Devices used for photobiomodulation of the brain-a comprehensive and systematic review.

A systematic review was conducted to determine the trends in devices and parameters used for brain photobiomodulation (PBM). The revised studies included clinical and cadaveric approaches, in which light stimuli were applied to the head and/or neck. PubMed, Scopus, Web of Science and Google Scholar databases were used for the systematic search. A total of 2133 records were screened, from which 97 were included in this review. The parameters that were extracted and analysed in each article were the device design, actuation area, actuation site, wavelength, mode of operation, power density, energy density, power output, energy per session and treatment time. To organize device information, 11 categories of devices were defined, according to their characteristics. The most used category of devices was laser handpieces, which relate to 21% of all devices, while 28% of the devices were not described. Studies for cognitive function and physiological characterisation are the most well defined ones and with more tangible results. There is a lack of consistency when reporting PBM studies, with several articles under defining the stimulation protocol, and a wide variety of parameters used for the same health conditions (e.g., Alzheimer's or Parkinson's disease) resulting in positive outcomes. Standardization for the report of these studies is warranted, as well as sham-controlled comparative studies to determine which parameters have the greatest effect on PBM treatments for different neurological conditions.

Radio-cephalic fistula recovered with drainage to median basilic vein by straightening of the forearm cephalic vein: A case report.

The distal arteriovenous fistula (AVF) has less complications and better patency than the proximal fistula, when it works properly. The complications of outflow of the fistula are complex, and it is necessary to analyze all solutions to solve the problem. We introduce a novel approach to solve outflow problems of a radio-cephalic AVF by straightening of the forearm cephalic vein with drainage into the median basilic vein.

Moving Beyond Nursing Standardized Language for Substance Use Problems.

Nursing knowledge has been accompanied by the evolution of nursing standardized language systems (SLS) that can help nurses to systematize nursing care. We analyzed referential integrity (diagnosis, results, interventions) of substance related problems in Nursing SLS through documentary analysis: ICNP®, NANDA-I, Nursing Intervention Classification (NIC), Nursing Outcome Classification (NOC), NANDA NIC NOC (NNN). ICNP® has a definition of "substance abuse" but there are no clinical indicators or related factors to help formulate a diagnosis. NANDA-I does not define any related diagnosis, although it appears as related to or as a risk factor in 36 diagnoses. In NIC and NOC there are interventions and outcomes related. The phenomenon is omitted in NANDA-I and treated in a stigmatized manner by ICNP. Clear clinical indicators may be needed to help nursing diagnosis and to lead clinical reasoning.

Optimization of the Extraction Process to Obtain a Colorant Ingredient from Leaves of Ocimum basilicum var. purpurascens.

Heat-Assisted Extraction (HAE) was used for the optimized production of an extract rich in anthocyanin compounds from Ocimum basilicum var. purpurascens leaves. The optimization was performed using the response surface methodology employing a central composite experimental design with five-levels for each of the assessed variables. The independent variables studied were the extraction time (t, 20⁻120 min), temperature (T, 25⁻85 °C), and solvent (S, 0⁻100% of ethanol, v/v). Anthocyanin compounds were analysed by HPLC-DAD-ESI/MS and the extraction yields were used as response variables. Theoretical models were developed for the obtained experimental data, then the models were validated by a selected number of statistical tests, and finally, those models were used in the prediction and optimization steps. The optimal HAE conditions for the extraction of anthocyanin compounds were: t = 65.37 ± 3.62 min, T = 85.00 ± 1.17 °C and S = 62.50 ± 4.24%, and originated 114.74 ± 0.58 TA mg/g of extract. This study highlighted the red rubin basil leaves as a promising natural matrix to extract pigmented compounds, using green solvents and reduced extraction times. The extract rich in anthocyanins also showed antimicrobial and anti-proliferative properties against four human tumor cell lines, without any toxicity on a primary porcine liver cell line.

Nursing Intervention to Prevent and Manage Delirium in Critically Ill Patients: A Scoping Review.

Delirium is an acute neuropsychiatric syndrome of multifactorial etiology with a high incidence in people admitted to intensive care units. In addition to reversible impairment of cognitive processes, it may be associated with changes in thinking and perception. If, in the past, it was considered an expected complication of severe disease, nowadays, delirium is associated with a poor short-term and long-term prognosis. Knowing that its prevention and early identification can reduce morbidity, mortality, and health costs, it is vital to investigate nursing interventions focused on delirium in critically ill patients. This study aimed to identify nursing interventions in the prevention and management of delirium in critically ill adults. The method used to answer the research question was a scoping review. The literature search was performed in the Medline (via PubMed), CINAHL (via EBSCOhost), Scopus, Web of Science, and JBI databases. The final sample included 15 articles. Several categories of non-pharmacological interventions were identified, addressing the modifiable risk factors that contribute to the development of delirium, and for which nurses have a privileged position in their minimization. No drug agent can, by itself, prevent or treat delirium. However, psychoactive drugs are justified to control hyperactive behaviors through cautious use. Early diagnosis, prevention, or treatment can reduce symptoms and improve the individual's quality of life. Therefore, nursing professionals must ensure harmonious coordination between non-pharmacological and pharmacological strategies.

Nutraceuticals and dietary supplements: balancing out the pros and cons.

While the market is full of different dietary supplements, in most countries, legislation is clear and strict towards these products, with severe limitations on their health claims. Overall, the claims cannot go beyond the consumption of a said supplement will contribute to a healthy diet. Thus, the supplement industry has been reacting and changing their approach to consumers. One change is the considerable growth of the nutraceutical market, which provides naturally produced products, with low processing and close to no claims on the label. The marketing of this industry shifts from claiming several benefits on the label (dietary supplements) to relying on the knowledge of consumers towards the benefits of minimally processed foods filled with natural products (nutraceuticals). This review focuses on the difference between these two products, their consumption patterns, forms of presentation, explaining what makes them different, their changes through time, and their most notable ingredients, basically balancing out their pros and cons.

Cistus, Acacia, and Lemon verbena Valorization through Response Surface Methodology: Optimization Studies and Potential Application in the Pharmaceutical and Nutraceutical Industries.

Cistus ladanifer L., Acacia dealbata L., and Aloysia citrodora Paláu were subject to an optimization procedure for two extraction techniques (heat-assisted extraction (HAE) and ultrasound-assisted extraction (UAE)). The extracts were then analyzed by HPLC-DAD-ESI/MS for their phenolic profile (cistus-15 compounds, acacia-21 compounds, and lemon verbena-9 compounds). The response surface methodology was applied, considering four varying factors: ethanol percentage; extraction time; temperature/power; and S/L ratio, generating two responses (the major phenolic compound, or family of compounds, and the extraction yield). For cistus, both techniques optimized the extraction yield of punicalagins, with UAE proving to be the most efficient extraction method (3.22% ethanol, 22 min, 171 W, and 35 g/L). For acacia, HAE maximized the extraction of procyanidin (74% ethanol, 86 min, 24 °C, and 50 g/L), and UAE maximized the content of myricetin (65% ethanol, 8 min, 50 W, and 50 g/L). For lemon verbena, HAE favored the extraction of martynoside (13% ethanol, 96 min, 49 °C and 17 g/L) and forsythiaside UAE (94% ethanol, 25 min, 399 W, and 29 g/L). The optimal conditions for the extraction of compounds with high added value and potential for use in pharmaceuticals and nutraceuticals were defined.

Antibiotic susceptibility pattern of Portuguese environmental Legionella isolates.

Introduction: Legionnaires' Disease is a pneumonia caused by Legionella spp., currently treated empirically with fluoroquinolones and macrolides. In this study, we aim to describe the antibiotic susceptibility pattern of environmental Legionella recovered in the south of Portugal. Methods: Minimal inhibitory concentration (MIC) determination of 57 Legionella isolates (10 Lp sg 1, 32, Lp sg 2-14 15 L. spp) was achieved by broth microdilution, as described by EUCAST, for azithromycin, clarithromycin, ciprofloxacin, levofloxacin, and doxycycline. Results: Fluoroquinolones were the most active antibiotic, displaying the lowest MIC values in contrast to doxycycline which had the highest. MIC90 and epidemiological cut-off (ECOFF) values were, respectively, 0.5/1 mg/L for azithromycin, 0.125/0.25 mg/L for clarithromycin, 0.064/0.125 mg/L for ciprofloxacin, 0.125/0.125 mg/L for levofloxacin and 16/32 mg/L for doxycycline. Discussion: MIC distributions were higher than reported by EUCAST for all antibiotics. Interestingly, two phenotypically resistant isolates with high-level quinolone resistance were identified. This is the first time that MIC distributions, lpeAB and tet56 genes have been investigated in Portuguese environmental isolates of Legionella.

Corrigendum: Antibiotic susceptibility pattern of Portuguese environmental Legionella isolates.

[This corrects the article DOI: 10.3389/fcimb.2023.1141115.].

The generally recognized as safe (GRAS) microalgae Haematococcus pluvialis (wet) as a multifunctional additive for coloring and improving the organoleptic and functional properties of foods.

This work proposes the application of astaxanthin-rich H. pluvialis wet paste (HPW) as a partial substitute for wheat flour in the preparation of filloas, a dish that combines the basic ingredients of industrial bakery. The nutritional and color profile of HPW-enriched samples was evaluated by comparative analysis with a mixture of synthetic food dyes. The highest content of carotenoids (798 ± 12 µg g-1) and fatty acids (76 ± 2 mg g-1) was obtained for a filloa fortified with H. pluvialis in contrast to a non-significant dye response. Subsequently, the color stability of the fortified filloa was evaluated over time (3, 6 and 9 days), as well as its physicochemical properties and microbiological profile. As a result, HPW provided filloas with a longer shelf life, brightness (*L), and texture, in comparison with a mixture of synthetic dyes. In addition, an inhibitory effect of HPW towards mesophilic aerobic microorganisms in the food was obtained.

How to choose the appropriate cannulation technique for vascular access in hemodialysis patients.

The cannulation technique is important for the survival of the arteriovenous access. Choosing the appropriate technique is a complex decision. Such choice must be customized to patients, considering their characteristics, the type of arteriovenous access and the experience of the hemodialysis team. We describe seven items that can help nurses to identify the appropriate cannulation technique: type of arteriovenous access; drainage vein; hygienic self-care profile; experience of the nursing staff in the cannulation technique and nurse-to-patient ratio; hemodialysis treatment method; patient's condition; and patient's decision. Such items can help nurses in decision-making on the "ideal" cannulation technique for each patient.

Arbutus unedo leaf extracts as potential dairy preservatives: case study on quark cheese.

The plant kingdom is an endless source of molecules that can be applied in almost all realms of society. The food industry has profited from the use of plants and their derived materials for many decades. Recently, the food industry has been looking into plants to find different ways of either preserving, coloring or sweetening foods. In this work, leaf extracts of Arbutus unedo L. obtained by dynamic maceration and ultrasound assisted extraction with prior optimization of their extraction conditions through the response-surface methodology, were incorporated in quark cheese as natural preservatives and analyzed over 8 days of shelf-life. Both extracts showed antioxidant activity with no toxicity towards primary cell lines at the maximum tested concentration, as well as antibacterial activity, especially against Gram-positive strains. After their incorporation in quark cheese, no significant changes were observed in the nutritional profile and physical traits of the quark cheeses, while the microbial load was highly reduced in the cheese, especially using the extracts obtained from dynamic maceration. Thus, leaf extracts of A. unedo can be promising candidates for use in the food industry as natural preservatives.

Improving the physicochemical properties of a traditional Portuguese cake - "económicos" with chestnut flour.

"Económicos" are traditional Portuguese pastry products; although their production is low-cost, their nutritional value is equally low. Since it is a widely consumed product in the Trás-os-Montes region, it is important to add value to it without making significant changes to the traditional recipe. Thus, this work has the main objective to increase the nutritional power of "económicos" through the incorporation of chestnut (Castanea sativa) fruit flour. The influence of the incorporation of 9% of chestnut flour as a new ingredient was analysed in terms of physical parameters (texture, colour, pH, water activity and moisture), nutritional content (according to the official AOAC methodology) and chemical parameters (sugars, fatty acids and organic acids) and the ability to control the microbial load over shelf life (32 days). Overall, the addition of the chestnut flour did not drastically change the appearance of the chemical and physical profiles of the cakes, but resulted in a lighter crumb (L*), slight changes in the texture profile, reduction of fat, and most importantly, introduced healthier flour to this inexpensive cake. Moreover, it did not stimulate the growth of microorganisms (total aerobic mesophiles, coliforms, Bacillus cereus, molds, and yeasts) during the 32 days of storage.

Promising Preserving Agents from Sage and Basil: A Case Study with Yogurts.

In the present work, sage (Salvia officinalis L.) and basil (Ocimum basilicum L.) were exploited for their preservative purposes, as viable alternatives to artificial ones. The ultrasound-assisted extraction (UAE) of bioactive compounds was pre-optimized using factorial screening analysis, prior to applying response surface methodology (RSM). The obtained extracts were characterized in terms of phenolic compounds by high-performance liquid chromatography coupled to photodiode array detector and mass spectrometer HPLC-DAD-ESI/MS and bioactivities, namely the antioxidant, antimicrobial and cytotoxic potential. In addition, the most promising extracts were incorporated into yogurts, that were further screened for nutritional and physico-chemical properties and microbial load, over a shelf life of 14 days. According to the obtained results, the solvent percentage is the most relevant factor for obtaining rosmarinic acid-rich extract, followed by the extraction time and ultrasonic power. For the antioxidant and antimicrobial activity, sage showed the best result for both analysis and none of the two plant extracts were hepatotoxic. Finally, both extracts did not show changes in the physicochemical and nutritional characteristics of the yogurts and did not interfere with the growth of lactic acid bacteria, an important microorganism during yogurt fermentation. These results highlight the high potential of sage and basil as natural preservatives.

Multiplex PCR Based Strategy for Detection of Fungal Pathogen DNA in Patients with Suspected Invasive Fungal Infections.

A new and easy polymerase chain reaction (PCR) multiplex strategy, for the identification of the most common fungal species involved in invasive fungal infections (IFI) was developed in this work. Two panels with species-specific markers were designed, the Candida Panel for the identification of Candida species, and the Filamentous Fungi Panel for the identification of Aspergillus species and Rhizopusarrhizus. The method allowed the correct identification of all targeted pathogens using extracted DNA or by colony PCR, showed no cross-reactivity with nontargeted species and allowed identification of different species in mixed infections. Sensitivity reached 10 to 1 pg of DNA and was suitable for clinical samples from sterile sites, with a sensitivity of 89% and specificity of 100%. Overall, the study showed that the new method is suitable for the identification of the ten most important fungal species involved in IFI, not only from positive blood cultures but also from clinical samples from sterile sites. The method provides a unique characteristic, of seeing the peak in the specific region of the panel with the correct fluorescence dye, that aids the ruling out of unspecific amplifications. Furthermore, the panels can be further customized, selecting markers for different species and/or resistance genes.

Antimicrobial Properties of Composites of Chitosan-Silver Doped Zeolites.

The antimicrobial functionality of composites constituted by chitosan with silver-doped zeolites was developed and characterized. A composite with chitosan particles and silver-doped zeolites was synthesized using an ionic gelation process with sodium tripolyphosphate. The chitosan silver-doped zeolites composite obtained presented sizes up to 5 µm, while the silver-doped zeolites had an average size between 0.5 µm and 3.3 µm. The synthesized chitosan silver-doped zeolites composites, as well as the silver-doped zeolites and the chitosan dissolution, were characterized through X-ray diffraction, Fourier Transform Infrared spectroscopy and scanning electron microscopy. The electro kinetic behaviour of chitosan, silver-doped zeolites and chitosan silver-doped zeolites composite was evaluated under different pH conditions. The antimicrobial activity of the composites was evaluated in terms of minimum inhibitory concentrations and minimum lethal concentrations and the results suggest that the chitosan silver-doped zeolites composites show antimicrobial activity against gram-negative and gram-positive bacteria, Escherichia coli and Staphylococcus aureus, respectively and against Candida albicans. The results here presented support the potential application of the composite of chitosan with silver-doped zeolites in the functionalization of textiles with antimicrobial properties.

Effect of Natural Preservatives on the Nutritional Profile, Chemical Composition, Bioactivity and Stability of a Nutraceutical Preparation of Aloe arborescens.

Citric acid, quercetin, dried chestnut flowers and an aqueous extract of chestnut flowers were screened as candidates for preserving a drinkable nutraceutical preparation for 45 days. The assays encompassed antioxidant and antimicrobial activities, nutritional and chemical profiles, and individual profiles of fatty acids and mineral composition, all of which in comparison with a sodium benzoate, a synthetic preservative. The centesimal composition of the nutraceutical formulation was mainly composed of carbohydrates, followed by proteins and fat, with moisture levels between 66% and 71%. Palmitic and stearic acid were the most abundant fatty acids, while calcium and magnesium where the minerals in higher amount. Anthroquinones, followed by flavonoids where the most abundant groups of phenolic compounds. In terms of the preserving effects of the extracts, the chestnut flowers and the citric acid were the most effective natural preservatives, which better preserved phenolic compounds. Furthermore, these two ingredients also revealed the strongest capacity to control the microbial growth in the formulation by inhibiting the growth of food contaminants. In general, these ingredients revealed higher preservation capacity than sodium benzoate, while not altering the nutritional and fatty acid profile. The chestnut flowers and citric acid could be used to preserve foods, food supplements, and nutraceutical formulations after passing the required regulatory procedures for food additives.

Wound Navigator Profiling: scoping review. / Competências do Gestor de Feridas: scoping review.

OBJECTIVE: Map specific skills of the Wound Navigator. METHODS: A scoping review of complete and free articles in the databases CINAHL®, Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE® and 12 specialist associations in tissue viability, references in Portuguese, English, Spanish and French, with no time limit. Realized by two researchers in August 2017, of the 746 articles found, 19 met the inclusion and exclusion criteria. RESULTS: Four competency domains were identified: care (prevention/treatment of wounds and advanced therapies, decision-making; empowerment and clinical supervision), quality (specialized training; peer qualification; research and audit), and leadership (change agent; teamwork and consultant) and management (material selection/cost control). CONCLUSIONS: With four areas of competences, the Wound Navigator in partnership focuses on redefining people's life plans in the presence of wounds.