOVA analysis, the results for Portugal were significantly higher than those for Spain and Poland, both overall and for each of the dimensions. Respondents with bachelor's, master's and doctoral degrees score significantly higher than those with certificates or diplomas. Multiple regression did not yield additional data of interest. Conclusions: The tested model proved to be valid, but although the majority of nurses are in favour of telenursing, given the nature of the care, which is mainly face-to-face, according to the respondents, the chances of carrying out their activities by telenursing is only 35.3%. The survey provides useful information on what can be expected from the implementation of telenursing and the questionnaire proves to be a useful tool to be applied in other countries.

Dietitians use and recommend dietary supplements: report of a survey.

BACKGROUND: Dietary supplement use is common in the United States, with more than half of the population using such products. Nutrition authorities consistently advocate a "food first" approach to achieving nutritional adequacy but some, including the Academy of Nutrition and Dietetics (formerly the American Dietetic Association), also recognize that dietary supplements have a role to play in improving nutrient intake to support health and wellness. Surveys show that many health professionals use dietary supplements themselves and also recommend dietary supplements to their patients or clients. METHODS: As one component of a series of surveys of healthcare professionals (the "Life...supplemented" HCP Impact Studies), 300 registered dietitians were surveyed in 2009 regarding their personal use of dietary supplements and whether they recommend dietary supplements to their clients. Respondents were registered dietitians whose business involved seeing clients in a private practice or at a clinic. RESULTS: Seventy-four percent of the dietitians surveyed said they were regular users of dietary supplements, while 22% said they used dietary supplements occasionally or seasonally. The primary reasons for using dietary supplements were for bone health (58%), overall health and wellness (53%), and to fill nutrient gaps (42%). When asked if they "ever recommend dietary supplements to clients," 97% of the respondents said they did. The primary reasons were for bone health (70%), to fill nutrient gaps (67%), and overall health and wellness (49%). Eighty-seven percent of the dietitians agreed with the statement, "There are gaps in clients' diets that could effectively be addressed with dietary supplements." The dietitians surveyed said they followed healthy habits including eating a balanced diet (96%), managing stress (92%), visiting their own healthcare professional regularly (86%), exercising regularly (83%), maintaining a healthy weight (80%), and getting a good night's sleep (72%). Nearly all respondents (95%) expressed an interest in continuing education about dietary supplements on a variety of topics. CONCLUSIONS: Many dietitians, like other health professionals, use dietary supplements regularly as part of their own approach to a healthy diet and lifestyle. They also recommend dietary supplements to their clients or patients, to promote health.

Use of dietary supplements by cardiologists, dermatologists and orthopedists: report of a survey.

BACKGROUND: Dietary supplements are regularly used by a majority of the American population, and usage by health professionals is also common. There is considerable interest in usage patterns within the population and in the reasons for using dietary supplements. The "Life...supplemented" Healthcare Professionals 2008 Impact Study (HCP Impact Study) surveyed usage of dietary supplements by physicians in three specialties: cardiology, dermatology, and orthopedics. METHODS: The HCP Impact Study was conducted online by Ipsos Public Affairs for the Council for Responsible Nutrition (CRN), a trade association of the dietary supplement industry. Respondents were 900 physicians, including 300 each from three specialties--cardiology, dermatology, and orthopedics. RESULTS: Fifty-seven percent of cardiologists said they use dietary supplements at least occasionally, as did 75% of dermatologists and 73% of orthopedists. The product most commonly reported to be used was a multivitamin, but over 25% in each specialty said they used omega-3 fatty acids and over 20% said they used some botanical supplements. Regular dietary supplement use was reported by 37% of cardiologists, 59% of dermatologists, and 50% of orthopedists. Seventy-two percent of cardiologists, 66% of dermatologists, and 91% of orthopedists reported recommending dietary supplements to their patients. The primary reason given for recommending dietary supplements to patients was for heart health or lowering cholesterol for the cardiologists; benefits for skin, hair and nails for the dermatologists; and bone and joint health for the orthopedists. CONCLUSIONS: Reported dietary supplement use was relatively common in this sample of physicians, and when they recommended dietary supplements to patients, they tended to do so for reasons related to their specialty.

COVID-19, Fake News, and Vaccines: Should Regulation Be Implemented?

We analysed issues concerning the establishment of compulsory vaccination against COVID-19, as well as the role of misinformation as a disincentive-especially when published by health professionals-and citizen acceptance of measures in this regard. Data from different surveys revealed a high degree of hesitation rather than outright opposition to vaccines. The most frequent complaint related to the COVID-19 vaccination was the fear of side effects. Within the Spanish and European legislative framework, both compulsory vaccination and government regulation of FN (Fake News) appear to be feasible options, counting on sufficient legal support, which could be reinforced by additional amendment. However, following current trends of good governance, policymakers must have public legitimation. Rather than compulsory COVID-19 vaccination, an approach based on education and truthful information, persuading the population of the benefits of a vaccine on a voluntary basis, is recommended. Disagreements between health professionals are positive, but they should be resolved following good practice and the procedures of the code of ethics. Furthermore, citizens do not support the involvement of government authorities in the direct control of news. Collaboration with the media and other organizations should be used instead.

Identification of Staphylococcus aureus strains negative for enterotoxins A, B and C isolated from bovine mastitis in México.

A total of 41 isolates of Staphylococcus aureus obtained from bovine mastitis in 7 different states in Mexico were analyzed by the polymerase chain reaction (PCR) to determine the presence of encoding genes for enterotoxins A, B and C. The oligonucleotides were designed by specific regions of the sea, seb, sec genes. Surprisingly, none of the isolates presented the prospective amplification bands when they were run on agarose gels. On the contrary, reference strains CECT 976 SEA; CECT 5191 SEB; and CECT 4465 SEC showed the prospective amplification products. In order to confirm these results, enterotoxin production A, B, C, D, and E was determined by enzyme linked fluorescent assay (ELFA) using a MiniVIDAS system, on 15 Staphylococcus aureus selected at random from among the 41 isolates. None of the analyzed strains was positive to the test, whereas reference strains enterotoxins producing: CECT 976 SEA; CECT 5191 SEB; CECT 4465 SEC, CECT 4466 SED; CECT 5192 SEE produced concentrations of the toxins detected for this technique. The role of enterotoxins in the pathogenicity of S. aureus in bovine mastitis in Mexico is discussed.

Impact of the new drugs in the cost of maintenance immunosuppression of renal transplantation. Is it justified?

BACKGROUND: The new immunosuppressive drugs control acute rejection better, and have potentially short-term economic advantages. However, their long-term cost-effectiveness must still be determined. The Spanish study of chronic transplant nephropathy provides data that facilitates the assessment of the economic importance of maintenance immunosuppression (MI). METHODS: We determined the frequency of use of the different MI drugs and their combinations in three renal transplantation cohorts performed in 1990, 1994 and 1998 (total: 3279), and their evolution over time. Based on the real costs found in a medium-sized service in our country at the end of 2000, the mean annual costs of MI drugs were calculated. We performed a multivariate analysis of graft survival in the 1998 cohort. RESULTS: In 1990 and 1994, cyclosporine (CsA) with or without azathioprine (AZA) was used almost exclusively as the initial MI drug. In 1998, 76% received mycophenolate mofetil (MMF) and 20% tacrolimus (TAC). During their follow-up, a growing number of patients from the 1990 and 1994 groups were converted to MMF (12 and 17%) and TAC (4 and 8%), while the treatment of those from 1998 remained stable. Using prices from the year 2000, the mean cost of the MI at the end of the first year in 1998 (5380) was almost double that of 1994 (2902) and 1990 (2855). In these two groups, the mean cost remained stable until 1996; afterwards, it increased in both, more rapidly in the 1994 (24.8%) than in the 1990 (17.3%) group, although it remained significantly inferior to that of 1998. Correction for the evolution of the drug prices and the peseta purchasing value lessened these changes in an important way. The new regimens allowed for the withdrawal of steroids in a greater proportion of cases; TAC was associated with a less frequent use of lipid-lowering drugs and antihypertensive drugs. In the whole patient group, the regimens with MMF and/or TAC showed a tendency to greater mean life of the organs, but without reaching statistical significance in the multivariate analysis of patients in 1998. CONCLUSIONS: The introduction of new drugs in the MI applied in Spain has had an important economic impact since 1996. Their cost-effectiveness is still pending confirmation in our country.