Clinical outcomes with biodegradable versus durable polymer drug-eluting stents in patients with ST-elevation myocardial infarction.

BACKGROUND: Coronary drug-eluting stents (DES) built with either durable (DP) or biodegradable (BP) polymeric coatings have been largely tested and are extensively available for routine use. However, their comparative performance remains an open question, particularly in more complex subsets of patients. AIMS: We evaluated the outcomes of patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI) using DP-DES versus BP-DES in a large multicenter real-world registry. METHODS: The population comprised patients with STEMI treated with pPCI within 12 h of symptoms onset. Those treated with more than one DES who received different polymer types were excluded. The final cohort for analysis was selected after propensity score matching (PSM), computed to generate similar groups of DP DES versus BP DES. Primary endpoint was the incidence of major adverse cardiac events (MACE), defined as the composite of total death, myocardial infarction and target lesion revascularization at 2 years. RESULTS: From January 2017 to April 2022, a total of 1527 STEMI patients underwent pPCI with a single DES type (587 DP-DES; 940 BP-DES). After PSM, 836 patients (418 patients in the DP-DES and 418 patients in the BP-DES groups), comprised the final study population. Both study groups had a similar baseline profile. Patients treated with BP-DES group had similar rates of MACE (15.3 % vs. 19.4 %, HR 0.69, 95 % CI 0.50-0.94, p = 0.022). Rates of target lesion revascularization was lower in BP DES group (0.7 % vs. 3.8 %, HR 0.17, 95 % CI 0.05-0.51, p = 0.006). CONCLUSION: In a cohort of STEMI patients submitted to pPCI, BP and DP DES had similar rates of the primary outcome. Patients treated with BP DES, however, had a decreased incidence of TLR at after 2-year follow-up.

Real-World Assessment of an Ultrathin Strut, Sirolimus-Eluting Stent in Patients with ST-Elevation Myocardial Infarction Submitted to Primary Percutaneous Coronary Intervention (INSTEMI Registry). / Avaliação no Mundo Real de um Stent Eluidor de Sirolimus de Hastes Ultrafinas em Pacientes com Infarto do Miocárdio com Supradesnivelamento do Segmento ST Submetidos à Intervenção Coronária Percutânea Primária (Registro INSTEMI).

BACKGROUND: The current gold standard of coronary drug-eluting stents (DES) consists of metal alloys with thinner struts and bioresorbable polymers. OBJECTIVES: Our aim was to compare an ultrathin strut, sirolimus-eluting stent (Inspiron®) with other third-generation DES platforms in patients with ST-elevation myocardial infarction (STEMI) submitted to primary percutaneous coronary intervention (PCI). METHODS: We analyzed data from a STEMI multicenter registry from reference centers in the South Region of Brazil. All patients were submitted to primary PCI, either with Inspiron® or other second- or third-generation DES. Propensity score matching (PSM) was computed to generate similar groups (Inspiron® versus other stents) in relation to clinical and procedural characteristics. All hypothesis tests had a two-sided significance level of 0.05. RESULTS: From January 2017 to January 2021, 1711 patients underwent primary PCI, and 1417 patients met our entry criteria (709 patients in the Inspiron® group and 708 patients in the other second- or third-generation DES group). After PSM, the study sample was comprised of 706 patients (353 patients in the Inspiron® group and 353 patients in the other the other second- or third-generation DES group). The rates of target vessel revascularization (OR 0.52, CI 0.21 - 1.34, p = 0.173), stent thrombosis (OR 1.00, CI 0.29 - 3.48, p = 1.000), mortality (HR 0.724, CI 0.41 - 1.27, p = 0.257), and major cardiovascular outcomes (OR 1.170, CI 0.77 - 1.77, p = 0.526) were similar between groups after a median follow-up of 17 months. CONCLUSION: Our findings show that Inspiron® was effective and safe when compared to other second- or third-generation DES in a contemporary cohort of real-world STEMI patients submitted to primary PCI.

FUNDAMENTO: O padrão-ouro atual dos stents farmacológicos (SF) coronários consiste em ligas metálicas com hastes mais finas e polímeros bioabsorvíveis. OBJETIVOS: Nosso objetivo foi comparar um stent eluidor de sirolimus de hastes ultrafinas (Inspiron®) com outras plataformas de SF de terceira geração em pacientes com infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST) submetidos à intervenção coronária percutânea (ICP) primária. MÉTODOS: Analisamos dados de um registro multicêntrico de IAMCSST de centros de referência da Região Sul do Brasil. Todos os pacientes foram submetidos à ICP primária, seja com Inspiron® ou outro SF de segunda ou terceira geração. Foi calculado pareamento por escore de propensão (PEP) para gerar grupos semelhantes (Inspiron® versus outros stents) em relação às características clínicas e do procedimento. Todos os testes de hipótese tiveram um nível de significância bilateral de 0,05. RESULTADOS: De janeiro de 2017 a janeiro de 2021, 1.711 pacientes foram submetidos à ICP primária, e 1.417 pacientes preencheram nossos critérios de inclusão (709 pacientes no grupo Inspiron® e 708 pacientes no grupo dos outros SF de segunda ou terceira geração). Após PEP, a amostra do estudo foi composta por 706 pacientes (353 pacientes no grupo Inspiron® e 353 pacientes no grupo dos demais SF de segunda ou terceira geração). As taxas de revascularização do vaso alvo (odds ratio [OR] 0,52; intervalo de confiança [IC] 0,21 a 1,34; p = 0,173), trombose de stent (OR 1,00; IC 0,29 a 3,48;p = 1,000), mortalidade (hazard ratio 0,724; IC 0,41 a 1,27; p = 0,257) e os desfechos cardiovasculares maiores (OR 1,170; IC 0,77 a 1,77; p = 0,526) foram semelhantes entre os grupos após um acompanhamento mediano de 17 meses. CONCLUSÃO: Nossos achados mostram que o stent Inspiron® foi eficaz e seguro quando comparado a outros SF de segunda ou terceira geração em uma coorte contemporânea do mundo real de pacientes com IAMCSST submetidos à ICP primária.

Combining Chitosan Nanoparticles and Garlic Essential Oil as Additive Fillers to Produce Pectin-Based Nanocomposite Edible Films.

Edible films were produced by combining a pectin (PEC) matrix with chitosan nanopar-ticle (CSNP), polysorbate 80 (T80), and garlic essential oil (GEO) as an antimicrobial agent. CSNPs were analyzed for their size and stability, and the films, throughout their contact angle, scanning electron microscopy (SEM), mechanical and thermal properties, water vapor transmission rate, and antimicrobial activity. Four filming-forming suspensions were investigated: PGEO (control); PGEO@T80; PGEO@CSNP; PGEO@T80@CSNP. The compositions are included in the methodology. The average particle size was 317 nm, with the zeta potential reaching +21.4 mV, which indicated colloidal stability. The contact angle of the films exhibited values of 65°, 43°, 78°, and 64°, respec-tively. These values showed films with variations in hydrophilicity. In antimicrobial tests, the films containing GEO showed inhibition only by contact for S. aureus. For E. coli, the inhibition occurred in films containing CSNP and by direct contact in the culture. The results indicate a promising al-ternative for designing stable antimicrobial nanoparticles for application in novel food packaging. Although, it still shows some deficiencies in the mechanical properties, as demonstrated in the elongation data.

Avaliação no Mundo Real de um Stent Eluidor de Sirolimus de Hastes Ultrafinas em Pacientes com Infarto do Miocárdio com Supradesnivelamento do Segmento ST Submetidos à Intervenção Coronária Percutânea Primária (Registro INSTEMI) / Real-World Assessment of an Ultrathin Strut, Sirolimus-Eluting Stent in Patients with ST-Elevation Myocardial Infarction Submitted to Primary Percutaneous Coronary Intervention (INSTEMI Registry)

Resumo Fundamento O padrão-ouro atual dos stents farmacológicos (SF) coronários consiste em ligas metálicas com hastes mais finas e polímeros bioabsorvíveis. Objetivos Nosso objetivo foi comparar um stent eluidor de sirolimus de hastes ultrafinas (Inspiron®) com outras plataformas de SF de terceira geração em pacientes com infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST) submetidos à intervenção coronária percutânea (ICP) primária. Métodos Analisamos dados de um registro multicêntrico de IAMCSST de centros de referência da Região Sul do Brasil. Todos os pacientes foram submetidos à ICP primária, seja com Inspiron® ou outro SF de segunda ou terceira geração. Foi calculado pareamento por escore de propensão (PEP) para gerar grupos semelhantes (Inspiron® versus outros stents) em relação às características clínicas e do procedimento. Todos os testes de hipótese tiveram um nível de significância bilateral de 0,05. Resultados De janeiro de 2017 a janeiro de 2021, 1.711 pacientes foram submetidos à ICP primária, e 1.417 pacientes preencheram nossos critérios de inclusão (709 pacientes no grupo Inspiron® e 708 pacientes no grupo dos outros SF de segunda ou terceira geração). Após PEP, a amostra do estudo foi composta por 706 pacientes (353 pacientes no grupo Inspiron® e 353 pacientes no grupo dos demais SF de segunda ou terceira geração). As taxas de revascularização do vaso alvo (odds ratio [OR] 0,52; intervalo de confiança [IC] 0,21 a 1,34; p = 0,173), trombose de stent (OR 1,00; IC 0,29 a 3,48;p = 1,000), mortalidade (hazard ratio 0,724; IC 0,41 a 1,27; p = 0,257) e os desfechos cardiovasculares maiores (OR 1,170; IC 0,77 a 1,77; p = 0,526) foram semelhantes entre os grupos após um acompanhamento mediano de 17 meses. Conclusão Nossos achados mostram que o stent Inspiron® foi eficaz e seguro quando comparado a outros SF de segunda ou terceira geração em uma coorte contemporânea do mundo real de pacientes com IAMCSST submetidos à ICP primária.

Abstract Background The current gold standard of coronary drug-eluting stents (DES) consists of metal alloys with thinner struts and bioresorbable polymers. Objectives Our aim was to compare an ultrathin strut, sirolimus-eluting stent (Inspiron®) with other third-generation DES platforms in patients with ST-elevation myocardial infarction (STEMI) submitted to primary percutaneous coronary intervention (PCI). Methods We analyzed data from a STEMI multicenter registry from reference centers in the South Region of Brazil. All patients were submitted to primary PCI, either with Inspiron® or other second- or third-generation DES. Propensity score matching (PSM) was computed to generate similar groups (Inspiron® versus other stents) in relation to clinical and procedural characteristics. All hypothesis tests had a two-sided significance level of 0.05. Results From January 2017 to January 2021, 1711 patients underwent primary PCI, and 1417 patients met our entry criteria (709 patients in the Inspiron® group and 708 patients in the other second- or third-generation DES group). After PSM, the study sample was comprised of 706 patients (353 patients in the Inspiron® group and 353 patients in the other the other second- or third-generation DES group). The rates of target vessel revascularization (OR 0.52, CI 0.21 - 1.34, p = 0.173), stent thrombosis (OR 1.00, CI 0.29 - 3.48, p = 1.000), mortality (HR 0.724, CI 0.41 - 1.27, p = 0.257), and major cardiovascular outcomes (OR 1.170, CI 0.77 - 1.77, p = 0.526) were similar between groups after a median follow-up of 17 months. Conclusion Our findings show that Inspiron® was effective and safe when compared to other second- or third-generation DES in a contemporary cohort of real-world STEMI patients submitted to primary PCI.

Synthesis, Application and Effect of Hybrid Nanocomposites Based on Hydrogel and Nanoclay in Cement-Mortars.

Hybrid nanocomposite hydrogels, as admixtures for internal curing of cementitious materials, have been widely studied. This study analyzes the effect of applying 0.5% (wt/wt cement) of pre-soaked hydrogels based on polyacrylamide, carboxymethylcellulose, and three different concentrations of Cloisite-Na+ (0, 10, and 20% wt/wt) on the fresh and hardened properties of cementitious mortars. In general, all mortars with hydrogel decreased the consistency index, mainly M20, due to the high concentration of Cloisite-Na+ that modifies the release kinect of the hydrogel. The results showed a slight variation, with an overall average value of 99% water retention in all mortars. This behavior is due to the portion of hydrogel-mortars dosage water retained to reduce the availability of free water in the mixture because this amount of water is stored, a priori, within the polymer particles. At 28 d, the mortars produced with hydrogels containing 20% of nanoclay (M20) exhibit mechanical behavior similar to the reference mortar (M), which corroborates the percentage of voids found. Scanning electron microscope images confirm that the M and M20 mortars are uniform and possess few pores or microcracks. Thus, these hybrid hydrogels have the potential to be innovative materials for water control improvements in cementitious materials technology.

Citric acid incorporated in a chitosan film as an active packaging material to improve the quality and duration of matured cheese shelf life.

Chitosan-based film incorporated with citric acid was prepared by the casting method for application in a Brazilian matured cheese. Three formulations of cheese were processed, with the intention of evaluating the application of a starter culture and the effect of the film in terms of its physiochemical, microbiological, and sensorial characteristics. It was observed by scanning electron microscopy (sem) analysis that the film has a homogeneous appearance, and the crosslinking between citric acid and chitosan was confirmed by the Fourier transform infrared spectroscopy (FTIR) analysis. The cheese with chitosan-based film presented lower weight loss (5.2%) and showed antimicrobial activity against aerobic mesophilic bacteria. All samples showed high rates of sensorial acceptability (>79%), with no significant differences between them. It is apparent that the chitosan film maintained the typical cheese characteristics. Therefore, chitosan and citric acid film can be used to improve the characteristics of matured cheese and extend its shelf life.

Effect of corn stigma extract on physical and antioxidant properties of biodegradable and edible gelatin and corn starch films.

The development of bio-based food packaging with antioxidant properties is an important research topic and has gained prominence these days. In this study, bioactive films were developed based gelatin-corn starch (GCS) incorporated with corn stigma extract (CSE) at different concentrations (15% and 25%; w/v). In preliminary tests, the extract maintained cell viability above 90% indicating that it is safe for application as an active ingredient. Insertion of the extract did not influence the thickness of the films but caused a slight change in optical properties. Scanning electron microscopy (SEM) analysis revealed interactions between the extract's bioactive compounds with gelatin and corn starch compounds, which may have improved the mechanical properties (elongation at break, Young's modulus). The addition of 25% corn stigma extract increased the contact angle, giving the film a hydrophobic character. Furthermore, at this concentration, a 15% reduction in water vapor permeability was observed. The elaborated films showed complete biodegradability before the tenth day of the study. It can be inferred that the films with corn stigma extract have good antioxidant properties, indicating that they can be used as an ingredient for food packaging.

Novel pulp capping material based on sodium trimetaphosphate: synthesis, characterization, and antimicrobial properties.

OBJECTIVES: To evaluate the mechanical, physicochemical, and antimicrobial properties of four different formulations containing micro- or nanoparticles of sodium trimetaphosphate (mTMP and nTMP, respectively). METHODOLOGY: Four experimental groups were used in this investigation: two mTMP groups and two nTMP groups, each containing zirconium oxide (ZrO2), and solution containing either chitosan or titanium oxide (TiO2) nanoparticles (NPs). Setting time, compression resistance, and radiopacity were estimated. The agar diffusion test was used to assess the antimicrobial activity of the formulations against five different microbial strains: Streptococcus mutans, Lactobacillus casei, Actinomyces israelii, Candida albicans, and Enterococcus faecalis. Parametric and nonparametric tests were performed after evaluating homoscedasticity data (p<0.05). RESULTS: From the properties evaluated, nTMP cements required less setting time and showed greater resistance to compression. Cements containing TiO2 showed greater radiopacity for both nTMP and mTMP. All four cement formulations showed antimicrobial activity against S. mutans and L. casei. CONCLUSION: Formulations containing nTMP have shorter setting times and higher compressive strength, and those with TiO2 nanoparticles showed antimicrobial activities. Clinical relevance: The cement containing nTMP, ZrO2, and TiO2 could be an alternative material for protecting the pulp complex.

Novel pulp capping material based on sodium trimetaphosphate: synthesis, characterization, and antimicrobial properties

Abstract Objectives: To evaluate the mechanical, physicochemical, and antimicrobial properties of four different formulations containing micro- or nanoparticles of sodium trimetaphosphate (mTMP and nTMP, respectively). Methodology: Four experimental groups were used in this investigation: two mTMP groups and two nTMP groups, each containing zirconium oxide (ZrO2), and solution containing either chitosan or titanium oxide (TiO2) nanoparticles (NPs). Setting time, compression resistance, and radiopacity were estimated. The agar diffusion test was used to assess the antimicrobial activity of the formulations against five different microbial strains: Streptococcus mutans, Lactobacillus casei, Actinomyces israelii, Candida albicans, and Enterococcus faecalis. Parametric and nonparametric tests were performed after evaluating homoscedasticity data (p<0.05). Results: From the properties evaluated, nTMP cements required less setting time and showed greater resistance to compression. Cements containing TiO2 showed greater radiopacity for both nTMP and mTMP. All four cement formulations showed antimicrobial activity against S. mutans and L. casei Conclusion: Formulations containing nTMP have shorter setting times and higher compressive strength, and those with TiO2 nanoparticles showed antimicrobial activities. Clinical relevance: The cement containing nTMP, ZrO2, and TiO2 could be an alternative material for protecting the pulp complex.

Performance of Gelatin Films Reinforced with Cloisite Na+ and Black Pepper Essential Oil Loaded Nanoemulsion.

The concern about consuming eco-friendly products has motivated research in the development of new materials. Therefore, films based on natural polymers have been used to replace traditional polymers. This study consists of a production of films based on gelatin reinforced with black pepper essential oil-loaded nanoemulsions and Cloisite Na+. The films were characterized by water vapor permeability, mechanical and thermal properties, surface contact angle, X-ray diffraction and scanning electron microscopy. It was observed that the films containing the nanoemulsion have higher permeability values and an increase in their mechanical resistance. The addition of nanoclay contributed to an increase in the surface hydrophobicity of the film and an increase in the tensile strength, at break, by about 150%. The addition of essential oil nanoemulsions led to an increase in thermal stability. The presence of clay dispersion contributed to the formation of a surface that was slightly rougher and grainier. The addition of the black pepper essential oil nanoemulsion resulted in an increase in porosity of the gelatin matrix. Through X-ray diffraction analysis, it was possible to conclude that both the polymeric gelatin matrix and the essential oils nanoemulsion are intercalated with the clay dispersion.

Congenital infections (syphilis and human immunodeficiency virus) in a federal hospital in Rio de Janeiro / Infecções congênitas (sífilis e vírus da imunodeficiência humana) em hospital federal no Rio de Janeiro

Introduction: Congenital infections are related to a higher risk of morbidity and mortality in the neonatal period and can cause serious complications in the newborn. Among the sexually transmitted infections (IST) present in this group, syphilis and vertical exposure to the human immunodeficiency virus (HIV) are still a challenge in the 21st century. Objective: To evaluate the prevalence of congenital syphilis and exposure to HIV among congenital infections. Methods: Cross-sectional, analytical study with data collected from medical records of newborns admitted to the Conventional Neonatal Intermediate Care Unit, Kangaroo and Joint Accommodation, in the database of the service of the Federal Hospital from Bonsucesso, from January 2015 to December 2018. Results: During the study, 2,202 newborns were discharged from the hospital and 474 were positive for congenital infection (21.8%). In cases of congenital infection, congenital syphilis (398­84%) and maternal HIV infection (40­8,4%) were the most frequently encountered clinical situations. The relationship between prenatal care and the absence of congenital infection was evident. Among the newborns, 117 (5.3%) were premature, 352 (16.3%) were older than 37 weeks and 95 (23.7%) had low birth weight. Conclusion: Congenital infection was one of the main causes of neonatal morbidity; syphilis and HIV had the highest prevalence, being associated with reducible deaths when adequate care is provided for women during pregnancy. Perinatology services demand a great effort in order to manage these avoidable and undesirable situations.

Introdução: As infecções congênitas estão relacionadas a um risco mais elevado de morbimortalidade no período neonatal e geram sérias complicações no recém-nascido. Dentre as infecções sexualmente transmitidas (IST) presentes nesse grupo, a sífilis e a exposição vertical ao vírus da imunodeficiência humana (HIV) ainda são um desafio em pleno século XXI. Objetivo: Avaliar a prevalência da sífilis congênita e exposição ao HIV entre as infecções congênitas. Métodos: Estudo de corte transversal e analítico, com dados coletados nos prontuários de alta dos recém-nascidos que ficaram internados na Unidade de Cuidado Intermediário Neonatal Convencional, Canguru e Alojamento Conjunto, no banco de dados do Serviço do Hospital Federal de Bonsucesso, de janeiro de 2015 a dezembro de 2018. Resultados: No período do estudo, 2.202 recém-nascidos receberam alta hospitalar e 474 apresentaram positividade para infecção congênita (21,8%). Nos quadros de infecção congênita, a sífilis congênita (398­84,0% dos casos) e a infecção materna pelo HIV (40­8,4%) foram as situações clínicas mais frequentemente encontradas. Ficou evidente a relação entre a realização do pré-natal e a ausência de infecção congênita. Desses recém-nascidos, 117 (5,3%) foram prematuros, 352 (16,3%) tinham mais de 37 semanas e 95 (23,7%) tinham peso abaixo de 2.500 g. Conclusão: A infecção congênita foi uma das principais causas de morbidade neonatal; a sífilis e o HIV tiveram as maiores prevalências, estando associados às mortes redutíveis por adequada atenção à mulher na gestação. Os serviços de perinatologia demandam um grande esforço para atender essas situações evitáveis e indesejáveis.

Effect of green tea extract on gelatin-based films incorporated with lemon essential oil.

The use of natural polymers, such as gelatin and other proteins, has increased in an attempt to replace part of the consumption of petroleum-based packaging. This study evaluated the influence of green tea extract and lemon nanoemulsion on mechanical, thermal and permeability properties of gelatin matrix. The results showed that green tea increased the gelatin tensile strength (TS) from 86 ± 7 MPa to 101 ± 5 MPa, on the other hand, the nanoemulsion decreases to 78 ± 8 MPa. The incorporation of green tea and nanoemulsion enhanced the water vapor permeability of gelatin film; this could be due to the interacting with the hydrophobic domains of gelatin. This was indicated by melting point (Tm) in differential scanning calorimetry (DSC) and degradation temperatures in the thermogravimetric analysis (TG), respectively. Changes in FTIR spectra of gelatin film were observed when the green tea and nanoemulsion were incorporated. Therefore, this study showed a new characterization and formulation of gelatin films incorporated by green tea extract and lemon nanoemulsion and their potential for edible film.

Epidemiologic and clinical investigations during a chikungunya outbreak in Rio Grande do Norte State, Brazil.

The first autochthonous case of chikungunya virus (CHIKV) infection in Brazil was in September 2014 in the State of Amapá, and from there it rapidly spread across the country. The present study was conducted in 2016 in the state of Rio Grande do Norte, and the aims were to describe the epidemiological and the clinical aspects of the CHIKV outbreak. Biological samples from 284 chikungunya suspected cases were screened for CHIKV and Flavivirus (FV) RNA using qRT-PCR. Negative PCR samples were also screened for anti-CHIKV and anti-FVIgM by ELISA. CHIKV RNA were detected in 125 samples mostly occurring from January through March (46%), mainly affecting adults and older adults. We found a gradual decrease in viral RNA over the disease time. Anti-CHIKV IgM was found in 47.5% after negative CHIKV qRT-PCR. Interestingly, 45.0% simultaneously had positive results for CHIKV and FV IgM, suggesting the occurrence of virus co-circulation. The most frequent symptom was fever (91%). Women presented more chance to develop nausea and abdominal pain compared to men. Our data described and allows us to better understand the clinical and epidemiological aspects of the 2016 chikungunya outbreak in Rio Grande do Norte and can help in the early clinical diagnosis of the virus.

Upcycling Microbial Cellulose Scraps into Nanowhiskers with Engineered Performance as Fillers in All-Cellulose Composites.

Cellulose is everywhere and renovates in nature continuously and rapidly, while petroleum does not. Unlike the latter, cellulose biodegrades and may represent a carbon sink. Inspired by the multiscale architecture of cellulose, we report on all-cellulose composites comprising cellulose ether as a matrix and highly pure bacterial cellulose nanocrystals (BCNCs) as fillers. Optimum performance as a packaging material was achieved by engineering BCNC surface chemistry as well as the filler-in-matrix dispersion, targeting the replacement of unsustainable, fossil-derived plastics intended for single-use applications. Cost could pose a hurdle, eliminated through the valorization of underutilized scraps from industrial operations, which is also in line with the circular bioeconomy in terms of the integral use of biomass. As far as performance, the optically transparent hydroxypropyl methylcellulose (HPMC) films presented improved tensile strength (from 61 ± 6 to 86 ± 9 MPa) and Young's modulus (from 1.5 ± 0.2 to 2.7 ± 0.4 GPa) while reduced elongation at break (from 15 ± 2 to 12 ± 2%) and water vapor permeability (from 0.40 ± 0.02 to 0.31 ± 0.01 g mm h-1 m-2 kPa-1) when filled with only 5 wt % of (120 ± 31) nm long, (13 ± 3) nm wide, 88% crystalline BCNC. This dual, win-win effect of BCNCs on the mechanical and barrier properties of HPMC films was enabled by a suitable dispersion state, achieved via high-energy mixing, and quenched by casting. This study adds to the current literature on all-cellulose composites and helps pave the route for the technical and economical feasibilities of replacing non-renewable, non-biodegradable plastics in short-term applications by materials that are both renewable and biodegradable, that are also produced through green protocols and isolated from surplus biomass, and that still perform similarly or even better.

Spatio-temporal dynamics of Aedes aegypti and Aedes albopictus oviposition in an urban area of northeastern Brazil.

OBJECTIVE: The objective of this study was to analyse abundance and spatial distribution of Aedes aegypti and Aedes albopictus oviposition in the city of Natal-RN, 2016 to 2018. METHODS: Three hundred and seven oviposition traps were installed covered the whole city and were monitored weekly from January 2016 to December 2018. To verify the abundance of the vector based on its location, the formation of oviposition clusters was studied using the Kernel statistics. Egg Density Index (EDI) and Oviposition Positivity Index (OPI) values were calculated. RESULTS: Temperature and humidity presented weak and very weak correlation, respectively, with the oviposition indicators. The median of oviposition positivity index (OPI) was 60.5%, and the egg density index (EDI) was 45.4 eggs/trap. The OPI (71.1%) was higher in the second quarter of the year. The areas with the most persistent oviposition are located in a continuous strip that extends from the extreme of the northern district and extends along the western district of the city. Also noteworthy is the proximity to the strategic points. CONCLUSION: The spatio-temporal distribution of oviposition revealed that there is spatial segregation and marked seasonality. Therefore, this study highlights the importance of maintaining surveillance targeting and control strategies focused on these areas, especially during the most important period of the year.

OBJECTIF: L'objectif de cette étude était d'analyser l'abondance et la distribution spatiale de la ponte d'Aedes aegypti et d'Aedes albopictus dans la ville de Natal-RN, de 2016 à 2018. MÉTHODES: 307 pièges de ponte ont été installés dans toute la ville et surveillés chaque semaine de janvier 2016 à décembre 2018. Pour vérifier l'abondance du vecteur en fonction de sa localisation, la formation de grappes de ponte a été étudiée à l'aide des statistiques de Kernel. Les valeurs de l'indice de densité des œufs (IDO) et de l'indice de positivité de la ponte(IPP) ont été calculées. RÉSULTATS: La température et l'humidité ont présenté une corrélation faible et très faible, respectivement, avec les indicateurs de ponte. L'indice médian de positivité de ponte (IPP) était de 60,5% et l'indice de densité des œufs (IDO) était de 45,4 œufs/piège. L'IPP (71,1%) était plus élevé au deuxième trimestre de l'année. Les zones avec la ponte la plus persistante sont situées dans une bande continue qui s'étend de l'extrémité du district nord et s'étend le long du district ouest de la ville. A noter également la proximité des points stratégiques. CONCLUSIONS: La distribution spatiotemporelle de la ponte a révélé une ségrégation spatiale et une saisonnalité marquée. Par conséquent, cette étude met en évidence l'importance de maintenir des stratégies de surveillance ciblée et de contrôle axés sur ces zones, en particulier pendant la période la plus importante de l'année.

Escalating the technical bounds for the production of cellulose-aided peach leathers: From the benchtop to the pilot plant.

This contribution falls within the context of sustainable functional materials. We report on the production of fruit leathers based chiefly on peach pulp, but combined with hydroxypropyl methylcellulose (HPMC) as binding agent and cellulose micro/nanofibrils (CMNF) as fillers. Increased permeability to moisture (from 0.9 to 5.6 g mm kPa-1 h-1m-2) and extensibility (from 10 to 17%) but reduced mechanical resistance (67-2 MPa) and stiffness (1.8 GPa-18 MPa) evidenced the plasticizing effect of peach pulp in HPMC matrix, which was reinforced by CMNF. A ternary mixture design allowed building response surfaces and optimizing leather composition. The laboratory-scale leather production via bench casting was extended to a pilot-scale through continuous casting. The effect of scaling up on the nutritional and sensory features of the peach leather was also depicted. The herein established composition-processing-property correlations are useful to support the large-scale production of peach leather towards applications both as packaging materials and as nutritional leathers.

Prevalence, characteristics, and costs of diagnosed homocystinuria, elevated homocysteine, and phenylketonuria in the United States: a retrospective claims-based comparison.

BACKGROUND: Classical homocystinuria (HCU), an inborn error of homocysteine metabolism, has previously been estimated to affect approximately 1 in 100,000-200,000 people in the United States (US). HCU is poorly detected by newborn screening, resulting in underestimates of its prevalence. This study compared characteristics, healthcare use and costs, and projected prevalence between patients with diagnosed HCU, elevated total homocysteine (tHcy), and diagnosed phenylketonuria (PKU). METHODS: Patients in the MarketScan® Research Databases were identified with strictly-defined HCU (> 2 diagnoses, including 1 ICD-10), broadly-defined HCU (> 1 ICD-10), elevated tHcy (> 20 µmol/L) without an HCU diagnosis, or > 1 ICD-9/ICD-10 PKU diagnosis during 1/1/2010-12/31/2016 (first qualifying claim = index). Demographics and healthcare utilization and costs per patient per month (PPPM) were compared between all cohorts, frequencies of comorbidities and medications were compared between HCU and elevated tHcy patients, and healthcare provider types were assessed among HCU patients. The prevalence of patients meeting each cohort definition was projected to the United States (US) population. RESULTS: Patients with strictly-defined (N = 2450) and broadly-defined (N = 6613) HCU, and with elevated tHcy (N = 2017), were significantly older than PKU patients (N = 5120) (57 vs. 56 vs. 53 vs. 18 years; p < 0.05). Vitamin D deficiency, hyperlipidemia, folic acid/B vitamins, and lipid-lowering medications, among others, were more common among diagnosed HCU patients vs. those with elevated tHcy (all p < 0.05). Rates of healthcare utilization were generally higher among HCU and elevated tHcy patients, compared to PKU, though total healthcare costs were similar between groups. Most HCU patients (~ 38%) received their index diagnosis from a primary care physician; very few (~ 1%) had any claim from a geneticist during their enrollment. The age-adjusted national prevalence of HCU was projected at 31,162 (95% CI: 30,411 - 31,913; ~ 1 in 10,000 of the US population) using the broad definition. CONCLUSIONS: The actual prevalence of HCU may be > 10 times prior estimates, at 1 in 10,000 in the US, and this study suggests that HCU is not being diagnosed until later in life. Improvements to newborn screening, detection in young children, and physician education regarding HCU among patients may be necessary to alleviate the burden of this genetic disease.

Estimated prevalence of moderate to severely elevated total homocysteine levels in the United States: A missed opportunity for diagnosis of homocystinuria?

Classical homocystinuria (HCU) is a genetic disorder caused by mutations in the cystathionine beta synthase gene, which results in impaired metabolism of the sulfur-bearing amino acid homocysteine and its accumulation in blood and tissues. Classical HCU can be detected via newborn screening in the United States, but the test is widely acknowledged to miss many patients. While severely elevated homocysteine levels (>100 µmol /L) frequently lead to a classical HCU diagnosis, intermediate levels (>30 to 100 µmol /L), though linked to many of the known complications of HCU, are not always recognized as associated with HCU. We aimed to identify and describe potentially undiagnosed classical HCU patients using a nationally-representative database of administrative claims and laboratory results. We estimated the national prevalence of patients with homocysteine >30 µmol /L, and compared their demographic and clinical characteristics to those of patients with homocysteine levels ≤30 µmol/L. Among 57,580 patients with a homocysteine test result, 1.8% had a value >30 µmol /L. Patients with homocysteine >30 µmol /L were more frequently diagnosed with hypothyroidism (39.2% vs. 20.7%, p < .001) and renal disease (9.7% vs. 5.5%, p < .001), and were more likely to have a prescription for an anxiolytic/antidepressant (44.5% vs. 38.9%), opioid (58.4% vs. 53.1%), steroid (46.4% vs. 42.5%), or thyroid hormone (38.8% vs. 18.8%), compared to patients with homocysteine ≤30 µmol /L (all p < .05). Both groups were equally likely to have a diagnosis of homocystinuria or another disorder of sulfur-bearing amino acid metabolism (3.8% vs. 4.0%, p = .752). The age-adjusted national prevalence of homocysteine >30 µmol /L was estimated at 33,068 (95% CI: 1033 - 35,104). These findings suggest that thousands of people in the US may be living with intermediate to severely elevated homocysteine levels and may require further evaluation for the presence of classical HCU.

Nanostructured Antimicrobials in Food Packaging-Recent Advances.

Active food packaging systems promote better food quality and/or stability, such as by releasing antimicrobial agents into food. Advantages of adding antimicrobials to the packaging material instead of into the bulk food include controlled diffusion, reduced antimicrobial contents, and improved cost effectiveness. Nanostructured antimicrobials are especially effective due to their high specific surface area. The present review is focused on recent advances and findings on the main nanostructured antimicrobial packaging systems for food packaging purposes. Several kinds of nanostructures, including both inorganic particles and organic structures, have been proven effective antimicrobials by different mechanisms of action and with different application scopes. Moreover, there are systems containing nanocarriers to protect antimicrobials and deliver them in a controlled fashion. On the other hand, scientific data about migration of nanostructures onto food and their toxicity are still limited, requiring special attention from researchers and regulation sectors.

Combining Cupuassu (Theobroma grandiflorum) Puree, Pectin, and Chitosan Nanoparticles into Novel Edible Films for Food Packaging Applications.

Every year, the residues generated by the disposal of packaging materials produced from fossil fuels have been growing, denoting a major environmental problem that can be mitigated by the development of biodegradable materials from natural polymers, particularly edible films. This work aimed at the development of pectin films added by cupuassu puree and chitosan nanoparticles and to evaluate the improvement of the physical-mechanical performance of the composite films. The nanostructures displayed an average size of 110 nm and a zeta potential of approximately +40 mV. The films were produced by casting, and they exhibited manageability, homogeneity, and continuity. Based upon the mechanical analysis of maximum stress and elongation, it was concluded that the nanoparticles functioned as fillers, increasing the toughness of the pectin films. Water vapor permeability assays demonstrated that the nanostructured films containing cupuassu exhibited improved barrier properties. The glass transition temperature of the films was not strongly affected by the addition of nanoparticles. Conversely, the initial degradation temperature decreased with the addition of nanoparticles and cupuassu puree. The outcomes of this research pave a new route for the development of nonconventional food packaging materials.