Endocrine Risk Factors for COVID-19 in Context of Aging

Aged people are the most susceptible group to COVID-19 infection. Immunosenescence characterized by impairment of immune function with inflamm-aging contributes to pathophysiological alterations, among which endocrine and metabolic diseases are not exception. Diabetes, obesity along with impairment of disorders of thyroid functions are the most frequent ones, the common feature of which is failure of immune system including autoimmune processes. In the minireview we discussed how COVID-19 and aging impact innate and adaptive immunity, diabetes and selected neuroendocrine processes. Mentioned is also beneficial effect of vitamin D for attenuation of these diseases and related epigenetic issues. Particular attention is devoted to the role of ACE2 protein in the light of its intimate link with renin-angiotensin regulating system.

Treating COVID-19 in the nursing home setting: an integrated approach for a complex and susceptible cohort

ABSTRACT Our patient, a nursing home resident, was reviewed by our frailty outreach service in November 2020. She initially was diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in September 2020 during an outbreak in her nursing home. On this occasion, she again tested positive for SARS-CoV-2. Our case report describes the resident’s poor immune response indicated by a low IgG level after her initial COVID infection as well as reinfection with a ‘non-variant’ SARS-CoV-2 lineage (B.1.177). The case describes the importance of integration of community and secondary care. The nursing home received close monitoring and nurse supervision for the detection of potential deterioration of the patient. Exit-seeking behaviour by nursing home residents was limited effectively. The issues of low immune response to COVID-19 in older people and the emergence of variants of concern will continue to pose a threat to this susceptible group.

Criblage de variétés de tomate pour de la résistance au flétrissement bactérien causé par Ralstonia solanacearum au Togo

Objectifs : Dans le cadre de la recherche de mesures de lutte efficace et durable contre le flétrissement bactérien causé par Ralstonia solanacearum (Rs), la présente étude s’est proposé d’évaluer les variétés de tomate pour leur résistance à la maladie. Méthodologie et Résultats : Six variétés de tomate cultivées aux Togo ont été inoculées par une suspension de la souche de Rs isolée du site de CECO de la prefecture de Sotouboua (Togo). Les résultats ont montré de fortes incidences et sévérités du flétrissement bactérien sur les variétés testées. Cependant, des différences de comportement vis-à-vis de cette maladie ont été observées entre les variétés. En considérant l’indice de maladie après inoculation et l’analyse des closters, deux groupes de variétés ont été identifiés parmi les six testées : un groupe “Résistant” constitué de la seule variété Cobra et un groupe “Sensible” constitué des variétés Petomech, Tropimech, Padma, Roma et Platinum. Conclusions et application des résultats : Cette étude a permis d’obtenir des données sur l’incidence et la sévérité du flétrissement bactérien cause par Rs et le comportement des variétés de tomate vis-à-vis de cette pathologie, et a permis aussi d’identifier les variétés Cobra, Roma et Platinum comme résistantes au flétrissement bactérien en conditions contrôlées. Ces résultats constituent une base de données importante pour des investigations futures en conditions de champs dans diverses zones agroécologiques du pays. Ces expérimentations permettront d’identifier des variétés résistantes pouvant être recommandées aux producteurs pour une gestion durable du flétrissement bactérien. Mots clés : R. solancearum, flétrissement bactérien de la tomate, criblage, résistance. Banito et al., J. Appl. Biosci. Vol : 166 2021 Criblage de variétés de tomate pour de la résistance au flétrissement bactérien causé par Ralstonia solanacearum au Togo 17213 ABSTRACT Objectives: In order to develop a control strategy against bacterial wilt caused by Ralstonia solanacearum (Rs), one of the most destructive diseases of tomato worldwide, the present study aimed to evaluate tomato varieties for resistance to Rs. Methodology and Results: Six tomato varieties cultivated in Togo were inoculated with Rs strain isolated from CECO site in the Prefecture of Sotouboua (Togo).The results revealed high incidence and severity occurring on these varieties. However, differences were observed among the tested varieties. The discrimination analysis based on the disease index after inoculation and the clusters analysis identified two groups of varieties: the resistant group composed of the varieties Cobra, Roma and Platinum and the susceptible group including the varieties Petomech, Tropimech, Padma. Conclusions and application of findings: The results provided useful information in terms of incidence and severity of Rs wilt on tomato and the behaviour of varieties against the disease. The results allowed identifying three tomato varieties, Cobra, Roma and Platinum as resistant to bacterial wilt under controlled conditions. These results are useful for further experiments under field conditions in different agroecological zones to find out resistant tomato varieties for sustainable management of bacterial wilt caused by Rs. Keywords: R. solancearum, bacterial wilt of tomato, screening, resistance.

How Important Is Behavioral Change during the Early Stages of the COVID-19 Pandemic? A Mathematical Modeling Study

How important is the speed and intensity of behavioral change due to government policies, such as enhanced social distancing or lockdown, when an emerging infectious disease occurs? In this study, we introduce a deterministic SEIR model considering the behavior-changed susceptible group to investigate the effect of the speed and intensity of behavioral change on the transmission dynamics of COVID-19. We used epidemiological data from South Korea and Italy for the simulation study, because South Korea and Italy were the first countries to report an outbreak of COVID-19 after China and the prevention and response policy of each government were similar during the first outbreak of COVID-19. Simulation results showed that it took approximately twenty fewer days in Korea than in Italy until 90% of susceptible individuals changed their behavior during the first outbreak. It was observed that the behavior-changed susceptible individuals reduced the COVID-19 transmission rate by up to 93% in Korea and 77% in Italy. Furthermore, if the intensity and speed of behavioral change in Italy were the same as in Korea, the expected number of cumulative confirmed cases would have been reduced by approximately 95%, from 210,700 to 10,700, until the end of the lockdown period. We assumed that behavioral change is influenced by the number of confirmed cases and does not take into account social and cultural differences, as well as the state of the healthcare system, between the two countries. Our mathematical modeling showed how important the high intensity and fast speed of behavioral change to reduce the number of confirmed cases in the early period of an epidemic are.

Flow cytometric analysis of equine bronchoalveolar lavage fluid cells in horses with and without severe equine asthma

Severe equine asthma (SEA) is a common, debilitating lower airway inflammatory disorder of older horses. Alveolar macrophages (AMs) survey inhaled particulates from barn sources causing them to switch from an anti-inflammatory to a proinflammatory phenotype, resulting in neutrophil recruitment to the lung. This proinflammatory switch may contribute to the development and prolongation of SEA. Validated antibodies to identify the cells involved in the pathogenesis of SEA are lacking. In this study, monoclonal antibodies against CD90, CD163, and CD206 were tested for reactivity with equine leukocytes by immunocytochemistry and flow cytometry. A multi-color flow cytometric assay was developed to identify leukocytes in equine bronchoalveolar lavage fluid (BALF). Four control and 4 SEA-susceptible horses had BALF collected before and after a 48-hour moldy hay challenge. Antibodies against CD90 uniquely labeled equine neutrophils, and antibodies against CD163 and CD206 identified equine macrophages. Postchallenge AM surface expression of CD163 increased in both groups of horses, but the increase was statistically significant in only the SEA-susceptible group ( P = .02). The surface expression of CD206 on AMs increased significantly in the SEA-susceptible group ( P = .03) but was unchanged in the control group ( P = .5). Increased expression of CD163 and CD206 during exacerbation of SEA suggested an association between AM phenotype and lung inflammation. However, functions of AMs in the pathogenesis of SEA remain to be elucidated.

Mineral profiling of resistant and susceptible tomato varieties against Alternaria solani causing early blight

The current research was conducted to investigate the alterations in the mineral status in the leaves of tomato plants against early blight (EB) caused by Alternaria solani. Six tomato varieties; viz. Riograndae, Roma and Basket (resistant) and T-88572, BHN-961 and BHN-1021(susceptible) were inoculated with a blend of five isolates of Alternaria solani, collected from different regions of Faisalabad District. These six varieties for mineral profiling were selected after two years screening from twenty-five varieties of tomatoes under field conditions. These varieties were sown in pots and artificial inoculation was performed to develop disease in inoculated type of tomato plants while distilled water was applied on un-inoculated type of plants. Newly infected leaves from upper, middle and lower parts of tomato plants from resistant and susceptible groups were used to prepare sample for mineral analysis at p ≤ 0.05 and variation in mineral profiling of resistant and susceptible groups of tomato plants was determined through Nested Structured Design. Significant variation was observed in inoculated (3.12, 0.48 %, 1.17, 0.14, 0.42, 0.21, 0.69 and 1.49 ppm and un-inoculated type (8.67, 1.61%, 10.45, 0.22, 1.75, 1.98, 3.09 and 3.39 ppm) while resistant group expressed 6.59, 1.19%, 8.13, 1.973, 1.69, 1.26, 1.36, 2.43 and 2.87ppm and susceptible group exhibited 5.19, 0.91%, 5.69, 1.693, 1.24, 0.91,0.83, 1.35 and 2.22 ppm with respect to NPK, Ca, Mg, Na, Zn, Iron and copper. Resistant variety, Riograndae expressed maximum amount while T-88572 exhibited minimum amount of all mineral contents. Alterations in the mineral profiling in leaves of tomato plants can be used by researchers as biochemical markers for identification and development of resistant source against early blight of tomato and for the development of ecofriendly management strategy towards A. solani.

Phenotypic and molecular characterization of pyrazinamide resistance among multidrug-resistant Mycobacterium tuberculosis isolates in Ningbo, China

Background Detection of pyrazinamide (PZA) resistance in Mycobacterium tuberculosis (TB) patients is critical, especially in dealing with multidrug-resistant Mycobacterium tuberculosis (MDR-TB) case. Up to date, PZA drug susceptibility testing (DST) has not been regularly performed in China. The prevalence and molecular characteristics of PZA resistance in M.tuberculosis isolates, especially MDR-TB have not been studied in Ningbo, China. This study aimed to analyze the phenotypic and molecular characterization of PZA resistance among MDR-TB isolates in Ningbo. Methods A total of 110 MDR-TB isolates were collected from the TB patients who were recorded at local TB dispensaries in Ningbo. All clinical isolates were examined by drug susceptibility testing and genotyping. DNA sequencing was used to detect mutations in the pncA gene associated with PZA resistance. Results The prevalence of PZA resistance among MDR-TB strains in Ningbo was 59.1%. With regard to the history and the outcome of treatments among MDR-TB cases, the percentages of re-treated MDR-TB patients in the PZA-resistant group and of successful patients in PZA-susceptible group were significantly higher than the ones in the PZA-susceptible group and in the PZA-resistant group, respectively (P = 0.027, P = 0.020). The results showed that the resistance of streptomycin (67.7% vs 46.7%, P = 0.027), ethambutol (56.9% vs 33.3%, P = 0.015), ofloxacin (43.1% vs 11.1%, P = 0.000), levofloxacin (43.1% vs 11.1%, P = 0.000), pre-XDR (pre-Xtensively Drug Resistance) (38.5% vs 15.6%, P = 0.009), were more frequently adverted among PZA-resistant isolates compared with PZA-susceptible isolates. In addition, 110 MDR-TB was composed of 87 (PZA resistant, 78.5%) Beijing strains and 23 (PZA resistant, 21.5%) non-Beijing strains. Fifty-four out of 65 (83.1%) PZA-resistant MDR strains harbored a mutation located in the pncA gene and the majority (90.7%) were point mutations. Compared with the phenotypic characterization, DNA sequencing of pncA has sensitivity and specificity of 83.1 and 95.6%. Conclusion The mutations within pncA gene was the primary mechanism of PZA resistance among MDR-TB and DNA sequencing of pncA gene could provide a rapid detection evidence in PZA drug resistance of MDR-TB in Ningbo.

Temporal Trend of ST131 Clone among Urinary Escherichia coli Isolates in the Community: A Taiwan National Surveillance from 2002 to 2016

Sequence type (ST) 131 is a multidrug-resistant pandemic lineage of E. coli responsible for extraintestinal infections. Few surveillance data of ST131 included all antimicrobial-susceptible and -resistant isolates or focused on community-acquired urinary tract infection (UTI). From a population-based surveillance pool of 2997 outpatient urine E. coli isolates, 542 were selected for detection of ST131 based on ciprofloxacin and/or cefotaxime resistance. Pulsed-field gel electrophoresis (PFGE) was performed on all ST131 isolates to further determine their relatedness. The estimated overall ST131 prevalence in this community UTI cohort increased from 11.2% (in 2002–2004), 12.2% (in 2006–2008), 13.6% (in 2010–2012), to 17.4% in 2014–2016 (p < 0.01). In the ciprofloxacin-resistant/cefotaxime-resistant group, ST131 increased from 33.3% in 2002–2004 to 72.1% in 2014–2016 (p < 0.01). In the ciprofloxacin-resistant/cefotaxime-susceptible group, ST131 was found in 24.3% overall without significant increase in its prevalence over time. PFGE showed emergence of a cluster of ciprofloxacin-resistant/cefotaxime-resistant ST131 carrying Gr. 1 CTX-M ESBL in 2014–2016, especially 2016. Multivariate analysis revealed that age (≥65 y.o) and ciprofloxacin resistance were independent factors associated with ST131. This longitudinal surveillance showed that ciprofloxacin-resistant/cefotaxime-susceptible ST131 has been circulating in the community since 2002 but ciprofloxacin-resistant/cefotaxime-resistant ST131 increased rapidly in the later years.

Clinical Impact of Revised Ciprofloxacin Breakpoint in Patients with Urinary Tract Infections by Enterobacteriaceae

In 2018, the Clinical and Laboratory Standards Institute (CLSI) revised ciprofloxacin (CIP)-susceptible breakpoint for Enterobacteriaceae from ≤1 μg/mL to ≤0.25 μg/mL, based on pharmacokinetic-pharmacodynamic (PK-PD) analysis. However, clinical data supporting the lowered CIP breakpoint are insufficient. This retrospective cohort study evaluated the clinical outcomes of patients with bacteremic urinary tract infections (UTIs) caused by Enterobacteriaceae, which were previously CIP-susceptible and changed to non-susceptible. Bacteremic UTIs caused by Enterobacteriaceae with CIP minimal inhibitory concentration (MIC) ≤ 1 μg/mL were screened, and then patients treated with CIP as a definitive treatment were finally included. Patients in CIP-non-susceptible group (MIC = 0.5 or 1 μg/mL) were compared with patients in CIP-susceptible group (MIC ≤ 0.25 μg/mL). Primary endpoints were recurrence of UTIs within 4 weeks and 90 days. A total of 334 patients were evaluated, including 282 of CIP-susceptible and 52 of CIP-non-susceptible. There were no significant differences in clinical outcomes between two groups. In multivariate analysis, CIP non-susceptibility was not associated with recurrence of UTIs. CIP non-susceptibility based on a revised CIP breakpoint, which was formerly susceptible, was not associated with poor clinical outcomes in bacteremic UTI patients were treated with CIP, similar to those of the susceptible group. Further evaluation is needed to guide the selection of definitive antibiotics for UTIs.

Protection of the Elderly from Abuse in Jordanian Law

The increase in the numbers of elderly globally and nationally has led to more attention to the rights of this most vulnerable group and the necessity to provide an effective legal protection against elder abuse. The significance of this research lies in the fact that it is necessary to protect elder people against abuse, as they are a vulnerable and susceptible group. Hence, this research revolves centrally around the extent to which the legal protection Jordanian laws provide to elder persons against abuse compared to the international standards. The research followed the analytical and comparative method, by conducting a comprehensive review of the Jordanian legal texts, analysing them and comparing them to the international standard. This research concludes that the protection provided by the Jordanian legislations and international conventions against elder abuse is not sufficient. The research provides several recommendations including criminalising all types of elder abuse, imposing deterrent sanctions and explicit provision for mandatory reporting of abuse cases.