A simple and inexpensive method to monitor and minimize exposure from manipulation of cytotoxic drugs.

Pharmacy personnel that manipulate cytotoxic drugs are under continuous exposure risk. Therefore, training and strict adherence to recommended practices should always be promoted. The main objective of this study was to develop and apply a safe, effective and low-cost method for the training and assessment of the safe handling of cytotoxic drugs, using commercially available tonic water. To evaluate the potential of tonic water as a replacement marker for quinine hydrochloride, deliberate spills of 1 mL of four different tonic waters (one coloured and three non-coloured) were analysed under ultraviolet light (300-400 nm). The pigmented sample did not produce fluorescence under ultraviolet (UV) light. The three commercially available tonic waters that exhibited fluorescence were further analysed by UV/Vis spectrophotometry (300-500 nm). Afterwards, a protocol of simulated manipulation of cytotoxic drugs was developed and applied to 12 pharmacy technicians, that prepared 24 intravenous bags according to recommended routine procedures using tonic water. Participants responded to a brief questionnaire to evaluate the adequacy and applicability of the activity. Seven of the participants had spillages during manipulation, the majority of which recorded during manipulation with needles. All participants scored the tonic water manipulation simulation with 4 or 5 points for simplicity, efficiency and feasibility. The obtained results suggest that tonic water can be used to simulate the manipulation of cytotoxic drugs in training and assessment programs. By using this replacement marker for quinine hydrochloride, it is possible to perform a more cost-effective, yet equally effective, assessment.

The impact of the prognostic nutritional index (PNI) in gastric cancer.

BACKGROUND: Regarding the assessment of patients' immune and nutritional status, prognostic nutritional index (PNI) has been reported as a predictive marker for surgical outcomes in various types of cancer. The aim of our study was to evaluate the effect of PNI in prognosis of gastric cancer patients submitted to curative-intent resectional surgery. MATERIAL AND METHODS: A retrospective analysis with 637 gastric cancer cases submitted to curative-intent surgery, between 2010 and 2017, in an upper GI surgery unit. We analyzed 396 patients that met the inclusion criteria for this study. The median follow-up was 37 (0-113) months. RESULTS: According to Youden's method, the optimal PNI cutoff for OS was 41.625 (sensitivity 89.3% and specificity 41.3%). OS was significantly shorter in the lower-PNI group of patients when compared to the higher-PNI group (40.26 vs 77.49 months; p < 0.001). Higher PNI had a positive impact on OS in univariable analysis. When adjusted to pStage, higher PNI was still significantly associated with better OS (HR 0.405; CI 95% 0.253-0.649; p < 0.001). Regarding DFS, higher PNI was associated with better DFS (HR 0.421; CI 95% 0.218-0.815; p = 0.010). Higher-PNI group had a protective effect regarding postoperative morbidity and mortality. CONCLUSIONS: In this cohort, PNI was disclosed to significantly impact GC patients' OS and DFS, including in multivariable analysis when adjusting for classical prognostic features. PNI can be used to predict patients at increased risk of postoperative morbidity and mortality. This index may be of use in identifying candidate patients who would benefit from perioperative nutritional support to improve surgical outcomes.

Motor dexterity and strength depend upon integrity of the attention-control system.

Attention control (or executive control) is a higher cognitive function involved in response selection and inhibition, through close interactions with the motor system. Here, we tested whether influences of attention control are also seen on lower level motor functions of dexterity and strength-by examining relationships between attention control and motor performance in healthy-aged and hemiparetic-stroke subjects (n = 93 and 167, respectively). Subjects undertook simple-tracking, precision-hold, and maximum force-generation tasks, with each hand. Performance across all tasks correlated strongly with attention control (measured as distractor resistance), independently of factors such as baseline performance, hand use, lesion size, mood, fatigue, or whether distraction was tested during motor or nonmotor cognitive tasks. Critically, asymmetric dissociations occurred in all tasks, in that severe motor impairment coexisted with normal (or impaired) attention control whereas normal motor performance was never associated with impaired attention control (below a task-dependent threshold). This implies that dexterity and force generation require intact attention control. Subsequently, we examined how motor and attention-control performance mapped to lesion location and cerebral functional connectivity. One component of motor performance (common to both arms), as well as attention control, correlated with the anatomical and functional integrity of a cingulo-opercular "salience" network. Independently of this, motor performance difference between arms correlated negatively with the integrity of the primary sensorimotor network and corticospinal tract. These results suggest that the salience network, and its attention-control function, are necessary for virtually all volitional motor acts while its damage contributes significantly to the cardinal motor deficits of stroke.

Aspergillosis in albatrosses.

Aspergillosis is a respiratory fungal disease of importance in captive marine birds. The aim of this study was to describe the occurrence of aspergillosis in Thalassarche melanophris during rehabilitation events and to identify the etiological agent. All the albatrosses that were received for rehabilitation and died within a 2-year period were included in the study. The proportionate mortality rate caused by aspergillosis was 21.4% (3/14). One of the etiological agents was Aspergillus flavus/oryzae lineage, and the other was A. fumigatus sensu stricto. Our study suggests that aspergillosis can act as a limiting factor in the rehabilitation of albatrosses.

Wearing failure as a path to innovation.

Innovation is a widely acknowledged key component of corporate performance management. However, most of the literature on this topic has tended to focus on determinants of corporate failure, thereby neglecting to look at the role of innovation failure in triggering innovative initiatives. By using a sample of companies covered by 2014 Community Innovation Survey data and applying econometric models, this study sought to analyze the impacts of innovative project failure. The results show that innovation failure is negatively correlated with companies' experience and acquisition of external knowledge. The main findings are consistent with the scarce literature on this research topic, and highlight the positive role that companies' accumulated experience has in their assimilation of knowledge flows.

A Snake Venom-Secreted Phospholipase A2 Induces Foam Cell Formation Depending on the Activation of Factors Involved in Lipid Homeostasis.

MT-III, a snake venom GIIA sPLA2, which shares structural and functional features with mammalian GIIA sPLA2s, activates macrophage defense functions including lipid droplet (LDs) formation, organelle involved in both lipid metabolism and inflammatory processes. Macrophages (MΦs) loaded with LDs, termed foam cells, characterize early blood vessel fatty-streak lesions during atherosclerosis. However, the factors involved in foam cell formation induced by a GIIA sPLA2 are still unknown. Here, we investigated the participation of lipid homeostasis-related factors in LD formation induced by MT-III in macrophages. We found that MT-III activated PPAR-γ and PPAR-ß/δ and increased the protein levels of both transcription factors and CD36 in macrophages. Pharmacological interventions evidenced that PPAR-γ, PPAR-ß/δ, and CD36 as well as the endoplasmic reticulum enzymes ACAT and DGAT are essential for LD formation. Moreover, PPAR-ß/δ, but not PPAR-γ, is involved in MT-III-induced PLIN2 protein expression, and both PPAR-ß/δ and PPAR-γ upregulated CD36 protein expression, which contributes to MT-III-induced COX-2 expression. Furthermore, production of 15-d-PGJ2, an activator of PPARs, induced by MT-III, was dependent on COX-1 being LDs an important platform for generation of this mediator.

Looking inside the pores of a MCM-41 based Mo heterogeneous styrene oxidation catalyst: an inelastic neutron scattering study.

Styrene oxidation mediated by a Mo-based mesoporous catalyst can yield selectively styrene oxide or benzaldehyde. Kinetic data evidenced that styrene oxide is the initial single-product formed by the catalytic Mo-mediated process. However, after some hours of reaction benzaldehyde yield rises while that of the epoxide decreases concomitantly. The mechanistic proposal pointed to a surface assisted acid-base mechanism by which styrene oxide is interconverted into benzaldehyde through over-oxidation and cleavage of the C-C bond and releases formaldehyde as well. In an attempt to gain some insight into whether this mechanistic proposal is realistic we have conducted a combined DRIFT and inelastic neutron scattering (INS) study to assess the adsorbed species at the catalyst's surface and confirm the mechanistic proposal. INS and DRIFT provided complementary insight into surface-adsorbed species by probing donor (INS) and acceptor (DRIFT) species. INS also allowed for an estimation of product selectivity by means of a Job method stressing the power of the technique.

Maternal Transfer of Bisphenol A During Nursing Causes Sperm Impairment in Male Offspring.

The health effects of environmental chemicals on animals and humans are of growing concern. Human epidemiological and animal study data indicate that reproductive disorders and diseases begin early during prenatal and postnatal development. An increase of human male reproductive disturbance in the past several decades was associated to chemicals called endocrine disruptors (ED). Bisphenol A (BPA) is a ubiquitous organic environmental contaminant with ED activity. This study verified the effect of BPA exposure via breast milk during the lactation (early postnatal) period in male mice. Dams were exposed to oral BPA (300, 900, and 3000 µg/kg/BW/day) during the breastfeeding period (21 days). BPA at all concentrations significantly impaired sperm parameters in adult mice (8 months old), but mitochondrial functionality was more affected at BPA 3000. The acrosome membrane parameter was affected by BPA concentrations from 900 to 3000, and DNA integrity showed pronounced impairment at BPA 900 and 3000. BPA 3000 treatment also induced testicular degeneration and complete aplasia in some seminiferous tubules. Testicular oxidative damage was observed, and the total antioxidant capacity was impaired in BPA 900 and 3000 treatment groups. Taken together, the present study demonstrated long-term adverse effects of BPA in male mice, including reduced sperm quality, antioxidant capacity, and changes in testicular tissue. Our results clearly demonstrate the danger of BPA transferred via lactation on sperm quality registered even after a long time-elapsed from exposure to this harmful chemical.

Preoperative diagnostic criteria for scleroatrophic gallbladder: A systematic review protocol.

BACKGROUND: Although scleroatrophic gallbladder is a rare condition, it presents significant clinical challenges in diagnosis and management. More agreement is needed on this disorder's diagnostic criteria and optimal management approach. We will conduct a systematic review to summarise the scleroatrophic gallbladder's preoperative diagnostic criteria, including imaging modalities. METHODS: A systematic review will be undertaken using the PRISMA guidelines. The protocol has been registered in PROSPERO (CRD42024503701). We will search in Medline (via PubMed), Embase, SCOPUS, the Cochrane Library, and Web of Science to find original studies reporting about scleroatrophic gallbladder or synonymous. Two reviewers will independently screen the titles and abstracts following the eligibility criteria. We will include all types of studies that describe any diagnostic criteria or tools. After retrieving the full text of the selected studies, we will conduct a standardised data extraction. Finally, a narrative synthesis will be performed. The quality of the identified studies will be assessed using the Quality Assessment of Diagnostic Accuracy Studies- 2 tool. DISCUSSION: This systematic review will provide information on the preoperative diagnostic criteria of the scleroatrophic gallbladder and the value of imaging studies in its diagnosis. In addition, this work will aid doctors in the decision-making process for diagnosing scleroatrophic gallbladder and propose treatment approaches to this condition. SYSTEMATIC REVIEW REGISTRATION: The protocol has been registered in PROSPERO (CRD42024503701).

Clinical Management and Neurosurgical Approach of Pott's Puffy Tumor: A Case Report.

Pott's puffy tumors are assumed to be infrequent concomitant intra- and extracranial abscesses, mainly secondary to complicated frontal sinusitis during infancy. Due to the close proximity to the superior sagittal sinus, there is a risk of developing venous infections, thrombosis, and morbidity. In this case report, we present a case of an 11-year-old girl who presented with headache and face edema. After recognizing the Pott's puffy tumor pattern on the CT scan and brain MRI, the neurosurgical approach involved pus evacuation and frontal sinus blockage, and the patient received antibiotic therapy and was evaluated for total recovery. To our knowledge, the prompt diagnosis and treatment of such conditions are paramount to avoid complications, and differential diagnosis should be encouraged in medical practice.

Snake and arthropod venoms: Search for inflammatory activity in human cells involved in joint diseases.

Most anti-inflammatory drugs currently adopted to treat chronic inflammatory joint diseases can alleviate symptoms but they do not lead to remission. Therefore, new and more efficient drugs are needed to block the course of joint inflammatory diseases. Animal venoms, rich in bioactive compounds, can contribute as valuable tools in this field of research. In this study, we first demonstrate the direct action of venoms on cells that constitute the articular joints. We established a platform consisting of cell-based assays to evaluate the release of cytokines (IL-6, IL-8, TNFα, IL-1ß, and IL-10) by human chondrocytes, synoviocytes and THP1 macrophages, as well as the release of neuropeptides (substance-P and ß-endorphin) by differentiated sensory neuron-like cells, 24 h after stimulation of cells with 21 animal venoms from snake and arthropod species, sourced from different taxonomic families and geographic origins. Results demonstrated that at non-cytotoxic concentrations, the venoms activate at varying degrees the secretion of inflammatory mediators involved in the pathology of articular diseases, such as IL-6, IL-8, and TNF-α by chondrocytes, synoviocytes, and macrophages and of substance P by neuron-like cells. Venoms of the Viperidae snake family were more inflammatory than those of the Elapidae family, while venoms of Arthropods were less inflammatory than snake venoms. Notably, some venoms also induced the release of the anti-inflammatory IL-10 by macrophages. However, the scorpion Buthus occitanus venom induced the release of IL-10 without increasing the release of inflammatory cytokines by macrophages. Since the cell types used in the experiments are crucial elements in joint inflammatory processes, the results of this work may guide future research on the activation of receptors and inflammatory signaling pathways by selected venoms in these particular cells, aiming at discovering new targets for therapeutic intervention.

Material Extrusion to Manufacture Carbide-Based Advanced Cutting Tools.

Material extrusion (MEX) allows for the production of advanced cutting tools with new internal cooling systems, which are suitable for new machining equipment. To produce cutting tools via this process, hardmetal and cermet feedstock must be prepared for the extrusion of 3D printing filaments. After shaping the 3D object (green), debinding and sintering must be performed to achieve densification. Defects and microstructural heterogeneities were studied according to the powder material. The present study shows that, although MEX is a viable solution for hardmetals, it needs to produce homogeneous filaments for cermets. The WC-Co bulk microstructures versus hardness were similar to the ones that were measured with pressing and sintering. While cermet (Ti(CN)/WC-Ni/Co) microstructures were heterogeneous, their hardness, when compared with that from the pressing and sintering manufacturing process, decreased significantly.

Patient safety in hemodialysis clinics: perception of the nursing team.

OBJECTIVE: To analyze the perception of the nursing team regarding patient safety in hemodialysis clinics. METHOD: Descriptive-exploratory study with a qualitative approach, conducted with 37 professionals from the nursing team of five hemodialysis clinics, located in the cities of Sobral and Fortaleza, in Ceará, Brazil. Data were collected from October to December 2021, through semi-structured interviews recorded and analyzed by Descending Hierarchical Classification. RESULTS: Four classes emerged: operation of hemodialysis clinics; role of companions and patients in their safety in hemodialysis clinics; role of the nursing team in the safe care of patients undergoing hemodialysis; international patient safety goals in hemodialysis clinics. CONCLUSION: The participants recognize the existence of shortcomings in international patient safety goals, mainly errors in patient identification and medication administration.

Fast and Simple UPLC-Q-TOF MS Method for Determination of Bitter Flavan-3-ols and Oligomeric Proanthocyanidins: Impact of Vegetable Protein Fining Agents on Red Wine Composition.

Wine phenolic compounds, particularly proanthocyanidins (PAs), play a significant role in wine sensory characteristics, specifically bitterness and astringency. Although not consensual, flavan-3-ols and oligomeric PAs are generally considered the primary contributors to wine bitterness. Patatin, a vegetable protein fining agent, has been explored as an alternative to animal and synthetic fining agents for reducing wine bitterness. However, contradictory results exist regarding its effectiveness in removing flavan-3-ols and oligomeric PAs in red wines. In this work, a UPLC-Q-TOF MS/MS method was optimized and validated for accurately measuring flavan-3-ols, as well as dimeric and trimeric PAs, in red wines. The MS/MS analysis of flavan-3-ols, in addition to the typical fragmentation described in the literature, revealed an intense mass fragment resulting from the loss of C3O2 and C3O2 + H2O from the parent ion. It was observed that flavan-3-ols and PAs undergo oxidation during sample preparation, which was reversed by the addition of 5 g/L of ascorbic acid. The method demonstrated good linearity range (2 mg/L to 20 mg/L), detection limit (0.3 mg/L to 0.7 mg/L), quantification limit (0.8 mg/L to 2.2 mg/L), precision (repeatability 2.2% to 7.3%), and accuracy (recovery 98.5% to 100.5%). The application of patatin at different doses (5 g/L to 30 g/L) in two different red wine matrices did not reduce the levels of monomeric, dimeric, and trimeric PAs in red wines. However, similar behaviors were observed for pea protein and gelatin. Therefore, wine fining trials and efficiency measurements of the treatments in each matrix are strongly advised.

Melanophoroma in a Lichtenstein's green racer snake.

Melanophoroma is a neoplasm of reptilian pigment cells, considered uncommon and part of a group of neoplasms called chromatophoromas. The objective of this work was to describe a case of melanophoroma in a free-living Lichtenstein's green racer snake (Philodryas olfersii), presenting with an ulcerative nodular neoformation in the integument of the head region. In the neurologic evaluation, a proprioceptive deficit was observed. Ultrasound, X-ray, and mass cytology examinations were performed. Radiographic and ultrasound findings of the tumor indicated infiltrative behavior, and cytology indicated a presumptive diagnosis of a melanocytic neoplasm. Based on the results of the examinations and the patient's clinical condition, euthanasia was chosen. At necropsy, there was a nodule measuring 4.5 × 2.5 × 2.0 cm, with a blackish-colored cut surface, mottled by gray areas, which infiltrated soft tissue and bone, and extended dorsally from the mouth to the cervical musculature. On microscopy, a non-delimited, non-encapsulated, and invasive neoplastic proliferation was observed, with moderate cellularity, which was predominantly composed of fusiform cells with distinct borders and foci of epithelioid cells. The cells had ample cytoplasm, which had a brown to black (melanocytic) granular pigment compatible with a melanophoroma. To the best of the authors' knowledge, this is a unique description of a melanophoroma in P. olfersii.

Experience of ambulance drivers on transfer of suspected or confirmed patients for COVID-19.

OBJECTIVE: To unveil the experience of ambulance drivers regarding the transfer of suspected or confirmed patients for COVID-19. METHOD: Exploratory study with a qualitative approach conducted in October 2021 with 18 drivers from the Northwestern Mesoregion of the State of Ceará-Brazil. The individual interviews occurred virtually, via Google Meet®, and for data processing the IRAMUTEQ® software was used. RESULTS: Six classes were obtained: Feelings experienced during transfers; Concern about contamination of the work team and family members; Therapeutic itinerary, patients' clinical status and increase in the number of transfers; Disinfection of ambulances between transfers of patients with suspected and/or diagnosed COVID-19; Gowning for patient transfers and Psychospiritual aspects of drivers during the pandemic. CONCLUSION: The experience was marked by challenges in adapting to the new routine and procedures during transfers. It was evidenced feelings of fear, insecurity, tension and anguish in the worker's reports.

Epidemiological findings and laboratory evaluation of sporotrichosis: a description of 103 cases in cats and dogs in southern Brazil.

Sporotrichosis is a subcutaneous mycosis, which affects mainly small animals, and is considered an important public health disease. This paper describes the epidemiological and laboratory characteristics of 103 clinical cases of sporotrichosis diagnosed over a 10-year period in southern Brazil. The 92 cats and 11 dogs from eight municipalities in Rio Grande do Sul State developed especially the disseminated cutaneous and fixed cutaneous forms of the disease. Respiratory signs such as sneezing, serous nasal discharge and dyspnea were found in about 57% of the animals. The detection of Sporothrix schenckii in different clinical samples showed highest isolation in testicles (46.6%), oral cavity (45.2%) and conjunctival mucosa (38.1%). A differentiated histological pattern was found between the fixed cutaneous and disseminated cutaneous (DC) manifestations of the disease; well-organized granulomas of nodular distribution and various fungal structures prevailed in the DC form in cats. Melanin detection in S. schenckii cells by the Fontana-Masson technique was positive in 45.4% of the samples. The study revealed that the State of Rio Grande do Sul is an endemic sporotrichosis area and demonstrated the possibility of involvement of other pathways in the infection and spread of the disease. In addition, it emphasized the importance of laboratory tests for mycosis confirmation, especially in dogs that develop clinical manifestations without the presence of cutaneous lesions.

Mechanical and Tribological Characterization of WC-Co and WC-AISI 304 Composites by a Newly Developed Equipment.

Tungsten carbide-based composites are, in many cases, the materials of choice in applications requiring high wear resistance. In the present research work, the mechanical characterization of the WC-Co and WC-AISI 304 composites was carried out, with evaluation of the hardness and fracture toughness and tribological characterization of the composites that included the study of friction and wear rate coefficient through unlubricated sliding tests according to the Pin-on-Disc test method. It was possible to correlate the effect of the different binding phases on the mechanical and tribological properties of WC-based composites, and it can be concluded that the system composed by the tribological pair WC-AISI304/100Cr6 was the one that showed the lowest coefficient of friction while the tribological pair WC-Co/Al2O3 was the one that showed the lowest wear rate coefficient.

Construction and validation of a serial album for companions of patients with stroke.

OBJECTIVES: to construct and validate a serial album, to be used in hospital discharge planning of patients with stroke. METHODS: a methodological study, with construction of a serial album, validity by 22 judges and assessment by 22 companions. Data were collected from the Health Education Content Validity Instrument, with the companions, from the Suitability Assessment of Materials. RESULTS: the serial album has 21 pages. The overall Content Validity Index was equal to 0.87 among expert judges and 1.0 among companions. CONCLUSIONS: the educational technology constructed was considered valid by the judges and assessed as understandable by the companions so that it presented itself as a viable technological resource for use in the health education of companions of patients with stroke.

ß-micrustoxin (Mlx-9), a PLA2 from Micrurus lemniscatus snake venom: biochemical characterization and anti-proliferative effect mediated by p53.

Background: Endogenous phospholipases A2 (PLA2) play a fundamental role in inflammation, neurodegenerative diseases, apoptosis and cellular senescence. Neurotoxins with PLA2 activity are found in snake venoms from the Elapidae and Viperidae families. The mechanism of action of these neurotoxins have been studied using hippocampal and cerebellar neuronal cultures showing [Ca2+]i increase, mitochondrial depolarization and cell death. Astrocytes are rarely used as a model, despite being modulators at the synapses and responsible for homeostasis and defense in the central nervous system. Preserving the cell division ability, they can be utilized to study the cell proliferation process. In the present work cultured astrocytes and glioblastoma cells were employed to characterize the action of ß-micrustoxin (previously named Mlx-9), a PLA2 isolated from Micrurus lemniscatus snake venom. The ß-micrustoxin structure was determined and the cell proliferation, cell cycle phases and the regulatory proteins p53, p21 and p27 were investigated. Methods: ß-micrustoxin was characterized biochemically by a proteomic approach. Astrocytes were obtained by dissociation of pineal glands from Wistar rats; glioblastoma tumor cells were purchased from ATCC and Sigma and cultured in DMEM medium. Cell viability was evaluated by MTT assay; cell proliferation and cell cycle phases were analyzed by flow cytometry; p53, p21 and p27 proteins were studied by western blotting and immunocytochemistry. Results: Proteomic analysis revealed fragments on ß-micrustoxin that aligned with a PLA2 from Micrurus lemniscatus lemniscatus previously identified as transcript ID DN112835_C3_g9_i1/m.9019. ß-micrustoxin impaired the viability of astrocytes and glioblastoma tumor cells. There was a reduction in cell proliferation, an increase in G2/M phase and activation of p53, p21 and p27 proteins in astrocytes. Conclusion: These findings indicate that ß-micrustoxin from Micrurus lemniscatus venom could inhibit cell proliferation through p53, p21 and p27 activation thus imposing cell cycle arrest at the checkpoint G2/M.