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Summary: Background & aims: Enteral nutrition (EN) is a critical medical nutritional treatment designed to meet the specific micro- and macronutrient requirements of patients unable to achieve adequate nutrition through oral intake. The aim of this study is to review the use of EN by tube in routine clinical practice, focusing on its management in patients with specific nutritional requirements, and to evaluate the effectiveness, tolerability, and quality of life improvements associated with the Nutrison® range of enteral tube enteral formulas. Methods: NUTRECONSONDA was a nationwide, multicentre, cross-sectional ecological study. Aggregated data were collected from the experience and knowledge of 142 physicians with experience treating patients with EN through an online survey. Results: According to the physicians, the main indications to EN were neoplasms (43.3 %) and neuromotor disorders (36.4 %), the most common administration techniques were percutaneous endoscopic gastrostomy tube (35.6 %) and nasogastric tube (29.2 %), the most common type of feeding was bolus feeding (52.1 %), and most frequent symptoms were diarrhoea (29.2 %), nausea (21.7 %), regurgitation (21.4 %) and abdominal distension (21.1 %). Moreover, 82.8 % of patients reported good tolerance to enteral formulas and these were effective in 91.4 % of patients in terms of nutritional requirements. The most important criteria considered for the selection of an enteral formula of the Nutrison® range in patients with specific EN requirements were patient's energy and nutritional needs (score: 8.8), nutritional formula composition (score: 8.5) and tolerability of the formula (score: 8.3). Nutrison® enteral formulas were effective in terms of nutritional requirements in 92.5 % of patients, had good tolerability in 86.9 %, improved quality of life in 67.1 % and improved general health status in 75.1 %. Most patients were also satisfied with Nutrison® enteral formulas (87.2 %) and their delivery system (87.5 %). Furthermore, the most representative lipid profile benefits in patients treated with Nutrison® enteral formulas were a higher EPA and DHA intake (54.9 %) and a higher combination of medium chain triglycerides (45.5 %). Conclusion: The key factors influencing formula selection were patient energy requirements, formula composition, and tolerance. Enteral formulas of the Nutrison® range were effective, safe and improved quality of life and lipid profile in most of the patients with specific nutritional requirements.

Background: Metformin is an antidiabetic drug that has shown its benefit in increasing the effect of radiotherapy in the treatment of solid tumors in preclinical studies. The objective of this systematic review is to study the effect of metformin as a radiosensitizer in studies carried out in clinical practice. Methods: Systematic review carried out according to PRISMA criteria of clinical trials, systematic reviews and observational studies focused on the influence of metformin as a radiosensitizer in solid tumors. The studies were published between the years 2010 and 2022. The results of the studies have been analyzed in terms of survival (OS, PFS, DFS, DMFS) and response (ORR) between patients treated with metformin and without it. Results: A total of 16 studies have been found in the literature (the most frequent tumor was prostate cancer, 5 studies). External radiotherapy was administered in all the studies and in two of them to greater brachytherapy. The use of metformin with radiotherapy showed a consistent benefit in terms of survival and response in tumors of prostate, hepatic and gynecological origin. The benefit in the rest of the tumors analyzed (lung, rectal, and head and neck cancer) is doubtful, and the results are contradictory. The greatest benefits were observed in prostate tumors both in OS and SLE. Conclusions: The use of metformin in combination with radiotherapy in solid tumors is one of the most promising treatments under development in oncology. The benefit observed in real-life studies makes it necessary to develop clinical trials that specifically evaluate its use in clinical practice in the future.

Based on a bibliographic review of articles and scientific documents regarding the composition of cocoa pod husk (CPH), the benefits of its use as a substrate, and the parameters required for the production of edible mushrooms, an environmental assessment for the operation phase was conducted. A total of 85 environmental aspects were identified, along with 85 direct impacts and 117 indirect impacts related to various environmental components. However, after reviewing the entire project phase, the environmental impacts were reduced to 38. Additionally, the utilization of CPH generates employment and economic income for the community, although it requires high consumption of water, energy, and fuel. The environmental categorization of the project indicated that it is a moderate-impact project, where its effects do not spread beyond the direct area of influence.

IntroductionExtracellular vesicles (EVs) are lipid bilayer membrane-enclosed nanoparticles, secreted by all cell types. Information regarding EVs and their molecular cargo in gestational parasitic infections, particularly those caused by Plasmodium and soil-transmitted helminths (STH), remains largely unexplored. This study aimed to perform isolation and molecular characterization of plasma-derived EVs from Colombian pregnant women and compare quantity, size, concentration and protein cargo of those EVs according to the infectious status, to investigate if parasite-derived proteins could be detected as biological cargo of circulating EVs of pregnant women infected with Plasmodium, STH and co-infections.Materials and methodsA descriptive study with 5 groups was performed: 1) Pregnant women with Plasmodium infection (n=10). 2) Pregnant women with STH infection (n=14). 3) Pregnant women with coinfection Plasmodium and STH (n=14). 4) Pregnant women without infection with Plasmodium nor STH (n=10). 5) Non-pregnant women without infection with Plasmodium nor STH (n=6). Plasma-derived EVs were isolated by size exclusion chromatography (SEC) and fractions containing EVs identified by a bead-based flow cytometric assay for CD9; the size and concentration of EVs were quantified by nanoparticle tracking analysis, and proteins associated with EVs were identified by liquid chromatography-mass spectrometry in a pool of samples per study group.ResultsThere were no statistical differences in expression of the CD9 EVs marker among study groups. The size range of EVs was more variable in the three infected groups (100-700 nm) compared to the size range of the uninfected groups (50-300 nm). A total of 823 quantifiable proteins with measurable abundance values were identified within the five study groups. Of the total quantifiable proteins, 758 were identified as human, six proteins pertained to P. vivax, fifteen to Trichiuris trichiura, and one to hookworms. Data are available via ProteomeXchange with identifier PXD051270.DiscussionThis is the first study that identifies proteins from Plasmodium and STH in EVs isolated from pregnant women. The identification of such proteins from neglected tropical parasites accounting for a major burden of disease worldwide, open the possibilities of studying their physiological role during infections as well as exploring them for antigen discovery, vaccine development and biomarker discovery.

Extracellular vesicles (EVs) released by virus-infected cells have the potential to encapsulate viral peptides, a characteristic that could facilitate vaccine development. Furthermore, plasma-derived EVs may elucidate pathological changes occurring in distal tissues during viral infections. We hypothesized that molecular characterization of EVs isolated from COVID-19 patients would reveal peptides suitable for vaccine development. Blood samples were collected from three cohorts: severe COVID-19 patients (G1), mild/asymptomatic cases (G2), and SARS-CoV-2-negative healthcare workers (G3). Samples were obtained at two time points: during the initial phase of the pandemic in early 2020 (m0) and eight months later (m8). Clinical data analysis revealed elevated inflammatory markers in G1. Notably, non-vaccinated individuals in G1 exhibited increased levels of neutralizing antibodies at m8, suggesting prolonged exposure to viral antigens. Proteomic profiling of EVs was performed using three distinct methods: immunocapture (targeting CD9), ganglioside-capture (utilizing Siglec-1) and size-exclusion chromatography (SEC). Contrary to our hypothesis, this analysis failed to identify viral peptides. These findings were subsequently validated through Western blot analysis targeting the RBD of the SARS-CoV-2 Spike protein’s and comparative studies using samples from experimentally infected Syrian hamsters. Furthermore, analysis of the EV cargo revealed a diverse molecular profile, including components involved in the regulation of viral replication, systemic inflammation, antigen presentation, and stress responses. These findings underscore the potential significance of EVs in the pathogenesis and progression of COVID-19.

Background & Aims: Barrett’s esophagus is the precursor of esophageal dysplasia and esophageal adenocarcinoma. CDKN2A-p16 deletions were reported in 34%–74% of patients with Barrett’s esophagus who progressed to dysplasia and esophageal adenocarcinoma, suggesting that p16 loss may drive neoplastic progression. KRAS activation frequently occurs in esophageal adenocarcinoma and precancer lesions. LGR5+ stem cells in the squamocolumnar-junction (SCJ) of mouse stomach contribute as Barrett’s esophagus progenitors. We aimed to determine the functional effects of p16 loss and KRAS activation in Barrett’s-like metaplasia and dysplasia development. Methods: We established mouse models with conditional knockout of CDKN2A-p16 (p16KO) and/or activated KRASG12D expression targeting SCJ LGR5+ cells in interleukin 1b transgenic mice and characterized histologic alterations (mucous-gland hyperplasia/metaplasia, inflammation, and dysplasia) in mouse SCJ. Gene expression was determined by microarray, RNA sequencing, and immunohistochemistry of SCJ tissues and cultured 3-dimensional organoids. Results: p16KO mice exhibited increased mucous-gland hyperplasia/metaplasia versus control mice (P = .0051). Combined p16KO+KRASG12D resulted in more frequent dysplasia and higher dysplasia scores (P = .0036), with 82% of p16KO+KRASG12D mice developing high-grade dysplasia. SCJ transcriptome analysis showed several activated pathways in p16KO versus control mice (apoptosis, tumor necrosis factor-α/nuclear factor-kB, proteasome degradation, p53 signaling, MAPK, KRAS, and G1-to-S transition). Conclusions: p16 deletion in LGR5+ cell precursors triggers increased SCJ mucous-gland hyperplasia/metaplasia. KRASG12D synergizes with p16 deletion resulting in higher grades of SCJ glandular dysplasia, mimicking Barrett’s high-grade dysplasia. These genetically modified mouse models establish a functional role of p16 and activated KRAS in the progression of Barrett’s-like lesions to dysplasia in mice, representing an in vivo model of esophageal adenocarcinoma precancer. Derived 3-dimensional organoid models further provide in vitro modeling opportunities of esophageal precancer stages.

Mental health is an increasing topic of focus since more than 500 million people in the world suffer from depression and anxiety. In this multifactorial disorder, parameters such as inflammation, the state of the microbiota and, therefore, the patient’s nutrition are receiving more attention. In addition, food products are the source of many essential ingredients involved in the regulation of mental processes, including amino acids, neurotransmitters, vitamins, and others. For this reason, this narrative review was carried out with the aim of analyzing the role of nutrition in depression and anxiety disorders. To reach the review aim, a critical review was conducted utilizing both primary sources, such as scientific publications and secondary sources, such as bibliographic indexes, web pages, and databases. The search was conducted in PsychINFO, MedLine (Pubmed), Cochrane (Wiley), Embase, and CinAhl. The results show a direct relationship between what we eat and the state of our nervous system. The gut–brain axis is a complex system in which the intestinal microbiota communicates directly with our nervous system and provides it with neurotransmitters for its proper functioning. An imbalance in our microbiota due to poor nutrition will cause an inflammatory response that, if sustained over time and together with other factors, can lead to disorders such as anxiety and depression. Changes in the functions of the microbiota–gut–brain axis have been linked to several mental disorders. It is believed that the modulation of the microbiome composition may be an effective strategy for a new treatment of these disorders. Modifications in nutritional behaviors and the use of ergogenic components are presented as important non-pharmacological interventions in anxiety and depression prevention and treatment. It is desirable that the choice of nutritional and probiotic treatment in individual patients be based on the results of appropriate biochemical and microbiological tests.

Recent studies indicate that human spleen contains over 95% of the total parasite biomass during chronic asymptomatic infections caused by Plasmodium vivax. Previous studies have demonstrated that extracellular vesicles (EVs) secreted from infected reticulocytes facilitate binding to human spleen fibroblasts (hSFs) and identified parasite genes whose expression was dependent on an intact spleen. Here, we characterize the P. vivax spleen-dependent hypothetical gene (PVX_114580). Using CRISPR/Cas9, PVX_114580 was integrated into P. falciparum 3D7 genome and expressed during asexual stages. Immunofluorescence analysis demonstrated that the protein, which we named P. vivax Spleen-Dependent Protein 1 (PvSDP1), was located at the surface of infected red blood cells in the transgenic line and this localization was later confirmed in natural infections. Plasma-derived EVs from P. vivax-infected individuals (PvEVs) significantly increased cytoadherence of 3D7_PvSDP1 transgenic line to hSFs and this binding was inhibited by anti-PvSDP1 antibodies. Single-cell RNAseq of PvEVs-treated hSFs revealed increased expression of adhesion-related genes. These findings demonstrate the importance of parasite spleen-dependent genes and EVs from natural infections in the formation of intrasplenic niches in P. vivax, a major challenge for malaria elimination.

BackgroundNational, regional and global scientific production and research capacity for physical activity - PA may contribute to improving public health PA policies and programs. There is an uneven distribution of research productivity by region and country income group, where countries with the highest burden of non-communicable diseases attributable to physical inactivity having low research productivity. A first step towards improving global research capacity is to objectively quantify patterns, trends, and gaps in PA research. This study describes national, regional and global trends and patterns of PA research from 1950 to 2019.MethodsA systematic review using searches in PubMed, SCOPUS and ISI Web of Knowledge databases was conducted in August 2017 and updated between January and May 2020. The review was registered at the PROSPERO database number CRD42017070153. PA publications per 100,000 inhabitants per country was the main variable of interest. Descriptive and time-trend analyses were conducted in STATA version 16.0.ResultsThe search retrieved 555,468 articles of which 75,756 were duplicates, leaving 479,712 eligible articles. After reviewing inclusion and exclusion criteria, 23,860 were eligible for data extraction. Eighty-one percent of countries (n = 176) had at least one PA publication. The overall worldwide publication rate in the PA field was 0.46 articles per 100,000 inhabitants. Europe had the highest rate (1.44 articles per 100,000 inhabitants) and South East Asia had the lowest (0.04 articles per 100,000 inhabitants). A more than a 50-fold difference in publications per 100,000 inhabitants was identified between high and low-income countries. The least productive and poorest regions have rates resembling previous decades of the most productive and the richest.ConclusionThis study showed an increasing number of publications over the last 60 years with a growing number of disciplines and research methods over time. However, striking inequities were revealed and the knowledge gap across geographic regions and by country income groups was substantial over time. The need for regular global surveillance of PA research, particularly in countries with the largest data gaps is clear. A focus on the public health impact and global equity of research will be an important contribution to making the world more active.

Abstract Cell shape is genetically inherited by all forms of life. Some unicellular microbes increase niche adaptation altering shape whereas most show invariant morphology. A universal system of peptidoglycan synthases guided by cytoskeletal scaffolds defines bacterial shape. In rod-shaped bacteria, this system consists of two supramolecular complexes, the elongasome and divisome, which insert cell wall material along major and minor axes. Microbes with invariant shape are thought to use a single morphogenetic system irrespective of the occupied niche. Here, we provide evidence for two elongasomes that generate (rod) shape in the same bacterium. This phenomenon was unveiled in Salmonella, a pathogen that switches between extra- and intracellular lifestyles. The two elongasomes can be purified independently, respond to different environmental cues, and are directed by distinct peptidoglycan synthases: the canonical PBP2 and the pathogen-specific homologue PBP2SAL. The PBP2-elongasome responds to neutral pH whereas that directed by PBP2SAL assembles in acidic conditions. Moreover, the PBP2SAL-elongasome moves at a lower speed. Besides Salmonella, other human, animal, and plant pathogens encode alternative PBPs with predicted morphogenetic functions. Therefore, contrasting the view of morphological plasticity facilitating niche adaptation, some pathogens may have acquired alternative systems to preserve their shape in the host.

Abstract Tumor growth is the result of the interplay of complex biological processes in huge numbers of individual cells living in changing environments. Effective simple mathematical laws have been shown to describe tumor growth in vitro, or simple animal models with bounded-growth dynamics accurately. However, results for the growth of human cancers in patients are scarce. Our study mined a large dataset of 1133 brain metastases (BMs) with longitudinal imaging follow-up to find growth laws for untreated BMs and recurrent treated BMs. Untreated BMs showed high growth exponents, most likely related to the underlying evolutionary dynamics, with experimental tumors in mice resembling accurately the disease. Recurrent BMs growth exponents were smaller, most probably due to a reduction in tumor heterogeneity after treatment, which may limit the tumor evolutionary capabilities. In silico simulations using a stochastic discrete mesoscopic model with basic evolutionary dynamics led to results in line with the observed data.

Canine inflammatory mammary carcinoma (IMC) is an aggressive and rare type of mammary gland cancer in dogs where vascular endothelial growth factor and cyclooxigenase-2 overexpression usually occur, which contribute to its invasive and angiogenic nature. This study aimed to evaluate the efficacy and safety of a combined treatment regimen of toceranib phosphate and carprofen in dogs with measurable IMC. Fifteen female dogs with histopathologically confirmed IMC were included, undergoing a regimen of toceranib (2.4–2.75 mg/kg PO, three times weekly) and carprofen (4.4 mg/kg/24 h PO). Initial evaluations included physical exams, tumor measurements, complete blood count, biochemistry, urinalysis, three view thoracic radiographs, and abdominal ultrasound. Follow-up assessments of physical condition and quality of life (QOL) were conducted bi-weekly, with tumor response evaluations monthly, using RECIST v1.0 criteria. While no complete or partial responses were observed, 60% of the dogs maintained stable disease, with a median progression-free survival of 76 days and an overall survival of 90 days. Notably, 60% of the dogs showed clinical benefit through improved QOL and disease stabilization. The treatment was well-tolerated, with only grade I/II toxicities reported. Despite limited biological activity against the cancer, this protocol may enhance QOL in dogs with IMC, offering a valuable palliative option.

The little bustard (Tetrax tetrax) is a steppe bird strongly and negatively influenced by agricultural intensification in Europe. Here, we use the little bustard as a model species to examine how favourability (relative occurrence likelihood of a species based on environmental characteristics, such as habitat availability) varies regionally with degree of protection in north-western Spain. The Natura2000 network is one of the main biodiversity conservation tools of the European Union, aiming to protect areas hosting species of conservation concern from unfavourable land-use changes. The network covers many landscapes across the continent, including farmland. Additionally, we examine the relationship between trends in land-use favourability and little bustard population trends over a decade in the Nature Reserve of Lagunas de Villafáfila, a protected area also in the Natura2000 network where active and intense management focused on steppe bird conservation is carried out. Favourability was much greater in Villafáfila than in both protected areas with lower degree of protection and in non-protected areas. Land-use favourability increased slightly between 2011 and 2020 both in and out of protected areas, whereas little bustard populations declined sharply in that period, even in Villafáfila. Spatial variations in little bustard abundance within Villafáfila depended on social attraction (increasing with the number of neighbouring males) but not significantly on small-scale variations in land-use favourability. These results suggest that land-use management in Natura2000 areas needs to be more conservation-focused, favouring natural and seminatural habitats and traditional farming practices to improve land-use favourability for little bustards and other steppe birds. Additional factors, such as field-level agricultural management or social interaction variables that may cause an Allee effect, should be incorporated in little bustard favourability models to improve their use in conservation planning.

In a country like Colombia, food drying plays an important role in the extension of technology so that farmers improve the quality of their productivity. The objective of this work is to develop a system for acquiring thermodynamic variables, to establish the energy efficiency of a product drying oven, specifically for cocoa beans using Arduino hardware and LabView software. This research begins by establishing the variables to be measured and recorded by the DHT11 sensors, such as temperature and humidity. These sensors are connected to an Arduino Uno board that has an Atmel microcontroller, which captures the information from each of these. An algorithm was also developed that captures the temperature and humidity data and sends it through the serial port to the LabView software, in which the visualization on the front panel and programming in the block diagram have been developed, being viewed from the HMI (Human Machine Interface). For the experimental tests, 3,309 grams of fermented cocoa beans were taken, and dried for 36 hours, removing a total mass of water of 1,650 grams. The results show an energy efficiency of 10.62%, concluding that the drying oven that takes advantage of the residual heat of an 18000 BTU condenser integrated with the proposed variable system is suitable for drying cocoa beans. Despite this efficiency being low, it meets the objective of removing moisture from them.

Abstract Parasites are responsible for the most neglected tropical diseases, affecting over a billion people worldwide (WHO, 2015) and accounting for billions of cases a year and responsible for several millions of deaths. Research on extracellular vesicles (EVs) has increased in recent years and demonstrated that EVs shed by pathogenic parasites interact with host cells playing an important role in the parasite's survival, such as facilitation of infection, immunomodulation, parasite adaptation to the host environment and the transfer of drug resistance factors. Thus, EVs released by parasites mediate parasite‐parasite and parasite‐host intercellular communication. In addition, they are being explored as biomarkers of asymptomatic infections and disease prognosis after drug treatment. However, most current protocols used for the isolation, size determination, quantification and characterization of molecular cargo of EVs lack greater rigor, standardization, and adequate quality controls to certify the enrichment or purity of the ensuing bioproducts. We are now initiating major guidelines based on the evolution of collective knowledge in recent years. The main points covered in this position paper are methods for the isolation and molecular characterization of EVs obtained from parasite‐infected cell cultures, experimental animals, and patients. The guideline also includes a discussion of suggested protocols and functional assays in host cells

Energy electrification is part of the European strategy for the decarbonization of the building sector and energy transition in cities. The present paper compares the heating costs of covering the heating demand by different systems: (i) domestic gas boiler and an air-to-air heat-pump, (ii) without and (iii) with local PV backup; in order to analyze the effects of the electric price volatility along with the weather condition dependency of the renewable systems. The study presents a heat pump model and a PV generation model to estimate the hourly performance of both systems. These models are then applied in an average dwelling in Bilbao, Spain, in November 2020, and November 2021. Results show that in November 2020 the combined use of a heat pump with PV generation to cover the heat demand was 66% cheaper than covering the same demand with a natural gas boiler. By contrast, the combined use of the PV and heat pump resulted in a 15% higher energy bill compared to the natural gas in 2021 due to the increase of the electricity prices (3 times higher), the lower temperatures (25%) and less solar radiation (70%).

Abstract Pericardial effusions requiring pericardiocentesis have multiple causes that vary among geographical regions and health contexts. This procedure can be performed for diagnostic or therapeutic indications. The purpose of this study was to identify the principal causes of pericardial effusions and indications for pericardiocentesis, exploring differences among groups. This was a retrospective case series of patients who underwent pericardiocentesis for pericardial effusion in a single center in Latin America. Demographic, clinical, echocardiographic, and procedural variables were recorded and analyzed. The primary outcome was to determine the causes of pericardial effusions in these patients and the indication (diagnostic, therapeutic, or both). The results are presented in two groups (inflammatory and noninflammatory) according to the cause of the pericardial effusion. One hundred sixteen patients with pericardial effusion underwent pericardiocentesis. The median age was 58 years (IQR 46.2–70.7), and 50% were male. In the noninflammatory pericardial effusion group, there were 61 cases (53%), among which neoplastic pericardial effusion was the most frequent cause (n = 25, 40.9%). In the inflammatory group, there were 55 cases (47%), and the main cause was postpericardiectomy syndrome after cardiac surgery (n = 31, 56.4%). In conclusion, the principal indication for pericardiocentesis was therapeutic (n = 66, 56.8%). Large pericardial effusion without hemodynamic effect of cardiac tamponade was significantly more frequent in the inflammatory group (p = 0.03). The principal cause of pericardial effusion in patients who underwent pericardiocentesis was postpericardiectomy syndrome after cardiac surgery, followed by neoplastic pericardial effusion. Pericardiocentesis is mainly a therapeutic procedure.

The European Union has established a legislative framework that aims to enable consumers and businesses to take information-based decisions to save energy and money. Additionally, the increase of Distributed Energy Resources (both on generation and consumption) requires additional efforts to maintain the reliability and stability of the electric grid and the need of flexibility from residential buildings. The present study introduces a domestic decision support tool for reducing heating costs. This app provides detailed recommendations to end-users based on the day-ahead hourly weather forecast, electric and district heating tariffs predictions, heating demand, and heating systems dynamic performance. The tool was tested in 6 dwellings of a neighborhood of Belgrade during the last months of 2021 heating season (March–May). Energetic results suggest that 40% of participants followed the given recommendations and changed their heating pattern. Additionally, survey results show that end-users found the lack of information and knowledge as the main barrier to actively participate in the energy market, also preferring to have automatic control in their heating system. Authors conclude that recommendation tools are key elements in user-engagement, but they should be supported by additional information and training.

The last decade has seen a sharp increase in the number of scientific publications describing physiological and pathological functions of extracellular vesicles (EVs), a collective term covering various subtypes of cell-released, membranous structures, called exosomes, microvesicles, microparticles, ectosomes, oncosomes, apoptotic bodies, and many other names. However, specific issues arise when working with these entities, whose size and amount often make them difficult to obtain as relatively pure preparations, and to characterize properly. The International Society for Extracellular Vesicles (ISEV) proposed Minimal Information for Studies of Extracellular Vesicles ("MISEV") guidelines for the field in 2014. We now update these "MISEV2014" guidelines based on evolution of the collective knowledge in the last four years. An important point to consider is that ascribing a specific function to EVs in general, or to subtypes of EVs, requires reporting of specific information beyond mere description of function in a crude, potentially contaminated, and heterogeneous preparation. For example, claims that exosomes are endowed with exquisite and specific activities remain difficult to support experimentally, given our still limited knowledge of their specific molecular machineries of biogenesis and release, as compared with other biophysically similar EVs. The MISEV2018 guidelines include tables and outlines of suggested protocols and steps to follow to document specific EV-associated functional activities. Finally, a checklist is provided with summaries of key points.

Pandoraea pnomenusa is a Gram-negative bacterium of the Pandoraea genus and is mainly associated with the colonization of structurally abnormal airways. During the COVID-19 pandemic, many microorganisms have been associated with coinfection and superinfection in SARS-CoV-2 pneumonia, but so far, no coinfection or superinfection by P. pnomenusa has been reported. We present the first case describing this association in a previously healthy patient. Clinical manifestations, treatment, and outcomes are shown.