The role of veterinarians in zoonosis prevention: Advising families of immunocompromised children with pets

Background

Pet ownership is widespread, offering numerous benefits to individuals and families. However, the risk of zoonotic diseases must be carefully considered, especially for immunosuppressed patients. Knowledge gaps in preventive measures for zoonoses have been identified, underscoring the vital role of veterinarians in addressing this issue.

Objectives

This study aimed to assess the knowledge and recommendations of veterinarians regarding pet ownership by immunocompromised individuals. Additionally, we compared these insights with responses from European healthcare professionals specializing in pediatric transplant recipients.

Methods

We conducted an observational, cross-sectional study involving small animal veterinarians in Spain. An online survey was administered to gather information on veterinarians' knowledge of zoonoses and their recommendations for immunocompromised pet owners.

Results

A survey of 514 individuals was collected from experienced veterinarians mainly working in primary care clinics. Surprisingly, 63% of respondents did not routinely inquire about the presence of immunocompromised individuals among pet owners, although 54% offered specific recommendations for this group. Most respondents adhered to deworming guidelines for pets owned by immunocompromised individuals and demonstrated sound practices in Leishmania and Leptospira prevention, as well as the avoidance of raw food. However, gaps were noted concerning Bordetella bronchiseptica vaccination. Notably, veterinarians outperformed medical professionals in their knowledge of zoonotic cases and identification of zoonotic microorganisms. The presence of specific recommendations in veterinary clinics was viewed positively by nearly all respondents.

Conclusions

Our findings indicate that veterinarians possess a superior understanding of zoonotic pathogens and exhibit greater proficiency in diagnosing zoonoses compared with physicians. They stay well-informed about recommendations outlined in established guidelines and are more likely to provide written recommendations in their clinics than physicians. Nevertheless, knowledge gaps among veterinarians emphasize the need for enhanced communication between medical and veterinary professionals. Reinforcing the "One Health" concept is imperative, with veterinarians playing a pivotal role in this collaborative effort.

Spatial and temporal analysis of African swine fever front-wave velocity in wild boar: implications for surveillance and control strategies

The front-wave velocity of African swine fever (ASF) virus spread is depicted through a retrospective spatial and temporal analyses of wild boar outbreaks from Jan. 2014 to Jan. 2022 in Estonia, Latvia, Lithuania and Eastern Poland-regions responsible for more than 50% of all wild boar cases in the EU. The study uses empirical semivariograms in a universal kriging model to assess spatial autocorrelation in notification dates and identifies a discernable large-scale spatial trend. The critical parameter of ASF front-wave velocity was identified (Mean = 66.33 km/month, SD = 163.24) in the whole study area, and explored the variations across countries, wild boar habitat suitability, seasons, and the study period. Statistical differences in front-wave velocity values among countries and temporal clusters are explored, shedding light on potential factors influencing ASF transmission dynamics. The implications of these findings for surveillance and control strategies are discussed.

First detection of herpesvirus and hemosporidians in the endangered Pyrenean Capercaillie (Tetrao urogallus aquitanicus)

Pathogens affect wild bird populations worldwide, contributing to their decline. Considering the scarce health data regarding the endangered Pyrenean Capercaillie (Tetrao urogallus aquitanicus), we molecularly surveyed selected pathogens (Newcastle disease virus, Avian influenza virus, Chlamydia psittaci, avian pathogenic Escherichia coli, Campylobacter jejuni, and Salmonella spp.) in 30 Pyrenean Capercaillie feces collected in the field (Catalonia, northeastern Spain). Additionally, swab and tissue samples from eight wild Pyrenean Capercaillies of Catalonia and Andorra were molecularly tested for herpesvirus and hemosporidians (Plasmodium spp., Haemoproteus spp., and Leucocytozoon spp.). All fecal samples were negative for the pathogens tested. Nevertheless, we detected a novel herpesvirus in 50% (4/8) of the Pyrenean Capercaillies, and hemosporidian DNA in 62.5% (5/8) of the tissue samples (i.e., Haemoproteus sp. [4 of 8] and/or Leucocytozoon sp. [3 of 8]). To our knowledge, this is the first detection of herpesvirus and hemosporidians infections in Pyrenean Capercaillies. The putative novel herpesvirus belongs to the genus Iltovirus. The presence of hemosporidian parasites in this mountain bird species is of concern, and could be related to the marked increase in the average temperature in the Pyrenees as a consequence of climate change. Our findings are fundamental to improve the conservation plans for the endangered Pyrenean Capercaillie population.

Salmonella assessment along the Spanish food chain: Likelihood of Salmonella occurrence in poultry and pig products is maintained across the food chain stages

Salmonellosis is one of the most important foodborne diseases worldwide, including the European Union. Despite the One Health approach measures for risk assessment and risk management implemented by the European Union, the occurrence of disease and disease outbreaks remains high (e.g. 694 outbreaks were reported in 2020), highlighting the need of new assessment methods. Herein we applied machine learning using the random forests method to evaluate and identify key points regarding the occurrence of Salmonella sp. along the Spanish food chain during 2015-2020, using data provided by the Spanish Agency for Food Safety and Nutrition. We compared the role of the three categorical variables [product (20 categories), region (18 categories) and stage (11 categories)]. Salmonella presence was influenced by the three explanatory variables considered: first by product, followed by region and stage. The most determinant product for Salmonella probability was 'meat', while the most important stage was 'slaughterhouse'. Specifically, the highest values were found in pig and poultry meats. In these products, the Salmonella probability was high at the early and final stages of the food chain, although not at intermediate stages. The presence of Salmonella in the final stages (retail) of the food chain is of concern, as it can cause human cases of salmonellosis, including outbreaks. This study demonstrates the utility of the random forest method to identify key points and evaluate the control efforts. We recommend improving the surveillance and control measures, especially in the product and stages pointed out by our analysis, and enhancing the data collection harmonization among the different autonomous communities.

Socio-economic factors affecting the distribution of marine litter: The Portuguese case study

Marine litter is a growing global problem with serious environmental, economic, social, and health threats. Understanding the socio-economic factors that influence the types and amounts of litter is of utmost importance. In this study, an integrative analysis of the socio-economic factors that characterize the beach litter distribution in continental Portugal and the Azores archipelago was conducted via a cluster analysis, implementing a novel technique to support the difficult task of marine litter characterization. The results highlighted that the most abundant beach litter material is plastic (92.9 %), followed by paper (2.2 %), wood (1.5 %), and metal (1.3 %). The majority of the items could not be attributed to a specific source (46.5 %). The remaining were attributed to public litter (34.5 % of total aggregated items), fishing (9.8 %), sewage-related debris (6.4 %) and shipping (2.2 %). The top-three beach litter categories were small plastic pieces (0-2.5 cm, 43.5 %), cigarette butts (30.1 %), and medium plastic pieces (2.5-50 cm, 26.4 %). A positive relation between both municipality environment expenditures and population density and the quantity and typology of litter was found. Beach litter quantity and categories were also associated with specific economic sectors, as well as with geographical/hydrodynamic conditions, demonstrating the utility of the technique and its applicability to other regions.

Immunomodulatory, Anti-Inflammatory, and Anti-Cancer Properties of Ginseng: A Pharmacological Update

Ginseng, a medicinal plant of the genus Panax, boasts a rich historical record of usage that dates back to the Paleolithic period. This botanical is extensively acknowledged and consumed in Eastern countries for its therapeutic properties, and, in Western countries, it is becoming increasingly popular as a remedy for fatigue and asthenia. This review provides an update on current research pertaining to ginseng and its isolated compounds, namely, ginsenosides and polysaccharides. The primary focus is on three crucial pharmacological activities, namely, immunomodulation, anti-inflammatory, and anti-cancer effects. The review encompasses studies on both isolated compounds and various ginseng extracts obtained from the root, leaves, and berries.

Analysis of perceived risk and satisfaction with telematic follow-up in patients and families of congenital diaphragmatic hernia patients during SARS-CoV-2 pandemia

BACKGROUND

The impact of COVID-19 in families and patients with congenital diaphragmatic hernia (CDH) is unknown, this situation has generated uncertainty not only in family members but also in the optimal outpatient follow-up. Telehealth has become a fundamental tool for the follow-up during the pandemic. The objective of this survey is to evaluated the impact of SARS-CoV-2 in families and patients with CDH and the satisfaction with telematic follow-up.

METHODS

Telephone survey of patient's caregivers with CHD, aged 1-16 years, followed in neonatal surgery outpatients, from January 31, 2020 to November 15, 2020. The ethical clearance for this study was taken from the Clinical Research Ethics Committee of our Research Institute vide letter number VHIR/239283/01.01.2021.

RESULTS

81 surveys of 100 patients with active follow-up were carried out. There were no refusals in any contacted parents. There were 30 contacts (37%), 44.8% at school and 27.6% from cohabiting family members. Four infections (4.9%) were diagnosed, half symptomatic. In 40 patients (49.4%) the follow-up was telematic, with a mean score of 3.1±1.3 out of 5. For future controls, 65% prefer presential follow-up, 25% alternate and 10% telematics. 50.6% reported greater anxiety and 34.6% (28/81) extreme measures of isolation, being more accentuated in the group of 3-6 years (p<0.05).

CONCLUSION

The impact of COVID19 in patients with CHD is not greater than in the general pediatric population. Although the incorporation of the telehealth was well valued, most of the caregivers prefer the face-to-face outpatient follow-up.

Balancing the Risks and Benefits of Pet Ownership in Pediatric Transplant Recipients

In recent decades, the number of pediatric transplantations and their survival rates have increased. Psychological problems and poorer quality of life are notable among children undergoing transplantation and can have long-lasting consequences and affect immunosuppressive therapy adherence. Pet ownership and animal contact have been associated with physical, mental, and social health benefits. Despite these potential benefits, however, companion animals are known to be a source of infection, which is one of the main concerns for clinicians. Because of immunosuppression, these children are particularly vulnerable to infections. Zoonoses comprise a long list of infectious diseases and represent a major public health problem. Nevertheless, many families and most healthcare providers are unaware of these potential risks, and there is a worrisome lack of recommendations to manage the risk-benefit balance, which could pose a risk for acquiring a zoonosis. Furthermore, no data are available on the number of transplanted patients with pets, and this risk-benefit balance is difficult to adequately evaluate. In this document, we review the currently available evidence regarding the epidemiology of zoonotic infections in patients undergoing transplantation, focusing on pediatric patients from a risk-benefit perspective, to help inform decision-making for clinicians. Families and healthcare professionals should be aware of the risks, and clinicians should actively screen for pets and offer comprehensive information as part of routine clinical practice. A multidisciplinary approach will ensure proper care of patients and pets and will establish preventive measures to ensure patients are safe living with their pets.

Oral saliva swab reverse transcription PCR for Covid-19 in the paediatric population

OBJECTIVES

To evaluate the performance of oral saliva swab (OSS) reverse transcription PCR (RT-PCR) compared with RT-PCR and antigen rapid diagnostic test (Ag-RDT) on nasopharyngeal swabs (NPS) for SARS-CoV-2 in children.

DESIGN

Cross-sectional multicentre diagnostic study.

SETTING

Study nested in a prospective, observational cohort (EPICO-AEP) performed between February and March 2021 including 10 hospitals in Spain.

PATIENTS

Children from 0 to 18 years with symptoms compatible with Covid-19 of ≤5 days of duration were included. Two NPS samples (Ag-RDT and RT-PCR) and one OSS sample for RT-PCR were collected.

MAIN OUTCOME

Performance of Ag-RDT and RT-PCR on NPS and RT-PCR on OSS sample for SARS-CoV-2.

RESULTS

1174 children were included, aged 3.8 years (IQR 1.7-9.0); 73/1174 (6.2%) patients tested positive by at least one of the techniques. Sensitivity and specificity of OSS RT-PCR were 72.1% (95% CI 59.7 to 81.9) and 99.6% (95% CI 99 to 99.9), respectively, versus 61.8% (95% CI 49.1 to 73) and 99.9% (95% CI 99.4 to 100) for the Ag-RDT. Kappa index was 0.79 (95% CI 0.72 to 0.88) for OSS RT-PCR and 0.74 (95% CI 0.65 to 0.84) for Ag-RDT versus NPS RT-PCR.

CONCLUSIONS

RT-PCR on the OSS sample is an accurate option for SARS-CoV-2 testing in children. A less intrusive technique for younger patients, who usually are tested frequently, might increase the number of patients tested.

Pets for pediatric transplant recipients: To have or not to have

Pets have many health, emotional and social benefits for children, but the risk of zoonotic infections cannot be underestimated, especially for immunosuppressed patients. We report the recommendations given by health professionals working with pediatric transplant recipients to their families regarding pet ownership. An online survey addressing zoonosis knowledge and recommendations provided by health care practitioners regarding pets was distributed to clinicians treating pediatric transplant recipients. The European Society of Pediatric Infectious Disease (ESPID) and the European Reference Network ERN-TransplantChild, which works to improve the quality of life of transplanted children, allowed the online distribution of the survey. A total of 151 practitioners from 28 countries participated in the survey. Up to 29% of the respondents had treated at least one case of zoonosis. Overall, 58% of the respondents considered that the current available evidence regarding zoonotic risk for transplanted children of having a pet is too scarce. In addition, up to 23% of the surveyed professionals recognized to be unaware or outdated. Still, 27% of the respondents would advise against buying a pet. Practitioners already owning a pet less frequently advised patients against pet ownership, whereas non-pet-owners were more keen to advise against pet ownership (p = 0.058). 61% of the participants stated that there were no institutional recommendations regarding pets in their centers/units. However, 43% of them reported therapeutic initiatives that involved animals in their centers. Infectious disease specialists were more likely to identify zoonotic agents among a list of pathogens compared to other specialists (p &lt; 0.05). We have observed a huge heterogeneity among the recommendations that health care providers offer to families in terms of risk related to pet ownership for transplant recipients. The lack of evidence regarding these recommendations results in practitioners' recommendations based on personal experience.

Casemix, management, and mortality of patients rreseceiving emergency neurosurgery for traumatic brain injury in the Global Neurotrauma Outcomes Study: a prospective observational cohort study

BACKGROUND

Traumatic brain injury (TBI) is increasingly recognised as being responsible for a substantial proportion of the global burden of disease. Neurosurgical interventions are an important aspect of care for patients with TBI, but there is little epidemiological data available on this patient population. We aimed to characterise differences in casemix, management, and mortality of patients receiving emergency neurosurgery for TBI across different levels of human development.

METHODS

We did a prospective observational cohort study of consecutive patients with TBI undergoing emergency neurosurgery, in a convenience sample of hospitals identified by open invitation, through international and regional scientific societies and meetings, individual contacts, and social media. Patients receiving emergency neurosurgery for TBI in each hospital's 30-day study period were all eligible for inclusion, with the exception of patients undergoing insertion of an intracranial pressure monitor only, ventriculostomy placement only, or a procedure for drainage of a chronic subdural haematoma. The primary outcome was mortality at 14 days postoperatively (or last point of observation if the patient was discharged before this time point). Countries were stratified according to their Human Development Index (HDI)-a composite of life expectancy, education, and income measures-into very high HDI, high HDI, medium HDI, and low HDI tiers. Mixed effects logistic regression was used to examine the effect of HDI on mortality while accounting for and quantifying between-hospital and between-country variation.

FINDINGS

Our study included 1635 records from 159 hospitals in 57 countries, collected between Nov 1, 2018, and Jan 31, 2020. 328 (20%) records were from countries in the very high HDI tier, 539 (33%) from countries in the high HDI tier, 614 (38%) from countries in the medium HDI tier, and 154 (9%) from countries in the low HDI tier. The median age was 35 years (IQR 24-51), with the oldest patients in the very high HDI tier (median 54 years, IQR 34-69) and the youngest in the low HDI tier (median 28 years, IQR 20-38). The most common procedures were elevation of a depressed skull fracture in the low HDI tier (69 [45%]), evacuation of a supratentorial extradural haematoma in the medium HDI tier (189 [31%]) and high HDI tier (173 [32%]), and evacuation of a supratentorial acute subdural haematoma in the very high HDI tier (155 [47%]). Median time from injury to surgery was 13 h (IQR 6-32). Overall mortality was 18% (299 of 1635). After adjustment for casemix, the odds of mortality were greater in the medium HDI tier (odds ratio [OR] 2·84, 95% CI 1·55-5·2) and high HDI tier (2·26, 1·23-4·15), but not the low HDI tier (1·66, 0·61-4·46), relative to the very high HDI tier. There was significant between-hospital variation in mortality (median OR 2·04, 95% CI 1·17-2·49).

INTERPRETATION

Patients receiving emergency neurosurgery for TBI differed considerably in their admission characteristics and management across human development settings. Level of human development was associated with mortality. Substantial opportunities to improve care globally were identified, including reducing delays to surgery. Between-hospital variation in mortality suggests changes at an institutional level could influence outcome and comparative effectiveness research could identify best practices.

FUNDING

National Institute for Health Research Global Health Research Group.

African Swine Fever Survey in a European Context

African swine fever (ASF) is currently the most threatening disease for domestic and wild pigs worldwide. Wild boar has been the main affected species in all EU countries except for Romania, where most notifications occur in domestic pigs. The spread of ASF in wild boar is challenging to control; risk factors are harder to identify and establish than in domestic pigs, which, together with an underestimation of the disease and the lack of treatment or an effective vaccine, are hindering control and eradication efforts. We distributed two online questionnaires, one for domestic pigs and one for wild boar, to experts of different background and countries in Europe, to explore risk factors in relation to ASF control connected to farming, hunting, trade, the environment, and domestic pig and wild boar populations. Overall, wild boar movements were estimated to pose the highest risk of ASF introduction and spread. The movement of pork and pork products for own consumption also ranked high. Here we explored, in addition to the assessment of risk pathways, the identification of risks of transmission at the domestic/wild boar interface, the importance of biosecurity practices and improved control efforts, and controversial opinions that require further attention.

RAS Mutational Status in Advanced Colorectal Adenocarcinoma Treated With Anti-angiogenics: Preliminary Experience With Liquid Biopsy

AIM

To determinate molecular changes in the downstream epidermal growth factor receptor signaling pathway using serial liquid biopsies in patients with metastatic colorectal tumors (mCRC) under anti-angiogenic treatment.

PATIENTS AND METHODS

Determination of RAS mutation in primary tissue samples from colorectal tumors was performed in the 23 patients included in the study at diagnosis using quantitative-polymerase chain reaction. Sequential mutations were studied in circulating tumor (ct) DNA obtained from plasma samples.

RESULTS

Twenty-three patients with RAS-mutated primary tumors were included. In the first ctDNA determination, 17 of these patients were found to have wild-type RAS status. Remarkably, three out of these 17 wild-type cases changed to RAS-mutated in subsequent ctDNA assays.

CONCLUSION

Serial liquid biopsies in patients with mCRC might be a useful tool for identifying changes in the RAS mutation status in patients who had undergone previous anti-angiogenic therapy. The understanding of these changes might help to better define the landscape of mCRC and be the path to future randomized studies.

Long-Range Ordering Effects in Magnetic Nanoparticles

The challenge for synthesizing magnetic nanoparticle chains may be achieved under the application of fixation fields, which are the externally applied fields, enhancing collective magnetic features due to adequate control of dipolar interactions among magnetic nanoparticles. However, relatively little attention has been devoted to how size, concentration of magnetic nanoparticles, and intensity of an external magnetic field affect the evolution of chain structures and collective magnetic features. Here, iron oxide nanoparticles are developed by the coprecipitation method at diameters below (10 and 20 nm) and above (50 and 80 nm) their superparamagnetic limit (at about 25 nm) and then are subjected to a tunable fixation field (40-400 mT). Eventually, the fixation field dictates smaller particles to form chain structures in two steps, first forming clusters and then guiding chain formation via "cluster-cluster" interactions, whereas larger particles readily form chains via "particle-particle" interactions. In both cases, dipolar interactions between the neighboring nanoparticles augment, leading to a substantial increase in their collective magnetic features which in turn results in magnetic particle hyperthermia efficiency enhancement of up to one order of magnitude. This study provides new perspectives for magnetic nanoparticles by arranging them in chain formulations as enhanced performance magnetic actors in magnetically driven magnetic applications.

Current uses and knowledge of medicinal plants in the Autonomous Community of Madrid (Spain): a descriptive cross-sectional study

BACKGROUND

The usage of medicinal plants as a key component of complementary and alternative medicine, has acquired renewed interest in developed countries. The current situation of medicinal plants in Spain is very limited. This paper provides new insights and greater knowledge about current trends and consumption patterns of medicinal plants in the Autonomous Community of Madrid (Spain) for health benefits.

METHODS

A descriptive cross-sectional study was designed for a population-based survey on medicinal plants. The data were collected (May 2018 to May 2019) using semi-structured face-to-face interviews in independent pharmacies, hospital centers and primary care health centers in the Autonomous Community of Madrid. The survey had 18 multiple choice and open-ended questions. Quantitative indices were calculated: Fidelity Level (FL), Use Value (UV) and Informants Consensus Factor (ICF). Chi-square test was used for data analysis.

RESULTS

Five hundred forty-three people were interviewed. The majority of the participants (89.6%) have used medicinal plants to treat health disorders in the past 12 months, mainly for digestive problems, sleep disorders and central nervous system diseases. A total of 78 plants were recorded, being Matricaria recutita, Valeriana officinalis, Tilia spp. and Aloe vera the most used. The highest UV was found for Mentha pulegium (UV 0.130) followed by Aloe vera (UV 0.097) and Vaccinium macrocarpon. (UV 0.080). The highest FL values were for Eucalyptus spp. (FL 90.47%) for respiratory conditions and, Matricaria recutita (85.55%) and Mentha pulegium (84.09%) for digestive problems. The highest ICF corresponded to metabolism and depression (ICF = 1), pain (ICF = 0.97), insomnia (ICF = 0.96) and anxiety (ICF = 0.95). Participants mostly acquired herbal medicines from pharmacies, herbal shops and supermarkets. Some side effects (tachycardia, dizziness and gastrointestinal symptoms) and potential interactions medicinal plants-drugs (V. officinalis and benzodiazepines) were reported.

CONCLUSION

Many inhabitants of the Autonomous Community of Madrid currently use herbal products to treat minor health problems. The most common consumer pattern are young women between 18 and 44 years of age with higher education. In order to confirm the pattern, further research should be focused to investigate current uses of medicinal plants in other Spanish regions.

Cross-reactivity between Parietaria judaica and Parietaria officinalis in immunotherapy extracts for the treatment of allergy to Parietaria

Parietaria judaica and P. officinalis are the two most common subspecies of the Parietaria genus. P. judaica and P. officinalis have exhibited cross-reactivity in previous studies. P. judaica pollen is the main cause of allergy in the Mediterranean area. It has been shown that a high percentage of patients sensitized to P. judaica with allergic rhinitis (AR) have an increased risk of developing asthma. The present study aimed to confirm the cross-reactivity between P. judaica and P. officinalis and to evaluate the use of a single P. officinalis extract in patients allergic to both subspecies as a preferable option for the diagnosis and treatment of allergy in a highly pollinated area of the Spanish Mediterranean coast. The present study was a single centre, observational cross-sectional study of adult patients diagnosed with AR and/or bronchial asthma who were sensitized to Parietaria pollen. A total of 24 patients were enrolled in the study and included in the analysis. Allergovit^® immunotherapy extracts were selected for the study based on the protein content (P. officinalis pollen extract). The results of an in vitro ELISA revealed that 79.1% (n=19) of the patient sera were reactive to immunotherapy extracts. ELISA inhibition assay of the IgE binding to P. officinalis demonstrated inhibition values >70% in the sera of highly reactive patients, confirming the cross-reactivity between the two Parietaria subspecies. In addition, all patients enrolled in the study exhibited double skin positivity against P. judaica and P. officinalis extracts, as assessed by the skin prick test, further supporting the in vivo reactivity between the two subspecies. The present study demonstrated that P. judaica and P. officinalis pollen extracts were highly cross-reactive, and that a unique P. officinalis pollen extract may be used for the diagnosis and immunotherapy of patients allergic to Parietaria.

Evolution of the ASF Infection Stage in Wild Boar Within the EU (2014-2018)

African swine fever (ASF) is one of the most important emerging transboundary diseases of pigs, causing trade restrictions, and a health impact on susceptible pigs. Nine countries in the continental European Union (Estonia, Lithuania, Latvia, Poland, Czech Republic, Bulgaria, Belgium, Romania, and Hungary) have been affected by ASF from 2014 to 2018 and it keeps spreading despite the efforts to control it. For a number of years, we have witnessed high case-fatality rates in wild boar found dead particularly in new infected areas, which is typical of the peracute and acute forms of the infection at the beginning of an ASF epidemic. Experimental evidence with currently circulating strains indicates that some infected animals can remain asymptomatic and might even survive the infection. An increased presence of virus of moderate virulence can complicate ASF diagnosis as well as the mitigation and control of the disease. We analyze the ASF surveillance data in wild boar in the four EU countries where ASF has been present for longer, comparing the spatial density of antibody positive notifications with the time ASF has been present per region. Results indicate an increasing annual distribution of notifications based on antibodies over nucleic acid detection in hunted wild boar in Estonia, Latvia and Poland. Potentially, Lithuania, and Poland seem to have experienced more acute forms in 2017 and 2018 than Latvia and Estonia. Overall there was a positive statistical correlation between time with infection (TWI) and antibody positive density, with some variations in certain regions, particularly of Lithuania and Estonia. The increasing trend in potential survivors (hunted wild boar with confirmed PCR negative and antibody positive results) enhances the importance of surveillance design to sample and test shot wild boar. In conclusion, surveillance data based on ASFV detection by PCR and serology can be used to assess the status of the epidemic in wild boar.

Pharmacological Update Properties of Aloe Vera and its Major Active Constituents

Aloe vera has been traditionally used to treat skin injuries (burns, cuts, insect bites, and eczemas) and digestive problems because its anti-inflammatory, antimicrobial, and wound healing properties. Research on this medicinal plant has been aimed at validating traditional uses and deepening the mechanism of action, identifying the compounds responsible for these activities. The most investigated active compounds are aloe-emodin, aloin, aloesin, emodin, and acemannan. Likewise, new actions have been investigated for Aloe vera and its active compounds. This review provides an overview of current pharmacological studies (in vitro, in vivo, and clinical trials), written in English during the last six years (2014–2019). In particular, new pharmacological data research has shown that most studies refer to anti-cancer action, skin and digestive protective activity, and antimicrobial properties. Most recent works are in vitro and in vivo. Clinical trials have been conducted just with Aloe vera, but not with isolated compounds; therefore, it would be interesting to study the clinical effect of relevant metabolites in different human conditions and pathologies. The promising results of these studies in basic research encourage a greater number of clinical trials to test the clinical application of Aloe vera and its main compounds, particularly on bone protection, cancer, and diabetes.

Linking contaminant distribution to hydrodynamic patterns in an urban estuary: The Douro estuary test case

An increase in anthropogenic activities in coastal regions can put at risk their flora and fauna and their ecosystem services. Therefore, it is important to evaluate possible impacts. In particular, we need to understand the links between contaminants concentrations and the hydrodynamic patterns of these highly productive regions to anticipate the effects of contaminants in the environment. Towards that aim there is the need to carry out regular campaigns to monitor the evolution of the coastal systems. In this work we analyse in-situ measurements of physico-chemical parameters, and look for possible relations between observed contaminants patterns and estuarine hydrodynamics. Data collected in the Douro estuary, one of the main estuarine regions of the Iberian western coast, revealed the presence of 5 hazardous and noxious substances (HNS), 14 polycyclic aromatic hydrocarbons (PAHs) and 6 trace metals in water and sediment samples. Water temperature and salinity analysis revealed a strong variability, which can affect the water solubility properties and the organisms' tolerance to certain toxins. A relationship between the salinity and the HNS and PAHs concentrations was found, caused by the existence of a salt-wedge that triggers the salting-out effect. Sinker contaminants (PAHs and trace metals) can be re-suspended both during low and high flow conditions associated with the salt-wedge and with strong river flows. Floater contaminants (HNS) are completely depended on the tide, which has the capacity to distribute them through the entire estuary, during low river flow regimes. However, strong river flows, with associated river plumes, can distribute both sinker and floater contaminants to the coastal region trapping them over the inner-shelf. The results clearly show that hydrodynamic patterns are a major driver for contaminants dispersion and pathways in coastal areas, inducing harmful effects to the flora and fauna and, consequently, to the ecosystem services of these regions.

The last frontier: Coupling technological developments with scientific challenges to improve hazard assessment of deep-sea mining

The growing economic interest in the exploitation of mineral resources on deep-ocean beds, including those in the vicinity of sensitive-rich habitats such as hydrothermal vents, raise a mounting concern about the damage that such actions might originate to these poorly-know ecosystems, which represent millions of years of evolution and adaptations to extreme environmental conditions. It has been suggested that mining may cause a major impact on vent ecosystems and other deep-sea areas. Yet, the scale and the nature of such impacts are unknown at present. Hence, building upon currently available scientific information it is crucial to develop new cost-effective technologies embedded into rigorous operating frameworks. The forward-thinking provided here will assist in the development of new technologies and tools to address the major challenges associated with deep sea-mining; technologies for in situ and ex situ observation and data acquisition, biogeochemical processes, hazard assessment of deep-sea mining to marine organisms and development of modeling tools in support of risk assessment scenarios. These technological developments are vital to validate a responsible and sustainable exploitation of the deep-sea mineral resources, based on the precautionary principle.

Comparative Study of Different Classification Models in Renal-Cell Carcinoma

The aim of this study was to compare the Memorial Sloan-Kettering Cancer Center (MSKCC) and the Cleveland Clinic Foundation (CCF) models of classification of aRCC patients. In addition, the model developed from the pivotal trial of temsirolimus and those proposed by Motzer et al. in 2004, Escudier et al., Heng et al., Choueiri et al. and Bamias et al. were examined. An observational, retrospective study of patients starting first-line systemic therapy was conducted between 2008 and 2011. The variables used to evaluate the classification models were median overall survival (mOS) and median progression-free survival (mPFS). The comparison of different classification models was performed by comparing the area under the ROC (Receiver Operating Characteristic) curve (AUC) for time-dependent variables proposed by Heagerty. Eighty-eight patients were included. When the different models were compared, it was found that although based on the mOS, the Escudier model had better short-term (1-year) prognostic value, followed by the Heng model; in the long term, the models that presented a higher prognosis capacity were the Hudes and CCF models, closely followed by the Heng model. In addition, the Heng model had a slightly higher predictive ability than the other models. Based on the results, and in line with the European society for medical oncology (ESMO) guidelines, it appears that the model of Heng could be the best model to classify patients with aRCC and combines good short- and long-term prognostics while possessing better predictive ability and a more equal distribution of patients.

Evaluation of the adaptogenic potential exerted by ginsenosides Rb1 and Rg1 against oxidative stress-mediated neurotoxicity in an in vitro neuronal model

Background

Ginseng (Panax sp.) is a drug with multiple pharmacological actions that has been largely used in traditional medicines for the treatment of many health problems. In the therapy of neurodegenerative disorders, it has been employed due to its capacity to strengthen mental processes by enhancing cognitive performance and psychological function. Current work aimed at evaluating the adaptogenic potential of Rb1 and Rg1 against oxidative-stress mediated degeneration in a model of nervous cells.

Methods

Oxidative stress and mitochondrial dysfunction were achieved by exposing SH-SY5Y cells to the mitochondrial complex I inhibitor rotenone. The cytoprotective activity of pre-treatments with ginsenosides Rb1 and Rg1 against rotenone was assessed by determining biochemical markers regarding oxidative stress (ROS scavenging, glutathione and lipid peroxidation levels, SOD activity and Nrf2 activation) and apoptosis-related alterations (mitochondrial membrane potential, calcium levels, aconitase activity and pro/antiapoptotic proteins). Their capacity to cross the blood brain barrier was also estimated.

Results

At their optimal doses, ginsenosides Rb1 and Rg1 significantly ameliorated redox status within the cells; they reduced ROS and TBARS levels and improved the glutathione system, as well as they enhanced SOD activity and Nrf2 pathway activation. They protected neuronal cells against MMP loss, calcium homeostasis disruption and aconitase inhibition. Consequently, apoptotic cell death was attenuated by the pre-treatment with ginsenosides, as evidenced by the reduction in caspase-3 and Bax, and the increase in Bcl-2 expressions; also, lower levels of cytochrome C were found in the cytosol. Poor BBB permeation was demonstrated for both ginsenosides.

Conclusions

In conclusion, ginsenosides Rb1 and Rg1 exhibit neuroprotective potential which is achieved, at least in part, via mitochondrial protection and the plausible involvement of Nrf2 pathway activation. Our results contribute to validate the traditional use of ginseng for cognitive-enhancing purposes and provide basis to encourage further research on the potential of ginsenosides in the treatment of neurodegenerative diseases.

Use of exome sequencing to determine the full profile of genetic variants in the fluoropyrimidine pathway in colorectal cancer patients affected by severe toxicity

Aim: To identify genetic variants associated with capecitabine toxicity in fluoropyrimidine pathway genes using exome sequencing. Patients & methods: Exomes from eight capecitabine-treated patients with severe adverse reactions (grade >2), among a population of 319, were sequenced (Ion Proton). SNPs in genes classified as potentially damaging (Sorting Intolerant from Tolerant and Polymorphism Phenotyping v2) were tested for association with toxicity in a validation cohort of 319 capecitabine-treated patients. Results: A total of 17 nonsynonymous genetic variants were identified. Of these, five putative damaging SNPs in DPYD, ABCC4 and MTHFR were genotyped in the validation cohort. DPYD rs1801160 was associated with the risk of toxicity (p = 0.029) and MTHFR rs1801133 with delayed administration of chemotherapy due to toxicity (p = 0.047). Conclusion: Exome sequencing revealed two specific biomarkers of the risk of toxicity to capecitabine.

A Cartographic Tool for Managing African Swine Fever in Eurasia: Mapping Wild Boar Distribution Based on the Quality of Available Habitats

The current African swine fever (ASF) epidemic in Eurasia represents a risk for the swine industry with devastating socio-economic and political consequences. Wild boar appears to be a key factor in maintaining the disease in endemic areas (mainly the Russian Federation) and spreading the disease across borders, including within the European Union. To help predict and interpret the dynamics of ASF infection, we developed a standardized distribution map based on global land cover vegetation (GLOBCOVER) that quantifies the quality of available habitats (QAH) for wild boar across Eurasia as an indirect index for quantifying numbers of wild boar. QAHs were estimated using a seven-level scale based on expert opinion and found to correlate closely with georeferenced presence of wild boar (n = 22 362): the highest wild boar densities (74.47%) were found in areas at the two highest QAH levels, while the lowest densities (5.66%) were found in areas at the lowest QAH levels. Mapping notifications from 2007 to 2016 onto the QAH map showed that in endemic areas, 60% of ASF notifications occurred in domestic pigs, mostly in agricultural landscapes (QAHs 1.75 and 1) containing low-biosecurity domestic pig farms. In the EU, in contrast, 95% of ASF notifications occurred in wild boar, within natural landscapes (QAH 2). These results suggest that the QAH map can be a useful epi-tool for defining risk scenarios and identifying potential travel corridors for ASF. This tool will help inform resource allocation decisions and improve prevention, control and surveillance of ASF and potentially of other diseases affecting swine and wild boar in Eurasia.

Update on the Risk of Introduction of African Swine Fever by Wild Boar into Disease-Free European Union Countries

Despite efforts to prevent the appearance and spread of African swine fever (ASF) in the European Union, several Member States are now affected (Lithuania, Poland, Latvia and Estonia). Disease appearance in 2014 was associated with multiple entrances linked to wild boar movement from endemic areas (EFSA Journal, 8, 2015, 1556), but the risk of new introductions remains high (Gallardo et al., Porcine Health Management, 1, and 21) as ASF continues to be active in endemic countries (Russian Federation, Belarus and Ukraine). Since 2014, the number of ASF notifications has increased substantially, particularly in wild boar (WB), in parallel with slow but constant geographical advance of the disease. This situation suggests a real risk of further disease spread into other Member States, posing a great threat to pig production in the EU. Following the principles of the risk-based veterinary surveillance, this article applies a methodology developed by De la Torre et al. (Transboundary and Emerging Diseases, 62, and 272) to assess the relative risk of new introductions of ASF by natural movements of WB according to the current epidemiological situation. This update incorporates the most recent available data and an improved version of the most important risk estimator: an optimized cartographic tool of WB distribution to analyse wild boar suitable habitat. The highest relative risk values were estimated for Slovakia (5) and Romania (5), followed by Finland (4), Czech Republic (3) and Germany (3). Relative risk for Romania and Finland is associated mainly with disease entrance from endemic areas such as the Russian Federation and Ukraine, where the disease is currently spreading; relative risk for Germany and Czech Republic is associated mainly with the potential progress of the disease through the EU, and relative risk for Slovakia is associated with both pathways. WB habitat is the most important risk estimator, whereas WB density is the least significant, suggesting that WB presence is more relevant than density. These results can provide actionable advice for dealing with risk. They can be directly used to inform risk-based national strategies and identify countries that may need to pay greater attention to surveillance or conduct additional evaluations at the subnational level.

African swine fever: a global view of the current challenge

African Swine Fever (ASF) is an important contagious haemorrhagic viral disease affecting swine whose notification is mandatory due to its high mortality rates and the great sanitary and socioeconomic impact it has on international trade in animal and swine products.

This disease only affects porcine species, both wild and domestic, and produces a variety of clinical signs such as fever and functional disorders of the digestive and respiratory systems. Lesions are mainly characterized by congestive-haemorrhagic alterations. ASF epidemiology varies significantly between countries, regions and continents, since it depends on the characteristics of the virus in circulation, the presence of wild hosts and reservoirs, environmental conditions and human social behaviour. Furthermore, a specific host will not necessarily always play the same active role in the spread and maintenance of ASF in a particular area.

Currently, ASF is endemic in most sub-Saharan African countries where wild hosts and tick vectors (Ornithodoros) play an important role acting as biological reservoirs for the virus. In Europe, the disease has been endemic since 1978 on the island of Sardinia (Italy) and since 2007, when it was first reported in Georgia, in a number of Eastern European countries. It is also endemic in certain regions of the Russia Federation, where domestic pig and wild boar populations are widely affected. By contrast, in the affected eastern European Union (EU) countries where ASF is currently as epidemic, the on-going spread of the disease affects mainly wild boar populations located in restricted areas and, to a much less extent, domestic pigs. Unlike most livestock diseases, no vaccine or specific treatment is currently available for ASF. Therefore, disease control is mainly based on early detection and the application of strict sanitary and biosecurity measures. Epidemiology of ASF is very complex by the existence of different virus circulating, reservoirs and a number of scenarios, and the on-going spread of the disease through Africa and Europe. Survivor pigs can remain persistently infected for months which may contribute to virus transmission and thus the spread and maintenance of the disease, thereby complicating attempts to control it.

Spatio-temporal Analysis of African Swine Fever in Sardinia (2012-2014): Trends in Domestic Pigs and Wild Boar

African swine fever (ASF) is a notifiable viral disease affecting domestic pigs and wild boars that has been endemic in Sardinia since 1978. Several risk factors complicate the control of ASF in Sardinia: generally poor level of biosecurity, traditional breeding practices, illegal behaviour in movements and feeding of pigs, and sporadic occurrence of long-term carriers. A previous study describes the disease in Sardinia during 1978-2013. The aim of this study was to gain more in-depth knowledge of the spatio-temporal pattern of ASF in Sardinia during 2012 to May 2014, comparing patterns of occurrence in domestic pigs and wild boar and identifying areas of local transmission. African swine fever notifications were studied considering seasonality, spatial autocorrelation, spatial point pattern and spatio-temporal clusters. Results showed differences in temporal and spatial pattern of wild boar and domestic pig notifications. The peak in wild boar notifications (October 2013 to February 2014) occurred six months after than in domestic pig (May to early summer 2013). Notifications of cases in both host species tended to be clustered, with a maximum significant distance of spatial association of 15 and 25 km in domestic pigs and wild boars, respectively. Five clusters for local ASF transmission were identified for domestic pigs, with a mean radius and duration of 4 km (3-9 km) and 38 days (6-55 days), respectively. Any wild boar clusters were found. The apparently secondary role of wild boar in ASF spread in Sardinia could be explained by certain socio-economic factors (illegal free-range pig breeding or the mingling of herds. The lack of effectiveness of previous surveillance and control programmes reveals the necessity of employing a new approach). Results present here provide better knowledge of the dynamics of ASF in Sardinia, which could be used in a more comprehensive risk analysis necessary to introduce a new approach in the eradication strategy.

Virulence genes, antibiotic resistance and integrons in Escherichia coli strains isolated from synanthropic birds from Spain

The aim of this study was to determine the presence of virulence genes and antibiotic resistance profiles in 164 Escherichia coli strains isolated from birds (feral pigeons, hybrid ducks, house sparrows and spotless starlings) inhabiting urban and rural environments. A total of eight atypical enteropathogenic E. coli strains were identified: one in a house sparrow, four in feral pigeons and three in spotless starlings. Antibiotic resistance was present in 32.9% (54) of E. coli strains. The dominant type of resistance was to tetracycline (21.3%), ampicillin (19.5%) and sulfamethoxazole (18.9%). Five isolates had class 1 integrons containing gene cassettes encoding for dihydrofolate reductase A (dfrA) and aminoglycoside adenyltransferase A (aadA), one in a feral pigeon and four in spotless starlings. To our knowledge, the present study constitutes the first detection of virulence genes from E. coli in spotless starlings and house sparrows, and is also the first identification worldwide of integrons containing antibiotic resistance gene cassettes in E. coli strains from spotless starlings and pigeons.

Reproductive Ratio for the Local Spread of African Swine Fever in Wild Boars in the Russian Federation

African swine fever (ASF) has caused the swine industry of the Russian Federation substantial economic losses over the last 7 years, and the disease spread from there to a number of neighbouring countries. Wild boar has been involved in the spread of the disease both at local and at transboundary levels. Understanding ASF dynamics in wild boars is prerequisite to preventing the spread and to designing and applying effective surveillance and control plans. The reproductive ratio (R₀ ) is an epidemiological indicator commonly used to quantify the extent of disease spread. Here, it was estimated in nine spatio-temporal clusters of ASF in wild boar cases in the Russian Federation (2007-2013). Clusters were defined by exploring the maximum distance of association of ASF cases using K Ripley analysis and spatio-temporal scan statistics. A maximum spatial association of 133 km in wild boar cases was identified which is within de the conventional radius of surveillance zone (100-150 km). The mean range value of R₀  = 1.58 (1.13-3.77) was lower compared to values previously estimated for ASF transmission within farms but similar to early estimates between farm (R₀  = 2-3), in domestic pigs using notification data in the Russian Federation. Results obtained provide quantitative knowledge on the epidemiology of ASF in wild boars in the Russian Federation. They identify the ASF transmission rate value in affected natural wild populations, for the first time, which could provide basis for modelling ASF transmission and suggest that current surveillance radius should be reviewed to make surveillance in wild nature more targeted and effective.

Neuroprotective Properties of Standardized Extracts of Hypericum perforatum on Rotenone Model of Parkinson's Disease

Hipericum perforatum is a well-known herbal for its antidepressant property. Recently, it has been shown to have nootropic effects against neurodegenerative disorders. The aim of the present study was to evaluate the protective role of chronic administration of two standardized extract of Hypericum perforatum SHP1 rich in hyperforin (6%) and SHP2 extract poor in hyperforin (0.2%) on the neurodegeneration induced by chronic administration of rotenone in rats. Quercetin in liposomes, one active constituent, was tested in the same experimental conditions. The animals received pretreatments with SHP1 (4 mg/Kg, ip), SHP2 (4 mg/Kg, ip) or quercetin liposomes (25 and 100 mg/kg, ip) 60 min before of rotenone injection (2.5 mg/kg) for 45 days. Pretreatment of the animals with SHP1 and SHP2 efficiently halted deleterious toxic effects of rotenone, revealing normalization of catalepsy in addition to amelioration of neurochemical parameters. Also, SHP1 reduced neuronal damage, diminishing substantia nigra dopaminergic cell death caused by the pesticide, indicating benefit of neuroprotective therapy. In general, the SHP1 was more active than SHP2. In addition, SHP1 inhibited the apoptotic cascade by decreasing Bax levels. The results presented here indicate that mainly hyperforin and quercetin, may be involved in the neuroprotective action of Hypericum standardized extracts. Combination of dietary antioxidants could provide better therapeutic advantage for the management of Parkinson, and possibly other neurodegenerative disorders. Therefore H. perforatum standardized extract enriched in hyperforin, could be a better alternative for depressed elderly patients with degenerative disorders exhibiting elevated oxidative stress status.