Methylene blue in sepsis and septic shock: a systematic review and meta-analysis.

Background: Methylene blue is an interesting approach in reducing fluid overload and vasoactive drug administration in vasodilatory shock. The inhibition of guanylate cyclase induced by methylene blue infusion reduces nitric oxide production and improves vasoconstriction. This systematic review and meta-analysis aimed to assess the effects of methylene blue administration compared to placebo on the hemodynamic status and clinical outcomes in patients with sepsis and septic shock. Methods: The authors specifically included randomized controlled trials that compared the use of methylene blue with placebo in adult patients with sepsis and septic shock. The outcomes were length of intensive care unit stay, hemodynamic parameters [vasopressor use], and days on mechanical ventilation. We also evaluated the abnormal levels of methemoglobinemia. This systematic review and meta-analysis were recorded in PROSPERO with the ID CRD42023423470. Results: During the initial search, a total of 1,014 records were identified, out of which 393 were duplicates. Fourteen citations were selected for detailed reading, and three were selected for inclusion. The studies enrolled 141 patients, with 70 of them in the methylene blue group and 71 of them in the control group. Methylene blue treatment was associated with a lower length of intensive care unit stay (MD -1.58; 95%CI -2.97, -0.20; I2 = 25%; p = 0.03), decreased days on mechanical ventilation (MD -0.72; 95%CI -1.26, -0.17; I2 = 0%; p = 0.010), and a shorter time to vasopressor discontinuation (MD -31.49; 95%CI -46.02, -16.96; I2 = 0%; p < 0.0001). No association was found with methemoglobinemia. Conclusion: Administering methylene blue to patients with sepsis and septic shock leads to reduced time to vasopressor discontinuation, length of intensive care unit stay, and days on mechanical ventilation. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023423470, CRD42023423470.

Online yarn hairiness- Loop & protruding fibers dataset.

This paper introduces an online dataset focused on detecting hairiness in yarn, including loop and protruding fibers. The dataset is designed for use in assessing artificial intelligence algorithms. The dataset consists of 684 original images. Through augmentation, this number increases to 1644, with 11,037 annotations derived from videos featuring 56.4tex purple cotton yarn. The videos were captured during the winding and unwinding processes of the purple yarn coil. An image acquisition system capable of capturing high-resolution images while the yarn is in motion was used, reaching speeds of up to 4.2 m/s and producing images with a resolution of 1.6M pixels. This dataset containing 100m of purple cotton yarn images was recorded and is available for download in various formats, including, among others, YOLOv8, YOLOv5, YOLOv7, MT-YOLOv6, COCO JSON, YOLO Darknet, Pascal VOC XML, TFRecord, CreateML JSON. Within an interface developed for a designed mechatronic prototype, users can choose to gather images or videos of yarn. Various characteristics of the yarn, such us: diameter, linear mass, volume, twist orientation, twist step, number of cables, hairiness index, number of loose fibers, thin places, thick places, neps (mass parameters) and U, CV and sH (statistical parameters) can be obtained. Recently, this online yarn spinning dataset was employed to validate artificial neural network models for real-time detection of hairiness in yarns, including loop fibers and protruding fibers. The dataset presented, with its clear annotations and wide array of augmentation techniques, serves as a foundational resource for prospective studies in textile engineering, enabling progress in the analysis and comprehension of yarn analysis.

Blockchain Protocols and Edge Computing Targeting Industry 5.0 Needs.

"Industry 5.0" is the latest industrial revolution. A variety of cutting-edge technologies, including artificial intelligence, the Internet of Things (IoT), and others, come together to form it. Billions of devices are connected for high-speed data transfer, especially in a 5G-enabled industrial environment for information collection and processing. Most of the issues, such as access control mechanism, time to fetch the data from different devices, and protocols used, may not be applicable in the future as these protocols are based upon a centralized mechanism. This centralized mechanism may have a single point of failure along with the computational overhead. Thus, there is a need for an efficient decentralized access control mechanism for device-to-device (D2D) communication in various industrial sectors, for example, sensors in different regions may collect and process the data for making intelligent decisions. In such an environment, reliability, security, and privacy are major concerns as most of the solutions are based upon a centralized control mechanism. To mitigate the aforementioned issues, this paper provides the opportunities for and highlights some of the most impressive initiatives that help to curve the future. This new era will bring about significant changes in the way businesses operate, allowing them to become more cost-effective, more efficient, and produce higher-quality goods and services. As sensors are getting more accurate, cheaper, and have lower time responses, 5G networks are being integrated, and more industrial equipment and machinery are becoming available; hence, various sectors, including the manufacturing sector, are going through a significant period of transition right now. Additionally, the emergence of the cloud enables modern production models that use the cloud (both internal and external services), networks, and systems to leverage the cloud's low cost, scalability, increased computational power, real-time communication, and data transfer capabilities to create much smarter and more autonomous systems. We discuss the ways in which decentralized networks that make use of protocols help to achieve decentralization and how network meshes can grow to make things more secure, reliable, and cohere with these technologies, which are not going away anytime soon. We emphasize the significance of new design in regard to cybersecurity, data integrity, and storage by using straightforward examples that have the potential to lead to the excellence of distributed systems. This groundbreaking paper delves deep into the world of industrial automation and explores the possibilities to adopt blockchain for developing solutions for smart cities, smart homes, healthcare, smart agriculture, autonomous vehicles, and supply chain management within Industry 5.0. With an in-depth examination of various consensus mechanisms, readers gain a comprehensive understanding of the latest developments in this field. The paper also explores the current issues and challenges associated with blockchain adaptation for industrial automation and provides a thorough comparison of the available consensus, enabling end customers to select the most suitable one based on its unique advantages. Case studies highlight how to enable the adoption of blockchain in Industry 5.0 solutions effectively and efficiently, offering valuable insights into the potential challenges that lie ahead, particularly for smart industrial applications.

Biofouling in-water cleaning and scrubbers wash waters, potential sources of marine pollution: the Brazilian case.

Maritime transport is considered a sustainable mean of transporting goods worldwide. In addition to cargo, ships unintentionally transport non-native species. While managing the transport of organisms through ballast water has been at the centre of international efforts, biofouling from ships has not been addressed in the same way and some potentially harmful practices, such as in-water cleaning, still occur worldwide. Another problem arising from ship operating standards is the equipment known as "open-loop scrubbers," which utilizes seawater to "wash" the sulfur content out of the heavy fuel oil (HFO) and, in turn, discharges an acidic wash water full of sulfur and other substances from fuel oils in the environment. Here, we compare the international regulations applied to both issues and how they have been implemented in Brazil so far, considering the perspective of ports and terminals. Results showed that six of sixteen states have already imposed restrictions/bans on scrubbers wash waters, indicating a clear movement in the direction of restricting the discharge as the best way to prevent air and marine pollution. Regarding biofouling, although there is hope with the adoption of the revised guidelines, there are still some doubts considering these are non-binding, depending on national policies to be implemented. In Brazil, there is no national policy yet, and all public ports prohibit vessels in-water cleaning.

Organizing pneumonia and COVID-19.

Organizing pneumonia (OP) is an interstitial lung disease, and can be cryptogenic, if no cause is identified, or secondary to several conditions. COVID-19-induced persistent inflammation can be associated with interstitial lung disease. We present a review of literature of OP and COVID-19-induced OP with an illustrative case. A 38-year-old man was admitted with COVID-19 that required mechanical ventilation for 56 days. Initial chest computed tomography (CT) revealed diffuse bilateral ground-glass opacities in the lungs with consolidation areas involving 75 % of the parenchyma. After weaning from MV, the patient still required oxygen supplementation. A new chest CT scan also showed extensive diffuse areas of consolidation and ground-glass opacity. OP was hypothesized and 40 mg/day prednisone initiated and continued for six months with resolution of lung functional and image abnormalities. Organizing pneumonia should be included in the differential diagnosis of COVID-19 patients with respiratory symptoms after partial pulmonary recovery.

Strategy nursing in children with compromised ventilation: Umbrella review.

PROBLEM: Changes in the ventilation demand nursing interventions duly adapted to the management of said impairment and to the adaptability of the child/parents. This revision aimed to investigate the evidence behind the interventions performed on children with impaired ventilation.' ELIGIBILITY CRITERIA: Systematic reviews of literature in English, Spanish, French, and Portuguese from studies on nursing interventions related to children with impaired ventilation in all contexts of the clinical practice. The Joanna Briggs Institute recommendations were followed. SAMPLE: We conducted a comprehensive search as of January 2022 and updated as of June 2023. The following electronic databases were searched: SCOPUS, Web of Science, Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, MEDLINE (via PubMed), CINAHL (via EBSCO), MedicLatina (via EBSCO), The Cochrane Database of Systematic Reviews (via EBSCO), and Database of Abstracts of Reviews of Effects (DARE). Nineteen articles published between 2012 and 2022 were included in this review. RESULTS: Nineteen studies investigated the efficacy of respiratory exercises (Breathing Control - relaxed breathing, pursed lip breathing, Diaphragmatic breathing exercises, respiratory expansion exercise - deep breathing exercise, thoracic expansion exercises (with device), exercises for respiratory muscle strengthening and position to optimize ventilation. In the majority of the studies, it was not possible to evaluate the interventions separately. Thirteen studies evidenced the efficacy of respiratory exercises, BIPAP, and oxygen therapy. Seven articles demonstrated the effectiveness of respiratory muscle-strengthening exercises, and only three mentioned the efficacy of positioning regarding impaired ventilation. Interventions based on respiratory exercises and respiratory muscle training were the most common ones. CONCLUSIONS: The results suggest that nursing interventions to optimize ventilation are efficient. Nevertheless, the same present a low to moderate evidence degree, justified by the population characteristics (small and heterogeneous). IMPLICATIONS: There is proof of evidence for the studied interventions. However, the lack of methodological robustness points to future research to duly describe interventions, data, and comparable results, using reliable samples in which the focus of the study is clear.

The role of ion homeostasis imbalance due to citrate accumulation in fluoroacetic acid (FAA) toxicity in Neurospora crassa.

Fluoroacetic acid (FAA) is a poison commonly used for the lethal control of invasive species in Australia and New Zealand. Despite its widespread use and long history as a pesticide, no effective treatment for accidental poisoning exists. Although it is known to inhibit the tricarboxylic acid (TCA) cycle, specific details of FAA toxicology have remained elusive, with hypocalcemia suggested to be involved in the neurological symptoms prior to death. Here, we study the effects of FAA on cell growth and mitochondrial function using the filamentous fungi Neurospora crassa as model organism. FAA toxicosis in N. crassa is characterized by an initial hyperpolarization and subsequent depolarization of the mitochondrial membranes, followed by a significant intracellular decrease in ATP and increase in Ca2+. The development of mycelium was markedly affected within 6 h, and growth impaired after 24 h of FAA exposure. Although the activity of mitochondrial complexes I, II and IV was impaired, the activity of citrate synthase was not affected. Supplementation with Ca2+ exacerbated the effects of FAA in cell growth and membrane potential. Our findings suggest that an imbalance created in the ratio of ions within the mitochondria may lead to conformational changes in ATP synthase dimers due to mitochondrial Ca2+ uptake, that ultimately result in the opening of the mitochondrial permeability transition pore (MPTP), a decrease in membrane potential, and cell death. Our findings suggest new approaches for the treatment research, as well as the possibility to use N. crassa as a high-throughput screening assay to evaluate a large number of FAA antidote candidates.

Conduction Disorders And Their Clinical Impact After Sutureless/Rapid Deployment Aortic Bioprosthesis.

INTRODUCTION: Aortic stenosis remains the number one heart valve pathology. The drive to improve the surgical outcomes brought to focus rapid deployment valves (RDV), which reduce aortic cross-clamping and cardio-pulmonary bypass (CPB) times. However, some centers have reported a higher rate of conduction abnormalities and permanent pacemaker (PPM) implantation. The aim of this study was to investigate the incidence of conduction abnormalities after aortic valve replacement with RDV, as well as its impact on immediate postoperative outcomes. METHODS: Retrospective analysis of associated conductions disorders and PPM implantation rates, as well as post-operative outcomes of all patients undergoing isolated aortic valve replacement between April 2014 and December 2019 with an RDV. Comparative analysis between the group with PPM implantation and the one with no PPM implantation. Patients with previous PPM implantation, reoperations and patients with missing pre or postoperative ECG data were excluded. RESULTS: We studied 201 patients. The majority of conduction abnormalities were left bundle branch block (54,0%). Twenty-six PPM were implanted (12,6%). Pre-operative characteristic between the groups were similar and little differences were found in regard to most complications. However, the PPM group showed significantly higher rates of stroke (7.7% vs 0.0%, p=0.016) and hemodynamic support for longer than 24 hours (60.0% vs 36.1%, p=0.028). From the multivariable analysis, preoperative right bundle branch block was the only independent risk factor associated with PPM. CONCLUSIONS: PPM implantation rates with RDV are relatively high and are associated with prolonged hospital and ICU stays, postoperative stroke rates and requirement of aminergic support. Their use should be made on a case-by-case basis taking into consideration the existence of preoperative conduction disorders, especially right bundle branch block.

Evolution of TOP1 and TOP1MT Topoisomerases in Chordata.

Type IB topoisomerases relax the torsional stress associated with DNA metabolism in the nucleus and mitochondria and constitute important molecular targets of anticancer drugs. Vertebrates stand out among eukaryotes by having two Type IB topoisomerases acting specifically in the nucleus (TOP1) and mitochondria (TOP1MT). Despite their major importance, the origin and evolution of these paralogues remain unknown. Here, we examine the molecular evolutionary processes acting on both TOP1 and TOP1MT in Chordata, taking advantage of the increasing number of available genome sequences. We found that both TOP1 and TOP1MT evolved under strong purifying selection, as expected considering their essential biological functions. Critical active sites, including those associated with resistance to anticancer agents, were found particularly conserved. However, TOP1MT presented a higher rate of molecular evolution than TOP1, possibly related with its specialized activity on the mitochondrial genome and a less critical role in cells. We could place the duplication event that originated the TOP1 and TOP1MT paralogues early in the radiation of vertebrates, most likely associated with the first round of vertebrate tetraploidization (1R). Moreover, our data suggest that cyclostomes present a specialized mitochondrial Type IB topoisomerase. Interestingly, we identified two missense mutations replacing amino acids in the Linker region of TOP1MT in Neanderthals, which appears as a rare event when comparing the genome of both species. In conclusion, TOP1 and TOP1MT differ in their rates of evolution, and their evolutionary histories allowed us to better understand the evolution of chordates.

Self-care nursing interventions: A qualitative study into electronic health records' contents.

AIMS: This study aims to (1) analyse all self-care-related interventions Portuguese nurses documented, (2) determine potential issues that may impair semantic interoperability and (3) propose a new set of interventions representing nursing actions regarding self-care that may integrate any HER application. BACKGROUND: As populations age and chronic diseases increase, self-care concerns rise. Individuals who seek healthcare, regardless of context, need prompt access to accurate health information. Healthcare professionals need to understand the information in all places where care is provided, creating the need for semantic interoperability within electronic health records. METHODS: A qualitative descriptive and exploratory study was conducted in two phases: (1) a content analysis of nursing interventions e-documentation and (2) a focus group with fifteen registered nurses exploring latent criteria or insights gleaned from the findings of content analysis. The COREQ statement was used to guide research reporting. RESULTS: We extracted 1529 nursing intervention sentences from the electronic health records and created 209 intervention categories. We identified the main issues with semantic interoperability in nursing intervention identification. CONCLUSION: According to the findings, nurses cooperate with clients, offering physical aid and encouraging them to overcome functional limitations to self-care tasks hampered by their conditions. IMPLICATIONS FOR NURSING POLICY AND HEALTH POLICY: This article provides evidence to warn policy makers against decisions to use locally customised electronic health records, as well as evidence on the importance of policy promoting the adoption of a nursing ontology for electronic health records. And, as a result, the harmonisation and effective provision of high-quality nursing care and the reduction of healthcare costs across nations.

How Personalization Affects Motivation in Gamified Review Assessments.

Personalized gamification aims to address shortcomings of the one-size-fits-all (OSFA) approach in improving students' motivations throughout the learning process. However, studies still focus on personalizing to a single user dimension, ignoring multiple individual and contextual factors that affect user motivation. Unlike prior research, we address this issue by exploring multidimensional personalization compared to OSFA based on a multi-institution sample. Thus, we conducted a controlled experiment in three institutions, comparing gamification designs (OSFA and Personalized to the learning task and users' gaming habits/preferences and demographics) in terms of 58 students' motivations to complete assessments for learning. Our results suggest no significant differences among OSFA and Personalized designs, despite suggesting user motivation depended on fewer user characteristics when using personalization. Additionally, exploratory analyses suggest personalization was positive for females and those holding a technical degree, but negative for those who prefer adventure games and those who prefer single-playing. Our contribution benefits designers, suggesting how personalization works; practitioners, demonstrating to whom the personalization strategy was more or less suitable; and researchers, providing future research directions. Supplementary Information: The online version contains supplementary material available at 10.1007/s40593-022-00326-x.

Serum Vitamin D Levels, Disease Activity Score-28 for Rheumatoid Arthritis with C-Reactive Protein (DAS28-CRP), and Cardiac Remodeling Determined by Ventricular Dimensions and Left Atrium Diameter in Patients with Rheumatoid Arthritis: A Prospective Observational Study.

BACKGROUND Rheumatoid arthritis (RA) can cause extra-articular manifestations, and the myocardium can be a target. This study aimed to describe structural and functional cardiac echocardiographic variables in RA patients and to evaluate whether vitamin D (VD) levels and inflammation markers, evaluated by Disease Activity Score-28 for Rheumatoid Arthritis with C-reactive protein (DAS28-CRP), are associated with cardiac remodeling (CR) in this population. MATERIAL AND METHODS This prospective observational study evaluated 90 patients with RA in Botucatu University Hospital wards from 2014 to 2017. Clinical data were recorded, including demographic information, comorbidities, length of disease, and treatment type. Serum VD and C-reactive protein levels were measured, and the DAS28-CRP was calculated. A transthoracic echocardiography study was performed. The outcome evaluated was CR. This parameter was assessed by left ventricular geometric patterns and left atrium diameter. RESULTS We evaluated 90 RA patients. The mean age was 52.9±10.8 years, and 17.8% were male. The length of the disease was 96 (60-180) months. Serum VD levels were 30.7±10.4 ng/mL and the DAS28 was 2.7±0.9. Regarding the CR parameters, 56.7% had altered left ventricular geometric patterns and 25.8% had enlargement of left atrium diameter. Even in multivariate analysis, the left ventricular geometric patterns were not associated with the VD levels and the inflammation marker used. However, sufficient VD levels protect from left atrium enlargement (OR: 0.905; IC 95%: 0.843-0.973; P=0.007). CONCLUSIONS Low serum vitamin D values, but not inflammation, are associated with CR in patients with RA.

Adoption of video consultations during the COVID-19 pandemic.

Background: Video consultations have the potential to play a significant role for the future of healthcare by solving some of the imminently arising healthcare challenges, as pointed by the European Commission in Europe and the National Academy of Medicine in the United States of America. This technology can improve quality, efficiency, and enhance access to healthcare. Objective: The aim of this study is to explore and understand individual video consultations acceptance drivers. Methods: An extended technology acceptance model was created based on the diffusion of innovation theory (DOI), unified theory of acceptance and use of technology (UTAUT), health belief model (HBM), and concerns for information privacy framework (CFIP). 346 valid responses were collected through an online questionnaire, and the partial least squares (PLS) modeling approach was used to test the model. Results: The model explained 77.6 % (R2) of the variance on intention to use, and 71.4 % (R2) of the variance in attitude. The predictors of intention to use are attitude (beta = 0.504, p-value<0.001), performance expectancy (beta = 0.196, p-value = 0.002), and COVID-19 (beta = 0.151, p-value<0.001). The predictors of attitude are performance expectancy (beta = 0.643, p-value>0.001), effort expectancy (beta = 0.138, p-value = 0.001), and COVID-19 (beta = 0.170, p-value<0.001). Conclusions: This research model highlights the importance of creating extended acceptance models to capture the specificities of each technology in healthcare. The model created helps to understand the most important drivers of video consultation acceptance, highlighting the importance of the COVID-19 pandemic and perceived health risks.

A Putative long-range RNA-RNA interaction between ORF8 and Spike of SARS-CoV-2.

SARS-CoV-2 has affected people worldwide as the causative agent of COVID-19. The virus is related to the highly lethal SARS-CoV-1 responsible for the 2002-2003 SARS outbreak in Asia. Research is ongoing to understand why both viruses have different spreading capacities and mortality rates. Like other beta coronaviruses, RNA-RNA interactions occur between different parts of the viral genomic RNA, resulting in discontinuous transcription and production of various sub-genomic RNAs. These sub-genomic RNAs are then translated into other viral proteins. In this work, we performed a comparative analysis for novel long-range RNA-RNA interactions that may involve the Spike region. Comparing in-silico fragment-based predictions between reference sequences of SARS-CoV-1 and SARS-CoV-2 revealed several predictions amongst which a thermodynamically stable long-range RNA-RNA interaction between (23660-23703 Spike) and (28025-28060 ORF8) unique to SARS-CoV-2 was observed. The patterns of sequence variation using data gathered worldwide further supported the predicted stability of the sub-interacting region (23679-23690 Spike) and (28031-28042 ORF8). Such RNA-RNA interactions can potentially impact viral life cycle including sub-genomic RNA production rates.

Surgical, anesthesical and perfusion strategies for open thoracoabdominal aneurysm repair.

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Geographical contrasts of Y-chromosomal haplogroups from wild and domestic goats reveal ancient migrations and recent introgressions.

By their paternal transmission, Y-chromosomal haplotypes are sensitive markers of population history and male-mediated introgression. Previous studies identified biallelic single-nucleotide variants in the SRY, ZFY and DDX3Y genes, which in domestic goats identified four major Y-chromosomal haplotypes, Y1A, Y1B, Y2A and Y2B, with a marked geographical partitioning. Here, we extracted goat Y-chromosomal variants from whole-genome sequences of 386 domestic goats (75 breeds) and seven wild goat species, which were generated by the VarGoats goat genome project. Phylogenetic analyses indicated domestic haplogroups corresponding to Y1B, Y2A and Y2B, respectively, whereas Y1A is split into Y1AA and Y1AB. All five haplogroups were detected in 26 ancient DNA samples from southeast Europe or Asia. Haplotypes from present-day bezoars are not shared with domestic goats and are attached to deep nodes of the trees and networks. Haplogroup distributions for 186 domestic breeds indicate ancient paternal population bottlenecks and expansions during migrations into northern Europe, eastern and southern Asia, and Africa south of the Sahara. In addition, sharing of haplogroups indicates male-mediated introgressions, most notably an early gene flow from Asian goats into Madagascar and the crossbreeding that in the 19th century resulted in the popular Boer and Anglo-Nubian breeds. More recent introgressions are those from European goats into the native Korean goat population and from Boer goat into Uganda, Kenya, Tanzania, Malawi and Zimbabwe. This study illustrates the power of the Y-chromosomal variants for reconstructing the history of domestic species with a wide geographical range.