Treatment of Positive Urine Cultures at End-of-Life and the Effect on Terminal Delirium Management

Background: The decision to initiate antibiotics in hospice patients that are very near end-of-life is a complex ethical and stewardship decision. Antibiotics may be ordered to improve urinary tract infection–related symptoms, such as delirium. However, infection symptoms may be managed using antipsychotics, antipyretics, antispasmodics, and analgesics instead. Currently, there are no studies that compare symptom management between those who receive antibiotics and those who do not. Methods: A retrospective chart review was conducted for patients admitted to a hospice inpatient unit. Charts were included if the patient was admitted for delirium and had a Palliative Performance Scale score ≤40%, the urine culture was positive for organism growth, and the patient died while in the HIU. Clinical and demographic data was collected. Medication use was tallied for the 5 days prior to the date of death. Results: Sixty-one charts met the inclusion criteria. Thirty-five patients received antibiotics (ABX+) and 26 did not (ABX−). There was no difference in any medication consumption between groups during the 5 days prior to death. The ABX+ group died 8.2 days after obtaining the urine sample vs 6 days ( P =0.046). The ABX+ group had more documented urinary tract–specific infection symptoms (66% vs 38%, P =0.042). More than half of antibiotic courses were discontinued prematurely. Conclusion: The results of this study do not show a difference in overall medication consumption between groups, which suggests that antibiotics may not help improve terminal delirium symptoms in those with a suspected urinary tract infection at end-of-life.

Feeding stimulates functional abilities of queen bees of the Carpathian subspecies

The researches were conductedon queen bees of the Carpathian subspecies in conditions of Tajikistan. Four groups of similar families were formed, 10 in each group. In the control group, sugar syrup (1:2) was given as a stimulating feeding, in small portions of 700 ml. Bees of the first experimental group were fed with the sugar syrup, with the addition of drone larvas’ homogenate. The second group was fed with the sugar syrup with addition of a feed mixture “Similak”, the third group - sugar syrup with the addition of a compositional form consisting of a feed mixture “Similak” and the drone larvas’ homogenate. In the experimental groups, in contrast to the control group, an increase in the egg production of queen bees and the brood breeding reflex by 1.3-1.44 times was found.In general, it has been established that to stimulate the physiological processes in bee’ organism, growth and development of colonies in spring, it is necessary to use stimulating feeding by sugar syrup in combination with drone larvas’ homogenate and feed mixture “Similak” 700 ml each.

Whole transcriptome sequencing identifies key circRNAs, lncRNAs, and miRNAs regulating neurogenesis in developing mouse retina

Background The molecular complexity of neural retina development remains poorly studied. Knowledge of retinal neurogenesis regulation sheds light on retinal degeneration therapy exploration. Therefore, we integrated the time-series circRNA, lncRNA, miRNA, and mRNA expression profiles of the developing retina through whole-transcriptome sequencing. The key functional ncRNAs and the ceRNA network regulating retinal neurogenesis were identified. Results Transcriptomic analysis identified circRNA as the most variable ncRNA subtype. We screened a series of neurogenesis-related circRNAs, lncRNAs, and miRNAs using different strategies based on their diversified molecular functions. The expression of circCDYL, circATXN1, circDYM, circPRGRIP, lncRNA Meg3, and lncRNA Vax2os was validated by quantitative real-time PCR. These circRNAs and lncRNAs participate in neurotransmitter transport and multicellular organism growth through the intricate circRNA/lncRNA-miRNA-mRNA network. Conclusion Whole-transcriptome sequencing and bioinformatics analysis systematically screened key ncRNAs in retinal neurogenesis. The validated ncRNAs and their circRNA/lncRNA-miRNA-mRNA network involve neurotransmitter transport and multicellular organism growth during retinal development.

A comparative analysis of Heat Shock Factor 1 in Cancer

The heat shock factor 1 (HSF1) is a DNA-binding factor that has responses under proteotoxic stress is well-known as an HSF. Heat shock factor 1 is a unique regulator that coordinates chaperone expression to enhance organism growth. Specifically, HSF’s drive transcriptional strategy is apparent from the HSP’s and promotes cell viability. A recent study supported the HSF1 coordinated with different cancer and robust in cancer immunotherapy. In this research, I designed to genome-wide analysis of HSF1 and its family in mammals. A comparative analysis of HSF’s is mandatory to explore functions and immunogenic mechanisms involved with HSP’s in organisms. Therefore, I performed a bioinformatics pipeline and tools to the current knowledge of HSF’s in two different organisms. This application can enhance in a significant way to study particular HSF’s in discrete organisms. My finding data demonstrated the number of HSF1 and their family in Homo sapiens and Mus musculus. The conserved domain, motifs, phylogeny, chromosome location, gene network, and expression analysis documented the HSF1 associated with cancer. The analysis data concluded the HSF1 is impact in various cancers and a signature of cancer immunotherapy.

A complex scalp resurfacing utilizing Integra® as temporary dressing in aplasia cutis congenita

BACKGROUND: Aplasia cutis congenita is a rare newborn malformation characterized by focal absence of skin. It possesses difficulty in reconstruction surgery for neurosurgeons and plastic surgeons. We report a challenging case of aplasia cutis congenita who received treatment in our center. CLINICAL CASE: A 2-year-old boy, presented to Plastic and Reconstructive Surgery, Hospital USM, with bilateral vertex defect with encephalocele who received a series of surgical interventions since 1 month old. Unfortunately, he returned after 2 years with a chronic nonhealing scalp wound associated with dura defect and cerebral spinal fluid leakage. The wound was debrided and the swab culture result showed no organism growth. Part of the wound bed with dura defect was repaired using a small piece of transplanted fascia lata and Integra was applied. DISCUSSION: There is scarcity in the medical literature on the reconstructive technique of aplasia cutis congenita. In the case we described here, we successfully managed the wound with multiple application of dermal substitute (Integra) dressing with negative pressure wound therapy and split-thickness skin graft. CONCLUSIONS: Management of aplasia cutis congenita with skull defect remains a controversy. Its management varies depends on its pattern and underlying condition. We successfully develop a new simple method in treating scalp accutilizing Integra.

The RNA helicase Ddx52 functions as a growth switch in juvenile zebrafish

Vertebrate animals usually display robust growth trajectories during juvenile stages, and reversible suspension of this growth momentum by a single genetic determinant has not been reported. Here, we report a single genetic factor that is essential for juvenile growth in zebrafish. Using a forward genetic screen, we recovered a temperature-sensitive allele, pan (after Peter Pan), that suspends whole-organism growth at juvenile stages. Remarkably, even after growth is halted for a full 8-week period, pan mutants are able to resume a robust growth trajectory after release from the restrictive temperature, eventually growing into fertile adults without apparent adverse phenotypes. Positional cloning and complementation assays revealed that pan encodes a probable ATP-Dependent RNA Helicase (DEAD-Box Helicase 52; ddx52) that maintains the level of 47S precursor ribosomal RNA. Furthermore, genetic silencing of ddx52 and pharmacological inhibition of bulk RNA transcription similarly suspend the growth of flies, zebrafish and mice. Our findings reveal evidence that safe, reversible pauses of juvenile growth can be mediated by targeting the activity of a single gene, and that its pausing mechanism has high evolutionary conservation.

The role of trematode parasites as a nutritional food source for higher trophic level consumers

Recently, there has been a call for the inclusion of free-living stages of trematode parasites in food web models as they are present in high numbers in aquatic ecosystems and serve as prey for higher trophic levels. I investigated the presence of lipids in cercariae, specifically neutral energy reserve lipid stores and long-chain polyunsaturated fatty acids (LC-PUFA), as they are considered the primary energy currency in aquatic ecosystems. Cercariae of all investigated taxa contained distinct neutral lipid compositions and Ribeiroia ondatrae cercariae had significant quantities of total lipids, as well as essential fatty acids (EFA). I also investigated the viability of cercariae as prey items for dragonfly larvae (Leucorrhinia intacta) and detected indistinguishable proportions of EFA in larvae subsisting on equivalent quantities of R. ondatrae and Daphnia spp. This suggests that cercariae may contribute to nutrient subsidies in aquatic ecosystems, thereby supporting aquatic organism growth and fitness.

The role of trematode parasites as a nutritional food source for higher trophic level consumers

Recently, there has been a call for the inclusion of free-living stages of trematode parasites in food web models as they are present in high numbers in aquatic ecosystems and serve as prey for higher trophic levels. I investigated the presence of lipids in cercariae, specifically neutral energy reserve lipid stores and long-chain polyunsaturated fatty acids (LC-PUFA), as they are considered the primary energy currency in aquatic ecosystems. Cercariae of all investigated taxa contained distinct neutral lipid compositions and Ribeiroia ondatrae cercariae had significant quantities of total lipids, as well as essential fatty acids (EFA). I also investigated the viability of cercariae as prey items for dragonfly larvae (Leucorrhinia intacta) and detected indistinguishable proportions of EFA in larvae subsisting on equivalent quantities of R. ondatrae and Daphnia spp. This suggests that cercariae may contribute to nutrient subsidies in aquatic ecosystems, thereby supporting aquatic organism growth and fitness.

27 Do Microbiology Swabs Taken During Incision and Drainage of Acute Perianal Abscess Affect Clinical Management and Future Clinical Course?

Introduction This study assesses whether microbiology swabs taken during incision and drainage of perianal abscesses have any impact on the post-operative clinical course and management. Method Data from emergency operative theatre lists were interrogated for patients undergoing incision and drainage of perianal abscess in the period March 2019 – March 2020. Each electronic medical record for patients who had perianal abscess surgery was interrogated for age, sex, smoking status, diabetic status, whether microbiology swab was taken for analysis, what organism was grown and any post-operative fistula development. Results 71 patients met inclusion criteria. 55 (77.5%) patients had pus swabs sent at incision and drainage for microbiological analysis. Of the 55 patients swabbed, 20 (36%) had no organism growth, 22 (40%) had anaerobes growth – the most common organism in this study. Of all 55 swabs sent, only 14 (25%) were acknowledged. The presence of smoking (p < 0.05) was statistically significantly associated with development of fistula-in-ano longer term. Conclusions Our data may indicate that microbiology swabs do not influence management of patients with acute perianal abscess. There are discrepancies in whether swabs are taken and acted upon. No organism was associated with fistula development. We would suggest national scale studies to explore our conclusions.

A New Approach to Quantifying Bioaccumulation of Elements in Biological Processes

Bioaccumulation, expressed as the bioaccumulation factor (BAF), is a phenomenon widely investigated in the natural environment and at laboratory scale. However, the BAF is more suitable for ecological studies, while in small-scale experiments it has limitations, which are discussed in this article. We propose a new indicator, the bioaccumulation index (BAI). The BAI takes into account the initial load of test elements, which are added to the experimental system together with the biomass of the organism. This offers the opportunity to explore the phenomena related to the bioaccumulation and, contrary to the BAF, can also reveal the dilution of element concentration in the organism. The BAF can overestimate bioaccumulation, and in an extremal situation, when the dilution of element concentration during organism growth occurs, the BAF may produce completely opposite results to the BAI. In one of the examples presented in this work (Tschirner and Simon, 2015), the concentration of phosphorous in fly larvae was lower after the experiment than in the younger larvae before the experiment. Because the phosphorous concentration in the feed was low, the BAF indicated a high bioaccumulation of this element (BAF = 14.85). In contrast, the BAI showed element dilution, which is a more realistic situation (BAI = −0.32). By taking more data into account, the BAI seems to be more valid in determining bioaccumulation, especially in the context of entomoremediation research.