Caregivers' and providers' perspectives of social and medical care after pediatric liver transplant: Results from the multicenter SOCIAL-Tx study.

Disparities exist in pediatric liver transplant (LT). We characterized barriers and facilitators to providing transplant and social care within pediatric LT clinics. This was a multicenter qualitative study. We oversampled caregivers reporting household financial strain, material economic hardship, or demonstrating poor health literacy. We also enrolled transplant team members. We conducted semistructured interviews with participants. Caregiver interviews focused on challenges addressing transplant and household needs. Transplant provider interviews focused on barriers and facilitators to providing social care within transplant teams. Interviews were recorded, transcribed, and coded according to the Capability, Opportunity, Motivation-Behavior model. We interviewed 27 caregivers and 27 transplant team members. Fifty-two percent of caregivers reported a household income <$60,000, and 62% reported financial resource strain. Caregivers reported experiencing (1) high financial burdens after LT, (2) added caregiving labor that compounds the financial burden, (3) dependency on their social network's generosity for financial and logistical support, and (4) additional support being limited to the perioperative period. Transplant providers reported (1) relying on the pretransplant psychosocial assessment for identifying social risks, (2) discomfort initiating social risk discussions in the post-transplant period, (3) reliance on social workers to address new social risks, and (4) social workers feeling overburdened by quantity and quality of the social work referrals. We identified barriers to providing effective social care in pediatric LT, primarily a lack of comfort in assessing and addressing new social risks in the post-transplant period. Addressing these barriers should enhance social care delivery and improve outcomes for these children.

Baseplate variability of Vibrio cholerae chemoreceptor arrays.

The chemoreceptor array, a remarkably ordered supramolecular complex, is composed of hexagonally packed trimers of receptor dimers networked by a histidine kinase and one or more coupling proteins. Even though the receptor packing is universal among chemotactic bacteria and archaea, the array architecture has been extensively studied only in selected model organisms. Here, we show that even in the complete absence of the kinase, the cluster II arrays in Vibrio cholerae retain their native spatial localization and the iconic hexagonal packing of the receptors with 12-nm spacing. Our results demonstrate that the chemotaxis array is versatile in composition, a property that allows auxiliary chemotaxis proteins such as ParP and CheV to integrate directly into the assembly. Along with its compositional variability, cluster II arrays exhibit a low degree of structural stability compared with the ultrastable arrays in Escherichia coli We propose that the variability in chemoreceptor arrays is an important mechanism that enables the incorporation of chemotaxis proteins based on their availability.

Bioconversion of Lignocellulosic Biomass into Value Added Products under Anaerobic Conditions: Insight into Proteomic Studies.

Production of biofuels and other value-added products from lignocellulose breakdown requires the coordinated metabolic activity of varied microorganisms. The increasing global demand for biofuels encourages the development and optimization of production strategies. Optimization in turn requires a thorough understanding of the microbial mechanisms and metabolic pathways behind the formation of each product of interest. Hydrolysis of lignocellulosic biomass is a bottleneck in its industrial use and often affects yield efficiency. The accessibility of the biomass to the microorganisms is the key to the release of sugars that are then taken up as substrates and subsequently transformed into the desired products. While the effects of different metabolic intermediates in the overall production of biofuel and other relevant products have been studied, the role of proteins and their activity under anaerobic conditions has not been widely explored. Shifts in enzyme production may inform the state of the microorganisms involved; thus, acquiring insights into the protein production and enzyme activity could be an effective resource to optimize production strategies. The application of proteomic analysis is currently a promising strategy in this area. This review deals on the aspects of enzymes and proteomics of bioprocesses of biofuels production using lignocellulosic biomass as substrate.

Elevated carbon dioxide and drought modulate physiology and storage-root development in sweet potato by regulating microRNAs.

Elevated CO2 along with drought is a serious global threat to crop productivity. Therefore, understanding the molecular mechanisms plants use to protect these stresses is the key for plant growth and development. In this study, we mimicked natural stress conditions under a controlled Soil-Plant-Atmosphere-Research (SPAR) system and provided the evidence for how miRNAs regulate target genes under elevated CO2 and drought conditions. Significant physiological and biomass data supported the effective utilization of source-sink (leaf to root) under elevated CO2. Additionally, elevated CO2 partially rescued the effect of drought on total biomass. We identified both known and novel miRNAs differentially expressed during drought, CO2, and combined stress, along with putative targets. A total of 32 conserved miRNAs belonged to 23 miRNA families, and 25 novel miRNAs were identified by deep sequencing. Using the existing sweet potato genome database and stringent analyses, a total of 42 and 22 potential target genes were predicted for the conserved and novel miRNAs, respectively. These target genes are involved in drought response, hormone signaling, photosynthesis, carbon fixation, sucrose and starch metabolism, etc. Gene ontology and KEGG ontology functional enrichment revealed that these miRNAs might target transcription factors (MYB, TCP, NAC), hormone signaling regulators (ARF, AP2/ERF), cold and drought factors (corA), carbon metabolism (ATP synthase, fructose-1,6-bisphosphate), and photosynthesis (photosystem I and II complex units). Our study is the first report identifying targets of miRNAs under elevated CO2 levels and could support the molecular mechanisms under elevated CO2 in sweet potato and other crops in the future.

Chemotaxis arrays in Vibrio species and their intracellular positioning by the ParC/ParP system.

Most motile bacteria are able to bias their movement towards more favorable environments or to escape from obnoxious substances by a process called chemotaxis. Chemotaxis depends on a chemosensory system that is able to sense specific environmental signals and generate a behavioral response. Typically, the signal is transmitted to the bacterial flagellum, ultimately regulating the swimming behavior of individual cells. Chemotaxis is mediated by proteins that assemble into large, highly ordered arrays. It is imperative for successful chemotactic behavior and cellular competitiveness that chemosensory arrays form and localize properly within the cell. Here we review how chemotaxis arrays form and localize in Vibrio cholerae and Vibrio parahaemolyticus We focus on how the ParC/ParP-system mediates cell cycle-dependent polar localization of chemotaxis arrays and thus ensures proper cell pole development and array inheritance upon cell division.

Reduction of microorganisms in carious dentin by photodynamic therapy mediated by potassium iodide added to methylene blue and red laser.

OBJECTIVE: To evaluate the effect of the association of potassium iodide to antimicrobial photodynamic therapy on human carious dentin produced with a microcosm biofilm model. METHODS: A microcosm biofilm model was used to generate a caries lesion on human dentin. Pooled human saliva diluted with glycerol was used as an inoculum on specimens immersed on McBain artificial saliva enriched with 1 % sucrose (24 h at 37 °C in 5 % CO2). After refreshing culture media for 7 days, the dentin specimens were divided in 5 groups (3 specimens per group, in triplicate; n = 9): C (NaCl 0.9 %), CX (2 % chlorhexidine), PKI (0.01 % methylene blue photosensitizer+50 mM KI), L (laser at 15 J, 180 s, 22.7 J/cm2), and PKIL (methylene blue + KI + Laser). After the treatments, dentin was collected, and a 10-fold serial dilution was performed. The number of total microorganisms, total lactobacilli, total streptococci, and Streptococcus mutans was analyzed by microbial counts (CFU/mL). After normality and homoscedasticity analysis, the Welch's ANOVA and Dunnett's tests were used for CFU. All tests used a 5 % significance level. RESULTS: CX and PKIL groups showed significant bacterial decontamination of dentin, compared to group C (p < 0.05) reaching reductions up to 3.8 log10 for CX for all microorganisms' groups and PKIL showed 0.93, 1.30, 1.45, and 1.22 log10 for total microorganisms, total lactobacilli, total streptococci, and S. mutans, respectively. CONCLUSION: aPDT mediated by the association of KI and methylene blue with red laser reduced the viability of microorganisms from carious dentin and could be a promising option for cavity decontamination.

Bacille-Calmette-Guerin modulates human macrophage and dendritic cell response to SARS-CoV-2 S-glycoprotein.

Background: Given that epidemiological evidence suggests a potential protective role for Bacille-Calmette-Guerin against COVID-19, we aimed to explore whether pre-exposure of human monocyte-derived macrophages and dendritic cells to BCG could modulate their response to SARS-CoV-2 S-glycoprotein. Methods: Dual THP-1 cells containing 2 reporter plasmids for transcription factors NF-κB, and IRF were differentiated into macrophages over 3 days using phorbol 12-myristate 13-acetate, or into dendritic cells over 6 days using commercial monocyte-dencritic cell differentiation media and matured with recombinant tumor necrosis factor-α. Cells were exposed to BCG for 24 h and then stimulated with SARS-CoV-2 S-glycoprotein for 24 hours. Results: Pre-exposure of human macrophages and DCs to BCG increased IRF and NF-kb activation in response to the SARS-CoV-2 S-glycoprotein. Conclusions: Our results showed that pre-exposure of both types of cells to BCG exhibited an increase in inflammatory transcription factors upon stimulation with S-glycoprotein. BCG-induced trained immunity may be an important tool for reducing susceptibility to SARS-CoV-2 infection and severity of COVID-19. Our findings help in the design of future BCG-based therapeutic approaches in the treatment of diseases caused by viral infections.

Maturity-onset diabetes of the young type 3 and premature ovarian insufficiency: chance or causality: a case report and literature review.

Summary: We present the case of a 23-year-old patient with maturity-onset diabetes of the young type 3 (MODY 3) and premature ovarian insufficiency (POI). There is no known correlation between MODY 3 and POI, although POI can impair glucose metabolism, and MODY can cause microvascular complications such as POI. We did not find literature describing a correlation between these two pathologies nor did we find similar cases described in the literature. Learning points: Maturity-onset diabetes of the young type 3 (MODY 3) is an infrequent cause of diabetes that should be considered in young patients with atypical presentation of type 1 or type 2 diabetes. MODY 3 can be associated with microvascular complications of diabetes, which is why it is important to diagnose as early as possible. Impairment of glucose metabolism has been demonstrated in patients with premature ovarian insufficiency and menopause.

Potassium iodide enhances inactivation of Streptococcus mutans biofilm in antimicrobial photodynamic therapy with red laser.

OBJECTIVE: To evaluate the effect of potassium iodide (KI) addition on antimicrobial photodynamic therapy (aPDT) mediated by red laser (λ = 660 nm) and methylene blue in Streptococcus mutans biofilm model. METHODS: S. mutans biofilms were cultured in 96-well plates containing BHI broth with 1% sucrose for 18 h, 10% CO2 and 37 °C and divided in groups (n = 3, in triplicate): C (NaCl 0.9%); CX (0.2% chlorhexidine); P (photosensitizer); KI (10, 25 and 50 mM); PKI (10, 25 and 50 mM); L (L1: 100 J/cm2, 9 J; L2: 200 J/cm2, 18 J); PL (photosensitizer + L1 or L2); KIL (KI at 10, 25 and 50 mM + L1 or L2); and PKIL (photosensitizer + 10, 25 and 50 mM KI + L1 or L2). Biofilms were submitted to three pre-irradiation (PI) times (5, 10, and 15 min). After the treatments, microbial counting's reduction was analyzed by Kruskal-Wallis and post-hoc Dunn's tests, respectively, and the interaction between light parameters and the PI times by two-way ANOVA (p < 0.05). RESULTS: The S. mutans viability significantly reduced in all aPDT groups, in the presence or absence of KI (p < 0.05). For all PI times, PKIL groups (10, 25, and 50 mM) significantly differed from PL groups (p < 0.05) with a reduction of 9.0 logs reached at 50 mM of KI with 15 min of PI, irradiated at 18 J. We found no significant interaction between PI time and irradiation (p > 0.05). CONCLUSION: The addition of KI to PDT mediated by methylene blue and red laser promoted an additional effect in reducing the microbial viability of S. mutans biofilm.

SARS-CoV-2 and Dengue Virus Coinfection in a Mexican Pediatric Patient: A Case Report from Early Molecular Diagnosis.

Mexico is an endemic region for dengue virus (DENV). The increase in this disease coincides with outbreaks of COVID-19, both of which are single-stranded positive RNA viruses. These characteristics make it difficult to distinguish each disease because they share clinical and laboratory features, which can consequently result in misdiagnoses. This is why the use of precision confirmatory tests (qRT-PCR) are crucial for early diagnosis. We herein report a pediatric patient who presented a coinfection for DENV and COVID-19, "SARS-CoV-2/Dengue". This patient initially presented a fever, cough, and headache and, three days later, developed generalized pain and epistaxis. Blood studies revealed thrombocytopenia and leukopenia, and the patient was admitted to the hospital for a probable DENV infection. Within 48 h, qRT-PCR tests specific for SARS-CoV-2 and DENV were performed and resulted as positive. The patient immediately received pharmacological treatment with azithromycin, oseltamivir, and metamizole. During hospitalization (9 days), the patient had no signs of respiratory distress and maintained normal body temperature and normal blood oxygen saturation. This case warns of the need for early diagnosis and adequate clinical and pharmacological management in the face of a "SARS-CoV-2/Dengue" coinfection. Early molecular detection of both viruses and timely treatment helped the patient to achieve a favorable recovery.

Does potassium iodide help in the microbial reduction of oral microcosm biofilms after photodynamic therapy with methylene blue and red laser?

OBJECTIVE: To evaluate the efficacy of methylene blue (MB)-mediated antimicrobial photodynamic therapy (aPDT) doped with potassium iodide (KI) against oral microcosms biofilms cultured in dentin. METHODS: A saliva-glycerol stock formed from pooled human saliva was diluted in McBain artificial saliva with 1% sucrose (1:1), inoculated on bovine dentin blocks, and refreshed daily for 5 days. The biofilms were divided (n = 9/group) and treated with 0.9% NaCl (C), 0.2% chlorhexidine (CX), 0.01% MB + low-power laser 15 J, 88 mW, 180 s (PL), and 0.01% MB + 50 mM KI + laser (PKIL). Serial dilution was performed, and cellular viability (CFU/mL) was evaluated for total microorganisms, total lactobacilli, total streptococci, and S. mutans. Additional biofilms were cultured and treated (n = 4) for biomass determination (%BMR). The microscopic structure of the biofilms was observed by SEM. One-way ANOVA and Tukey tests were conducted (α=5%). RESULTS: Total microorganisms and total streptococci significantly reduced in biofilms treated with CX and PKIL when compared to C, but the CX, PKIL, and PL treatments did not differ from each other. Total lactobacilli and S. mutans showed a significant reduction in the CX, PL, and PKIL groups when compared to C, but with no difference between them. Biomass analysis showed a significantly reduction for CX and PKIL compared to C. SEM micrographs showed noticeable changes in bacterial membrane integrity for the PKIL and CX groups. CONCLUSION: The addition of KI to methylene blue-mediated aPDT in microcosm biofilms was effective in reducing oral microorganisms, but the effect was group dependent.

Protein Activity Sensing in Bacteria in Regulating Metabolism and Motility.

Bacteria have evolved complex sensing and signaling systems to react to their changing environments, most of which are present in all domains of life. Canonical bacterial sensing and signaling modules, such as membrane-bound ligand-binding receptors and kinases, are very well described. However, there are distinct sensing mechanisms in bacteria that are less studied. For instance, the sensing of internal or external cues can also be mediated by changes in protein conformation, which can either be implicated in enzymatic reactions, transport channel formation or other important cellular functions. These activities can then feed into pathways of characterized kinases, which translocate the information to the DNA or other response units. This type of bacterial sensory activity has previously been termed protein activity sensing. In this review, we highlight the recent findings about this non-canonical sensory mechanism, as well as its involvement in metabolic functions and bacterial motility. Additionally, we explore some of the specific proteins and protein-protein interactions that mediate protein activity sensing and their downstream effects. The complex sensory activities covered in this review are important for bacterial navigation and gene regulation in their dynamic environment, be it host-associated, in microbial communities or free-living.

Sesgos cognitivos en el dolor crónico no oncológico / Cognitive biases in chronic non-cancer pain

Los sesgos cognitivos son un constructo que acuñaron Kahneman & Tveysky (1972) en su Enfoque de Sesgos dentro de la Psicología Cognitiva. Estos son atajos intelectuales que realizan siempre las personas, desde un razonamiento probabilístico intuitivo. El presente trabajo es una primera aproximación que intenta aplicar y describir algunos sesgos cognitivos en el complejo mundo de las representaciones mentales en la experiencia dolorosa, como la ilusión de control; del presente; la confirmación; representatividad; disponibilidad, entre otros. Los sesgos en dolor nos permiten comprender el procesamiento de información frente al dolor y utilizar estrategias comunicacionales más efectivas para su abordaje.

Cognitive biases are a construct coined by Kahneman & Tveysky (1972) in their Approach to Biases in Cognitive Psychology. These are intellectual shortcuts that people always carry out, from an intuitive probabilistic reasoning. An attempt is made to apply and describe some cognitive biases in the complex world of mental representations in the painful experience, like the illusion of control; of the present; the confirmation; representativeness; availability among others. Biases in pain allow us to understand the processing of information in the face of pain and use more effective communication strategies to address it.

Induction of Cellular Differentiation and Single Cell Imaging of Vibrio parahaemolyticus Swimmer and Swarmer Cells.

The ability to study the intracellular localization of proteins is essential for the understanding of many cellular processes. In turn, this requires the ability to obtain single cells for fluorescence microscopy, which can be particularly challenging when imaging cells that exist within bacterial communities. For example, the human pathogen Vibrio parahaemolyticus exists as short rod-shaped swimmer cells in liquid conditions that upon surface contact differentiate into a subpopulation of highly elongated swarmer cells specialized for growth on solid surfaces. This paper presents a method to perform single cell fluorescence microscopy analysis of V. parahaemolyticus in its two differential states. This protocol very reproducibly induces differentiation of V. parahaemolyticus into a swarmer cell life-cycle and facilitates their proliferation over solid surfaces. The method produces flares of differentiated swarmer cells extending from the edge of the swarm-colony. Notably, at the very tip of the swarm-flares, swarmer cells exist in a single layer of cells, which allows for their easy transfer to a microscope slide and subsequent fluorescence microscopy imaging of single cells. Additionally, the workflow of image analysis for demographic representation of bacterial societies is presented. As a proof of principle, the analysis of the intracellular localization of chemotaxis signaling arrays in swimmer and swarmer cells of V. parahaemolyticus is described.

Coupling chemosensory array formation and localization.

Chemotaxis proteins organize into large, highly ordered, chemotactic signaling arrays, which in Vibrio species are found at the cell pole. Proper localization of signaling arrays is mediated by ParP, which tethers arrays to a cell pole anchor, ParC. Here we show that ParP's C-terminus integrates into the core-unit of signaling arrays through interactions with MCP-proteins and CheA. Its intercalation within core-units stimulates array formation, whereas its N-terminal interaction domain enables polar recruitment of arrays and facilitates its own polar localization. Linkage of these domains within ParP couples array formation and localization and results in controlled array positioning at the cell pole. Notably, ParP's integration into arrays modifies its own and ParC's subcellular localization dynamics, promoting their polar retention. ParP serves as a critical nexus that regulates the localization dynamics of its network constituents and drives the localized assembly and stability of the chemotactic machinery, resulting in proper cell pole development.

[Correlation between chest radiography and the echocardiogram to evaluate cardiomegaly in patients with systemic arterial hypertension]. / Correlación entre la radiografía de tórax y el ecocardiograma para la valoración de cardiomegalia en pacientes con hipertensión arterial sistémica.

UNLABELLED: The chest radiography is used routinely by the clinician as a tool in the scan of patients with systemic arterial hypertension (SAH) to evaluate the dimensions of the heart. However the highest reported sensitivity for the evaluation of heart growth with this method is 77.3% in contrast to the transthoracic echocardiogram (TTE) that reaches between 90 to 100%. The aim of this study was assess in our population of patients with SAH, the correlation between chest radiography and the TTE in regard to cardiomegaly. PATIENTS AND METHODS: Seventy two patients with SAH and radiological cardiomegaly, graded by measuring the cardiothoracic ratio (CTR), were evaluated by transthoracic echocardiography. The Pearson's and Spearman's correlation coefficients between both methods were assessed. Significance level was set at < 0.05. RESULTS: Forty one (56.9%) patients were women and 31 (43.1%) were men. The age was 62.4 +/- 10 years (43-83 years). Left ventricular concentric hypertrophy (LVCH) was found in 56 (77.8%) patients. In 13 (18%) patients the left ventricular end diastolic diameter (LVEDD) was higher than the normal value. The correlation coefficient between the diastolic ventricular septal thickness (DST) and CTR was 0.285 (p < 0.05) and between the LVEDD and radiological cardiomegaly was 0.203 (p = NS). CONCLUSIONS: In patients with SAH, the radiological evidence of cardiomegaly keeps a correlation with ventricular hypertrophy, but not with ventricular dilation.

Genome-Wide Differentiation of Various Melon Horticultural Groups for Use in GWAS for Fruit Firmness and Construction of a High Resolution Genetic Map.

Melon (Cucumis melo L.) is a phenotypically diverse eudicot diploid (2n = 2x = 24) has climacteric and non-climacteric morphotypes and show wide variation for fruit firmness, an important trait for transportation and shelf life. We generated 13,789 SNP markers using genotyping-by-sequencing (GBS) and anchored them to chromosomes to understand genome-wide fixation indices (Fst) between various melon morphotypes and genomewide linkage disequilibrium (LD) decay. The FST between accessions of cantalupensis and inodorus was 0.23. The FST between cantalupensis and various agrestis accessions was in a range of 0.19-0.53 and between inodorus and agrestis accessions was in a range of 0.21-0.59 indicating sporadic to wide ranging introgression. The EM (Expectation Maximization) algorithm was used for estimation of 1436 haplotypes. Average genome-wide LD decay for the melon genome was noted to be 9.27 Kb. In the current research, we focused on the genome-wide divergence underlying diverse melon horticultural groups. A high-resolution genetic map with 7153 loci was constructed. Genome-wide segregation distortion and recombination rate across various chromosomes were characterized. Melon has climacteric and non-climacteric morphotypes and wide variation for fruit firmness, a very important trait for transportation and shelf life. Various levels of QTLs were identified with high to moderate stringency and linked to fruit firmness using both genome-wide association study (GWAS) and biparental mapping. Gene annotation revealed some of the SNPs are located in ß-D-xylosidase, glyoxysomal malate synthase, chloroplastic anthranilate phosphoribosyltransferase, and histidine kinase, the genes that were previously characterized for fruit ripening and softening in other crops.

Quiste dermoide nasofrontal: presentación de un caso y revisión narrativa / Nasofrontal dermoid cyst: case presentation

Las lesiones de la región nasofrontal en los niños son un reto diagnóstico debido a su rareza, y su potencial comunicación con el sistema nervioso central también aumenta su complicaciones. Dentro de las principales entidades de esta región se encuentran los quistes dermoides, los gliomas nasales y los encefaloceles. Un abordaje diagnóstico y terapéutico inapropiado podría generar desde simples recurrencias hasta fistulas e infecciones en el sistema nervioso central, que podrían contribuir a mayores complicaciones o incluso, poner en riesgo la vida de los pacientes.

Injuries to the naso-frontal region in children are a diagnostic challenge, associated with their rarity, their complexity also implies their potential communication with the central nervous system. Dermoid cysts, nasal gliomas, and encephaloceles are among the main entities in this region. An inappropriate diagnostic and therapeutic approach could generate from simple recurrences (as in our case), to fistulas and infections of the central nervous system that could contribute to greater complications or even put the lives of patients at risk.

Un caso exitoso de trasplante bipulmonar durante la pandemia por SARS CoV-2 en la Ciudad de Buenos Aires / A Successful Case of Double-Lung Transplant During the SARS CoV-2 Pandemic in the City of Buenos Aires

Paciente masculino portador de hipertesión pulmonar severa refractaria a tratamiento médico, sometido a trasplante bipulmonar durante la pandemia por SARS-CoV-2 en la ciudad de Buenos Aires. Para disminuir el riesgo de contagio se realizaron todas las medidas de prevención actualmente recomendadas, con especial énfasis en el uso del equipo de protección personal, contribuyendo de esta forma con el éxito terapéutico alcanzado.

Male patient with severe pulmonary hypertension refractory to medical treatment who underwent a double-lung transplant during the SARS-CoV-2 in the city of Buenos Aires. In order to reduce the risk of contagion all the currently recommended prevention measures were adopted, especially the use of personal protective equipment, thus contributing to the resultant therapeutic success.