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ABSTRACT Background Methods Results Conclusion The 2015 International Society for Heart and Lung Transplant (ISHLT) fungal guidelines recommend the use of bronchoalveolar lavage (BAL) galactomannan over serum galactomannan for the diagnosis of invasive aspergillosis (IA) in lung transplant (LTx) recipients, based on limited evidence. Galactomannan testing is costly.A single‐center, retrospective cohort study reviewing all 814 serum and BAL galactomannan samples received from 184 LTx recipients in our center between 2021 and 2022 and assessing their diagnostic performance in the diagnosis of IA.Over the study period, 394 serum galactomannan samples were received from 144 patients and 420 BAL galactomannan samples from 143 patients. Using a cut‐off of ≥ 1.0 for BAL galactomannan, the sensitivity and specificity were 65.9% and 98.4%, respectively. In total, 30 patients had positive BAL galactomannan. Antifungal therapy was commenced or continued in 29 of these patients either as targeted or pre‐emptive treatment. Using a cut‐off of ≥ 0.5 for serum galactomannan, the sensitivity and specificity were 9.7% and 99.7%, respectively. In total, four patients had a positive serum galactomannan. All four patients were either already on antifungal treatment for IA or were started before the serum galactomannan result was available, supported by laboratory, clinical, and radiological findings. A positive serum galactomannan was used to monitor treatment response in one patient.Serum galactomannan is not a valuable test in the diagnosis of IA in our LTx recipients, is costly, and does not remove the need for bronchoscopy and BAL galactomannan. This supports the ISHLT recommendation. [ABSTRACT FROM AUTHOR]

Guar is a legume of industrial importance due to the presence of gum (galactomannan) in its seed endosperm. The mannose (M)/galactose (G) ratio in the galactomannan molecule is critical in deciding the physico-chemical properties of guar gum. We report down regulation of galactomannan galactosyltransferase (GMGT) which links G residues to the M backbone in the galactomannan molecule. The RNAi cassette containing the sense-antisense sequence for gmgt was delivered into guar variety RGC-936 using Agrobacterium tumefaciens-mediated gene transfer. Maximum number of putative transformed shoots regenerated from the cotyledonary node explants cultured in vitro on Murashige and Skoog (MS) medium containing 1.5 mg/L indole-3-acetic acid (IAA), 4.0 mg/L butyric acid (BA) and 1.0 mg/L gibberellic acid (GA3). In vitro regenerated shoots were rooted on half-strength MS medium containing 4% sucrose and 2 mg/L indole-3-butyric acid (IBA). The quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) analysis showed reduced levels of GMGT expression in the seed endosperm of 35 days after flowering (DAF) stage pods. The present findings are expected to be beneficial in taking up gene characterization and agronomic traits improvement studies in guar. [ABSTRACT FROM AUTHOR]

Background: Invasive fungal disease (IFD) is a sinister complication encountered in patients with haematological disorders. When occurring in the central nervous system (CNS), IFDs can have catastrophic outcomes. Objectives: To study the clinical presentation, predisposing etiological factors, and prognosis of a CNS‐IFD in a patient with a haematological disorder. Patients and Methods: This is a retrospective study focusing on the clinical profile, diagnosis, treatment strategy and outcomes of 43 patients with an underlying haematological disorder, who were diagnosed with CNS‐IFD between 2018 and 2022. Results: Of the 43 patients, 18 were chemotherapy recipients, while 23 were stem cell transplant (SCT) recipients and 2 presented with CNS‐IFD at diagnosis. AML/MDS (37.2%) and ALL (18.6%) were the predominant underlying diagnoses. A sudden deterioration in sensorium (53.5%) was the earliest clinical sign, while T2 hyperintensities (26.8%), vascular involvement (26.8%) and ring‐enhancing lesions (16.3%) were the commonest radiological findings, with all patients exhibiting diffusion restriction in diffusion‐weighted images. Microbiological evidence of infection was obtained in all patients; however, culture positivity was established in only 25 patients. Rhizopus spp (23.2%) and Aspergillus spp (20.9%) were implicated in most cases. Overall survival of the cohort was 27.9% at a median follow‐up of 6 months. In patients who succumbed, the median time to death was 4 days (0–46). Conclusion: CNS‐IFD is associated with very poor survival in patients undergoing chemotherapy or an SCT, urging the need for prompt diagnosis and initiation of suitable antifungal therapy. [ABSTRACT FROM AUTHOR]

Carob (Ceratonia siliqua) seeds are rich in diverse bioactive compounds, including galactomannan, β-sitosterol, unsaturated fatty acids and proteins with bioactive peptides in their sequence. This study delineates the compositional characterization of six carob seed flour types derived from different production processes, providing valuable insights for designing tailored nutraceutical products based on desired bioactive compound profiles. Our analysis indicated that a higher purity of galactomannan resulted in a greater mannose/galactose ratio, which increased the linearity of the galactomannan polymer and could enhance interchain interaction, thereby increasing aggregation capacity. A higher viscosity could potentially increase the capacity of galactomannan to create satiety and lower cholesterol levels. Among the different tested flours, those whose main compound was the endosperm were optimal for containing high galactomannan content, whereas those derived from the germ were ideal for having high concentrations of fatty acids (i.e., oleic and linoleic acids) and β-sitosterol. The presence of these lipids in carob flours could offer cardiovascular and metabolic health benefits, contributing synergistically. Additionally, flours that contain the germ have beneficial peptides included in proteins like glycinin and conglutin with potential anticholesterolemic and antidiabetic properties. This work provides different methods for obtaining carob flours rich in bioactive compounds, offering the nutraceutical industry a framework to select the best option for industrial-scale production. [ABSTRACT FROM AUTHOR]

Fenugreek (Trigonella foenum-graecum L.) is an annual, dicotyledonous medicinal plant which belongs to the Leguminosae family, and its leaves and seeds are widely used and cultivated throughout the world. Their widespread utilization is attributed to the great variety of primary and secondary metabolites they contain, such as flavonoids, alkaloids, steroidal saponins, tannins, as well as carbohydrates, in particular galactomannan, which is the focus of the current study. The presence of an equal number of galactose and mannose residues (Gal/Man ratio of 1:1) prevents the formation of hydrogen bonds between the mannose ones. This determines the good solubility of fenugreek galactomannan in cold water, even at low concentrations. The water solubility would be significantly better than that of carob and even slightly higher than that of guar gum, precisely due to their structural characteristics, which contribute to their possible advantages. Moreover, it is a good alternative as an excipient for the development of pharmaceutical dosage forms, as well as in the preparation of food products, affecting not only their structure but also their shelf life. Furthermore, it has promising applications not only in the fields of medicine and pharmaceutics but also offers environmental benefits. All of the above-mentioned factors are of high interest and qualify fenugreek galactomannan as a versatile polysaccharide, which is the reason for summarizing its benefits in this review.

Background and Objectives The serum galactomannan test (GM test) and the (1,3)-β-D-glucan test (G test) are utilized in diagnosing invasive fungal sinusitis. However, their effectiveness in detecting paranasal sinus fungus balls (FBs) has not been established. This study aimed to explore their diagnostic value in patients with FBs. Methods We retrospectively reviewed the medical records of 105 patients (42 with FBs and 63 with chronic rhinosinusitis [CRS]) who underwent serum GM and G tests between June 2020 and May 2021. Olfactory test results and demographics were also analyzed. Results There were 42 FB patients (10 men, 32 women) and 63 CRS patients (27 men, 36 women). The positivity rates for serum GM (7.1% in the FB group vs. 3.2% in the CRS group, p=0.640) and G test (9.5% in the FB group vs. 11.1% in the CRS group, p=0.482) did not differ significantly between groups. The sensitivities of the GM and G tests were 7.1% and 9.5%, respectively, and their specificities were 96.8% and 88.9%, respectively. The positive predictive values were 60.0% for the GM test and 36.3% for the G test, and the negative predictive values were 61.0% for the GM test and 59.6% for the G test. Conclusion Serum GM and G tests demonstrated low sensitivity and high specificity, indicating limited effectiveness in differentiating between patients with FBs and those with CRS. Histological examination remains the gold standard for the definitive diagnosis of FBs.

Fenugreek (Trigonella foenum-graecum L.) is an annual, dicotyledonous medicinal plant which belongs to the Leguminosae family, and its leaves and seeds are widely used and cultivated throughout the world. Their widespread utilization is attributed to the great variety of primary and secondary metabolites they contain, such as flavonoids, alkaloids, steroidal saponins, tannins, as well as carbohydrates, in particular galactomannan, which is the focus of the current study. The presence of an equal number of galactose and mannose residues (Gal/Man ratio of 1:1) prevents the formation of hydrogen bonds between the mannose ones. This determines the good solubility of fenugreek galactomannan in cold water, even at low concentrations. The water solubility would be significantly better than that of carob and even slightly higher than that of guar gum, precisely due to their structural characteristics, which contribute to their possible advantages. Moreover, it is a good alternative as an excipient for the development of pharmaceutical dosage forms, as well as in the preparation of food products, affecting not only their structure but also their shelf life. Furthermore, it has promising applications not only in the fields of medicine and pharmaceutics but also offers environmental benefits. All of the above-mentioned factors are of high interest and qualify fenugreek galactomannan as a versatile polysaccharide, which is the reason for summarizing its benefits in this review. [ABSTRACT FROM AUTHOR]

Purpose: To identify pathogenic microorganisms and microbiological risk factors causing high morbidity and mortality in immunocompromised patients requiring invasive mechanical ventilation due to pneumonia. Methods: A retrospective single-center study was performed at the intensive care unit (ICU) of the Department of Internal Medicine at Heidelberg University Hospital (Germany) including 246 consecutive patients with hematological malignancies requiring invasive mechanical ventilation due to pneumonia from 08/2004 to 07/2016. Microbiological and radiological data were collected and statistically analyzed for risk factors for ICU and 1-year mortality. Results: ICU and 1-year mortality were 63.0% (155/246) and 81.0% (196/242), respectively. Pneumonia causing pathogens were identified in 143 (58.1%) patients, multimicrobial infections were present in 51 (20.7%) patients. Fungal, bacterial and viral pathogens were detected in 89 (36.2%), 55 (22.4%) and 41 (16.7%) patients, respectively. Human herpesviruses were concomitantly reactivated in 85 (34.6%) patients. As significant microbiological risk factors for ICU mortality probable invasive Aspergillus disease with positive serum-Galactomannan (odds ratio 3.1 (1.2-8.0), p = 0.021,) and pulmonary Cytomegalovirus reactivation at intubation (odds ratio 5.3 (1.1–26.8), p = 0.043,) were identified. 1-year mortality was not significantly associated with type of infection. Of interest, 19 patients had infections with various respiratory viruses and Aspergillus spp. superinfections and experienced high ICU and 1-year mortality of 78.9% (15/19) and 89.5% (17/19), respectively. Conclusions: Patients with hematological malignancies requiring invasive mechanical ventilation due to pneumonia showed high ICU and 1-year mortality. Pulmonary Aspergillosis and pulmonary reactivation of Cytomegalovirus at intubation were significantly associated with negative outcome. [ABSTRACT FROM AUTHOR]

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Galactomannans are polysaccharides commonly extracted from the endosperm of various leguminous seeds, exhibiting variations in their man/gal ratio based on their botanical origin. These gums are highly valued for their biodegradability and excellent stability. However, their applications have been limited due to their high viscosity and molecular weight. In this study, enzymatic and ultrasound depolymerisation of galactomannans (guar gum, locust bean gum, and unconventional Neltuma ruscifolia seed gum) was carried out, resulting in hydrolysates, which were subsequently freeze-dried and characterised. The hydrolysis process leads to a decrease in viscosity and molecular weight, accompanied by a noticeable increase in polydispersity through enzymatic treatment. Thin-layer chromatography (TLC) analysis indicates the generation of at least eight-membered subunits. Fourier-transform infrared (FT-IR) spectroscopy analysis demonstrates no significant changes in functional groups following ultrasound hydrolysis. Furthermore, in agreement with TLC results, enzymatic hydrolysates display partial reactivity towards non-enzymatic browning (NEB), yielding mostly intermediate products with limited browning development. This study diversifies potential applications of these gums in different industries. [ABSTRACT FROM AUTHOR]

Background: Galactomannan (GM) testing using Platelia Aspergillus enzyme immunoassay (Platelia AGM) from bronchoalveolar lavage fluid (BALF) aids in early diagnosis of invasive pulmonary aspergillosis (IPA). Globally, only a minority of laboratories have the capability to perform on-site GM testing, necessitating accessible and affordable alternatives. Hence, we conducted a comparative evaluation of the new clarus Aspergillus GM enzyme immunoassay prototype (clarus AGM prototype) with Platelia AGM using BALF samples. Methods: This is a single-center, prospective, cross-sectional study, where Platelia AGM testing was routinely performed followed by clarus AGM prototype testing in those with true positive or true negative AGM test results according to the 2020 EORTC/MSG and the 2024 FUNDICU consensus definitions. Descriptive statistics, ROC curve analysis, and Spearman’s correlation analysis were used to evaluate analytical performance of the clarus AGM prototype assay. Results: This study enrolled 259 adult patients, of which 53 (20%) were classified as probable IPA, while 206 did not fulfill IPA-criteria. Spearman's correlation analysis revealed a strong correlation between the two assays (rho = 0.727, p < 0.001). The clarus AGM prototype had a sensitivity of 96% (51/53) and a specificity of 74% (153/206) for differentiating probable versus no IPA when using the manufacturer recommended cut-off. ROC curve analysis showed an AUC of 0.936 (95% CI 0.901–0.971) for the clarus AGM prototype, while the Platelia AGM yielded an AUC of 0.918 (95% CI 0.876–0.959). Conclusions: Clarus AGM prototype demonstrated a strong correlation and promising test performance, comparable to Platelia AGM, rendering it a viable alternative in patients at risk of IPA. [ABSTRACT FROM AUTHOR]

The replacement of synthetic chemical herbicides and traditional plastic sheets is a major challenge of modern horticulture in view of a sustainable weed management. In the first step of this research, we tested the weed control efficacy of two biodegradable polymers, chitosan and galactomannan, applied to the soil surface as spray mulching, with or without the addition of charcoal as a light masking agent, and five essential oils with recognized herbicide properties. The results showed the ability of chitosan in reducing the number and the biomass of annual plants, regardless of the addition of charcoal and essential oils. In the second step, we tested the efficacy of one or three days of false seeding to increase the effectiveness of chitosan against seed germination. The results showed, on average, a reduction of 79% of annual weed presence after three days of false seeding. In both steps, the microbial biomass and three indicators of microbial activity (i.e., basal respiration, FDA hydrolysis activity, and D-glucosamine-induced respiration) were measured in the soil under the experiments in order to investigate possible alterations of soil biological activity induced by the treatments. The results provided no evidence of negative impact of the treatments on soil microbial biomass and activity. [ABSTRACT FROM AUTHOR]

Background Coronavirus disease 2019 (COVID-19)–associated pulmonary aspergillosis (CAPA) is a life-threatening fungal infection. Studies focusing on CAPA in low- and middle-income countries are limited. Methods This retrospective matched case-control study was conducted at a tertiary care center in South India. Cases of CAPA were classified using the 2020 European Confederation of Medical Mycology/International Society for Human and Animal Mycology consensus criteria. A total of 95 cases were matched 1:1 with COVID-19 patients without CAPA. Matching was done based on age and period of admission. Inverse probability weighting was used to account for imbalances in COVID-19 severity and intensive care unit (ICU) admission. Data on demographics, clinical details, microbiologic and radiologic data, and treatment outcomes were collected. A predictive score for CAPA was developed from baseline risk factors. Results The predictive score identified lymphopenia, European Organisation for Research and Treatment of Cancer risk factors, and broad-spectrum antibiotic use as the main risk factors for CAPA. Positivity for bacterial pathogens in blood or bronchoalveolar lavage samples reduced the risk of CAPA. The predictive model performed well in cross-validation, with an area under the curve value of 82%. CAPA diagnosis significantly increased mortality and shift to ICU. Conclusions The predictive model derived from the current study offers a valuable tool for clinicians, especially in high-endemic low- and middle-income countries, for the early identification and treatment of CAPA. With further validation, this risk score could improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background: The performance of serum galactomannan (GM) for the diagnosis of invasive aspergillosis (IA) has been studied mainly in adults. Paediatric data are scarce and based on small and heterogeneous cohorts. Objective: To evaluate the performance of serum GM for the diagnosis of IA in a paediatric oncologic population at high risk of IA and to clarify the impact of antifungal prophylaxis on this test. Methods: We performed a retrospective study from January 2014 to December 2020 in the paediatric oncologic haematologic department of the University Hospital of Bordeaux. The diagnosis of IA was made using the recommendations of the EORTC and the MSGERC. Results: Among the 329 periods at high risk of IA in 222 patients, the prevalence of IA was 1.8% (3 proven and 3 probable IA). In the total population, the sensitivity, and the positive predictive value (PPV) were respectively 50% and 17.6%. Under antifungal prophylaxis, the sensitivity and PPV dropped, respectively, to 33.3% and 14.3%. In this group, the post‐test probability of IA was 2% for a negative serum GM and only 14%. Conclusion: In this large cohort of children at high risk of IA, the incidence of IA is low and the diagnostic performance of GM is poor, especially in the case of mould‐active prophylaxis. Screening should be targeted rather than systematic and should be reserved for patients at highest risk for IA without mould‐active prophylaxis. Combination with other tests such as Aspergillus PCR would increase the accuracy of GM in screening setting. [ABSTRACT FROM AUTHOR]

Aim: Using atenolol as a model active pharmaceutical and galactomannan from the seeds of Trigonella foenumgraecum as a mucoadhesive polymer, an effort was made to develop a gastroretentive bioadhesive floating delivery system to improve the residence time in the stomach. Materials and Methods: Different formulations were made with Hydroxypropyl Methyl Cellulose (HPMC) and galactomannan. Galactomannan was chosen because of its exceptional swelling properties in aqueous environments. In this investigation, citric acid and sodium bicarbonate were utilized as gas-producing components. Pre- and postcompression evaluations were performed on the manufactured tablets. The floating properties as well as the atenolol release pattern were investigated. Results: The extracted polymer was characterized using various techniques and found to be similar to literature. The results from GC analysis showed a residual acetone content of 0.127 ppm, indicating that the extracted polymer is safer to use in the formulation of gastroretentive tablets. The physicochemical properties of the manufactured tablets were satisfactory in terms of swelling index, release characteristics, and buoyancy pattern. All of the manufactured batches had adequate in vitro buoyancy. The gastroretentive tablet exhibited axial and radial swelling throughout the in vitro buoyancy test. According to the testing, the formulation remained buoyant for approximately 8 to 12 hr. Conclusion: According to the results of the evaluation, the manufactured tablet has a pleasing look, is heat stable, and is therapeutically efficient. F3 was determined to be the optimal formulation based on the data collected. [ABSTRACT FROM AUTHOR]

Ovalbumin (OVA) is the primary allergenic protein, associated with T helper 2 (Th2)-mediated allergy reactions. Here, we studied OVA’s conformational structure, digestibility, and allergenic potency upon galactomannan (Man) conjugation along with transglutaminase-catalyzed crosslinking (TG-Man/OVA) and tyrosinase/caffeic acid-catalyzed crosslinking (Tyr-Man/OVA). Enzymatic glycosylation altered OVA’s conformation and enhanced the gastrointestinal digestibility. Stimulation of bone marrow-derived dendritic cells (BMDCs) with enzymatically glycosylated OVA reduced the expression of CD40, CD80, CD86 and MHC class II molecules. Furthermore, glycosylated OVA increased IL-10 production while suppressing proinflammatory cytokine production in BMDCs. In an OVA-induced mouse asthma model, TG-Man/OVA and Tyr-Man/OVA upregulated IFN-γ and IL-10 expression and downregulated IL-4, IL-5, and IL-13 in lungs. Crosslinked OVA diminished infiltrated cells in bronchoalveolar lavage fluid and lung and attenuated eosinophilic airway inflammation. These findings offer valuable insights into the development of a novel product with improved hypoallergenic and immunomodulatory properties and hold promise in attenuating allergic diseases.

Aspergillus is a ubiquitous saprophytic mold that humans and animals constantly inhale. In health, the conidia are eliminated by the innate immune system. However, a subset of individuals with risk factors such as neutropenia, receiving high doses of glucocorticoids or certain biologicals, and recipients of hematopoietic or solid-organ transplants develop invasive aspergillosis. The mortality associated with invasive aspergillosis is 42%–64%. The early diagnosis of invasive pulmonary aspergillosis in patients without classical risk factors remains challenging. We present a case of an elderly female with uncontrolled diabetes mellitus who presented with acute-onset chest pain, breathlessness, and cough without expectoration. On evaluation, her chest radiograph showed a mass lesion in the right upper zone. 18Fluorodeoxyglucose (FDG)-positron emission tomography-computed tomography showed two FDG-avid lesions in the apical and medial segment of the right upper lobe. The lung biopsy was negative for malignancy; however, she was diagnosed with invasive pulmonary aspergillosis based on serum and bronchoalveolar fluid galactomannan positivity. She was managed with voriconazole with complete resolution of the lesion.

Abstract Background Acute leukaemias (AL) are life-threatening blood cancers that can be potentially cured with treatment involving myelosuppressive, multiagent, intensive chemotherapy (IC). However, such treatment is associated with a risk of serious infection, in particular invasive fungal infection (IFI) associated with prolonged neutropenia. Current practice guidelines recommend primary antifungal (AF) prophylaxis to be administered to high-risk patients to reduce IFI incidence. AFs are also used empirically to manage prolonged neutropenic fever. Current strategies lead to substantial overuse of AFs. Galactomannan (GM) and β-D-glucan (BG) biomarkers are also used to diagnose IFI. Combining both biomarkers may enhance the predictability of IFI compared to administering each test alone. Currently, no large-scale randomised controlled trial (RCT) has directly compared a biomarker-based diagnostic screening strategy without AF prophylaxis to AF prophylaxis (without systematic biomarker testing). Methods BioDriveAFS is a multicentre, parallel, two-arm RCT of 404 participants from UK NHS Haematology departments. Participants will be allocated on a 1:1 basis to receive either a biomarker-based antifungal stewardship (AFS) strategy, or a prophylactic AF strategy, which includes existing standard of care (SoC). The co-primary outcomes will be AF exposure in the 12-month post randomisation and the patient-reported EQ-5D-5L measured at 12-month post randomisation. Secondary outcomes will include total AF exposure, probable/proven IFI, survival (all-cause mortality and IFI mortality), IFI treatment outcome, AF-associated adverse effects/events/complications, resource use, episodes of neutropenic fever requiring hospital admission or outpatient management, AF resistance in fungi (non-invasive and invasive) and a Desirability of Outcome Ranking. The trial will have an internal pilot phase during the first 9 months. A mixed methods process evaluation will be integrated in parallel to the internal pilot phase and full trial, aiming to robustly assess how the intervention is delivered. Cost-effectiveness analysis will also be performed. Discussion The BioDriveAFS trial aims to further the knowledge of strategies that will safely optimise AF use through comparison of the clinical and cost-effectiveness of a biomarker-led diagnostic strategy versus prophylactic AF to prevent and manage IFI within acute leukaemia. The evidence generated from the study will help inform global clinical practice and approaches within antifungal stewardship. Trial registration ISRCTN11633399. Registered 24/06/2022.

Invasive Aspergillosis (IA) is a severe and fatal infection, especially in immunocompromised patients. Galactomannan is a polysaccharide antigen present in the cell wall of Aspergillus species, which is secreted into the blood and other body fluids during hyphal growth. Therefore, detecting galactomannan antigen is very useful in diagnosing IA, along with clinical features and radiological findings. The study period was one year (January 2022 to December 2022). The data was collected retrospectively from the medical records and case sheets of all clinically suspected invasive aspergillosis patients. Galactomannan antigen assay was performed using an FDA-approved Platelia Aspergillus EIA test kit, and results were interpreted according to the manufacturer’s instructions (Cut off > 0.5). A total of 236 clinically suspected Invasive Aspergillosis cases were enrolled in the study. Galactomannan positivity was predominantly seen in patients aged 40 – 60 years, with male preponderance. Of 236 patients, 14.40% were immunocompromised, and 85.59% were immunocompetent. According to EORTC/MSG definitions, we got one proven IA case, 21 probable cases (8.89%), and nine (3.81%) possible cases. In immunocompetent individuals also, we observed 48.72% (115/236) galactomannan positivity, especially in old Pulmonary Tuberculosis (PTB) patients. Galactomannan positivity was higher in Broncho alveolar lavage (BAL) samples (n=70, 85.36%) than in serum samples (n=77, 46.67%). We found culture positivity of 14.06%, with Aspergillus fumigatus being the commonest isolate, followed by Aspergillus flavus. There is increased positivity of galactomannan in BAL samples compared to serum; hence BAL is a better specimen for diagnosis of Invasive Pulmonary Aspergillosis (IPA).

Background: Acute leukaemias (AL) are life-threatening blood cancers that can be potentially cured with treatment involving myelosuppressive, multiagent, intensive chemotherapy (IC). However, such treatment is associated with a risk of serious infection, in particular invasive fungal infection (IFI) associated with prolonged neutropenia. Current practice guidelines recommend primary antifungal (AF) prophylaxis to be administered to high-risk patients to reduce IFI incidence. AFs are also used empirically to manage prolonged neutropenic fever. Current strategies lead to substantial overuse of AFs. Galactomannan (GM) and β-D-glucan (BG) biomarkers are also used to diagnose IFI. Combining both biomarkers may enhance the predictability of IFI compared to administering each test alone. Currently, no large-scale randomised controlled trial (RCT) has directly compared a biomarker-based diagnostic screening strategy without AF prophylaxis to AF prophylaxis (without systematic biomarker testing). Methods: BioDriveAFS is a multicentre, parallel, two-arm RCT of 404 participants from UK NHS Haematology departments. Participants will be allocated on a 1:1 basis to receive either a biomarker-based antifungal stewardship (AFS) strategy, or a prophylactic AF strategy, which includes existing standard of care (SoC). The co-primary outcomes will be AF exposure in the 12-month post randomisation and the patient-reported EQ-5D-5L measured at 12-month post randomisation. Secondary outcomes will include total AF exposure, probable/proven IFI, survival (all-cause mortality and IFI mortality), IFI treatment outcome, AF-associated adverse effects/events/complications, resource use, episodes of neutropenic fever requiring hospital admission or outpatient management, AF resistance in fungi (non-invasive and invasive) and a Desirability of Outcome Ranking. The trial will have an internal pilot phase during the first 9 months. A mixed methods process evaluation will be integrated in parallel to the internal pilot phase and full trial, aiming to robustly assess how the intervention is delivered. Cost-effectiveness analysis will also be performed. Discussion: The BioDriveAFS trial aims to further the knowledge of strategies that will safely optimise AF use through comparison of the clinical and cost-effectiveness of a biomarker-led diagnostic strategy versus prophylactic AF to prevent and manage IFI within acute leukaemia. The evidence generated from the study will help inform global clinical practice and approaches within antifungal stewardship. Trial registration: ISRCTN11633399. Registered 24/06/2022. [ABSTRACT FROM AUTHOR]

Background: Serum galactomannan (GM) testing is essential for diagnosing invasive aspergillosis (IA), particularly in immunocompromised individuals. The global lack of on‐site GM testing capacities necessitates cost‐effective alternatives, such as.the clarus Aspergillus GM enzyme immunoassay prototype (clarus AGM prototype). Methods: This single‐centre, cross‐sectional study compared the diagnostic performance of the clarus AGM prototype (IMMY, Norman, Oklahoma) with the serological gold standard (=Platelia AGM assay; Bio‐Rad, Marnes‐la‐Cocquette, France). IA was classified according to modified 2020 EORTC/MSG consensus and 2024 FUNDICU criteria. In total, 300 prospectively (May‐Dec 2023) and retrospectively (2012–2015) collected samples were included. Results: Among 300 samples from 232 patients, 49 (16%) were classified as proven (n = 1) or probable IA (n = 48). In non‐IA cases (n = 250), one patient was classified as possible IA. With the manufacturer recommended cut‐off of ≥0.2, sensitivity and specificity of the clarus AGM prototype were 27% (13/49; 95% confidence interval [CI]: 15%–41%) and 99% (248/250; 95% CI: 97%–100%), respectively, while sensitivity and specificity were 78% and 79% when using the optimised Youden's cut‐off of 0.0045 ODI. ROC curve analysis demonstrated an area under the curve (AUC) of 0.829 (95% CI: 0.760–0.898) for the clarus AGM prototype in distinguishing between proven/probable IA and non‐IA. The AUC for the Platelia AGM was 0.951 (95% CI: 0.909–994). Spearman's correlation analysis showed a weak correlation between the two assays (0.382; p <.001). Conclusions: The weak correlation between the clarus AGM prototype and Platelia AGM highlights the need for further investigation into the clinical performance of the clarus AGM prototype, giving the different antigen epitopes addressed. [ABSTRACT FROM AUTHOR]

Histoplasmosis is a global infection caused by the thermally dimorphic fungus, Histoplasma capsulatum complex. It is endemic in the United States, as well as in Central and South America. In Taiwan, histoplasmosis is rare, with the first reported case not occurring until 1977. We summarized a total of 17 cases reported in Taiwan over the past 40 years and provided detailed descriptions for four probable indigenous cases. Due to the lack of rapid diagnostic tools and clinical suspicion, histoplasmosis may be underdiagnosed in Taiwan. We recognize that a limitation of our review is the lack of data on the environmental surveillance for H. capsulatum complex in Taiwan. Conducting a further phylogenetic analysis on both environmental and clinical isolates would provide valuable evidence for the region. [ABSTRACT FROM AUTHOR]

Multidrug resistant strains and fungi add to treatment conundrums in skull base osteomyelitis (SBO). Deep tissue culture in these patients is challenging due to their advanced age and co-morbidities. Besides, fungal culture positivity is seen only in 60% of invasive aspergillosis. To determine the efficacy of a minimally invasive test—Serum Galactomannan (sGM)–for diagnosing fungal SBO. Prospective observational study. Thirty- three patients, clinically diagnosed with SBO were included in this study. Baseline ESR (Erythrocyte Sedimentation Rate), CRP (C- Reactive Protein), pain score, and sGM were noted for all patients. Antifungal Voriconazole was initiated on patients if the sGM values were more than 0.8. At the 12th week of treatment, all parameters were repeated and compared with the baseline values. A significant reduction was noted in ESR, CRP, and pain scores at the 12th week of treatment compared to the baseline values in patients with raised sGM values who were started on Voriconazole. For a culture-proven fungal skull base osteomyelitis with a cut-off value of sGM > / = 0.8, the obtained sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 81.82, 36.36, 39.13, 80 and 51.52% respectively. At a cut-off value of sGM > / = 01.6, the values of sensitivity/specificity, PPV, NPV and accuracy were 81.82/72.73%, 60%, 88.89% and 75.76%. Culture-negative patients in SBO with sGM value > 0.8 were more likely to be fungal SBO. An sGM cut-off of 1.6 was observed to give maximum accuracy for diagnosing fungal SBO. [ABSTRACT FROM AUTHOR]

Galactomannans are polysaccharides obtained from legume seed extraction. They present a chemical structure consisting of D-mannose chains linked by glycosidic bonds and galactose branches. The main focus lies in their use as thickeners in the food industry, aimed at improving the dielectric properties of food during heating processes within the radiofrequency and microwave ranges. In this work, the prepared galactomannan samples were electrically analyzed through impedance spectroscopy, which is a powerful physical technique. From the experimental measurements, the dielectric permittivity and loss tangent of the galactomannan solutions were analyzed and the electrical modulus formalism was used to study the dielectric relaxations. Crude galactomannans exhibited higher values of permittivity, conductivity, and losses compared to purified galactomannans. Increasing ethanol concentration in galactomannan purification causes an increase in the permittivity and conductivity of galactomannan solutions. In a 1% solution, at 1 kHz, the permittivity increased from 378.56 to 538.09, while in the 2% solution, this increase was from 656.22 to 1103.24. Regarding the conductivity, at the same frequency, the increase was from 1.6 × 10−3 to 3.3 × 10−3 Ω−1m−1 and from 2.9 × 10−3 to 5.5 × 10−3 Ω−1m−1, respectively. The rise of the ethanol concentration in galactomannan purification led to a decrease in the relaxation time, from 448.56 to 159.15 μs and from 224.81 to 89.50 μs in the solution with 1 and 2%, respectively. The results suggest that galactomannan from Adenanthera pavonina L. has potential for use in the food industry. [ABSTRACT FROM AUTHOR]

Invasive Aspergillosis (IA) is a severe and fatal infection, especially in immunocompromised patients. Galactomannan is a polysaccharide antigen present in the cell wall of Aspergillus species, which is secreted into the blood and other body fluids during hyphal growth. Therefore, detecting galactomannan antigen is very useful in diagnosing IA, along with clinical features and radiological findings. The study period was one year (January 2022 to December 2022). The data was collected retrospectively from the medical records and case sheets of all clinically suspected invasive aspergillosis patients. Galactomannan antigen assay was performed using an FDA-approved Platelia Aspergillus EIA test kit, and results were interpreted according to the manufacturer’s instructions (Cut off > 0.5). A total of 236 clinically suspected Invasive Aspergillosis cases were enrolled in the study. Galactomannan positivity was predominantly seen in patients aged 40 – 60 years, with male preponderance. Of 236 patients, 14.40% were immunocompromised, and 85.59% were immunocompetent. According to EORTC/MSG definitions, we got one proven IA case, 21 probable cases (8.89%), and nine (3.81%) possible cases. In immunocompetent individuals also, we observed 48.72% (115/236) galactomannan positivity, especially in old Pulmonary Tuberculosis (PTB) patients. Galactomannan positivity was higher in Broncho alveolar lavage (BAL) samples (n=70, 85.36%) than in serum samples (n=77, 46.67%). We found culture positivity of 14.06%, with Aspergillus fumigatus being the commonest isolate, followed by Aspergillus flavus. There is increased positivity of galactomannan in BAL samples compared to serum; hence BAL is a better specimen for diagnosis of Invasive Pulmonary Aspergillosis (IPA). [ABSTRACT FROM AUTHOR]

The golden spice turmeric with its main bioactive component curcumin is one of the most popular and extensively studied nutraceuticals. Despite numerous pre-clinical studies reporting positive pharmacodynamics of turmeric extracts and curcumin, the main issues in translating the pharmacological effects to clinical efficacy have been to overcome its poor pharmacokinetics and to deliver significant amounts of the biologically relevant forms of the actives to various tissues. This review is aimed at providing a first critical evaluation of the current published literature with the novel curcumagalactomannoside (CGM) formulation of curcumin using fenugreek galactomannan dietary fibre, specifically designed to address curcumin poor pharmacokinetics. We describe CGM and its technology as a food-grade formulation to deliver 'free' unconjugated curcuminoids with enhanced bioavailability and improved pharmacokinetic properties. The therapeutic relevance of improving bioavailability of 'free' curcuminoids and some of the technical challenges in the measurement of the 'free' form of curcuminoids in plasma and tissues are also discussed. A total of twenty-six manuscripts are reviewed here, including fourteen pre-clinical and twelve clinical studies that have investigated CGM pharmacokinetics, safety and efficacy in various animal models and human conditions. Overall current scientific evidence suggests CGM formulation has improved bioavailability and tissue distribution of the biologically relevant unconjugated forms of turmeric actives called 'free' curcuminoids that may be responsible for the superior clinical outcomes reported with CGM treatments in comparison with unformulated standard curcumin across multiple studies. [ABSTRACT FROM AUTHOR]

The impact of invasive pulmonary aspergillosis (IPA) on non-neutropenic critically ill patients in intensive care units (ICU) has been demonstrated in recent decades. Furthermore, after the start of the COVID-19 pandemic, COVID-19 associated with pulmonary aspergillosis (CAPA) has become a major concern in ICUs. However, epidemiological data from different regions are scarce. We evaluated the prevalence and clinical-epidemiological data of IPA in patients with COVID-19 requiring mechanical ventilation (MV) in the ICU (“severe COVID-19”) and non-COVID ICU patients in MV of a tertiary hospital in the southern region of Brazil. Eighty-seven patients admitted between June 2020 and August 2022 were included; 31 with severe COVID-19. For the diagnosis of IPA or CAPA, algorithms including host factors and mycological criteria (positive culture for Aspergillus spp., immunoassay for galactomannan detection, and/or qPCR) were utilized. The overall incidence of IPA and CAPA in our ICU was 73 cases/1000 ICU hospitalizations. Aspergillosis occurred in 13% (4/31) of the COVID-19 patients, and in 16% (9/56) of the critically ill patients without COVID-19, with mortality rates of 75% (3/4) and 67% (6/9), respectively. Our results highlight the need for physicians enrolled in ICU care to be aware of aspergillosis and for more access of the patients to sensitive and robust diagnostic tests by biomarkers detection. [ABSTRACT FROM AUTHOR]

Simple Summary: There are many causes of discospondylitis (infection in the discs and neighboring bones in the vertebral column), and it can be difficult to identify the relevant infection in all cases. In this study, we report the diseases we detected after recommending a specific series of tests to owners of affected dogs in this Brucella canis endemic region of the world. We found a moderate proportion (~12%) of cases that had Brucella canis infection (which is infectious to people) and suspected fungal infection (which can be very difficult to treat). Blood cultures were frequently (39%) positive for an infectious agent. The outcome for most cases, even those with suspected fungal disease, was good. It appears that blood culture is a helpful diagnostic method, and stabilizing implants can be safely used even when there is bone infection. Our results suggest that both fungal and Brucella spp. infections may be moderately common causes of discospondylitis in dogs in the USA, where Brucella canis is endemic. Discospondylitis is a well-recognized disease in dogs, but the relative prevalence of causal infectious agents and efficiency of relevant diagnostic tests are not well-established. Medical record review identified 117 dogs diagnosed with discospondylitis in our clinic over a 5-year period. In 32 dogs, discospondylitis was diagnosed as an incidental imaging finding; 24 of these dogs had concomitant neoplasia. A likely causal infection was identified in 45 of the remaining 85 dogs in which blood and urine cultures, serology for Brucella spp., and galactomannan fungal antigen testing were recommended. Ten dogs were diagnosed with Brucella canis, and ten were diagnosed with suspected fungal infection. Brucella suis serology was negative in all 35 dogs that were tested. Blood cultures were positive in 28 of 71 (39%) tested dogs, and urine culture was positive in 12 of 79 (15%). Cultures were positive from the lesion site of four of eight dogs that underwent surgery and one of the five dogs that underwent image-guided lesion sample collection. Subluxation secondary to discospondylitis was stabilized with metallic implants in four dogs. A similar proportion of known satisfactory treatment outcomes at last follow-up were recorded in dogs that had suspected fungal disease, other bacterial infections, or were Brucella-positive and in those dogs with imaging diagnosis only, although some individuals continued to receive anti-microbial agents or showed recurrent signs. These data support the value of blood culture in discospondylitis and suggest a relatively high prevalence of infection with Brucella spp. and suspected fungal infection. [ABSTRACT FROM AUTHOR]

Biopolymers are gaining increased attention in the industry due to their unique characteristics, including being cost-effective, environmentally friendly, and biodegradable. It is also worth noting that natural polymers can be obtained in significant quantities from various renewable sources, whereas synthetic polymers are derived from non-renewable petroleum resources. Enhanced oil recovery (EOR) using biopolymers such as galactomannan, xanthan, welan gum, acacia gum, carboxy methyl cellulose, and corn starch is a developing trend and is projected to replace synthetic polymers (hydrophobically associated polyacrylamides) in the nearby future. The choice of polymers to be utilized in EOR technologies should be based on their cost and availability in addition to their functional properties. Biopolymers in enhanced oil recovery serve to enhance the mobility ratio by increasing the viscosity of displacing fluid and reducing permeability. Even though biopolymers have a tough structure and long polysaccharide chains that make them suitable for enduring severe reservoir conditions, they are highly susceptible to bacterial destruction. In this comprehensive review, we have illustrated the different techniques used to enhance the performance of biopolymers (xanthan gum, guar gum, and starch) in enhanced oil recovery and create new composites that can overcome the challenges faced by these biopolymers under reservoir conditions. We have found that the most famous and favorable techniques used in this approach are, grafting copolymerization, nanocomposites functionalization, amphiphilic style, and hydrogel formation. The review also discussed some other biopolymers (carboxy methyl cellulose, welan gum, and acacia gum) that can be utilized to improve oil recovery and evaluated how widely they have been applied in this field. In this review, we have addressed several important issues (knowledge gaps) that have not been covered in recent studies. We have also provided recommendations and prospects for the successful future implementation of these composites in the EOR field. In conclusion, we hope that this review will help in better understanding the use of these modified biopolymers for enhanced oil recovery (EOR). [ABSTRACT FROM AUTHOR]

Copyright of Food & Fermentation Industries is the property of Food & Fermentation Industries and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We studied patients diagnosed with aspergillosis based on positive bronchoalveolar lavage (BAL) Aspergillus galactomannan (GM) who had follow-up BAL sampling within 180 days. GM trend and clinical outcome were concordant in only 60% (30/50). While useful for the initial diagnosis, BAL GM trending does not always correlate with treatment response. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Chinese Institute of Food Science & Technology / Zhongguo Shipin Xuebao is the property of Journal of Chinese Institute of Food Science & Technology Periodical Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this work, it was obtained and characterized a gum extracted from Crotalaria Juncea seeds. For this purpose, 2³ factorial experimental design was performed to generate significant and predictive first-order mathematical models. It was evaluated how the independent variables used in the extraction processes (temperature, NaCl concentration and time) influenced the dependent variables (yield, organic matter content and viscosity). The yields were between 11 and 36 w/w% and the molar masses of the gum were between 7.499 × 105 and 1.448 × 106 g/mol, with average organic matter content of 72.76 w/w%. The characterization analyses confirmed the predominance of a galactomannan polysaccharide. Brine samples containing the gum with different ion concentrations had a pseudoplastic rheological profile, without alteration of the viscosity values with variation of the salt concentration in the brine, but the viscosity decreased with rising temperature. [ABSTRACT FROM AUTHOR]

Invasive Pulmonary Aspergillosis (IPA) is an important opportunistic infection in critically ill patients with various underlying risk factors and is associated with a high degree of morbidity and mortality. In recent years, it has been reported that the incidence of IPA has also increased in patients with chronic obstructive pulmonary disease (COPD). Aims & Objectives: The purpose of the study was to determine the Serum Galactomannan Assay positivity rate for Invasive Pulmonary Aspergillosis in Chronic Obstructive Pulmonary Disease patients and to study co-morbid conditions and risk factors for invasive aspergillosis. Materials & Methods: The study population included 56 patients admitted to PKTB hospital, Mysore with COPD/AECOPD. Serum Galactomannan antigen detection by ELISA was done in all subjects. Results: Serum Galactomannan assay positivity was seen in 10(17.85%) of the study population. The clinical features seen in the study population were dyspnea (98.2%), chest pain (98.2%), cough with expectoration (83.9%), Haemoptysis (12.5%), fever (10.7%), at the time of presentation. Nonspecific Consolidation(46%) comprised the major XRay finding followed by Diffuse Patchy Infiltration (29%). Comorbidities like Diabetes Mellitus (71.4%), Smoking (83.9%), prior administration of steroid (73.2%), past history of COPD (66.1%), Pulmonary Tuberculosis (10.71%) was seen in the study population. Conclusion: Serum GM assay could increase the diagnostic sensitivity for IPA in COPD patients. Further studies with attention to the assessment of antifungal therapy, false-positive results and utility of the test are needed. [ABSTRACT FROM AUTHOR]

Background Invasive fungal infections (IFI) mainly caused by aspergillus species are one of the leading causes of death in patients undergoing immunosuppressive therapy for hematological malignancies. The presence of galactomannan in bronchoalveolar lavage fluid (BAL GM) is an important diagnostic marker. Some of the factors affecting the BAL GM are still unknown. Antifungal treatment administered before or after BAL also affect BAL GM results. Methods To investigate the effect of BAL GM timing on the diagnosis of IFE, 100 patients receiving immunosuppressive therapy with hematological malignancy at the Uludağ University Faculty of Medicine, Hematology Department, and underwent BAL over a 3-year period with the suspicion of IFE as well as 127 BAL procedures of these patients were examined. Results There were 70 patients who started antifungal therapy before BAL and 30 patients who did not. BAL GM was found positive in 33 (47.1%) of the 70 patients who received antifungal therapy compared to 22 (73.3%) of the 30 patients who did not receive antifungal therapy. There was a significant difference between the two groups in terms of BAL GM positivity (p = 0.016). Subsequently, 127 BAL procedures of these 100 patients were evaluated. When the second, third, and subsequent BAL procedures of the same patients were included in the study, BAL GM was positive in 41 (46.6%) of the 88 procedures in patients who received treatment before BAL and in 25 (64.1%) of the 39 procedures in patients who did not receive treatment before BAL. The rate of BAL GM positivity did not differ between groups (p = 0.068). Conclusions The balance between reducing the risk by initiating early antifungal therapy and maximizing the diagnostic value of BAL GM should be evaluated individually for each patient. [ABSTRACT FROM AUTHOR]

The ascomycete filamentous fungus Neurospora intermedia is commonly used in the food industry and considered nonpathogenic to humans. This study characterizes four N. intermedia isolates recovered from three patients. The first patient had a mediastinal germ cell tumor with multiple metastases. N. intermedia was recovered from his endotracheal aspirate and from the endobronchial mass obtained by bronchoscopic forceps biopsy. Histopathology of the biopsy tissue revealed necrotic tissue mixed with septate fungal hyphae with right-angle branching. An endobronchial mass caused by N. intermedia was thus diagnosed. Another two N. intermedia isolates were recovered from the endotracheal aspirates of two critically ill patients. In vitro, N. intermedia grows rapidly and forms orange, conidiating colonies composed of septate hyphae. Two isolates from the first patient belong to mating type a; the other two isolates belong to mating type A. Coculture of isolates of opposite mating types yielded dark ascomata containing ascospores, supporting that N. intermedia is a heterothallic fungus. N. intermedia isolates cross-reacted with the Aspergillus galactomannan antigen assay and were susceptible to amphotericin B and voriconazole. In conclusion, this report describes the first human infection (endobronchial mass) caused by N. intermedia, highlighting its potential to invade the human respiratory tract.

ABSTRACT The Platelia Aspergillus Antigen immunoassay is the “gold standard” for Aspergillus galactomannan (GLM) measurement in sera and bronchoalveolar lavage (BAL) for the diagnosis of invasive pulmonary aspergillosis (IPA). We evaluated the performance of the Aspergillus GLM antigen Virclia Monotest compared to the Platelia assay. A total of 535 specimens [320 sera, 86 bronchial aspirates (BAs), 70 BAL, and 59 tracheal aspirates (TAs)] from 177 adult patients (72 hematological, 32 Intensive Care Unit, and 73 hospitalized in other wards) were processed for GLM testing upon clinical request. One patient had proven IPA, and 11 had probable disease. After excluding indeterminate Virclia results (n = 38), 396 specimens yielded concordant results (56 positive and 340 negative) and 101 discordant results (Virclia positive/Platelia negative, n = 95). The overall agreement between immunoassays was higher for sera (κ 0.56) than for BAL (κ ≤ 0.24) or BAS and TA (κ ≤ 0.22). When considering all specimen types in combination, the overall sensitivity and specificity of the Virclia assay for the diagnosis of proven/probable IPA were 100% and 65%, respectively, and for the Platelia immunoassay, sensitivity and specificity were 91.7% and 89.4%, respectively. The correlation between index values by both immunoassays was strong for serum/BAL (ρ = 0.73; P < 0.001) and moderate for BAS/TA (Rho = 0.52; P = 0.001). The conversion of Virclia index values into the Platelia index could be derived by the formula y = (11.97 * X)/3.62 + X). Data from GLM-positive serum/BAL clinical specimens fitted the regression model optimally (R2 = 0.94), whereas that of BAS and TA data did not (R2 = 0.11). Further studies are needed to determine whether the Virclia assay may be an alternative to the Platelia assay for GLM measurement in sera and lower respiratory tract specimens.IMPORTANCEGalactomannan detection in serum or bronchoalveolar fluid specimens is pivotal for the diagnosis of invasive pulmonary aspergillosis (IPA). The Platelia Aspergillus Antigen immunoassay has become the “gold standard” for Aspergillus GLM measurement. Here, we provide data suggesting that the Virclia Monotest assay, which displays several operational advantages compared with the Platelia assay, may become an alternative to the Platelia assay, although further studies are needed to validate this assumption. We also provide a formula allowing the conversion of Virclia index values into Platelia values. The study may contribute toward positioning the Virclia assay within the diagnostic algorithm of IPA.

Background: Aspergillus spp. causes a wide range of diseases called Invasive Aspergillosis (IA) which is a fatal illness that affects a variety of immunocompromised people worldwide. Objective: Using the lateral flow test for the detection of Galactomannan antigen in immunocompromised patients suspected to have IA. Patients and Methods: This study was conducted on 72 patients, whose samples (serum, Bronchoalveolar lavage, Blood) were collected from the Hematology-Oncology Unit at Baghdad Teaching Hospital and Pediatric Welfare Hospital, and ICU in Ghazi AL-Hariri Surgical Specialties Hospital, and Bone Marrow Transplantation Center in period between November 2022 to February 2023. Patients’ blood and sputum were sent for fungal culture to confirm the diagnosis in most cases. Results: QuicGM Aspergillus Lateral Flow Assay was conducted on 72 patients, of whom 34 () were positive and 38 (52.7) were negative (P-value of 0.001 and 0.5) respectively. This screening aimed at detecting IA. One week later, the second confirmative result was obtained from 24 patients to determine the response to antifungal drugs or recovery from neutropenia on which 15 readings were negative and nine were positive. Out of 48 single readings, 25 were positive and 23 were negative. All for 72 members of the control group gave negative results. This study is the first in Iraq to use this assay. Conclusion: QuicGM Aspergillus Lateral Flow Assay was found to be reliable, sensitive, and specific, and proved to be a very good guide for the early diagnosis of IA in immunocompromised patients and in monitoring treatment outcomes and follow-up.

Background: Efficient diagnosis of patients at high risk for invasive aspergillosis (IA) improves the outcome of the disease. Lateral flow assay (LFA) is a novel technology and assessing its diagnostic accuracy is of great significance in the clinical management of IA. Methods: A meta-analysis using case-control studies was performed to assess the diagnostic performance of LFA alone or galactomannan (GM) combined with LFA (GM-LFA) as screening tests for IA. The sensitivity, specificity, and summary receiver operating characteristic curves were constructed. Results: Nineteen studies with 2838 patients were included. The pooled effect sizes for different indicators included: sensitivity (77 % for LFA and 75 % for GM-LFA), specificity (88 % for LFA and 87 % for GM-LFA), positive likelihood ratio (6.65 for LFA and 12.02 for GM-LFA), negative likelihood ratio (0.26 for LFA and 0.27 for GM-LFA), and the diagnostic odds ratio (25.81 for LFA and 44.87 for GM-LFA). The area under the curve was 0.91 for LFA and 0.94 for GM-LFA with a cut-off value ≥ 0.5. Conclusion: The present meta-analysis suggested that LFA or GM-LFA at an optical density index (ODI) cutoff of ≥0.5 was a useful diagnostic tool for IA in patients. The results showed no significant differences in the accuracy of LFA alone and GM-LFA in diagnosing IA. In the clinical diagnosis and treatment of IA, LFA can be recommended if timely results are needed.

Background: Histoplasmosis is a fungus disease caused by a dimorphic organism called Histoplasma capsulatum, it is endemic in United States, Asia, and Africa. Inoculation is through inhalation of infectious spores. Histoplasmosis is missed in diagnosis because it mimics tuberculosis in clinical presentations and not all patients suffering from tuberculosis are tuberculosis patients. The aim is to determine the prevalence of disseminated histoplasmosis among patients with pulmonary infections. Method: This is cross sectional and hospital based. Samples were collected from patients and questionnaires were administered. Three hundred and twenty-two (322) urine samples were aseptically collected in urine tubes and analyzed by enzyme linked immunosorbent assay to detect the presence of galactomannan in the urine samples. Results: Out of 322 samples analyzed, 12 (3.74 %) were positive for the presence of galactomannan while 310 (96.27 %) were negative. Participants of the geriatric age group had the highest prevalence of 12.5 %. Male 8.07 % were more prone to histoplasmosis disease than their female 3.10 % counterpart. The married displayed a high prevalence value of 6.25 % than singles 2.25 % and the divorced 3.57 % and framer were demonstrated a high value of 7.69 % prevalence. Among the risk factors trader had an odd ratio of 3.800 and chest discomfort 1.037 % is a disease symptom associated with histoplasmosis. Conclusion: Disseminated histoplasmosis occur among the study participants through low in prevalence, awareness of its presence should be known to the general public and clinician, diagnosis of histoplasmosis is be done along that of Tuberculosis because it can be co-infection with Tuberculosis for proper treatment regime.

Anna Basok,1 Elvira Romanjuk,1 Boris Rogachev,1 Yosef Shmuel Haviv,1 Ruth Shaco Halevy,2 Marina Vorobiov1 1Nephrology Department, Ben Gurion University Medical Center, Beer Sheva, Israel; 2Pathology Department, Ben Gurion University Medical Center, Beer Sheva, IsraelCorrespondence: Anna Basok, Nephrology Department, Ben Gurion University Medical Center, Uchmanit 13, Beer-Sheva, 8485283, Israel, Email basok@bgu.ac.ilAbstract: We described an extraordinary case of invasive aspergillosis (IA) after commercial kidney transplantation. Massive infestation by angiotrophic fungi with morphological features of Aspergillus caused fungal arteritis of renal blood vessels with detachment of the kidney graft from the iliac artery with ipsilateral leg ischemia, necessitating graft removal and recurrent vascular surgery to restore the blood supply to the leg. A literature review comprising various features of invasive aspergillosis and ethical aspects of commercial kidney transplantations is elucidated in this paper.Keywords: invasive aspergillosis, IA, transplant tourism, TT, galactomannan

Aspergillus is a ubiquitous saprophytic mold that humans and animals constantly inhale. In health, the conidia are eliminated by the innate immune system. However, a subset of individuals with risk factors such as neutropenia, receiving high doses of glucocorticoids or certain biologicals, and recipients of hematopoietic or solid-organ transplants develop invasive aspergillosis. The mortality associated with invasive aspergillosis is 42%–64%. The early diagnosis of invasive pulmonary aspergillosis in patients without classical risk factors remains challenging. We present a case of an elderly female with uncontrolled diabetes mellitus who presented with acute-onset chest pain, breathlessness, and cough without expectoration. On evaluation, her chest radiograph showed a mass lesion in the right upper zone. 18Fluorodeoxyglucose (FDG)-positron emission tomography-computed tomography showed two FDG-avid lesions in the apical and medial segment of the right upper lobe. The lung biopsy was negative for malignancy; however, she was diagnosed with invasive pulmonary aspergillosis based on serum and bronchoalveolar fluid galactomannan positivity. She was managed with voriconazole with complete resolution of the lesion. [ABSTRACT FROM AUTHOR]

Beta-mannans are insoluble plant polysaccharides with beta-1,4-linked mannose as the backbone. We used three forms of this polysaccharide, namely, pure mannan, glucomannan, and galactomannan, to enrich haloarchaea, which have the ability to utilize mannans for growth. Four mannan-utilizing strains obtained in pure cultures were closely related to each other on the level of the same species. Furthermore, another strain selected from the same habitats with a soluble beta-1,4-glucan (xyloglucan) was also able to grow with mannan. The phylogenomic analysis placed the isolates into a separate lineage of the new genus level within the family Natrialbaceae of the class Halobacteria. The strains are moderate alkaliphiles, extremely halophilic, and aerobic saccharolytics. In addition to the three beta-mannan forms, they can also grow with cellulose, xylan, and xyloglucan. Functional genome analysis of two representative strains demonstrated the presence of several genes coding for extracellular endo- beta-1,4-mannanase from the GH5_7 and 5_8 subfamilies and the GH26 family of glycosyl hydrolases. Furthermore, a large spectrum of genes encoding other glycoside hydrolases that were potentially involved in the hydrolysis of cellulose and xylan were also identified in the genomes. A comparative genomics analysis also showed the presence of similar endo-beta-1,4-mannanase homologs in the cellulotrophic genera Natronobiforma and Halococcoides. Based on the unique physiological properties and the results of phylogenomic analysis, the novel mannan-utilizing halolarchaea are proposed to be classified into a new genus and species Natronoglomus mannanivorans gen. nov., sp. nov. with the type strain AArc-m2/3/4 (=JCM 34861=UQM 41565). [ABSTRACT FROM AUTHOR]

Background: Invasive fungal disease is common in immunocompromised children, although rare in children suffering from viral pneumonia. Recently, it was our observation that a large number of children who were otherwise normal were suffering from invasive fungal disease along with viral pneumonia. The aim of our study is to determine the epidemiological and clinical profile of fungal infection in children suffering from viral pneumonia. Subjects and Methods: It was a retrospective study of medical records of children between January 2023 and March 2023 from pediatric intensive care unit (PICU) tertiary care hospital from Eastern India. Children with suspected fungal disease as per inclusion criteria were included in the study. A total of 27 patients were enrolled in this study. The serum galactomannan and beta-D-glucan (BDG) were measured. Clinical profile and outcome were compared between children with and without invasive fungal disease. Results: Out of 27 subjects, 16 (59%) had invasive fungal disease. All had adenovirus pneumonia. Seven (4.44%) had acute respiratory distress syndrome while four (25%) had shock and multiple organ dysfunction syndrome each. The duration of mechanical ventilation (P = 0.01), duration of PICU stay (P = 0.02), and duration of hospital stay (P = 0.004) were significantly higher in children with invasive fungal disease. These children had significantly higher rates of complications (P = 0.001) and higher mortality (P = 0.04). Conclusions: The serum galactomannan and BDG can diagnose invasive fungal disease in patients of viral pneumonia with persistent symptoms for more than 2 weeks. The invasive fungal disease is associated with higher morbidity and mortality in these children. [ABSTRACT FROM AUTHOR]

As microbiological tests play an important role in our diagnostic algorithms and clinical approach towards patients at-risk for pulmonary aspergillosis, a good knowledge of the diagnostic possibilities and especially their limitations is extremely important. In this review, we aim to reflect critically on the available microbiological diagnostic modalities for diagnosis of pulmonary aspergillosis and formulate some future prospects. Timely start of adequate antifungal treatment leads to a better patient outcome, but overuse of antifungals should be avoided. Current diagnostic possibilities are expanding, and are mainly driven by enzyme immunoassays and lateral flow device tests for the detection of Aspergillus antigens. Most of these tests are directed towards similar antigens, but new antibodies towards different targets are under development. For chronic forms of pulmonary aspergillosis, anti- Aspergillus IgG antibodies and precipitins remain the cornerstone. More studies on the possibilities and limitations of molecular testing including targeting resistance markers are ongoing. Also, metagenomic next-generation sequencing is expanding our future possibilities. It remains important to combine different test results and interpret them in the appropriate clinical context to improve performance. Test performances may differ according to the patient population and test results may be influenced by timing, the tested matrix, and prophylactic and empiric antifungal therapy. Despite the increasing armamentarium, a simple blood or urine test for the diagnosis of aspergillosis in all patient populations at-risk is still lacking. Research on diagnostic tools is broadening from a pathogen focus on biomarkers related to the patient and its immune system. [ABSTRACT FROM AUTHOR]

Two types of cell wall glycopolymers of different structure were found in the type strains of two species of phytopathogenic bacteria, Clavibacter insidiosus VKM Ac-1402T and Clavibacter nebraskensis VKM Ac-1404T (family Microbacteriaceae, class Actinomycetes). The first type was represented by new, previously undescribed (1→6)-linked β-D-galactofuranans, which in the studied strains differed in the structure of side oligosaccharide chains (the structures are given in the text). The structure of the second glycopolymer, a pyruvate-containing galactomannan, was identical in both strains. The results obtained in this work, together with those published previously, indicate that the presence of the pyruvate-containing galactomannan and galactofuranans (with an identical core structure and different side oligosaccharide substituents) can be considered as a chemotaxonomic trait of the genus Clavibacter, and galactofuranans with di-, tri-, or tetrasaccharide substituents of different composition and structures can serve as chemotaxonomic markers of the species. The data obtained expand our understanding of the structural diversity of natural glycopolymers and structural features of the bacterial cell walls in various taxa and may be of interest for taxonomic studies and the studies aimed at elucidating the molecular mechanisms of interaction between bacteria and plant cells. [ABSTRACT FROM AUTHOR]

Background: Histoplasmosis is a fungus disease caused by a dimorphic organism called Histoplasma capsulatum, it is endemic in United States, Asia, and Africa. Inoculation is through inhalation of infectious spores. Histoplasmosis is missed in diagnosis because it mimics tuberculosis in clinical presentations and not all patients suffering from tuberculosis are tuberculosis patients. The aim is to determine the prevalence of disseminated histoplasmosis among patients with pulmonary infections. Method: This is cross sectional and hospital based. Samples were collected from patients and questionnaires were administered. Three hundred and twenty-two (322) urine samples were aseptically collected in urine tubes and analyzed by enzyme linked immunosorbent assay to detect the presence of galactomannan in the urine samples. Results: Out of 322 samples analyzed, 12 (3.74 %) were positive for the presence of galactomannan while 310 (96.27 %) were negative. Participants of the geriatric age group had the highest prevalence of 12.5 %. Male 8.07 % were more prone to histoplasmosis disease than their female 3.10 % counterpart. The married displayed a high prevalence value of 6.25 % than singles 2.25 % and the divorced 3.57 % and framer were demonstrated a high value of 7.69 % prevalence. Among the risk factors trader had an odd ratio of 3.800 and chest discomfort 1.037 % is a disease symptom associated with histoplasmosis. Conclusion: Disseminated histoplasmosis occur among the study participants through low in prevalence, awareness of its presence should be known to the general public and clinician, diagnosis of histoplasmosis is be done along that of Tuberculosis because it can be co-infection with Tuberculosis for proper treatment regime. [ABSTRACT FROM AUTHOR]

Purpose: H. capsulatum is endemic in Indonesia, but the value of Histoplasma antigen detection has not been studied. Patients and Methods: Histoplasma galactomannan (GM) ELISA was applied to sera of patients with unproven pulmonary tuberculosis (TB) and patients with a positive Aspergillus GM. Both Histoplasma and Aspergillus GM tests were performed to determine any possible cross-reaction with certain foods. Results: Fourteen of 122 (11.5%) sera of patients with newly diagnosed clinical TB were positive for Histoplasma GM. The positivity rate in the serum of patients 5-6 and 12 months after TB diagnosis was 3.8% and 3.5%, respectively. Of 88 positive Aspergillus GM sera, 63 (71.6%) were also positive for Histoplasma GM. All tested foods were positive for Aspergillus GM, while 65% of foods were positive for Histoplasma GM. Conclusion: Galactomannan is widespread in sera and food in Jakarta, possibly related to food consumption. Histoplasma and Aspergillus antigen detection for the diagnosis will require additional means of confirming the diagnosis; negative tests may be more helpful for ruling out invasive histoplasmosis and aspergillosis. [ABSTRACT FROM AUTHOR]

The present study investigates the mechanism of cold plasma modification (CP) of guar seed galactomannan on the structural, chemical, dietary fiber profile and the possibility to stabilize the orange juice. The cold plasma treatments were done at 170 and 230 V for 30 and 60 min and investigated for the modifications. The polar oxidative functionalities COOH- (283.36% rise) and OH- (16% rise) increased sequentially as a result of plasma-induced depolymerization with an increase in plasma voltage and time which was also supported by FTIR findings. The inclusion of COOH- reduced the pH from 7.09 ± 0.01 to a minimum of 4.96 ± 0.01. The cleavage of galactose side chains increased the free galactose content and reduced the M/G ratio from 2.38 ± 0.73 to 1.67 ± 0.19. The plasma etching phenomena reduced the average particle size to a minimum of 14.36 nm and is also seen in SEM. An increase in surface negative charges was shown with a decrease in zeta potential. The phenomenon of depolymerization, glycosidic cleavages at the side chains, and surface etching of cold plasma was exhibited with substantial evidence. Total dietary fiber was unaffected with an elevated soluble fiber content. Plasma treated guar gum has improved the stability of orange juice (rise in serum cloudiness with reduction in sedimentation and viscosity) without significant modifications in the quality (total soluble solids, pH, color). The obtained results demonstrate the CP interaction with guar gum and prove the potential of this green technology for the production of partially depolymerized guar gum. [ABSTRACT FROM AUTHOR]