Rabies virus variants from marmosets are found in bats

The emergence of rabies in distinct wildlife species is a potential source of human infection and poses life-threatening risks. A 36-year-old farm worker died in May, in Northeast Brazil, only weeks after being bitten by a marmoset

Peer-Reviewed Publication

FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO

 

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A SEBA’S SHORT-TAILED BAT (CAROLLIA PERSPICILLATA) BEING EXAMINED AT CEARÁ STATE’S CENTRAL PUBLIC HEALTH LABORATORY: BATS ARE IMPORTANT TO ECOSYSTEM EQUILIBRIUM AND SHOULD BE HANDLED ONLY BY SPECIALLY TRAINED PROFESSIONALS

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CREDIT: LARISSA LEÃO FERRER DE SOUSA

Rabies virus variants closely related to variants present in White-tufted marmosets (Callithrix jacchus) have been detected in bats in Ceará state, Northeast Brazil. 

Rabies is a deadly disease for humans. Its emergence in distinct wildlife species is a potential source of human infection and hence a public health concern. Marmosets are common in forests and conservation units throughout Brazil. In or near urban areas, they are often captured as pets and later abandoned. They have been linked to cases of human rabies.

The study was supported by FAPESP and led by researchers at the Federal University of São Paulo’s Medical School (EPM-UNIFESP). An article about it is published in the Journal of Medical Virology.

Besides the similarity between the variants found in marmosets and the bats analyzed by the researchers, they were struck by the presence of the virus in fruit- and insect-eating bat species. Bats that feed on blood are considered more frequent hosts and important transmitters of rabies.

“Seven marmosets have recently tested positive for rabies. Rabies is endemic in Ceará, where people have been attacked by marmosets and died from rabies. One such death occurred in May,” said Larissa Leão Ferrer de Sousa, a PhD candidate at EPM-UNIFESP and a veterinarian at the Ceará Central Public Health Laboratory (LACEN-CE) in Fortaleza.

This death resulted from an attack on a 36-year-old farm worker in February near a town called Cariús. The man went to a health clinic in April, when symptoms started to appear but died shortly afterwards. Infection by rabies virus causes progressive encephalitis, a rapid inflammation of the brain that leads to death in almost 100% of cases.

“The marmoset fell into his backyard. It was semi-paralyzed, which is one of the symptoms of rabies. The man tried to help it, and it bit him. Animals with rabies aren’t always aggressive and don’t necessarily foam at the mouth, the symptom most people associate with rabies. Sometimes there are no apparent symptoms at all,” she said. 

People should never touch bats or other wild animals, Sousa warned. Anyone who finds a dead wild animal should alert the local animal health surveillance agency, which will collect the remains for analysis. If they do have direct contact with the animal, they must immediately go to the nearest health clinic to be vaccinated against rabies and/or be given anti-rabies serum.

“Rabies incubates for 45 days on average, so it’s extremely important for anyone who’s infected to get post-exposure prophylaxis [serum and vaccine] immediately. When symptoms appear, it’s normally too late, and the patient will die,” said Ricardo Durães-Carvalho, a researcher at EPM-UNIFESP supported by FAPESP and principal investigator for the study.

Genetic sequencing

The researchers analyzed 144 brain tissue samples from 15 bat species. The animals arrived at LACEN-CE between January and July 2022 as part of the national epidemiological surveillance program, which requires health workers to collect mammals found dead or with symptoms of rabies in Ceará.

RNA extracted from the samples was sequenced, and the genetic sequences for rabies virus were compared with sequences deposited in public databases. The researchers used computer-assisted tools to trace the evolutionary history of the viruses they found.

The first set of sequences was compatible with rabies virus variants found in 2010 in Tadarida brasiliensis and Nyctinomops laticaudatus, insectivorous bat species from Southeast Brazil. However, another group of variants first found in bats (two insectivorous and one frugivorous species) were very close in evolutionary terms to the virus detected in marmosets from the Northeast.

“Our results allowed us to infer that the different rabies virus variants that were closely related in evolutionary terms were originally from the same animal, revealing complex spillover dynamics and multiple viral transmission between hosts,” Durães-Carvalho said.

Since vaccination of domestic animals became widespread, wild animals have been the main source of human rabies in the Americas. The first death from rabies linked to a marmoset was reported in 1991, also in Ceará. Since then, 14 other deaths in the same state have been attributed to transmission by these primates.

Bats and marmosets may be key links in the rabies transmission chain in Brazil, but both play important ecological roles and are suffering from habitat loss due to urban and agricultural expansion.

Bats in particular are important to ecosystem equilibrium, and fundamental to seed dispersal, pollination and pest control. “It’s best to respect these animals and leave them alone to live in the wild,” Sousa said.

The study was also supported by FAPESP via five other projects (20/08943-5, 19/14526‐0, 22/09684‐9, 22/08748‐3 and 21/05661‐1).

About São Paulo Research Foundation (FAPESP)

The São Paulo Research Foundation (FAPESP) is a public institution with the mission of supporting scientific research in all fields of knowledge by awarding scholarships, fellowships and grants to investigators linked with higher education and research institutions in the State of São Paulo, Brazil. FAPESP is aware that the very best research can only be done by working with the best researchers internationally. Therefore, it has established partnerships with funding agencies, higher education, private companies, and research organizations in other countries known for the quality of their research and has been encouraging scientists funded by its grants to further develop their international collaboration. You can learn more about FAPESP at www.fapesp.br/en and visit FAPESP news agency at www.agencia.fapesp.br/en to keep updated with the latest scientific breakthroughs FAPESP helps achieve through its many programs, awards and research centers. You may also subscribe to FAPESP news agency at http://agencia.fapesp.br/subscribe.

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JOURNAL

Journal of Medical Virology

DOI

10.1002/jmv.29046 

ARTICLE TITLE

Rabies virus variants from bats closely related to variants found in marmosets (Callithrix jacchus), a neglected source of human rabies infection in Brazil

 

Study finds motorist disorientation syndrome is not only caused by vestibular dysfunction

Journal of Vestibular Research article leads to greater insights into why some drivers get dizzy and disoriented behind the wheel

Peer-Reviewed Publication

IOS PRESS

Amsterdam, November 16, 2023 – A large case series aimed at understanding the factors underlying Motorist Disorientation Syndrome (MDS) has found that patients experience severe, consistent symptoms comparable to vestibular migraine. Previously there has been speculation that underlying peripheral vestibular hypofunction, when the inner ear part of the balance system is not working properly, contributes to this presentation. However, vestibular deficits were not a consistent feature in the patients studied. The findings have been published in the Journal of Vestibular Research.

In recent years there has been increasing interest in the complex integration of input signals that control spatial orientation, retinal stability, and balance in response to a changing visual environment such as in a moving car. MDS is a term used to describe patients who primarily experience symptoms of dizziness and/or disorientation when driving a car. There is currently only a limited amount of evidence-based information available about this condition.

Lead investigator Carolyn Ainsworth, MD, Neuro-otology, Department of ENT, Guy’s and St Thomas’ NHS Trust, explains, "Our research entailed looking at the presenting symptoms, characteristics and vestibular test results of a group of patients whose main complaint was of illusions of movement of self/vehicle when driving. We found consistencies in the presenting symptoms and a high symptom burden, however only 60% of patients had underlying vestibular test deficits. Although this does not exclude vestibular dysfunction, it does raise the possibility of other factors contributing to the development of this presentation.”

The study also found similarities to visually induced dizziness and persistent postural perceptual dizziness (PPPD), a functional neurological disorder. Other contributing factors could be anxiety and depression.

The symptoms of the 18 patients assessed were severe enough to cause 17 patients to change their driving habits. Six subjects stopped driving completely, while 11 stopped driving on roads that provoke MDS (open, featureless roads, going over the brow or descending hills, or going around corners). Only one patient continued to drive as usual.

"Diagnostic criteria are very much needed to aid research into effective treatments for patients. This study provides data that can contribute to discussion about where MDS should be placed within the current framework for diagnosis of vestibular disorders. In turn, improved recognition and appropriate classification of this symptom complex will help clinicians recognize the specific features of the condition, inspiring further research into the role of potential factors such as visual dependency and facilitating further research into treatment," Dr. Ainsworth concludes.

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JOURNAL

Journal of Vestibular Research

DOI

10.3233/VES-220088 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Motorist disorientation syndrome: clinical features and vestibular findings

 

Non-native diversity mirrors Earth’s biodiversity

New study reveals huge potential for future waves of invasive species

Peer-Reviewed Publication

HELMHOLTZ CENTRE FOR OCEAN RESEARCH KIEL (GEOMAR)

“Everything that exists can be introduced somewhere at some point,” says Dr Elizabeta Briski. The marine biologist is an expert in invasion ecology at GEOMAR Helmholtz Centre for Ocean Research in Kiel. Along with a large international team of renowned ecologists, she has conducted a study to investigate whether non-native species mirror Earth's patterns of biodiversity and found that greater numbers of non-native species tend to come from more diverse species groups. The results have now been published in the journal Global Ecology and Biogeography.

Briski generally says: “Biological invasions can cause extinctions, cost trillions of dollars in damage and control, and spread diseases.” But that is not necessarily the case, which is why Briski prefers a neutral term “non-native species” instead of “invaders”. And their numbers are growing rapidly, making large-scale understandings and predictions of invasion patterns crucial to protect environments, economies, and societies.

“We investigated whether the number of non-native species reflects patterns in global biodiversity. We then looked at whether certain groups of species are disproportionately prone to establish in new areas.” To do this, the researchers compiled a comprehensive list of non-native species described to date - there are around 37,000 worldwide - and grouped them according to biological taxonomy - from phyla to classes and families. Then, they put them in relation to global biodiversity. The result: whether microscopically small or the size of a hippopotamus, whether on land or under water - on average about 1% of all living organisms have been transported by humans somewhere in the world.

“Of course, the data situation varies greatly in some cases” Briski points out. Species on land are generally better studied than those in the water. A greater research effort would therefore probably uncover a significant number of new non-native species in marine habitats. Other understudied groups, such as microorganisms, are also likely to be vastly underestimated in non-native species inventories. In addition, richer countries tend to have more research on non-native species than poorer countries. “It is therefore quite possible that there are many non-native species in the tropical rainforest that we simply don't know about.”

The researchers found that some groups have excessively established outside their native range, including mammals, birds, fishes, insects, spiders, and plants. Briski: “The most commonly reported introduced non-native species tend to be those that have been introduced intentionally for agriculture, horticulture, forestry or other purposes.” And unwanted species always come along with the wanted ones, for example as stowaways on ships. “Nobody wanted to introduce rats, but they have spread across the globe alongside humans,” says Briski.

Overall, the results indicate a huge potential for future biological invasions in various species groups. Briski: “If only one per cent of global biodiversity has been affected so far, we can assume that the extent will increase considerably”. The randomness of the process is remarkable: “Sooner or later, any species can use our transport manners and routes to reach areas to which it would not naturally have access”. The magnitude of environmental and socio-economic impacts due to new invasions is thus likely to rise substantially in the coming decades, particularly as trade and transport accelerate and shift, connecting distant countries and their unique species pools. Briski and colleagues call for urgent action to prevent future introductions and to control the most damaging invaders that are already established.

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JOURNAL

Global Ecology and Biogeography

DOI

10.1111/geb.13781 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Does Non-Native Diversity Mirror Earth’s Biodiversity?

 

Sea Wall Project launched by Heriot-Watt University and Virginia Tech in transatlantic collaboration

Business Announcement

HERIOT-WATT UNIVERSITY

 

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WAVES CRASHING AGAINST SEA WALL

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CREDIT: PHOTO BY RAY-BILCLIFF (PEXELS)

A pioneering research project that aims to strengthen the resilience of sea walls to increased coastal flooding has been launched by Heriot-Watt University in Edinburgh, Scotland and Virginia Tech in Blacksburg, Virginia, USA.

The PIONEER project has been funded by the Engineering and Physical Sciences Research Council (EPSRC) and hopes to be the first step in an international collaboration to strengthen coastal sea defences globally.

Around 148 million people worldwide are exposed to coastal flooding events, which are predicted to surge in frequency and severity in the coming decades as climate change drives sea levels higher.

The research being conducted by Heriot-Watt and Virginia Tech will investigate how the soil behind sea walls is impacted by repeated wetting and drying cycles over time from waves overtopping the sea walls. It’s hoped this will highlight areas where the design and resilience of sea walls could be strengthened.

Dr Melis Sütman, an Assistant Professor in Geotechnical Engineering at Heriot-Watt’s School of Energy, Geoscience, Infrastructure and Society, said: “The sea level around the UK has already risen by around 1.5 millimetres a year on average from the start of the 20th century. And even in the best case climate change scenario, the sea level will continue to rise. So our coastal defence structures will be of paramount importance to defend our shorelines – not only for the UK, but also for the United States on the other side of the Atlantic.”

Under a low emissions scenario, by the year 2300, the sea level for London and Cardiff is predicted to rise between 0.5 metres and 2.2 metres and up to 1.7 metres for Edinburgh and Belfast. Under a high emissions scenario, this increases to between 1.4 metres and 4.3 metres for London and Cardiff, and between 0.7 metres and 3.6 metres for Edinburgh and Belfast.

In the US, the coastal sea level by 2050 is predicted to be between 0.25- 0.30 meters higher than in 2020 – and as much as the rise measured over the last 100 years before that, from 1920 to 2020.

“According to the Intergovernmental Panel on Climate Change, unavoidable sea level rise will bring cascading and compounding impacts resulting in flooding and damage to coastal infrastructure that cascades into risks to livelihoods, settlements, health, well-being, food, and water security in the near to long-term,” Dr Sütman said.

She added that rising sea level also has strong economic consequences. For example, the investment needed to protect London is expected to exceed £20 billion. And at Staten Island in New York City, $165 million is being invested to build an 8.5 km seawall along the coastline to build resilience to sea level rise and extreme events.

PIONEER stands for ‘An adaPtatIon apprOach for resilieNt coastal infrastructurE against sEa level Rise’ and is being funded through an EPSRC Early career researcher international collaboration grant. EPSRC is part of UK Research and Innovation – the UK’s national funding agency for investing in science and research.

The research will involve testing wave overtopping scenarios on interfaces that mimic the interaction between sea walls and the backfill soils. At Heriot-Watt, tests will take place in the lab on a small-scale device that the University says it has developed as a world first. This is called a thermo-hydro-mechanical direct shear interface device, and it allows numerous scenarios to be tested and measured. This includes, for example, different water contents, overtopping frequencies and lengths and different properties of the both the soil behind the wall and the wall itself.

“It means that we can create a soil and structure interface – or a concrete interface – in the lab in the size of 60 by 60 millimetres, so very small,” Dr Sütman explained. “And we can apply almost every possible temperature and water content change to this interface. Because this is a small-scale device, the setup is easier – and it’s cheaper – so we’ll be able to investigate many different parameters in a relatively short amount of time.”

Virginia Tech will then conduct its set of experiments on a full-sized wall that is 5 metres in height.

Dr Sherif Abdelaziz, Associate Professor of Geotechnical Engineering at the Charles E Via, Jr. Department of Civil and Environmental Engineering at Virginia Tech, said: “Our large-scale tests will investigate how the soil and wall are affected by different levels of temperature, suction, water pressure and other parameters. Heriot-Watt will then perform additional lab-scale tests to investigate the conditions we record at full-scale. So our investigations on each side of the Atlantic will very much go hand-in-hand.”

PIONEER’s Advisory Board features world-renowned experts from both academia and industry. These include Advisory Board Chair Professor Paul Jowitt, who is the former President of the Institute of Civil Engineers in the UK. Also on the UK Advisory Board is Professor Lindsay Beevers from the University of Edinburgh, who is an expert in hydrological extremes – extreme water-related events such as floods. Professor Beevers is developing numerical models to understand and quantify these events, their future evolution and associated impacts on society and the environment. In the US, Advisory Board members include Prof Thomas Brandon, Professor of Geotechnical Engineering at Virginia Tech. Prof Brandon works with the US Army Corps of Engineers (USACE) to investigate multiple breaches in floodwalls, as a member of the Interagency Performance Evaluation Task Force. This was set up after Hurricane Katrina devastated the southeastern coast of the United States in August 2005.

Also involved in the project is US infrastructure consulting firm AECOM, whose offices in both the UK and US will help to share the research results and apply them in practice. And in the UK, William Allsop Consulting, who are experts in seawall design, including most seawall developments in the UK, will be consulted to advise on the practical implications, and plan the next stages of PIONEER. 

Dr Sütman is a Turkish civil engineer who has an MSc and a PhD degree in Geotechnical Engineering from Virginia Tech. Geotechnical Engineering is a branch of civil engineering focused on how man-made structures interact with the ground – for example, tunnels, metro lines and building foundations.

Sea walls are thought to have been first constructed in in 448 AD by the Roman Emperor Constantine I, as part of a larger defence system to safeguard the city of Constantinople (now Istanbul, Turkey) from attackers by land or sea.

 

Cultivating euglena in tomato juice

Scientists from Japan find a simple method for cultivating Euglena gracilis, an edible microalgae with high nutritional and functional content

Peer-Reviewed Publication

TOKYO UNIVERSITY OF SCIENCE

 

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USING TOMATO JUICE FORTIFIED WITH ESSENTIAL VITAMINS (B1 AND B12) AS A MEDIUM TO GROW THE EDIBLE MICROALGAE E. GRACILIS IS SIX TIMES LESS EXPENSIVE THAN USING THE TRADITIONAL “KH” MEDIUM. THIS INNOVATIVE APPROACH COULD BOOST THE PRODUCTION OF E. GRACILIS AS FOOD PRODUCTS AND SUPPLEMENTS.   

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CREDIT: KYOHEI YAMASHITA FROM TOKYO UNIVERSITY OF SCIENCE

Euglena (Euglena gracilis) is a microalga containing chloroplasts and producing organic matter through photosynthesis in a well-lit environment, while taking in organic matter from outside in an unlit environment. It is known to be rich in nutrients like vitamins, minerals, amino acids, and essential fatty acids, such as DHA and EPA. Owing to the lack of cell walls, Euglena has a high digestion and absorption rate, making it attractive as a new source of nutritious and health enhancing food.

Moreover, Euglena protein is rich in methionine, a characteristic of animal protein, and its nutritional value is comparable to casein found in milk. Therefore, it is expected to be one of the solutions to the shortage of animal protein due to the effects of climate change and population growth, as well as one of the production technologies for space exploration, which is flourishing these days. In addition, Euglena also contains a high percentage of a special type of beta-1,3-glucan called paramylon, known for its immunomodulatory and hepatoprotective effects. Paramylon may also be effective in reducing atopic dermatitis, influenza, and arthritis symptoms, as well as in preventing colon cancer. However, the existing methods for food-grade manufacturing of Euglena are quite complicated.

Currently, Euglena can be propagated using both autotrophic as well as heterotrophic culture mediums. Conventionally, the Koren–Hutner (KH) medium, a higher yielding heterotrophic medium, is used for its culture. But it requires measuring and mixing 26 different chemicals. Moreover, after the microalgae has reproduced to high densities in large pools, it must be extracted, washed, concentrated, and dried to foods or nutritional supplements. The energy required for these processes accounts for about 30% of the total production cost, and other costs such as cultivation land and transportation costs are also incurred in the production of Euglena as a food ingredient.

Aimed at improving the efficiency of existing production processes, a team of researchers from Japan conducted experiments to find a promising method to grow Euglena in large quantities. As explained in their latest paper, the team examined several beverages to find a suitable growing medium for Euglena. This paper was made available online on August 14, 2023 and was published in Issue 5 of the journal Sustainable Food Technology on September 1st, 2023. The study was led by Assistant Professor Kyohei Yamashita from Tokyo University of Science (TUS) and co-authored by Dr. Kengo Suzuki and Dr. Koji Yamada from Euglena Co., Ltd. and Professor Eiji Tokunaga from TUS.

Interestingly, this study is a part of follow-up research for which a patent was filed by Dr. Yamashita during his doctoral course in 2017. Dr. Yamashita explains, “We had previously confirmed that E. gracilis can grow even when foods such as seaweed, dried sardines, and boiled rice are used as a source of essential vitamins.”

The researchers first cultured Euglena with initial cell density of 4.2 x 103 cells/mL statically under aerobic conditions for about 10 days. For this, they used either Cramers–Myers (CM) medium, an independent nutrient medium, or KH medium, a heterotrophic medium. The cell density increased to 106 cells/mL and 107 cells/mL, respectively. Next, they incubated Euglena with initial cell density of 1.6 x 104 cells/mL in 13 different beverages, including diluted grape juice (with juice-to-water ratio of 3:7 or 7:3), pineapple juice, apple juice, sweet wine, diluted carrot juice (with juice-to-water ratio of 3:7 or 7:3), tomato juice, orange juice, grapefruit juice, prune juice, coconut water, and maple water, and culture medium supplemented with essential vitamins B1 and B12 under aerobic conditions. The cells were cultured under ‘light’ (26 °C, white light irradiation) or ‘dark’ (23 °C, no light irradiation) conditions.

Interestingly, the researchers found that the cell density of Euglena cells reached a maximum when cultured in tomato juice, especially under light conditions, and increased to 107 cells/mL, the same level as in KH medium. This also resulted in a change in the appearance of the culture medium from red to green after incubation (as shown in Image 1). The bright green chloroplasts in Euglena cultured in tomato juice were observed to be tightly packed inside the cells. On the other hand, in the non-tomato juice, the number of chloroplasts was low, and the green color was lighter. These findings suggest that tomato juice is more suitable for the growth of Euglena than other beverages.

Furthermore, on culturing Euglena under aerobic conditions using tomato juice diluted with water (in a ratio of 3:7, 4:6, or 5:5) and without essential vitamins, it grew to approximately 100 times of its initial cell density to 106 cells/mL under all dilution conditions. This revealed that the nutrient composition of tomato juice itself is suitable for Euglena growth.

“During static incubation, tomato juice diluted with water separated into a solid sediment layer and an upper aqueous solution layer in the container, and Euglena proliferated actively near the boundary of these layers. Therefore, when cultured under aerobic conditions using ‘tomato (filtered) medium,’ in which solid components were removed from tomato juice, Euglena were distributed throughout the entire culture medium,” points out Dr. Yamashita. Notably, the cell density was greater than that in the unfiltered tomato juice medium. This indicates that the removal of solid components may mitigate the effects of density, including growth space, light and nutrient acquisition, and waste accumulation.

Finally, the team cultured Euglena in CM medium with glutamic acid, a nutrient characteristic of tomato juice. The cell density reached two to three times that of the CM medium, but only about half that of the tomato juice medium. These findings suggest that components other than glutamic acid contained in tomato juice also contribute to the good growth of Euglena.

"Euglena is rich in nutrients and functional ingredients, so it is possible to easily fortify foods by converting some of the nutrients in the food into Euglena. Being simple and economically feasible, we expect this method to be useful for carbon-neutral and sustainable food production. It could also contribute to the achievement of sustainable development goals related to food and hunger and has the potential to contribute as a food production technology in space exploration," concludes Dr. Yamashita, expressing his hopes for the future development of this research.

 

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Reference                     

DOI: https://doi.org/10.1039/d3fb00086a

 

About The Tokyo University of Science
Tokyo University of Science (TUS) is a well-known and respected university, and the largest science-specialized private research university in Japan, with four campuses in central Tokyo and its suburbs and in Hokkaido. Established in 1881, the university has continually contributed to Japan's development in science through inculcating the love for science in researchers, technicians, and educators.

With a mission of “Creating science and technology for the harmonious development of nature, human beings, and society," TUS has undertaken a wide range of research from basic to applied science. TUS has embraced a multidisciplinary approach to research and undertaken intensive study in some of today's most vital fields. TUS is a meritocracy where the best in science is recognized and nurtured. It is the only private university in Japan that has produced a Nobel Prize winner and the only private university in Asia to produce Nobel Prize winners within the natural sciences field.

Website: https://www.tus.ac.jp/en/mediarelations/

 

About Assistant Professor Kyohei Yamashita from Tokyo University of Science
Dr. Kyohei Yamashita is currently an Assistant Professor at the Department of Physics of the Tokyo University of Science (TUS), Japan. He completed his Ph.D. from TUS in 2019. His research is primarily focused on applying basic methodologies of bioscience to food processing technologies. Upon his discovery early on in his career of a revolutionary natural pigment extracted from Monascus purpureus, his research has become interdisciplinary, relevant to several medical and life sciences fields. He has around 20 publications to his credit.

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JOURNAL

Sustainable Food Technology

DOI

10.1039/d3fb00086a 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Cells

ARTICLE TITLE

Method for growing edible Euglena gracilis in an inexpensive medium with tomato juice to a high cell density equivalent to the density in KH medium

 

Understanding survival factors in critically ill patients on extracorporeal membrane oxygenation

Scientists from Korea have identified the factors associated with in-hospital mortality in critically ill patients requiring extracorporeal membrane oxygenation

Peer-Reviewed Publication

CHUNG ANG UNIVERSITY

 

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A RETROSPECTIVE COHORT STUDY INVESTIGATES THE PREVALENCE AND RISK FACTORS ASSOCIATED WITH THE 30 DAY IN-HOSPITAL MORTALITY RATE IN KOREAN PATIENTS REQUIRING ECMO SUPPORT (LEFT). ECMO IS AN ADVANCED LIFE SUPPORT DEVICE THAT ENSURES END ORGAN PERFUSION AND TEMPORARILY SUPPORTS ORGAN RECOVERY (RIGHT).

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CREDIT: GUSTAVO BASSO FROM WIKIMEDIA COMMONS (LEFT) AND CHUNG-ANG UNIVERSITY (RIGHT) IMAGE SOURCE: HTTPS://COMMONS.WIKIMEDIA.ORG/W/INDEX.PHP?CURID=112916636 (LEFT) AND HTTPS://GH.CAUHS.OR.KR/HOME/CONTS/105015008012001.DO (RIGHT)

Extracorporeal membrane oxygenation (ECMO) is a widely used advanced life support procedure that provides cardiac and respiratory support to critically ill patients. ECMO use has been increasing exponentially over the last decade as it has shown success in resuscitating patients in critical situations like the COVID-19 pandemic and is now a lifesaving treatment modality in intensive care units (ICUs). However, prolonged ECMO use may be associated with an increased risk of mortality. Identifying risk factors for in-hospital mortality and developing standardized nursing practice guidelines for ECMO management may improve the survival rates in patients.

In this vein, a group of researchers led by Professor Youn-Jung Son from Chung-Ang University, South Korea, set out to study the prevalence and risk factors associated with the 30-day in-hospital mortality in critically ill adult Korean patients on ECMO. This paper was made available online on July 12, 2023 and will be published in Volume 79 of the journal Intensive and Critical Care Nursing on 1st December 2023. 

“In-hospital mortality due to ECMO support, regardless of its type, has not been well reported in Korea. Thus, it is crucial to provide training to various stakeholders in Korea (e.g., ICU nurses) to enhance collaboration, particularly for the optimal ECMO management to reduce in-hospital mortality or improve the survival rate post- hospital discharge.” explains Prof. Son.

They conducted a retrospective cohort study in a single tertiary-care university hospital between May 2020 and April 2021. Patients were screened using their electronic medical records, and 148 patients aged 18 years or above, who received ECMO support for at least 48 hours, were included in the study. Based on their 30-day in-hospital survival status following ECMO initiation, the researchers categorized the patients as survivors and non-survivors. Various pre-ECMO and post-ECMO (up to 30 days from the day of initiation) parameters were collected and compared.

The 30-day mortality rate is used to measure performance in clinical settings. In the current study, the researchers found the 30-day in-hospital mortality rate to be 49.3%, with heart and multi-organ failures identified as the most common causes of death. Furthermore, the average duration of ECMO support was approximately 11 days, and the in-hospital median survival was 13 days. This finding emphasizes the importance of early detection of risk factors for mortality to improve patient outcomes.

Further investigations found significant differences in various pre-ECMO and post-ECMO parameters between survivors and non-survivors. Statistical analyses revealed that ECMO weaning failure, new-onset renal failure, and a lower average mean arterial pressure (MAP) of <65 mmHg post-ECMO were associated with an increased risk of 30-day in-hospital mortality rate. Among these factors, ECMO weaning failure was identified as the strongest predictor of death in patients requiring ECMO.

Interestingly, this is the first retrospective cohort study to investigate the prevalence and risk factors associated with 30-day in-hospital mortality in a Korean sample. The current study reveals that vigilant monitoring of post-ECMO renal function and average MAP is the key to minimize the death rate, especially within the first two weeks of ECMO initiation. Additionally, the ECMO team must work together and cooperate for successful ECMO weaning for higher survival rates.

Patients on ECMO are usually cared for by ECMO specialist nurses or ICU nurses, who hold certifications in this area. However, in Korea, ICU nurses are the primary medical staff caring for ECMO patients, yet there are no specific training modules or qualification exams for this role. This study highlights the role of ICU nurses in reducing ECMO mortality rates and provides significant evidence-based framework for development of nursing practice guidelines.

Elaborating on the long-term impacts of their study, Prof. Youn-Jung concludes, “The results of our study provide sufficient evidence for developing standardized nursing practice guidelines that may provide patients with appropriate care at each point in their ECMO journey, thereby improving patient safety and reducing hospital mortality in critically ill adults on ECMO.” Furthermore, these findings could be the foundation for development of multifaceted interventions that can contribute to the improvement of health-related quality of life in patients discharged from ECMO. Finally, by reducing adverse events in patients on ECMO, unnecessary healthcare expenditures for individuals and various countries can be reduced.

 

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Reference

DOI: https://doi.org/10.1016/j.iccn.2023.103489

 

Authors: Youngeon Lee a, Insil Jang b, Joonhwa Hong c, Youn-Jung Son b

 

Affiliations:

a Emergency Intensive Care Unit, Department of Nursing, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, South Korea

b Red Cross College of Nursing, Chung-Ang University, 84 Heukseok ro, Dongjak-gu, Seoul 06974, South Korea

c Department of Thoracic and Cardiovascular Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 84 Heukseok ro, Dongjak-gu, Seoul 06974, South Korea

 

About Chung-Ang University
Chung-Ang University is a private comprehensive research university located in Seoul, South Korea. It was started as a kindergarten in 1916 and attained university status in 1953. It is fully accredited by the Ministry of Education of Korea. Chung-Ang University conducts research activities under the slogan of “Justice and Truth.” Its new vision for completing 100 years is “The Global Creative Leader.” Chung-Ang University offers undergraduate, postgraduate, and doctoral programs, which encompass a law school, management program, and medical school; it has 16 undergraduate and graduate schools each. Chung-Ang University’s culture and arts programs are considered the best in Korea.

Website: https://neweng.cau.ac.kr/index.do

 

About Professor Youn-Jung Son
Youn-Jung Son is a Professor at Cross College of Nursing, Chung-Ang University. Son and her research team are interested in reducing adverse events among patients with critical illness, especially cardiovascular diseases. She has also been working on developing dyadic intervention considering health literacy for improving adherence to self-care behaviors of patients with chronic heart failure after hospital discharge. Recently, her research team has been studying on identifying risk factors of frailty and sarcopenia among patients with cardiovascular diseases using electronic medical records or survey data. Prof. Son has nearly 240 publications to her credit, with an impressive h-index of 30.

Website: https://scholarworks.bwise.kr/cau/researcher-profile?ep=967

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JOURNAL

Intensive and Critical Care Nursing

DOI

10.1016/j.iccn.2023.103489 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Factors associated with 30-day in-hospital mortality in critically ill adult patients receiving extracorporeal membrane oxygenation: A retrospective cohort study

ARTICLE PUBLICATION DATE

1-Dec-2023

 

Bear genes show circadian rhythms even during hibernation

Peer-Reviewed Publication

WASHINGTON STATE UNIVERSITY

 

VIDEO: 

GRIZZLY BEARS OUTSIDE AT WSU BEAR CENTER

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CREDIT: WASHINGTON STATE UNIVERSITY

PULLMAN, Wash. – The internal clocks of grizzly bears appear to keep ticking through hibernation, according to a genetic study. This persistence highlights the strong role of circadian rhythms in the metabolism of many organisms including humans.  

The Washington State University-led genetic study confirmed observational evidence that bears’ energy production still waxes and wanes in a daily pattern even as they slumber for several months without eating. The researchers also found that during hibernation the amplitude of the energy production was blunted, meaning the range of highs and lows was reduced. The peak also occurred later in the day under hibernation than during the active season, but the daily fluctuation was still there. 

“This underscores the importance of the circadian rhythms themselves—that they give organisms the flexibility to still function in a state as extreme as a hibernating bear,” said Heiko Jansen, a professor in WSU’s integrative physiology and neuroscience department and senior author on the study in the Journal of Comparative Physiology B.

Other research has shown that circadian rhythms, the 24-hour physical cycles common to most living animals on Earth, have ties to metabolic health. In humans, major disruptions to these patterns, such as occur in night shift work, have been linked to metabolic problems like weight gain and higher prevalence of diabetes.

In some sense, bears are extreme shift workers, taking as much as six months off when they hibernate. Researchers like Jansen’s team are attempting to figure out how they engage in seemingly unhealthy habits of gaining excessive weight then going without food and not moving much for several months – all without detrimental effects like loss of bone mass or diseases like diabetes.

Unlike hibernating rodents who are almost comatose, bears do move around occasionally during this dormant period. Through observation studies of grizzly bears at the WSU Bear Center, researchers found these movements tend to follow a circadian rhythm with more activity during the day than at night.

In the current study, the researchers looked to see if that circadian rhythm was expressed on the cellular level. They took cell samples from six bears during active and hibernating seasons, then cultured those cells to conduct an array of genetic analyses.

To mimic hibernation, the researchers examined the cells at the bears’ typical lowered body temperature during hibernation at about 34 degrees Celsius (93.2 degrees Fahrenheit) and compared that to 37 C (98.6 F) during the active season.

They found thousands of genes were expressed rhythmically in hibernating bear cells. This translated into rhythms of energy through rise and fall of production of adenosine triphosphate or ATP, the body’s cellular source of energy. ATP was still produced in a daily pattern under hibernation but the production had a blunted amplitude, lower peaks and valleys. The highest production point also shifted to later in the day under hibernation than under active season conditions.

Maintaining a circadian rhythm requires some energy itself. The researchers believe that by altering this rhythm some during hibernation may allow bears to still get some energetic benefit of the daily cycle without as much of cost – which likely helps them survive going without food for months.

“It's like setting a thermostat. If you want to conserve some energy, you turn down the thermostat, and this is essentially what the bears are doing,” Jansen said. “They’re using the ability to suppress the circadian rhythm, but they don’t stop the clock from running. It's a really novel way of fine-tuning a metabolic process and energy expenditure in an animal.”

Co-authors on the study include first author Ellery Vincent as well as Blair Perry and Charles Robbins of WSU and Joanna Kelley of University of California, Santa Cruz. This research received support from the National Science Foundation and the Bear Research and Conservation Endowment at WSU.

Hibernating grizzly bears at W [VIDEO] | 

Grizzly bear outside at WSU Bear Center

Grizzly bears outside at WSU Bear Center

CREDIT

Bob Hubner, Washington State UniversityJOURNAL

Journal of Comparative Physiology B

DOI

10.1007/s00360-023-01513-5