The Romans were among the first societies to extensively exploit fish resources, establishing large-scale salting and preservation plants where small pelagic fish were fermented to produce sauces such as garum. Here, the authors demonstrate that, despite being crushed and exposed to acidic conditions, usable DNA can be recovered from ichthyological residues at the bottom of fish-salting vats. At third-century AD Adro Vello (O Grove), Galicia, they confirm the use of European sardines (Sardina pilchardus) and move beyond morphology to explore population range and admixture and reveal the potential of this overlooked archaeological resource.

In spite of decades of research on the subject, the crystal structure of illite is still poorly understood. The purpose of this study was to address this problem by investigating the nature of the interlayer content in illite IMt-2 from Silver Hill, Montana, using analytical transmission electron microscopy (ATEM), thermogravimetry (TG), and X-ray powder diffraction (XRPD) analyses. The ATEM data, together with literature and TG results, yielded the formula K0.70a0.01(H2O)0.42 (Al1.53Fe2+0.06Fe3+0.19Mg0.28)Σ−2.06(Si3.44Al0.56)O10(OH)2 or, assuming the presence of H3O+, K0.69Na0.01(H3O)+0.28(Al1.47Fe2+0.06Fe3+0.19Mg0.28)Σ−1.99(Si3.40Al0.60)O10(OH)2. The first formula indicates surplus interlayer and octahedral species, whereas the second shows no excess. The XRPD data were refined by Rietveld techniques, down to an Rp factor of 10.48–13.8%. The mineral composition consists largely of illite-2M1, illite-1M, and minor quartz. Although the refinement accuracy is limited by the intrinsic poor quality diffraction of the illites, the partially refined model is consistent with the chemical composition; in particular, attempts to introduce octahedral cations in excess of 2 were fruitless. All the results support the simple structural model, by which the illite structure strictly corresponds to a dioctahedral mica with H3O+ replacing K. As a consequence, the crystalchemical formula of illites should be calculated on the basis of six tetrahedral plus octahedral cations.

The effects of a subvolcanic intrusion on its host rocks in the Priego de Córdoba area (SE Spain) was studied by optical microscopy, X-ray diffraction and electron microscopy. The intrusion of a laccolith of stratiform dolerite in partially consolidated marly sediments at quite shallow depths below the ocean floor took place during the intracontinental rifting phase of the Subbetic zone of the Betic Cordilleras. In the first stage, contact metamorphism caused the crystallization of calc-silicate consisting of grossular andradite garnet, diopside, vesuvianite and titanite for which the upper temperature limit was 500°C. Phyllosilicates are found in a network of veins cross-cutting the carbonate and calc-silicate matrix, indicating their formation during a process of hydrothermal alteration superimposed on the contact aureole. In the area closest to the subvolcanic rocks, saponite is the main phyllosilicate although some dispersed chlorite is found. In the zone furthest from the contact, corrensite together with saponite and beidellitic smectites were observed. The presence of low-temperature phases (saponite) in the area closest to the laccolith reveals the evolution of the hydrothermal system toward cooler conditions. In the early stage, the circulation of a hot hydrothermal fluid caused the crystallization of chlorite in the area surrounding the subvolcanic body and corrensite in the more distal area, which might have begun even during the contact metamorphism stage. A cooling phase followed, resulting in the crystallization of saponite in the host rocks, and the crystallization of dioctahedral and trioctahedral smectites inside the subvolcanic body.

The arguments of Vidal et al. (2010) against the incorporation of H3O+ rather than of H2O in the interlayer position of illite are disputable. Stoichiometric arguments do indeed suggest that the excess water in the Silver Hill illite is in the formof H3O+. No reason exists to assume less water content in the IMt-2 sample than in those determined by Hower and Mowatt (1966) and confirmed by the thermogravimetric analyses of Nieto et al. (2010). The comparison between element contents calculated from end-members and those from the structural formula in figure 1 of Vidal et al. (2010) is not an experimental result, but rather a trivial mathematical artifact. The fact that thermodynamic models, based on the incorporation of interlayer H2O in illite, may provide reasonable estimates neither proves nor disproves the presence of H3O+; this is because thermodynamics is a non-atomistic, macroscopic approach.

Background: Burkholderia cepacia complex is an opportunistic environmental pathogen that has been linked to nosocomial outbreaks. We describe an outbreak of bacteremia caused by Burkholderia cenocepacia from a contaminated chlorhexidine gluconate solution. Methods: The hospital infection control team carried out an outbreak investigation on February 21, 2021, when 3 adult hemodialysis patients developed B. cenocepacia bacteremia. Patient demographics and clinical profile were reviewed retrospectively. Potential sources of infection were identified, and environmental screening was performed in several units. Processes of catheter care in the hemodialysis unit were reviewed. Water samples from the hemodialysis unit, and samples of solutions used in patient care were sent for culture. Isolates from patients and from environmental samples were sent for 16S rRNA gene sequencing to determine genetic relatedness. Results: In total, 16 patients, 8 of whom were male, developed B. cenocepacia bacteremia during the investigated period. The median age was 68 years (range, 19–83), and 15 of 16 had at least 1 comorbidity. All patients used a central venous catheter (CVC) for hemodialysis, and 11 (70%) of these 16 were temporary. Chlorhexidine gluconate solution was routinely used as part of CVC care and 1 bottle was shared among 4 hemodialysis stations. On suspicion of contamination, all identified chlorhexidine bottles were recalled on February 26, 2021, and random samples from 15 opened and 19 unopened bottles were sent for culture from the following units: hemodialysis (n = 2), ICU (n = 14), wards (n = 6), and 4 each from transplant surgery, and delivery suites. O0f 34 sampled bottles, 17 grew B. cenocepacia: 8 opened and 9 unopened bottles. The Bayesian inference tree (Fig. 1) supports the hypothesis that patient samples and the samples from the chlorhexidine solutions were most probably related to each other based on the 16S rRNA sequences. However, the individual identities of the specific sample sequences could not be determined using the analyzed region of the gene, possibly due to low quality of the sequences received. No new cases of B. cenocepacia were identified after recall of the chlorhexidine solution, and the outbreak was deemed resolved on March 24, 2021. Conclusions: Medical solutions routinely used in patient care can cause outbreaks and should be suspected as a potential source of infection by infection control teams.

Disclosures: None

Background: Data on the incidence and outcome of ventilator-associated pneumonia (VAP) and multidrug-resistant VAP (MDR-VAP) among COVID-19 patients are limited. We compared the incidence and incidence density (ie, number of VAP per 1,000 ventilatory days) of MDR-VAP prior to and during the COVID-19 period in an urban, tertiary-care hospital. Methods: A retrospective study was conducted to compare the incidence, profile, and outcomes of patients with MDR-VAP during the pre–COVID-19 period (2018–2019) and during the COVID-19 pandemic (2020–2021). Results: In total, 80 (22%) of 362 patients developed VAP and were included in the cohort: 27 (33.75%) from the pre–COVID-19 period and 53 (66.25%) from the COVID-19 period, respectively. Most were male [20 (74%) of 27 vs 34 (64%) of 53], with median ages of 66 years (range, 35–90) and 67 years (range, 32–92) in the pre–COVID-19 and COVID-19 periods, respectively. Comorbidities were similar between the 2 periods, except for cardiovascular disease (14 vs 11; P = .005) and chronic lung disease (14 vs 9; P = .0012), which decreased significantly from the pre–COVID-19 period to the COVID-19 period. Only 15 (56%) of 27 versus 37 (70%) of 53 patients developed MDR-VAP during the pre–COVID-19 and COVID-19 period, with incidence densities of 19.3 of 1,000 and 27.8 of 1,000 ventilator days (P = .0371), respectively. The median length of stay prior to VAP for the pre–COVID-19 and COVID-19 periods were 17 and 10 days, respectively (P < .0001). Extended-spectrum β-lactamase (ESBL) resistance increased significantly from 1 (3.7%) of 27 before COVID-19 to 15 (28.3%) of 53 during the COVID-19 period. Carbapenem-resistant Enterobacteriaceae (CRE) resistance was higher before COVID-19 than during the COVID-19 period: 15 (56%) of 27 versus 10 (19%) of 53. In both periods, Klebsiella pneumoniae and Acinetobacter baumannii were the most common pathogens isolated. Mortality was high in both periods at 93% and 83%, respectively. Only female sex was associated with MDR-VAP in the COVID-19 period on multivariate analysis (OR, 3.47; 95% CI, 1.019–11.824; P < .047). Conclusions: The frequency of VAP and MDR-VAP increased during the COVID-19 period, despite a shorter median hospital stay. Mechanisms of resistance differed in the pre–COVID-19 and COVID-19 periods. Mortality with VAP was extremely high. The factors associated with increased risk of VAP and COVID-19 need to be studied further, and measures to prevent VAP should be prioritized.

Disclosures: None

Background: Information regarding catheter-related bloodstream infections (CRBSIs) among patients on hemodialysis in the Philippines is lacking. Objective: In this study, we described the clinical profile, CRBSI incidence density, and outcomes of patients in a single-center hemodialysis unit. Methods: A retrospective review of patients receiving hemodialysis (HD) through a central venous catheter (CVC) from January 2016 to December 2020 in a tertiary-care, private hospital was performed. Baseline demographic data were recorded, and CRBSI incidence density rates (no. of CRBSIs per 1,000 catheter days) were calculated. Results: Of 868 hemodialysis patients (57%), 499 used a CVC and were followed for 182,135 catheter days. Half were male (248 of 499, 49.7%) with a median age of 62 years (range, 24–90). Only 48 (9.6%) of 499 developed CRBSI, with an overall CRBSI incidence of 2.63 per 1,000 catheter days. Of those with CRBSI, 31 (64.6%) of 48 were female. The median age was 74.5 years (range, 30–90). Hypertension (40 of 48, 83.3%) and diabetes mellitus (26 of 48, 54.2%) were frequent comorbidities. Fever with chills was the most common symptom, occurring in 30 (62.5%) of 48 patients. Both gram-positive (n = 24) and gram-negative (n = 25) organisms were isolated. Staphylococcus aureus was the most common gram-positive isolate (14 of 25, 56%); isolates from the order Enterobacterales (12 of 24, 50%) were the most common gram-negative organisms. More CRBSIs occurred among those with a nontunneled versus tunneled CVCs (28 vs 20). The median time to CRBSI occurrence was 7 weeks (range, 0.43–280) from CVC insertion. The most common empiric treatment was either vancomycin (n = 28) or piperacillin-tazobactam (n = 26), which were also used in combination (11 of 28, 39.3%). Treatment involved CVC removal in most patients (34 of 48, 70.8%), either alone (n = 1), or with systemic antibiotic therapy (SAT; n = 16), or SAT plus antibiotic lock therapy (ALT; n = 17). The remainder (14 of 48, 29.2%) retained their CVCs because of difficult access, and received both SAT and ALT. Attributable mortality (6 of 9, 33%) and overall mortality (9 of 48, 18.5%) were high. Mortality of those whose CVC was retained was lower compared to those whose line was removed: (3 of 9, 33%) versus (6 of 9, 66%). Conclusions: The overall CRBSI rate in our hemodialysis unit was low and occurred more commonly in the older age group with a nontunneled CVC. Both gram-positive and gram-negative pathogens were common. CRBSI was associated with high attributable mortality. Successful treatment often required CVC, SAT, and ALT. However, CVC retention was a viable option in some patients with specific limiting factors such as difficult access.

Disclosures: None

The role of legumes in healthy and sustainable diets is increasingly of interest. Few studies have investigated the association between legume consumption and the consumption of other food groups and the intake of nutrients. This study examined how legume consumption is associated with the consumption of other foods and the intake of nutrients among Finnish adults. Our study used cross-sectional data from the population-based FinHealth 2017 Study consisting of 2250 men and 2875 women aged ≥18 years. The associations between legume consumption (quartile classification), food groups and nutrients were analysed using multivariable linear regression. The models were initially adjusted for energy intake and additionally for age, educational level, smoking status, leisure-time physical activity and BMI. Legume consumption had a positive association with age, education level and leisure-time physical activity. The consumption of legumes was positively associated with the consumption of fruits and berries, vegetables, nuts and seeds and fish and fish products and inversely associated with the consumption of red and processed meat, cereals and butter and butter-based fat spreads. Furthermore, legume consumption was positively associated with the intake of protein, fibre, folate, thiamine and salt in both sexes and inversely associated with the intake of saturated fatty acids and sucrose (sucrose, women only). Thus, legume consumption appears to reflect overall healthier food choices. An increase in legume consumption could accelerate the transition to more sustainable diets. The confounding role of other foods and nutrients should be considered when studying associations between legume consumption and health outcomes.

The General Decision-Making Styles (GDMS) scale measures five decision-making styles: rational, intuitive, dependent, avoidant and spontaneous. GDMS has been related to coping and some personality factors and sex-differences has been described. In spite of its usefulness, there is not a validated Spanish translation. The aim of this study is to translate to Spanish and provide psychometric evidence considering sex differences and the relationships between GDMS, personality and coping variables. Two samples were used for this study; the first sample composed by 300 participants who completed the GDMS and the Rational-Experiential Inventory (REI), and the second sample of 361 participants who completed the GDMS, the Ten Item Personality Trait Inventory and the brief COPE scales. Participants from second sample filled in GDMS a second time (137 participants) after eight weeks from the first data collection. Confirmatory factor analyses showed a five-factor composition of GDMS with equivalence across sex using invariance analyses. Moreover, GDMS showed acceptable internal consistency and temporal stability. Finally, rational and intuitive styles were related to healthier coping patterns and emotional stability, while dependent, avoidant and spontaneous styles were associated with unhealthy coping patterns and emotional instability.

Despite the widely recognized value of wetlands in providing vital ecosystem services, these are presently being degraded and ultimately destroyed, leading to a decrease in the biodiversity associated with these areas. Some species inextricably linked to wetlands, however, have been increasing and (re)colonizing areas across their range; a notable example being the Eurasian Spoonbill Platalea leucorodia. In this study we aimed to identify the most important habitats for juvenile spoonbills fledging from a traditional colony in Portugal, located in Ria Formosa, during the period of their life with the lowest survival rates: the first months after leaving the colony. We deployed 16 GPS/GSM tags on juveniles captured in different years (2016 to 2020) and tracked them during post-fledging dispersal and first winter (average 166.4 ± 29.2 SE days). Using Corine Land Cover data, we were able to identify which habitats were most important. Several habitats were used in variable proportions by individuals originating from the same colony, but there was a general trend towards using fewer habitats along the first months of life. Intertidal wetlands were the most used habitat, but anthropogenic habitats such as Wastewater Treatment Plants, saltpans and rice fields were identified as alternative habitats for young spoonbills, and may had contributed to the recent expansion of this species in Portugal.

Sin olvidar la importancia que el factor económico juega en el fenómeno migratorio, y sin caer en el riesgo de proyectar una visión romántica del mismo, este trabajo pretende profundizar en aquellas migraciones que se inician siguiendo determinadas “motivaciones extraeconómicas”. De ahí que, desde el intento de contribuir a visibilizar la heterogeneidad de situaciones personales que conforman las migraciones internacionales, este artículo se centra en otro tipo de factores que incitan a migrar: razones profesionales, políticas, de orientación sexual o de ampliación de horizontes vitales. Para ello se parte de diferentes relatos de mujeres migrantes cubanas y ecuatorianas en España.

Hyperglycemia during the first trimester leads to an increased risk of innate malformations as well as death at times close to delivery dates. The methylated genes include those from paternal H19 and PEG3 and those from maternal MEST and MEG3 that are necessary for the growth and regulation of the human fetus and its placenta. The aim of this study was to evaluate and compare the expression of these genes in the cord blood of healthy infants born to mothers with gestational diabetes mellitus (GDM) and healthy mothers.

This case-control study was conducted on the cord blood of 40 infants born to mothers with GDM and 35 infants born to healthy mothers. Mothers were identified by measuring oral glucose tolerance in the 24th–26th week of pregnancy. Cord blood was obtained post-delivery, and cord blood mononuclear cells were immediately extracted, using Ficoll solution. Then, RNA extraction and cDNA synthesis were performed, and gene expression of MEG3, PEG3, H19, and MEST was assessed through quantitative real-time PCR.

Findings show that the expression levels of MEG3, PEG3, H19, and MEST genes were significantly decreased in mononuclear cord blood cells of infants born to mothers with GDM when compared to those of the healthy control group.

These findings reveal that the reduction of imprinted genes in mothers with GDM is most likely due to changes in their methylation by an epigenetic process. Considering the importance of GDM due to its high prevalence and its side effects both for mother and fetus, recognizing their exact mechanisms is of high importance. This has to be studied more widely.

Background: Catheter-related bloodstream infection (CRBSI) rates remain high despite the use of an insertion bundle. We hypothesized that line care and maintenance by a dedicated team would help decrease CRBSI rates. This study was conducted in The Medical City (TMC), is a 526-bed, private, tertiary-care center in Pasig City, Philippines. Methods: All adult hospitalized patients from October 1, 2020, to October 31, 2021, with a newly inserted temporary central venous catheter (CVC) were eligible for inclusion. CRBSI rates before the intervention (October 2019 to March 2020) and after the intervention (April to October 2021) were compared. The intervention arm consisted of a dedicated central venous access team (CVAT) who provided education and performed daily line care and dressing changes per protocol. A series of χ2 and Wilcoxon rank-sum tests were performed to compare characteristics between exposure groups. Incidence rates of CRBSI before and after the intervention were compared using an incidence rate ratio approach. Results: In total, 209 CVCs were enrolled in the study, with 103 CVCs (49.28%) in the preintervention arm and 106 CVCs (50.72%) in the postintervention arm. Baseline patient characteristics were similar. CRBSIs were more frequent in the preintervention arm than the postintervention arm (39 of 103 vs 28 of 106; P = .08). The CRBSI incidence density rate was higher in the preintervention arm than the postintervention arm, but the difference was not statistically significant (37.46 per 1,000 patient days vs 25.97 per 1,000 patient days; P = .14). Median time to CRBSI was similar in both groups (9 vs 8 days). Conclusions: Baseline CRBSI rates were high and risk of infection increased by day 8 after line insertion. We detected a decreasing trend in rates of CRBSI with a dedicated CVAT, but multiple interventions are likely needed to influence overall rates.

Funding: None

Disclosures: None

Background: Antimicrobials are often given to patients with COVID-19 despite the absence of a bacterial coinfection. Procalcitonin (PCT), when elevated, often indicates the presence of a bacterial infection and is used to guide empiric antibiotic therapy. We sought to determine the utility of PCT and the optimal cutoff value of PCT among patients with COVID-19. Methods: We retrospectively reviewed all COVID-19 confirmed ca-ses hospitalized in our institution from March to December 2020. Of 729 cases, we included 403 (55.3%) who had baseline PCT and blood or respiratory tract specimens (eg, sputum, endotracheal aspirate) within 48 hours of admission. Participants were classified according to PCT levels and COVID-19 severity. A receiver operating characteristic (ROC) curve analysis was performed. The area under the curve (AUC) obtained was used to compute the possible optimal cutoff value using the Youden index. A χ2 test was used to define association between groups according to the characteristics of variables. Results: Of a total cohort of 403, 245 (57%) were male, with an overall median age of 60 years (range, 22–94). Overall, 28 presented with mild COVID-19, 194 presented with moderate COVID-19, and 181 presented with severe or critical COVID-19. Moreover, 363 (90%) were given antibiotics. Of 28 with mild COVID-19, 22 (79%) received empiric antibiotics. The rate of bacterial coinfection was high at 28% (113 of 403). Klebsiella pneumoniae was the most commonly identified microorganism: 52 (19.5%) of 266 patients. Based on the ROC curve, the optimal cutoff for PCT was 4.72 ng/mL, with 97% specificity and only 6% sensitivity. Only 17 participants had PCT > 4.72 ng/mL. Of these, 1 was mild, 5 were moderate COVID-19, 8 had severe COVID-19, and 3 had critical COVID-19; all received antibiotic therapy. Conclusions: In our cohort, the rate of bacterial coinfection was high. A PCT of >4.72 ng/mL increased the likelihood of a coinfection. However, PCT had poor sensitivity and may not detect the presence of bacterial coinfection, especially when used alone. Serial PCT monitoring, its use in conjunction with other markers, or as a prognostic tool, need to be explored further.

Funding: None

Disclosures: None