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BACKGROUND: Numerous biomarkers have been proposed for diagnosis, therapeutic, and prognosis in sepsis. Previous evaluations of the value of biomarkers for predicting mortality due to this life-threatening condition fail to address the complexity of this condition and the risk of bias associated with prognostic studies. We evaluate the predictive performance of four of these biomarkers in the prognosis of mortality through a methodologically sound evaluation. METHODS: We conducted a systematic review a systematic review and meta-analysis to determine, in critically ill adults with sepsis, whether procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), and presepsin (sCD14) are independent prognostic factors for mortality. We searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials up to March 2023. Only Phase-2 confirmatory prognostic factor studies among critically ill septic adults were included. Random effects meta-analyses pooled the prognostic association estimates. RESULTS: We included 60 studies (15,681 patients) with 99 biomarker assessments. Quality of the statistical analysis and reporting domains using the QUIPS tool showed high risk of bias in > 60% assessments. The biomarker measurement as a continuous variable in models adjusted by key covariates (age and severity score) for predicting mortality at 28-30 days showed a null or near to null association for basal PCT (pooled OR = 0.99, 95% CI = 0.99-1.003), CRP (OR = 1.01, 95% CI = 0.87 to 1.17), and IL-6 (OR = 1.02, 95% CI = 1.01-1.03) and sCD14 (pooled HR = 1.003, 95% CI = 1.000 to 1.006). Additional meta-analyses accounting for other prognostic covariates had similarly null findings. CONCLUSION: Baseline, isolated measurement of PCT, CRP, IL-6, and sCD14 has not been shown to help predict mortality in critically ill patients with sepsis. The role of these biomarkers should be evaluated in new studies where the patient selection would be standardized and the measurement of biomarker results. TRIAL REGISTRATION: PROSPERO (CRD42019128790).

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In this study, edible packaging based on discarded green banana (Musa acuminata AAA) flour (whole banana and banana peel flours) was developed for food applications. Films were characterized in terms of film-forming ability, mechanical, barrier, thermal, microbiological, and sensory properties. The film forming solutions were studied for rheological properties. Two formulations were selected based on their film-forming ability: whole banana flour (2.5%), peel flour (1.5%) and glycerol (1.0 %, F-1.0 G or 1.5%, F-1.5 G). Adding 1.5% plasticizer, due to the hygroscopic effect, favored the water retention of the films, increasing the density, which also resulted in a decrease in lightness and transparency. Water activity shows no difference between the two formulations, which were water resistant for at least 25 h. DSC results showed a similar melting temperature (Tm) for both films, around 122 °C. Both films solutions showed a viscoelastic behavior in the frequency spectrum, being the elastic modulus greater in F-1.0 G film than F-1.5 G film at low frequency. F-1.0 G film was less firm, deformable and elastic, with a less compact structure and a rougher surface as confirmed by AFM, favoring a higher water vapor permeability with respect to F.1.5 G film. Microorganisms such as Enterobacteria and Staphylococcus aureus were not found in the films after a period of storage (1 year under ambient conditions). The F-1.0 G film with added spices (cumin, oregano, garlic, onion, pepper, and nutmeg) was tested for some food applications: as a snack (with or without heat treatment) and as a wrap for grilled chicken. The performance of the seasoned film during chilled storage of chicken breast was also studied. Sensory evaluation showed good overall acceptability of all applications. In addition, the chicken breast wrapped with the seasoned film registered lower counts (1-log cycle) than the control (covered with a polystyrene bag) and the film without spices. Green banana flour is a promising material to develop edible films for food applications.

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Batrachochytrium dendrobatidis (Bd) infection is one of the principal causes of amphibian declines worldwide. The presence of Bd has been determined in Gastrotheca riobambae tadpoles that inhabit ponds in Quito's Metropolitan Guangüiltagua Park, Ecuador. This study sought to determine whether these tadpoles are infected and to determine the presence of chytridiomycosis in another frog species, Pristimantis unistrigatus, which also inhabits the park and has different reproductive biology and distinct behavioral habits. We used end-point and real-time PCR techniques to detect and quantify Bd infection. At 1 yr, samples were taken from the skin of P. unistrigatus using swabs and were also taken from the mouthparts of G. riobambae tadpoles. It was found that the two species were infected with a Bd prevalence of 39% (53/135) in G. riobambae tadpoles and 15% (57/382) in P. unistrigatus frogs. The two types of samples (tissue and swabs) from mouthparts showed differences in the zoospores per microliter loads (x̄=1,376.7±3,450.2 vs. x̄=285.0±652.3). Moreover, a correlation (r2=0.621) was discovered between the monthly mean maximum temperature of the pond with disease prevalence in G. riobambae tadpoles. Infection levels in the P. unistrigatus population varied significantly over time, and distance to the pond was a determinant factor for infection intensity.

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Microbiome-pathogen interactions are increasingly recognized as an important element of host immunity. While these host-level interactions will have consequences for community disease dynamics, the factors which influence host microbiomes at larger scales are poorly understood. We here describe landscape-scale pathogen-microbiome associations within the context of post-epizootic amphibian chytridiomycosis, a disease caused by the panzootic chytrid fungus Batrachochytrium dendrobatidis. We undertook a survey of Neotropical amphibians across altitudinal gradients in Ecuador ~30 years following the observed amphibian declines and collected skin swab-samples which were metabarcoded using both fungal (ITS-2) and bacterial (r16S) amplicons. The data revealed marked variation in patterns of both B. dendrobatidis infection and microbiome structure that are associated with host life history. Stream breeding amphibians were most likely to be infected with B. dendrobatidis. This increased probability of infection was further associated with increased abundance and diversity of non-Batrachochytrium chytrid fungi in the skin and environmental microbiome. We also show that increased alpha diversity and the relative abundance of fungi are lower in the skin microbiome of adult stream amphibians compared to adult pond-breeding amphibians, an association not seen for bacteria. Finally, stream tadpoles exhibit lower proportions of predicted protective microbial taxa than pond tadpoles, suggesting reduced biotic resistance. Our analyses show that host breeding ecology strongly shapes pathogen-microbiome associations at a landscape scale, a trait that may influence resilience in the face of emerging infectious diseases.

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La maloclusión se considera uno de los problemas más comunes relacionados con la salud bucal, su diagnóstico temprano y adecuado permite establecer un correcto plan de tratamiento más efectivo. El objetivo fue describir las maloclusiones en estudiantes de último año de la carrera de Odontología de la Universidad UTE en Quito, Ecuador, durante los años 2018 y 2019. Los datos fueron obtenidos a partir de las respectivas historias clínicas archivadas en la clínica universitaria SERODU. Las valoraciones para determinar la maloclusión se hicieron a partir de la caracterización de los planos vertical, horizontal y transversal, utilizando los criterios de Angle. La media de edad entre los pacientes fue de 24,5 años, con una desviación estándar de 1,91. El análisis de la presencia de overjet y overbite permitió establecer que la mayor medida media estuvo enmarcada en la clase molar II, para 4,19 mm (DE=3,07) y 3,59 mm (DE=2,47) respectivamente. La mordida cruzada unilateral en el eje transversal (26,67%). La categoría normal preponderó en el tipo de mordida en los planos horizontal y vertical en las tres clases molares.

Malocclusion is considered one of the most common problems related to oral health, its early and adequate diagnosis allows establishing a correct and more effective treatment plan. The objective was to describe the malocclusions of students of the school of dentistry in final academic term at the UTE University in Quito, Ecuador, during the years 2018 and 2019. The data were obtained from the respective medical records on file at the SERODU university clinic. The evaluations to determine the malocclusion were made from the characterization of the vertical, horizontal, and transverse planes, using the Angle criteria. The mean age among the patients was 24.5 years, with a standard deviation of 1.91. The analysis of the presence of overjet and overbite allowed establishing that the highest mean measurement was framed in molar class II, for 4.19 mm (SD = 3.07) and 3.59 mm (SD = 2.47), respectively. The unilateral crossbite on the transverse axis (26.67%). The normal category prevailed in the type of bite in the horizontal and vertical planes in the three molar classes.

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This study aims to analyze the thermal biology and climatic vulnerability of two closely related lizard species (Stenocercus festae and S. guentheri) inhabiting the Ecuadorian Andes at high altitudes. Four physiological parameters-body temperature (Tb), preferred temperature (Tpref), critical thermal maximum (CTmax), and critical thermal minimum (CTmin)-were evaluated to analyze the variation of thermophysiological traits among these populations that inhabit different environmental and altitudinal conditions. We also evaluate the availability of operative temperatures, warming tolerance, and thermal safety margin of each population to estimate their possible risks in the face of future raising temperatures. Similar to previous studies, our results suggest that some physiological traits (CTmax and Tb) are influenced by environmental heterogeneity, which brings changes on the thermoregulatory behavior. Other parameters (Tpref and CTmin), may be also influenced by phylogenetic constraints. Moreover, the fluctuating air temperature (Tair) as well as the operative temperatures (Te) showed that these lizards exploit a variety of thermal microenvironments, which may facilitate behavioral thermoregulation. Warming tolerance and thermal safety margin analyses suggest that both species find thermal refugia and remain active without reducing their performance or undergoing thermal stress within their habitats. We suggest that studies on the thermal biology of tropical Andean lizards living at high altitudes are extremely important as these environments exhibit a unique diversity of microclimates, which consequently result on particular thermophysiological adaptations.

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OBJECTIVE: Edema syndrome is highly prevalent but under researched in captive frogs around the world. The objective of the present study was to characterize at a basic microbiological and cytological level of the bacteria of the edema fluid of 20 individuals of the genus Gastrotheca to determine the presence of possible anaerobic and aerobic bacteria. RESULTS: Fourteen types of bacteria were identified in the edema fluid, 12 of them at the species level (Pasteurella haemolytica, Hafnia alvei, Enterobacter agglomerans, Aeromonas hydrophila, Pseudomonas fluorescens, Burkholderia pseudomallei, Salmonella arizonae, Enterobacter gergoviae, Enterobacter sakazakii, Yersinia enterocolitica, Klebsiella oxytoca, and Klebsiella ozaenae) and two at the genus level (Enterococcus spp. and Streptococcus spp.). The most frequently identified cells were lymphocytes (37.7% in females and 46.4% in males), erythrocytes (23.5% in females and 17.5% in males) and neutrophils (4.2% in females and 2.8% in males). Finally, no relationship was found between the data obtained and the sex of the individuals studied.

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Bone alterations due to metabolic bone disease in captive animal populations can have a negative impact on repopulation and research initiatives. This investigation has the purpose of describing the principal radiographic and anatomopathological findings present in nine gliding leaf frogs (Agalychnis spurrelli) kept in captivity with alterations in their spines and long bones. The observed histopathological findings were in the canalis vertebralis, paraspinal muscle and long bones, and included deformed bones with alteration of the adjacent tissues, alterations in the ossification process, bone degeneration and resorption, decreased number of osteocytes and deposition of osteoid and fibrous material in the compact bone tissue. Additionally, the spinal cord showed compressed white matter, chronic meningitis in the duramater, alteration in the number of glial cells and loss of delimitation between the gray and white matter. Radiographical changes were found mainly in the long bones and included moth-eaten osteolysis, solid periosteal reaction, bone deformities, cortical tunneling and inflammation of adjacent soft tissues. Also, pathological fractures of the femur and urostyle were observed together with spinal column deviations with increased bone density.

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Many amphibian species are at risk of extinction in their natural habitats due to the presence of the fungal pathogen Batrachochytrium dendrobatidis (Bd). For the most highly endangered species, captive assurance colonies have been established as an emergency measure to avoid extinction. Experimental research has suggested that symbiotic microorganisms in the skin of amphibians play a key role against Bd. While previous studies have addressed the effects of captivity on the cutaneous bacterial community, it remains poorly studied whether and how captive conditions affect the proportion of beneficial bacteria or their anti-Bd performance on amphibian hosts. In this study we sampled three amphibian species of the highly threatened genus, Atelopus, that remain in the wild but are also part of ex situ breeding programs in Colombia and Ecuador. Our goals were to (1) estimate the diversity of culturable bacterial assemblages in these three species of Atelopus, (2) describe the effect of captivity on the composition of skin microbiota, and (3) examine how captivity affects the bacterial ability to inhibit Bd growth. Using challenge assays we tested each bacterial isolate against Bd, and through sequencing of the 16S rRNA gene, we identified species from thirteen genera of bacteria that inhibited Bd growth. Surprisingly, we did not detect a reduction in skin bacteria diversity in captive frogs. Moreover, we found that frogs in captivity still harbor bacteria with anti-Bd activity. Although the scope of our study is limited to a few species and to the culturable portion of the bacterial community, our results indicate that captive programs do not necessarily change bacterial communities of the toad skins in a way that impedes the control of Bd in case of an eventual reintroduction.

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As the Earth warms, many species are likely to disappear, often because of changing disease dynamics. Here we show that a recent mass extinction associated with pathogen outbreaks is tied to global warming. Seventeen years ago, in the mountains of Costa Rica, the Monteverde harlequin frog (Atelopus sp.) vanished along with the golden toad (Bufo periglenes). An estimated 67% of the 110 or so species of Atelopus, which are endemic to the American tropics, have met the same fate, and a pathogenic chytrid fungus (Batrachochytrium dendrobatidis) is implicated. Analysing the timing of losses in relation to changes in sea surface and air temperatures, we conclude with 'very high confidence' (> 99%, following the Intergovernmental Panel on Climate Change, IPCC) that large-scale warming is a key factor in the disappearances. We propose that temperatures at many highland localities are shifting towards the growth optimum of Batrachochytrium, thus encouraging outbreaks. With climate change promoting infectious disease and eroding biodiversity, the urgency of reducing greenhouse-gas concentrations is now undeniable.

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