A Sweet Talk: The Molecular Systems of Perineuronal Nets in Controlling Neuronal Communication

Perineuronal nets (PNNs) are mesh-like structures, composed of a hierarchical assembly of extracellular matrix molecules in the central nervous system (CNS), ensheathing neurons and regulating plasticity. The mechanism of interactions between PNNs and neurons remain uncharacterized. In this review, we pose the question: how do PNNs regulate communication to and from neurons? We provide an overview of the current knowledge on PNNs with a focus on the cellular interactions. PNNs ensheath a subset of the neuronal population with distinct molecular aspects in different areas of the CNS. PNNs control neuronal communication through molecular interactions involving specific components of the PNNs. This review proposes that the PNNs are an integral part of neurons, crucial for the regulation of plasticity in the CNS

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Comparative analysis of the role of healthcare beliefs on childhood vaccination uptake among parents in Malaysia and Singapore during the COVID-19 pandemic

IntroductionThe rollout of successful vaccination programs during the COVID-19 pandemic has been impeded worldwide by high rates of vaccine hesitancy. We investigated vaccine hesitancy rates in Malaysia and Singapore, and explored whether these rates were associated with parents’ health beliefs.MethodsA total of 226 Malaysian parents (MPs) and 635 Singaporean parents (SPs) participated in an online voluntary survey between November 2021 and August 2022.ResultsMPs were younger and had more children compared to SPs. SPs were more likely to have received the COVID-19 vaccine than MPs, and less likely to delay vaccinations for their children. SPs displayed greater trust in information about vaccines, their children’s doctors and healthcare authorities than MPs. Despite the similarities in ethnography and geographic proximity, the prevalence of perceived parental vaccine hesitancy was higher in Malaysia than in Singapore; this was associated with differences in healthcare beliefs.DiscussionBeyond educational campaigns, strengthening community-based healthcare support, addressing misinformation, and fostering transparent communication from healthcare authorities may further enhance parental trust in vaccine

Spread of artemisinin resistance in Plasmodium falciparum malaria.

BACKGROUND: Artemisinin resistance in Plasmodium falciparum has emerged in Southeast Asia and now poses a threat to the control and elimination of malaria. Mapping the geographic extent of resistance is essential for planning containment and elimination strategies. METHODS: Between May 2011 and April 2013, we enrolled 1241 adults and children with acute, uncomplicated falciparum malaria in an open-label trial at 15 sites in 10 countries (7 in Asia and 3 in Africa). Patients received artesunate, administered orally at a daily dose of either 2 mg per kilogram of body weight per day or 4 mg per kilogram, for 3 days, followed by a standard 3-day course of artemisinin-based combination therapy. Parasite counts in peripheral-blood samples were measured every 6 hours, and the parasite clearance half-lives were determined. RESULTS: The median parasite clearance half-lives ranged from 1.9 hours in the Democratic Republic of Congo to 7.0 hours at the Thailand-Cambodia border. Slowly clearing infections (parasite clearance half-life >5 hours), strongly associated with single point mutations in the "propeller" region of the P. falciparum kelch protein gene on chromosome 13 (kelch13), were detected throughout mainland Southeast Asia from southern Vietnam to central Myanmar. The incidence of pretreatment and post-treatment gametocytemia was higher among patients with slow parasite clearance, suggesting greater potential for transmission. In western Cambodia, where artemisinin-based combination therapies are failing, the 6-day course of antimalarial therapy was associated with a cure rate of 97.7% (95% confidence interval, 90.9 to 99.4) at 42 days. CONCLUSIONS: Artemisinin resistance to P. falciparum, which is now prevalent across mainland Southeast Asia, is associated with mutations in kelch13. Prolonged courses of artemisinin-based combination therapies are currently efficacious in areas where standard 3-day treatments are failing. (Funded by the U.K. Department of International Development and others; ClinicalTrials.gov number, NCT01350856.)

Mapping the distribution of the Sunda pangolin (Manis javanica) within natural forest in Sabah, Malaysian Borneo

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Breast implant-associated anaplastic large-cell lymphoma: long-term follow-up of 60 patients

Presenta la revisión de la literatura de todos los casos publicados de linfoma anaplásico de células grandes (ALCL por sus siglas en inglés) asociados a implantes mamarios desde 1997 hasta diciembre de 2012 y se estableció contacto con los autores correspondientes para actualizar el seguimiento clínico del ALCL

Integrins promote axonal regeneration after injury of the nervous system.

Integrins are cell surface receptors that form the link between extracellular matrix molecules of the cell environment and internal cell signalling and the cytoskeleton. They are involved in several processes, e.g. adhesion and migration during development and repair. This review focuses on the role of integrins in axonal regeneration. Integrins participate in spontaneous axonal regeneration in the peripheral nervous system through binding to various ligands that either inhibit or enhance their activation and signalling. Integrin biology is more complex in the central nervous system. Integrins receptors are transported into growing axons during development, but selective polarised transport of integrins limits the regenerative response in adult neurons. Manipulation of integrins and related molecules to control their activation state and localisation within axons is a promising route towards stimulating effective regeneration in the central nervous system

Dynamic Energy Landscapes of Riboswitches Help Interpret Conformational Rearrangements and Function

Riboswitches are RNAs that modulate gene expression by ligand-induced conformational changes. However, the way in which sequence dictates alternative folding pathways of gene regulation remains unclear. In this study, we compute energy landscapes, which describe the accessible secondary structures for a range of sequence lengths, to analyze the transcriptional process as a given sequence elongates to full length. In line with experimental evidence, we find that most riboswitch landscapes can be characterized by three broad classes as a function of sequence length in terms of the distribution and barrier type of the conformational clusters: low-barrier landscape with an ensemble of different conformations in equilibrium before encountering a substrate; barrier-free landscape in which a direct, dominant “downhill” pathway to the minimum free energy structure is apparent; and a barrier-dominated landscape with two isolated conformational states, each associated with a different biological function. Sharing concepts with the “new view” of protein folding energy landscapes, we term the three sequence ranges above as the sensing, downhill folding, and functional windows, respectively. We find that these energy landscape patterns are conserved in various riboswitch classes, though the order of the windows may vary. In fact, the order of the three windows suggests either kinetic or thermodynamic control of ligand binding. These findings help understand riboswitch structure/function relationships and open new avenues to riboswitch design

Review of biochar role as additive in anaerobic digestion processes

because of the urgent need to provide renewable energy sources and efficiently manage the continuously growing amount of organic waste. Biochar (BC) is an extremely versatile material, which could be produced by carbonization of organic materials, including biomass and wastes, consistently with Circular Economy principles, and “tailor-made” for specific applications. The potential BC role as additive in the control of the many wellknown critical issues of AD processes has been increasingly explored over the past few years. However, a clear and comprehensive understanding of the connections between BC and AD is still missing. This review paper analyses and discusses significant references (review articles, research papers and international databases and reports), mostly published in the last 10 years. This review is aimed at addressing three key issues related to the better understanding of the BC role in AD processes: 1. Investigation of the influence of BC properties on AD performances and of their ability to counteract its main challenges; 2. Assessment of the optimal BC production chain (i.e. feedstock-pyrolysis-activation) to achieve the desired features; 3. Evaluation of the economic and environmental advantages connected to BC use in AD processes, compared to conventional solutions applied to address AD challenges

Mapping the distribution of the Sunda pangolin (Manis javanica) within natural forest in Sabah, Malaysian Borneo

Pangolins are the most trafficked mammals in the world and are severely threatened by poaching the loss, degradation, and fragmentation of habitat. In Malaysian Borneo, conservation initiatives for the Sunda pangolin (Manis javanica) are hindered by a paucity of data on their distribution and population size. Using MaxEnt niche modelling and consolidated species location data, we projected the distribution of Sunda pangolins in Sabah. Additionally, we assessed the accessibility of their forest habitats to humans to understand potential threats. Our model indicated that, as of 2015, approximately half of Sabah’s land area (39,530 km²) is suitable for pangolins, with 43% in protected forests, 38% in production forests, and 19% outside of these areas. Alarmingly, our data suggest that nearly all (91%) of these suitable habitats are relatively easily accessible to poachers. Our findings provide a state-level baseline understanding of Sunda pangolin distribution and assess potential threats in Sabah. These can inform short- and long-term conservation management plans for pangolin to safeguard this critically endangered species