Colonization Index Research Articles

Unravelling the relationships among Verticillium wilt, irrigation, and susceptible and tolerant olive cultivars

AbstractSurvival, germination, olive colonization, and water‐use efficiency (WUE) impairments by Verticillium dahliae could be influenced by cultivar susceptibility or irrigation, and this could modify the irrigation–pathogen–disease relationship. In this study, the combined effects of irrigation and cultivar susceptibility on Verticillium wilt (VW) development were modelled by the temporary assessment of V. dahliae propagules (total inoculum density, density of micropropagules, and sclerotia in wet and air‐dried soil; ID, MpD, SwD, and SdD, respectively), root (RCI) and shoot (SCI) colonization indexes, and WUE. The relationship of disease severity to the measured parameters was then explored. Under controlled conditions, plants of cultivars ‘Picual’ and ‘Frantoio’ were irrigated to a high and low rate by varying drip‐irrigation frequencies: daily, twice weekly, and a combination of daily for 11 days and then twice weekly. Disease severity and colonization parameters were higher in ‘Picual’, while WUE was higher in ‘Frantoio’. However, high rate and twice weekly and combination treatments significantly increased disease incidence and reduced time‐to‐symptoms‐onset only in ‘Picual’, while high rate reduced WUE and increased relative ID, MpD, and SwD in both cultivars. Irrigation did not affect SCI, but a higher RCI was found at high rate during the development of symptoms in ‘Picual’. By using classification trees to examine parameters—disease severity relationships, it was possible to determine the degree to which VW was affected by irrigation and/or cultivar susceptibility. MpD was the best indicator for VW detection at any time, WUE was best before symptoms developed, and RCI, total ID, and SdD after symptoms developed.

Protective effects of total saponins of Codonopsis on ulcerative colitis induced by TNBS in rats and its mechanism

Objective: To study the protective effects and mechanisms of total saponins of Codonopsis (TSC) on ulcerative colitis in rats. Methods: Fifty male Wistar rats were randomly divided into 5 groups: control group, model group, salazosulfadiazine (SASP) positive control group (0.3 g/kg), TSC high- and low-dose experimental groups(1.2, 0.4 g/kg). UC rat model was established by trinitrobenzene sulfonic acid (TNBS)/ ethanol enema. After administration for 21 days, the rats' symptoms and signs, disease activity index (DAI), colonic mucosal injury index (CMDI) and colonic tissue morphology were observed. The contents of superoxide dismutase (SOD), malondialdehyde (MDA), inflammatory cytokines interleukin-6 (IL-6), interleukin-10 (IL-10) and tumor necrosis factor (TNF-α) in colon tissues were determined. Protein expression of nuclear nuclear transcription factor-κB (NF-κB) in colon tissues was detected. Finally, the effect of TCS therapy was evaluated. Results: Compared with the control group, the DAI and CMDI scores of the rats in the model group were increased significantly, meanwhile the colonic mucosa was seriously damaged, indicating that the model was successful. Compared with the model group, the TSC high and low dose groups could significantly reduce the DAI and CMDI score (P＜0.05) and improve the colonic mucosa form. TSC also could increase the SOD activity and decrease MDA content in colon tissues(P＜0.05), while inhibit the levels of IL-6 and TNF-α mRNA in the colon tissues and promote the expression of IL-10 mRNA (P＜0.01). At the same time, TSC reduced the expressions of NF-κB protein in the colon (P＜0.01). The TSC high-dose group was superior to the low-dose group (P＜0.05). Conclusion: TSC has significant protective effects on ulcerative colonic mucosal damage in UC rats, and there is a dose-dependent relationship; its mechanism may be related to anti-lipid peroxidation and inhibiting the NF-κB signaling pathway to regulate the release of inflammatory factors.

Exploring the Mechanism of Berberine Intervention in Ulcerative Colitis from the Perspective of Inflammation and Immunity Based on Systemic Pharmacology.

Background Ulcerative colitis (UC) is a chronic nonspecific inflammatory disease of the colon and rectum. Recent studies found that berberine had effects on inflammatory diseases and immune diseases. Methods The PharmMapper database was used to predict the berberine potential target and GeneCards database and OMIM database were utilized to collect UC genes. The Cytoscape software was used to construct and analyze the networks and DAVID was utilized to perform enrichment analysis. Then, animal experiments were performed to validate the prediction results. The experimental rats were randomly divided into normal group (control group), model group, and berberine group. The general condition, body weight, gross morphology of colon tissue, and colonic mucosal damage index (CMDI) score were observed. The pathological changes of colon tissue were observed by H&E staining. The levels of serum interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and IL-4 were detected by ELISA. The expressions of IL-1β, TNF-α, and IL-4 protein in colon tissue were detected by immunohistochemistry. Results A total of 211 Berberine's potential targets and 210 UC genes were obtained. The enrichment analysis showed that berberine may regulate inflammation, inflammatory cytokines, and their mediated inflammation signal pathways such as inflammatory bowel disease (IBD), rheumatoid arthritis, cytokine-cytokine receptor interaction, TNF, T cell receptor, Toll-like receptor, and JAK/STAT signaling pathway. Compared with the model group, the body mass of rats in the berberine group was significantly increased (P < 0.05); the general morphology and pathological changes of colon tissue were significantly improved; CMDI score, serum and colon tissue IL-1β, TNF-α content, and protein expression were decreased significantly (P < 0.05); and IL-4 content and protein expression increased significantly (P < 0.05). Conclusion Berberine can interfere with UC through related biological processes and signal pathways related to inflammation and immunity. In-depth exploration of the mechanism of berberine in the treatment of UC will provide a basis for clinical application.

The fermentation characteristics of Sparassis crispa polysaccharides and their effects on the intestinal microbes in mice

BackgroundSparassis crispa polysaccharides (SCPs) have multiple pharmacological activities. Fermentation characteristics of SCPs and its effects on the intestinal microbes in mice remain inconclusive.ResultsIn this study, SCPs were fermented by the human feces and used to administer the Kunming mice to explore the fermentation characteristics of SCPs in the intestinal tract and the effects on the intestinal microbes in mice. Results from in vitro experiments revealed that SCPs were utilized by intestinal microbiota to produce short-chain fatty acids (SCFAs). The specific monosaccharide composition of SCPs determines which SCFAs are produced. Furthermore, the colon index and villi length of the SCPs-treated mice were significantly higher compared with the control group. In addition, SCPs exhibited beneficial effect on the relative abundance and diversity of dominant bacteria in the intestinal tract, such as increasing Bacteroidetes/Firmicutes ratio and up-regulating SCFA-producing bacteria, including Bacteroidales_S24-7_group, Alloprevotella, Alistipes, Bacteroides, Butyricimonas, Parabacteroides, Lachnospiraceae_NK4A136_group and Oscillibacter. SCPs increased the abundance of genes in carbohydrate, amino acid, and energy metabolism.ConclusionOur results indicate SCPs can improve the physiological indices of the colon in mice, which is likely to be associated with the increase in the relative abundance and diversity of SCFA-producing bacteria and SCFAs level produced by intestinal microbiota.Graphic abstract

Molecular Epidemiology, Natural History, and Long-Term Outcomes of Multidrug-Resistant Enterobacterales Colonization and Infections Among Solid Organ Transplant Recipients.

Multidrug-resistant Enterobacterales (MDR-E), including carbapenem-resistant and third-generation cephalosporin-resistant Enterobacterales (CRE, CefR-E), are major pathogens following solid organ transplantation (SOT). We prospectively studied patients who underwent lung, liver, and small bowel transplant from February 2015 through March 2017. Weekly perirectal swabs (up to 100 days post-transplant) were cultured for MDR-E. Whole-genome sequencing (WGS) was performed on gastrointestinal (GI) tract-colonizing and disease-causing isolates. Twenty-five percent (40 of 162) of patients were MDR-E GI-colonized. Klebsiella pneumoniae was the most common CRE and CefR-E. Klebsiella pneumoniae carbapenemases and CTX-M were leading causes of CR and CefR, respectively. Thirty-five percent of GI colonizers developed MDR-E infection vs 2% of noncolonizers (P < .0001). The attack rate was higher among CRE colonizers than CefR-E colonizers (53% vs 21%, P = .049). GI colonization and high body mass index were independent risk factors for MDR-E infection (P ≤ .004). Thirty-day mortality among infected patients was 6%. However, 44% of survivors developed recurrent infections; 43% of recurrences were late (285 days to 3.9 years after the initial infection). Long-term survival (median, 4.3 years post-transplant) did not differ significantly between MDR-E-infected and MDR-E-noninfected patients (71% vs 77%, P = .56). WGS phylogenetic analyses revealed that infections were caused by GI-colonizing strains and suggested unrecognized transmission of novel clonal group-258 sublineage CR-K. pneumoniae and horizontal transfer of resistance genes. MDR-E GI colonization was common following SOT and predisposed patients to infections by colonizing strains. MDR-E infections were associated with low short- and long-term mortality, but recurrences were frequent and often occurred years after initial infections. Findings provide support for MDR-E surveillance in our SOT program.

Risk factors for infestation by Triatoma dimidiata in a rural locality of Veracruz, Mexico, with active transmission of Trypanosoma cruzi: weather and rain as factors.

To analyse the ecological and social factors involved in infestation of houses by Triatoma dimidiata in a rural locality of Veracruz, Mexico, where active transmission of the parasite is occurring. A survey was applied to the households of the locality to obtain sociodemographic data. In parallel, T.dimidiata insects were collected during one year through community participation. Using PCR, the insects were genotyped, their infection status was assessed, and parasite genotypes infecting the insects were identified. The vector's blood meal sources were identified using a polymerase-heteroduplex chain reaction assay. Seasonal variations in the patterns of infestation by T.dimidiata were observed. An overall infestation rate of 19.46%, a colonisation index of 9.09%, a dispersion rate of 22.15% and a synanthropy index of 80.6% were found. The collected insects were identified as ITS-2 group 2 insects, and a natural infection with T. cruzi of 54.35% was found. TcI and no-TcI genotypes of T. cruzi were found in infected insects. Factors such as rain (P=0.0006) and temperature (P<0.0001) were associated with infestation. Analysis of the blood meal sources indicated frequent feeding upon humans and mice. Furthermore, house materials and peridomiciles were found to play an important role in the dynamics of infestation. The contribution of this study is important for understanding the epidemiology of Chagas disease in rural areas of the state of Veracruz and will help to the establishment of an entomological surveillance system and implementation of prevention and control measures in accordance with the reality of the area.

Gastroparesis Symptoms Associated with Intestinal Hypomotility: An Explorative Study Using Wireless Motility Capsule.

ObjectiveGastric emptying measurements are mandatory in gastroparesis diagnostics, but the association between delayed emptying and symptoms is questionable. It is imperative to find biomarkers better correlated to symptom generation. Hence, we examined the association between symptom severity and gastrointestinal motility measured by wireless motility capsule.Patients and MethodsIn this prospective single-centre study, patients with gastroparesis symptoms were simultaneously investigated with gastric emptying scintigraphy and wireless motility capsule, measuring regional transit times and contractility parameters. Symptom severity was assessed with the Patient Assessment of Upper Gastrointestinal Symptom Severity Index (PAGI-SYM), including the Gastroparesis Cardinal Symptom Index (GCSI).ResultsWe included 107 patients (70% women). In the whole patient group, nausea correlated with the gastric (rs = −0.31, p = 0.007), small bowel (rs = −0.41, p < 0.001) and colonic (rs = −0.33, p = 0.012) motility indices. In patients with idiopathic etiology, nausea correlated with small bowel motility index (rs = −0.81, p < 0.001) and mean stomach pressure (rs = −0.64, p = 0.013). We also found negative correlations between total GCSI score and maximum pressure of the small bowel (rs = −0.77, p < 0.001) and colon (rs = −0.74, p = 0.002). In diabetes patients, total PAGI-SYM score correlated with colonic motility index (rs = −0.34, p = 0.012), and mean pressure of the colon correlated with upper abdominal pain (rs = −0.37, p = 0.007). We found no association between symptoms, gastric emptying nor any other transit times.ConclusionIn patients with gastroparesis symptoms, we found that symptom severity was associated with intestinal hypomotility. Based on these results, gastroparesis diagnostics should also include an evaluation of the small bowel and colon.

Diversidad de hongos micorrízicos arbusculares asociados a calabaza italiana (Cucurbita pepo L.) bajo acolchado plástico en campo.

Las comunidades microbianas tienen efectos sobre el crecimiento y productividad de los cultivos. Sin embargo, se pueden ver afectadas por diversas prácticas agrícolas. El objetivo de la investigación fue determinar la diversidad de hongos micorrízicos arbusculares (HMA) asociados al cultivo de calabaza italiana establecido en campo bajo acolchado plástico. Se evaluó la colonización, riqueza, abundancia, e índice de diversidad micorrízica en ocho tratamientos: V (vermicomposta), APB (acolchado plástico blanco), APB+V; APR (acolchado plástico rojo), APR+V; APN (acolchado plástico negro), APN+V y C (control = sin vermicomposta y acolchado plástico), distribuidos en un diseño de bloques al azar de efectos aleatorios en arreglo factorial, y las interacciones vermicomposta (con y sin vermicomposta), acolchado (sin acolchar, con APR, APB, APN) y ciclo de cultivo invierno-primavera (I-P) y verano-otoño (V-O) con tres repeticiones. Para el análisis estadístico se utilizó el software Statistica v. 12.0 para Windows. Tras comprobar la distribución normal de los datos y la homogeneidad de las varianzas, se realizaron análisis de varianza multifactorial y las medias se compararon según el criterio de Tukey (α = 0.05). Para colonización micorrízica y riqueza el ANOVA mostró diferencias signif icativas (P ≤ 0.05) por efecto de la vermicomposta, el acolchado plástico y el ciclo de cultivo. En la abundancia relativa de HMA, el número de esporas de Acaulospora morrowiae fue el más alto en el tratamiento APN (37.0%) del ciclo I-P, y la misma predisposición natural ocurrió en el ciclo V-O, donde A. morrowiae fue la morfoespecie predominante (50%) en el tratamiento APN. En índice de diversidad solo influyeron los factores vermicomposta y acolchado plástico. Se identif icaron 21 morfoespecies en V-O y solo 12 en I-P, y se constató que el APN afectó a los HMA en todas las variables evaluadas.

Characterization of Fusarium population associated with wilt of jojoba in Israel

AbstractFusarium wilt, caused by Fusarium oxysporum, is a major disease of jojoba, causing serious economic losses. This study was aimed at characterizing the Fusarium populations associated with jojoba in Israel. Fifty Fusarium isolates used in this study included 23 isolates from the 1990s (“past”) and 27 recently isolated (“recent”). All the isolates were characterized by arbitrarily primed (ap)‐PCR and 16 representatives were additionally delineated using multilocus (tef1, rpb1, rpb2) phylogeny and evaluated for their pathogenic potential. Consequently, 88% of the isolates were identified and characterized to the F. oxysporum species complex. The remaining 12% grouped within the F. fujikuroi, F. solani, and F. redolens species complexes. Variations in the infection rate (16.7%–100%), disease symptoms (0.08–1.25, on a scale of 0–3), and fungal colonization index (0.67–2.17, on a scale of 0–4) were observed within the tested isolates, with no significant differences between the past and recent isolates. The representative isolates were assigned to 11 groups based on ap‐PCR. Pathogenicity tests showed that isolates from Groups II, IV, and V were the most aggressive, whereas isolates from Groups III, VIII, and IX were the least aggressive. Among the tested isolates, F. oxysporum sensu lato was the most aggressive, followed by F. proliferatum, while F. nygamai was the least aggressive. This study demonstrates the complexity and genetic diversity of Fusarium wilt on jojoba in Israel, indicating possible multiple introductions of infected germplasm into the country.

Carob fruit extract-enriched meat, as preventive and curative treatments, improves gut microbiota and colonic barrier integrity in a late-stage T2DM model

Epidemiological and experimental studies have suggested that dietary fiber and proanthocyanidins play an important role on gut microbiota (GM), colonic integrity and body health. Type 2 Diabetes Mellitus (T2DM) is a prevalent disease in which the modifications in the GM and colonic markers stand out. This manuscript hypothesizes the consumption of functional meat enriched in carob fruit extract [CFE; CFE-restructured meat (RM)] ameliorates the dysbiosis and colonic barrier integrity loss in a late-stage T2DM rat model induced by the conjoint action of a high-saturated-fat/high-cholesterol diet (Chol-diet) and a low dose of streptozotocin (STZ) plus a nicotinamide (NAD) injection. Three groups of eight rats were used: (1) D group, a T2DM control group, fed the Chol-diet; (2) ED group, a T2DM preventive strategy group fed the CFE-Chol-diet since the beginning of the study; and (3) DE group, a T2DM curative treatment group, fed the CFE-Chol-diet once the diabetic state was confirmed. The study lasted 8 weeks. Amount and variety of GM, feces short-chain-fatty acids (SCFAs), colonic morphology [crypt depth and density, goblet cells, proliferating cell nuclear antigen (PCNA) and transferase dUTP nick end labelling (TUNEL) indexes] and tight junctions were evaluated. A global colonic index combining 17 markers (GCindex) was calculated. ED rats displayed higher levels of GM richness, SCFAs production, crypt depth, and goblet cells than the D group. DE group showed lower Enterobacteriaceae abundance and greater TUNEL index and occludin expression in the distal colon than D counterpart. GCindex differentiated the colonic health status of the experimental groups in the order (ED > DE > D; P < 0.001) as a 17–51 range-quotation, ED, DE, and D groups displayed the values 43, 32.5, and 27, respectively. Thus, CFE-RM used as a T2DM preventive therapy could induce higher GM richness, more adequate SCFAs production, and better colonic barrier integrity. Furthermore, CFE-RM used with curative purposes induced more modest changes and mainly at the distal colonic mucosa. Further studies are needed to confirm this study’s results, to ascertain the benefits of consuming proanthocyanidins-rich fiber during different T2DM stages.

Investigation of Factors Influencing the Reproduction of Non-Gregarious Locust Pests in Northern Kazakhstan to Substantiate the Forecast of their Number and Planning of Protective Measures

The article presents the results of many years of research on the phytosanitary state of agricultural land for non-gregarious locust pests. As polyphagous pests, non-gregarious locusts are one of the key destabilizing factors in the production of economically important agricultural plants in the agricultural regions of Northern Kazakhstan. Research on the long-term population dynamics of non-gregarious locust pests to determine bioecological regularities and factors influencing them for early forecasting an increase in the number and rational planning of plant protection products is very relevant. The studies were carried out in 1999-2019 based on the use of data on the distribution of non-gregarious locusts in Akmola, Pavlodar, Kostanay and North Kazakhstan regions. Numerical indicators of pest colonization and abundance indices were used as diagnostic predictors characterizing the phase state of species in a given year, which made it possible to establish patterns of population dynamics of locusts. Based on the research results, the authors concluded that the expected onset of certain phases of the dynamics of the phytophagous population was not always preserved and was subject to change under the influence of environmental factors. The trend in the dynamics of the number of studied phytophages depends to a large extent on the weather conditions of the previous and current year, as well as on the full amount of volumes and compliance with the necessary procedures. The data obtained can be proposed as criteria for predicting the phase state of populations of non-gregarious locusts in Northern Kazakhstan to justify and plan protective measures, as well as to improve phytosanitary control over non-gregarious locusts.

Protective Effect of Apium graveolens L. (Celery) Seeds Extracts and Luteolin on Acetic Acid-Induced Colitis in Rats.

Introduction:Anti-oxidant, antispasmodic, anti-inflammatory, and analgesic effects have been reported for Apium graveolens Linn. ) Celery( seeds and its active component luteolin. So, this study was carried out to investigate the protective effects of hexane (AGHE) and methanol (AGME) extracts of A. graveolens seeds and luteolin on acetic acid-induced colitis in rats.Methods:Three doses of AGHE (100, 200, and 400 mg/kg), AGME (200, 400, and 800 mg/kg), and luteolin (5, 10, and 20 mg/kg) were administered orally (p.o.) to separate groups of male Wistar rats, 2 h before ulcer induction (acetic acid 4%) and continued once daily for 4 days. Prednisolone (4 mg/kg) and mesalazine (100 mg/kg) were used as reference and vehicle (2 mL/kg) as control groups. Colon biopsies were taken for weighting, macroscopic and histopathologic evaluation, and measuring myeloperoxidase (MPO) activity.Results:Our findings showed that AGHE (200 and 400 mg/kg), AGME (400 and 800 mg/kg), and luteolin (10 and 20 mg/kg) were effective to reduce colonic ulcer score, area, and index as well as total colitis index, and MPO activity significantly in comparison with controls. Since the lowest doses of extracts and luteolin were not significantly effective to diminish evaluated parameters of colitis, it is concluded that the ameliorative effect was dose related.Conclusion:It is also concluded that both extracts and luteolin, as an important ingredient of celery extract, were effective in the amelioration of colitis in rats, but further clinical and detailed mechanistic experiments are required to introduce these natural agents for colitis treatment or prevention in human.

Cornelian Cherry Iridoid-Polyphenolic Extract Improves Mucosal Epithelial Barrier Integrity in Rat Experimental Colitis and Exerts Antimicrobial and Antiadhesive Activities In Vitro.

Background and Aims Inflammatory bowel disease pharmacotherapy, despite substantial progress, is still not satisfactory for both patients and clinicians. In view of the chronic and relapsing disease course and not always effective treatment with adverse effects, attempts to search for new, more efficient, and safer substances are essential and reasonable. This study was designed to elucidate the impact of cornelian cherry iridoid-polyphenolic extract (CE) and loganic acid (LA) on adherent-invasive E. coli growth and adhesion in vitro and to assess the effect of pretreatment with CE or LA on the course of intestinal inflammation in rat experimental colitis compared with sulfasalazine. Methods Antibacterial and antiadhesive activities of CE and LA were assessed using microdilution, Int407 cell adherence, and yeast agglutination assays. The colitis model was induced by 2,4,6-trinitrobenzenesulfonic acid. Studied substances were administered intragastrically for 16 days prior to colitis induction. Body weight loss; colon index; histological injuries; IL-23, IL-17, TNF-α, and chemerin levels; and STAT3, Muc2, and TFF3 mRNA expression were evaluated. Results Only CE exerted antimicrobial and antiadhesive activities in vitro and alleviated colonic symptoms. CE coadministrated with sulfasalazine was more effective than single compounds in reversing increased concentrations of TNF-α, IL-17, and chemerin and decreased Muc2 mRNA expression. Conclusions CE exerted a protective effect against experimental colitis via impaired mucosal epithelial barrier restoration and intestinal inflammatory response attenuation and given concomitantly with sulfasalazine counteracted colitis in a more effective way than sulfasalazine alone, which indicates their synergistic interaction. The beneficial effect of CE may also be due to its bacteriostatic and antiadhesive activities.

КЛИНИКО-ЛАБОРАТОРНАЯ ОЦЕНКА ПРИМЕНЕНИЯ БАЛЬЗАМА ДЛЯ ДЕСЕН «ЛЕСНОЙ БАЛЬЗАМ» ПРИ ЛЕЧЕНИИ ВОСПАЛИТЕЛЬНЫХ ЗАБОЛЕВАНИЙ ПАРОДОНТА

Subject. Microorganisms are a fundamental factor in the development of inflammation. The choice of a medicinal composition in the form of a gel can provide a prolonged introduction of dosage forms into the focus of inflammation. For our research, the herbal medicine Gum balm "Forest Balm" was selected. The main components are aloe juice, bisabolol, panthenol and ginger extract, which have an anti-inflammatory and wound-healing effect; troxerutin, which helps reduce gum bleeding; fir extract, which blocks the growth of pathogenic oral microbiota.&#x0D; Purpose ― to assess the effectiveness of the use of gum balm "Forest Balsam" in the treatment of inflammatory periodontal diseases &#x0D; Methodology. A survey of 30 volunteer patients aged 20 to 22 years was conducted. Dental examinations were performed at the following time intervals: before application, after the 1st application, after 3 days, after 5 days and 7 days of application. The prevalence of the inflammatory process was assessed using the papillary-marginal-alveolar index and the Muhlemann bleeding index (modified by Cowell). Qualitative and quantitative study of microbiological material was performed by measuring the buccal epithelial colonization index to determine the status of local immunity.&#x0D; Results. Changes in the cytological picture in the direction of normocenosis are determined on the third day of applying the gum balm "Forest balm". On the 7th day of application, it eliminates all visible symptoms of gum disease (bleeding, inflammation, swelling).&#x0D; Conclusions. Gum balm "Forest balm" improves the protective function of the oral cavity by activating cellular defense mechanisms, strengthens local immunity, activates its own immune defense of the oral cavity to fight opportunistic microorganisms, increases the colonization resistance of the oral mucosa to opportunistic microorganisms.

Invasive candidiasis in critical care: challenges and future directions.

Invasive candidiasis is the most common critical care-associated fungal infection with a crude mortality of ~ 40-55%. Important factors contributing to risk of invasive candidiasis in ICU include use of broad-spectrum antimicrobials, immunosuppressive drugs, and total parenteral nutrition alongside iatrogenic interventions which breach natural barriers to infection [vascular catheters, renal replacement therapy, extracorporeal membrane oxygenation (ECMO), surgery]. This review discusses three key challenges in this field. The first is the shift in Candida epidemiology across the globe to more resistant non-albicans species, in particular, the emergence of multi-resistant Candida glabrata and Candida auris, which pose significant treatment and infection control challenges in critical care. The second challenge lies in the timely and appropriate initiation and discontinuation of antifungal therapy. Early antifungal strategies (prophylaxis, empirical and pre-emptive) using tools such as the Candida colonisation index, clinical prediction rules and fungal non-culture-based tests have been developed: we review the evidence on implementation of these tools in critical care to aid clinical decision-making around the prescribing and cessation of antifungal therapy. The third challenge is selection of the most appropriate antifungal to use in critical care patients. While guidelines exist to aid choice, this heterogenous and complex patient group require a more tailored approach, particularly in cases of acute kidney injury, liver impairment and for patients supported by extracorporeal membrane oxygenation. We highlight key research priorities to overcome these challenges in the future.

A Retrospective Ecological Status Assessment of the Lakes Based on Historical and Current Maps of Submerged Vegetation—A Case Study from Five Stratified Lakes in Poland

This article presents and tests a new method for the retrospective assessment of ecological status assessment of the lakes in accordance with the Ecological State Macophyte Index (ESMI), which is formally used in biological monitoring in Poland. The proposed method is based on three metrics, the Z colonization index, the average maximum depth of lake vegetation Cmax, and the Secchi disk depth. Mathematical functions of ecological class were developed on the basis of the mean values of these three indicators in summer for different ecological status classes in 88 stratified lakes in northern Poland and the Łęczyńsko-Włodawskie Lake District and five lakes in the catchment area of the Wel River (published data). The new metrics were validated on the basis of literature data—ESMI, Cmax, Z and SD values from 11 lakes near Olsztyn (Poland). The obtained results are similar to those calculated based on macrophyte field surveys and can be an alternative of the Ecological State Macophyte Index (ESMI), which is formally used in biological monitoring in Poland. The proposed method makes it possible to compare long-term changes in the ecological state of lakes, because it enables an analogous assessment on the basis of data calculated from historical bathymetric maps showing the distribution of hydro macrophytes (parameters Z and Cmax) as well as contemporary data, collected, among others, during hydroacoustic research.

Patterns of Health Insurance Coverage and Lung Disease Progression in Adolescents and Young Adults with Cystic Fibrosis.

Rationale: Health insurance coverage has been implicated as a socioeconomic factor affecting clinical outcomes in patients with cystic fibrosis (CF), but evidence for this is mixed and varies by age.Objectives: Focusing on adolescents and young adults with CF, we examined how multiyear patterns of health insurance coverage were associated with lung function decline and related outcomes.Methods: We used data from the 2000 to 2015 CF Foundation Patient Registry to classify patients in three cohorts (ages 12-17 yr, adolescents; 18-23 yr, transitioning to adulthood; and 24-29 yr, young adults) according to health insurance coverage, as follows: continuous private, continuous public, intermittent public, and coverage gaps. The primary outcome was the percentage predicted forced expiratory volume in 1 second (FEV1pp), which was modeled using mixed-effects regression. Additional outcomes included outpatient visits, hospital days for pulmonary exacerbation treatment, bacterial colonization, and body mass index. Outcomes were assessed over a 6-year period (e.g., ages 12-17 yr), whereas exposures were assessed over the prior 6 years (e.g., ages 6-11 yr).Results: The three cohorts included 3,365, 2,800, and 1,807 patients, respectively. The highest rate of FEV1pp decline was found in the middle cohort, with the annual decline being steeper among patients with continuous public (-3.1/yr; 95% confidence interval [CI], -3.3 to -2.8) or intermittent public (-2.4/yr; 95% CI, -2.6 to -2.2) coverage compared with patients with continuous private coverage (-2.1/yr; 95% CI, -2.2 to -2.0). These differences were not explained by differences in outpatient care utilization.Conclusions: During the transition to adulthood, use of public insurance was associated with accelerated lung function decline among patients with CF. The role of insurance as a causal factor in this decline or proxy for other socioeconomic characteristics should be explored in further studies.

Effect of Schizonepetae Herba and Saposhnikoviae Radix on expression of AQP4 and AQP8 in colonic mucosa of rats with ulcerative colitis

The aim of this paper was to investigate the effect of Schizonepetae Herba and Saposhnikoviae Radix(wind medicine) on the expression of AQP4 and AQP8 in colonic mucosa in rats with ulcerative colitis(UC). A total of 35 healthy SD male rats were randomly divided into normal group(gavaged with normal saline), DSS model group, as well as low, middle, and high dose wind medicine groups(Schizonepeta and Saposhnikovia 1∶1, gavaged at dosages of 6, 12, and 24 g·kg~(-1)·d~(-1)), with 7 in each group. UC rat model was established by free drinking of 3% dextran sulphate sodium(DSS) solution for 10 days. At the end of the 10 th day after the treatment, mice were put to death to collect colonic mucosa. The length of colon was measured; the colonic mucosal injury index(CMDI) and pathological changes of colon were observed. ELISA method was used for measuring the content of serum IL-1, IL-8, and immunohistochemical method was used to measure AQP4, AQP8 protein expressions in colon mucosa. The expressions of AQP4, AQP8 mRNA were measured by Real-time PCR. As compared with the normal group, the length of colon tissue was significantly reduced(P&lt;0.01), CMDI scores and pathological scores were significantly increased(P&lt;0.01), the levels of serum IL-1 and IL-8 were significantly increased(P&lt;0.05) in model group; the immunohistochemical results showed that the protein expressions of AQP4, AQP8 were lower; the color was light yellow or brown; AQP4, AQP8 mRNA expressions in colon mucosa were significantly decreased in model group(P&lt;0.01). CMDI scores, pathological scores, and the levels of serum IL-1, IL-8 in high, middle, low dose wind medicine groups were obvious lower than those in the model group(P&lt;0.01 or P&lt;0.05); the protein expressions of AQP4, AQP8 were higher; the color was chocolate brown or dark brown; the length of colon tissue, and the expressions of AQP4, AQP8 mRNA were obvious higher in wind medicine groups(P&lt;0.01 or P&lt;0.05). Schizonepetae Herba and Saposhnikoviae Radix could significantly improve the symptoms and histopathology of UC model rats and accelerate the intestinal mucosal healing. The mechanism may be related with up-regulating the expression level of AQP4 and AQP8 in colonic mucosa.

Effect of Sishen Pill on Memory T Cells From Experimental Colitis Induced by Dextran Sulfate Sodium.

Immune memory has a protective effect on the human body, but abnormal immune memory is closely related to the occurrence and development of autoimmune diseases including inflammatory bowel disease (IBD). Sishen Pill (SSP) is a classic prescription of traditional Chinese medicine, which is often used to treat chronic colitis, but it is not clear whether SSP can alleviate experimental colitis by remodeling immune memory. In the present study, the therapeutic effect of SSP on chronic colitis induced by dextran sulfate sodium (DSS) was evaluated by colonic length, colonic weight index, macroscopic and microscopic scores, and pathological observation. The cytokine levels were tested by enzyme-linked immunosorbent assay (ELISA); the percentages of central memory T (Tcm) and effector memory T (Tem) cells were analyze\\d by flow cytometry; and activation of phosphoinositide 3-kinase (PI3K)/Akt signaling proteins was measured by western blotting. After 7-days' treatment, SSP alleviated DSS-induced colitis, which was demonstrated by decreased colonic weight index, colonic weight, histopathological injury scores, restored colonic length, gradual recovery of colonic mucosa, and lower levels of interleukin (IL)-2, IL-7, IL-12, and IL-15, while SSP increased IL-10 expression. SSP obviously regulated the quantity and subpopulation of Tcm and Tem cells. Furthermore, SSP markedly inhibited activation of PI3K, Akt, phospho-Akt, Id2, T-bet, forkhead box O3a, Noxa, and C-myc proteins in the PI3K/Akt signaling pathway and activated Rictor, Raptor, tuberous sclerosis complex (TSC)1, TSC2, phospho-AMP-activated kinase (AMPK)-α, AMPK-α, eukaryotic translation initiation factor 4E-binding protein 2, kinesin family member 2a, and 70-kDa ribosomal protein S6 kinase. These results indicate that SSP effectively controls Tem cells in the peripheral blood to relieve experimental colitis induced by DSS, which were potentially related with inhibiting the PI3K/Akt signaling pathway.

Gastrointestinal symptoms and cardiac vagal tone in type 1 diabetes correlates with gut transit times and motility index.

Although gastrointestinal (GI) symptoms are common in diabetes, they frequently do not correlate with measurable sensorimotor abnormalities. The wireless motility capsule (WMC) measures pressure, temperature, and pH as it traverses the GI tract wherefrom transit times and motility indices are derived. The aim was to investigate whether GI symptoms correlate with changes in (a) segmental transit times, (b) segmental motility index, (c) cardiac vagal tone, or (d) presence/absence of peripheral neuropathy in type 1 diabetes. Gastrointestinal symptoms in 104 participants with type 1 diabetes were measured using Gastroparesis Cardinal Symptoms Index and Gastrointestinal Symptom Rating Scale. All underwent standardized WMC investigation measuring segmental transit time and motility. Cardiac vagal tone and presence of peripheral neuropathy were measured using electrocardiographic and nerve conduction velocity testing. Colonic transit time was correlated with postprandial fullness (P=.01) and constipation (P=.03), while decreased colonic motility index was correlated with diarrhea (P=.01) and decreased bloating (P<.05). Symptoms were not correlated with gastric or small bowel transit time or motility index. In participants with low cardiac vagal tone, gastric motility index (P<.01) and colonic transit time (P<.05) were increased, but not in those with peripheral neuropathy. Abdominal pain was decreased with both peripheral neuropathy (P=.04) and decreased cardiac vagal tone (P=.02). This study supports the rationale for whole gut investigation, using not only transit times but incorporating contractility indices as well. Furthermore, a decreased parasympathetic modulation and an increased hyposensate state appear to be present in type 1 diabetes.