Inorganic Polyphosphate Affects Biofilm Assembly, Capsule Formation, and Virulence of Hypervirulent ST23 Klebsiella pneumoniae

The emergence of hypervirulent Klebsiella pneumoniae (hvKP) strains poses a significant threat to public health due to high mortality rates and propensity to cause severe community-acquired infections in healthy individuals. The ability to form biofilms and produce a protective capsule contributes to its enhanced virulence and is a significant challenge to effective antibiotic treatment. Polyphosphate kinase 1 (PPK1) is an enzyme responsible for inorganic polyphosphate synthesis and plays a vital role in regulating various physiological processes in bacteria. In this study, we investigated the impact of polyP metabolism on the biofilm and capsule formation and virulence traits in hvKP using Dictyostelium discoideum amoeba as a model host. We found that the PPK1 null mutant was impaired in biofilm and capsule formation and showed attenuated virulence in D. discoideum compared to the wild-type strain. We performed a proteomic analysis to gain further insights into the underlying molecular mechanism. The results revealed that the PPK1 mutant had a differential expression of proteins involved in capsule synthesis (Wzi-Ugd), biofilm formation (MrkC-D-H), synthesis of the colibactin genotoxin precursor (ClbB), as well as proteins associated with the synthesis and modification of lipid A (ArnB-LpxC-PagP). These proteomic findings corroborate the phenotypic observations and indicate that the PPK1 mutation is associated with impaired biofilm and capsule formation and attenuated virulence in hvKP. Overall, our study highlights the importance of polyP synthesis in regulating extracellular biomolecules and virulence in K. pneumoniae and provides insights into potential therapeutic targets for treating K. pneumoniae infections.

Mir324 knockout regulates the structure of dendritic spines and impairs hippocampal long-term potentiation

MicroRNAs are an emerging class of synaptic regulators. These small noncoding RNAs post-transcriptionally regulate gene expression, thereby altering neuronal pathways and shaping cell-to-cell communication. Their ability to rapidly alter gene expression and target multiple pathways makes them interesting candidates in the study of synaptic plasticity. Here, we demonstrate that the proconvulsive microRNA miR-324-5p regulates excitatory synapse structure and function in the hippocampus of mice. Both Mir324 knockout (KO) and miR-324-5p antagomir treatment significantly reduce dendritic spine density in the hippocampal CA1 subregion, and Mir324 KO, but not miR-324-5p antagomir treatment, shift dendritic spine morphology, reducing the proportion of thin, "unstable" spines. Western blot and quantitative Real-Time PCR revealed changes in protein and mRNA levels for potassium channels, cytoskeletal components, and synaptic markers, including MAP2 and Kv4.2, which are important for long-term potentiation (LTP). In line with these findings, slice electrophysiology revealed that LTP is severely impaired in Mir324 KO mice, while neurotransmitter release probability remains unchanged. Overall, this study demonstrates that miR-324-5p regulates dendritic spine density, morphology, and plasticity in the hippocampus, potentially via multiple cytoskeletal and synaptic modulators.

Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3)

BACKGROUND

Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology.

METHODS

We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator.

RESULTS

The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults.

CONCLUSIONS

To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.

Breaking Down Barriers: Easter Island's First Telestroke Thrombolysis Experience and Case Report

Easter Island (Rapa Nui), Chile, is remote, located in the Polynesian Triangle in Oceania. The closest continental point is Chile, 3,512 km east. It has a population of 7,750 inhabitants, who are Chilean citizens, and receives more than 60,000 tourists a year. For this entire population, there is a medium complexity hospital without a neurology specialist. In 2019, local professionals were trained in a Telestroke program with remote clinical support conducted by neurologists located on mainland Chile. We present a 50-year-old native male, with unknown medical history, who suddenly presented right-half-body weakness and aphasia. He was evaluated via Telestroke consultation, and thrombolysis with tenecteplase was indicated. The patient improved rapidly and 45 min later the NIHSS score was 0 points. To our knowledge, this is the first reported case of Telestroke treatment in such a remote area, highlighting the importance of telemedicine to overcome geographical and technological stroke care barriers and to improve patients' outcome, no matter where they live.

Review of Control Techniques in Microinverters

The use of renewable energies sources is taking great importance due to the high demand for electricity and the decrease in the use of fossil fuels worldwide. In this context, electricity generation through photovoltaic panels is gaining a lot of interest due to the reduction in installation costs and the rapid advance of the development of new technologies. To minimize or reduce the negative impact of partial shading or mismatches of photovoltaic panels, many researchers have proposed four configurations that depend on the power ranges and the application. The microinverter is a promising solution in photovoltaic systems, due to its high efficiency of Maximum Power Point Tracking and high flexibility. However, there are several challenges to improve microinverter’s reliability and conversion efficiency that depend on the proper control design and the power converter design. This paper presents a review of different control strategies in microinverters for different applications. The control strategies are described and compared based on stability, dynamic response, topologies, and control objectives. One of the most important results showed that there is little research regarding the stability and robustness analysis of the reviewed control strategies.

In vitro preconditioning of equine adipose mesenchymal stem cells with prostaglandin E2, substance P and their combination changes the cellular protein secretomics and improves their immunomodulatory competence without compromising stemness

Mesenchymal stem cells (MSC) are modern tools in regenerative therapies of humans and animals owed to their immunomodulatory properties, which are activated in a pro-inflammatory environment. Different preconditioning strategies had been devised to enhance the immunomodulatory properties of MSC. In this research, we evaluated the immunological attributes of equine adipose MSC (eAMSC) before and after preconditioning in vitro with prostaglandin E₂ (PGE₂), substance P (SP), their combination and IFNγ. PGE₂/SP was the best combination to keep or enhance the mesodermal lineage differentiation of eAMSC. Alongside with this, preconditioning of eMSC with PGE₂ and SP did not affect expression of stemness MSC surface phenotype: CD90⁺, CD44⁺, MHC class I⁺, MHC class II^- and CD45^-, assessed by cytometry. Both naïve and preconditioned eAMSC expressed genes related with immune properties, such as MHC-I, PTGES, IL6, IL1A, TNFα and IL8 assessed by qPCR. Only TNFα was under expressed in treated cells, while the other markers were either overexpressed or not changed. In no cases MHC-II expression was detected. The antiproliferative effect of preconditioned eAMSC exposed to activated peripheral blood mononuclear cells (PBMC) showed that SP treatment significantly inhibited proliferation of LPS stimulated PBMC. When eAMSC were stimulated with Poly I:C, all the treatments significantly inhibited proliferation of stimulated PBMC (p < 0.05). Direct contact (coculture) between the preconditioned eAMSC and PBMC, induced a shift of significantly more (CD4/CD25/FOXP3)⁺ T-regulatory PBMC than naïve eAMSC. In the experiments of this research, we investigated the secreted proteomic profile of naïve and preconditioned eAMSC, 42 up-regulated and 40 down-regulated proteins were found in the proteomic assay. Our proteomic data revealed profound changes in the secretory pattern of MSC exposed to different treatments, compared to naïve eAMSC as well as among treatments. In overall, compared to naïve cells, the protein profile of preconditioned cells resembled the mesenchymal-epithelial transition (MET). Here we showed that the combined use of PGE₂ and SP provoked in overall the highest expression of anti-inflammatory markers as well as lead to an increased acquisition of a T-regulatory phenotype in preconditioned eAMSC without affecting their "stemness".

Novel benzoate-lipophilic cations selectively induce cell death in human colorectal cancer cell lines

INTRODUCTION

Colorectal cancer (CRC) is a critical health issue worldwide. The high rate of liver and lung metastasis associated with CRC creates a significant barrier to effective and efficient therapy. Tumour cells, including CRC cells, have metabolic alterations, such as high levels of glycolytic activity, increased cell proliferation and invasiveness, and chemo- and radio-resistance. However, the abnormally elevated mitochondrial transmembrane potential of these cells also provides an opportunity to develop drugs that selectively target the mitochondrial functions of tumour cells.

METHODS

In this work, we used a new batch of benzoic acid esters with cytotoxic activities attached to the triphenylphosphonium group as a vehicle to target tumour mitochondria and improve their activity. We evaluated the cytotoxicity, selectivity, and mechanism of action of these derivatives, including the effects on energy stress-induced apoptosis and metabolic behaviour in the human CRC cell lines HCT-15 and COLO-205.

RESULTS

The benzoic acid derivatives selectively targeted the tumour cells with high potency and efficacy. The derivatives induced the uncoupling of the oxidative phosphorylation system, decreased the transmembrane potential, and reduced ATP levels while increasing AMPK activation, thereby triggering tumour cell apoptosis in both tumour cell lines tested.

CONCLUSION

The benzoic acid derivatives studied here are promising candidates for assessing in vivo models of CRC, despite the diverse metabolic characteristics of these tumour cells.

52 Blocking of embryonic development by nanoparticles derived from endometrial and oviductal cells isolated with an Amicon filter system

The success of development of invitro embryo production needs to mimic culture conditions in the maternal environment. Recently, it has been seen that extracellular vesicles (EVs) secreted by oviducal or endometrial cells may improve development and quality of embryos produced invitro. Extracellular vesicles are a mechanism of cellular communication; they carry molecules that are delivered into the target cells changing gene expression and function. Due to the size range and characteristics of EVs, they require specific methods for purification and characterisation. However, the possible contamination with other nanoparticles and their effect on embryo development have not been considered. Based on that, the goal of this work was to evaluate the effect on invitro bovine embryo development, of the addition to culture medium EVs secreted by oviducal and endometrial cells and isolated by centrifugation and concentrates with Amicon filters. For this purpose, cells were isolated from bovine oviduct and endometrium collected in local abattoir and primary cultures of epithelial and stromal cells were derived. The primary cultures from both sources were exposed or not to progesterone (P4; 15ngmL−1) for 4 days and then cultured for 24h in EV depleted media. The supernatant was harvested and EVs were isolated by serial centrifugations and subsequently concentrated by a 100 kDa Amicon filter system. The isolated EVs were characterised by transmission electron microscopy, nanoparticle tracking analysis, and flow cytometry. Oocytes were obtained from ovaries collected in the abattoir. The cumulus-oocyte complexes were matured invitro for 22h and subsequently fertilised for 18h. Presumptive zygotes were invitro cultured in synthetic oviducal fluid with EVs (1000ngmL−1 of total proteins) or not according to experimental group (1: EVs− (control); 2: EVs−OP4+; 3: EVs−OP4−; 4: EVs−EP4+ and 4: EVs−EP4−). Embryos were cultured for 7 days in 5% CO2, 5% O2, and 90% N2 (25 embryos/well in 4-well plates). At Day 7, embryo development was evaluated considering the blastocyst yield. Transmission electron microscopy showed typical structures and morphology of EVs and they were positive for CD9, CD63, and CD81 markers, and negative for CD40. According to nanoparticle tracking analysis, the mean size of EVs was 160±62nm and concentration of 3.29×1011 particlesmL−1 for oviducal and endometrial cells, respectively. A significant reduction of blastocyst rate was observed when embryos were cultured with cell-derived EVs; control: 152/44 (28.9%) vs. treatments with EVs; OP4+: 74/3 (4.1%), OP4−:76/2 (2.6%), EP4+: 74/6 (8.1%), and EP4−: 73/2 (2.7%) (P ≤ 0.01). Our results indicate that the use of nanoparticles, including EVs, isolated from cells of oviduct or endometrium, has a blocking effect on embryonic development and compromises the performance of blastocysts on Day 7 when used at concentrations of 1000ngmL−1 total protein, independent of the use or not of P4 and the source. These data provide insights regarding the use and protocols of acquiring exosomes for embryo supplementation. This research was supported by FONDECYT, Chile-1170310.

207 Editing of prostaglandin E2 gene receptors EP2 and EP4 by CRISPR/Cas9 technology in equine adipose mesenchymal stem cells

Prostaglandin E2 (PGE2) is an important mediator of cellular responses, playing a key role in limiting inflammation. PGE2 acts distinctly through one of four EP receptors. In MSCs, it PGE2 stimulation of EP2 and EP4 receptors triggers processes such as migration, self-renewal, survival, and proliferation, and their activation is involved in homing. PGE2 has been proposed as a key factor of MSC immunomodulation. The CRISPR-Cas9 system has been adapted successfully to edit the genome of animals. Loss of EP2 and EP4 receptors in equine adipose mesenchymal stem cells (eAT-MSC) could help us understand their role in cell migration, homing, and self-renewal capacities. Here, we aimed to edit these receptors in eAT-MSC to test their function. The eAT-MSC were obtained from three Chilean breed horses and cultured in Dulbecco's modified Eagle's medium-high glucose with 10% fetal bovine serum. Guide RNAs (sgRNA) for CRISPR-Cas 9 editing were designed based on EP2 and EP4 DNA sequences. The sgRNA and PAM sequence targeting exon 1 of the equine genes (EP2-sgRNA: TGGTGCTGGCTTCGTACGCG; PAM:CGG and EP4-sgRNA: GGAGACGACCTTCTACACGT;PAM:TGG) were cloned into linearized LentiCRISPRv2GFP vector (#82416; Addgene). The lentiviral vector plus helping packaging plasmids was co-transfected into HEK293FT cells. The produced viral particles were harvested and transduced into eAT-MSC. After 48h, cells were sorted and green fluorescent protein (GFP)-positive cells were expanded to obtain individual clones. Genomic DNA was extracted for PCR amplification, and the frequency of site directed-mutation was assessed by T7 endonuclease assay. Because of the high background (e.g. excessive banding) produced by the T7E1 assay, the PCR products were cloned into a pUC57 vector, and sequenced. Quantitative PCR and immunocytochemistry staining examined expression of EP2 and EP4. The statistical analyses were performed using GraphPad Prism 6 (GraphPad Inc.) with unpaired t-test; P-values&lt;0.05 were considered statistically significant. Transduction efficiency of eAT-MSC/EP2ko and eAT-MSC/EP4ko was 31 and 38%, respectively. A total of 15 clones for each lineage obtained from a single cell culture were subjected to T7EI assay to identify the frequency of mutation. Eight eAT-MSC/EP2ko and 7 eAT-MSC/EP4ko clones showed mutations; DNA sequencing confirmed mutations in 3 eAT-MSC/EP2ko clones and 3 eAT-MSC/EP4ko clones. Immunostaining with specific anti-EP2 and anti-EP4 antibodies showed diminished expression of the particular receptors in the knockout cells. Decreased expression was quantitatively confirmed by quantitative PCR analysis, showing downregulation of PTGER2 (4.3-fold) and PTGER4 (2.7-fold) in the edited clones compared with eAT-MSC naïve cells (P&lt;0.05). This CRISPR/Cas9 design allows the possibility of using these mutant cell lines as a model system to elucidate the role of EP2 and EP4 in cell migration, homing, and self-renewal. Research was supported by FONDECYT 3170390 to ACFM, Ministry of Education, Chile.

208 Effect of growth factors and reprogramming molecules on induction to multipotency of dermal fibroblasts from colocolo (Leopardus colocolo)

Reprogramming of terminally differentiated cells to higher plasticity levels can be achieved with small molecules. This can be of value for somatic cell nucleus transfer, deriving multi and pluripotent cells and conservation purposes. Recently, induced mesenchymal stem cells were derived from differentiated human and mouse cells by using small molecules and growth factors. The pampas cat or colocolo (Leopardus colocolo) is a South American felid categorrized as near threatened by the International Union for Conservation of Nature (IUCN) Red List of Threatened Species. Major historical threats to the pampas cat include illegal hunting, habitat loss or transformation, and conflict retaliation for poultry predation. Here, we tested 5-azacytidine (an epigenetic modifier) and A8301 (a potent inhibitor of transforming growth factor-β type I receptor superfamily), linked to platelet-rich plasma (PRP) and platelet-derived growth factor (PDGF-B) to induce changes in the expression of pluripotency genes and differentiation capacity of colocolo fibroblasts towards other mesodermal lineages. For this, dermal fibroblasts were treated with (I) 5-azacytidine + PRP + A8301 + VitC, or (II) 5- azacytidine + VitC + A8301 + PDFG for 12 days. On Days 0, 5, and 12 of reprogramming, expression of OCT4, NANOG, E-cadherin and SNAIL was evaluated by reverse transcription-PCR, and tri-lineage differentiation was induced. For treatment I, no statistical difference was found in the expression of OCT4 and NANOG. Chondrogenic and osteogenic differentiation was observed. In treatment II, significant expression of OCT4 and NANOG (P&lt;0.05) was induced, and reprogrammed fibroblasts were differentiated into chondrogenic and osteogenic lineages. Immunohistochemistry positivity for OCT4 was detected in treatment II. In summary, we showed that dermal fibroblasts of pampas cat can be reprogrammed into cells with multipotent characteristics, particularly when a cocktail of 5-azacytidine + VitC + A8301 + PDFG was used. Treatment I probably failed because of other growth factors and proteins present in PRP, which might inhibit successful reprogramming or activate other pathways leading to a nonmultipotent phenotype. Further refinements of these protocols are required to improve the reprogramming protocol. This in turn should help us obtain cells that can be used in nucleus transfer or cellular therapies in endangered felid species.

210 Horse allogeneic mesenchymal stem cells perform homing and ameliorate endometrial inflammation after induced endometritis of mares

Post-mating induced endometritis (PMIE) is an acute inflammatory response of the endometrium to spermatozoa, linked to an incapability of some mares to drain out the fluids associated with inflammation. This is of pivotal importance for reproductive success in mares. Mesenchymal stem cells (MSCs) are potential candidates for anti-inflammatory uterine therapies. Here, we aimed to study inflammatory markers in the endometrium of healthy mares and of those with induced endometritis, before and after intrauterine inoculation of MSCs, and to characterise their homing potential invivo in an induced endometritis horse model. Nine mares during their ovulatory season were selected after gynaecologic examination (absence of free liquid in the uterus, no polymorphonuclear leucocytes (PMNs) at cytology, negative bacteriology, and grade I in Kenney's scale on uterine biopsies). Mares were infused in the uterine body with 2mL of 500×106 spermmL−1 previously killed by repeated frozen-thawing cycles. At 3h, uteri were flushed with 250mL of sterile saline and the inflammatory response was monitored in the lavages and biopsies. Parameters measured included cytology, protein expression of inflammatory markers (supernatant) after lavage centrifugation (800×g, 10min), ELISA, and immunostaining for interleukin (IL)-6 and tumor necrosis factor alpha (TNFα). The mares were divided into three groups (3 mares each). Then, 24h after dead sperm challenge, group 1 received intrauterine infusion of 2×107 adipose MSC in 0.9% sterile saline; group 2, received the same amount of endometrial MSCs in the same vehicle; and group 3 received only saline. The volume of infusion in the uterine body was 20mL for all groups. Cells (passage 4) were previously labelled with 10μM Vybrant CFDA SE Cell Tracer Kit (ThermoFisher Scientific). After 48h, the same lavages, biopsies, and measurements as described above were performed. Additional biopsies were taken at Days 10 and 30 after intrauterine infusions. Biopsies were split in two, one for confocal microscopy and the other for quantitative PCR. Endometritis was induced in all mares, as judged by cytology and expression of protein markers of inflammation. After 48h, reduction in IL-6 and TNFα was detected by immunostaining of biopsies and confirmed by ELISA in the lavages, as well as by PCR. Homing was detected in all mares infused with MSC and it persisted at Days 10 and 30 after infusion. No homing was found in the control mares. As a result of these experiments, we conclude that inoculation of MSCs significantly reduced inflammation independently of the origin of the cells (adipose or endometrial). Both types of cells were nested in the endometrium at low quantities, although the number of cells actually detected at fixed time points was not quantified. Overall, we can propose that, given the number of homed cells detected and the marked decrease in inflammatory markers after inoculation of cells, MSCs exert their anti-inflammatory function preferentially by a paracrine mechanism and not necessarily by nesting and proliferation, although both events occur. Funding for this study was provided by Fondecyt 1150757.

[Telestroke in Chile: 1 year experience at 7 hospitals]

BACKGROUND

Acute ischemic stroke (AIS) is one of the leading causes of death in Chile. Intravenous thrombolysis (IVT) is an effective treatment. Geographical barriers and lack of specialists limit its application. Telemedicine can overcome some of these pitfalls.

AIM

To describe the implementation and results of AIS treatment by telemedicine at the TeleStroke Unit (TeleACV) of the Southern Metropolitan Health Service, connected with seven hospitals in Chile.

MATERIAL AND METHODS

Descriptive analysis of a prospective tele-thrombolysis data-base that covers from 2016 to 2018, with an emphasis in the last year.

RESULTS

During the analyzed period, seven remote telemedicine centers were activated as far as 830 kilometers on a continental level from the reference center and up to 3,700 kilometers on an island level. There were 1,024 telemedicine consultations, 144 (14%) of them resulted in an IVT treatment. During 2018, 597 tele-consultations were made, thrombolysis was done in 115 (19%) patients aged 66+-13 years; 54 (46.6%) being female. The median admission National Institute of Health Stroke Scale was 8 (interquartile range (IQR) 5-14). The median door-to-needle time was 56.5 (IQR 44.8-73.3) minutes; 60% of patients were treated within 60 minutes. Eight patients (7%) were referred for a subsequent mechanical thrombectomy to a center of greater complexity. Symptomatic intra-cranial hemorrhages occurred in four treated patients (4%). One patient had a systemic bleeding.

CONCLUSIONS

The Telestroke Unit achieved a high rate of IVT and good door-to-needle times. This may help to overcome some of the geographic barriers and the specialist availability gap in our country.

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.

Transitando hacia el ejercicio de autonomía y liderazgo: … «para el posicionamiento hay que luchar»

Introducción: En Chile, las enfermeras/os tienen respaldo legal para gestionar el cuidado, esto facilita el desarrollo de competencias para ejercer autonomía y liderazgo. Actualmente persisten barreras para transitar hacia un reconocimiento real de la independencia profesional. Objetivo: Develar la experiencia vivida de enfermeras con cargos en niveles de jefatura respecto al propio desarrollo para lograr el liderazgo y autonomía profesional. Metodología: Estudio cualitativo descriptivo-interpretativo, desde la trayectoria fenomenológica de Edmund Husserl. Muestreo selectivo de caso homogéneo de tres enfermeras que desempeñaban rol de jefatura en instituciones de salud, región Valparaíso, Chile. Participación consentida. Entrevista no estructurada. Análisis del discurso utilizando el modelo de liderazgo integral de Ken Wilber. Resultados: Categorías: Conciencia del líder «ser inquieta...intelectualmente». Construyendo competencias «el liderazgo se aprende». Transitando hacia el ejercicio de la autonomía y el liderazgo, “para el posicionamiento hay que luchar”. El peso de las estructuras organizacionales «tu rol es parte de un hospital». Interpretación: El eEjercicio del liderazgo y la autonomía se fundamenta en competencias actitudinales por sobre las cognitivas y técnicas. Existe mayor apoyo y reconocimiento a nivel institucional, que al interior del equipo de salud. Persisten limitaciones para lograr máxima expresión del liderazgo y autonomía, por persistencia de modelos institucionales hegemónicos, centrados en decisiones médicas y desconocimiento del rol integrado. Conclusión: El líder se mueve en un escenario dual, entre un menor reconocimiento del equipo y un creciente empoderamiento del rol autónomo y visibilidad a nivel directivo institucional.

Synthesis of Copper Nanowires and Their Antimicrobial Activity on Strains Isolated Persistent Endodontic Infections

Copper nanowires, Cu-NWs may have a good antimicrobial effect in endodontic treatment. The objective of this work was to synthesize, characterize and evaluate the antibacterial activity of Cu-NWs on strains obtained from human root canal. A wide distribution of Cu-NWs diameters from 30 to 90 nm was obtained with lengths ranging from 5 to 40 μm. Structural analysis of Cu-NWs showed crystalline planes, which corresponded to Cu, with preferential growth in the direction [110]. The geometric mean MICs was of 289.30 μg/mL, with a MIC50 of 256 μg/mL and a MIC90 of 512 μg/mL for Cu-NWs. Cellular viability of 28 a biofilm tends to decrease the longer it is exposed to Cu-NWs. Synthesized and characterized Cu-NWs have a good antimicrobial effect against clinical strains used in the present study and has a potential to be used for disinfection of the root canal system.

What makes the difference in people's lives when they have a mental disorder?

OBJECTIVES

The objective of this study was to identify which environmental factors are the most responsible for the disability experienced by persons with mental disorders and whether they differ (1) from those in cardiovascular diseases, chronic respiratory conditions, diabetes, and cancer, and (2) depending on the capacity level-a proxy for the impact of health conditions on the health state of individuals.

METHODS

Nationally representative data from 12,265 adults in Chile collected in 2015 with the WHO Model Disability Survey was analyzed.

RESULTS

The availability of personal assistance, frequency of receiving personal assistance, and assistive devices for mobility were the most important environmental factors across mental and other non-communicable diseases. Perception of discrimination and use of health services were also prominent factors. There was a huge overlap between the factors found relevant for mental and other non-communicable diseases, but a substantial variability depending on the intensity of difficulties in capacity.

CONCLUSIONS

This study challenges the appropriateness of disease-specific approaches and suggests that considering intrinsic capacity levels is more informative than focusing on diagnosis alone when comparing needs and barriers that affect the performance in daily life of specific groups of individuals.

Viability of Basidiomycete fungal strains under different conservation methods: Crypreservation vs. freeze-drying processes

Four basidiomycete fungi; Agaricus blazei Murrill (Agaricomycetideae), Ganoderma lucidum (W.Curt.: Fr.) P. Karst., Grifola frondosa (Dicks.: Fr.) S.F. Gray (Higher Basidiomycetes), and Pleurotus pulmonarius (Fr.) Quél. (Agaricomycetideae) were evaluated using three conservation methods for 12 months, recording their viability in order to establish the best conservation method. Growth kinetics, biomass, and polysaccharide production were studied. The conservation methods implemented included: distilled wáter at 24 ºC; sawdust and rice bran with 10% glicerol at -20 ºC, sawdustand rice bran with 10% glicerol at -80 ºC; and freeze-drying of biomass with trehalose or simmed milk. After conducting the analysis of the results after 12 months of conservation, we determined that the distilled water treatment at 24 ºC was the best conservation method with the highest percentage of recoverability, at 83.3% during the 12 month, followed by the cryoconservation treatment at 80º C, where 75% were recovered with no negative effects on biomass and polysaccharide production. The -20 ºC and freeze-drying treatments were not effective; with cryoconservation at -20 ºC treatment, strain recovery only occurred during the first month and with freeze-drying it was not possible to recover any strains during the entire 12-month period evaluated.

Equine mesenchymal stem cells derived from endometrial or adipose tissue share significant biological properties, but have distinctive pattern of surface markers and migration

Adult stromal mesenchymal stem cells (MSCs) have been postulated as responsible for cell renewal in highly and continuously regenerative tissues such as the endometrium. MSCs have been identified in the endometrium of many species including humans, rodents, pets and some farm animals, but not in horses. The objective of this work was to isolate such cells from the endometrium of mares and to compare their main biological attributes with horse adipose-derived MSCs. Here we successfully isolated and characterized endometrial MSCs (eMSCs) from mares. Said cells showed fibroblast-like morphology, grew on plastic, had doubling population times of 46.4 ± 3.38 h, underwent tri-lineage (osteo, chondro and adipogenic) differentiation after appropriate inductions, migrated toward the attraction of fetal calf serum and displayed a pattern of surface markers commonly accepted for horse MSCs. All these are properties of MSCs. Some of these attributes were shared with equine adipose-derived MSCs, but the migration pattern of eMSC at 12 and 24 h after stimulation was reduced in comparison with adipose MSCs. Also, expression of CD44, CD90 and MHCI surface markers were dramatically down-regulated in eMSCs. In conclusion, equine-derived endometrial MSC share biological attributes with adipose MSC of this species, but displayed a different surface marker phenotype and an impaired migration ability. Conceivably, this phenotype is distinctive for MSC of this origin.

Determinants of Work Performance in Workers with Depression and Anxiety: A Cross-Sectional Study

Depression and anxiety are highly prevalent disorders with an impact on existential aspects of person’s life, including employment i.e., work performance (WP). In order to develop appropriate strategies, it is essential to identify determinants of WP. The objective of this study was to identify the built, social, attitudinal and health system-related environmental determinants of WP in workers with anxiety or depression in total (N = 1211) and regarding the level of disability. Hierarchical binary logistic regression was performed on data obtained from implementation of the WHO Model Disability Survey (MDS) in Chile in 2015. Hindering aspects of means of transportation and workplace, and the use of personal assistance were determinants of WP for all workers with anxiety or depression. Results differed with level of disability. Hindering aspects of means of transportation and workplace, and discrimination were determinants of WP for persons with mild to moderate disability, while hindering aspects of the workplace and dwelling, and the use of personal assistance were determinants of WP for persons with severe disability. Our results emphasize the need for a broader understanding of determinants of WP and the requirement for an integrative approach in developing both universal and specific strategies that go beyond workplace settings.

Characterization of mesenchymal stem cells in bovine endometrium during follicular phase of oestrous cycle

Stem cells have been postulated as responsible for cell regeneration in highly and continuously regenerative tissues such as the endometrium. Few studies in cattle have identified and specified the presence of stem cells in the endometrium during the oestrous cycle. The aim of this study was to investigate the presence of mesenchymal stem cells (MSCs) in the bovine endometrium during the follicular phase (FP) of the oestrous cycle. Uterine tissue was collected in the time-frame comprising day 18 of the cycle and ovulation (day 0). We isolated, cultured and expanded four primary cell lines from endometrium and identified byRT-qPCR the expression of OCT4, SOX2 but not NANOG (undifferentiated/embryonic markers), CD44 (MSCs marker) and c-KIT (stem cell marker) genes; and the encoded Oct4, Sox2 and Cd44 proteins by Western blot or immunostaining of paraffin-embedded tissue in endometrium. We demonstrated that cells isolated from bovine endometrium displayed essentially the same gene expression pattern; however, at the protein level, Oct4 and Cd44 were not detected. Besides, they showed typical functional characteristics of MSCs such as fibroblast-like morphology, plastic adherence, high proliferative capacity, clone formation in vitro and the ability to differentiate into chondrogenic, osteogenic and adipogenic lineages. We obtained for the first time an extensive characterization of undifferentiated cells populations contained in the bovine endometrium during the FP of the oestrous cycle.

The endometrium of cycling cows contains populations of putative mesenchymal progenitor cells

Endometrial stem cells have been identified in humans, mice and pigs. This study was designed to determine whether the uterine endometrium of cycling cows contains such cells, to identify markers of stemness and ultimately to isolate putative stem/progenitor cell and evaluate their capability to differentiate into mesodermal derivatives. Uteri from healthy cows in the early (days 1-5) and late luteal phases (days 13-18) of the oestrous cycle were collected. Total RNA and proteins were isolated and searched for gene markers of embryonic (OCT4, NANOG, SOX2) and mesenchymal (CD44, STAT3, CD-117) stem cells and for protein markers (Oct4, Sox2, Cd44) in Western blots or immunostaining of paraffin-embedded tissue. Primary cell cultures were isolated; characterized in terms of morphology, colony formation and gene/protein expression; and induced osteogenic and chondrogenic differentiation. We identified expression of embryonic (OCT4 and SOX2, but not NANOG) and mesenchymal (STAT3, CD44 and c-KIT) gene markers in the endometrium of cycling cows and the encoded proteins (Oct4, Sox2 and Cd44) in both stages of the oestrous cycle. Derived cell lines displayed essentially the same gene expression pattern; however, at the protein level, Oct4 was not detected. No clear influence of the stage of the oestrous cycle was found. Cell lines from late luteal phase displayed osteogenic and chondrogenic differentiation potential upon chemical stimulation. In this research, we demonstrated the presence of mesenchymal progenitor cell populations of apparently mesenchymal origin in the endometrium of cycling cows, in both the early and late phases of the oestrous cycle. The cells isolated from the late luteal phase were more acquiescent to differentiate into mesodermal derivatives than cells in the early luteal phase. Our findings might have implications for the understanding of uterine stem cell biology in cows and other farm animal species.

184 ISOLATION AND CHARACTERIZATION OF BOVINE ENDOMETRIAL STEM CELLS

Adult mesenchymal stem cells had been isolated from various tissues of different species, including endometrial tissue of humans, mice, and pigs, but not from cattle. The aim of our work was to identify such cells in the bovine endometrium and to establish a model system in which to test inducers of differentiation and recruiters of stem cell niches, for potential therapeutic use in this and other species, such as horses. We searched for endometrial stem cells in healthy cycling cows and in cattle with clinical (C) or subclinical (SC) endometritis. For this, the uterine tracts of slaughtered cows were collected at early (Days 2 to 5; ELF) and late luteal phases (Days 11 to 15; LLF) of the oestrus cycle of healthy cows. For endometritis-diseased cattle, uterine biopsies were taken in live animals. In all cases, markers of stemness, inflammation, uterine function, and housekeeping were studied both at mRNA and protein level, by RT-qPCR and Western blot/immunohistochemistry respectively. In addition, cell primary cultures were established in vitro from all the animals (n = 4 for ELF, n = 4 for LLF; n = 4 for C and n = 4 for SC). We found that the endometrium of the majority of studied animals expressed embryonic stem cell markers, OCT4 and SOX2, but not or little NANOG, as well as CD44, c-Kit, and STAT3, all markers of mesenchymal stem cells. The expression profile of these markers was not related to the stage of the oestrus cycle; however there was a statistically significant reduction in the expression of embryonic stem cell markers in ill animals, being the lowest in clinically ill and intermediate in subclinical endometritis, (P < 0.05 and Pearson correlation coefficient 0.92). For markers of multipotency (mesenchymal), the expression was lower in clinical endometritis (P < 0.05). In conclusion, the expression profile of stem cell markers is indicative of the presence of stem cells in the bovine endometrium. At the protein level, we verified our findings for OCT4, SOX2, and CD44 using Western blot and immunohistochemistry. In general, there was a concordance between mRNA and protein profiles. Inflammatory markers showed a pattern characteristic for each of the studied stages. In order to have an ultimate criterion of the presence of stem cells, we tested the differentiation potential of the isolated cell lines, upon induction towards chondrogenic, osteogenic, and adipogenic lineages. We found that all the cell lines tested (n = 8) displayed mesenchymal differentiation potential as demonstrated by specific staining and gene expression markers. At present, work is in progress to isolate pure stem cell populations from these primary cultures to further characterise these cells. Conclusion: we showed for the first time the presence and differentiation potential of endometrial stem cells in cattle. This can have an effect on the development of new therapeutic approaches to combat uterine diseases, such as endometritis or endometriosis (in horses). This work was supported by grant FONDECYT REGULAR 1110642, from the Government of Chile.

Production of biomass, polysaccharides, and ganoderic acid using non-conventional carbon sources under submerged culture of the Lingzhi or Reishi medicinal mushroom, Ganoderma lucidum (W.Curt.:Fr.)P. Karst. (higher Basidiomycetes)

The effect of different non-conventional carbon sources was studied in the submerged culture of Lingzhi or Reishi medicinal mushroom, Ganoderma lucidum, for simultaneous production of mycelial biomass, bioactive ganoderic acid, and polysaccharides, in less time, using non-conventional carbon sources to minimize the high costs of current culture media. The optimal medium composition was defined as (g/L): 50 of barley flour, 0.2 of KH2PO4, 0.1 of MgSO4ⁱ7H2O, and 1 NH4Cl. Cultivated under this complex culture medium, the mycelial biomass production was 23.49 ± 0.37 g/L; the extracellular polysaccharides production was 2.72 ± 0.11 g/L; the intracellular polysaccharides production was 2.22 ± 0.06 g/L; the ganoderic acids production was 299.67 ± 11.63 mg/L. One liter of culture medium developed in this project was priced at USD $ 0.11 if barley flour is used as carbon source or $ 0.13 with oat flour in order to get a good amount of products of interest.

A strategy to obtain axenic cultures of Arthrospira spp. cyanobacteria

A strategy to obtain axenic cultures of the cyanobacterium Arthrospira sp. ('platensis') Lefevre 1963/M-132-1 strain, consisting of a series of physical and chemical procedures, and the application of an optimized pool of antibiotics, is described in this paper. This strategy, which is an inexpensive and fast way to obtain axenic cultures, can be applied to Arthrospira spp. from culture collections or samples from their natural habitats to eliminate a wide spectrum of contaminants. A high alkaline treatment (pH 12, using KOH) of 72 h is a determinant initial procedure applied to eliminate protozoa and Microcystis sp. Bacteria were eliminated by an optimal antibiotic pool treatment, and Chroococcus sp. residuals were discarded by serial dilution. Optimal concentrations of the antibiotics composing the pool were obtained by a 2(4) factorial central composite rotatable design (CCRD) and Response Surface Methodology (RSM), resulting in: ampicillin 61.6 μg/ml, penicillin 85.8 μg/ml, cefoxitin 76.9 μg/ml, and meropenem 38.9 μg/ml. The results also indicate that cefoxitin was the most effective antibiotic of this pool. After obtaining the axenic culture, identification of Lefevre 1963/M-132-1 strain was performed using amplification and sequencing of the ITS region (including part of 16S rRNA, tRNA Ile, ITS, tRNA Ala and part of 23S rRNA region) and fatty acid composition data. Data base comparison revealed that Lefevre strain is closely related to A. platensis species (99% identity), while fatty acid composition data suggested A. maxima. These seemingly contradictory results are discussed.

Breeding system and factors limiting fruit production in the nectarless orchid Broughtonia lindenii

Low fruit set values in most orchids (especially epiphytic and tropical species) are normally thought to be the consequence of pollination constraints and limited resources. In particular, pollination constraints are modulated by pollinator visitation rates, pollinator visitation behaviour (promoting crossing or selfing), the type and number of pollinia deposited on stigmas (in the case of orchids with subequal pollinia) and the amount of pollen loaded per inflorescence. In order to assess to what extent these factors can affect fruit set in specific orchid-pollinator systems, the repercussions of some of these aspects on reproduction of Broughtonia lindenii were examined in a coastal population in western Cuba. The study focused on plant breeding system, importance of pollen load and type of pollinia on subsequent fruit and seed, limiting factors of seed production and interaction with pollinators. This species presents long-lasting flowers that senesce after all forms of effective visit. Pollinator dependence for fruit production was demonstrated, while hand-pollination experiments revealed self-compatibility and inbreeding depression at seed level. More pollinia on stigmas enhance the proportion of well-developed seeds. In contrast, the pollinia type used in pollination is not important for seed quality of fruits, suggesting that small pollinia are not rudimentary. Natural fruit set in two consecutive years was substantially affected by pollinator activity, and also by systematic depredatory activity of ants and a caterpillar. Considering that this orchid completely lacks nectar and that the local assemblage of pollinators and predators influenced its reproduction, a minor importance of resource constraints in this epiphyte (with long-lasting reserve structures) is confirmed at least for a short time.

Lessons Learned from Implementation of Information and Communication Technologies in Spain's Healthcare Services: Issues and Opportunities

BACKGROUND

Spain's health services have undertaken a number of important projects aimed at the creation of Electronic Health Records (EHR) through the incorporation of Information and Communication Technologies (ICT) into patient care practices. The objective of this endeavor is to improve care quality and efficiency and increase responsiveness to the population's needs and demands. Between 2006-2009 over 300 million Euro were invested in projects of this type.

OBJECTIVE

To better understand the success criteria, the difficulties encountered and certain issues that must be kept in mind to ensure successful implementation of ICT projects in health organizations, based on Spain's experiences in this field.

METHODS

The projects' results are analyzed using the criteria of compliance with the expected scope, cost and time frame.

RESULTS

The results can be considered satisfactory in primary care facilities, where almost 90% of Spain's general practitioners, pediatricians and primary care nurses are using electronic health record (EHR) systems. In hospitals EHR implementation is more uneven. Over 40% of Spanish primary care centers and 42% of pharmacies are using electronic prescription (the information system that connects the physician to the dispensing pharmacy and the dispensing pharmacy to the payer).

DISCUSSION

All of Spain's health services are currently carrying out projects involving ICT application in healthcare, and a priori the benefits of ICT are not questioned. However, the costs and time frames required for these projects are clearly surpassing initial expectations, while the benefits perceived by both professionals and institutions remain limited. This situation may be due in part to the absence of a project management culture in the health services, which has led them to pay insufficient attention to the main difficulties and key issues related to the implementation of EHR.

[Oxidative stress and inflammation in heart failure: mechanisms of damage and therapeutic alternatives]

Despite advances in treatment, chronic heart failure still is associated with a poor prognosis and remains a leading cause of cardiovascular death. Cumulating evidence suggests that imbalances in redox state lead to a higher generation of reactive oxygen species. This phenomenon, along with pro-inflammatory cytokine activation and extra cellular matrix alterations with reactive fibrosis, play an important role in the pathogenesis and progression of heart failure, through the development of endothelial and myocardial dysfunction. The understanding of the underlying phenomena and the metabolic pathways involved will allow further development of therapies aiming to change the natural history of heart failure.

Hippocampal to pituitary volume ratio: a specific measure of reciprocal neuroendocrine alterations in alcohol dependence

OBJECTIVE

Studies to date provide conflicting views of the relationship between corticosteroids and decreased hippocampal volume in alcoholism. If this were mediated through the hypothalamic-pituitary-adrenal (HPA) axis, enlarged pituitary volumes relative to hippocampal volumes might be expected and be measurable using the hippocampus to pituitary volume (H:P) ratio.

METHOD

Using magnetic resonance imaging (MRI), we performed volumetric analysis of the pituitary and hippocampus on 10 subjects with alcohol dependence (AD) and on 10 normal control subjects.

RESULTS

Compared to normal controls, AD subjects demonstrated a trend towards decreased hippocampal volume (p < .06) and increased pituitary volume (p < .07). More importantly, H:P ratios were significantly smaller in AD subjects (p < .01). This observation persisted even when covaried for age.

CONCLUSIONS

Reduced H:P ratio fits the hypothesis that ethanol stimulates pituitary corticotrophs resulting in elevated corticosteroid levels and possible injury to the hippocampus. If replicated, reduced H:P ratio may serve as a clinical measure of reciprocal neuroendocrine changes in chronic heavy ethanol use.

Adverse effects of dextromethorphan on the spatial learning of rats in the Morris water maze

The effects of the non-competitive NMDA receptor antagonist dextromethorphan on spatial learning were assessed using the Morris water maze. Dextromethorphan was administered to 4 groups of rats in 10, 20, 30, and 40 mg/kg doses. An additional group of rats was administered saline to serve as a vehicle control group. Dextromethorphan impaired learning dose dependently in the initial training phase of the experiment. During the probe trial, dose-dependent performance deficits were noted in the first 15 s of the trial only. Search strategy differences between the lowest and highest dose groups were also observed during the probe trial. During the reversal training phase, when the platform was moved to a new location, the dose-dependent impairment was seen again, but the 40 mg/kg group perseverated to the former location longer than the other groups. A cued control trial indicated that in addition to the learning impairment produced, the highest dose of dextromethorphan may also impair sensory-motor coordination.

[POEMS syndrome. A case report]

A 48 years old male is reported. He presented with lower limb progressive and severe polyneuropathy, hypertrichosis, endocrinological alterations (hypothyroidism and hypogonadism) and organomegaly (hepatosplenomegaly and lymphadenopathies). This syndrome was associated with an osteosclerotic myeloma. The patient died two months after admission.

[A neurobiological model of mind]

An essential difference is established between the dorsal, and ventral regions of the cerebral cortex: While dorsal cortex--linked to archicortex or hippocampal allocortex--elaborates acts, and objects used in, or by, acts, ventral cortex--linked to paleocortex or olfactory allocortex, builds up preventive values favoring the inhibition of acts whenever the use of objects may become dangerous. Such a distinction between the dorsal and ventral regions of the cerebral cortex is founded mainly on disinhibition syndromes appearing in patients with ventral lesions--besides, the said distinction can explain some disinhibition demonstrations included in the schizophrenic clinical pictures.

[Epidemiologic and nutritional characteristics of the elderly]

A sample of 1365 elders of both sexes from rural and urban populations was studied. Thirty four percent of the subjects were older that 80 years. 21.6% lived alone, 25% were illiterate and 50% did not finish elementary school. Mental impairment was found in 5.6% and body mass index was normal in 41.4% of subjects. Eighty seven percent did not smoke and 80% were teetotalers. Medical services were requested at least every one year by 15.4% and twice a year by 11.9% of subjects. These numbers will help to design preventive and interventional policies directed to this segment of the population.