Association between Urinary Sodium Excretion and Body Fat in School-Aged Children: Insights from the ARIA Study

Childhood obesity has been associated with increased sodium intake. Nonetheless, evidence linking sodium intake to Body Mass Index (BMI) and Body Fat Mass Percentage (%BF) remains limited, especially in the pediatric age group. Therefore, this study aims to investigate whether there is an association between 24 h urinary sodium excretion with BMI and %BF in a sample group of children from the ARIA study. This cross-sectional analysis included 303 children aged 7 to 12 from across 20 public schools in Porto, Portugal. Weight and %BF were assessed using the Tanita™ BC-418 Segmental Body Analyzer. Children's Total Energy Intake (TEI) was estimated through a single 24 h Recall Questionnaire, and urinary sodium and potassium excretion was estimated by a 24 h urine collection. The association of %BF and BMI with 24 h sodium excretion was estimated by a binary logistic regression adjusted for sex, age, physical activity, total energy intake, parental education, and 24 h urinary excreted potassium. There was a significant positive association between higher levels of urinary sodium excretion and higher %BF values, even after adjusting for confounders. However, the same was not observed for BMI. Our findings suggest that higher sodium intake is associated with higher values of %BF among children, regardless of TEI and potassium intake.

Phylogenomics reveals extensive misidentification of fungal strains from the genus Aspergillus

Modern taxonomic classification is often based on phylogenetic analyses of a few molecular markers, although single-gene studies are still common. Here, we leverage genome-scale molecular phylogenetics (phylogenomics) of species and populations to reconstruct evolutionary relationships in a dense data set of 710 fungal genomes from the biomedically and technologically important genus Aspergillus. To do so, we generated a novel set of 1,362 high-quality molecular markers specific for Aspergillus and provided profile Hidden Markov Models for each, facilitating their use by others. Examining the resulting phylogeny helped resolve ongoing taxonomic controversies, identified new ones, and revealed extensive strain misidentification (7.59% of strains were previously misidentified), underscoring the importance of population-level sampling in species classification. These findings were corroborated using the current standard, taxonomically informative loci. These findings suggest that phylogenomics of species and populations can facilitate accurate taxonomic classifications and reconstructions of the Tree of Life.IMPORTANCEIdentification of fungal species relies on the use of molecular markers. Advances in genomic technologies have made it possible to sequence the genome of any fungal strain, making it possible to use genomic data for the accurate assignment of strains to fungal species (and for the discovery of new ones). We examined the usefulness and current limitations of genomic data using a large data set of 710 publicly available genomes from multiple strains and species of the biomedically, agriculturally, and industrially important genus Aspergillus. Our evolutionary genomic analyses revealed that nearly 8% of publicly available Aspergillus genomes are misidentified. Our work highlights the usefulness of genomic data for fungal systematic biology and suggests that systematic genome sequencing of multiple strains, including reference strains (e.g., type strains), of fungal species will be required to reduce misidentification errors in public databases.

Functional and Evolutionary Integration of a Fungal Gene With a Bacterial Operon

Siderophores are crucial for iron-scavenging in microorganisms. While many yeasts can uptake siderophores produced by other organisms, they are typically unable to synthesize siderophores themselves. In contrast, Wickerhamiella/Starmerella (W/S) clade yeasts gained the capacity to make the siderophore enterobactin following the remarkable horizontal acquisition of a bacterial operon enabling enterobactin synthesis. Yet, how these yeasts absorb the iron bound by enterobactin remains unresolved. Here, we demonstrate that Enb1 is the key enterobactin importer in the W/S-clade species Starmerella bombicola. Through phylogenomic analyses, we show that ENB1 is present in all W/S clade yeast species that retained the enterobactin biosynthetic genes. Conversely, it is absent in species that lost the ent genes, except for Starmerella stellata, making this species the only cheater in the W/S clade that can utilize enterobactin without producing it. Through phylogenetic analyses, we infer that ENB1 is a fungal gene that likely existed in the W/S clade prior to the acquisition of the ent genes and subsequently experienced multiple gene losses and duplications. Through phylogenetic topology tests, we show that ENB1 likely underwent horizontal gene transfer from an ancient W/S clade yeast to the order Saccharomycetales, which includes the model yeast Saccharomyces cerevisiae, followed by extensive secondary losses. Taken together, these results suggest that the fungal ENB1 and bacterial ent genes were cooperatively integrated into a functional unit within the W/S clade that enabled adaptation to iron-limited environments. This integrated fungal-bacterial circuit and its dynamic evolution determine the extant distribution of yeast enterobactin producers and cheaters.

Tracking alternative versions of the galactose gene network in the genus Saccharomyces and their expansion after domestication

When Saccharomyces cerevisiae grows on mixtures of glucose and galactose, galactose utilization is repressed by glucose, and induction of the GAL gene network only occurs when glucose is exhausted. Contrary to reference GAL alleles, alternative alleles support faster growth on galactose, thus enabling distinct galactose utilization strategies maintained by balancing selection. Here, we report on new wild populations of Saccharomyces cerevisiae harboring alternative GAL versions and, for the first time, of Saccharomyces paradoxus alternative alleles. We also show that the non-functional GAL version found earlier in Saccharomyces kudriavzevii is phylogenetically related to the alternative versions, which constitutes a case of trans-specific maintenance of highly divergent alleles. Strains harboring the different GAL network variants show different levels of alleviation of glucose repression and growth proficiency on galactose. We propose that domestication involved specialization toward thriving in milk from a generalist ancestor partially adapted to galactose consumption in the plant niche.

Efficacy and safety of enzyme replacement therapy with alglucosidase alfa for the treatment of patients with infantile-onset Pompe disease: a systematic review and metanalysis

Introduction

Pompe disease (PD) is a glycogen disorder caused by the deficient activity of acid alpha-glucosidase (GAA). We sought to review the latest available evidence on the safety and efficacy of recombinant human GAA enzyme replacement therapy (ERT) for infantile-onset PD (IOPD).

Methods

We systematically searched the MEDLINE (via PubMed) and Embase databases for prospective clinical studies evaluating ERT for IOPD on pre-specified outcomes. Meta-analysis was also performed.

Results

Of 1,722 articles identified, 16 were included, evaluating 316 patients. Studies were heterogeneous and with very low certainty of evidence for most outcomes. A moderate/high risk of bias was present for most included articles. The following outcomes showed improvements associated with alglucosidase alfa, over natural history of PD/placebo, for a mean follow-up of 48.3 months: left ventricular (LV) mass {mean change 131.3 g/m2 [95% confidence interval (CI) 81.02, 181.59]}, time to start ventilation (TSV) [HR 0.21 (95% CI: 0.12, 0.36)], and survival [HR 0.10 (95% CI: 0.05, 0.19)]. There were no differences between the pre- and post-ERT period for myocardial function and psychomotor development. Adverse events (AEs) after ERT were mild in most cases.

Conclusion

Our data suggest that alglucosidase alfa potentially improves LV mass, TSV, and survival in IOPD patients, with no important safety issues.

Systematic Review Registration

PROSPERO identifier (CRD42019123700).

Taxogenomic analyses of Starmerella gilliamiae f.a, sp. nov. and Starmerella monicapupoae f.a., sp. nov., two novel species isolated from plant substrates and insects

Four yeast isolates collected from flowers from different ecosystems in Brazil, one from fruit of Nothofagus alpina in Argentina, three from flowers of Neltuma chilensis in Chile and one obtained from the proventriculus of a female bumblebee in Canada were demonstred, by analysis of the sequences of the internal transcribed spacer (ITS) region and D1/D2 domains of the large subunit rRNA gene, to represent two novel species of the genus Starmerella. These species are described here as Starmerella gilliamiae f.a, sp. nov. (CBS 16166T; Mycobank MB 851206) and Starmerella monicapupoae f.a., sp. nov. (PYCC 8997T; Mycobank MB 851207). The results of a phylogenomic analysis using 1037 single-copy orthogroups indicated that S. gilliamiae is a member of a subclade that contains Starmerella opuntiae, Starmerella aceti and Starmerella apicola. The results also indicated that S. monicapupoae is phylogenetically related to Starmerella riodocensis. The two isolates of S. monicapupoae were obtained from flowers in Brazil and were probably vectored by insects that visit these substrates. Starmerella gilliamiae has a wide geographical distribution having been isolated in flowers from Brazil and Chile, fruit from Argentina and a bumblebee from Canada.

Phylogenomic delineation of two new species of ascomycetous yeasts, Wickerhamiella koratensis sp. nov. and Wickerhamiella limtongiae sp. nov., and proposal of two synonyms, Wickerhamiella infanticola and Wickerhamiella tropicalis

Two novel ascomycetous yeast species of the genus Wickerhamiella are proposed based on isolates obtained in Thailand from food waste and the fruiting body of a polypore fungus, and on a combination of conventional DNA-barcode sequence analyses and whole-genome phylogenies. We focus on a particular subclade of the genus Wickerhamiella that contains species found in anthropic environments and describe Wickerhamiella limtongiae sp. nov. (DMKU-FW31-5T=PYCC 9022T=TBRC 15055T), found on food waste samples. In an adjacent clade, we describe Wickerhamiella koratensis sp. nov. (DMKU-KO16T=PYCC 8908T=TBRC 14869T), which represents the closest relative of Wickerhamiella slavikovae and was isolated from the fruiting body of Bjerkandera sp. In the subclade of W. limtongiae sp. nov., we propose that Wickerhamiella infanticola should be regarded as a synonym of Wickerhamiella sorbophila and that Wickerhamiella tropicalis should be regarded as a synonym of Wickerhamiella verensis.

Systematic review of mediterranean diet interventions in menopausal women

The increasing lifespan of women and their extended time spent in menopause pose significant challenges for health care systems, primarily due to the impacts of postmenopausal estrogen deficiency and aging on health. Menopause's onset is linked to a heightened prevalence of obesity, metabolic syndrome, cardiovascular disease, and osteoporosis. Diet is particularly relevant during menopause given its impact on quality of life and longevity and its modifiability. Because the Mediterranean diet is currently regarded as one of the healthiest dietary models in the world, the aim of this systematic review was to assess current evidence regarding the effectiveness of studies on the Mediterranean diet as an intervention for menopausal women. A systematic review of intervention-based studies involving the Mediterranean diet among menopausal women was performed in Scopus, PubMed, and Web of Science. The results of seven that met the inclusion criteria suggests that adherence to the Mediterranean diet can have beneficial impacts on menopausal women's health, including reductions in weight, blood pressure, blood ω6: ω3 ratio, triglycerides, total cholesterol, and LDL levels. Those results seem to be relevant for public health interventions aimed at improving menopausal women's quality of life.

Reducing Dietary Sodium and Improving Human Health 2.0

This Special Issue of Nutrients, "Reducing Dietary Sodium and Improving Human Health 2 [...].

Functional and evolutionary integration of a fungal gene with a bacterial operon

Siderophores are crucial for iron-scavenging in microorganisms. While many yeasts can uptake siderophores produced by other organisms, they are typically unable to synthesize siderophores themselves. In contrast, Wickerhamiella/Starmerella (W/S) clade yeasts gained the capacity to make the siderophore enterobactin following the remarkable horizontal acquisition of a bacterial operon enabling enterobactin synthesis. Yet, how these yeasts absorb the iron bound by enterobactin remains unresolved. Here, we demonstrate that Enb1 is the key enterobactin importer in the W/S-clade species Starmerella bombicola. Through phylogenomic analyses, we show that ENB1 is present in all W/S clade yeast species that retained the enterobactin biosynthetic genes. Conversely, it is absent in species that lost the ent genes, except for Starmerella stellata, making this species the only cheater in the W/S clade that can utilize enterobactin without producing it. Through phylogenetic analyses, we infer that ENB1 is a fungal gene that likely existed in the W/S clade prior to the acquisition of the ent genes and subsequently experienced multiple gene losses and duplications. Through phylogenetic topology tests, we show that ENB1 likely underwent horizontal gene transfer from an ancient W/S clade yeast to the order Saccharomycetales, which includes the model yeast Saccharomyces cerevisiae, followed by extensive secondary losses. Taken together, these results suggest that the fungal ENB1 and bacterial ent genes were cooperatively integrated into a functional unit within the W/S clade that enabled adaptation to iron-limited environments. This integrated fungal-bacterial circuit and its dynamic evolution determines the extant distribution of yeast enterobactin producers and cheaters.

Yeasts from tropical forests: Biodiversity, ecological interactions, and as sources of bioinnovation

Tropical rainforests and related biomes are found in Asia, Australia, Africa, Central and South America, Mexico, and many Pacific Islands. These biomes encompass less than 20% of Earth's terrestrial area, may contain about 50% of the planet's biodiversity, and are endangered regions vulnerable to deforestation. Tropical rainforests have a great diversity of substrates that can be colonized by yeasts. These unicellular fungi contribute to the recycling of organic matter, may serve as a food source for other organisms, or have ecological interactions that benefit or harm plants, animals, and other fungi. In this review, we summarize the most important studies of yeast biodiversity carried out in these biomes, as well as new data, and discuss the ecology of yeast genera frequently isolated from tropical forests and the potential of these microorganisms as a source of bioinnovation. We show that tropical forest biomes represent a tremendous source of new yeast species. Although many studies, most using culture-dependent methods, have already been carried out in Central America, South America, and Asia, the tropical forest biomes of Africa and Australasia remain an underexplored source of novel yeasts. We hope that this review will encourage new researchers to study yeasts in unexplored tropical forest habitats.

Diverse signatures of convergent evolution in cacti-associated yeasts

Many distantly related organisms have convergently evolved traits and lifestyles that enable them to live in similar ecological environments. However, the extent of phenotypic convergence evolving through the same or distinct genetic trajectories remains an open question. Here, we leverage a comprehensive dataset of genomic and phenotypic data from 1,049 yeast species in the subphylum Saccharomycotina (Kingdom Fungi, Phylum Ascomycota) to explore signatures of convergent evolution in cactophilic yeasts, ecological specialists associated with cacti. We inferred that the ecological association of yeasts with cacti arose independently ~17 times. Using machine-learning, we further found that cactophily can be predicted with 76% accuracy from functional genomic and phenotypic data. The most informative feature for predicting cactophily was thermotolerance, which is likely associated with duplication and altered evolutionary rates of genes impacting the cell envelope in several cactophilic lineages. We also identified horizontal gene transfer and duplication events of plant cell wall-degrading enzymes in distantly related cactophilic clades, suggesting that putatively adaptive traits evolved through disparate molecular mechanisms. Remarkably, multiple cactophilic lineages and their close relatives are emerging human opportunistic pathogens, suggesting that the cactophilic lifestyle-and perhaps more generally lifestyles favoring thermotolerance-may preadapt yeasts to cause human disease. This work underscores the potential of a multifaceted approach involving high throughput genomic and phenotypic data to shed light onto ecological adaptation and highlights how convergent evolution to wild environments could facilitate the transition to human pathogenicity.

Genomic and ecological factors shaping specialism and generalism across an entire subphylum

Organisms exhibit extensive variation in ecological niche breadth, from very narrow (specialists) to very broad (generalists). Paradigms proposed to explain this variation either invoke trade-offs between performance efficiency and breadth or underlying intrinsic or extrinsic factors. We assembled genomic (1,154 yeast strains from 1,049 species), metabolic (quantitative measures of growth of 843 species in 24 conditions), and ecological (environmental ontology of 1,088 species) data from nearly all known species of the ancient fungal subphylum Saccharomycotina to examine niche breadth evolution. We found large interspecific differences in carbon breadth stem from intrinsic differences in genes encoding specific metabolic pathways but no evidence of trade-offs and a limited role of extrinsic ecological factors. These comprehensive data argue that intrinsic factors driving microbial niche breadth variation.

Drilling into "Quality by Design" Approach for Analytical Methods

The need for consistency in analytical method development reinforces the dependence of pharmaceutical product development and manufacturing on robust analytical data. The Analytical Quality by Design (AQbD), akin to the product Quality by Design (QbD) endows a high degree of confidence to the method quality developed. AQbD involves the definition of the analytical target profile as starting point, followed by the identification of critical method variables and critical analytical attributes, supported on risk assessment and design of experiment tools for the establishment of a method operable design region and control strategy of the method. This systematic approach moves away from reactive troubleshooting to proactive failure reduction. The objective of this review is to highlight the elements of the AQbD framework and provide an overview of their implementation status in various analytical methods used in the pharmaceutical field. These methodologies include but are not limited to, high-performance liquid chromatography, UV-Vis spectrophotometry, capillary electrophoresis, supercritical fluid chromatography, and high-performance thin-layer chromatography. Finally, a critical appraisal is provided to highlight how regulators have encouraged AQbD principles application to boost the prevention of method failures and a better understanding of the method operable design region (MODR) and control strategy, ultimately resulting in cost-effectiveness and regulatory flexibility.

Iodine intake assessment in the staff of a Porto region university (Portugal): the iMC Salt trial

PURPOSE

Iodine deficiency disorder (IDD) is an ongoing worldwide recognized problem with over two billion individuals having insufficient iodine intake. School-aged children and pregnant women are often target groups for epidemiological studies, but there is a lack of knowledge on the general adult population. The aim of this study was to assess the iodine status among a Portuguese public university staff as a proxy for the adult working population.

METHODS

The population study covered 103 adults within the iMC Salt randomized clinical trial, aged 24-69 years. Urinary iodine concentration was measured spectrophotometrically using the Sandell-Kolthoff reaction. Iodine food intake was assessed using a 24-h dietary recall. The contribution of discretionary salt to the iodine daily intake was assessed through 24-h urinary sodium excretion (UIE) and potentiometric iodine determination of household salt.

RESULTS

The mean urine volume in 24 h was 1.5 L. The median daily iodine intake estimated from 24-h UIE was 113 µg/day, being lower among women (p < 0.05). Only 22% of participants showed iodine intake above the WHO-recommended cutoff (150 µg/day). The median daily iodine intake estimated from the 24-h dietary recall was 58 µg/day (51 and 68 µg/day in women and men, respectively). Dairy, including yoghurt and milk products, were the primary dietary iodine source (55%). Iodine intake estimated from 24-h UIE and 24-h dietary recall was moderately correlated (Spearman rank correlation coefficient r = 0.34, p < 0.05). The average iodine concentration in household salt was 14 mg I/kg, with 45% of the samples below the minimum threshold preconized by WHO (15 mg I/kg). The contribution of discretionary salt to the daily iodine intake was around 38%.

CONCLUSION

This study contributes new knowledge about iodine status in Portuguese working adults. The results revealed moderate iodine deficiency, particularly in women. Public health strategies and monitoring programs are needed to ensure iodine adequacy in all population groups.

Macroevolutionary diversity of traits and genomes in the model yeast genus Saccharomyces

Species is the fundamental unit to quantify biodiversity. In recent years, the model yeast Saccharomyces cerevisiae has seen an increased number of studies related to its geographical distribution, population structure, and phenotypic diversity. However, seven additional species from the same genus have been less thoroughly studied, which has limited our understanding of the macroevolutionary events leading to the diversification of this genus over the last 20 million years. Here, we show the geographies, hosts, substrates, and phylogenetic relationships for approximately 1,800 Saccharomyces strains, covering the complete genus with unprecedented breadth and depth. We generated and analyzed complete genome sequences of 163 strains and phenotyped 128 phylogenetically diverse strains. This dataset provides insights about genetic and phenotypic diversity within and between species and populations, quantifies reticulation and incomplete lineage sorting, and demonstrates how gene flow and selection have affected traits, such as galactose metabolism. These findings elevate the genus Saccharomyces as a model to understand biodiversity and evolution in microbial eukaryotes.

Public interest in food sustainability: an infodemiology study of Google trends data in Europe from 2010-2021

Understanding food sustainability and healthy diets public awareness is of utmost importance since consumers are the main drivers of global consumption patterns. Using Google Trends data, from 2010 to 2021, we aim to explore the temporal dynamics of food sustainability public interest across Europe and its association with interest in sustainability, healthy diet, Mediterranean diet (MedDiet), and flexitarianism. Public interest in food sustainability has increased and is positively associated with the interest in the topic of sustainability. With few exceptions, no general association between food sustainability and healthy diet or MedDiet interest were found. Consistent associations between food sustainability and flexitarianism were found across most of the European regions and countries. Despite the growing interest, only flexitarianism seems to be associated with food sustainability. Understanding consumers' interest in food sustainability is crucial for the transition towards healthy and sustainable diets and to define educational and behavioural interventions.

Hannaella floricola sp. nov., a novel basidiomycetous yeast species isolated from a flower of Lantana camara in Portugal

During a survey of floricolous yeasts in Portugal, a basidiomycetous yeast representing a novel species in the genus Hannaella was isolated in Portugal from the flower of Lantana camara, an ornamental exotic species native to Central and South America. A combination of phylogenetic analyses of DNA barcode sequences used in yeast molecular systematics, namely the D1/D2 domain and the complete internal transcribed spacer (ITS) region supported the recognition of a new species of Hannaella, that we designate Hannaella floricola sp. nov. (ex-type strain PYCC 9191^T=CBS 18097^T). Although the assignment of the new species to the genus Hannaella was evident, the detection of its closest relatives appeared more problematic. Nevertheless, our analyses suggested that H. floricola sp. nov. belongs a clade that also includes H. coprosmae, H. oryzae and H. surugaensis, together four candidate novel species. In addition we provide the molecular identification of several unidentified strains whose D1/D2 and ITS sequences are available from GenBank.

Horizontal gene transfer in yeasts

Horizontal gene transfer (HGT), defined as the exchange of genetic material other than from parent to progeny, is very common in bacteria and appears to constitute the most important mechanism contributing to enlarge a species gene pool. However, in eukaryotes, HGT is certainly much less common and some early insufficiently consubstantiated cases involving bacterial donors led some to consider that it was unlikely to occur in eukaryotes outside the host/endosymbiont relationship. More recently, plenty of reports of interdomain HGT have seen the light based on the strictest criteria, many concerning filamentous fungi and yeasts. Here, we attempt to summarize the most prominent instances of HGT reported in yeasts as well as what we have been able to learn so far concerning frequency and distribution, mechanisms, barriers, function of horizontally acquired genes, and the role of HGT in domestication.

The Effects of COVID-19 Lockdown on the Perception of Physical Activity and on the Perception of Musculoskeletal Symptoms in Computer Workers: Comparative Longitudinal Study Design

Lockdown resulting from the pandemic led to a change in the health habits of the computer workers community. Sedentary work, together with less active lifestyles, aggravated by the COVID-19 pandemic leads to impacts on physical activity (PA) and can contribute to the development of musculoskeletal symptoms (MSS). Aim(s): Understand the effects of lockdown on the perception of physical activity levels and on the perception of frequency of musculoskeletal symptoms, over periods of 12 months and 7 days, in computer workers. Methods: Longitudinal comparative study between 2019 (M1) and 2021 (M2), over 18 months, in 40 volunteer participants. The inclusion criteria were full-time workers aged between 18 and 65 and the exclusion criteria included diagnosis of non-work-related medical conditions. In addition to a socio-demographic questionnaire, the Nordic musculoskeletal questionnaire (NMQ) was used to evaluate the MSS and the International Physical Activity Questionnaire (IPAQ), was used to analyse the perception of the level of PA. These questionnaires were used in two assessment stages (M1 and M2). McNemar test and Wilcoxon paired test were used to evaluate the effect of lockdown on the perception of PA, and on the perception of frequency of musculoskeletal symptoms. Results: The MSS prevalence in the previous 12 months increased significantly in the neck (M1: 45.0%, M2: 62.5%, p = 0.046), in the shoulders (M1: 37.5%, M2: 55.0%, p = 0.033), and in the hands/wrists (M1: 25.0%, M2: 45.0%, p = 0.019). The mean pain score increased in the shoulders (1.43 ± 2.24, 2.35 ± 2.55, p = 0.003) and in the elbows (0.18 ± 0.59, 0.60 ± 1.34, p = 0.015). No differences were found in the PA between M1 and M2, but the weekly mean sitting time increased from 4.75 ± 2.26 to 6.26 ± 2.65 (p < 0.001). Conclusion: After 18 months it became clear that MSS perception increased mainly in the neck, shoulders and hands/wrists with a significant increase in pain intensity in the shoulder and elbow regions. The weekly sitting time increased significantly. Further studies are needed in order to determine the impact of teleworking in a pandemic context. But multifactor behind these results should be taken into account by health institutions and those responsible for the Prevention of Occupational Risks in Computer Workers in order to adopt educational strategies for the promotion of Physical activity (PA), in these workers.

BioKIT: a versatile toolkit for processing and analyzing diverse types of sequence data

Bioinformatic analysis-such as genome assembly quality assessment, alignment summary statistics, relative synonymous codon usage, file format conversion, and processing and analysis-is integrated into diverse disciplines in the biological sciences. Several command-line pieces of software have been developed to conduct some of these individual analyses, but unified toolkits that conduct all these analyses are lacking. To address this gap, we introduce BioKIT, a versatile command line toolkit that has, upon publication, 42 functions, several of which were community-sourced, that conduct routine and novel processing and analysis of genome assemblies, multiple sequence alignments, coding sequences, sequencing data, and more. To demonstrate the utility of BioKIT, we conducted a comprehensive examination of relative synonymous codon usage across 171 fungal genomes that use alternative genetic codes, showed that the novel metric of gene-wise relative synonymous codon usage can accurately estimate gene-wise codon optimization, evaluated the quality and characteristics of 901 eukaryotic genome assemblies, and calculated alignment summary statistics for 10 phylogenomic data matrices. BioKIT will be helpful in facilitating and streamlining sequence analysis workflows. BioKIT is freely available under the MIT license from GitHub (https://github.com/JLSteenwyk/BioKIT), PyPi (https://pypi.org/project/jlsteenwyk-biokit/), and the Anaconda Cloud (https://anaconda.org/jlsteenwyk/jlsteenwyk-biokit). Documentation, user tutorials, and instructions for requesting new features are available online (https://jlsteenwyk.com/BioKIT).

White wine grape pomace as a suitable carbon source for lipid and carotenoid production by fructophilic Rhodorotula babjevae

AIM

We aim to explore the non-structural sugars from white wine grape pomace (WWGP) as the input carbon source for the co-production of multiple high-value products by the non-fastidious yeast Rhodotorula babjevae to create a sustainable and economically appealing process.

METHODS AND RESULTS

Water extraction of unfermented, soluble sugars from WWGP yielded extracts with similar amounts of glucose and fructose, which were used to prepare a growth medium. R. babjevae multiplied as fast on WWGP-based medium as on a reference medium but achieved higher cell dry weight (CDW) and lower intracellular triacylglycerol accumulation (22.5% vs 28.6%) in WWGP-based medium. In addition, R. babjevae produced mannitol and arabitol, carotenoids, and secreted polyol esters of fatty acids (PEFA), a rare type of glycolipid as confirmed by FTIR, NMR and HPLC analyses. Remarkably, R. babjevae consumed simultaneously both fructose and glucose when on WWGP-based medium and left glucose practically untouched in the reference medium, evidencing a fructophilic character.

CONCLUSIONS

R. babjevae, a metabolic versatile yeast, proliferated on a minimally processed extract and successfully converted glucose and fructose into high-value products.

SIGNIFICANCE AND IMPACT OF STUDY

Different chemicals with market potential can be produced through the valorization of abundant waste feedstocks generated by the wine industry to which R. babjevae can contribute.

Long-term feeder-free culture of human pancreatic progenitors on fibronectin or matrix-free polymer potentiates β cell differentiation

With the aim of producing β cells for replacement therapies to treat diabetes, several protocols have been developed to differentiate human pluripotent stem cells to β cells via pancreatic progenitors. While in vivo pancreatic progenitors expand throughout development, the in vitro protocols have been designed to make these cells progress as fast as possible to β cells. Here, we report on a protocol enabling a long-term expansion of human pancreatic progenitors in a defined medium on fibronectin, in the absence of feeder layers. Moreover, through a screening of a polymer library we identify a polymer that can replace fibronectin. Our experiments, comparing expanded progenitors to directly differentiated progenitors, show that the expanded progenitors differentiate more efficiently into glucose-responsive β cells and produce fewer glucagon-expressing cells. The ability to expand progenitors under defined conditions and cryopreserve them will provide flexibility in research and therapeutic production.

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hPSC-derived pancreatic progenitors can be expanded long term without feeders

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Expansion can be achieved on fibronectin or on a polymer identified by screening

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Expansion enables increased NKX6-1 expression, which is crucial for β cell generation

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Expansion potentiates glucose-responsive β-like cells and decreases α cells

Salt-Related Knowledge, Attitudes and Behavior in an Intervention to Reduce Added Salt When Cooking in a Sample of Adults in Portugal

(1) Background: Excessive salt intake is associated with an increased risk of hypertension and cardiovascular disease, so reducing it is critical. The main objective of this study was to verify whether one intervention to reduce added salt during cooking changed knowledge, attitudes and behavior (KAB) towards salt, and to analyze changes in the main sources of salt. (2) Methods: The intervention study was an 8-week randomized controlled trial with 97 workers from a public university. KAB in relation to salt were obtained through the WHO STEPwise questionnaire, and the main sources of salt were obtained by 24-h food recall and 24 h urinary sodium excretion over two days. (3) Results: After the intervention, participants in the intervention group reported a decrease in the addition of salt when cooking (p = 0.037), an increase in the percentage of subjects who avoided the consumption of processed foods (from 54.2% to 83.3%, p = 0.001), who looked for salt on food labels (from 18.8% to 39.6%, p = 0.013), and who bought low-salt food alternatives (from 43.8% to 60.4%, p = 0.039). However, there were no significant differences between the intervention group and the control group at baseline and post-intervention assessments. In the intervention group, after the intervention, the added salt decreased by 5%; food sources of salt such as the snacks and pizza group decreased by 7%, and the meat, fish and eggs group increased by 4%, but without statistical significance. (4) Conclusions: With innovative equipment for dosing salt when cooking, it is possible to change some dimensions of consumer behavior in relation to salt.

The effect of incarceration on TB treatment outcomes

BACKGROUND: TB notifications in Latin American prisons have more than doubled over the past two decades; however, treatment outcomes and their determinants among incarcerated individuals in this region are not well understood.METHODS: Newly diagnosed drug-susceptible TB cases reported to Brazil´s Information System for Notifiable Diseases (Sistema de Informação de Agravos de Notificação, SINAN) between January 2015 and December 2017 were included. Multivariate logistic regression was used to assess socio-economic and clinical factors associated with treatment success among incarcerated individuals.RESULTS: Incarcerated individuals (n = 17,776) had greater treatment success than non-incarcerated individuals (n = 160,728; 82.2% vs. 75.1%; P < 0.0001), including after adjusting for demographic and clinical risk factors (adjusted odds ratio aOR 1.27, 95% CI 1.19-1.34). These differences were partially mediated by increased use of directly observed therapy among incarcerated individuals (DOT) (61% vs. 47%; P < 0.001), which was associated with greater efficacy in the incarcerated population (aOR 2.56 vs. aOR 2.17; P < 0.001). DOT was associated with improved treatment success among incarcerated subpopulations at elevated risk of poor outcomes.CONCLUSION: TB treatment success among incarcerated individuals in Brazil is higher than non-incarcerated individuals, but both fall below WHO targets. Expanding the use of DOT and services for socially and medically vulnerable individuals may improve outcomes in carceral settings.

Assessment of the Methodology That Is Used to Determine the Nutritional Sustainability of the Mediterranean Diet-A Scoping Review

Mediterranean diet (MedDiet) is often used as an example of a sustainable diet that promotes a sustainable food system. MedDiet presents low environmental impacts, is characterized by high sociocultural food values, allows for positive local economic returns, and presents major health and nutrition benefits. Previous studies have not systematically examined the methodological assessment of MedDiet nutritional sustainability. In our study, we review the methodological assessment of nutritional sustainability, filling a crucial gap in the literature that can inform the state of the art regarding the cross-disciplinary assessment of MedDiet nutritional sustainability. Through a systematic search on PubMed and Scopus, we identified 28 studies, published between 2013 and 2021, that dealt with the MedDiet nutritional sustainability. Studies that assessed the sustainability of MedDiet based on dietary consumption data, studies that explored the MedDiet sustainability resorting to dietary scenarios, and studies with a mixed approach (dietary consumption and dietary scenarios) and proposals of methodological approaches to assess the MedDiet nutritional sustainability were summarized. We identified 24 studies exploring the dimensions of nutritional sustainability of the MedDiet, and 4 proposing the methodological approaches to assess the MedDiet nutritional sustainability or the sustainability of MedDiet typical agro-foods. From the 24 studies exploring the sustainability of MedDiet, none fully addressed the complexity of the four dimensions of nutritional sustainability (environmental, economic, socio-cultural, and health-nutrition). One of the methodological proposals to assess the MedDiet nutritional sustainability contemplated on the four dimensions of nutritional sustainability, as well as one of the methodological proposals to assess the sustainability of typical agro-foods of MedDiet. Environmental sustainability was the most well-studied dimension, while no study focuses on the socio-cultural dimension of sustainability. Our study reviewed for the first time the assessment of nutritional sustainability of MedDiet. To the best of our knowledge, no research has been made assessing MedDiet in all the dimensions of the complex concept, that is nutritional sustainability. Integrating health and nutrition, environmental, economic, and socio-cultural considerations across scales and contexts can offer a more complete understanding of the opportunities and barriers to achieving nutritional sustainability not only in MedDiet but also in other dietary patterns and food products.

Food Waste and Qualitative Evaluation of Menus in Public University Canteens-Challenges and Opportunities

BACKGROUND

This study aims to evaluate food waste and menu quality in two canteens (A and B) from a Portuguese public university in order to identify challenges and opportunities to improve the food service.

METHODS

Food waste included the analysis of two canteens over 5 consecutive days by selective aggregate weighing. A qualitative evaluation of a 5-week menu cycle related to lunches was performed through the Qualitative Evaluation of Menus (AQE-d) method.

RESULTS

Both menus have "satisfactory" evaluations and lower adequacy to the dietary guidelines in criteria A, which evaluates general items from the dish, and in criteria B, which evaluates meat, fish and eggs. The calculated mean of food waste in both canteens exceeded the acceptable limit of 10%, except for the vegetarian (7.5%) dish in canteen A. The biggest waste was found in the vegetarian dish (16.8%) in canteen A. In meat dishes the conduit presents more waste (17.0%) than in fish and vegetarian dishes. Among these, the vegetables were the most wasted (25.3% and 27.9%, respectively).

CONCLUSION

This work presents some insights to future interventions in the direction of a healthier and more sustainable foodservice.

Porous aligned ZnSr-doped β-TCP/silk fibroin scaffolds using ice-templating method for bone tissue engineering applications

The bone is a complex and dynamic structure subjected to constant stress and remodeling. Due to the worldwide incidence of bone disorders, tissue scaffolds and engineered bone tissues have emerged as solutions for bone grafting, which require sophisticated scaffolding architectures while keeping high mechanical performance. However, the conjugation of a bone-like scaffold architecture with efficient mechanical properties is still a critical challenge for biomedical applications. In this sense, the present study focused on the modulating the architecture of silk fibroin (SF) scaffolds crosslinked with horseradish peroxidase and mixed with zinc (Zn) and strontium (Sr)-doped β-tricalcium phosphate (ZnSr.TCP) to mimic bone structures. The ZnSr.TCP-SF hydrogels were tuned by programmable ice-templating parameters, and further freeze-dried, in order to obtain 3D scaffolds with controlled pore orientation. The results showed interconnected channels in the ZnSr.TCP-SF scaffolds that mimic the porous network of the native subchondral bone matrix. The architecture of the scaffolds was characterized by microCT, showing tunable pore size according to freezing temperatures (-196 °C: ∼80.2 ± 20.5 µm; -80 °C: ∼73.1 ± 20.5 µm; -20 °C: ∼104.7 ± 33.7 µm). The swelling ratio, weight loss, and rheological properties were also assessed, revealing efficient scaffold integrity and morphology after aqueous immersion. Thus, the ZnSr.TCP-SF scaffolds made of aligned porous structure were developed as affordable candidates for future applications in clinical osteoregeneration and in vitro bone tissue modelling.

Effects of bodyweight neuromuscular training with and without instability on balance control in active universitarians

The purpose of this study was to analyse the effects of a nine-week unstable vs stable bodyweight neuromuscular training programme on balance control. Seventy-seven physically active universitarians were randomly distributed into an unstable training group (UTG), a stable training group (STG), and a control group (CG). The intervention was conducted three times a week for nine weeks. Pre- and post-intervention assessments included static balance control under an unstable surface (eyes open (EOFS), eyes closed (ECFS), challenging visual-vestibular system (CVVS)), assessed as centre-of-pressure fluctuations with a force plate. A mixed ANOVA was performed to test the within- and between-subjects factors. After the intervention, no significant differences were found between groups. All groups presented significant improvements in balance measurements in EOFS (p = 0.01), ECFS (p = 0.01; p = 0.02), and CVVS (p = 0.01) conditions. The training groups tended to have significantly better balance control (antero-posterior) than the CG on EOFS. In the CVVS condition, the UTG tended to have better balance control than the CG. There was no overall significant training advantage gained by using unstable or stable surfaces in terms of the improvement in static balance control in active universitarians. Both training groups exhibited similar training adaptations.

Effect of Instability and Bodyweight Neuromuscular Training on Dynamic Balance Control in Active Young Adults

The aims of this study were to analyse the effects of unstable and stable bodyweight neuromuscular training on dynamic balance control and to analyse the between-group differences after the training period. Seventy-seven physically active young adults (48 males, 29 females, 19.1 ± 1.1 years, 170.2 ± 9.2 cm, 64.1 ± 10.7 kg) were distributed into an unstable training group (UTG), a stable training group (STG), and a control group (CG). Training was conducted three times a week for nine weeks. Pre-intervention and post-intervention measures included dynamic balance control using a Y Balance Test (YBT), anterior (A), posteromedial (PM), and posterolateral (PL) reach direction. A mixed ANOVA was executed to test the within-subjects factor and the between-subjects factor. Statistically significant differences were found for all YBT measures within groups (p = 0.01) and between groups (p = 0.01). After the intervention, UTG and STG presented meaningfully improved results in all YBT measures (A: 7%, p = 0.01; 4%, p = 0.02, PM: 8%, p = 0.01; 5%, p = 0.01, PL: 8%, p = 0.01; 4%, p = 0.04, respectively). No statistical changes were found for any of the measures in the CG. After the intervention, significant differences were observed between the UTG and CG for the YBTA and PM (p = 0.03; p = 0.01). The results suggest that neuromuscular training using an unstable surface had similar effects on dynamic balance control as training using a stable surface. When compared to CG, UTG showed better performance in YBTA and PM.

Sodium and Potassium Intake and Cardiovascular Disease in Older People: A Systematic Review

This review aims to examine the relationship of sodium and potassium intake and cardiovascular disease (CVD) among older people. Methods: We performed a literature search using PubMed and Web of Science (January 2015 to July 2020) without language restriction. Observational and experimental studies that reported the relationship between sodium, potassium, or sodium-to-potassium ratio with CVD among older adults aged higher than 60 years were included. The authors independently screened all identified studies, extracted information, and assessed the quality of included studies. Risk of bias was assessed using the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) for observational studies and the revised Cochrane risk-of-bias tool (RoB 2 tool) for randomized trials. Results: We included 12 studies (6 prospective cohort studies, 5 cross-sectional studies, and 1 experimental study). Five of the studies reported on sodium-to-potassium ratio (n = 5), and the others on potassium and/or sodium intake. Cardiovascular events (e.g., stroke and heart failure) were the most reported outcome (n = 9). Of the 12 studies included, five observational studies had low bias risk and the randomized controlled trial was judged as uncertain risk of bias. We found inconsistent results for the effect of the reduction of sodium intake in this population for lower risk of CVD. We found that both the increase of potassium intake and the decrease of sodium-to-potassium ratio were associated with lower risk of hypertension and CVD, particularly stroke. Conclusion: The present review suggests that both higher potassium and lower sodium-to-potassium ratio are associated with lower risk of CVD.

Knowledge and behaviors regarding salt intake according to urinary Na excretion and blood pressure

Background

Understanding salt-related knowledge, attitudes and behaviors can help the design of effective health interventions. Therefore, our objective was to describe knowledge and behaviors related to salt intake according to urinary sodium excretion and blood pressure in University workers.

Methods

We performed our study in a subsample of the participants of the iMC Salt project (n = 60 subjects, 60.5% women, mean age 48±9.5 years). Sodium excretion were measured by one 24-h urinary collection, validated by creatinine excretion and participants were grouped according to the WHO sodium recommendations (&lt;2.0 g/day; high, ≥2.0 g/day). Subjects were classified as hypertensive if the systolic blood pressure was ≥130 mmHg and/or diastolic blood pressure was ≥80mmHg. Knowledge and behaviors regarding salt intake were assessed by the WHO Stepwise Approach to Chronic Disease Risk Factor Surveillance.

Results

About 74.6% of the participants reported that reducing salt in their diet was very important and 93.2% think that salt is harmful to health. However, 76.3% always add salt during cooking, 42.4% said that they always or often consume processed foods high in salt, 79.7% reported that they don't look at the salt on food labels, 50.8% don't buy low salt alternatives and 30.5% don't use spices as one substitute for salt when cooking. Hypertensive subjects had a higher mean sodium excretion (3710±1508mg/day vs 2478±871mg/day, p = 0.002) and reported a significant higher frequency of consumption of processed foods high in salt (53.1% vs 29.6%, p = 0.024). No significant differences were found with the other variables.

Conclusions

Most university workers were aware that high salt intake can cause health problems, but they reported low adherence to behaviors to control their salt intake. Hypertensive subjects recognized that frequently consume processed foods high in salt, so reduce salt content on those products could have important impact on their daily salt consumption.

Key messages

This study provides evidence on knowledge and behaviors regarding salt intake to guide salt reduction policies. Hypertensive participants reported a higher frequency of eating processed foods rich in salt.

Universal neonatal hearing screening in a public hospital in Brazil: parents participation

Background

The National Policy for Hearing Health Care in Brazil proposes that all newborns in the country undergo hearing screening in the first month of life.The Universal Neonatal Hearing Screening Program being extremely important for the early intervention of deafness. However, many parents/guardians do not return to the auditory retest, interrupting the neonatal protocol and making early auditory diagnosis impossible. Objective:To analyze the reasons for the non-attendance to retest of the Hearing Screening of a hospital in Curitiba.

Methods

This study was carried out in a Public Hospital, with live births from August 2017-May 2018. All the born were considered for the variables gender, risk for hearing loss, age at birth, results of Hearing Screening. Failed babies were analyzed, including the active search of those who did not attend the retest, through contact with parents/guardians to collect the reasons for faults.

Results

2,531 infants were born, male had a prevalence of 1,275 (50.38%), term born 1,734(68.51%) and ICU stay as the most common risk indicator - 118(79.73%). 2,261(89.33%) infant passed on both ear; among those who failed only 94(40.0%) attended the retest. An active search was performed by phone, and 78(55.31%) could not establish contact, totaling 47(54.02%) mothers contacting. These motherś age was 19 to 24 years, 56.92% of whom had high school. The majority of those in charge are aware of the result of the test of the ear of their son (82.97%), was directed to test again (87.23%), were not able to answer the reason for not attending (27.65%) or had forgotten about this commitment (19.14%).

Conclusions

The data analyzed showed the lack of information that parents / guardians of the newborns give to the Hearing Screening, which compromises the integrality of health actions in newborns, making it necessary to seek other ways to ensure family adherence to the Program.

Key messages

Babies at risk of deafness need constant monitoring. Without parental participation, there is no success in health programs.

Hydration status and hypertension in University workers

Background

Vascular function and blood pressure regulation may be impaired by acute hypohydration but data on the association between hypertension and hydration status is scarce. The objectives of this study were to evaluate the hydration status in a sample of university workers and to assess the association between hypertension and hydration status.

Methods

A cross-sectional evaluation of a sample of 60 university workers (32 women) was conducted in 2019/2020 in Portugal. A 24-hour urine sample was collected; urinary volume, creatinine and osmolality were quantified. Free water reserve (FWR) was used to assess hydration status and subjects were classified as hypohydrated (FWR&lt;0) or euhydrated (FWR &gt; =0). Arterial blood pressure was evaluated [average of 2 blood pressure (BP) measurements] by researchers using standard methodology and participants with systolic and diastolic blood pressure ≥130 mm Hg and/or ≥80 mm Hg, respectively, were classified as hypertensive. A binary logistic regression model was used to estimate the association between hypohydration and hypertension, adjusting for sex, age and use of anti-hypertensive drugs. Odds Ratios (OR) and respective 95% Confidence Intervals (95%CI) were calculated.

Results

Hypertension was observed in 40.6% of women and 67.9% of men whereas hypohydration affected 31.3% of women and 32.1% of men. After adjusting for confounders, hypertension was associated with a 7-fold increased risk of hypohydration (OR = 7.56; 95% CI: 1.81-31.59).

Conclusions

These results stress the positive association between hypohydration and hypertension and highlight the need for implementing strategies for the promotion of water intake, particularly in the hypertensive patients.

This project was granted by Fundação para a Ciência e Tecnologia - Grant POCI-01-0145-FEDER-029269.

Key messages

Hypohydration affect nearly one third of this sample of university workers. Hypertension was associated with a 7-fold increased risk of hypohydration.

Innovative equipments to monitor and control salt usage during culinary

Issue

In Portugal, most of the salt consumed comes from the salt added during preparation/cooking. Therefore, it is urgent to introduce mechanisms to allow the quantification of the salt in foods, and the salt added during culinary.

Description of the Problem

To tackle salt reduction, we considered: having a portable and user-friendly instrument that measure salt content of foods; and controlling the amount of salt added to foods during culinary, assessing its impact on health. The first project was SALT QUANTI (co-funded by NORTE 2020), promoted by a consortium between EVOLEO Technologies and the University of Porto (finished in September 2018, duration 18 months); its major deliverable was to obtain a prototype of a portable device and the analytical procedure that enabled the analysis of salt content in foods/meals produced in catering kitchens, in less than 5 minutes. The second project was iMC SALT (supported by FCT, Grant POCI-01-0145-FEDER-029269), started in July 2018 (duration 36 months), aiming to develop prototypes for controlling the amount of salt added to foods during culinary, at home and catering, according international recommendations; one clinical intervention to assess the impact on health of the prototype at home is underway.

Results

The SALT QUANTI and iMC SALT prototypes showed good results in validation tests. The preliminary results of the health impact of the iMC SALT prototype will be presented at the conference.

Lessons

The implementation of innovative equipments to help consumers and catering industry to monitor or control the addition of salt during preparation of food or cooking are expected to be available soon and to be useful to consumers and catering industry to reduce salt intake.

Key messages

Innovative equipments may contribute to estimate salt in foods, and to reduce salt added during culinary. The implementation of an equipment to control culinary salt could be one valid approach to reduce salt consumption with impact on health.

Reporting of noise-induced hearing loss: perceptions of primary health care professionals

Background

Worldwide, workers' health is still a Public Health concern, given the high number of hazardous occupational activities, as well as workers affected by work-related diseases. Among these diseases, occupational Noise-Induced Hearing Loss-NIHL is considered the second commonest occupational disease, and in Brazil, its reporting is compulsory. However, occupational diseases are usually underreported, hindering the knowledge of their actual magnitude, and the elaboration of prevention-oriented public policies.

Objective

To analyze the perception and knowledge of Primary Health Care professionals in Curitiba-Parana State, Brazil, on the compulsory NIHL reporting.

Methods

quantitative and qualitative approach conducted in three steps: analysis of a series of NIHL case histories reported in the official database between 2007 and 2018; application of a questionnaire to Primary Health Care Network professionals; collective interview with Primary Health Care Network nurses, speech therapists and doctors.

Results

NIHL reporting evidenced 82 cases, 67 (81.7%) among males, age ranging 50-64 years, 10 (12.2%) had complete high school level, 27 (32.9%) were formally employed, and 12 (14.6%) worked in the processing industry. Regarding the result of the applied questionnaire among the Primary Health Care professionals, 48 (68.7%) stated that they were prepared to identify workers' health problems, to 33 (68.7%) professionals, guidance to reassure users' comprehensive care is more important than the compulsory reporting, 21 (43.7%) claimed that they were qualified to identify NIHL cases, and 25 (52.1%) did not report the cases. Difficulties in reporting NIHL cases are: not understanding their flow, being afraid of the legal implications, which may generate difficulties in requesting audiometric testing, not having the management support, etc.

Conclusions

Most health care professionals are knowledgeable on NIHL, but they do not report the suspected cases due to lack of guidance.

Key messages

Primary care health professionals does not consider occupational health as part of the service to be provided. Primary care services are not prepared to establish the relationship between the injury and the job.

Hepatitis C treatment outcome in former or current intravenous drug users coinfected with HIV, with or without directly observed therapy

BACKGROUND

Intravenous drug users (IDUs) with hepatitis C virus (HCV)/human immunodeficiency virus (HIV)-coinfection are recognised as a high-risk, vulnerable group.

METHODS

Between February 2015 and April 2018, a single-centre, non-interventional cohort study was conducted in an outpatient setting, to evaluate the sustained virologic response (SVR12) and assess treatment uptake models. The study included 385 former or recent IDUs divided into two groups: A-without use of opioid substitution treatment (OST) and B-patients taking opioid substitution; patients in group B received OST and self-administered therapy (B1) or OST and therapy under DOT (B2). Patients were characterised by demographic and clinical features and compared for treatment response. Correlations between SVR12 and independent variables were determined by logistic regression.

RESULTS

Patients were mostly males (88.3%) with a mean age of 46 ± 5 years and HCV genotype 1a (63.7%). Approximately 28% were treatment-experienced and 84.9% received sofosbuvir/ledipasvir. The mean CD4⁺T count was 649 cells/mm³, and most individuals were on antiretroviral therapy with undetectable viral loads (97.4%). SVR12 was achieved in 94.8%, and only eight patients relapsed. No significant differences were found in treatment effect between individuals taking opioid substitutes under different treatment models. Correlations were found between HCV viral response and both HIV suppression and albumin levels.

CONCLUSIONS

IDU with HCV/HIV coinfection, including individuals on self-administration of HCV therapy and opioid substitution treatments or in DOT programmes, are no longer considered a difficult-to-treat group, as they achieve high rates of SVR12.

Innovative equipment to monitor and control salt usage when cooking at home: iMC SALT research protocol for a randomised controlled trial

INTRODUCTION

Excessive salt intake is a public health concern due to its deleterious impact on health. Most of the salt consumed come from those that are added when cooking. This study will improve knowledge on the effectiveness of interventions to reduce salt consumption among consumers.

METHODS AND ANALYSIS

In this randomised clinical trial, we will be evaluating the efficacy of an intervention-the Salt Control H, an innovative prototype equipment to monitor and control use of salt when cooking-among workers from a public university, with the aim of reducing their dietary salt intake. We will randomly select 260 workers who meet the eligibility criteria and who are enrolled to an occupational health appointment and randomise them into one of the two arms of the study (either control or intervention), with matched baseline characteristics (sex and hypertension). The intervention will last for 8 weeks, during which the participants will use the equipment at home to monitor and control their use of salt when cooking. The main outcome will be 24-hour urinary sodium excretion at baseline, at fourth and eighth weeks of intervention, and at 6 months after intervention.

ETHICS AND DISSEMINATION

Ethical approval for the study has been obtained from the Ethics Committee of the Centro Hospitalar Universitário São João. The results of the investigation will be published in peer-reviewed scientific papers and presented at international conferences.

TRIAL REGISTRATION NUMBER

NCT03974477 EQUIPMENT PROVISIONAL PATENT NUMBER: Registered at INPI: 20191000033265.

A New Pathway for Mannitol Metabolism in Yeasts Suggests a Link to the Evolution of Alcoholic Fermentation

The yeasts belonging to the Wickerhamiella and Starmerella genera (W/S clade) share a distinctive evolutionary history marked by loss and subsequent reinstatement of alcoholic fermentation mediated by horizontal gene transfer events. Species in this clade also share unusual features of metabolism, namely the preference for fructose over glucose as carbon source, a rare trait known as fructophily. Here we show that fructose may be the preferred sugar in W/S-clade species because, unlike glucose, it can be converted directly to mannitol in a reaction with impact on redox balance. According to our results, mannitol is excreted to the growth medium in appreciable amounts along with other fermentation products such as glycerol and ethanol but unlike the latter metabolites mannitol production increases with temperature. We used comparative genomics to find genes involved in mannitol metabolism and established the mannitol biosynthesis pathway in W/S-clade species Starmerella bombicola using molecular genetics tools. Surprisingly, mannitol production seems to be so important that St. bombicola (and other W/S-clade species) deploys a novel pathway to mediate the conversion of glucose to fructose, thereby allowing cells to produce mannitol even when glucose is the sole carbon source. Using targeted mutations and ¹³C-labeled glucose followed by NMR analysis of end-products, we showed that the novel mannitol biosynthesis pathway involves fructose-6-phosphate as an intermediate, implying a key role for a yet unknown fructose-6-P phosphatase. We hypothesize that mannitol production contributed to mitigate the negative effects on redox balance of the ancient loss of alcoholic fermentation in the W/S clade. Presently, mannitol also seems to play a role in stress protection.

Regionalizing eco-toxicity characterization factors for copper soil emissions considering edaphic information for Northern Spain and Portuguese vineyards

The management of vineyards depends on the use of plant protection agents. Regardless of the numerous environmental impacts that these pesticides generate during their production, their dosage as pest control agents in vineyards causes an important toxic effect that must be monitored. Copper-based inorganic pesticides are the most widely used agents to control fungal diseases in humid wine-growing regions. It is, however, significant that the environmental analysis of their use through the Life Cycle Assessment (LCA) methodology does not provide detailed information on the potential toxicity of this type of pesticides. Hence, most studies report average values for copper characterization factors (CFs), excluding local soil characteristics. The objective of the study was the spatial characterization of the ecotoxicity factors of copper soil emissions as a function of the chemical characteristics of vineyard soils located in Portugal and Galicia (NW Spain). A multiple linear regression model was applied to calculate the comparative toxic potential. Subsequently, CFs for copper were calculated based on spatial differentiation considering the variable properties of the soil within each wine appellation. The CFs obtained for the area evaluated ranged from 141 to 5937 PAF·m³·day/kg_{Cu emitted}, for fibric histosols (HSf) and dystic cambisols (CMd), respectively. Moreover, the average values obtained for Galician and Portuguese soils were 1145 and 2274 PAF·m³·day/kg_{Cu emitted}, respectively. The results obtained illustrate the high variability of CF values as a function of the chemical characteristics of each type of soil. For example, Cu soil mobility was linked to organic carbon content and pH. Finally, to validate the representativeness of the calculated CFs, these were applied to the results of 12 literature life cycle inventories of grape production in the area evaluated, revealing that impact scores associated with Cu emissions can considerably vary when spatially-differentiated CFs are implemented.

Association of Dairy Product Consumption with Metabolic and Inflammatory Biomarkers in Adolescents: A Cross-Sectional Analysis from the LabMed Study

This study aimed to investigate the association between dairy product consumption and metabolic and inflammatory biomarkers in Portuguese adolescents, and whether the association differed by weight status. A cross-sectional study was conducted during the school year 2011/2012 with 412 Portuguese adolescents (52.4% girls) in 7th and 10th grade (aged 12 to 18 years old). The World Health Organization cutoffs were used to categorize adolescents as non-overweight (NW) or overweight (OW). Blood samples were collected to analyze C-reactive protein (CRP), interleukin-6 (IL-6), leptin, and adiponectin. Dairy product intake was evaluated using a food frequency questionnaire. Participants were divided by tertiles according to the amount of dairy product consumed. The associations between dairy product consumption with metabolic and inflammatory biomarkers were evaluated using generalized linear regression models with logarithmic link and gamma distribution and adjusted for potential confounders. The majority of adolescents were NW (67.2%). NW adolescents had lower IL-6, CRP, and leptin concentration than their counterparts (p < 0.05, for all comparisons). Higher levels of total dairy product and milk intake were inversely associated with IL-6 (P for trend <0.05, for all) in NW adolescents, but not in OW adolescents. NW adolescents in the second tertile of yogurt consumption had lower level of IL-6 compared to those in the first tertile (p = 0.004). Our results suggest an inverse association between total dairy product and milk intake and serum concentrations of IL-6 only among NW adolescents.

Microvascular Dysfunction in Dilated Cardiomyopathy: A Quantitative Stress Perfusion Cardiovascular Magnetic Resonance Study

OBJECTIVES

This study sought to quantify myocardial blood flow (MBF) and myocardial perfusion reserve (MPR) in dilated cardiomyopathy (DCM) and examine the relationship between myocardial perfusion and adverse left ventricular (LV) remodeling.

BACKGROUND

Although regarded as a nonischemic condition, DCM has been associated with microvascular dysfunction, which is postulated to play a role in its pathogenesis. However, the relationship of the resulting perfusion abnormalities to myocardial fibrosis and the degree of LV remodeling is unclear.

METHODS

A total of 65 patients and 35 healthy control subjects underwent adenosine (140 μg/kg/min) stress perfusion cardiovascular magnetic resonance with late gadolinium enhancement imaging. Stress and rest MBF and MPR were derived using a modified Fermi-constrained deconvolution algorithm.

RESULTS

Patients had significantly higher global rest MBF compared with control subjects (1.73 ± 0.42 ml/g/min vs. 1.14 ± 0.42 ml/g/min; p < 0.001). In contrast, global stress MBF was significantly lower versus control subjects (3.07 ± 1.02 ml/g/min vs. 3.53 ± 0.79 ml/g/min; p = 0.02), resulting in impaired MPR in the DCM group (1.83 ± 0.58 vs. 3.50 ± 1.45; p < 0.001). Global stress MBF (2.70 ± 0.89 ml/g/min vs. 3.44 ± 1.03 ml/g/min; p = 0.017) and global MPR (1.67 ± 0.61 vs. 1.99 ± 0.50; p = 0.047) were significantly reduced in patients with DCM with LV ejection fraction ≤35% compared with those with LV ejection fraction >35%. Segments with fibrosis had lower rest MBF (mean difference: -0.12 ml/g/min; 95% confidence interval: -0.23 to -0.01 ml/g/min; p = 0.035) and lower stress MBF (mean difference: -0.15 ml/g/min; 95% confidence interval: -0.28 to -0.03 ml/g/min; p = 0.013).

CONCLUSIONS

Patients with DCM exhibit microvascular dysfunction, the severity of which is associated with the degree of LV impairment. However, rest MBF is elevated rather than reduced in DCM. If microvascular dysfunction contributes to the pathogenesis of DCM, then the underlying mechanism is more likely to involve stress-induced repetitive stunning rather than chronic myocardial hypoperfusion.

Weaning practices in phenylketonuria vary between health professionals in Europe

Background

In phenylketonuria (PKU), weaning is considered more challenging when compared to feeding healthy infants. The primary aim of weaning is to gradually replace natural protein from breast milk or standard infant formula with solids containing equivalent phenylalanine (Phe). In addition, a Phe-free second stage L-amino acid supplement is usually recommended from around 6 months to replace Phe-free infant formula. Our aim was to assess different weaning approaches used by health professionals across Europe.

Methods

A cross sectional questionnaire (survey monkey®) composed of 31 multiple and single choice questions was sent to European colleagues caring for inherited metabolic disorders (IMD). Centres were grouped into geographical regions for analysis.

Results

Weaning started at 17–26 weeks in 85% (n = 81/95) of centres, >26 weeks in 12% (n = 11/95) and < 17 weeks in 3% (n = 3/95). Infant's showing an interest in solid foods, and their age, were important determinant factors influencing weaning commencement. 51% (n = 48/95) of centres introduced Phe containing foods at 17–26 weeks and 48% (n = 46/95) at >26 weeks. First solids were mainly low Phe vegetables (59%, n = 56/95) and fruit (34%, n = 32/95).

A Phe exchange system to allocate dietary Phe was used by 52% (n = 49/95) of centres predominantly from Northern and Southern Europe and 48% (n = 46/95) calculated most Phe containing food sources (all centres in Eastern Europe and the majority from Germany and Austria). Some centres used a combination of both methods.

A second stage Phe-free L-amino acid supplement containing a higher protein equivalent was introduced by 41% (n = 39/95) of centres at infant age 26–36 weeks (mainly from Germany, Austria, Northern and Eastern Europe) and 37% (n = 35/95) at infant age > 1y mainly from Southern Europe. 53% (n = 50/95) of centres recommended a second stage Phe-free L-amino acid supplement in a spoonable or semi-solid form.

Conclusions

Weaning strategies vary throughout European PKU centres. There is evidence to suggest that different infant weaning strategies may influence longer term adherence to the PKU diet or acceptance of Phe-free L-amino acid supplements; rendering prospective long-term studies important. It is essential to identify an effective weaning strategy that reduces caregiver burden but is associated with acceptable dietary adherence and optimal infant feeding development.

Portugal nutritional transition during the last 4 decades: 1974-2011

Objective:

To examine trends in food availability for Portugal during the last 4 decades (1974–2011) and analyze such changes in accordance with the nutritional transition theory.

Methods:

Food balance sheets from Portugal from 1974 to 2011 were analyzed for potential trends by linear regression to study the availability of protein, fat, carbohydrate, ethanol, and total energy and the availability of the following food groups: (i) cereals and tubers; (ii) vegetables; (iii) fruit; (iv) milk; (v) meat, fish, and eggs; (vi) fat; (vii) pulses; (viii) alcoholic beverages; and (ix) sugar and sweeteners. A comparison regarding protein, fat, and carbohydrate availability and WHO recommendation was also performed.

Results:

The data suggest that in Portugal food availability and consumption have changed throughout the analyzed period. The national availability of most food groups increased considerably, which also resulted in an increase in daily energy. The consumption of cereals and tubers, pulses, and alcohol diminished during this time. Energy availability increased by 406 kcal/person/day, a result from an increase in protein and fat. Protein availability was in accordance with WHO recommendations during the 4 decades analyzed, whereas carbohydrate have always been below the recommended level and fat has been above the recommended level since the second decade (1984).

Conclusion:

Portugal has crossed into a nutritional transition over the last 4 decades, revealing characteristics of a pattern of degenerative diseases. The country may experience a new nutritional transition that would involve positive changes of behavior, as observed in other developed countries, driven by community multisectorial strategies.