Disease Management Approach Research Articles

Clinical and metabolic aspects of non-alcoholic fatty liver disease depending on BMI

At present, the issues of the relationship between non-alcoholic fatty liver disease (NAFLD) and obesity, especially abdominal, as well as metabolic syndrome, which, in turn, significantly increases the cardiometabolic risk and affects the incidence, prognosis and life expectancy of patients, are quite well studied. And although the prevalence of various clinical forms of NAFLD is significantly higher in obese patients than in the general population, 7–20 % of people with NAFLD are estimated to have a lean body habit. At the same time, the rate of disease progression, associated conditions, anddiagnostic and management approaches differ for patients with NAFLD depending on body mass index (BMI), which reveals the need for clear guidance to clinicians regarding the NAFLD treatment depending on nutritional status. We performed a systematic review to summarize the clinical and metabolic aspects of NAFLD depending on nutritional status, as well as approaches to non-drug treatment through lifestyle changes. The fundamental clinical and functional, metabolic, hormonal and other factors of the pathological process that determine the mechanisms and prognosis of the disease in patients with NAFLD with different BMI are discussed. Information on the topic from publications based on the PubMed and RSCI databases was used.

Increased vascular risk factors, atherosclerosis, and psychological distress among Indian adults with refractory epilepsy in comparison to well-controlled epilepsy

ObjectiveComparison of cardiovascular risk factors, atherosclerosis, and psychological distress among adults with refractory versus well-controlled epilepsy. MethodsThe cross-sectional study consisted of two groups of 40 people each: Group I – People with well-controlled epilepsy, Group II – People with refractory epilepsy. Age- and gender-matched people of 20–50 years were recruited. People who were diabetic, smokers, hypertensive, alcoholic, pregnant, with infections, and lactating women were excluded from the study. Biochemical parameters, fasting glucose, lipid profile, fasting insulin, leptin, adiponectin, Lp[a], hsCRP, TyG INDEX, HOMA1-%S, HOMA1-IR, HOMA1-%B, QUICKI, FIRI, AIP, AC, CLTI, MLTI, CRI-I, CRI-II, and CIMT were estimated. Stress levels [PSS-10, GAD-7 & PHQ-9] were assessed based on the scoring system from the questionnaires. ResultsThe existence of metabolic syndrome, levels of triglycerides, TyG index, MDA, OSI, CIMT, AIP, and stress scores [PSS-10, GAD-7 & PHQ-9] were significantly higher in the refractory-epilepsy group in comparison to the well-controlled group. There were associations between LDL -C and CIMT as well as between GAD-7 and CIMT among all the study subjects. There were no significant differences in the levels of glucose homeostasis parameters, hsCRP, leptin, adiponectin, and Lp[a] between the two groups. Based on the ROC analysis, MDA [AUC = 0.853] and GAD-7 [AUC = 0.900] are useful in the differential diagnosis of the study groups. ConclusionPeople with refractory epilepsy had increased levels of vascular risk factors, atherosclerosis, and stress levels compared to people with well-controlled epilepsy. Suitable disease management and therapeutic approaches to address cardiovascular and psychological distress could be planned out among people with refractory epilepsy to improve their quality of life.

Fabrication of supramolecular self-assembly of the Schiff base complex for improving bioavailability of aldehyde-containing plant essential oil

Plant essential oils have enormous potential in the management of crop disease for their easy availability, biocompatibility, biodegradability, and excellent antimicrobial activities. However, these substances usually show poor performance in practical applications due to the poor stability caused by their volatilization and oxidation. Herein, taking advantage of the biological characteristics that some plant pathogenic microorganisms can acidify microenvironment, a pH-responsive supramolecular self-assembly based on the Schiff base complex of cinnamaldehyde (Cin) and branched polyethylenimine (BPEI) was constructed through multiple covalent and noncovalent interactions. The results showed that the formation and physicochemical properties of the self-assembly were positively correlated with the molecular weight of BPEI. Combined with the stability, particle size, zeta potential, self-assembly rates, and morphological characteristics in different systems, BPEI with an average molecular weight of 10,000 (BPEI 10 k) was a preferable choice to push the formation of the self-assembly and the optimum mass ratio of Cin to BPEI 10 k was 3:4. The prepared spherical nanoparticles had low volatility, good surface activity, and high stability and could respond to acidic environments to release Cin by a Fickian diffusion or a non-Fickian behavior. The self-assembly exhibited superior activities against plant pathogenic fungi, desirable environmental compatibility, and convincing biosafety to the plants. These findings would provide guidance for achieving efficient utilization of aldehyde-containing plant essential oil and exploring a useful approach for sustainable plant disease management.

A QUALITATIVE STUDY ON THE IMPROVEMENT OF DISEASE MANAGEMENT POLICIES IN DIABETES IN TURKEY

This study, it was aimed to determine the need for disease management in diabetes in Turkey and to reveal the recommendations for diabetes disease management policies as part of the identified needs. In this study, the research design was planned as a case study and, the snowball sampling method was used as part of the scope of qualitative research. A total of 21 individuals, 6 doctors, 3 diabetic nurses, 6 academics, and 6 adult diabetics were actualized using semi-structured forms with a thorough interview technique. The data collected were evaluated with descriptive analysis and content analysis methods. In the analysis of the data, the “Nvivo 12. Program” was used. The findings were discussed based on the relevant literature, and conclusions and recommendations were reached in line with the research purposes. The participants stated that the practices related to disease management in diabetes have improved compared to the past, but that the development process should continue. The participants stated that there is a need for a multidisciplinary systematic process structuring that will prioritize the patient and their needs and that will help patients to live their lives healthy and free from complications. In terms of the burden of disease, diabetes is a significant issue that affects both Turkey and the rest of the world. We propose that the health policy, health service delivery, health system structure, and multidisciplinary work related to the disease management approach in diabetes in Turkey should be determined and steps should be taken to improve it.

Metaplastic Breast Carcinoma in U.S. Population: Racial Disparities, Survival Benefit of Adjuvant Chemoradiation and Future Personalized Treatment with Genomic Landscape.

In this population-based study, we aim to identify factors that are influential on the survival outcome in MBC and investigate novel molecular approaches in personalized disease management. The data of this study were collected from the SEER database from 2000-2018. A total of 5315 cases were extracted from the database. The data were evaluated for demographics, tumor characteristics, metastasis, and treatment. Survival analysis was completed by using SAS software for multivariate analysis, univariate analysis, and non-parametric survival analysis. The molecular data with the most common mutations in MBC were extracted from the Catalogue of Somatic Mutations in Cancer (COSMIC) database. The mean age at the time of presentation was 63.1 with a standard deviation (SD) of 14.2 years. Most patients were White (77.3%) with 15.7% Black patients, 6.1% Asian or Pacific Islander, and 0.5% American Indian. Histologically, most of the reported tumors were grade III (74.4%); 37% of the cases were triple negative (ER-, PR- and HER2-), whereas the hormone status was unknown in 46% of the cases. Spread was localized in 67.3% of patients while 26.3% had regional spread and 6.3% had distant metastases. Most tumors were unilateral (99.9%) and between 20-50 mm in size (50.6%). The lungs were the most common site for distant metastasis at diagnosis (3.42%) followed by bone (1.94%), liver (0.98%), and brain (0.56%). A combination of surgery, chemotherapy, and radiation therapy was the most common treatment with a cause-specific survival rate of 78.1% (95% CI = 75.4-80.4). The overall survival rate at 5 years was 63.6% (95% confidence interval (CI) = 62.0-65.1) with a cause-specific survival of 71.1% (95% CI = 69.5-72.6). Cause-specific survival was found to be 63.2% (95% CI = 58.9-67.1) in Black patients as compared to 72.4% (95% CI = 70.1-74.1) in White patients. Black patients also presented with higher rates of grade III disease, distant metastasis, and larger tumor size. On multivariate analysis, age > 60, grade III+, metastasis, and tumor size > 50 mm were associated with worse survival. The most common mutations in MBC identified in COSMIC data were TP53, PIK3CA, LRP1B, PTEN, and KMT2C. Though rare, MBC is aggressive, with poor prognosis associated with high-grade tumors, metastasis, tumor size over 50 mm, and advanced age at the time of presentation. Overall, Black women had worse clinical outcomes. MBC is difficult to treat and carries a poor prognosis that affects various races disproportionately. Continued enhancement of treatment strategies to foster more individualized care as well as continued enrollment in clinical trials are needed to improve outcomes among patients with MBC.

Understanding bud rot development, caused by Botrytis cinerea, on cannabis (Cannabis sativa L.) plants grown under greenhouse conditions

Botrytis cinerea is a widespread necrotrophic plant pathogen that causes diseases on >1000 plant species, including vegetables and ornamental greenhouse crops. On cannabis ( Cannabis sativ a L.), the pathogen is responsible for causing “bud rot”, a major disease affecting the inflorescences (compound flowers), as well as seedling damping-off and leaf blight under certain conditions. During greenhouse cultivation, Botrytis cinerea can destroy cannabis inflorescences rapidly under optimal relative humidity conditions (>70%) and moderate temperatures (17–24 °C). Little is currently known about the host–pathogen interactions of Botrytis cinerea on cannabis. Information gleaned from other hosts can provide valuable insights for comparative purposes to understand disease development, epidemiology, and pathogenicity of Botrytis cinerea on cannabis crops. This review describes the pathogenesis and host responses to Botrytis infection and assesses potential mechanisms involved in disease resistance. The effects of microclimatic and other environmental conditions on disease development, strategies for early disease detection using prediction models, and the application of biological control agents that can prevent Botrytis cinerea development on cannabis are discussed. Other potential disease management approaches to reduce the impact of Botrytis bud rot are also reviewed. Numerous opportunities for conducting additional research to better understand the cannabis– Botrytis cinerea interaction are identified.

Nano-metals forming bacteria in Egypt. II. Efficacy towards biomolecules, ultrastructure, growth parameters, and eco-friendly therapeutic of soft rot/blackleg genera

The nanoparticles (NPs) formed by Enterococcus thailandicus, Pseudomonas putida, Marinobacter hydrocarbonoclasticus, and P. geniculate were tested against soft rot/blackleg genera. The effects of NPs recorded on bacterial DNA, proteins, and carbohydrates concentration of Pectobacterium carotovorum subsp. carotovorum, Enterobacter cloacae (soft rot), and Dickeya solani (soft rot/blackleg). Treated cells showed degradation in isolated DNA, decreased proteins and carbohydrates concentration compared with untreated cells. Using Scanning Electron Microscope (SEM), the treated cells showed collapsed and small pits in the cell wall. Using Transmission Electron Microscope (TEM), internal changes showed penetration of NPs inside the tested bacterial cells, the appearance of periplasmic space, formation of vacuoles, and condensation of cytoplasm. Disease severity ex vivo of potato tuber infected with tested genera demonstrated that NPs treatment didn’t show any rotted tissue compared with untreated. The ability to uptake and accumulate FeNPs from the soil in potato (Solanum tuberosum) seedlings; Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-OES) was used. It recorded an increase in iron content of treated potato (Solanum tuberosum) seedlings with NPs, compared with untreated. FeNPs can be used to control soft rot/blackleg diseases, instead of copper pesticides. It could be a new, approach for disease management and increase the plant’s nutritional value.

A COMPREHENSIVE STRATEGY FOR LATE BLIGHT MANAGEMENT IN POTATO AND TOMATO

Late blight is a highly destructive disease primarily affecting potato (Solanum tuberosum) and tomato (Solanum lycopersicum) and some other closely related crops such as aubergine, pepper, solanaceous weeds such as nightshade species, wild tomato etc. This disease is caused by fungus-like organism oomycetes also known as water mold called Phytophthora infestans. Whereas early blight of potato and tomato are caused by fungus Alternaria solani and Alternaria tomatophila respectively. Heinrich Anton De Bary, the father of modern plant pathology studied the epidemics of Late Blight in 1863 and renamed the causal organism Phytophthora infestans (infectious plant destroyer). The disease is severe in areas with high humidity and rainfall and spreads through wind, rain, or contaminated plant material capable of causing entire crop failure if left uncontrolled. Late blight affects foliage, fruit, and tuber and its symptoms include dark, water-soaked lesions on the stem, leaves, and fruit which can rapidly develop into brown, necrotic areas ultimately leading to plant death. Control measures for late blight includes crop rotation, the use of resistant varieties and the application of fungicides. However, the emergence of more virulent strains of Phytophthora infestans and the development of resistance to fungicide application pose ongoing challenges to effective disease management. This paper reviews the current knowledge on management strategies for late blight focusing on integrated disease management approaches. Furthermore, the challenges and prospects of integrated management strategies are discussed.

Unmet needs in uncomplicated urinary tract infection in the United States and Germany: a physician survey

BackgroundUncomplicated urinary tract infections (uUTIs/acute cystitis) are among the most common infections in women worldwide. There are differences in uUTI treatment guidelines between countries and understanding the needs of physicians in diverse healthcare systems is important for developing new treatments. We performed a survey of physicians in the United States (US) and Germany to understand their perceptions of, and management approaches to uUTI.MethodsThis was a cross-sectional online survey of physicians in the US and Germany who were actively treating patients with uUTI (≥ 10 patients/month). Physicians were recruited via a specialist panel and the survey was piloted with 2 physicians (1 US, 1 Germany) prior to study commencement. Data were analyzed with descriptive statistics.ResultsA total of 300 physicians were surveyed (n = 200 US, n = 100 Germany). Across countries and specialties, physicians estimated 16–43% of patients did not receive complete relief from initial therapy and 33–37% had recurrent infections. Urine culture and susceptibility testing was more common in the US and among urologists. The most commonly selected first-line therapy was trimethoprim-sulfamethoxazole in the US (76%) and fosfomycin in Germany (61%). Ciprofloxacin was the most selected following multiple treatment failures (51% US, 45% Germany). Overall, 35% of US and 45% of German physicians agreed with the statement “I feel there is a good selection of treatment options” and ≥ 50% felt that current treatments provided good symptom relief. More than 90% of physicians included symptom relief amongst their top 3 treatment goals. The overall impact of symptoms on patients’ lives was rated “a great deal” by 51% of US and 38% of German physicians, increasing with each treatment failure. Most physicians (> 80%) agreed that antimicrobial resistance (AMR) is serious, but fewer (56% US, 46% Germany) had a high level of confidence in their knowledge of AMR.ConclusionsTreatment goals for uUTI were similar in the US and Germany, although with nuances to disease management approaches. Physicians recognized that treatment failures have a significant impact on patients’ lives and that AMR is a serious problem, though many did not have confidence in their own knowledge of AMR.

Preface

The emerging pest and disease incursions in coconut growing countries result in great economic yield losses and negative impact to the industry, biodiversity loss, and disrupted native and agricultural system.Repeated use of the same active ingredient of pesticide to control pests and diseases could lead to pest and disease resistance. The inevitable effect of climate change, other environmental factors, and the destruction of natural enemies could trigger the incursion and migration of devastating pests and diseases. The massive planting and replanting could create homogeneity in coconut farms, predisposing these to disease infection and pest infestation. The concurrent reported outbreaks of Brontispa in Southeast Asia, Coconut Rhinoceros Beetle, Guam type (CRB-G) in Guam, and Asia-Pacic countries, Coconut Scale Insect in the Philippines, Lethal Yellowing in Jamaica, and Mexico, Bogia Coconut Syndrome in Papua New Guinea, Sexava, Rhyncophorus in Indonesia, and the recognition of the need to develop international biosecurity protocols for safe germplasm exchange have prompted the International Coconut Community (ICC) to hold the 1st IPM symposium.We know that pests and diseases reduced the ability of the industry to fully benefit from the market opportunities. In the face of this situation ICC Sessions and Ministerial meetings as the highest authority and the ICC recommended the ICC Secretariat to convene an IPM symposium to help countries overcome low coconut production due to pests and diseases.The general objective of the symposium is to establish an international IPM network system and synergy to protect the coconut producers & industries and conserve the coconut genetic resources and diversity from the adverse impact of pests and diseases through expertise and experience sharing.The specific objectives of the symposium are:1. To bring together key members of the scientific community for an interactive discussion on emerging issues and advances related to IPM, that will help enhance and develop IPM extension and research on invasive coconut pests and diseases2. To craft ecologically sound, science-based, and sustainable pest and disease management approaches based on IPM practices across countries.3. To create an international platform/network among coconut growing countries to strengthen the development of IPM strategies, pest and disease risk assessment, and inter-country collaborations that will address the research gaps and challenges of managing invasive pests/diseases losses and negative impact on the industry, biodiversity loss, and disrupted native and agricultural system.List of Editor-in-Chief, Managing Editor, Associate Editor, Scientific Committee of IPM Symposium Proceedings are available in this Pdf.

Prophylactic Anti-Seizure Medication Use in Newly Diagnosed Brain Tumor Patients (P3-13.002)

<h3>Objective:</h3> To evaluate the use of prophylactic anti-seizure medications (ASM) in seizure-naïve patients with newly diagnosed brain tumors <h3>Background:</h3> Many physicians continue to prescribe ASM to seizure-naïve brain tumor patients, even though treatment guidelines recommend against such practice. <h3>Design/Methods:</h3> In this retrospective observational study, electronic medical records from the TriNetX Dataworks – USA Network were used to identify patients with a record of brain tumor diagnosis and no evidence of seizure diagnosis from 2012 to 2017. Patients who were prescribed a prophylactic ASM were propensity-score (PS) matched with those who were not at a 1:1 ratio on age, sex, race, ethnicity, tumor types, comorbidities, prescription medications, and procedures. Prophylactic ASM use was defined as the prescription of ≥1 ASM from 30 days before the first brain tumor diagnosis and up to 30 days afterwards. Hazard ratios for seizure development and mortality were assessed using Cox proportional hazards regression models. The first brain tumor diagnosis date was considered the index date, and patients were followed up to 5 years from their first prescription record, death, or whichever occurred first. <h3>Results:</h3> Of the 117,834 seizure-naïve patients who were newly diagnosed with brain tumor, 18,963 (16.1%) were prescribed a prophylactic ASM. Of the 14,238 patients in each PS-matched cohort, 778 of those on prophylaxis (5.5%) and 452 of those not on prophylaxis (3.0%) developed a seizure during the follow-up period (Hazard Ratio: 2.3 [95% CI: 2.0, 2.6]). Mortality hazard was 1.1 times (95% CI: 1.1, 1.2) higher in those on prophylactic ASM. <h3>Conclusions:</h3> Seizure-naïve patients with brain tumor who were prescribed a prophylactic ASM had a higher hazard of developing a seizure compared with those who were not. Unobserved risk factors that were not controlled for may explain the apparent analysis results. Clinical trials are warranted to further examine this controversial disease management approach. <b>Disclosure:</b> Miss Jang has received personal compensation for serving as an employee of Eisai Inc.. Miss Jang has received research support from Eisai Inc.. Dr. Peters has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Vivacitas Oncology. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Servier. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sapience. Dr. Peters has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NuVox Therapeutics. Dr. Peters has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Cordance Medical. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ONO Pharmaceutical. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Blue Earth Diagnostics. The institution of Dr. Peters has received research support from Novocure. The institution of Dr. Peters has received research support from Biomimetix. The institution of Dr. Peters has received research support from Servier. The institution of Dr. Peters has received research support from Varian. The institution of Dr. Peters has received research support from Sapience. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving as a Educational Lecturer with Eisai. Dr. Ngo has received personal compensation for serving as an employee of Eisai Inc.. An immediate family member of Dr. Morita-Sherman has received personal compensation for serving as an employee of Forrester Research. Dr. Morita-Sherman has received personal compensation for serving as an employee of Eisai Inc.. An immediate family member of Dr. Morita-Sherman has stock in Forrester Research. The institution of Dr. Morita-Sherman has received research support from Cleveland Clinic.

A health-systems journey towards more people-centred care: lessons from neglected tropical disease programme integration in Liberia

BackgroundNeglected tropical diseases (NTDs) are associated with high levels of morbidity and disability as a result of stigma and social exclusion. To date, the management of NTDs has been largely biomedical. Consequently, ongoing policy and programme reform within the NTD community is demanding the development of more holistic disease management, disability and inclusion (DMDI) approaches. Simultaneously, integrated, people-centred health systems are increasingly viewed as essential to ensure the efficient, effective and sustainable attainment of Universal Health Coverage. Currently, there has been minimal consideration of the extent to which the development of holistic DMDI strategies are aligned to and can support the development of people-centred health systems. The Liberian NTD programme is at the forefront of trying to establish a more integrated, person-centred approach to the management of NTDs and provides a unique learning site for health systems decision makers to consider how shifts in vertical programme delivery can support overarching systems strengthening efforts that are designed to promote the attainment of health equity.MethodsWe use a qualitative case study approach to explore how policy and programme reform of the NTD programme in Liberia supports systems change to enable the development of integrated people-centred services.ResultsA cumulation of factors, catalysed by the shock to the health system presented by the Ebola epidemic, created a window of opportunity for policy change. However, programmatic change aimed at achieving person-centred practice was more challenging. Deep reliance on donor funding for health service delivery in Liberia limits the availability of flexible funding, and the ongoing funding prioritization towards specific disease conditions limits flexibility in health systems design that can shape more person-centred care.ConclusionSheikh et al.’s four key aspects of people centred health systems, that is, (1) putting peoples voices and needs first; (2) people centredness in service delivery; (3) relationships matter: health systems as social institutions; and (4) values drive people centred health systems, enable the illumination of varying push and pull factors that can facilitate or hinder the alignment of DMDI interventions with the development of people-centred health systems to support disease programme integration and the attainment of health equity.

Essential Oils: An Ecofriendly Approach for Plant Pest and Disease Management

Recently plant essential oils received increasing attention for plant health and food security in the sustainable agriculture context. Essential oils are promising biological sources since they are cost-effective, biodegradable, and safe for human health and the environment. This review covers the essential extraction characteristic, extraction methods, and conservation needed for the scientist’s and industries’ knowledge. Furthermore, the main biological activities and involvement of essential oils in plant pests and diseases are outlined. Finally, this review concludes the potential commercial application and the future challenges of essential oils as an eco-friendly method in sustainable agriculture.

Barriers and Facilitators to the Choice of Active Surveillance for Low-risk Papillary Thyroid Cancer in China: A Qualitative Study Examining Patient Perspectives.

Internationally, several clinical practice guidelines recommend active surveillance as a non-surgical management strategy for select patients with low-risk papillary thyroid carcinoma. However, patient's decision making when choosing active surveillance as a management approach is not well understood. Thus, our aim was to examine the barriers and facilitators to selecting active surveillance amongst patients with low-risk papillary thyroid carcinoma in China. Thirty-nine participants diagnosed with low-risk papillary thyroid carcinoma were purposively recruited between July - Nov 2021 for semi-structured interviews; 24 of whom rejected and 15 patients chose 'active surveillance' as a management approach in our sample. Inductive content analysis illustrated emerging themes. Audit trails, member checks and thematic discussions were used to assert rigor. Barriers and facilitators were classified as patient-related, disease-related, and external factors. Patient-related factors included patient's knowledge, attitudes and emotions. Disease-related factors included the response to having cancer, the constant state of being diseased and perceived value of the thyroid gland. External factors included the residual effects of surgery, the active surveillance protocol and physicians' recommendations. Patient's the acceptability of the active surveillance as a management approach are complex with many influencing factors. The public acceptance of active surveillance as a disease management approach needs to be improved, through the presentation of active surveillance as an evidence-based and optimized dynamic management strategy. Clinicians must address their patients' psychological struggles when patients choosing active surveillance and patients require more attention and supportive intervention.

"I Need to Be the First One with a Different Approach and to Make a Difference to the People": A Mixed Methods Pilot Study on Non-Physician Clinicians Training in Malawi.

To improve child health care depends on the availability of sufficient numbers of skilled healthcare workers. To achieve this, the German Society of Tropical Paediatrics & International Child Health supported the existing three-year Bachelor of Science in Paediatrics and Child Health training for Clinical Officers, a non-physician clinician cadre, from 09/2017 to 08/2019. This study aims to evaluate the project to inform forthcoming training. All 17 students who were in training took part in this study. Quantitative data collection took place between 01/2018 to 06/2019 using the post-self-assessment bloc course survey, Research Self-Efficacy Scale (RSES), and Stages of Change (SOC) model. Students and key informants participated in three focus group discussions and five in-depth interviews during April 1-10, 2019. Students mostly perceived bloc course contents "At their level" (92%) and "Very important/relevant" (61%) with "Good quality" teaching (70.5%). The mean (SD) score for RSES (10-point scale) was 9.10 (0.91). The SOC (4-point scale) scores were higher for "Attitude" and "Intention" statements than "Action". Students found the program well-paced, felt that their clinical knowledge and skills had improved, and valued the acquired holistic disease management approach. They reported increased confidence and being more prepared for leadership roles in their future work. The involvement of international teachers and supervisors enriched their global perspectives. Students improved their clinical and non-clinical skills, developed self-efficacy and attitudes toward research, and were confident to build and utilize their networks. These transformative experiences could facilitate the development of change agents among current and future trainees.

Passaging Phyllosphere Microbial Communities Develop Suppression Towards Bacterial Speck Disease in Tomato

Microbial community-based disease management approaches have the potential to substitute or combine with currently employed strategies. Suppressive soils are great examples of microbial communities that suppress soilborne plant disease after severe outbreaks and are maintained over multiple years or crop cycles. Although there are many suppressive soil examples, to our knowledge, there are no descriptions of disease-suppressive phyllosphere communities. Therefore, we investigated whether a phyllosphere microbial community could be developed through a selective passaging method to suppress disease using the model pathosystem of Pseudomonas syringae pv. tomato ( Pto) and tomato. Field tomato phyllosphere microbial communities were recovered and spray transferred to greenhouse tomato plants, after which they were inoculated with Pto. Disease severity was visually estimated and the microbial communities were recovered to be independently applied to the next passage. Overall, greenhouse passaging resulted in an increase in disease severity for all passage lines from the initial passage, which peaked at passage 4 to 5, followed by a sharp decline until passage 9. The disease severity at passage 9 was also significantly lower than a non-passaged Pto-only comparison. Heat treatment of passage 9 communities resulted in elevated disease severity over several subsequent passages in the growth chamber, whereas the untreated community maintained low disease. Community-only passage lines (without Pto inclusion during passaging) did not show disease suppression after subsequent pathogen introduction. This work presents an experimental approach to develop phyllosphere microbial communities in the presence of a phytopathogen to enrich for a low disease phenotype and results in maintained disease suppression. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .

Intermittent fasting with ketogenic diet: A combination approach for management of chronic diseases

Intermittent Fasting (IF) is the consumption of food and drinks within a defined time, while the ketogenic diet (KD) switches the metabolism from glucose to fats. Continuation of intermittent fasting leads to the generation of ketones, the exact mechanism for a ketogenic diet. This article discusses the types of IF and KD, the monitoring required, and the mechanisms underlying IF and KD, followed by disorders in which the combination strategy could be applied. The strategies for successfully applying combination therapy are included, along with recommendations for the primary care physicians (PCP) which could serve as a handy guide for patient management. This opinion article could serve as the baseline for future clinical studies since there is an utmost need for developing new wholesome strategies for managing chronic disorders.

Potato bacterial wilt in Ethiopia: history, current status, and future perspectives.

Potato is an essential food staple and a critical tuber crop for rural livelihoods in Ethiopia, where many pathogenic pests are threatening production. Bacterial wilt, also known as brown rot of potato, ranks among the diseases that most affect many potato farmers in Ethiopia and the disease losses dramatically threatening the vibrant potato sector even in the highlands of the country where it has been uncommon so far. To devise a strategy towards boosting potato productivity in Ethiopia where food insecurity is most prevalent, production constraints should be investigated and properly addressed. Hence, we have used existing reviews and reports on the subjects, such as textbooks, and proceeding and conference abstracts in Plant Protection Society of Ethiopia; Web of Science; Google Scholar; Research Gate and CIP's database to document most relevant information on the occurrence, distribution, and disease management of bacterial wilt in Ethiopia. Provision of comprehensive information on potato bacterial wilt occurrence, distribution, and management techniques are crucial for potato growers, researchers and stakeholders engaged on potato industry. In this review, we provided insights on the history, status, and future perspectives of potato bacterial wilt in Ethiopia. Awareness of potato bacterial wilt and integrated disease management approaches could bring a fundamental impact to the farming community mostly to smallholder farmers in developing countries. This document compiled such imperative information targeting bacterial wilt management techniques to ensure food security.

Genome and Transcriptome Analysis of Ascochyta pisi Provides Insights into the Pathogenesis of Ascochyta Blight of Pea.

Ascochyta blight caused by Ascochyta pisi is a major constraint to pea (Pisum sativum L.) production worldwide. Deciphering the pathogenic mechanism of A. pisi on peas will help in breeding resistant pea varieties and developing effective approaches for disease management. However, little is known about the genomic features and pathogenic factors of A. pisi. In this study, we first report that A. pisi is one of the causal agents of ascochyta blight disease of pea in China. The genome of the representative isolate A. pisi HNA23 was sequenced using PacBio and Illumina sequencing technologies. The HNA23 genome assembly is almost 41.5 Mb in size and harbors 10,796 putative protein-encoding genes. We predicted 555 carbohydrate-active enzymes (CAZymes), 1,008 secreted proteins, 74 small secreted cysteine-rich proteins (SSCPs), and 26 secondary metabolite biosynthetic gene clusters (SMGCs). A comparison of A. pisi genome features with the features of 6 other available genomes of Ascochyta species showed that CAZymes, the secretome, and SMGCs of this genus are considerably conserved. Importantly, the transcriptomes of HNA23 during infection of peas at three stages were further analyzed. We found that 245 CAZymes and 29 SSCPs were upregulated at all three tested infection stages. SMGCs were also trigged, but most of them were induced at only one stage of infection. Together, our results provide important genomic information on Ascochyta spp. and offer insights into the pathogenesis of A. pisi. IMPORTANCE Ascochyta blight is a major disease of legumes worldwide. Ascochyta pisi and other Ascochyta species have been identified as pathogens of ascochyta blight. Here, we first report that A. pisi causes ascochyta blight of pea in China, and we report the high-quality, fully annotated genome of A. pisi. Comparative genome analysis was performed to elucidate the differences and similarities among 7 Ascochyta species. We predict abundant CAZymes (569 per species), secreted proteins (851 per species), and prolific secondary metabolite gene clusters (29 per species) in these species. We identified a set of genes that may be responsible for fungal virulence based on transcriptomes in planta, including CAZymes, SSCPs, and secondary metabolites. The findings from the comparative genome analysis highlight the genetic diversity and help in understanding the evolutionary relationship of Ascochyta species. In planta transcriptome analysis provides reliable information for further investigation of the mechanism of the interaction between Ascochyta spp. and legumes.

The SUMOylation Pathway Components Are Required for Vegetative Growth, Asexual Development, Cytotoxic Responses, and Programmed Cell Death Events in Fusarium oxysporum f. sp. niveum.

SUMOylation is an essential protein modification process that regulates numerous crucial cellular and biochemical processes in phytopathogenic fungi, and thus plays important roles in multiple biological functions. The present study characterizes the SUMOylation pathway components, including SMT3 (SUMO), AOS1 (an E1 enzyme), UBC9 (an E2 enzyme), and MMS21 (an E3 ligase), in Fusarium oxysporum f. sp. niveum (Fon), the causative agent of watermelon Fusarium wilt, in terms of the phylogenetic relationship, gene/protein structures, and basic biological functions. The SUMOylation components FonSMT3, FonAOS1, FonUBC9, and FonMMS21 are predominantly located in the nucleus. FonSMT3, FonAOS1, FonUBC9, and FonMMS21 are highly expressed in the germinating macroconidia, but their expression is downregulated gradually in infected watermelon roots with the disease progression. The disruption of FonUBA2 and FonSIZ1 seems to be lethal in Fon. The deletion mutant strains for FonSMT3, FonAOS1, FonUBC9, and FonMMS21 are viable, but exhibit significant defects in vegetative growth, asexual reproduction, conidial morphology, spore germination, responses to metal ions and DNA-damaging agents, and apoptosis. The disruption of FonSMT3, FonAOS1, FonUBC9, and FonMMS21 enhances sensitivity to cell wall-perturbing agents, but confers tolerance to digestion by cell wall-degrading enzymes. Furthermore, the disruption of FonSMT3, FonAOS1, and FonUBC9 negatively regulates autophagy in Fon. Overall, these results demonstrate that the SUMOylation pathway plays vital roles in regulating multiple basic biological processes in Fon, and, thus, can serve as a potential target for developing a disease management approach to control Fusarium wilt in watermelon.