Association of antimicrobial resistance and gut microbiota composition in human and non-human primates at an urban ecotourism site

Background

The rise of nature-based ecotourism in the past decade has introduced unprecedented challenges in managing the increasing interaction between humans and animals. The potential transmission of antibiotic resistant microbes between humans and non-human primate populations is a concern due to their genetic similarity. Malaysia is well known for hotspots of wildlife diversity where non-human primates like monkeys and orangutans have become popular tourist attractions. In this study, we assessed the prevalence of antimicrobial resistant Staphylococcus aureus, Enterococcus species, and other Enterobacteriaceae in the faeces of human (HS) and two non-human primates (NHP) in Malaysia, the Long-tailed macaque (Macaca fascicularis, MF) and Silvered leaf monkey (Trachypithecus cristatus, TC). In addition, the faecal bacterial composition was profiled to evaluate the potential association between antibiotic resistant profiles and composition of gut microbiota.

Results

We tested the isolated bacteria using a selection of antibiotics. The results showed that both the number of antibiotic resistant strains and resistance level were higher in humans than NHPs. Overall, the composition of gut microbiome and pattern of antibiotic resistance showed that there was higher similarity between MF and TC, the two NHPs, than with HS. In addition, samples with higher levels of antibiotic resistance showed lower bacterial richness. Homo sapiens had the lowest bacterial diversity and yet it had higher abundance of Bacteroides. In contrast, NHPs displayed higher bacterial richness and greater prevalence of Firmicutes such as Ruminococceae and Oscillospira.

Conclusion

Higher antibiotic susceptibility in NHPs is likely related to low direct exposure to antibiotics. The lack of resistance may also suggest limited antimicrobial resistance transmission between humans and NHP. Nonetheless, continued monitoring over a long period will help mitigate the risk of anthropozoonosis and zooanthroponosis.

Road toward rapid-molecular point of care test to detect novel SARS-coronavirus 2019 (COVID-19): Review from updated literature

Coronavirus disease 2019 (COVID-19) named by the WHO as a result of the global public health emergency. COVID-19 is caused by a new coronavirus named as novel coronavirus (2019-nCOV). From the first case reported in December 2019 it is now a pandemic situation and a major public health emergency. The COVID-19 transmission rate is very high, infecting two to three persons on average with contact to an already infected person. There is a need for the health system, specially in developing countries such as in Pakistan, to combat such a novel disease by rapid, accurate, and high quality diagnostic testing in order to screen suspected cases and also surveillance of the disease. A rapid, accurate and low-cost diagnostic point-of-care device is needed for timely diagnosis of COVID-19 and is essential to combat such outbreaks for compelling preventive measures against the disease spread. This review is to highlight the importance of point-of-care diagnostics device for robust and accurate diagnosis of COVID-19 in physician offices and other urgent healthcare-type settings and encourage academics and stake holders towards advancement in order to control outbreaks and develop the public health surveillance system.

Plant-based oil-sorbents harbor native microbial communities effective in spilled oil-bioremediation under nitrogen starvation and heavy metal-stresses

Cultivation on selective media revealed that the oil-sorbents, wheat straw, corncobs and sugarcane bagasse harbor hydrocarbonoclastic, diazotrophic and heavy metal-resistant microorganisms. Nitrogen-free media containing 1.0% crude oil lost between 32.2 and 37.5% of this oil, after 8 months when they have been inoculated with such microorganism-loaded sorbents. The used wheat straw, corncobs and sugarcane bagasse samples, 1.0 g each, absorbed respectively, 1.9, 1.1 and 2.5 g oil samples, and lost 24.3-39.2% of these amounts, after they had been incubated for 8 months. Total genomic DNA's from culture media and sorbents revealed various nitrogenase-coding nifH-genes. Pure hydrocarbonoclastic microbial isolates tolerated certain concentrations of, Hg²⁺, Cd²⁺, Pb²⁺, AsO₄^3- and AsO₃^3-. Some of those isolates even grew excellently with up to 1000 ppm of Pb²⁺ and 36,000 ppm of AsO₄^3- also in the presence of oil. Tested strains removed the tested heavy metals, Hg²⁺, Cd²⁺ and Pb²⁺ from the media and thus, reduced their toxicity against the hydrocarbon-degraders. It was concluded that plant-based sorbents, not only remove oil physically, but also harbor microbial communities effective in spilled oil-bioremediation under multiple stresses. Although each community consisted of one to three species only, the consortia which reached in numbers millions of CFU ml^-1 enrich the oily media with fixed nitrogen, and remove heavy metals which otherwise inhibit the oil-degrading microorganisms.

Numerical study of hydromagnetic axisymmetric peristaltic flow at high Reynolds number and wave number

The computational study of MHD peristaltic motion is investigated for axisymmetric flow problem. The developed model is present in the form of partial differential equations. Then obtained partial differential equations are transferred into stream-vorticity (ψ - ω) form. Then Galerkin Finite element method is used to find the computational results of governing problem. The current study is compared with the existing well-known results at low Reynolds number and wave number. It is revealed that the present results are in well agreement with existing results in the literature. So, it is effective for higher values of Reynolds number and wave number. The variations of streamline are present graphically against high Reynolds number. It concludes that high Reynolds number and Hartmann number increase pressure rise per unit wavelength in positive pumping region sharply.

Newborn screening for Pompe disease: impact on families

Pompe disease (PD) is an autosomal recessive lysosomal storage disorder causing progressive glycogen accumulation in muscles, with variability in age of onset and severity. For infantile-onset PD (IOPD), initiation of early treatment can be life-saving; however, current newborn screening (NBS) technology cannot distinguish IOPD from late-onset PD (LOPD) without clinical workup. Therefore, families of LOPD infants diagnosed by NBS may now spend years or even decades aware of their illness before symptoms appear, creating a pre-symptomatic awareness phase with which the medical community has little experience. The present study examines the effects of receiving a positive NBS result for PD on families. In-depth qualitative interviews were conducted with mothers of nine children (three IOPD and six LOPD) diagnosed via NBS, exploring their experiences, understanding of PD, how they are coping, and what impact diagnosis is having on family life. Interviews were coded using MaxQDA v.12 and analyzed for thematic trends. While overall opinion of NBS was favorable, it is clear many of the concerns anticipated by HCPs, patients, and families regarding NBS for late-onset LSDs are being realized to varying degrees; LOPD families are becoming patients-in-waiting. Increased fear/anxiety and living with uncertainty (regarding diagnosis, their children's future, and when to start treatment) were predominant themes, with all families voicing considerable emotional reactions and varied social and healthcare support concerns. Coping strategies and psychosocial challenges are interpreted using Rolland & Williams' Family Systems Genetic Illness model. Recommendations for improvement in delivery of service, as well as families' advice for future parents and HCPs, are discussed.

Giant cell arteritis in patients of Indian Subcontinental descent in the UK

BACKGROUND

GCA in the Indian Subcontinent (ISC) is rare. Our centre in London, UK, serves an ethnically diverse population, including a significant population of patients of ISC descent. We hypothesise that patients of ISC descent are no less likely than others to present with symptoms suggestive of GCA and therefore to undergo temporal artery biopsy (TAB).

METHOD

A retrospective audit of all TABs performed at our institution over an 8 year period, to identify ethnicity (white, black, ISC, other, unknown) and biopsy result. We compared the proportion of all patients of ISC descent attending the ED to the proportion of ISC patients undergoing TAB. We compared the proportion of positive TABs among ISC patients with positive TABs among white patients. We also compared the proportion of TAB in ISC patients with all non-ISC ethnicities combined.

RESULTS

The proportion of patients undergoing TAB who were of ISC descent (16.3% of 92) was comparable to the proportion of A&E attendances made up by ISC patients [p = 0.1339]. 3.8% (1/26) of positive biopsies were among patients of ISC descent. White patients were significantly more likely to have a positive biopsy than patients of ISC ethnicity (33% of 61 white patients vs. 7% of 15 ISC [p = 0.0456]), as were patients of non-ISC ethnicity (32.5% of 77 non-ISC patients vs. 7% of 15 ISC patients [p = 0.0464]).

DISCUSSION

At our centre, biopsy proven GCA occurs in patients of ISC descent, but rarely. Full investigation for GCA continues to be appropriate where it is suspected, regardless of ethnicity.

Increasing Trend in the Incidence of Colorectal Cancer on Malaysia

Background: Colorectal cancer (CRC) is the second most common cancer in Malaysia (13.2%). Aim: To study the epidemiologic trend of colorectal cancer in Malaysia and to suggest the strategy in reducing the incidence of CRC in Malaysia. Methods: Total of 13,693 cases of colorectal cancer diagnosed in 2007-2011 were extracted from the Malaysian National Cancer Registry (MNCR). MNCR is a population-based cancer registry which collects data from all government and private facilities (hospitals, clinics, laboratories, National Registration Department and Health Informatics, MOH) by passive notification and active case findings. The registry registers all new cancer cases among Malaysian citizen diagnosed in Malaysia into CanReg4 software. Data were explored using IARC tools and analyzed using CanReg4 software. Results: 55.8% of the colorectal cancer cases were in male and 44.2% in female. ASR was 14.6 per 100,000 population for male and 11.1 per 100,000 populations for female. The male to female ASR ratio was 1.3:1. The 5-years trend shows increasing incidence for both gender. The age-specific incidence rates of the cases were between 45 to 75 years old. The lifetime risk for males was 1 in 56 and in females was 1 in 74. Majority of the cancer were detected among Chinese followed by Malays and Indians. 66% of the colorectal cancer presented at advanced stage (stage 3 and 4) in males and 65% in female. Conclusion: The trend of colorectal cancer is increasing in Malaysia and most of the cancer cases were diagnosed at late stage. To increase the detection rate of CRC at early stage, Ministry of Health Malaysia has introduce screening program using immunochemical fecal occult blood test (iFOBT) since 2013. Tremendous campaigns also being carry out in the community to create awareness on the importance of colorectal cancer screening for early detection and treatment hence improved the survival.

Osteoglycin, a novel coordinator of bone and glucose homeostasis

Objective

The skeleton, which is strongly controlled by endocrine factors, has recently been shown to also play an active endocrine role itself, specifically influencing energy metabolism. However, much less is known about this role. Therefore, we sought to identify novel endocrine factors involved in the regulation of both bone mass and whole-body glucose homeostasis.

Methods

We used transcriptomic and proteomic analysis of Y1 receptor deficient osteoblasts combined with the generation of a novel osteoglycin deficient mouse model and performed comprehensive in vivo phenotype profiling, combined with osteoglycin administration in wildtype mice and human studies.

Results

Here we identify a novel role for osteoglycin, a secreted proteoglycan, in coordinating bone accretion with changes in energy balance. Using an osteoglycin knockout mouse model, we show that at a whole body level, osteoglycin acts to suppress bone formation and modulate whole body energy supplies by altering glucose uptake through changes in insulin secretion and sensitivity, as well as by altering food intake through central signaling. Examining humans following gastric surgery as a model of negative energy balance, we show that osteoglycin is associated with BMI and lean mass as well as changes in weight, BMI, and glucose levels.

Conclusions

Thus, we identify osteoglycin as a novel factor involved in the regulation of energy homeostasis and identify a role for it in facilitating the matching of bone acquisition to alterations in energy status.

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Osteoglycin regulates insulin action, bone mass and food intake in mice.

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Osteoglycin is associated with changes in weight, BMI and glucose in obese humans.

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Osteoglycin is a downstream mediator of NPY signaling via osteoblastic Y1 receptors.

Donor-Derived Metastatic Melanoma and Checkpoint Inhibition

Donor-derived malignancy, particularly melanoma, is a rare but known complication of organ transplantation. Here we describe a case of metastatic melanoma in a deceased-donor kidney transplant recipient. After diagnosis, the patient was successfully treated with cessation of immunosuppression, explantation of the renal allograft, and novel melanoma therapies, including the mutation-targeted agents dabrafenib and trametinib and the immune checkpoint inhibitor nivolumab. These 2 new classes of melanoma therapy have revolutionized the course of metastatic melanoma, altering it from one of nearly certain mortality to one of potential cure. This case reviews the mechanisms of action of these therapies and reports our experience with them in the rare setting of donor-derived melanoma in a dialysis-dependent patient.

ntra-species profiling of Cleome viscosa growing in Swat district (Pakistan)

Intra-specific genetic variation was studied in 28 genotypes of Cleome viscosa L. growing in Swat district, Khyber Pakhtunkhwa, Pakistan. It was found that genotypes showed the utmost allelic variation for leaf upper and lower surface with emerald green (75%), and yellow green (75%) respectively, other leaves lower and upper surfaces were (25%) green and yellow green (26%) respectively. The majority of C. viscosa genotypes were (50%) yellow flowers while others were with (29%) white yellow colour and (21%) dull yellow. Most of the seeds were with black (46%). The protein profiling was carried out on 12% gel electrophoresis; seven reproducible bands with molecular weight ranges from 180 to 10 KDa were detected in C. viscosa, the locus contribution toward genetic disagreement (LCTGD) of C. viscosa was 57%. Notably, L-3, L-4 L-5, was monomorphic in C. viscosa and was treated as species specific. L-1, L-2, L-7 were polymorphic. These bands showed 79%, 4%, 14% and 79% variation respectively. In the current investigation the intra-specific variation was observed limited and alone SDS-PAGE did not determine the high level of intra-specific variation; however, diverse germplasm were suggested to be acquired from various sources.

Abstract PD6-04: Not presented

This abstract was not presented at the symposium.

Relationship between Mastery and Caregiving Competence in Protecting against Burden, Anxiety and Depression among Caregivers of Frail Older Adults

OBJECTIVE

Studies suggest the protective effect of mastery and caregiving competence against psychological stressors of caregiving in the context of dementia, although the interplay between the two with caregiver outcomes is not well understood. This study examines the independent and moderating impact of mastery and caregiving competence on burden, anxiety and depression among caregivers of older adults with frailty-related care needs.

DESIGN, SETTING AND PARTICIPANTS

This is a cross-sectional study of 274 older adults-family caregiver dyads from a hospital in Singapore. Mean ages of the older adults and their caregivers were 85 and 59 years respectively.

MEASUREMENTS

We performed hierarchical linear regression models to examine the independent influence of mastery and caregiving competence on caregiver burden, anxiety and depression. We also examined the interaction effect between mastery and caregiving competence for each outcome.

RESULTS

Mastery and caregiving competence were independently negatively associated with caregiver burden, anxiety and depression. Mastery explained more variance than caregiving competence and had a stronger correlation with all outcomes. There was a statistically significant interaction between mastery and caregiving competence for depression (interaction term beta=.14, p<0.01), but not burden and anxiety. High levels of mastery are associated with less depression. particularly among caregivers with below-average levels of caregiving competence. Likewise, high levels of caregiving competence are associated with less depression. particularly among caregivers with below-average levels of mastery.

CONCLUSION

Our findings suggest potential benefits adressing targeted interventions for mastery and caregiving competence of caregivers to older adults as they independently influence caregiver outcomes and moderate each other's effect on depression. Mastery-based interventions should be incorporated into current caregiver training which traditionally has focused on caregiver competence alone.