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The aviation industry accounts for part of the CO2 emissions contributing to climate change. The industry has established a target to reduce 2050 net aviation carbon emissions by 50 % relative to 2005 levels. With this in mind, waste heat recovery is a key pathway to achieve reduced emissions and improve system efficiency. The waste heat may potentially be converted to electric power using a supercritical CO2 Brayton power cycle. The sCO2 power system offers the advantage of compactness owing to the high working fluid density, which is an important consideration for aircraft performance. The present work focuses on the integration of the sCO2 power system into the aircraft propulsion system and evaluation of its performance. Detailed optimization of the sCO2 waste heat system will be evaluated with a focus on cycle efficiency and net power under different operating conditions, including ground, takeoff, climb, cruise, and landing operations. The study is divided into two parts with two different turbofan engines, one with a nominal thrust of 30 kN and the other with a nominal thrust of 9 kN. The first part shows the effect and operation of the waste heat recovery unit under the different operating conditions. The second part is focused on cycle optimization and performance evaluation. The results demonstrate the potential of waste heat recovery during a range of operational conditions. The sCO2 cycle efficiency can reach between 25 and 39 % (depending on aircraft engine) with net power output in the range of 100 to 260 kW.

Abstract Background The large intestine is a colonization site of beneficial microbes complementing the nutrition of cattle but also of zoonotic and animal pathogens. Here, we present the first global gene catalog of cattle fecal microbiomes, a proxy of the large intestine microbiomes, from 436 metagenomes from six countries. Results Phylogenomics suggested that the reconstructed genomes and their close relatives form distinct branches and produced clustering patterns that were reminiscent of the metagenomics sample origin. Bacterial taxa had distinct metabolic profiles, and complete metabolic pathways were mainly linked to carbohydrates and amino acids metabolism. Dietary changes affected the community composition, diversity, and potential virulence. However, predicted enzymes, which were part of complete metabolic pathways, remained present, albeit encoded by different microbes. Conclusions Our findings provide a global insight into the phylogenetic relationships and the metabolic potential of a rich yet understudied bacterial community and suggest that it provides valuable services to the host. However, we tentatively infer that members of that community are not irreplaceable, because similar to previous findings, symbionts of complex bacterial communities of mammals are expendable if there are substitutes that can perform the same task. Video Abstract

Située à la croisée des sciences d’Homme-Nature, l’ethno-pharmacologie est une discipline qui s’intéresse aux médecines traditionnelles dont l’objectif est la recherche de nouveaux traitements de demain. Dans ce cadre, nous avons mené une enquête ethno-pharmacologique sur l'utilisation traditionnelle de l’Aneth (Anethum graveolens L.) dans quelques régions de Nord-Ouest de la Tunisie pour examiner les connaissances des Tunisiens concernant son usage pour se soigner et pour lutter contre les maladies. Une fiche d’enquête a été préparée avec deux rubriques dont la première s’intéresse au profil de l’enquêté (âge, sexe, niveau d’étude) et la deuxième a été consacrée à l’identification et à l’usage de la plante choisie (les parties utilisées, les maladies traitées et les modes de préparations et d’administration). Les données obtenues ont révélé que l’Aneth est utilisé comme remède thérapeutique pour le traitement de diverses pathologies, essentiellement les troubles digestifs (40,7%). L’enquête a également révélé dans la partie mode de préparation que les enquêtés l’utilise comme aliment (50,9%) suivis par l’infusion et la décoction de (24,7% et 23,7%, respectivement). La partie la plus utilisée selon eux est la feuille (29,2%) alors que le mode d’administration est essentiellement oral (97,1%). En conclusion, les informations obtenues des habitants des régions de Tabarka, Bou Salem et Nefza à propos de cette plante médicinale et aromatique sont intéressantes pour une éventuelle innovation thérapeutique. Elles pourraient être une base de données pour des évaluations pharmacologiques et expérimentales ultérieurs pour explorer les potentialités curatives de cette plante. Mots clés: Ethno-pharmacologie, Médecine traditionnelle, Aneth, Enquête, Tunisie

Background: COVID-19 is a new pandemic disease. This disease course and its effect on pregnancy is little known due to limited available data. The objective of this study was to describe the demographic profile of COVID-19 positive mothers admitted in Government Rajaji hospital, Madurai in terms of time, place and person and to assess the general and pregnancy outcome of study population. Methods: This cross-sectional study was done among 381 COVID-19 positive mothers* admitted during March 22 – August 31, 2020 in dedicated COVID-19 hospital, Madurai. Data was collected using Case Investigation Form (CIF) as a part of Rapid Response Team*(RRT) by Community Medicine* Department and analysed using SPSS version 21. Descriptive statistics done; Chi-square test & Fischer exact test was done to find out association between patient profile and outcomes. Results: Out of 381, 154 (40.4%) belonged to 21–25 years, 192 (50.4%) to rural area, 318 (83.5%) to 3rd trimester,189 (49.6%) Primi gravida. 125 (32.8%) were symptomatic and 153 (80.8%) had at least one comorbidity. Death as general outcome was 3 (0.8%), all of them were referred cases and had comorbidity like GDM/PIH. 10 (2.62%) had abortion or perinatal death, 14 (3.77%) had preterm delivery, 99 (25.98%) babies were born small for gestational age. Increased maternal age had more death but was not statistically significant; All symptomatic mothers (p = 0.000),1st & 2nd trimester (p = 0.000) mothers had statistically significant poor pregnancy outcome*. Conclusion: COVID positive mothers with increased age, symptomatic, 1st & 2nd trimester were significantly associated with poor outcome, requires special attention. Early referral must be emphasized to mitigate maternal death.

Introduction: The COVID19 pandemic has turned out to be one of the public health* burdens in 2020. The fear of deaths due to COVID19 has surmounted even in developed countries and hasn't spared young age. This study aims in assessing the mortality due to COVID19 among patients below 30years of age in TamilNadu. Methods: The data was collected from a publicly available secondary data source(www.stopcorona.tn.gov.in)which is an official COVID19 state dashboard. Details of the young COVID19 deaths* under 30yrs of age, their gender, symptoms, Co-morbidities, date of symptoms, date of admission, and death were collected till October 2020. A total of 158 deaths were included in the analysis. Fischer exact test and Mann Whitney U test* were used and p-value

Introduction: COVID19* is a new disease with significant mortality risk. Because of the scarcity of the study on factors associated with the mortality in Tamil Nadu present study was done to determine the factors associated with the outcome of the COVID19 patients admitted in a tertiary care hospital, Madurai. Methodology: 4530 lab confirmed COVID19 patients admitted from March to August 31st, 2020; excluding the non-responders or who gave incomplete information were included in the study. Data retrieved from Case Investigation Forms *filled through telephonic interview. Chi -square test, Univariate and multivariate logistic regression were used to find out the association between the factors and risk of death(outcome). Results: Out of 4530 COVID19 positive patients 381(8.4%) died and 4149(91.6%) were discharged. Using multivariate logistic regression* following were the factors predicted to be associated with mortality:Age group

Vineyards are one of the eco-geomorphological systems most conditioned by human activity in Germany. The vineyards of the Ruwer Valley (Germany) are characterized by high soil erosion rates and rill problems on steep slopes (between 23 and 26°) caused by the increasingly frequent heavy rainfall events as well as deterioration due to incorrect land use managements. The objective of this paper is to determine and to quantify the hydrological and erosive phenomena in one vineyard in Germany during different seasons and under different management conditions (before, during and after vintage). For this purpose, a combined methodology was applied. Climatic (rainfall depth distributions and return periods), pedological (soil analysis and classification), geomorphological (sediment movements and rills evolution) and biological (botanic marks on the vines) variables were used on the two experimental plots in the village of Waldrach (Trier, region of Rhineland-Palatinate). The results showed high infiltration rates (near 100 %) and subsurface flow which were detected by rainfall simulations performed at different times of the year (between September and December). The highest variations of the monitored rills (lateral and frontal movements) were noted before and during vintage, when footsteps occurred concentrated during a short period of time (between September and October). Finally, two maps of soil loss were generated, indicated by botanic marks on the graft union of the vines. 62.5 t ha−1 yr−1 soil loss was registered in the experimental plots of the new vineyards (2 years), while 3.4 t ha−1 yr−1 was recorded in the old one (35 years).

For a long time, studies concerning erosion caused by concentrated overland flow mainly dealt with the erosion and the transport of fine material. More recent studies have shown that rock fragments reduce the intensity of soil erosion processes on the one hand, but on the other hand rock fragment movements also have been observed both in the rill- and interrill erosion processes. However, there is little knowledge about the movement process of rock fragments in shallow channel flow. Are certain movement patterns typical for different shapes? Are there relationships between movement patterns and slope and flow velocity? Are all these patterns and relationships reproducible? To answer these questions, we performed laboratory channel experiments. With these experiments, we could obtain information about movement patterns of pebbles, by varying the following parameters: shape (flat, ellipsoidal, nearly spherical), size (diameter between 1.97 and 4.0 cm) and channel slope (5°, 10°). During the experiments, a high-speed camera was used to capture the motion of eight specially painted pebbles. The resulting image sequences were processed using both automatic image processing and manual visual inspection. Besides the movement patterns, the pebbles velocity, the water velocity and the water depth were estimated. We could show that there were different movement patterns depending on the shape and the slope. For the 5° experiments, the big, flat pebbles lie at the beginning of the tests. After the following yawing, the pebbles mainly showed the movement form rolling around the longest axis. For the 10° experiments the big, flat pebbles showed the same movement pattern firstly, but later in the sequence, they started to roll around their shortest axis and in the end this movement form was combined with saltation. These patterns are described using a simple symbolic language: sequences of pictograms describe the consecutive movement forms. Furthermore, we detected five different velocity groups of the pebbles for each slope: different cross-section shapes of the pebbles result in different acceleration behavior. The methodology is limited to clear water in laboratory use. Even a larger water depth restricts the image processing. Thus, in the future the experiments will be combined with a small sensor that is implanted in the pebbles and measures forces (acceleration), compass (magnetic flux density) and rotations (gyroscope).

Objective: This study investigates differences in health (Somatic Symptoms, Anxiety / Insomnia, Social Dysfunction and Severe Depression) relating to professional burnout (emotional exhaustion, depersonalization and personal fulfillment) suffered by prison staff, taking into account the workplace where they perform their activities (therapeutic vs. non therapeutic modules). Methods: The participants consisted of 222 workers of both sexes, with ages ranging from 18 to 60 years, working in different prisons in Spain (Educational and Therapeutic Modules, N = 1001; Non Educational and Therapeutic Modules = 121). The tools used were the General Health Questionnaire (GHQ-28) of Goldberg and Hillier (1979) and the burnout Inventory of Maslach and Jackson (1981). A mean comparison was performed using Student’s t test along with a linear regression analysis, differentiating between Educational and Therapeutic Modules and Non Educational and Therapeutic Modules. Results: Significant differences were found between both clusters and predictive values of burnout factors for the different health levels in both prison models were identified. Possible explanations for the findings and the implications for intervention are discussed.

The aim of this study was to examine glycoconjugate secretion in human airways with and without an epithelium. Glycoconjugate release in supernatants derived from human airways in vitro was determined using an ELISA assay with an anti-human mucin monoclonal antibody (MAb 3D3). This monoclonal antibody reacted strongly with Leb antigen but also recognized in vitro Lea and Ley determinents. In 11 of the 34 different lung samples (32%) studied the glycoconjugate levels were below the threshhold of detection for this assay. The mean basal secretion of glycoconjugates in human airways in vitro was 100 ±28 μg/g tissue (Period I; n=23 different lung samples). The amount of glycoconjugate measured in the medium derived from human isolated bronchial ring preparations did not change under control conditions during the course of the experimental procedure (Period I; 128 ± 46 μg/g tissue and Period II; 159 ± 48 μg/g tissue; n=13 paired lung samples). In the supernatants of airway preparations with an intact epithelium the amount of glycoconjugates detected was 90 ± 38 μg/g tissue (Period I; n=12 different lung samples) and removal of the epithelium did not alter this basal glycoconjugate release (94 ± 60 μg/g tissue: Period I, n=8 different lung samples). The absence of the epithelial layer was confirmed by histological evaluation. Methacholine (100 μM) induced a 10- and four-fold increase in glycoconjugate release from airways with and without an epithelium, respectively. In contrast, in preparations with an epithelium, LTD4 (10 μM) and anti-IgE (dilution: 1/1000) did not cause an increase of glycoconjugate release. The methacholine difference between airways with and without an epithelium was not significantly different (P>0.10). However, a treatment with atropine (100 μM) prevented the increase of glycoconjugate release in preparations with an epithelium. These data derived from a limited number of experiments suggest that the epithelium may not regulate the basal or stimulated release of glycoconjugates from isolated human airways.

The circulating levels of leukotriene E4 in infants with congenital heart defects, increased pulmonary blood flow and pulmonary arterial hypertension, were determined and compared with infants with decreased pulmonary blood flow (Tetralogy of Fallot). There was no correlation (r=0.38) between the pulmonary arterial pressure (56 ± 4 mmHg) and the leukotriene E4 levels (1.37 ± 0.67 ng/ml blood) measured in peripheral blood samples from the hypertensive group prior to surgery. There was considerable variation in the detectable leukotriene E4 levels in blood samples from different patients. The levels detected in the blood samples between the two groups of patients was similar. These data suggest that neither the surgical repair during cardiopulmonary bypass nor the pulmonary hypertension appeared to modify the leukotriene E4 blood levels in the small number of patients studied.

Heman airway preparations at resting tone were relaxed with either the leukotriene synthesis inhibitor BAY x1005 (3 μM), chlorpheniramine (1 μM) or the thromboxane receptor antagonist BAY u3405 (0.1 μM). The response to anti-IgE (1:1000) was 58 ± 8% of acetylcholine pre-contraction (2.19 ± 0.28 g). Indomethacin (3 μM) enhanced the anti-IgE-induced contraction by 28%. The anti-IgE maximal response was not modified by either chlorpheniramine, BAY x1005 or BAY u3405. When the tissues were treated with either BAY xl005/indomethacin or BAY x1005/chlorpheniramine, the anti-IgE-induced contraction was reduced. In addition, in presence of BAY xl005/indomethacin/chlorpheniramine the response was completely blocked. These results suggest that mediatots released during anti-IgE challenge cause airway contraction which may mask the evaluation of the leukotriene component.

We present Enterocytozoon bieneusi infection in four patients with autoimmune diseases undergoing prolonged monoclonal antibody therapies. Two patients suffered from inflammatory bowel disease and received anti-TNF therapies, whereas two other patients suffered from systemic lupus erythematosus with renal involvement and received anti-CD20 or anti-BLyS protein therapies. Three out of four patients consulted for diarrhea with abdominal pain without intestinal inflammation or bleeding at the time of sampling. The fourth patient did not declare intestinal troubles. Microsporidia genotype detected in this study were S9, C, Wildboard3 with one patient harboring 2 genotypes S6 and EBCMAP-038. Management of microsporidia infection included albendazole and reduction of immunosuppression treatment, but no specific treatment was implemented in two other patients. In conclusion, microsporidia infection occurs in patients with autoimmune diseases undergoing prolonged monoclonal antibody therapies. Diagnosis should be carefully assessed in this population and a thorough benefit-risk analysis is essential prior to initiating therapeutic interventions., Competing Interests: Declarations. Conflict of interest: Authors declare no conflict of interest in this study., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Xanthomonas citri pv. fuscans ( Xcf ) and Xanthomonas phaseoli pv. phaseoli ( Xpp ) are responsible for the Common Bacterial Blight (CBB), a major common bean ( Phaseolus vulgaris ) disease. The pathogenicity of Xcf and Xpp is known to be dependent upon a functional Type III Secretion System (T3SS) allowing the injection of numerous bacterial Type III Effectors (T3Es) into plant cells. T3Es have been described as able to disrupt plant defence and manipulate plant metabolism. In this work we described the transcriptomic response of one susceptible (Flavert) and one resistant (Vezer) cultivars of P. vulgaris to the inoculation of the virulent strain Xcf CFBP4885 or its avirulent T3SS-defective hrcV mutant (CFBP13802). Leaves of both bean cultivars were infiltrated with water or bacterial suspensions. Inoculated leaves were sampled at 24 or 48 h post inoculation (hpi). The experiment was independently repeated three times for total RNA extraction and sequencing analysis. Library construction and total RNA sequencing were performed with BGISEQ-500 at Beijing Genomics Institute (BGI, Hong-Kong), generating an average of 24M of paired-end reads of 100bp per sample. FastQC was used to check reads quality. Mapping analyses were made using a quasi-mapping alignment from Salmon (version 1.2.1) against the Phaseolus vulgaris reference genome (version 2.1), revealing the expression profiles of 36,978 transcripts in leaf tissues. Fastq raw data and count files from 36 samples are available in the Gene Expression Omnibus (GEO) repository of the National Center for Biotechnology Information (NCBI) under the accession number GSE271236. This dataset is a valuable resource to investigate the role of T3Es in subverting the cellular functions of bean., (© 2024 Published by Elsevier Inc.)

Background: The majority of adults suffering from alcohol use disorders (AUD) do not receive treatment. To address this gap in care, we must develop new models to increase identification, engagement and delivery of accessible and effective treatment. This paper describes the protocol for a randomized controlled trial (RCT) testing a novel telehealth treatment model for primary care patients with untreated AUD., Methods: We aim to recruit 300 adults across 2 healthcare systems for this two-arm RCT. Participants, initially identified for recruitment based on AUD-related indicators in their electronic health record (EHR), are RCT-eligible if they meet AUD criteria (mild, moderate, severe), report ≥ 3 drinking days/week in past 30 days, and have not received AUD psychotherapy in the past 90 days. Participants are randomized to an intervention or enhanced usual care control (EUC) condition, both individually-delivered. The intervention includes a telephone-delivered motivational interviewing (MI) engagement session and 8 sessions of MI-Cognitive Behavioral Therapy (MI-CBT). EUC involves AUD psychoeducation, advice to reduce drinking and seek treatment, and provision of community resources. Outcomes will be measured at 3-, 6-, and 12-months; primary outcomes include: AUD psychotherapy initiation and engagement (within the study and external community) and alcohol consumption (percent drinking days and heavy drinking days)., Conclusions: This study addresses whether proactive patient identification and engagement and delivery of patient-centered telehealth psychotherapy to patients with untreated AUD is effective in increasing treatment use and improving alcohol outcomes. If effective, this could be a highly scalable model for reducing the public health impact of AUD., Trial Registration: ClinicalTrials.gov # NCT05410561. University of Michigan HUM00204315. Ann Arbor VA IRB #1655886., Competing Interests: Declaration of competing interest Dr. Lin has consulted on telehealth for substance use disorder treatment for National Committee for Quality Assurance with funding from Alkermes and for Providers Clinical Support System with funding from SAMHSA. The remaining authors do not have any personal financial interests related to the subject matters discussed in this manuscript., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background & Aims: SARS-Cov-2 infection manifests as a wide spectrum of clinical presentation and even now, despite the global spread of the vaccine, contagiousness is still elevated. The aim of the study was the evaluation of the impact of liver fibrosis assessed by FIB-4 and liver impairment, assessed by cytolysis indices, on intrahospital mortality in COVID-19 subjects., Methods: This is a retrospective observational cohort study, which involved 23 COVID Hospital Units in Campania Region, Italy. Exposure variables were collected during hospital admission and at discharge. According to FIB-4 values, we subdivided the overall population in three groups (FIB-4<1.45; 1.453.25), respectively group 1,2,3., Results: At the end of the study, 938 individuals had complete discharged/dead data. At admission, 428 patients were in group 1 (45.6%), 387 in group 2 (41.3%) and 123 in group 3 (13.1%). Among them, 758 (81%) subjects were discharged, while the remaining 180 (19%) individuals died. Multivariable Cox's regression model showed a significant association between mortality risk and severity of FIB-4 stages (group 3 vs group 1, HR 2.12, 95%CI 1.38-3.28, p<0.001). Moreover, Kaplan-Meier analysis described a progressive and statistically significant difference (p<0.001 Log-rank test) in mortality according to FIB-4 groups. Among discharged subjects, 507 showed a FIB-4<1.45 (66.9%, group 1), 182 a value 1.453.25 (9.0%, group 3). Among dead subjects, 42 showed a FIB-4<1.45 (23.3%, group 1), 62 a value 1.453.25 (42.3%, group 3)., Conclusions: FIB-4 value is significantly associated with intrahospital mortality of COVID-19 patients. During hospitalization, particularly in patients with worse outcomes, COVID-19 seems to increase the risk of acute progression of liver damage., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Galiero et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background and Aims: The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has fundamentally reshaped the landscape of global public health, with some people suffering more adverse clinical outcomes than others. The aim of this study is to deepen our understanding of the specific impact of acute kidney injury (AKI) on the in-hospital mortality in octogenarian patients with COVID-19., Methods: This is a prospective observational cohort study, which involved 23 COVID-19 hospital units in the Campania Region, Italy. Exposure variables were collected during hospital admission and at discharge. Only patients aged ≥80 years were deemed eligible for the study., Results: 197 patients were included in the study (median age 83.0 [82.0-87.0] years; 51.5% men), with a median duration of hospitalization of 15.0 [8.0-25.0] days. From the multivariable Cox regression analysis, after the application of Šidák correction, only the respiratory rate (HR 1.09, 95% CI: 1.04 to 1.14; p < 0.001) and AKI development (HR: 3.40, 95% CI: 1.80 to 6.40; p < 0.001) were independently associated with the primary outcome. Moreover, the Kaplan-Meier analysis showed a significantly different risk of in-hospital mortality between patients with and without AKI (log-rank: <0.0001)., Conclusions: In our investigation, we identified a significant association between AKI and mortality rates among octogenarian patients admitted for COVID-19. These findings raise notable concerns and emphasize the imperative for vigilant monitoring of this demographic cohort.

Stenotrophomonas rhizophila CFBP13503 is a seedborne commensal bacterial strain, which is efficiently transmitted to seedlings and can outcompete the phytopathogenic bacterium Xanthomonas campestris pv. campestris (Xcc8004). The type VI secretion system (T6SS), an interference contact-dependent mechanism, is a critical component of interbacterial competition. The involvement of the T6SS of S. rhizophila CFBP13503 in the inhibition of Xcc8004 growth and seed-to-seedling transmission was assessed. The T6SS cluster of S. rhizophila CFBP13503 and nine putative effectors were identified. Deletion of two T6SS structural genes, hcp and tssB, abolished the competitive advantage of S. rhizophila against Xcc8004 in vitro. The population sizes of these two bacterial species were monitored in seedlings after inoculation of radish seeds with mixtures of Xcc8004 and either S. rhizophila wild-type (wt) strain or isogenic hcp mutant. A significant decrease in the population size of Xcc8004 was observed during confrontation with the S. rhizophila wt in comparison with T6SS-deletion mutants in germinated seeds and seedlings. We found that the T6SS distribution among 835 genomes of the Stenotrophomonas genus is scarce. In contrast, in all available S. rhizophila genomes, T6SS clusters are widespread and mainly belong to the T6SS group i4. In conclusion, the T6SS of S. rhizophila CFBP13503 is involved in the antibiosis against Xcc8004 and reduces seedling transmission of Xcc8004 in radish. The distribution of this T6SS cluster in the S. rhizophila complex could make it possible to exploit these strains as biocontrol agents against X. campestris pv. campestris., (© 2024 The Authors. Molecular Plant Pathology published by British Society for Plant Pathology and John Wiley & Sons Ltd.)

Transmission of dermatophytes, especially Trichophyton mentagrophytes genotype VII, during sexual intercourse has been recently reported. We report 13 such cases in France. All patients were male; 12 were men who have sex with men. Our findings suggest sexual transmission of this pathogen within a specific population, men who have sex with men.

Diabetic neuropathy (DN) is one of the main microvascular complications of both type 1 and type 2 diabetes mellitus. Sometimes, this could already be present at the time of diagnosis for type 2 diabetes mellitus (T2DM), while it appears in subjects with type 1 diabetes mellitus (T1DM) almost 10 years after the onset of the disease. The impairment can involve both somatic fibers of the peripheral nervous system, with sensory-motor manifestations, as well as the autonomic system, with neurovegetative multiorgan manifestations through an impairment of sympathetic/parasympathetic conduction. It seems that, both indirectly and directly, the hyperglycemic state and oxygen delivery reduction through the vasa nervorum can determine inflammatory damage, which in turn is responsible for the alteration of the activity of the nerves. The symptoms and signs are therefore various, although symmetrical painful somatic neuropathy at the level of the lower limbs seems the most frequent manifestation. The pathophysiological aspects underlying the onset and progression of DN are not entirely clear. The purpose of this review is to shed light on the most recent discoveries in the pathophysiological and diagnostic fields concerning this complex and frequent complication of diabetes mellitus.

Background: Monkeypox virus (MPXV) is currently spreading among men who have sex with men, outside of sub-Saharan Africa, and close contact during sex seems to be one of the key pathways of viral transmission in the current outbreak. Our aim was to describe the distribution of MPXV in the human body, as it might play a role in its dissemination through sexual contact., Methods: The study population in this case series consisted of patients with confirmed MPXV infection attending the Pitié-Salpêtrière Hospital (Paris, France), who had been sampled from multiple anatomical sites, including skin, anus, throat, blood, urine, and semen, at diagnosis and 2 weeks later. We compared the proportion of positive samples and MPXV viral loads (given as PCR cycle thresholds [Ct]) between anatomical sites, and between day 0 (D0) and D14., Findings: Overall, 356 samples were collected between May 20 and June 13, 2022, from 50 men with a median age of 34 years (IQR 29-40). 22 (44%) of the 50 men were classified as HIV-negative on day (D)0, and 22 (44%) were living with HIV. At D0, MPXV detection was more frequent from skin (44 [88%] of 50), anus (30 [71%] of 42), and throat (36 [77%] of 47) than from blood (13 [29%] of 45), urine (nine [22%] of 41), or semen (13 [54%] of 24). Viral loads were significantly higher from skin lesions (Ct 19·8) and anal samples (Ct 20·9) than from throat (Ct 27·2), blood (Ct 32·8), urine (31·1), or semen samples (Ct 27·8). When analysing the 107 samples taken from 24 patients at D14, the proportion of positive samples strongly decreased between D0 and D14 at all sites: skin (four [22%] of 18), anus (two [9%] of 22), throat (none of 21), blood (one [5%] of 21), urine (none of 14), and semen (two [9%] of 11)., Interpretation: These data contribute to a better understanding of how the virus might spread between sexual partners over a relatively short period of time. High MPXV viral loads from skin and mucosa, including genital and anal sites, suggest that transmission most likely occurs through direct body contact rather than through the respiratory route or contact with body fluids, which should help to refine the prevention messages delivered to individuals most exposed to the virus., Funding: None., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Acute respiratory distress syndrome (ARDS) is one of the most severe complications of SARS-CoV-2 infection. Non-Invasive Respiratory Support (NRS) as Continuous Positive Airway Pressure (CPAP) and/or Non-Invasive Ventilation (NIV) has been proven as effective in the management of SARS-CoV-2-related ARDS. However, the most appropriate timing for start NRS is unknown., Methods: We conducted a prospective pilot study including all consecutive patients who developed moderate SARS-CoV-2-related ARDS during hospitalization. Patients were randomly divided into two intervention groups according to ARDS severity (assessed by PaO 2 /FiO 2 -P/F) at NRS beginning: group A started CPAP/NIV when P/F was ≤ 200 and group B started CPAP/NIV when P/F was ≤ 150. Eligible patients who did not give their consent to CPAP/NIV until the severe stage of ARDS and started non-invasive treatment when P/F ≤ 100 (group C) was added. The considered outcomes were in-hospital mortality, oro-tracheal intubation (OTI) and days of hospitalization., Results: Among 146 eligible patients, 29 underwent CPAP/NIV when P/F was ≤ 200 (Group A), 68 when P/F was ≤ 150 (Group B) and 31 patients agreed to non-invasive treatment only when P/F was ≤ 100 (Group C). Starting NRS at P/F level between 151 and 200 did not results in significant differences in the outcomes as compared to treatment starting with P/F ranging 101-150. Conversely, patients undergone CPAP/NIV in a moderate stage (P/F 101-200) had a significantly lower in-hospital mortality rate (13.4 vs. 29.0%, p = 0.044) and hospitalization length (14 vs. 15 days, p = 0.038) than those in the severe stage (P/F ≤ 100). Age and need for continuous ventilation were independent predictors of CPAP/NIV failure., Conclusions: Starting CPAP/NIV in patients with SARS-CoV-2-related ARDS in moderate stage (100 > P/F ≤ 200) is associated to a reduction of both in-hospital mortality and hospitalization length compared to the severe stage (P/F ≤ 100). Starting CPAP/NIV with a P/F > 150 does not appear to be of clinical utility., (© 2022. The Author(s).)

Background. Evidence has shown a close association between COVID-19 infection and renal complications in both individuals with previously normal renal function and those with chronic kidney disease (CKD). Methods. The aim of this study is to evaluate the in-hospital mortality of SARS-CoV-2 patients according to their clinical history of CKD or estimated glomerular filtration rate (eGFR). This is a prospective multicenter observational cohort study which involved adult patients (≥18 years old) who tested positive with SARS-CoV-2 infection and completed their hospitalization in the period between November 2020 and June 2021. Results. 1246 patients were included in the study, with a mean age of 64 years (SD 14.6) and a median duration of hospitalization of 15 days (IQR 9−22 days). Cox’s multivariable regression model revealed that mortality risk was strongly associated with the stage of renal impairment and the Kaplan−Meier survival analysis showed a progressive and statistically significant difference (p < 0.0001) in mortality according to the stage of CKD. Conclusion. This study further validates the association between CKD stage at admission and mortality in patients hospitalized for COVID-19. The risk stratification based on eGFR allows clinicians to identify the subjects with the highest risk of intra-hospital mortality despite the duration of hospitalization.

Type 2 Diabetes Mellitus (T2DM) is associated with an elevated incidence of cardiovascular and renal diseases, responsible for mortality rates significantly higher than in the general population. The management of both cardiovascular risk and progression of kidney disease thus seem crucial in the treatment of the diabetic patient. The availability of new classes of drugs which positively affect both cardiovascular and renal risk, regardless of the glycemic control, represents a revolution in the treatment of T2DM and shifts the attention from the intensive glycemic control to a holistic management of the diabetic patient. Among these, sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been associated with a remarkable reduction of cardiovascular and renal mortality, lower hospitalization rates for heart failure and lower progression of renal damage and albuminuria. Thus, their use in selected subpopulations seems mandatory. Aim of this review was the assessment of the current evidence on SGLT2i and their related impact on the cardiovascular and renal profiles., Competing Interests: The authors declare no conflict of interest. Ferdinando Carlo Sasso is serving as one of the Editorial Board members of this journal. We declare that Ferdinando Carlo Sasso had no involvement in the peer review of this article and has no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to Massimo Volpe, Filippos Triposkiadis, Grigorios Korosoglou and Matteo Cameli., (© 2022 The Author(s). Published by IMR Press.)

Objectives: We report the characteristics of Mycoplasmagenitalium (MG) infection in patients from a STI center in Paris. We evaluated outcomes after treatment., Methods: We included all patients tested for MG, Chlamydiatrachomatis (CT) and Neisseria gonorrhoeae (NG) infection in our center from January 2017 to December 2018, using multiplex PCR on urine specimen, vaginal or rectal swabs. We collected data regarding sex, age, HIV status, PrEP use, sexual behavior, NG and CT co-infection, symptoms and treatment., Results: MG infection prevalence was 7% (397/5586) (95% CI 6.4-7.8). It ranged from 4.6% in patients consulting for routine STI testing (3.9% in women, 5% in men), to 16% in HIV-positive patients and 25% in PrEP users. Among the 397 MG infected patients, 351 (88%) were asymptomatic and 87 (22%) were co-infected with NG or CT. Among the 270 (68%) treated patients, 249 (92%) received azithromycin. Failure rate was 74% in the 103 patients tested post-treatment. Treatment failure tended to be higher with azithromycin single dose than with 5-day azithromycin (88% vs. 70%; P=0.07). Azithromycin and moxifloxacin were used as second-line treatment in 24 and 23 patients, respectively. Post-treatment PCR remained positive in 55% of the 44 tested patients with a better eradication rate with moxifloxacin than with azithromycin (70% vs. 33%; P=0.04)., Conclusion: MG infection is highly prevalent in PrEP users and HIV-positive patients and is mostly asymptomatic. Management of MG infection should be tailored and adapted to the risk of antibiotic resistance and reinfection., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Background: There is no consensus on the treatment of drug reaction with eosinophilia and systemic symptoms (DRESS). At our center, systemic steroids (SS) are used for severe cases while topical steroids (TS) are used for mild and moderate forms., Objectives: To investigate the short-term outcome for patients with DRESS receiving SS as first-line therapy before being transferred to our department and then switched to TS after admission., Methods: A retrospective monocenter study in DRESS patients (RegiSCAR score≥4) transferred to our dermatology department from a different setting between 07/2012 and 06/2018 and who had received SS before being transferred. Epidemiological, clinical and laboratory data were collected, as well as details of treatment modalities and outcome., Results: Twenty patients were included. On admission to our department, 4 were assessed as having severe DRESS and continued on SS, while 16 were assessed as mild/moderate DRESS and were switched to TS. Among these 16 patients, the outcome on TS was favorable for 12 and quickly unfavorable for 4, who had to be switched back to SS. Retrospective analysis of the initial data (before transfer) showed that these 4 patients had previously had a greater number of severity criteria than the other 12., Conclusion: Caution is needed not only when deciding to initiate SS in DRESS but also on withdrawal of these drugs. Our series suggests that when SS are used as first-line therapy in DRESS patients with initial severity criteria, they should not be withdrawn quickly for a switch to TS, even where progression appears favorable, due to the risk of relapse., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Background: We report a case of subdural empyema in a homeless patient caused by Bartonella quintana. B. quintana is a facultative intracellular bacteria for which bacterial growth is fastidious. The molecular biology approach has been a real help in establishing the diagnosis., Case Report: A 59-years old homeless patient, with a history of chronic alcohol abuse, was brought to the emergency department with a massive subdural empyema. Extensive microbiological evaluation didn't reveal any pathogen in the pus collected before antibiotic treatment. B. quintana was detected in the pus from the empyema using a 16S rRNA-based PCR. Histology of intraoperative samples was consistent with the diagnosis and a serological assay was positive. The patient responded well to a treatment that included craniectomy with drainage of the loculated pus, total removal of the infected capsule and a combination of antibiotics., Conclusion: This unique case of B. quintana-related empyema illustrates the risk of secondary infection of subdural hematoma with B. quintana since such infections have recently reemerged, predominantly among the homeless populations. Patients with subdural empyema in at-risk populations should be systematically evaluated for B. quintana with an appropriate diagnostic approach involving molecular biology.

Phenotyping biotic stresses in plant-pathogen interactions studies is often hindered by phenotypes that can hardly be discriminated by visual assessment. Particularly, single gene mutants in virulence factors could lack visible phenotypes. Chlorophyll fluorescence (CF) imaging is a valuable tool to monitor plant-pathogen interactions. However, while numerous CF parameters can be measured, studies on plant-pathogen interactions often focus on a restricted number of parameters. It could result in limited abilities to discriminate visually similar phenotypes. In this study, we assess the ability of the combination of multiple CF parameters to improve the discrimination of such phenotypes. Such an approach could be of interest for screening and discriminating the impact of bacterial virulence factors without prior knowledge. A computation method was developed, based on the combination of multiple CF parameters, without any parameter selection. It involves histogram Bhattacharyya distance calculations and hierarchical clustering, with a normalization approach to take into account the inter-leaves and intra-phenotypes heterogeneities. To assess the efficiency of the method, two datasets were analyzed the same way. The first dataset featured single gene mutants of a Xanthomonas strain which differed only by their abilities to secrete bacterial virulence proteins. This dataset displayed expected phenotypes at 6 days post-inoculation and was used as ground truth dataset to setup the method. The efficiency of the computation method was demonstrated by the relevant discrimination of phenotypes at 3 days post-inoculation. A second dataset was composed of transient expression (agrotransformation) of Type 3 Effectors. This second dataset displayed phenotypes that cannot be discriminated by visual assessment and no prior knowledge can be made on the respective impact of each Type 3 Effectors on leaf tissues. Using the computation method resulted in clustering the leaf samples according to the Type 3 Effectors, thereby demonstrating an improvement of the discrimination of the visually similar phenotypes. The relevant discrimination of visually similar phenotypes induced by bacterial strains differing only by one virulence factor illustrated the importance of using a combination of CF parameters to monitor plant-pathogen interactions. It opens a perspective for the identification of specific signatures of biotic stresses., (Copyright © 2020 Méline, Brin, Lebreton, Ledroit, Sochard, Hunault, Boureau and Belin.)

Cases of emergence of novel plant-pathogenic strains are regularly reported that reduce the yields of crops and trees. However, the molecular mechanisms underlying such emergence are still poorly understood. The acquisition by environmental non-pathogenic strains of novel virulence genes by horizontal gene transfer has been suggested as a driver for the emergence of novel pathogenic strains. In this study, we tested such an hypothesis by transferring a plasmid encoding the type 3 secretion system (T3SS) and four associated type 3 secreted proteins (T3SPs) to the non-pathogenic strains of Xanthomonas CFBP 7698 and CFBP 7700, which lack genes encoding T3SS and any previously known T3SPs. The resulting strains were phenotyped on Nicotiana benthamiana using chlorophyll fluorescence imaging and image analysis. Wild-type, non-pathogenic strains induced a hypersensitive response (HR)-like necrosis, whereas strains complemented with T3SS and T3SPs suppressed this response. Such suppression depends on a functional T3SS. Amongst the T3SPs encoded on the plasmid, Hpa2, Hpa1 and, to a lesser extent, XopF1 collectively participate in suppression. Monitoring of the population sizes in planta showed that the sole acquisition of a functional T3SS by non-pathogenic strains impairs growth inside leaf tissues. These results provide functional evidence that the acquisition via horizontal gene transfer of a T3SS and four T3SPs by environmental non-pathogenic strains is not sufficient to make strains pathogenic. In the absence of a canonical effector, the sole acquisition of a T3SS seems to be counter-selective, and further acquisition of type 3 effectors is probably needed to allow the emergence of novel pathogenic strains., (© 2018 BSPP and John Wiley & Sons Ltd.)

The acquisition of virulence-related genes through horizontal gene transfer can modify the pathogenic profiles of strains and lead to the emergence of new diseases. Xanthomonas arboricola is a bacterial species largely known for the damage it causes to stone and nut fruit trees worldwide. In addition to these host-specific populations called pathovars, many nonpathogenic strains have been identified in this species. Their evolutionary significance in the context of pathogen emergence is unknown. We looked at seven housekeeping genes amplified from 187 pathogenic and nonpathogenic strains isolated from various plants worldwide to analyze population genetics and recombination dynamics. We also examined the dynamics of the gains and losses of genes associated with life history traits (LHTs) during X. arboricola evolution. We discovered that X. arboricola presents an epidemic population structure. Successful pathovars of trees (i.e. pruni, corylina and juglandis) are epidemic clones whose emergence appears to be linked to the acquisition of eight genes coding for Type III effectors. The other strains of this species are part of a recombinant network, within which LHT-associated genes might have been lost. We suggest that nonpathogenic strains, because of their high genetic diversity and propensity for recombination, may promote the emergence of pathogenic strains., (© 2016 Society for Applied Microbiology and John Wiley & Sons Ltd.)

Background: Xanthomonads are plant-associated bacteria responsible for diseases on economically important crops. Xanthomonas fuscans subsp. fuscans (Xff) is one of the causal agents of common bacterial blight of bean. In this study, the complete genome sequence of strain Xff 4834-R was determined and compared to other Xanthomonas genome sequences., Results: Comparative genomics analyses revealed core characteristics shared between Xff 4834-R and other xanthomonads including chemotaxis elements, two-component systems, TonB-dependent transporters, secretion systems (from T1SS to T6SS) and multiple effectors. For instance a repertoire of 29 Type 3 Effectors (T3Es) with two Transcription Activator-Like Effectors was predicted. Mobile elements were associated with major modifications in the genome structure and gene content in comparison to other Xanthomonas genomes. Notably, a deletion of 33 kbp affects flagellum biosynthesis in Xff 4834-R. The presence of a complete flagellar cluster was assessed in a collection of more than 300 strains representing different species and pathovars of Xanthomonas. Five percent of the tested strains presented a deletion in the flagellar cluster and were non-motile. Moreover, half of the Xff strains isolated from the same epidemic than 4834-R was non-motile and this ratio was conserved in the strains colonizing the next bean seed generations., Conclusions: This work describes the first genome of a Xanthomonas strain pathogenic on bean and reports the existence of non-motile xanthomonads belonging to different species and pathovars. Isolation of such Xff variants from a natural epidemic may suggest that flagellar motility is not a key function for in planta fitness.