Levels Of Mortality Research Articles

A case report of lactobacillus bacteremia in a patient on chronic parenteral nutrition

Short bowel syndrome is a malabsorption disorder typically caused by the physical loss of a portion of the intestine, whereafter the body is unable to adequately absorb nutrients, fluids, and electrolytes. Many patients with short bowel syndrome are reliant on home parenteral nutrition through a tunneled or peripherally inserted central catheter to ensure sufficient hydration and nutrition. Central venous catheters are a nidus for bacteria, and patients are at risk for infections associated with high levels of morbidity and mortality. Lactobacillus is a ubiquitous microorganism that most frequently colonizes mucosal surfaces such as the gastrointestinal tract. Lactobacillus bacteremia is rare, with limited occurrence in current medical literature. Our patient is a 60-year-old female with a past medical history significant for multiple abdominal surgeries resulting in short bowel syndrome, with subsequent dependence on home parenteral nutrition via peripherally inserted central catheter. She had type III chronic intestinal failure, category D2, and stage 1 moderate malnutrition. She was originally admitted to the hospital for a presumed pulmonary embolism and was found to have a deep vein thrombosis in the setting of her peripherally inserted central catheter. On admission her abdominal exam was unremarkable, she denied abdominal pain, and her only gastrointestinal complaint was chronic stable diarrhea. During the hospitalization she developed severe left lower quadrant abdominal pain and noted decreased frequency of her bowel movements. A computed tomography scan of her abdomen revealed chronic stable intestinal distension and was concerning for obstruction. Clinically she remained without symptoms of acute obstruction or ileus. During the admission she became febrile, with blood cultures from her peripherally inserted central catheter and peripheral IV growing out gram negative rods determined to be lactobacillus bacteremia. The infectious disease team recommended removal of her peripherally inserted central catheter given their concern for a line infection. The patient was treated with broad-spectrum antibiotics, did well clinically, and was ultimately discharged following reinsertion of her peripherally inserted central catheter after negative repeat blood cultures. Though she initially did well in the outpatient setting, she ultimately passed away ten months later after re-presenting to the hospital in septic shock, secondary to bowel ischemia and suspected fungemia of her peripherally inserted central catheter. In this case report, we describe an unusual case of a patient with short bowel syndrome on chronic parenteral nutrition who developed catheter-associated lactobacillus bacteremia - the first reported case in an adult patient on parenteral nutrition.

Impacts of Inflammatory Cytokines Variants on Systemic Inflammatory Profile and COVID-19 Severity

BackgroundCytokine storm is known to impact the prognosis of coronavirus disease 2019 (COVID-19), since pro-inflammatory cytokine variants are associated with cytokine storm. It is tempting to speculate that pro-inflammatory cytokines variants may impact COVID-19 outcomes by modulating cytokine storm. Here, we verified this hypothesis via a comprehensive analysis.MethodsPubMed, Cochrane Library, Central, CINAHL, and ClinicalTrials.gov were searched until December 15, 2023. Case–control or cohort studies that investigated the impacts of rs1800795 or rs1800629 on COVID-19 susceptibility, severity, mortality, IL-6, TNF-α, or CRP levels were included after an anonymous review by two independent reviewers and consultations of disagreement by a third independent reviewer.Results47 studies (8305 COVID-19 individuals and 17,846 non-COVID-19 individuals) were analyzed. The rs1800629 A allele (adenine at the −308 position of the promoter was encoded by the A allele) was associated with higher levels of tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP). In contrast, the rs1800795 C allele (cytosine at the −174 position of the promoter was encoded by the C allele) was linked to higher levels of interleukin-6 (IL-6) and CRP. In addition, the A allele of rs1800629 increased the severity and mortality of COVID-19. However, the C allele of rs1800795 only increased COVID-19 susceptibility.Conclusionsrs1800629 and rs1800795 variants of pro-inflammatory cytokines have significant impacts on systemic inflammatory profile and COVID-19 clinical outcomes. rs1800629 may serve as a genetic marker for severe COVID-19.

US exceptionalism? International trends in midlife mortality.

Rising midlife mortality in the USA has raised concerns, particularly the increase in 'deaths of despair' (due to drugs, alcohol and suicide). Life expectancy is also stalling in other countries such as the UK, but how trends in midlife mortality are evolving outside the USA is less understood. We provide a synthesis of cause-specific mortality trends in midlife (25-64years of age) for the USA and the UK as well as other high-income and Central and Eastern European (CEE) countries. We document trends in midlife mortality in the USA, UK and a group of 13 high-income countries in Western Europe, Australia, Canada and Japan, as well as seven CEE countries from 1990 to 2019. We use annual mortality data from the World Health Organization Mortality Database to analyse sex- and age-specific (25-44, 45-54 and 55-64years) age-standardized death rates across 15 major cause-of-death categories. US midlife mortality rates have worsened since 1990 for several causes of death including drug-related, alcohol-related, suicide, metabolic diseases, nervous system diseases, respiratory diseases and infectious/parasitic diseases. Deaths due to homicide, transport accidents and cardiovascular diseases have declined since 1990 but saw recent increases or stalling of improvements. Midlife mortality also increased in the UK for people aged 45-54year and in Canada, Poland and Sweden among for those aged 25-44 years. The USA is increasingly falling behind not only high-income, but also CEE countries, some of which were heavily impacted by the post-socialist mortality crisis of the 1990s. Although levels of midlife mortality in the UK are substantially lower than those in the USA overall, there are signs that UK midlife mortality is worsening relative to that in Western Europe.

Mortality from extreme meteorological and hydrogeological events in Italy: a rising health threat connected to climate change

The aim of the present work is to assess mortality associated to extreme meteorological and hydrological events (storms, floods, landslides, avalanches) for the period 2003–2020 in Italy. These extreme events are particularly worrying phenomena due to their increasing frequency and intensity connected to climate change. The considerable rise of extreme meteorological events in Italy has been having a dramatic impact on the environment and territories, particularly on intrinsically fragile ones, and on resident populations. More than 90% of Italian municipalities are at risk for extreme events, with more than 8 million inhabitants exposed. Number of deaths and SMRates due to such extreme events (X International Classification of Diseases: X36, X37 and X38) in Italy were calculated from regional to municipal level by ENEA mortality database (data source ISTAT). Geographic maps were elaborated by QGIS software (QGIS, RRID:SCR_018507) version 3.28. In the selected period, 378 overall deaths were detected: 321 deaths due to landslides and avalanches, 28 to cataclysmic storm, and 29 to floods. The regions with the highest mortality levels and/or number of municipalities involved and the municipalities at highest risk were identified. In consideration of the forecasted increase of such extreme events in Italy, the knowledge of Italian areas at highest risk can be used in the decision-making processes to assess priorities, allocate financial resources, define warning measures, and undertake preventive or mitigation actions. Moreover, the attributable mortality levels can be a useful basis for further risk assessment research aimed at estimating the cost in terms of human lives’ loss associated to such events in future climatic scenarios.

Individual and community-level factors associated with women’s utilization of postnatal care services in Uganda, 2016: a multilevel and spatial analysis

BackgroundOver time, Uganda has experienced high levels of maternal mortality (435 deaths per 100,000 live births in 2006 to 336 deaths per 100,000 live births in 2016). The persistence of high levels of maternal mortality jeopardizes the achievement of Sustainable Development Goal (SDG) 3.1, which calls for reducing maternal mortality to 70 deaths per 100,000 live births by 2030. Conversely, the utilization of postnatal care (PNC) services in Uganda remained very low and has varied across regions. This study examined the individual and community-level factors influencing women’s utilization of postnatal care services in Uganda.MethodsSecondary data from the 2016 Uganda Demographic and Health Survey (UDHS) were used in this study. The study population consisted of women aged 15 to 49 who reported giving birth in the five years preceding the 2016 UDHS survey. The factors associated with postnatal care services were identified using multilevel binary logistic regression and spatial analysis.ResultsThe result shows that the prevalence of postnatal care service utilization in Uganda was low (58.3%) compared to the World Health Organization (WHO) target of 100%. The univariate analysis shows that 13.7% of women were adolescents, 79% were of higher parity, and 70.4% had primary/no formal education, of which 76.6% resided in rural areas. On the other hand, the multilevel analysis results showed that women aged 20-29 years and 30-39 years were also found to be more likely to use PNC services (AOR = 1.2, 95% CI: 1.01-1.47). Women who received quality ANC (AOR = 2.1, 95% CI: 1.78–2.36) were more likely to use postnatal care services than their counterparts. At the community level, women who lived in media-saturated communities were more likely to use postnatal care services (AOR = 1.3, 95% CI: 1.01–1.65). The spatial analysis found that the Central, Eastern, and Northern regions were the areas of hotspots in the utilization of postnatal care services.ConclusionThis study found that age, parity, level of education, place of residence, employment status, quality of the content of antenatal care, and community media saturation were the predictors of postnatal care service utilization. The spatial analysis showed that the spatial distributions of postnatal care service utilization were significantly varied across Uganda. The government must expand access to various forms of media throughout the country to increase PNC utilization.

On the genetic diversity of Chimaera monstrosa Linnaeus, 1758 (Chordata, Chondrichthyes, Holocephali) in the Mediterranean Sea

The sustainable management and conservation of deep-sea species may be hampered by the paucity of data on their population structure and connectivity, in the face of ever-increasing fisheries pressure and other forms of impacts on deep-sea ecosystems. The rabbit fish, Chimaera monstrosa, is a deep-sea cartilaginous fish, reported worldwide in the past, but currently distributed only in the North-Eastern Atlantic Ocean and Mediterranean Sea. It is currently experiencing high levels of mortality associated with by-catch. Its slow growth, low fecundity and late maturity make this species particularly vulnerable to anthropogenic impact, although little is known about processes of connectivity between ecoregions. This study utilized DNA sequencing of the mitochondrial cytochrome c oxidase subunit I (COI) gene to investigate the population structure and demography of C. monstrosa both at the small (around the coasts of Sardinia, western Mediterranean Sea) and at larger spatial scales (at the pan-Mediterranean level, and between the Atlantic Ocean and the Mediterranean Sea). A total of 100 new sequences were obtained from specimens of Mediterranean origin, identifying 15 new haplotypes out of the 30 known so far for the species. Evidence of feeble but significant differentiation was detected among locations within the Tyrrhenian basin. Bayesian clustering analyses indicated the occurrence of three distinct haplogroups: the most common spread all over the Mediterranean, and the other two limited to the Western basin. Greater levels of genetic differentiation were found between the Atlantic and Mediterranean populations which constituted two main genetic clusters, with no shared haplotypes. The two populations became separated at the end of the Middle Pleistocene, with a clear sign of demographic expansion during the same period. The rabbit fish constitutes an important exception to a general paradigm of deep-sea species being connected by high levels of gene flow and such results could be useful to implement current management strategies to conserve this vulnerable by-caught species.

Social determinants of spatial inequalities in COVID-19 outcomes across England: A multiscale geographically weighted regression analysis

A variety of factors are associated with greater COVID-19 morbidity or mortality, due to how these factors influence exposure to (in the case of morbidity) or severity of (in the case of mortality) COVID-19 infections. We use multiscale geographically weighted regression to study spatial variation in the factors associated with COVID-19 morbidity and mortality rates at the local authority level across England (UK). We investigate the period between March 2020 and March 2021, prior to the rollout of the COVID-19 vaccination program. We consider a variety of factors including demographic (e.g. age, gender, and ethnicity), health (e.g. rates of smoking, obesity, and diabetes), social (e.g. Index of Multiple Deprivation), and economic (e.g. the Gini coefficient and economic complexity index) factors that have previously been found to impact COVID-19 morbidity and mortality. The Index of Multiple Deprivation has a significant impact on COVID-19 cases and deaths in all local authorities, although the effect is the strongest in the south of England. Higher proportions of ethnic minorities are associated with higher levels of COVID-19 mortality, with the strongest effect being found in the west of England. There is again a similar pattern in terms of cases, but strongest in the north of the country. Other factors including age and gender are also found to have significant effects on COVID-19 morbidity and mortality, with differential spatial effects across the country. The results provide insights into how national and local policymakers can take account of localized factors to address spatial health inequalities and address future infectious disease pandemics.

Oystershell scale (Hemiptera: Diaspididae) population growth, spread, and phenology on aspen in Arizona, USA.

Oystershell scale (OSS; Lepidosaphes ulmi L.) is an invasive insect that threatens sustainability of aspen (Populus tremuloides Michx.) in the southwestern United States. OSS invasions have created challenges for land managers tasked with maintaining healthy aspen ecosystems for the ecological, economic, and aesthetic benefits they provide. Active management is required to suppress OSS populations and mitigate damage to aspen ecosystems, but before management strategies can be implemented, critical knowledge gaps about OSS biology and ecology must be filled. This study sought to fill these gaps by addressing 3 questions: (i) What is the short-term rate of aspen mortality in OSS-infested stands in northern Arizona, USA? (ii) What are the short-term rates of OSS population growth on trees and OSS spread among trees in aspen stands? (iii) What is the phenology of OSS on aspen and does climate influence phenology? We observed high levels of aspen mortality (annual mortality rate = 10.4%) and found that OSS spread rapidly within stands (annual spread rate = 10-12.3%). We found first, second, and young third instars throughout the year and observed 2 waves of first instars (i.e., crawlers), one throughout the summer and a second in mid-winter. The first wave appeared to be driven by warming seasonal temperatures, but the cause of the second wave is unknown and might represent a second generation. We provide recommendations for future OSS research, including suggestions for more precise quantification of OSS phenology, and discuss how our results can inform management of OSS and invaded aspen ecosystems.

Epidemiological trends and burden analysis of cervical cancer attributable to unsafe sex: A population-based study from 1990 to 2019.

Unsafe sex is recognized as an important risk factor for cervical cancer (CC). Understanding the global disease burden of CC attributable to unsafe sex can assist policymakers in allocating healthcare resources. Data were obtained from the 2019 global burden of disease database (GBD). We examined global, regional, and national levels of CC mortality, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) caused by unsafe sex. ASRs were evaluated using estimated annual percentage changes (EAPCs). Attributable to unsafe sex, there were 280,479 CC-related deaths in 2019 and 8,955,013 CC-related DALYs. In the period 1990-2019, the global ASRs of CC due to unsafe sex decreased around the world; for age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR), the EAPCs were -0.93 and -0.95. The highest ASMRs and ASDRs were found in central sub-Saharan Africa and the lowest in Australasia. In the past few decades, the ASMR and ASDR of CC caused by unsafe sexual practices have decreased over time, with significant variations observed among different countries and regions. Increased focus is needed on spreading awareness about sexual health and promoting CC prevention and screening, particularly in low- and middle-income nations.

Essential oils from three Cupressaceae species as stored wheat protectants: will they kill different developmental stages of nine noxious arthropods?

Several plant species belonging to the Cupressaceae family are used in the industry for the production of various pharmaceuticals, food additives, and paint materials. Various essential oils (EOs) derived from these species have been examined for their insecticidal and acaricidal actions. In this study, we examined the efficacy of Hesperocyparis arizonica, × Hesperotropsis leylandii, and Juniperus × pfitzeriana EOs as wheat protectants to control different stages of development of nine stored-product pest species (1 dermestid, 1 curculionid, 1 bostrychid, 1 silvanid, 1 mite, and 4 tenebrionids). The EOs of the above plants were characterized by high percentages of monoterpenoids among which α-pinene (16.7–41.0%), sabinene (5.4–10.4%), δ-3-carene (20.5%), limonene (6.9–15.4%), bornyl acetate (36.3%), and trans-sabinyl acetate (18.2%) were the most representative ones depending on the species. Mortality caused by the three EOs at 1000 ppm to Trogoderma granarium adults ranged between 88.9 and 100.0%, after 7 days (d). The EO of H. arizonica, at the highest concentration (1000 ppm), killed 94.4% of exposed Oryzaephilus surinamensis adults, after one week. Complete mortality (100%) of Alphitobius diaperinus larvae occurred after exposure for 5 d to × H. leylandii EO at 1000 ppm. High mortality rates were also reported for Tribolium castaneum (93.3%) and Tribolium confusum (91.1%) larvae, and Tenebrio molitor adults (87.9%) at 1000 ppm of × H. leylandii EO, 7 d after exposure. This investigation shows that × H. leylandii EO provided elevated mortality levels to the majority of the tested pests exhibiting high potential to be considered as an effective grain protectant.

Anti-S-layer monoclonal antibodies impact Clostridioides difficile physiology

ABSTRACT Clostridioides difficile (C. difficile), a gram-positive anaerobic and spore-forming bacterium, is the leading cause of nosocomial antibiotic-associated diarrhea in adults which is characterized by high levels of recurrence and mortality. Surface (S)-layer Protein A (SlpA), the most abundantly expressed protein on the bacterial surface, plays a crucial role in the early stages of infection although the nature of its involvement in C. difficile physiology is yet to be fully understood. Anti-S-layer antibodies have been identified in the sera of convalescent patients and have been correlated with improved outcomes of C. difficile infection (CDI). However, the precise mechanisms by which anti-S-layer antibodies confer protection to the host remain unknown. In this study, we report the first monoclonal antibodies (mAbs) targeting the S-layer of reference strain 630. Characterization of these mAbs unraveled important roles for the S-layer protein in growth, toxin secretion, and biofilm formation by C. difficile, with differential and even opposite effects of various anti-SlpA mAbs on these functions. Moreover, one anti-SlpA mAb impaired C. difficile growth and conferred sensitivity to lysozyme-induced lysis. The results of this study show that anti-S-layer antibody responses can be beneficial or harmful for the course of CDI and provide important insights for the development of adequate S-layer-targeting therapeutics.

The Heart of the World.

Cardiovascular diseases (CVDs) are the leading cause of mortality globally. Of the 20.5 million CVD-related deaths in 2021, approximately 80% occurred in low- and middle-income countries. Using data from the Global Burden of Disease Study, NCD Risk Factor Collaboration, NCD Countdown initiative, WHO Global Health Observatory, and WHO Global Health Expenditure database, we present the burden of CVDs, associated risk factors, their association with national health expenditures, and an index of critical policy implementation. The Central Europe, Eastern Europe, and Central Asia region face the highest levels of CVD mortality globally. Although CVD mortality levels are generally lower in women than men, this is not true in almost 30% of countries in the North Africa and Middle East and Sub-Saharan regions. Raised blood pressure remains the leading global CVD risk factor, contributing to 10.8 million deaths in 2019. The regions with the highest proportion of countries achieving the maximum score for the WHF Policy Index were South Asia, Central Europe, Eastern Europe, and Central Asia, and the High-Income regions. The Sub-Saharan Africa region had the highest proportion of countries scoring two or less. Policymakers must assess their country's risk factor profile to craft effective strategies for CVD prevention and management. Fundamental strategies such as the implementation of National Tobacco Control Programmes, ensuring the availability of CVD medications, and establishing specialised units within health ministries to tackle non-communicable diseases should be embraced in all countries. Adequate healthcare system funding is equally vital, ensuring reasonable access to care for all communities.

Protective effect of Achyranthes aspera against compound 48/80, histamine and ovalbumin-induced allergic disorders in murine model.

Achyranthes aspera L. (family Amaranthaceae) is a plant species valued in Ayurveda for the treatment of respiratory ailments. Scientific validation of its antiallergic potential was aimed. Three extracts of A. aspera [aqueous (AaAq), hydroalcoholic (AaHA), ethanolic (AaEt)] were evaluated for their potency against C48/80-induced anaphylaxis in mice at 200mg/kg BW oral dose. The effective dose of the most potent extract was determined through its effect on C48/80-induced anaphylaxis, and was further analyzed through its effect on mast cell degranulation, histamine-induced bronchospasm and ovalbumin (OVA)-induced asthma in a murine model. Among the three extracts, AaAq was found to be most potent at 200mg/kg BW. AaAq 400 (400mg/kg BW) was found to be the most effective dose in terms of inhibition of mortality and histamine level. AaAq 400 prevented the peritoneal and mesenteric mast cells from undergoing morphological changes due to degranulation induced by C48/80. Further, AaAq 400 delayed pre-convulsive time in histamine-induced bronchospasm. In the OVA-induced asthma model, AaAq 400 inhibited the level of inflammatory cell count in blood, bronchoalveolar lavage fluid and peritoneal fluid of mice. The Th2 cytokines (IL-4, IL-5, IL-13), TGF-β and OVA-specific IgE were also reduced as evaluated by ELISA. Also, significant reduction in IL-5 (an eosinophilia indicator) transcript abundance and lung inflammatory score was observed. AaAq was safe up to 4000mg/kg BW. Thus AaAq 400 possesses significant antiallergic potential and acts via attenuation of C48/80-induced anaphylaxis and inhibition of mast cell degranulation. It reduces pre-convulsive dyspnea in histamine-induced bronchospasm and Th2 cytokines in asthmatic mice.

Increased abundance of potentially pathogenic Vibrio and a marine heatwave co-occur with a Pacific Oyster summer mortality event

The Pacific Oyster (Crassostrea gigas) is an important aquaculture species, that has been globally affected by “summer mortality” outbreaks. The causes of summer mortality are often unclear, but several contributing factors have been implicated. To better understand the factors contributing to C. gigas summer mortality, we performed a 24 week experiment in tanks filled by a continuous flow of unfiltered surface seawater during a summer mortality high-risk period. Throughout this period, we measured a suite of environmental parameters, with weekly sampling to characterise the bacterial community composition, the abundance and diversity of the Vibrio genus, and the expression of oyster immune response genes. We observed three clear phases of oyster mortality: Phase 1 (day 0 to 75) was characterised by sporadic and low levels (mean < 1% per week) of oyster mortality; Phase 2 (day 82 to 119) involved constant levels of ongoing mortality (mean < 10% per week); and Phase 3 (day 125 to 161) involved a sharp increase in mortality (mean > 10% per week) reaching up to weekly mortality of 51%. The shift between phase 2 and 3 coincided with heavy rainfall and a marine heatwave (MHW) event at our study site, which lasted 13 days, when the average water temperature was elevated by 0.8 °C when compared to the weeks prior and following the MHW, and a maximum water temperature of 27.7 °C was reached. Oyster mortality was positively correlated with the occurrence of the MHW as well as bacterial and Vibrio abundance, and negatively correlated with seawater salinity that decreased from a salinity of 34.6 to 31.4 psu following rainfall events. In addition, the relative abundance of several Vibrio species, including V. campbellii, V. rotiferianus and V. owensii displayed positive correlations to oyster mortality. Shifts in the oyster-associated bacterial community and oyster immunity gene expression profiles occurred in parallel to increased mortality levels, with genes involved in the regulation of antimicrobial peptides (IkB1 and NF-kB p105) significantly over-expressed during high mortality. Overall, we observed a C. gigas mortality event that coincided with a marine heatwave, rainfall event and a shift in bacterial community composition. Our analyses provides further evidence for the putative role of Vibrio in summer mortality events.

Comparison of morbidity and mortality after bloodstream infection with vancomycin-resistant versus -susceptible Enterococcus faecium: a nationwide cohort study in Denmark, 2010–2019

ABSTRACT The emergence of bloodstream infections (BSI) caused by vancomycin-resistant Enterococci (VRE) has caused concern. Nonetheless, it remains unclear whether these types are associated with an excess risk of severe outcomes when compared with infections caused by vancomycin-susceptible Enterococci (VSE). This cohort study included hospitalized patients in Denmark with Enterococcus faecium-positive blood cultures collected between 2010 and 2019 identified in the Danish Microbiology Database. We estimated 30-day hazard ratio (HR) of death or discharge among VRE compared to VSE patients adjusted for age, sex, and comorbidity. The cohort included 6071 patients with E. faecium BSI (335 VRE, 5736 VSE) among whom VRE increased (2010–13, 2.6%; 2014–16, 6.3%; 2017–19; 9.4%). Mortality (HR 1.08, 95%CI 0.90–1.29; 126 VRE, 37.6%; 2223 VSE, 37.0%) or discharge (HR 0.89, 95%CI 0.75–1.06; 126 VRE, 37.6%; 2386 VSE, 41.6%) was not different between VRE and VSE except in 2014 (HR 1.87, 95% CI 1.18–2.96). There was no interaction between time from admission to BSI (1–2, 3–14, and >14 days) and HR of death (P = 0.14) or discharge (P = 0.45) after VRE compared to VSE, despite longer time for VRE patients (17 vs. 10 days for VSE, P < 0.0001). In conclusion, VRE BSI was not associated with excess morbidity and mortality. The excess mortality in 2014 only may be attributed to improved diagnostic- and patient-management practices after 2014, reducing time to appropriate antibiotic therapy. The high level of mortality after E. faecium BSI warrants further study.

Immunological insights into COVID-19 in Southern Nigeria.

One of the unexpected outcomes of the COVID-19 pandemic was the relatively low levels of morbidity and mortality in Africa compared to the rest of the world. Nigeria, Africa's most populous nation, accounted for less than 0.01% of the global COVID-19 fatalities. The factors responsible for Nigeria's relatively low loss of life due to COVID-19 are unknown. Also, the correlates of protective immunity to SARS-CoV-2 and the impact of pre-existing immunity on the outcome of the COVID-19 pandemic in Africa are yet to be elucidated. Here, we evaluated the natural and vaccine-induced immune responses from vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria throughout the three waves of the COVID-19 pandemic in Nigeria. We also examined the pre-existing immune responses to SARS-CoV-2 from samples collected prior to the COVID-19 pandemic. We used spike RBD and N- IgG antibody ELISA to measure binding antibody responses, SARS-CoV-2 pseudotype assay protocol expressing the spike protein of different variants (D614G, Delta, Beta, Omicron BA1) to measure neutralizing antibody responses and nucleoprotein (N) and spike (S1, S2) direct ex vivo interferon gamma (IFNγ) T cell ELISpot to measure T cell responses. Our study demonstrated a similar magnitude of both binding (N-IgG (74% and 62%), S-RBD IgG (70% and 53%) and neutralizing (D614G (49% and 29%), Delta (56% and 47%), Beta (48% and 24%), Omicron BA1 (41% and 21%)) antibody responses from symptomatic and asymptomatic survivors in Nigeria. A similar magnitude was also seen among vaccinated participants. Interestingly, we revealed the presence of preexisting binding antibodies (N-IgG (60%) and S-RBD IgG (44%)) but no neutralizing antibodies from samples collected prior to the pandemic. These findings revealed that both vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria make similar magnitude of both binding and cross-reactive neutralizing antibody responses. It supported the presence of preexisting binding antibody responses among some Nigerians prior to the COVID-19 pandemic. Lastly, hybrid immunity and heterologous vaccine boosting induced the strongest binding and broadly neutralizing antibody responses compared to vaccine or infection-acquired immunity alone.

Proteomic Investigation of Cape Cobra (Naja nivea) Venom Reveals First Evidence of Quaternary Protein Structures.

Naja nivea (N. nivea) is classed as a category one snake by the World Health Organization since its envenomation causes high levels of mortality and disability annually. Despite this, there has been little research into the venom composition of N. nivea, with only one full venom proteome published to date. Our current study separated N. nivea venom using size exclusion chromatography before utilizing a traditional bottom-up proteomics approach to unravel the composition of the venom proteome. As expected by its clinical presentation, N. nivea venom was found to consist mainly of neurotoxins, with three-finger toxins (3FTx), making up 76.01% of the total venom proteome. Additionally, cysteine-rich secretory proteins (CRISPs), vespryns (VESPs), cobra venom factors (CVFs), 5'-nucleotidases (5'NUCs), nerve growth factors (NGFs), phospholipase A2s (PLA2), acetylcholinesterases (AChEs), Kunitz-type serine protease inhibitor (KUN), phosphodiesterases (PDEs), L-amino acid oxidases (LAAOs), hydrolases (HYDs), snake venom metalloproteinases (SVMPs), and snake venom serine protease (SVSP) toxins were also identified in decreasing order of abundance. Interestingly, contrary to previous reports, we find PLA2 toxins in N. nivea venom. This highlights the importance of repeatedly profiling the venom of the same species to account for intra-species variation. Additionally, we report the first evidence of covalent protein complexes in N. nivea venom, which likely contribute to the potency of this venom.

Molecular Detection and Identification of oprl and lasb Genes Isolated from Pseudomonas aeruginosa

: Species Pseudomonas aeruginosa is a distinguished opportunistic nosocomial bacterium that is commonly dispersed in nature. A pathogen that causes a large range of infections i.e. chronic as well as acute, with considerable levels of mortality and morbidity. Infections of P. aeruginosa are extremely hard to eliminate because of the presence of several virulence determinants as well as the intrinsic resistance against antibiotics. The present study investigated the detection of the virulence genes by polymerase chain reaction (PCR) namely oprL and lasB in the P. aeruginosa that were isolated detection from both human and animal specimens. 120 specimens of P. aeruginosa including samples were then collected from hospitals and veterinary laboratories, from which 55 isolates of P. aeruginosa were identified and selected. Pseudomonas aeruginosa strains were present in 40% of animal sample isolates and 86% of human sample isolates. The PCR results showed that oprL genes were detected in 54.16% of isolates obtained from animal samples and 80.76% of isolates obtained from human samples. While, the lasB gene was present at 58.33% and 92.30% in the isolates obtained from animal and human samples, respectively. Our results also showed the coexistence of both virulence genes in 32.34% of animal sample isolates and 25.10% of human sample isolations. The detection of gene oprL and lasB by the PCR technique can be effectively used for the molecular-level identification of P. aeruginosa. The identification of such virulence genes in P. aeruginosa isolates suggests that these may be linked with varying degrees of the pathogenesis and inherent virulence in this pathogen.

Are Freshwater Sources Safe for the Health of Humans and Domestic Animals in Terms of Deadly Trematodiases?

There are many types of lentic and lotic freshwater sources on earth, such as puddles, ponds, rivers, springs, dams, lakes, etc. and many of them are found near human settlements. But most of the people are not known and aware of these freshwater sources how safe and dangerous they can be. In fact, these water sources are potentially responsible for spreading various deadly trematodiases (trematode parasitic diseases) to both humans and domestic animals. The most common zoonotic or vector-borne dreaded trematodiases found in humans and domestic animals are fascioliasis, schistosomiasis, paragonimiasis, echinostomiasis, amphistomiasis, etc. These parasitic diseases are endemic in almost every country. But these diseases can occur in any geographical area only when different species of snails (Mollusca: Gastropoda) and crabs or crayfish (Crustaceans) are found in the freshwater bodies there. In fact, these aquatic invertebrates are the intermediate hosts of diverse pathogenic digenetic trematode parasites including Fasciola hepatica, Schistosoma mansoni, Paragonimus westermani, Ceylonocotyle scoliocoelium, etc. and complete their life cycle. These are also known as vectors or carriers and are responsible for the transmission or spread of various trematodiases in different geographical areas. Therefore, these diseases are also called vector- borne diseases. Apart from causing varying levels of morbidity and mortality in humans and animals, these diseases also cause tremendous economic losses to livestock owners. However, it is not necessary that all types of freshwater sources are beneficial, but from the point of view of trematodiases, the water sources in which different types of snail species are found can also be dangerous or unsafe for the health of humans and domestic animals. But most of the people are ignorant and unaware of how these parasitic diseases transmitted or spread to humans and domestic animals through various freshwater bodies located around them. The current review highlights how freshwater sources can be hazardous or dangerous to the health of humans and domestic animals in the context of diverse trematodiases and also focused on their prevention and control.

Effects of vitamin D on the incidence and severity of COVID-19

In the fall of 2023, infection of a number of European countries population with coronavirus intensified, with the most noticeable increase in incidence observed in the Russian Federation. Patients infected with SARS-CoV-2 usually have a low level and high prevalence of vitamin D deficiency. Data from measurements of vitamin D levels in the municipalities of the Khanty-Mansiysk autonomous Okrug — Ugra, compared with information from the department of health of the autonomous okrug based on the results of 2021, suggest that in the Khanty-Mansi autonomous Okrug — Ugra, the average duration of one case of disability due to illness with a diagnosis of COVID-19 is directly proportional to the prevalence of severe vitamin D deficiency. Our data characterizing the positive effect of a high level of vitamin D in the blood serum of a patient infected SARS-CoV-2, on the body’s ability to recover, is confirmed in foreign clinical practice, as evidenced by the results of our statistical calculations. In the Russian Federation, the dependence of the overall incidence of COVID-19 is directly proportional to the geographical latitude of the territory, and the relationship b etween the parameters is extremely high (p = 0.0008 in 2021 and p &lt; 0.000001 in 2022), which, along with other reasons, suggests the effect of ultraviolet radiation level decrease. Vitamin D levels are one of the key factors in the incidence of COVID-19, as it has a major impact on its duration, more severe lung damage, and higher mortality in patients infected with SARS-CoV-2. Clinical studies by domestic and foreign scientists have shown that severe vitamin D deficiency [25(OH)D &lt; 10 ng/ml] in patients infected with SARS-CoV-2 can be considered a predictor of death. During the COVID-19 pandemic, enormous positive experience has been gained in the use of vitamin D as a therapeutic agent to reduce the severity of the disease and the level of hospital mortality, however, in order to prepare informed recommendations for taking medications and identify severe vitamin D deficiency, mandatory measurement of 25(OH)D levels in patients is required in patients diagnosed with SARS-CoV-2 infection.