Powdery mildew negatively impacts wheat yield and quality.Emmer wheat(Triticum dicoccum),an ancestral species of common wheat,is a gene donor for wheat improvement.Cultivated emmer accession H1-707 exhibited all-stage...Powdery mildew negatively impacts wheat yield and quality.Emmer wheat(Triticum dicoccum),an ancestral species of common wheat,is a gene donor for wheat improvement.Cultivated emmer accession H1-707 exhibited all-stage resistance to powdery mildew over consecutive years.Genetic analysis of H1-707 at the seedling stage revealed a dominant monogenic inheritance pattern,and the underlying gene was designated Pm71.By employing bulked segregant exome sequencing(BSE-Seq)and using 2000 F2:3 families,Pm71 was fine mapped to a 336-kb interval on chromosome arm 6AS by referencing to the durum cv.Svevo RefSeq 1.0.Collinearity analysis revealed high homology in the candidate interval between Svevo and six Triticum species.Among six high-confidence genes annotated within this interval,TRITD6Av1G005050 encoding a GDSL esterase/lipase was identified as a key candidate for Pm71.展开更多
Exploring high-efficiency and broadband microwave absorption(MA)materials with corrosion resistance and low cost is ur-gently needed for wide practical applications.Herein,the natural porous attapulgite(ATP)nanorods e...Exploring high-efficiency and broadband microwave absorption(MA)materials with corrosion resistance and low cost is ur-gently needed for wide practical applications.Herein,the natural porous attapulgite(ATP)nanorods embedded with TiO_(2)and polyaniline(PANI)nanoparticles are synthesized via heterogeneous precipitation and in-situ polymerization.The obtained PANI-TiO_(2)-ATP one-di-mensional(1D)nanostructures can intertwine into three-dimensional(3D)conductive network,which favors energy dissipation.The min-imum reflection loss(RL_(min))of the PANI-TiO_(2)-ATP coating(20wt%)reaches-49.36 dB at 9.53 GHz,and the effective absorption band-width(EAB)can reach 6.53 GHz with a thickness of 2.1 mm.The excellent MA properties are attributed to interfacial polarization,mul-tiple loss mechanisms,and good impedance matching induced by the synergistic effect of PANI-TiO_(2)nanoparticle shells and ATP nanor-ods.In addition,salt spray and Tafel polarization curve tests reveal that the PANI-TiO_(2)-ATP coating shows outstanding corrosion resist-ance performance.This study provides a low-cost and high-efficiency strategy for constructing 1D nanonetwork composites for MA and corrosion resistance applications using natural porous ATP nanorods as carriers.展开更多
Alzheimer's disease(AD),the most common form of neurodegeneration,is characterized by selective neuronal vulnerability and brain regionselective neuron demise.The entorhinal cortex and hippoc,ampal CA1 projection ...Alzheimer's disease(AD),the most common form of neurodegeneration,is characterized by selective neuronal vulnerability and brain regionselective neuron demise.The entorhinal cortex and hippoc,ampal CA1 projection neurons are at greater risk in AD whereas other regions display resistance to neurodegeneration.Interestingly,the cerebellum,a phylogenetically very old region,is affected only very late in the disease progression.展开更多
Type 2 diabetes mellitus and Parkinson's disease are chronic diseases linked to a growing pandemic that affects older adults and causes significant socio-economic burden.Epidemiological data supporting a close rel...Type 2 diabetes mellitus and Parkinson's disease are chronic diseases linked to a growing pandemic that affects older adults and causes significant socio-economic burden.Epidemiological data supporting a close relationship between these two aging-related diseases have resulted in the investigation of shared pathophysiological molecular mechanisms.Impaired insulin signaling in the brain has gained increasing attention during the last decade and has been suggested to contribute to the development of Parkinson's disease through the dysregulation of several pathological processes.The contribution of type 2 diabetes mellitus and insulin resistance in neurodegeneration in Parkinson's disease,with emphasis on brain insulin resistance,is extensively discussed in this article and new therapeutic strategies targeting this pathological link are presented and reviewed.展开更多
Bacterial blight(BB),caused by Xanthomonas oryzae pathovar oryzae(Xoo),poses a significant threat to rice production,particularly in Asia and West Africa.Breeding resistance against BB in elite rice varieties is cruci...Bacterial blight(BB),caused by Xanthomonas oryzae pathovar oryzae(Xoo),poses a significant threat to rice production,particularly in Asia and West Africa.Breeding resistance against BB in elite rice varieties is crucial to advancing rice breeding program and supporting smallholder farmers.Transcription Activator-Like effectors(TALes)are key virulence factors in Xoo,with some targeting the susceptibility(S)genes such as the sugar transporter SWEET genes in rice.Among these,SWEET14 is an important S gene,with its promoter bound by the TALe TalC which exists across all sequenced African Xoo isolates.In the present study,we utilized CRISPR/Cas9-based cytidine and adenine base editors to alter the effector binding element(EBE)of TalC in the promoter of SWEET14 in rice cultivars Kitaake,IR24,and Zhonghua 11.Mutations with C to T changes in EBE led to reduced SWEET14 induction by TalC-containing Xoo strains,resulting in resistance to African Xoo isolates reliant on TalC for virulence.Conversely,A to G changes retained SWEET14 inducibility and susceptibility to Xoo in edited lines.Importantly,no off-target mutations were detected at predicted sites,and the edited lines exhibited no obvious defects in major agronomic traits in Kitaake.These results underscore the effectiveness of base editing systems for both molecular biology research and crop improvement endeavors.展开更多
BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring except...BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring exceptional high-dose insulin is rare.CASE SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest,subsequently developing transient EIR following a new episode of sepsis.Remarkably,insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour(a total of 18224 units on that day),and it was promptly titrated down to zero upon achieving the target glucose level.CONCLUSION Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR,which is typically transient.Clinicians should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.展开更多
In-situ formed high Mn steel coating reinforced by carbides was formed by laser surface alloying(LSA).Laser alloyed layers on 1Cr18Ni9Ti steel with Mn+W_(2)C(specimen A),Mn+NiWC(specimen B)and Mn+SiC(specimen C)powder...In-situ formed high Mn steel coating reinforced by carbides was formed by laser surface alloying(LSA).Laser alloyed layers on 1Cr18Ni9Ti steel with Mn+W_(2)C(specimen A),Mn+NiWC(specimen B)and Mn+SiC(specimen C)powders were fabricated to improve the wear and corrosion behavior of 1Cr18Ni9Ti steel blades in high speed mixers.Microstructure evolution,phases,element distribution,microhardness,wear and corrosion behavior of the laser alloyed layers were investigated.Results indicated that high Mn steel matrix composites with undissolved W_(2)C,WC and other in-situ formed carbides were formed by LSA with Mn+W_(2)C and Mn+NiWC while SiC totally dissolved into the high Mn matrix when adding Mn+SiC.Ni as the binding phase in Ni-WC powder decreased the crack sensitivity of the alloyed layer as compared with the addition of W_(2)C powder.An improvement in average microhardness was achieved in the matrix in specimen A,B and C,with the value of 615,602 and 277 HV_(0.5),while that of the substrate was 212 HV_(0.5).The increase of microhardness,wear and corrosion resistance is highly corelated to microstructure,formed phases,type and content of carbides,micro-hardness and toughness of the alloyed layers.展开更多
Viruses are significant pathogens causing severe plant infections and crop losses globally.The resistance mechanisms of rice to viral diseases,particularly Southern rice black-streaked dwarf virus(SRBSDV),remain poorl...Viruses are significant pathogens causing severe plant infections and crop losses globally.The resistance mechanisms of rice to viral diseases,particularly Southern rice black-streaked dwarf virus(SRBSDV),remain poorly understood.In this study,we assessed SRBSDV susceptibility in 20 Xian/indica(XI)and 20 Geng/japonica(GJ)rice varieties.XI-1B accessions in the Xian subgroup displayed higher resistance than GJ accessions.Comparative transcriptome analysis revealed changes in processes like oxidoreductase activity,jasmonic acid(JA)metabolism,and stress response.JA sensitivity assays further linked antiviral defense to the JA pathway.These findings highlight a JA-mediated resistance mechanism in rice and offer insights for breeding SRBSDV-resistant varieties.展开更多
BACKGROUND Through deeper understanding of targetable driver mutations in non-small-cell lung cancer(NSCLC)over the past years,some patients with driver mutations have benefited from the targeted molecular therapies.A...BACKGROUND Through deeper understanding of targetable driver mutations in non-small-cell lung cancer(NSCLC)over the past years,some patients with driver mutations have benefited from the targeted molecular therapies.Although the anaplastic lymphoma kinase and BRAF mutations are not frequent subtypes in NSCLC,the availability of several targeted-drugs has been confirmed through a series of clinical trials.But little is clear about the proper strategy in rare BRAF G469A mutation,not to mention co-exhibition of anaplastic lymphoma kinase and BRAF G469A mutations,which is extremely rare in NSCLC.CASE SUMMARY We present a patient to stage IVA lung adenocarcinoma with coexisting echinoderm microtubule associated protein like-4 rearrangement and BRAF G469A mutation.She received several targeted drugs with unintended resistance and suffered from unbearable adverse events.CONCLUSION Due to the rarity of co-mutations,the case not only enriches the limited literature on NSCLC harbouring BRAF G469A and echinoderm microtubule associated protein like-4 mutations,but also suggests the efficacy and safety of specific multiple-drug therapy in such patients.展开更多
Introduction: The misuse of antibiotics has driven the emergence of antimicrobial resistance, with certain bacterial species, including Klebsiella pneumoniae, initially susceptible to most antibiotics, now exhibiting ...Introduction: The misuse of antibiotics has driven the emergence of antimicrobial resistance, with certain bacterial species, including Klebsiella pneumoniae, initially susceptible to most antibiotics, now exhibiting resistance to multiple antimicrobial agents. The objective of this study was to investigate the distribution and antimicrobial resistance profiles of Klebsiella pneumoniae strains isolated at the Yaoundé Central Hospital. Methodology: The study was conducted over a period of 4 months (March 1st, 2023-July 1st, 2023) and involved 32 strains isolated from bacterial cultures performed on patients, regardless of sex. The different Klebsiella pneumoniae strains were isolated using conventional methods. Identification, antibiogram, and detection of resistance enzyme production were generated using the VITEK 2 system. The Carbapenem-resistant K.N.I.V.O. kit was used to detect carbapenemases. Data analysis was performed using EXCEL 2019 software. Results: Out of 196 samples collected from various biological products, 32 Klebsiella pneumoniae strains were isolated, representing 16.32% (196/32). Urine samples were most frequently affected, accounting for 53.125%. The emergency department was the most represented (40.63%) by these isolates. The mean age was 50 years, with a minimum of 20 years and a maximum of 80 years. The sex ratio was equal to 1. The identified strains were resistant to cefotaxime (78.13%), cefoxitin (62.50%), tobramycin (71.88%), gentamicin (56.25%), ofloxacin (81.25%), and cotrimoxazole (78.13%). 78.25% were ESBL producers. Three strains were resistant to carbapenems, accounting for 9.37%;one of which exhibited the NDM type. Conclusion: This study highlights the evolving bacterial resistance to antibiotics, which requires adequate measures through the strengthening of the Antimicrobial Resistance (AMR) program in Cameroon.展开更多
Background: Antimicrobial Resistance (AMR) has been recognized as a global public health problem of utmost importance that needs to be tackled. Low-income countries such as Uganda have the greatest burden of severe an...Background: Antimicrobial Resistance (AMR) has been recognized as a global public health problem of utmost importance that needs to be tackled. Low-income countries such as Uganda have the greatest burden of severe and life-threatening infections and are most likely to suffer more from the spread of untreatable resistant bacteria. Despite the generally increasing trends in AMR, there is hardly any documented data on AMR in orthopedic care. Methods: We analyzed data from the pathogenic isolates from pus and tissue from the laboratory from 2019 to 2023. We calculated the proportions of isolates resistant to commonly used antimicrobial classes. We used the chi-square test for trends to evaluate changes in AMR across the study period. Results: Out of the 286 isolates, 104 (43.5%) were from pus, 112 (46.9%) were from tissue samples and the remaining 9.6% were from different fluid aspirates like synovial fluid. Most of the isolates were from males (64.2%) and aged between 19 and 45 years (46.2%). The distribution of whether the bacteria were gram-positive or negative was relatively equal with 114 (45.2%) being gram-negative and 120 (47.6%) gram-positive. Generally, there was increased AMR across all antibiotics from 2019 to 2021 e.g. for Imipinem, it went from 0% in 2019 to 70.8% in 2021 and for Amoxyclav, it went from 10% in 2019 to 93.2% in 2021. There was a general decline in AMR noted from 2021 to 2023. However, currently, the highest resistance is noted in ceftriaxone (80.0%) and the lowest in Imipinem (11.76%). Conclusion: There is a general decreasing trend in AMR, most probably due to increasing policies governing the use of antibiotics. However, there is still high resistance to commonly used and affordable antibiotics. Continuous monitoring of AMR is still recommended to reduce the AMR problem in Uganda at large through public health policy and planning.展开更多
Despite their biodegradability and economic advantage, plant leaves used as packaging can constitute a public health problem. The aim of this study was to characterize the microbial diversity contaminating plant leave...Despite their biodegradability and economic advantage, plant leaves used as packaging can constitute a public health problem. The aim of this study was to characterize the microbial diversity contaminating plant leaves used as food packaging. In total, two hundred and forty (240) samples composed of Thaumatococcus daniellii and Musa paradisiaca leaves were collected and analyzed. Microbial diversity was assessed using specific medium and biochemical tests. The resistance profile was determined by the Müeller-Hinton agar diffusion method. The resistance (blaSHV, blaIMP, blaTEM) and biofilm formation (pslA, pelA) genes were searched by PCR method. Plant leaves were contaminated by bacterial (68.7%) and fungal (100%) strains. Extreme bacterial (7.1 log10 cfu/cm2) and fungal (3.5 log10 cfu/cm2) loads were obtained on Thaumatococcus daniellii leaves. Bacterial prevalence was 45.1% (S. aureus), 38.8% (E. coli) and 16.1 (P. aeruginosa). In order of decreasing importance, the prevalence of fungal species was 41.1% (A. flavus), 33.1% (A. fumigattus), 13.7% (A. niger) and 12.1% Candida sp. Resistance of E. coli to penicillins ranges from 31.6% to 87.3% and to cephalosporins from 13.3% to 28%. The P. aeruginosa strains were mainly resistant to aztreonam (87.6%). Those of S. aureus showed resistance to tetracycline (67.6), vancomycin (53), erythromycin (44.6) and levofloxacin (32.7). The blaSHV (14.28% to 18.60%) and blaIMP (9.52% to 16.28%) genes were detected in the bacterial strains. P. aeruginosa strains (19.05%) harbored the pslA and pelA genes. The health safety of these biodegradable plant-based packaging contributes to their valorization.展开更多
Aims and objectives: The frequent and unprescribed use of antibiotics has led to the development of resistance by microorganisms responsible for urinary tract infection (UTI). In order to facilitate the follow-up of t...Aims and objectives: The frequent and unprescribed use of antibiotics has led to the development of resistance by microorganisms responsible for urinary tract infection (UTI). In order to facilitate the follow-up of this microbial resistance, the aim of this study was to determine the bacteria resistant phenotypes. Method: To achieve the following objectives, this study was conducted from June to August 2023. The isolation and identification were performed by standard methods why susceptibility testing was done by Kirby-Bauer disk diffusion technique according to CLSI guidelines. Double-disk synergy test was applied to determine the presence of extended-spectrum β-lactamase (ESBL) produced by bacteria. The Imipenem EDTA Combined Disc Test (CDT) for Metallo beta lactamase (MBL) screening, the D-zone test to detect macrolides, lincosamides and streptogramins type B (MLSB) and Meticillin resistant Staphylococcus aureus (MRS A) which was assessed using a Cefoxitin (30 µg) disc. Results: A total of 40 bacteria were identified with a prevalence of 37.03%. Overall, E. coli was the predominant isolate 14 (35%), followed by Staphylococcus aureus 10 (25%) and Klesbsiella pneumonia 4 (10%). Pseudomonas aeruginosa, Salmonella arinosa and Enterobacter were the most sensible (100%) bacteria against ciprofloxin, ceftriaxone and cefixime. Almost all bacteria were resistant to Amoxicillin/clavulanic acid (>50%). The isolates were in the majority resistant to imipenem. ESBL-producing Enterobacteriaceae represented 25.92%, with a higher rate among E. coli. No MBL production was found among the isolates while 38.46% represented cMLSB, 15.38% represented iMLSB, 23.07% represented MSB and 23.07% represented MRSA. Conclusion: Clinical strains of UTI from Protestant Hospital of Ngaoundere exhibiting ESBL, cMLSB, iMLSB, MSB and MRSA. The regular updating of antibiotic resistance statistics of isolated strains allows for a better adaptation of probabilistic antibiotic therapy.展开更多
Purpose: Gastrointestinal stromal tumor (GIST) has been considered radiation-resistant and data on the radiotherapy for GIST in previous studies are lacking. The purpose of this article is to accumulate more experienc...Purpose: Gastrointestinal stromal tumor (GIST) has been considered radiation-resistant and data on the radiotherapy for GIST in previous studies are lacking. The purpose of this article is to accumulate more experience in the application of radiotherapy for GISTs. Materials and methods: Review our own case material and the relevant English literature. Results: A huge pelvic GIST after resistance to tyrosine kinase inhibitors (TKIs) has been well controlled by simultaneous-integrated boost intensity-modulated radiation therapy (SIB-IMRT). The time from the initial shrinkage of the mass and subsequent stabilization to now was more than 18 months. The patient was palliated from the series of symptoms caused by tumor compression and well tolerated to the adverse reactions by radiotherapy. And the previous studies have shown that GISTs had a certain sensitivity to radiotherapy. Conclusion: SIB-IMRT may provide a new means of achieving objective response and prolonging survival in selected GIST patients.展开更多
Firefighters rely on their protective gear for thermal insulation during fires. This study evaluated the flame resistance of firefighter PPE, including helmets, turnout gear, and gloves, under extreme conditions. Resu...Firefighters rely on their protective gear for thermal insulation during fires. This study evaluated the flame resistance of firefighter PPE, including helmets, turnout gear, and gloves, under extreme conditions. Results showed excellent performance of the F1 helmet but identified areas for improvement in gloves and turnout gear. The study provides insights into the heat transfer properties of different PPE components and offers recommendations for enhancing firefighter safety.展开更多
Background: Diabetes mellitus (DM) is a disease characterized by hyperglycemia due to (a) insulin-insufficiency (type I DM), or (b) impaired glucose cell-entry (insulin resistance) due to the downregulation of insulin...Background: Diabetes mellitus (DM) is a disease characterized by hyperglycemia due to (a) insulin-insufficiency (type I DM), or (b) impaired glucose cell-entry (insulin resistance) due to the downregulation of insulin cell receptors (type II DM). Type I DM usually presents with florid manifestations contrary to a slowly-progressive type II. Patients and methods: Over the past 10 years, we encountered 9 obese patients with controlled insulin-requiring type II DM for years, at a dose of 62 ± 5 units/day, who developed sudden and severe insulin resistance (IR) that required 210 ± 25 units daily. All patients had very high levels of anti-Glutamic Acid Decarboxylase (GAD) antibodies. Despite a lack of previous testing for anti-GAD antibodies, they were treated, with Cyclosporin A (Cy), as an autoimmune disorder superimposed on their type II MD. Initially all patients were treated with 100 mg, of Cy, twice daily aiming at an initial trough level of 100 - 150 ng/ml. Three months later, the dose was reduced to 50 mg twice daily for a total of 2 years. Results: Amelioration of IR was achieved by 1 month with a reduction of daily insulin requirement to 123 ± 16 units that further decreased to 76 ± 11 by the end of the 3rd month. Such improvement persisted for 2 years and >1 year after Cy discontinuation. Moreover, a decline in insulin requirements was associated with a parallel decrease in anti-GAD antibody levels and an increase in C-peptide insulin without kidney disease. Conclusion: Anti-GAD antibodies can induce acute IR in type II DM, and this phenomenon can be treated safely and effectively with Cy.展开更多
Concrete buildings used in cold regions are prone to freeze-thaw damage, leading to internal cracking and surface peeling of the concrete. Therefore, improving the freeze-thaw resistance of concrete is of great signif...Concrete buildings used in cold regions are prone to freeze-thaw damage, leading to internal cracking and surface peeling of the concrete. Therefore, improving the freeze-thaw resistance of concrete is of great significance for the safety of hydraulic engineering. This paper explores the effect of basalt fibers on improving the frost resistance index of concrete through a series of experiments, and analyzes the influencing mechanism. The results show that adding an appropriate amount of basalt fibers can significantly improve the frost resistance of concrete and reduce the freeze-thaw damage phenomenon indicated by concrete specimens. Adding 0.1% basalt fiber can maintain the relative dynamic modulus of concrete specimens at 98% after 150 freeze-thaw cycles, while adding 0.3% basalt fiber can control the quality loss rate of concrete specimens after 150 freeze-thaw cycles at 0.87%. Taking into account both the frost resistance effect and economic factors, it is recommended that the basalt fiber content in frost resistant concrete be 0.1%. The research results can provide reference and guidance for the optimization design of the mix proportion of hydraulic concrete in cold regions.展开更多
This editorial discusses the findings of Elbarky et al on the role of selenoprotein P1(SEPP1)in pediatric obesity and insulin resistance.Their study uncovered si-gnificantly lower SEPP1 Levels in children who were obe...This editorial discusses the findings of Elbarky et al on the role of selenoprotein P1(SEPP1)in pediatric obesity and insulin resistance.Their study uncovered si-gnificantly lower SEPP1 Levels in children who were obese compared with hea-lthy peers,demonstrating a negative correlation between SEPP1 levels and mea-sures of adiposity and insulin resistance.These findings suggest that SEPP1 is a biomarker useful in the early identification of insulin resistance in pediatric populations.This editorial emphasizes the clinical implications of the study and calls for further research to validate and explore the role of SEPP1 in metabolic health.展开更多
Asian rice comprises two major subspecies:Xian(X)and Geng(G),and the diverged resistance genes(R)have provided a foundation for breeding improved cultivars to control rice blast disease.After conducting two-phase alle...Asian rice comprises two major subspecies:Xian(X)and Geng(G),and the diverged resistance genes(R)have provided a foundation for breeding improved cultivars to control rice blast disease.After conducting two-phase allele mining using six updated FNP marker systems,the functional haplotypes at Pit,Pib,and Pi63 strictly diverged into the X-populations and were defined as X-R loci,while those at Pi54,Pi37,and Pi36 into the G-populations as G-R loci.The genic diversity at the three X-R loci(16 alleles)was twofold higher than that at the three G-R loci(8 alleles),and the allelic diversity in the Southern region(21 alleles)was nearly double that in the Northeastern region(11 alleles).Both observations reflect a significant difference in genetic diversity between X-and G-populations,and indicate that the effective R-genes mainly originated from X-subspecies.Based on the allelic structures characterized by a set of 10 parameters,8 and 16 alleles were respectively recognized as favorable and promising ones for the regional breeding programs.The genotypic structures of the two regional populations were almost different,indicating that the diverged alleles have been further assembled into two series of regional genotypes through long-term breeding programs,despite the presence of one-third of region-common alleles.The genotypic diversity in the Southern region(55 genotypes)was nearly twice as high as that in the Northeastern region(28),which perfectly reflects the aforementioned differences in both genic and allelic diversities.After analyzing the genotypic structures using a set of 13 parameters,4 and 23 genotypes,respectively,can be recommended as the favorable and promising ones for the regional breeding programs.The case study serves as a concrete sample of how to identify the favorable and promising alleles and genotypes,and beneficial parents based their comprehensive population structures for gene-designed breeding.展开更多
BACKGROUND In the absence of effective antimicrobials,transplant surgery is not viable,and antirejection immunosuppressants cannot be administered,as resistant infections compromise the life-saving goal of organ trans...BACKGROUND In the absence of effective antimicrobials,transplant surgery is not viable,and antirejection immunosuppressants cannot be administered,as resistant infections compromise the life-saving goal of organ transplantation.AIM To evaluate the efficacy of antimicrobials in preventing resistance in solid organ transplant recipients.METHODS A systematic review was conducted using a search methodology consistent with the preferred reporting items for systematic reviews and meta-analyses.This review included randomized clinical trials that evaluated the efficacy of antimicrobial agents(prophylactic or therapeutic)aimed at preventing antimicrobial resistance.The search strategy involved analyzing multiple databases,including PubMed/MEDLINE,Web of Science,Embase,Scopus,and SciELO,as well as examining gray literature sources on Google Scholar.A comprehensive electronic database search was conducted from the databases’inception until May 2024,with no language restrictions.RESULTS After the final phase of the eligibility assessment,this systematic review ultimate-ly included 7 articles.A total of 2318 patients were studied.The most studied microorganisms were cytomegalovirus,although vancomycinresistant enterococci,Clostridioides difficile,and multidrug-resistant Enterobacterales were also analyzed.The antimicrobials used in the interventions were mainly maribavir,valganciclovir,gancic-lovir,and colistin-neomycin.Of concern,all clinical trials showed significant proportions of resistant microorga-nisms after the interventions,with no statistically significant differences between the groups(mean resistance 13.47%vs 14.39%),except for two studies that demonstrated greater efficacy of maribavir and valganciclovir(mean resistance 22.2%vs 41.1%in the control group;P<0.05).The total reported deaths in three clinical trials were 75,and there were 24 graft rejections in two studies.CONCLUSION All clinical trials reported significant proportions of antimicrobial-resistant microorganisms following interventions.More high-quality randomized clinical trials are needed to corroborate these results.展开更多
基金financially supported by National Natural Science Foundation of China(32301800,32301923 and 32072053)Wheat Industrial Technology System of Shandong Province(SDAIT-01-01)Key Research and Development Project of Shandong Province(2022LZG002-4,2023LZGC009-4-4).
文摘Powdery mildew negatively impacts wheat yield and quality.Emmer wheat(Triticum dicoccum),an ancestral species of common wheat,is a gene donor for wheat improvement.Cultivated emmer accession H1-707 exhibited all-stage resistance to powdery mildew over consecutive years.Genetic analysis of H1-707 at the seedling stage revealed a dominant monogenic inheritance pattern,and the underlying gene was designated Pm71.By employing bulked segregant exome sequencing(BSE-Seq)and using 2000 F2:3 families,Pm71 was fine mapped to a 336-kb interval on chromosome arm 6AS by referencing to the durum cv.Svevo RefSeq 1.0.Collinearity analysis revealed high homology in the candidate interval between Svevo and six Triticum species.Among six high-confidence genes annotated within this interval,TRITD6Av1G005050 encoding a GDSL esterase/lipase was identified as a key candidate for Pm71.
基金support from the National Key Research and Development Program of China(No.2021YFB3701503)the Key Research and Development Program of Ningbo,China(No.2023Z107)+1 种基金the Jiangsu Key R&D program,China(No.BE2019072)the special project of Gansu regional science and technology cooperation,China(No.20JR10 QA579).
文摘Exploring high-efficiency and broadband microwave absorption(MA)materials with corrosion resistance and low cost is ur-gently needed for wide practical applications.Herein,the natural porous attapulgite(ATP)nanorods embedded with TiO_(2)and polyaniline(PANI)nanoparticles are synthesized via heterogeneous precipitation and in-situ polymerization.The obtained PANI-TiO_(2)-ATP one-di-mensional(1D)nanostructures can intertwine into three-dimensional(3D)conductive network,which favors energy dissipation.The min-imum reflection loss(RL_(min))of the PANI-TiO_(2)-ATP coating(20wt%)reaches-49.36 dB at 9.53 GHz,and the effective absorption band-width(EAB)can reach 6.53 GHz with a thickness of 2.1 mm.The excellent MA properties are attributed to interfacial polarization,mul-tiple loss mechanisms,and good impedance matching induced by the synergistic effect of PANI-TiO_(2)nanoparticle shells and ATP nanor-ods.In addition,salt spray and Tafel polarization curve tests reveal that the PANI-TiO_(2)-ATP coating shows outstanding corrosion resist-ance performance.This study provides a low-cost and high-efficiency strategy for constructing 1D nanonetwork composites for MA and corrosion resistance applications using natural porous ATP nanorods as carriers.
基金supported by a grant of the Deutsche Forschungsgemeinschaft(DFGCRC1177 and joint DFG/ANR grant)(to CB)a fellowship of the Deutscher Akademischer Austauschdienst(DAAD)(to TNMP)。
文摘Alzheimer's disease(AD),the most common form of neurodegeneration,is characterized by selective neuronal vulnerability and brain regionselective neuron demise.The entorhinal cortex and hippoc,ampal CA1 projection neurons are at greater risk in AD whereas other regions display resistance to neurodegeneration.Interestingly,the cerebellum,a phylogenetically very old region,is affected only very late in the disease progression.
基金support from Region Stockholm,ALF-project(FoUI-960041)Open Access funding is provided by Karolinska Institute(both to IM)。
文摘Type 2 diabetes mellitus and Parkinson's disease are chronic diseases linked to a growing pandemic that affects older adults and causes significant socio-economic burden.Epidemiological data supporting a close relationship between these two aging-related diseases have resulted in the investigation of shared pathophysiological molecular mechanisms.Impaired insulin signaling in the brain has gained increasing attention during the last decade and has been suggested to contribute to the development of Parkinson's disease through the dysregulation of several pathological processes.The contribution of type 2 diabetes mellitus and insulin resistance in neurodegeneration in Parkinson's disease,with emphasis on brain insulin resistance,is extensively discussed in this article and new therapeutic strategies targeting this pathological link are presented and reviewed.
基金supported by a sub-award to the University of Missouri from the Heinrich Heine University of Dusseldorf funded by the Bill&Melinda Gates Foundation(OPP1155704)(Bing Yang)and the China Scholar Council(Chenhao Li,as a joint Ph.D.student).
文摘Bacterial blight(BB),caused by Xanthomonas oryzae pathovar oryzae(Xoo),poses a significant threat to rice production,particularly in Asia and West Africa.Breeding resistance against BB in elite rice varieties is crucial to advancing rice breeding program and supporting smallholder farmers.Transcription Activator-Like effectors(TALes)are key virulence factors in Xoo,with some targeting the susceptibility(S)genes such as the sugar transporter SWEET genes in rice.Among these,SWEET14 is an important S gene,with its promoter bound by the TALe TalC which exists across all sequenced African Xoo isolates.In the present study,we utilized CRISPR/Cas9-based cytidine and adenine base editors to alter the effector binding element(EBE)of TalC in the promoter of SWEET14 in rice cultivars Kitaake,IR24,and Zhonghua 11.Mutations with C to T changes in EBE led to reduced SWEET14 induction by TalC-containing Xoo strains,resulting in resistance to African Xoo isolates reliant on TalC for virulence.Conversely,A to G changes retained SWEET14 inducibility and susceptibility to Xoo in edited lines.Importantly,no off-target mutations were detected at predicted sites,and the edited lines exhibited no obvious defects in major agronomic traits in Kitaake.These results underscore the effectiveness of base editing systems for both molecular biology research and crop improvement endeavors.
文摘BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring exceptional high-dose insulin is rare.CASE SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest,subsequently developing transient EIR following a new episode of sepsis.Remarkably,insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour(a total of 18224 units on that day),and it was promptly titrated down to zero upon achieving the target glucose level.CONCLUSION Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR,which is typically transient.Clinicians should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.
文摘In-situ formed high Mn steel coating reinforced by carbides was formed by laser surface alloying(LSA).Laser alloyed layers on 1Cr18Ni9Ti steel with Mn+W_(2)C(specimen A),Mn+NiWC(specimen B)and Mn+SiC(specimen C)powders were fabricated to improve the wear and corrosion behavior of 1Cr18Ni9Ti steel blades in high speed mixers.Microstructure evolution,phases,element distribution,microhardness,wear and corrosion behavior of the laser alloyed layers were investigated.Results indicated that high Mn steel matrix composites with undissolved W_(2)C,WC and other in-situ formed carbides were formed by LSA with Mn+W_(2)C and Mn+NiWC while SiC totally dissolved into the high Mn matrix when adding Mn+SiC.Ni as the binding phase in Ni-WC powder decreased the crack sensitivity of the alloyed layer as compared with the addition of W_(2)C powder.An improvement in average microhardness was achieved in the matrix in specimen A,B and C,with the value of 615,602 and 277 HV_(0.5),while that of the substrate was 212 HV_(0.5).The increase of microhardness,wear and corrosion resistance is highly corelated to microstructure,formed phases,type and content of carbides,micro-hardness and toughness of the alloyed layers.
基金funded by the National Key Research and Development Plan of China(2023YFD1400300)National Natural Science Foundation of China(U23A6006,32270149,32272555)+1 种基金Zhejiang Provincial Natural Science Foundation(LZ22C140001)the Ningbo Major Research and Development Plan Project(2023Z124).
文摘Viruses are significant pathogens causing severe plant infections and crop losses globally.The resistance mechanisms of rice to viral diseases,particularly Southern rice black-streaked dwarf virus(SRBSDV),remain poorly understood.In this study,we assessed SRBSDV susceptibility in 20 Xian/indica(XI)and 20 Geng/japonica(GJ)rice varieties.XI-1B accessions in the Xian subgroup displayed higher resistance than GJ accessions.Comparative transcriptome analysis revealed changes in processes like oxidoreductase activity,jasmonic acid(JA)metabolism,and stress response.JA sensitivity assays further linked antiviral defense to the JA pathway.These findings highlight a JA-mediated resistance mechanism in rice and offer insights for breeding SRBSDV-resistant varieties.
基金Supported by the Medical Education Collaborative Innovation Fund of Jiangsu University,No.JDY2022015。
文摘BACKGROUND Through deeper understanding of targetable driver mutations in non-small-cell lung cancer(NSCLC)over the past years,some patients with driver mutations have benefited from the targeted molecular therapies.Although the anaplastic lymphoma kinase and BRAF mutations are not frequent subtypes in NSCLC,the availability of several targeted-drugs has been confirmed through a series of clinical trials.But little is clear about the proper strategy in rare BRAF G469A mutation,not to mention co-exhibition of anaplastic lymphoma kinase and BRAF G469A mutations,which is extremely rare in NSCLC.CASE SUMMARY We present a patient to stage IVA lung adenocarcinoma with coexisting echinoderm microtubule associated protein like-4 rearrangement and BRAF G469A mutation.She received several targeted drugs with unintended resistance and suffered from unbearable adverse events.CONCLUSION Due to the rarity of co-mutations,the case not only enriches the limited literature on NSCLC harbouring BRAF G469A and echinoderm microtubule associated protein like-4 mutations,but also suggests the efficacy and safety of specific multiple-drug therapy in such patients.
文摘Introduction: The misuse of antibiotics has driven the emergence of antimicrobial resistance, with certain bacterial species, including Klebsiella pneumoniae, initially susceptible to most antibiotics, now exhibiting resistance to multiple antimicrobial agents. The objective of this study was to investigate the distribution and antimicrobial resistance profiles of Klebsiella pneumoniae strains isolated at the Yaoundé Central Hospital. Methodology: The study was conducted over a period of 4 months (March 1st, 2023-July 1st, 2023) and involved 32 strains isolated from bacterial cultures performed on patients, regardless of sex. The different Klebsiella pneumoniae strains were isolated using conventional methods. Identification, antibiogram, and detection of resistance enzyme production were generated using the VITEK 2 system. The Carbapenem-resistant K.N.I.V.O. kit was used to detect carbapenemases. Data analysis was performed using EXCEL 2019 software. Results: Out of 196 samples collected from various biological products, 32 Klebsiella pneumoniae strains were isolated, representing 16.32% (196/32). Urine samples were most frequently affected, accounting for 53.125%. The emergency department was the most represented (40.63%) by these isolates. The mean age was 50 years, with a minimum of 20 years and a maximum of 80 years. The sex ratio was equal to 1. The identified strains were resistant to cefotaxime (78.13%), cefoxitin (62.50%), tobramycin (71.88%), gentamicin (56.25%), ofloxacin (81.25%), and cotrimoxazole (78.13%). 78.25% were ESBL producers. Three strains were resistant to carbapenems, accounting for 9.37%;one of which exhibited the NDM type. Conclusion: This study highlights the evolving bacterial resistance to antibiotics, which requires adequate measures through the strengthening of the Antimicrobial Resistance (AMR) program in Cameroon.
文摘Background: Antimicrobial Resistance (AMR) has been recognized as a global public health problem of utmost importance that needs to be tackled. Low-income countries such as Uganda have the greatest burden of severe and life-threatening infections and are most likely to suffer more from the spread of untreatable resistant bacteria. Despite the generally increasing trends in AMR, there is hardly any documented data on AMR in orthopedic care. Methods: We analyzed data from the pathogenic isolates from pus and tissue from the laboratory from 2019 to 2023. We calculated the proportions of isolates resistant to commonly used antimicrobial classes. We used the chi-square test for trends to evaluate changes in AMR across the study period. Results: Out of the 286 isolates, 104 (43.5%) were from pus, 112 (46.9%) were from tissue samples and the remaining 9.6% were from different fluid aspirates like synovial fluid. Most of the isolates were from males (64.2%) and aged between 19 and 45 years (46.2%). The distribution of whether the bacteria were gram-positive or negative was relatively equal with 114 (45.2%) being gram-negative and 120 (47.6%) gram-positive. Generally, there was increased AMR across all antibiotics from 2019 to 2021 e.g. for Imipinem, it went from 0% in 2019 to 70.8% in 2021 and for Amoxyclav, it went from 10% in 2019 to 93.2% in 2021. There was a general decline in AMR noted from 2021 to 2023. However, currently, the highest resistance is noted in ceftriaxone (80.0%) and the lowest in Imipinem (11.76%). Conclusion: There is a general decreasing trend in AMR, most probably due to increasing policies governing the use of antibiotics. However, there is still high resistance to commonly used and affordable antibiotics. Continuous monitoring of AMR is still recommended to reduce the AMR problem in Uganda at large through public health policy and planning.
文摘Despite their biodegradability and economic advantage, plant leaves used as packaging can constitute a public health problem. The aim of this study was to characterize the microbial diversity contaminating plant leaves used as food packaging. In total, two hundred and forty (240) samples composed of Thaumatococcus daniellii and Musa paradisiaca leaves were collected and analyzed. Microbial diversity was assessed using specific medium and biochemical tests. The resistance profile was determined by the Müeller-Hinton agar diffusion method. The resistance (blaSHV, blaIMP, blaTEM) and biofilm formation (pslA, pelA) genes were searched by PCR method. Plant leaves were contaminated by bacterial (68.7%) and fungal (100%) strains. Extreme bacterial (7.1 log10 cfu/cm2) and fungal (3.5 log10 cfu/cm2) loads were obtained on Thaumatococcus daniellii leaves. Bacterial prevalence was 45.1% (S. aureus), 38.8% (E. coli) and 16.1 (P. aeruginosa). In order of decreasing importance, the prevalence of fungal species was 41.1% (A. flavus), 33.1% (A. fumigattus), 13.7% (A. niger) and 12.1% Candida sp. Resistance of E. coli to penicillins ranges from 31.6% to 87.3% and to cephalosporins from 13.3% to 28%. The P. aeruginosa strains were mainly resistant to aztreonam (87.6%). Those of S. aureus showed resistance to tetracycline (67.6), vancomycin (53), erythromycin (44.6) and levofloxacin (32.7). The blaSHV (14.28% to 18.60%) and blaIMP (9.52% to 16.28%) genes were detected in the bacterial strains. P. aeruginosa strains (19.05%) harbored the pslA and pelA genes. The health safety of these biodegradable plant-based packaging contributes to their valorization.
文摘Aims and objectives: The frequent and unprescribed use of antibiotics has led to the development of resistance by microorganisms responsible for urinary tract infection (UTI). In order to facilitate the follow-up of this microbial resistance, the aim of this study was to determine the bacteria resistant phenotypes. Method: To achieve the following objectives, this study was conducted from June to August 2023. The isolation and identification were performed by standard methods why susceptibility testing was done by Kirby-Bauer disk diffusion technique according to CLSI guidelines. Double-disk synergy test was applied to determine the presence of extended-spectrum β-lactamase (ESBL) produced by bacteria. The Imipenem EDTA Combined Disc Test (CDT) for Metallo beta lactamase (MBL) screening, the D-zone test to detect macrolides, lincosamides and streptogramins type B (MLSB) and Meticillin resistant Staphylococcus aureus (MRS A) which was assessed using a Cefoxitin (30 µg) disc. Results: A total of 40 bacteria were identified with a prevalence of 37.03%. Overall, E. coli was the predominant isolate 14 (35%), followed by Staphylococcus aureus 10 (25%) and Klesbsiella pneumonia 4 (10%). Pseudomonas aeruginosa, Salmonella arinosa and Enterobacter were the most sensible (100%) bacteria against ciprofloxin, ceftriaxone and cefixime. Almost all bacteria were resistant to Amoxicillin/clavulanic acid (>50%). The isolates were in the majority resistant to imipenem. ESBL-producing Enterobacteriaceae represented 25.92%, with a higher rate among E. coli. No MBL production was found among the isolates while 38.46% represented cMLSB, 15.38% represented iMLSB, 23.07% represented MSB and 23.07% represented MRSA. Conclusion: Clinical strains of UTI from Protestant Hospital of Ngaoundere exhibiting ESBL, cMLSB, iMLSB, MSB and MRSA. The regular updating of antibiotic resistance statistics of isolated strains allows for a better adaptation of probabilistic antibiotic therapy.
文摘Purpose: Gastrointestinal stromal tumor (GIST) has been considered radiation-resistant and data on the radiotherapy for GIST in previous studies are lacking. The purpose of this article is to accumulate more experience in the application of radiotherapy for GISTs. Materials and methods: Review our own case material and the relevant English literature. Results: A huge pelvic GIST after resistance to tyrosine kinase inhibitors (TKIs) has been well controlled by simultaneous-integrated boost intensity-modulated radiation therapy (SIB-IMRT). The time from the initial shrinkage of the mass and subsequent stabilization to now was more than 18 months. The patient was palliated from the series of symptoms caused by tumor compression and well tolerated to the adverse reactions by radiotherapy. And the previous studies have shown that GISTs had a certain sensitivity to radiotherapy. Conclusion: SIB-IMRT may provide a new means of achieving objective response and prolonging survival in selected GIST patients.
文摘Firefighters rely on their protective gear for thermal insulation during fires. This study evaluated the flame resistance of firefighter PPE, including helmets, turnout gear, and gloves, under extreme conditions. Results showed excellent performance of the F1 helmet but identified areas for improvement in gloves and turnout gear. The study provides insights into the heat transfer properties of different PPE components and offers recommendations for enhancing firefighter safety.
文摘Background: Diabetes mellitus (DM) is a disease characterized by hyperglycemia due to (a) insulin-insufficiency (type I DM), or (b) impaired glucose cell-entry (insulin resistance) due to the downregulation of insulin cell receptors (type II DM). Type I DM usually presents with florid manifestations contrary to a slowly-progressive type II. Patients and methods: Over the past 10 years, we encountered 9 obese patients with controlled insulin-requiring type II DM for years, at a dose of 62 ± 5 units/day, who developed sudden and severe insulin resistance (IR) that required 210 ± 25 units daily. All patients had very high levels of anti-Glutamic Acid Decarboxylase (GAD) antibodies. Despite a lack of previous testing for anti-GAD antibodies, they were treated, with Cyclosporin A (Cy), as an autoimmune disorder superimposed on their type II MD. Initially all patients were treated with 100 mg, of Cy, twice daily aiming at an initial trough level of 100 - 150 ng/ml. Three months later, the dose was reduced to 50 mg twice daily for a total of 2 years. Results: Amelioration of IR was achieved by 1 month with a reduction of daily insulin requirement to 123 ± 16 units that further decreased to 76 ± 11 by the end of the 3rd month. Such improvement persisted for 2 years and >1 year after Cy discontinuation. Moreover, a decline in insulin requirements was associated with a parallel decrease in anti-GAD antibody levels and an increase in C-peptide insulin without kidney disease. Conclusion: Anti-GAD antibodies can induce acute IR in type II DM, and this phenomenon can be treated safely and effectively with Cy.
文摘Concrete buildings used in cold regions are prone to freeze-thaw damage, leading to internal cracking and surface peeling of the concrete. Therefore, improving the freeze-thaw resistance of concrete is of great significance for the safety of hydraulic engineering. This paper explores the effect of basalt fibers on improving the frost resistance index of concrete through a series of experiments, and analyzes the influencing mechanism. The results show that adding an appropriate amount of basalt fibers can significantly improve the frost resistance of concrete and reduce the freeze-thaw damage phenomenon indicated by concrete specimens. Adding 0.1% basalt fiber can maintain the relative dynamic modulus of concrete specimens at 98% after 150 freeze-thaw cycles, while adding 0.3% basalt fiber can control the quality loss rate of concrete specimens after 150 freeze-thaw cycles at 0.87%. Taking into account both the frost resistance effect and economic factors, it is recommended that the basalt fiber content in frost resistant concrete be 0.1%. The research results can provide reference and guidance for the optimization design of the mix proportion of hydraulic concrete in cold regions.
文摘This editorial discusses the findings of Elbarky et al on the role of selenoprotein P1(SEPP1)in pediatric obesity and insulin resistance.Their study uncovered si-gnificantly lower SEPP1 Levels in children who were obese compared with hea-lthy peers,demonstrating a negative correlation between SEPP1 levels and mea-sures of adiposity and insulin resistance.These findings suggest that SEPP1 is a biomarker useful in the early identification of insulin resistance in pediatric populations.This editorial emphasizes the clinical implications of the study and calls for further research to validate and explore the role of SEPP1 in metabolic health.
基金funded by grants from the National Key R&D Project(2023YFD1400201-02,2023YFD1400203-02)the National Natural Science Foundation of China(31870137)+1 种基金the National Transgenic Research Project(2015ZX08001-002)the Key R&D Project of Guangdong Province(2022B0202060005).
文摘Asian rice comprises two major subspecies:Xian(X)and Geng(G),and the diverged resistance genes(R)have provided a foundation for breeding improved cultivars to control rice blast disease.After conducting two-phase allele mining using six updated FNP marker systems,the functional haplotypes at Pit,Pib,and Pi63 strictly diverged into the X-populations and were defined as X-R loci,while those at Pi54,Pi37,and Pi36 into the G-populations as G-R loci.The genic diversity at the three X-R loci(16 alleles)was twofold higher than that at the three G-R loci(8 alleles),and the allelic diversity in the Southern region(21 alleles)was nearly double that in the Northeastern region(11 alleles).Both observations reflect a significant difference in genetic diversity between X-and G-populations,and indicate that the effective R-genes mainly originated from X-subspecies.Based on the allelic structures characterized by a set of 10 parameters,8 and 16 alleles were respectively recognized as favorable and promising ones for the regional breeding programs.The genotypic structures of the two regional populations were almost different,indicating that the diverged alleles have been further assembled into two series of regional genotypes through long-term breeding programs,despite the presence of one-third of region-common alleles.The genotypic diversity in the Southern region(55 genotypes)was nearly twice as high as that in the Northeastern region(28),which perfectly reflects the aforementioned differences in both genic and allelic diversities.After analyzing the genotypic structures using a set of 13 parameters,4 and 23 genotypes,respectively,can be recommended as the favorable and promising ones for the regional breeding programs.The case study serves as a concrete sample of how to identify the favorable and promising alleles and genotypes,and beneficial parents based their comprehensive population structures for gene-designed breeding.
文摘BACKGROUND In the absence of effective antimicrobials,transplant surgery is not viable,and antirejection immunosuppressants cannot be administered,as resistant infections compromise the life-saving goal of organ transplantation.AIM To evaluate the efficacy of antimicrobials in preventing resistance in solid organ transplant recipients.METHODS A systematic review was conducted using a search methodology consistent with the preferred reporting items for systematic reviews and meta-analyses.This review included randomized clinical trials that evaluated the efficacy of antimicrobial agents(prophylactic or therapeutic)aimed at preventing antimicrobial resistance.The search strategy involved analyzing multiple databases,including PubMed/MEDLINE,Web of Science,Embase,Scopus,and SciELO,as well as examining gray literature sources on Google Scholar.A comprehensive electronic database search was conducted from the databases’inception until May 2024,with no language restrictions.RESULTS After the final phase of the eligibility assessment,this systematic review ultimate-ly included 7 articles.A total of 2318 patients were studied.The most studied microorganisms were cytomegalovirus,although vancomycinresistant enterococci,Clostridioides difficile,and multidrug-resistant Enterobacterales were also analyzed.The antimicrobials used in the interventions were mainly maribavir,valganciclovir,gancic-lovir,and colistin-neomycin.Of concern,all clinical trials showed significant proportions of resistant microorga-nisms after the interventions,with no statistically significant differences between the groups(mean resistance 13.47%vs 14.39%),except for two studies that demonstrated greater efficacy of maribavir and valganciclovir(mean resistance 22.2%vs 41.1%in the control group;P<0.05).The total reported deaths in three clinical trials were 75,and there were 24 graft rejections in two studies.CONCLUSION All clinical trials reported significant proportions of antimicrobial-resistant microorganisms following interventions.More high-quality randomized clinical trials are needed to corroborate these results.
