Clinical presentations and outcomes of HIV-1 and HIV-2 among infected children in Guinea-Bissau: a nationwide study

OBJECTIVES

Disease progression, loss to follow-up, and mortality of HIV-2 compared with HIV-1 in children is not well understood. This is the first nationwide study reporting outcomes in children with the two HIV types in Guinea-Bissau.

STUDY DESIGN

Nationwide retrospective follow-up study.

METHODS

This is a retrospective follow-up study among HIV-infected children <15 years at nine ART centers from 2006 to 2021. Baseline parameters and disease outcomes for children with HIV-2 and HIV-1 were compared.

RESULTS

The annual number of children diagnosed with HIV peaked in 2017. HIV-2 (n = 64) and HIV-1 (n = 1945) infected children were different concerning baseline median age (6.5 vs 3.1 years, P < 0.01), but had similar levels of severe immunodeficiency (P = 0.58) and severe anemia (P = 0.26). Within the first year of follow-up, 36.3% were lost, 5.9% died, 2.7% had transferred clinic, and 55.2% remained for follow-up. Mortality (HR = 1.05 95% CI: 0.53-2.08 for HIV-2) and attrition (HR = 0.86 95% CI: 0.62-1.19 for HIV-2) rates were similar for HIV types.

CONCLUSIONS

The decline in children diagnosed per year since 2017 is possibly due to lower HIV prevalence, lack of HIV tests, and the SARS-CoV-2 epidemic. Children with HIV-2 were twice as old as HIV-1 infected when diagnosed, which suggests a slower disease progression. However, once they develop immunosuppression mortality is similar.

Biocidal effects of organometallic materials supported on ZSM-5 Zeolite: Influence of the physicochemical and surface properties

Antifouling coatings containing biocidal agents can be used to prevent the accumulation of biotic deposits on submerged surfaces; however, several commercial biocides can negatively affect the ecosystem. In this study, various formulations of a potential biocide product comprising copper nanoparticles and capsaicin supported on zeolite ZSM-5 were analyzed to determine the influence of the concentration of each component. The incorporation of copper was evidenced by scanning electron microscopy and energy dispersive spectroscopy. Similarly, Fourier-transform infrared spectroscopy confirmed that capsaicin was supported on the zeolite surface. The presence of capsaicin on the external zeolite surface significantly reduced the surface area of the zeolite. Finally, bacterial growth inhibition analysis showed that copper nanoparticles inhibited the growth of strains Idiomarina loihiensis UCO25, Pseudoalteromonas sp. UCO92, and Halomonas boliviensis UCO24 while the organic component acted as a reinforcing biocide.

Assessing Feed-Forward Backpropagation Artificial Neural Networks for Strain-Rate-Sensitive Mechanical Modeling

The manufacturing processes and design of metal and alloy products can be performed over a wide range of strain rates and temperatures. To design and optimize these processes using computational mechanics tools, the selection and calibration of the constitutive models is critical. In the case of hazardous and explosive impact loads, it is not always possible to test material properties. For this purpose, this paper assesses the efficiency and the accuracy of different architectures of ANNs for the identification of the Johnson-Cook material model parameters. The implemented computational tool of an ANN-based parameter identification strategy provides adequate results in a range of strain rates required for general manufacturing and product design applications. Four ANN architectures are studied to find the most suitable configuration for a reduced amount of experimental data, particularly for cases where high-impact testing is constrained. The different ANN structures are evaluated based on the model's predictive capability, revealing that the perceptron-based network of 66 inputs and one hidden layer of 30 neurons provides the highest prediction accuracy of the effective flow stress-strain behavior of Ti64 alloy and three virtual materials.

A Novel System to Selective Tagging of Sinorhizobium fredii Symbiotic Plasmids

Conventional systems used to tag and transfer symbiotic plasmids (pSyms) of rhizobial strains are based in mutagenesis with transposons. In those processes, numerous clones must be analyzed to find one of them with the transposon inserted in the pSym. Following this strategy, the insertion might interrupt a gene that can affect the symbiotic phenotype of the bacteria tagged. Here, we have developed a new system based in homologous recombination that generates Sinorhizobium fredii strains with pSyms tagged by the insertion of a suicide vector which harbor a truncated copy of S. fredii HH103 nodZ gene, a mob site, and a kanamycin-resistant gene. When it is introduced by conjugation in a S. fredii strain, the vector integrates in pSym by only one recombination event. This pSym tagged can be transferred in matting experiments to other strains in the presence of a helper plasmid. Following this method, we have tagged several strains and transferred their pSyms to a recipient strain demonstrating the potential of this new system.

Microscope Subcellular Localization of Plant-Interacting Bacterial Effectors in Animal Cell Cultures

Eukaryote-interacting bacteria have developed along the evolution of an arsenal of tools to interact with potential hosts and to evade their defensive responses. Among these tools, the effector proteins are gaining a special importance due to the high diversity of molecular actions that they play in the host cell, with the final aim of taking the control over the cell. Bacteria inject these effectors into the cytosol of the host cells through distinct ways, as the type III secretion system. The study of the effectors' molecular roles inside the host cell is challenging, due in part to the lack of traceability of such proteins once they are delivered by the bacteria. Here, we describe in depth a methodology that combines the increase of the bacterial effector concentration by protein expression systems with the use of heterologous hosts to facilitate the visualization of the subcellular targeting of the effector inside the host cell by fluorescence microscopy.

Design, Synthesis, and Biochemical Analysis of a Molecule Designed to Enhance Endosomal Escape

RNA therapeutics, including siRNAs, ASOs, and PMOs, have great potential to treat human disease. However, RNA therapeutics are too large, too charged, and/or too hydrophilic to cross the cellular membrane and are instead taken up into cells by endocytosis. Unfortunately, the vast majority of RNA therapeutics remain trapped inside endosomes (≥ 99%), which is the sole reason preventing their use to treat cancer, COVID, and other diseases. In contrast, enveloped viruses, such as influenza, also have an endosomal escape problem, but have evolved a highly efficient endosomal escape mechanism using trimeric hemagglutinin (HA) fusogenic protein. HA contains an outer hydrophilic domain (HA1) that masks an inner hydrophobic fusogenic/endosomal escape domain (HA2). Once inside endosomes, HA1 is shed to expose HA2 that, due to hydrophobicity, buries itself into the endosomal lipid bilayer, driving escape into the cytoplasm in a non-toxic fashion. To begin to address the RNA therapeutics rate-limiting endosomal escape problem, we report here a first step in the design and synthesis of a universal endosomal escape domain (uEED) that biomimics the enveloped virus escape mechanism. uEED contains an outer hydrophilic mask covalently attached to an inner hydrophobic escape domain. In plasma, uEED is inert and highly metabolically stable; however, when placed in endo/lysosomal conditions, uEED is activated by enzymatic removal of the hydrophilic mask, followed by self-immolation of the linker resulting in exposure of the hydrophobic indole ring domain in the absence of any hydrophilic tags. Thus, uEED is a synthetic biomimetic of the highly efficient viral endosomal escape mechanism.

A complex regulatory network governs the expression of symbiotic genes in Sinorhizobium fredii HH103

Introduction

The establishment of the rhizobium-legume nitrogen-fixing symbiosis relies on the interchange of molecular signals between the two symbionts. We have previously studied by RNA-seq the effect of the symbiotic regulators NodD1, SyrM, and TtsI on the expression of the symbiotic genes (the nod regulon) of Sinorhizobium fredii HH103 upon treatment with the isoflavone genistein. In this work we have further investigated this regulatory network by incorporating new RNA-seq data of HH103 mutants in two other regulatory genes, nodD2 and nolR. Both genes code for global regulators with a predominant repressor effect on the nod regulon, although NodD2 acts as an activator of a small number of HH103 symbiotic genes.

Methods

By combining RNA-seq data, qPCR experiments, and b-galactosidase assays of HH103 mutants harbouring a lacZ gene inserted into a regulatory gene, we have analysed the regulatory relations between the nodD1, nodD2, nolR, syrM, and ttsI genes, confirming previous data and discovering previously unknown relations.

Results and discussion

Previously we showed that HH103 mutants in the nodD2, nolR, syrM, or ttsI genes gain effective nodulation with Lotus japonicus, a model legume, although with different symbiotic performances. Here we show that the combinations of mutations in these genes led, in most cases, to a decrease in symbiotic effectiveness, although all of them retained the ability to induce the formation of nitrogen-fixing nodules. In fact, the nodD2, nolR, and syrM single and double mutants share a set of Nod factors, either overproduced by them or not generated by the wild-type strain, that might be responsible for gaining effective nodulation with L. japonicus.

The elucidation of the life cycle of Saccocoelioides nanii Szidat, 1954 (Digenea: Haploporidae) using molecular techniques

In South America, the knowledge of trematode diversity parasitizing freshwater fishes is still scarce, as less than 5% of the freshwater fish fauna has been examined for parasites. A similar situation applies to studies on digenean life cycles, which have become increasingly rare. Among the digenean families parasitizing freshwater fishes in the region, Haploporidae is considered the richest in species diversity. However, information about the developmental stages of haploporid life cycles remains fragmentary. Particularly, in Argentina, nine cercariae attributed to the family Haploporidae have been described using morphological analysis, and only two life cycles of this family have been completely elucidated. In this study a new type of cercaria, morphologically assigned to the family Haploporidae and collected from the snail Heleobia parchappii (Cochliopidae) in Los Padres shallow lake, Buenos Aires province, was identified using morphological and molecular techniques. The molecular analysis, based on 28S and ITS2 sequences, revealed that the cercariae were 100% identical to adult specimens of Saccocoelioides nanii (Haploporidae) parasitizing the fish Prochilodus lineatus (Prochilodontidae) from Los Talas, Buenos Aires province. Our results not only provide information about the life cycle of S.nanii but also show that a molecular and morphological approach can be extremely useful in identifying the developmental stages of digeneans and elucidating their life cycles.

Synthesis and Application of ZSM-5 Catalyst Supported with Zinc and/or Nickel in the Conversion of Pyrolytic Gases from Recycled Polypropylene and Polystyrene Mixtures under Hydrogen Atmosphere

Currently, catalytic pyrolysis has become a versatile and highly useful technology in the treatment of different plastic wastes. Thus, the development of selective catalysts to carry out cracking reactions and obtain a greater fraction of the desired products is essential. This study focuses on the synthesis of monometallic (Ni) and bimetallic (Ni-Zn) catalysts supported on ZSM-5 zeolite using an impregnation and co-impregnation method, respectively. The obtained catalysts were characterized by FTIR spectroscopy, N2 adsorption/desorption measurements, scanning electron microscopy (SEM) and energy dispersive X-Ray spectroscopy (EDS), temperature programmed NH3 desorption (TPD-NH3) and thermogravimetric analysis (TGA). In this way, a mixture of polystyrene and polypropylene recycled with a catalyst/plastic waste ratio of 1:500 was used for pyrolysis tests. The best results were obtained using the Ni-Zn/ZSM-5 catalyst, which included better impregnation, increased surface acidity, decreased dispersion and a shorter reaction time in the catalytic pyrolysis process. Under the optimized conditions, catalytic pyrolysis showed an excellent performance to generate hydrocarbons of greater industrial interest.

Study of the Antibacterial Capacity of a Biomaterial of Zeolites Saturated with Copper Ions (Cu2+) and Supported with Copper Oxide (CuO) Nanoparticles

In this work, copper (II) ions were saturated and copper oxide nanoparticles (CuO NPs) were supported in natural zeolite from Chile; this was achieved by making the adsorbent material come into contact with a copper ion precursor solution and using mechanical agitation, respectively. The kinetic and physicochemical process of the adsorption of copper ions in the zeolite was studied, as well as the effect of the addition of CuO NPs on the antibacterial properties. The results showed that the saturation of copper (II) ions in the zeolite is an efficient process, obtaining a 27 g L^-1 concentration of copper ions in a time of 30 min. The TEM images showed that a good dispersion of the CuO NPs was obtained via mechanical stirring. The material effectively inhibited the growth of Gram-negative and Gram-positive bacteria that have shown resistance to methicillin and carbapenem. Furthermore, the zeolite saturated with copper at the same concentration had a better bactericidal effect than the zeolite supported with CuO NPs. The results suggested that the ease of processing and low cost of copper (II) ion-saturated zeolitic material could potentially be used for dental biomedical applications, either directly or as a bactericidal additive for 3D printing filaments.

Efficient Indirect Interatomic Coulombic Decay Induced by Photoelectron Impact Excitation in Large Pure Helium Nanodroplets

Ionization of matter by energetic radiation generally causes complex secondary reactions that are hard to decipher. Using large helium nanodroplets irradiated by extreme ultraviolet (XUV) photons, we show that the full chain of processes ensuing primary photoionization can be tracked in detail by means of high-resolution electron spectroscopy. We find that elastic and inelastic scattering of photoelectrons efficiently induces interatomic Coulombic decay (ICD) in the droplets. This type of indirect ICD even becomes the dominant process of electron emission in nearly the entire XUV range in large droplets with radius ≳40  nm. Indirect ICD processes induced by electron scattering likely play an important role in other condensed-phase systems exposed to ionizing radiation as well, including biological matter.

Multitask Approach to Localize Rhizobial Type Three Secretion System Effector Proteins Inside Eukaryotic Cells

Rhizobia can establish mutually beneficial interactions with legume plants by colonizing their roots to induce the formation of a specialized structure known as a nodule, inside of which the bacteria are able to fix atmospheric nitrogen. It is well established that the compatibility of such interactions is mainly determined by the bacterial recognition of flavonoids secreted by the plants, which in response to these flavonoids trigger the synthesis of the bacterial Nod factors that drive the nodulation process. Additionally, other bacterial signals are involved in the recognition and the efficiency of this interaction, such as extracellular polysaccharides or some secreted proteins. Some rhizobial strains inject proteins through the type III secretion system to the cytosol of legume root cells during the nodulation process. Such proteins, called type III-secreted effectors (T3E), exert their function in the host cell and are involved, among other tasks, in the attenuation of host defense responses to facilitate the infection, contributing to the specificity of the process. One of the main challenges of studying rhizobial T3E is the inherent difficulty in localizing them in vivo in the different subcellular compartments within their host cells, since in addition to their low concentration under physiological conditions, it is not always known when or where they are being produced and secreted. In this paper, we use a well-known rhizobial T3E, named NopL, to illustrate by a multitask approach where it localizes in heterologous hosts models, such as tobacco plant leaf cells, and also for the first time in transfected and/or Salmonella-infected animal cells. The consistency of our results serves as an example to study the location inside eukaryotic cells of effectors in distinct hosts with different handling techniques that can be used in almost every research laboratory.

Kinetic Analysis of Thermal Degradation of Recycled Polypropylene and Polystyrene Mixtures Using Regenerated Catalyst from Fluidized Catalytic Cracking Process (FCC)

The pyrolysis process is a thermochemical recycling process that in recent years has gained importance due to its application in plastic waste, which is one of the biggest environmental problems today. Thus, it is essential to carry out kinetic and thermodynamic analyses to understand the thermocatalytic degradation processes involved in plastic waste mixtures. In this sense, the main objective of this study is to analyze the degradation kinetics of the specific mixture of polypropylene (25%) and polystyrene (75%) with 10% mass of regenerated FCC catalyst which was recovered from conventional refining processes using 3 heating rates at 5, 10 and 15 K min^-1 by thermogravimetric analysis (TGA). The obtained TGA data were compared with the isoconversional models used in this work that include Friedman (FR), Kissinger Akahira Sunose (KAS), Flynn-Wall-Ozawa (FWO), Starink (ST) and Miura-Maki (MM) in order to determine the one that best fits the experimental data and to analyze the activation energy and the pre-exponential factor; the model is optimized by means of the difference of minimum squares. Activation energy values between 148 and 308 kJ/mol were obtained where the catalytic action has been notorious, decreasing the activation energy values with respect to thermal processes.

Towards recycling of waste carbon fiber: Strength, morphology and structural features of recovered carbon fibers

Carbon fiber is one of the most widely used materials in high demand applications due to its high specific properties, however, its post-recycling properties limit its use to low performance applications. In this research, the carbon fiber recovering is examined using two methods: two-step pyrolysis and microwave-assisted thermolysis. The results indicate that the fibers recovered by pyrolysis show reduced surface and structural damage, maintaining the original mechanical properties of the fiber with losses below 5%. The fibers recovered by microwaves undergo significant surface changes that reduce their tensile strength by up to 60% and changes in their graphitic structure, increasing their degree of crystallinity by Raman index I_D/I_G from 1.98 to 2.86 and their amorphous degree by I_D"/I_G ratio from 0.411 to 1.599. Recovering fibers from microwave technique is 70% faster compared to two step pyrolysis, and provides recycled fibers with superior surface activation with the presence of polar functional groups -OH, -CO, and -CH that react with the epoxy matrix. The thermal, morphological, structural and mechanical characterizations of the recovered fibers detailed in this work provide valuable findings to evaluate their direct reuse in new composite materials.

New onset urinary incontinence in a pediatric patient with transverse myelitis

Transverse myelitis is an inflammatory disorder of the spinal cord that can present with a wide array of lower urinary tract symptoms including urinary retention, frequency, urgency, and urge incontinence. We report a case of a 15 year old male with new onset urinary incontinence who initially presented to the urologist and was subsequently diagnosed with transverse myelitis.

Optimized Nanostructured Lipid Carriers Integrated into in situ Nasal Gel for Enhancing Brain Delivery of Flibanserin [Retraction]

[This retracts the article DOI: 10.2147/IJN.S258791.].

The Rhizobial Type 3 Secretion System: The Dr. Jekyll and Mr. Hyde in the Rhizobium–Legume Symbiosis

Rhizobia are soil bacteria that can establish a symbiotic association with legumes. As a result, plant nodules are formed on the roots of the host plants where rhizobia differentiate to bacteroids capable of fixing atmospheric nitrogen into ammonia. This ammonia is transferred to the plant in exchange of a carbon source and an appropriate environment for bacterial survival. This process is subjected to a tight regulation with several checkpoints to allow the progression of the infection or its restriction. The type 3 secretion system (T3SS) is a secretory system that injects proteins, called effectors (T3E), directly into the cytoplasm of the host cell, altering host pathways or suppressing host defense responses. This secretion system is not present in all rhizobia but its role in symbiosis is crucial for some symbiotic associations, showing two possible faces as Dr. Jekyll and Mr. Hyde: it can be completely necessary for the formation of nodules, or it can block nodulation in different legume species/cultivars. In this review, we compile all the information currently available about the effects of different rhizobial effectors on plant symbiotic phenotypes. These phenotypes are diverse and highlight the importance of the T3SS in certain rhizobium–legume symbioses.

Oxytocin-Cholinergic Central Interaction: Implications for Non-Social Memory Formation

Oxytocin (OT) and vasopressin (AVP) are two closely related neuropeptides implicated in learning and memory processes, anxiety, nociception, addiction, feeding behavior and social information processing. Regarding learning and memory, OT has induced long-lasting impairment in different behaviors, while the opposite was observed with AVP. We have previously evaluated the effect of peripheral administration of OT or its antagonist (AOT) on the inhibitory avoidance response of mice and on the modulation of cholinergic mechanisms. Here, we replicate and validate those results, but this time through central administration of neuropeptides, considering their poor passage through the blood-brain barrier (BBB). When we delivered OT (0.10 ng/mouse) and its antagonist (0.10 ng/mouse) through intracerebroventricular (ICV) injections, the neuropeptide impaired and AOT enhanced the behavioral performance on an inhibitory avoidance response evaluated 48 h after training in a dose-dependent manner. On top of that, we investigated a possible central interaction between OT and the cholinergic system. Administration of anticholinesterases inhibitors with access to the central nervous system (CNS), the activation of muscarinic acetylcholine (Ach) receptors and the increase of evoked ACh release using linopirdine (Lino) (3-10 µg/kg, IP), reversed the impairment of retention performance induced by OT. Besides, either muscarinic or nicotinic antagonists with unrestricted access to the CNS reduced the magnitude of the performance-facilitating effect of AOT's central infusion. We suggest that OT might induce a cholinergic hypofunction state, resulting in an impairment of IA memory formation, a process for which the cholinergic system is crucially necessary.

Harnessing the epic electronic medical record to track indwelling ureteral stents in a pediatric population

INTRODUCTION

Retention of indwelling ureteral stents due to loss to follow-up can result in significant harm to patients, often requiring multiple trips to the operating room. Despite widespread use of electronic medical records, there are few standardized options for urologists to track ureteral stents and no data on the rate of retained stents in a pediatric population.

OBJECTIVE

This pilot quality improvement project aims to: 1) develop a simple process to track indwelling ureteral stents using the Epic electronic medical record and 2) determine the incidence of forgotten stents in a pediatric population.

METHODS

We identified that operating room staff scan a barcode for ureteral stents at the time of surgery to log the stent as "Implanted" in the patient's medical record. The stent can later be marked as "Explanted" at the time of removal. A report was designed within Epic to identify all patients with a ureteral stent implanted from April 2014 to June 2019 at our hospital. We reviewed the records of patients whose stents had never been marked as "Explanted" to determine if any had a retained stent. A workflow was then designed to ensure staff would mark stents as "Explanted" at the time of removal and to periodically run the report within Epic to ensure that all patients with ureteral stents in place have appropriate follow-up.

RESULTS

Our report identified 152 ureteral stents with a status of "Implanted". 3 patients did not have evidence of stent removal documented in their medical record. Follow up with these patients revealed stent removal at an outside location.

DISCUSSION

Current approaches to stent tracking are laborious with limitations to adherence. The Epic software directly incorporates stent tracking into the individual patient chart allowing for easy implementation and follow up. Our study revealed no retained stents in our pediatric population.

CONCLUSIONS

All patients with ureteral stents placed at a single institution over a 5-year period were easily identified using an automated Epic report. Through this report, we will prevent morbidity associated with stent retention. This technique could easily be implemented at other hospital systems that use Epic, and similar reporting tools could be designed within other electronic medical record systems. The incidence of ureteral stent retention in the pediatric population is likely significantly lower than for their adult counterparts.

Reliability and validity of the Mexican teachers' physical activity questionnaire (MTPAQ) in a subsample of female Mexican teachers

BACKGROUND

Reliable and valid instruments are needed to estimate physical activity levels. The purposes of this study were to estimate the reliability and validity of the Physical Activity Questionnaire (MTPAQ) in a subsample of the Mexican Teachers Cohort study.

METHODS

We completed telephone interviews and clinical examinations of 82 teachers. Two MTPAQ, five International Physical Activity Questionnaire (IPAQ)-long form, and two accelerometer (AC) measures were used to determine physical activity levels throughout 24 months. Moderate and walking physical activity (MWPA min/week), vigorous physical activity (VPA min/week), and moderate-to-vigorous physical activity minutes per week (MVPA min/week) were estimated for each instrument. Pearson, Intra-class correlations and deattenuated adjustments were used to determine the reliability and validity of MTPAQ.

RESULTS

MWPA and MVPA min/week of MTPAQs were moderately correlated (r ≥ 0.54) to min/week of IPAQ-long form. MWPA and MVPA min/week average MTPAQ and MTPAQ1 and average AC, AC1 and AC2 were fairly correlated (r ≥ 0.20). A higher correlation was observed when correlation coefficients were attenuated (r ≥ 0.32).

CONCLUSIONS

MTPAQ1 is a reliable and valid tool to measure physical activity levels.

REPRODUCTIVE PERFORMANCE OF BROWN SWISS AND MESTIZO BOVINE IN HUMID TROPIC

The ability of ruminants to regulate body temperature depends on the genotype. Dairy breeds are generally more sensitive to heat stress than beef breeds. Higher-producing animals are more susceptible to heat stress because they generate more metabolic heat. The objective of evaluating reproductive performance as a response of adaptability to the management and climatic conditions of the Humid Tropics. 78 animals were used (40 Brown Swiss, from Puno and 38 Mestizas from local origin) raised in humid tropic conditions. Parametric statistics are presented as analysis of measures of central tendency and dispersion, non-parametric statistics by frequency analysis, the χ2 test of independence was used to detect differences, α = 0.05. The categorized and continuous dependent variables were evaluated with Student's t test using SPSS Software v.23. The mean age at first estrus in Brown Swiss was 12.43 months, in mestizo cattle 18.68 months (P <0.05). Average age of first calving in Brown Swiss of 25.25 months versus mestizo cattle 28.34 months (P <0.05). Interval from calving to the first service in Brown Swiss was 99.29 days. Open days observed in Brown Swiss was 107.29 days. The pregnancy rate at the first service in Brown Swiss was 70.0% pregnancy at the first service and 30.0% at the second service, for the mestizo genotype it was 68.4% at the first service, 28.9 at the second and 2.6 at the third service (P> 0.05; X2 = 0.50; p = 0.47). It is concluded that bovine animals of the Brown Swiss genotype have a good reproductive performance in the Humid Tropic climate compared to the Mestizo genotype

Oxygen saturation as a predictor of mortality in hospitalized adult patients with COVID-19 in a public hospital in Lima, Peru

INTRODUCTION

Peru is among the top ten countries with the highest number of coronavirus disease 2019 (COVID-19) cases worldwide. The aim of the study was to describe the clinical features of hospitalized adult patients with COVID-19 and to determine the prognostic factors associated with in-hospital mortality.

METHODS

We conducted a retrospective cohort study among adult patients with COVID-19 admitted to Hospital Cayetano Heredia; a tertiary care hospital in Lima, Peru. The primary outcome was in-hospital mortality. Multivariate Cox proportional hazards regression was used to identify factors independently associated with in-hospital mortality.

RESULTS

A total of 369 patients (median age 59 years [IQR:49-68]; 241 (65.31%) male) were included. Most patients (68.56%) reported at least one comorbidity; more frequently: obesity (42.55%), diabetes mellitus (21.95%), and hypertension (21.68%). The median duration of symptoms prior to hospital admission was 7 days (IQR: 5-10). Reported in-hospital mortality was 49.59%. By multiple Cox regression, oxygen saturation (SaO2) values of less than 90% on admission correlated with mortality, presenting 1.86 (95%CI: 1.02-3.39), 4.44 (95%CI: 2.46-8.02) and 7.74 (95%CI: 4.54-13.19) times greater risk of death for SaO2 of 89-85%, 84-80% and <80%, respectively, when compared to patients with SaO2 >90%. Additionally, age >60 years was associated with 1.88 times greater mortality.

CONCLUSIONS

Oxygen saturation below 90% on admission is a strong predictor of in-hospital mortality in patients with COVID-19. In settings with limited resources, efforts to reduce mortality in COVID-19 should focus on early identification of hypoxemia and timely access to hospital care.

Threshold stability using active fixation LV lead

Introduction

The proper functioning of the CRT devices depends on the correct positioning of the electrodes, sometimes being compromised by the absence of suitable epicardial veins, leads instability or unacceptable high thresholds, among other. In 2017, a novel quadripolar active fixation LV lead was released with an innovative helical mechanism that expands to attach the lead within the vessel.

Objectives

Study the impact of the active fixation LV lead on threshold stability and dislocations.

Methods

We included 127 consecutive patients undergoing CRT between September 2017 to December 2019 in one hospital. They were randomly assigned: 62p active fixation VI leads vs 65p standard VI leads. LV thresholds, capture losses and dislocations were collected at standard pacing checks (1 week, 2 months, 6 months).

Results

The mean age of the sample was 73,9±8,4 years. 75% patients were male and 48,4% suffered ischemic cardiomyopathy. The two groups were similar according to this variables. 5 (7.7%) dislocations were reported in the control group against 2 (3.2%) in the active fixation group (n.s). The mean threshold (V) at the moment of the implant was 1,4 in the active fixation vs 1,41 in the standard LV leads; at the first visit 1,55 vs 1,99; at two months 1,59 vs 2,13 and at six months 1,74 vs 2,48.

The threshold stability is shown in Figure 1.

Conclusions

– The active fixation LV lead provides higher threshold stability than the conventional one.

– There is a non-significant tendency to reduce dislocations.

Figure 1

Funding Acknowledgement

Type of funding source: None

The Sinorhizobium fredii HH103 type III secretion system effector NopC blocks nodulation with Lotus japonicus Gifu

The broad-host-range bacterium Sinorhizobium fredii HH103 cannot nodulate the model legume Lotus japonicus Gifu. This bacterium possesses a type III secretion system (T3SS), a specialized secretion apparatus used to deliver effector proteins (T3Es) into the host cell cytosol to alter host signaling and/or suppress host defence responses to promote infection. However, some of these T3Es are recognized by specific plant receptors and hence trigger a strong defence response to block infection. In rhizobia, T3Es are involved in nodulation efficiency and host-range determination, and in some cases directly activate host symbiosis signalling in a Nod factor-independent manner. In this work, we show that HH103 RifR T3SS mutants, unable to secrete T3Es, gain nodulation with L. japonicus Gifu through infection threads, suggesting that plant recognition of a T3E could block the infection process. To identify the T3E involved, we performed nodulation assays with a collection of mutants that affect secretion of each T3E identified in HH103 RifR so far. The nopC mutant could infect L. japonicus Gifu by infection thread invasion and switch the infection mechanism in Lotus burttii from intercellular infection to infection thread formation. Lotus japonicus gene expression analysis indicated that the infection-blocking event occurs at early stages of the symbiosis.

Integrated Analysis of Transcriptome and Secretome From Umbilical Cord Mesenchymal Stromal Cells Reveal New Mechanisms for the Modulation of Inflammation and Immune Activation

Mesenchymal stromal cells (MSC) have been used in over 800 clinical trials with encouraging results in the field of transplant medicine and chronic inflammatory diseases. Today, Umbilical Cord (UC)-derived MSC are the second leading source used for clinical purposes, mainly due to its easy access and superior immune modulatory effects. Although the underlying molecular mechanisms of immune suppressive activities have not been fully understood, research over the last decade strongly suggests that MSC-mediated benefits are closely related to activation of secretome networks. Nevertheless, recent findings also point to cytokine-independent mechanisms as key players of MSC-mediated immune modulation. Here, we set up a robust in vitro immune assay using phytohemagglutinin- or anti-CD3/CD28-treated human peripheral blood mononuclear cells in cell-to-cell interaction or in cell-contact independent format with UC-MSC and conducted integrated transcriptome and secretome analyses to dissect molecular pathways driving UC-MSC-mediated immune modulation. Under inflammatory stimuli, multiparametric analyses of the secretome led us to identify cytokine/chemokine expression patterns associated with the induction of MSC-reprogrammed macrophages and T cell subsets ultimately leading to immune suppression. UC-MSC transcriptome analysis under inflammatory challenge allowed the identification of 47 differentially expressed genes, including chemokines, anti- and pro-inflammatory cytokines and adhesion molecules found also in UC-MSC-immunosupressive secretomes, including the novel candidate soluble IL-2R. This study enabled us to track functionally activated UC-MSC during immune suppression and opened an opportunity to explore new pathways involved in immunity control by UC-MSC. We propose that identified immunomodulatory molecules and pathways could potentially be translated into clinical settings in order to improve UC-MSC-therapy quality and efficacy.

Optimized Nanostructured Lipid Carriers Integrated into In Situ Nasal Gel for Enhancing Brain Delivery of Flibanserin

Background and Aim

Flibanserin (FLB) is a multifunctional serotonergic agent used for treating hypoactive sexual desire disorder in premenopausal women via oral administration. FLB has a reported limited oral bioavailability of 33% that could be attributed to the drug’s first-pass metabolism. In addition, FLB has a pH-dependent solubility that could be a challenging factor for drug dissolution in the body neutral fluid, and consequently, absorption via mucosal barriers. Thus, this work aims at investigating the potential of utilizing nanostructured lipid carriers (NLCs) to overcome the aforementioned drawbacks and to enhance nose-to-brain drug delivery.

Methods

Box-Behnken design was applied to explore the impact of solid lipid % (SL%, X₁), liquid lipid % (LL%, X₂), and sonication time (ST, X₃) on particle size. The optimized NLC formulation was characterized and incorporated into gellan gum in situ gel. The prepared gel was subjected to in vitro drug release, in vivo pharmacokinetic performance, and histopathological assessment in rats.

Results

Statistical analysis revealed a significant negative effect for both SL% and ST on NLCs size. In contrast, a significant positive effect was observed for the LL%. The optimized formulation showed spherical shape with vesicular size of 114.63 nm. The optimized FLB-NLC in situ gel exhibited adequate stability and enhanced in vitro release compared to raw FLB control gel. The plasma and brain concentrations of the drug after nasal administration in rats increased by more than 3–6-fold, respectively, compared to raw FLB in situ gel. In addition, the histopathological studies revealed the absence of any pathological signs.

Conclusion

The aforementioned results highlight the safety of FLB-NLC in situ nasal gel and its potential to improve the drug bioavailability and brain delivery.

Novel Barbiturate-Nitrate Compounds Inhibit the Upregulation of Matrix Metalloproteinase-9 Gene Expression in Intestinal Inflammation through a cGMP-Mediated Pathway

Matrix metalloproteinase-9 is upregulated in inflammatory bowel disease. Barbiturate nitrate hybrid compounds have been designed to inhibit MMP secretion and enzyme activity. In this study, we investigated the mechanism of action of barbiturate-nitrate hybrid compounds and their component parts using models of intestinal inflammation in vitro. Cytokine-stimulated Caco-2 cells were used in all in vitro experiments. The NO donors SNAP and DETA-NONOate were used to study the effect of NO on MMP-9 mRNA. Mechanistic elucidation was carried out using the soluble guanylate cyclase (sGC) inhibitor, ODQ, and the cGMP analogue, 8-Bromo-cGMP. Further experiments were carried out to elucidate the role of NF-κB. NO donors exerted an inhibitory effect on MMP-9 mRNA in cytokine-stimulated cells. While the non-nitrate barbiturates had a limited effect on MMP-9 expression, the hybrid compounds inhibited MMP-9 expression through its NO-mimetic properties. No effect could be observed on mRNA for MMP-1 or MMP-2. The sGC inhibitior, ODQ, abolished the nitrate-barbiturate inhibition of MMP-9 gene expression, an effect which was reversed by 8-Br-cGMP. This study shows that the barbiturate scaffold is suitable for hybrid design as an MMP-9 inhibitor in cytokine-stimulated Caco-2 cells. The inhibition of MMP-9 levels was largely mediated through a reduction in its mRNA by a sGC/cGMP pathway mediated mechanism.

Construction and demolition waste applications and maximum daily output in Spanish recycling plants

The pursuit of construction sustainability has driven the use of partially or wholly waste-based eco-materials. New applications are being sought for recycled aggregate (RA) to further the use of this material and ensure the survival of the construction and demolition waste (C&DW) industry. RA, currently used in the construction of pavements, fills and embankments and only incipiently to manufacture structural or non-structural concrete, is a mere 8.99% of the total aggregate extracted in EU countries where RA is produced. Against this backdrop, the utility of this study lies in the overview afforded of RA typology, the application of the product in bound or unbound materials, the pursuit of new applications, structural or otherwise, and the assessment of daily maximum output by C&DW recycling facilities in Spain. The findings show that irrespective of its origin, RA most commonly adopts the form of wet mix macadam, gravel or sand used primarily in unbound applications with only dubious quality standards. Plant managers contend that RA from clean waste can feasibly be used in bound applications that require higher-performance materials. Maximum daily output varies widely, with capacity under 200 t d^-1 in 30% of the plants. One of the conclusions drawn is that the current business model is in need of revision, with an emphasis on aggregate quality control (certification) and the adoption of technology for separating out impurities, pollutants and undesirable materials to improve the quality of RA.

Sinorhizobium fredii HH103 syrM inactivation affects the expression of a large number of genes, impairs nodulation with soybean and extends the host-range to Lotus japonicus

Sinorhizobium fredii HH103 RifR is a broad host-range rhizobial strain able to nodulate with soybean and Lotus burttii, but it is ineffective with L. japonicus. Here, we study the role of the HH103 RifR SyrM protein in the regulation of gene expression and its relevance in symbiosis with those three legumes. RNAseq analyses show that HH103 SyrM is an important transcriptional regulator not only in the presence of inducer flavonoids but also in its absence. Lack of SyrM increases Nod factors production and decreases genistein-mediated repression of exopolysaccharide production in HH103. In symbiosis, mutation of syrM partially impaired interaction with soybean but improves effectiveness with L. burttii and extends the host-rage to L. japonicus Gifu. In addition, HH103 syrM mutants enter in both Lotus species by infection threads, whereas HH103 uses the more primitive intercellular infection to enter into L. burttii roots These symbiotic phenotypes were previously observed in two other HH103 mutants affected in symbiotic regulators, nodD2 and nolR, revealing that in S. fredii HH103 numerous transcriptional regulators finely modulate symbiotic gene expression.

HIV treatment in Guinea-Bissau: room for improvement and time for new treatment options

Despite advances in the treatment quality of HIV throughout the world, several countries are still facing numerous obstacles in delivering HIV treatment at a sufficiently high quality, putting patients' lives in jeopardy. The aim of this status article is to give an overview of HIV treatment outcomes in the West African country, Guinea-Bissau, and to assess how newer treatment strategies such as long-acting injectable drugs or an HIV cure may limit or stop the HIV epidemic in this politically unstable and low-resource setting. Several HIV cohorts in Guinea-Bissau have been established and are used as platforms for epidemiological, virological, immunological and clinical studies often with a special focus on HIV-2, which is prevalent in the country. The Bandim Health Project, a demographic surveillance site, has performed epidemiological HIV surveys since 1987 among an urban population in the capital Bissau. The Police cohort, an occupational cohort of police officers, has enabled analyses of persons seroconverting with estimated times of seroconversion among HIV-1 and HIV-2-infected individuals, allowing incidence measurements while the Bissau HIV Cohort and a newer Nationwide HIV Cohort have provided clinical data on large numbers of HIV-infected patients. The HIV cohorts in Guinea-Bissau are unique platforms for research and represent real life in many African countries. Poor adherence, lack of HIV viral load measurements, inadequate laboratory facilities, high rates of loss to follow-up, mortality, treatment failure and resistance development, are just some of the challenges faced putting the goal of "90-90-90″ for Guinea-Bissau well out of reach by 2020. Maintaining undetectable viral loads on treatment as a prerequisite of a cure strategy seems not possible at the moment. Thinking beyond one-pill-once-a-day, long-acting antiretroviral treatment options such as injectable drugs or implants may be a better treatment option in settings like Guinea-Bissau and may even pave the way for an HIV cure. If the delivery of antiretroviral treatment in sub-Saharan Africa in a sustainable way for the future should be improved by focusing on existing treatment options or through focusing on new treatment options remains to be determined.

Interhospital Sepsis Code in Catalonia (Spain): Territorial model for initial care of patients with sepsis

Sepsis is a syndromic entity with high prevalence and mortality. The management of sepsis is standardized and exhibits time-dependent efficiency. However, the management of patients with sepsis is complex. The heterogeneity of the forms of presentation can make it difficult to detect and manage such cases, in the same way as differences in training, professional competences or the availability of health resources. The Advisory Commission for Patient Care with Sepsis (CAAPAS), comprising 7 scientific societies, the Emergency Medical System (SEM) and the Catalan Health Service (CatSalut), have developed the Interhospital Sepsis Code (CSI) in Catalonia (Spain). The general objective of the CSI is to increase awareness, promote early detection and facilitate initial care and interhospital coordination to attend septic patients in a homogeneous manner throughout Catalonia.

Effect on Platelet Function of Metal-Based Nanoparticles Developed for Medical Applications

Nanomaterials have been recently introduced as potential diagnostic and therapeutic tools in the medical field. One of the main concerns in relation to the use of nanomaterials in humans is their potential toxicity profile and blood compatibility. In fact, and due to their small size, NPs can translocate into the systemic circulation even after dermal contact, inhalation, or oral ingestion. Once in the blood stream, nanoparticles become in contact with the different components of the blood and can potentially interfere with normal platelet function leading to bleeding or thrombosis. Metallic NPs have been already used for diagnosis and treatment purposes due to their unique characteristics. However, the potential interactions between metallic NPs and platelets has not been widely studied and reported. This review focuses on the factors that can affect platelet activation and aggregation by metal NPs and the nature of such interactions, providing a summary of the effect of various metal NPs on platelet function available in the literature.

Persistent central inflammation and region specific cellular activation accompany depression- and anxiety-like behaviours during the resolution phase of experimental colitis

Depression and anxiety-related psychological symptoms are increasingly recognised as important co-morbidities in patients with inflammatory bowel disease (IBD). Dextran sulfate sodium (DSS) -induced colitis is an animal model of IBD in which afferent activation of the gut-brain axis can be assessed and explored as a source of behavioural change. Exposure of adult male Wistar rats to DSS (5%) in drinking water induced distal colitis. In parallel to local inflammatory responses in the gut wall, increased expression of IL-6 and iNOS was found in the cerebral cortex and an increase in ventricular volume. Immunoreactivity of immediate early gene FosB/ΔFosB activation was measured as an index of cellular activation and was increased in the nucleus accumbens and dorsal raphe nucleus in acutely colitic animals. Following resolution of the acute colitic response, sustained anhedonia in the saccharin preference test, immobility in the forced swim test, reduced burying behaviour in the marble burying test, and mild signs of anxiety in the elevated plus maze and light/dark box were observed. Central increases in iNOS expression persisted during the recovery phase and mapped to reactive microglia, particularly those found in the parenchyma surrounding circumventricular regions. Evidence of associated nitration was also found. Sustained increases in ventricular volume and reduced T2 magnetic resonance relaxometry time in cortical regions were observed during the recovery period. FosB/ΔFosB activation was evident in the dorsal raphe during recovery. Persistent central inflammation and cellular activation may underpin the emergence of symptoms of depression and anxiety in experimental colitis.

Regulation of Protein Secretion Systems Mediated by Cyclic Diguanylate in Plant-Interacting Bacteria

The ubiquitous second messenger cyclic diguanylate (c-di-GMP) is involved in the regulation of different processes in bacteria. In phytopathogens, intracellular fluctuations in the concentration of this molecule contribute to the lifestyle switching from a motile and virulent stage to a sessile and biofilm-forming phase. Among the virulence mechanisms used by bacterial pathogens, different specific type secretion systems (TSSs) and the effector proteins that they translocate are included. Some of these TSS are conceived to suppress host immune responses during bacterial colonization. The modulation of the expression of secretion systems components and/or effector proteins can be influenced by c-di-GMP levels at transcriptional, translational, or post-translational levels and can take place directly by binding to specific or global regulators, or via transducer proteins. Different genera of plant-interacting bacteria have been analyzed to shed some light in the implications of c-di-GMP in the regulation of host plant colonization through protein secretion systems. Expression of (1) adhesins secreted by Type 1 secretion systems to bind the host plant in Pectobacterium (formerly Erwinia) and some beneficial Pseudomonas strains; (2) catalytic exoproteins delivered by Type 2 secretion systems to break plant cell wall in Dickeya; (3) effectors secreted by Type 3 secretion systems to suppress plant immunity in Xanthomonas; or (4) the activity of Type 6 secretion systems to export an ATPase in Pseudomonas, are finely tuned by c-di-GMP levels. In this minireview, we summarize the knowledge available about the implications of c-di-GMP in the regulation of protein secretion in different plant-interacting bacteria. Topic: Secretion systems and effector proteins of phytopathogenic and beneficial bacteria regulated by NSM.

Comparative Study of the Antimicrobial Effect of Nanocomposites and Composite Based on Poly(butylene adipate-co-terephthalate) Using Cu and Cu/Cu2O Nanoparticles and CuSO4

Nanocomposites and a composite based on poly(butylene adipate-co-terephthalate) (PBAT) were synthesized using commercial copper nanoparticles (Cu-NPs), copper/cuprous oxide nanoparticles (Cu|Cu₂O-NPs), and copper sulfate (CuSO₄), respectively. The Cu|Cu₂O-NPs were synthesized using chemical reduction and characterized by X-ray diffraction (XRD) and transmission electron microscopy (TEM). The synthesis of Cu|Cu₂O-NPs yielded a mixture of Cu and Cu₂O, with metal Cu having a spherical morphology of approximately 40 nm in diameter and Cu₂O with a diameter of 150 nm. To prepare the nanocomposites (NCs) and the composite material (MC), the NPs and the CuSO₄ salt were incorporated into the PBAT matrix in concentrations of 1, 3, and 5% p/p via an ex situ method. Fourier transform infrared spectroscopy (FTIR), a tensile test, differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and agar diffusion assays were used for structural, thermomechanical, and antimicrobial characterization. Results showed that the reinforcements did not modify the chemical structure of the PBAT and only slightly increased the percentage of crystallization. The mechanical and thermal properties of the PBAT did not change much with the addition of fillers, except for a slight increase in tensile strength and thermal stability, respectively. The agar diffusion antimicrobial assays showed that the NCs and MCs had good inhibitory responses against the nonresistant strains Enterococcus faecalis, Streptococcus mutans, and Staphylococcus aureus. The MCs based on CuSO₄ had the highest biocidal effect, even against the resistant bacteria Acinetobacter baumannii.

Biodiversity of rhizobia present in plant nodules of Biserrula pelecinus across Southwest Spain

Biodiversity studies of native Mesorhizobium spp. strains able to nodulate the annual herbaceous legume Biserrula pelecinus L. in soils from Southwest Spain have been carried out. One or two isolates per plant, 30 in total, were randomly selected for further characterization. There was no association between the presence of mesorhizobia nodulating-B. pelecinus and the chemical or textural properties of the soils. The isolates were tested for their symbiotic effectiveness on this forage legume under greenhouse conditions and characterized on the basis of physiological parameters: carbon source utilisation (API 50CH), 16S rRNA sequencing and ERIC-PCR, lipopolysaccharide, protein and plasmid profiles. Our results show that in spite of the great diversity found among the native isolates, most of them belong to the genus Mesorhizobium, the exception being strain B24 which sequence matches 97.52% with Neorhizobium huautlense; this is the first description of a Neorhizobium strain effectively nodulating-biserrula plants. Results of a field trial indicated that some of these isolates could be recommended as inoculants for this legume. B24=DSM 28743=CECT 8815; ENA (HF955513) 16S rRNA sequences of isolates B13, B18, B26, B30 and B1 are deposited at ENA under numbers LS999402 to LS999406, respectively.

Autochthonous cutaneous leishmaniasis in urban domestic animals (Felis catus / Canis lupus familiaris) from central-western Venezuela

Leishmaniasis is a zoonotic disease caused by intracellular protozoa of the Leishmania genus that are spread and transmitted by sandflies. Natural infection and clinical disease in domestic cats and dogs appear to be rare or perhaps largely under-reported in endemic areas. However, previous reports on infected domestic animals usually implicate the same Leishmania species that affect humans in tropical and subtropical areas of the world suggesting a potential role for zoonotic transmission. In the present study we assessed a representative sample of cats and dogs from endemic urban / suburban areas of Lara state in central western Venezuela. In both dogs and cats, cutaneous disease exhibits a spectrum of manifestations that range from single papules or nodules, which may evolve into ulcerative, plaque-like or scaly lesions. Cytochrome b (cyt b) PCR gene sequence analysis revealed L. mexicana as the causative agent in all cases, including two human cases proceeding from the same study area at the same time the study was carried out. In order to improve our understanding on feline/canine infection with Leishmania mexicana, and address potential zoonotic concerns it is necessary to characterize its enzootic reservoirs and vectors as well as the possible anthropophilic players linking to the peridomestic and domestic cycles.

Hydrogel-based delivery of Il-10 improves treatment of bleomycin-induced lung fibrosis in mice

Idiopathic pulmonary fibrosis (IPF) is a life-threatening progressive lung disorder with limited therapeutic options. While interleukin-10 (IL-10) is a potent anti-inflammatory and anti-fibrotic cytokine, its utility in treating lung fibrosis has been limited by its short half-life. We describe an innovative hydrogel-based approach to deliver recombinant IL-10 to the lung for the prevention and reversal of pulmonary fibrosis in a mouse model of bleomycin-induced lung injury. Our studies show that a hyaluronan and heparin-based hydrogel system locally delivers IL-10 by capitalizing on the ability of heparin to reversibly bind IL-10 without bleeding or other complications. This formulation is significantly more effective than soluble IL-10 for both preventing and reducing collagen deposition in the lung parenchyma after 7 days of intratracheal administration. The anti-fibrotic effect of IL-10 in this system is dependent on suppression of TGF-β driven collagen production by lung fibroblasts and myofibroblasts. We conclude that hydrogel-based delivery of IL-10 to the lung is a promising therapy for fibrotic lung disorders.

Long-term effects of smallpox vaccination on expression of the HIV-1 co-receptor CCR5 in women

Background

Smallpox vaccinations were stopped globally in 1980. Recent studies have shown that in women, being smallpox vaccinated was associated with a reduced risk of HIV infection compared with not being smallpox vaccinated. At the initial infection, HIV-1 most often uses CCR5 as a co-receptor to infect the T-lymphocytes. We therefore investigated whether smallpox vaccination is associated with a down-regulation of CCR5 on the surface of peripheral T-lymphocytes in healthy women in Guinea-Bissau.

Methods

We included HIV seronegative women from Bissau, Guinea-Bissau, born before 1974, with and without a smallpox vaccination scar. Blood samples were stabilised in a TransFix buffer solution and stained for flow cytometry according to a T-cell maturation profile.

Results

Ninety-seven women were included in the study; 52 with a smallpox vaccination scar and 45 without a scar. No association between smallpox vaccination scar and CCR5 expression was found in any T-lymphocyte subtype.

Conclusion

Among HIV seronegative women, being smallpox vaccinated more than 40 years ago was not associated with a down-regulation of CCR5 receptors on the surface of peripheral T-lymphocytes.