Predictive biomarkers of mortality in patients with severe COVID-19 hospitalized in intensive care unit.

Objectives: This study was performed to identify predictive markers of worse outcomes in patients with severe COVID-19 in an intensive care unit. Methods: Sixty patients with severe COVID-19, hospitalized in the Intensive Care Unit (ICU) between March and July 2021, were stratified into two groups according to the outcome survivors and non-survivors. After admission to the ICU, blood samples were collected directly for biomarker analysis. Routine hematological and biochemical biomarkers, as well as serum levels of cytokines, chemokines, and immunoglobulins, were investigated. Results: Lymphopenia, neutrophilia, and thrombocytopenia were more pronounced in non-surviving patients, while the levels of CRP, AST, creatinine, ferritin, AST, troponin I, urea, magnesium, and potassium were higher in the non-surviving group than the survival group. In addition, serum levels of IL-10, CCL2, CXCL9, and CXCL10 were significantly increased in patients who did not survive. These changes in the biomarkers evaluated were associated with increased mortality in patients with severe COVID-19. Conclusion: The present study confirmed and expanded the validity of laboratory biomarkers as indicators of mortality in severe COVID-19.

Molecular and Phylogenetic Evidence of Interfamilial Transmission of HTLV-1 in the Afro-Descendant Community of São José de Icatú in the Brazilian Amazon.

This study aimed to describe the prevalence of HTLV-1/2 in quilombola communities in the state of Pará and investigate the possible sociodemographic risk factors associated with the infection, as well as to trace the occurrence of the familial transmission of the virus. A total of 310 individuals living in eight quilombos located in the state of Pará (northern Brazil) were investigated for the presence of anti-HTLV-1/2 antibodies using an enzyme-linked immunosorbent assay (ELISA), and positive samples were confirmed using Western blot and/or real-time quantitative polymerase chain reaction (qPCR). Participants answered a questionnaire about sociodemographic aspects and risk factors for infection. Anti-HTLV-1/2 antibodies were detected in two individuals (one man and one woman), for an overall seroprevalence of 0.65%. Both individuals belonged to the community of São José de Icatú. The search for intrafamilial infection identified two other infected women, which increased the general prevalence of HTLV-1 among the Icatú to 6.25% (4/64). Western blot and qPCR confirmed their HTLV-1 infection, and phylogenetic analysis demonstrated that the isolates were of the cosmopolitan subtype and transcontinental subgroup. Epidemiological investigation of the cases revealed that the three women, at some point in their lives, had a relationship with the infected male individual. HTLV-1 is transmitted silently between individuals in the community of São José de Icatú with a present or past family relationship, stressing the need for screening and laboratory diagnosis to prevent further dissemination of the virus and surveillance of disease emergence.

Biotransformation of rifampicin by Aspergillus niger and antimicrobial activity of proposed metabolites.

Drug biotransformation studies emerges as an alternative to pharmacological investigations of metabolites, development of new drug candidates with reduced investment and most efficient production. The present study aims to evaluate the capacity of biotransformation of rifampicin by the filamentous fungus Aspergillus niger ATCC 9029. After incubation for 312 h, the drug was metabolized to two molecules: an isomer (m/z 455) and the rifampicin quinone (m/z 821). The monitoring of metabolite formation was performed by high-performance liquid chromatography, followed by their identification through ultra-high-performance liquid chromatography coupled to tandem mass spectrometer. In vitro antimicrobial activity of the proposed metabolites was evaluated against Staphylococus aureus microorganism, resulting in the loss of inhibitory activity when compared with the standards, with minimum inhibitory concentration of 7.5 µg/ml. The significant biotransformation power of the ATCC 9029 strain of A. niger was confirmed in this study, making this strain a candidate for pilot studies in fermentation tanks for the enzymatic metabolization of the antimicrobial rifampicin. The unprecedented result allows us to conclude that the prospect of new biotransforming strains in species of anemophilic fungi is a promising choice.

Evaluation biodegradable films with green tea extract for interleafing sliced meat products.

A selection of formulations with different polymers and concentrations of green tea extract was conducted for application as interleafs in sliced meat products. Films were formulated using cellulose acetate, corn starch, and chitosan with the addition of 1.0, 2.5, and 5.0% green tea extract. Higher antioxidant activity was observed with the 1.0% concentration of green tea extract (P < 0.05), regardless of the formulation, with continuous release of the extract for up to 60 days and average IC50 of 0.09 and 0.31 mg/mL for the corn starch and chitosan active films, respectively. Interleafing the sliced ham resulted in lower lipid oxidation after 60 days of storage (P < 0.05). Starch-based films with green tea extract were effective, significantly reducing lipid oxidation in sliced and interleafed cooked ham, suggesting their potential to extend the shelf life of these refrigerated products.

Occupational Physicians' Management of Workers With Multiple Sclerosis in Italy: Results From a Survey.

BACKGROUND: This study, conducted on a sample of Italian occupational physicians (OPs), aimed to gather data regarding professional activity and their needs in managing workers with multiple sclerosis. METHODS: A convenience sample of OPs recruited by e-mail invitation to the list of Italian Society of Occupational Medicine members was considered. A total of 220 OPs participated between July and October 2022. An ad hoc questionnaire was developed based on previous survey experiences. It investigated, among others, the characteristics of OP respondents, the evaluation of fitness for work issues, and the OP training and updating needs on multiple sclerosis and work. RESULTS: Ninety-one percent of OPs had to assess the fitness for work of workers with multiple sclerosis during their activity. Sixty-four percent experienced particular difficulties in issuing a fitness for work judgment. Regarding the level of knowledge on multiple sclerosis, 54% judged it sufficient. The "Assessment of fitness for work for the specific task" and the "Role of the OPs in identifying reasonable accommodations" were the most interesting training topics regarding MS management in work contexts chosen by the respondents. CONCLUSIONS: The interest in the work inclusion and job retention of people with disability, particularly the aspects linked to the Identification and implementation of reasonable accommodations, will require integration with the occupational safety and health protection system and will undoubtedly impact the OP's activities.

Implementing regular physical activity for older individuals in the family strategy program using the RE-AIM framework to ensure feasibility and sustainability: EISI study protocol.

The EISI study protocol aims to address the low participation rate in physical exercise programs among older individuals, emphasizing its significance as a non-pharmacological therapeutic approach for overall health and increased physical activity. The objectives include implementing physical activity (PA) and educational health programs in Jequié, Bahia, Brazil, targeting the Family Health Strategy population to enhance local physical activity levels among older individuals. The study also seeks to evaluate the program's feasibility, safety, and sustainability for large-scale implementation, along with assessing its impact on immune and inflammatory response biomarkers to the SARS-CoV virus, as well as physical-functional and brain health. Participants, aged 60 or above, will be divided into two groups: multicomponent exercise (MCE) and behavioral change interventions (BCI). The study employs a mixed-method approach, utilizing a non-randomized controlled short-term pathway model for a 4-8 weeks of pilot study and 16-week intervention impact assessment. Data collection encompasses various aspects such as sociodemographic information, mental health, physical fitness, fall risk, functional capacity, anthropometric measurements, hemodynamic assessment, habitual physical activity, and health-related quality of life. Blood and saliva samples are collected for cytokine and antibody biomarker analysis related to SARS-CoV immunity. Pre- and post-intervention evaluations for both groups will be conducted, with the hypothesis that MCE will yield more favorable responses compared to BCI. The study's holistic approach, including the assessment of feasibility, safety, and sustainability, aims to contribute to achieving Sustainable Development Goals (SDG) 3 and SDG 9 b y promoting accessible and sustainable healthcare initiatives for older individuals. This research aligns with global efforts to enhance health and well-being, emphasizing the importance of regular exercise in the aging population.

Purification, bioactivity and application of maltobionic acid in active films.

The objective of this study was to purify sodium maltobionate using Zymomonas mobilis cells immobilized in situ on flexible polyurethane (PU) and convert it into maltobionic acid for further evaluation of bioactivity (iron chelating ability, antibacterial potential and cytoprotection) and incorporation into films based on cassava starch, chitosan, and cellulose acetate. Sodium maltobionate exhibited a purity of 98.1% and demonstrated an iron chelating ability of approximately 50% at concentrations ranging from 15 to 20 mg mL-1. Maltobionic acid displayed minimal inhibitory concentrations (MIC) of 8.5, 10.5, 8.0, and 8.0 mg mL-1 for Salmonella enterica serovar Choleraesuis, Escherichia coli, Staphylococcus aureus, and Listeria monocytogenes, respectively. Maltobionic acid did not exhibit cytotoxicity in HEK-293 cells at concentrations up to 500 µg mL-1. Films incorporating 7.5% maltobionic acid into cassava starch and chitosan demonstrated inhibition of microbial growth, with halo sizes ranging from 15.67 to 22.33 mm. These films had a thickness of 0.17 and 0.13 mm, water solubility of 62.68% and 78.85%, and oil solubility of 6.23% and 11.91%, respectively. The cellulose acetate film exhibited a non-uniform visual appearance due to the low solubility of maltobionic acid in acetone. Mechanical and optical properties were enhanced with the addition of maltobionic acid to chitosan and cassava films. The chitosan film with 7.5% maltobionic acid demonstrated higher tensile strength (30.3 MPa) and elongation at break (9.0%). In contrast, the cassava starch film exhibited a high elastic modulus (1.7). Overall, maltobionic acid, with its antibacterial activity, holds promise for applications in active films suitable for food packaging. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-023-03879-3.

Anthraquinone as emerging contaminant: technological, toxicological, regulatory and analytical aspects.

Anthraquinone (anthracene-9,10-dione) is a multifaceted chemical used in the paper industry, in the production of synthetic dyes, in crop protection against birds and is released from fossil fuels. Additionally, the anthraquinone scaffold, when substituted with sugars and hydroxyl groups is found in plants as metabolites. Because of these multiple applications, it is produced on a large scale worldwide. However, its toxicological aspects have gained interest, due to the low limits in the foods defined by legislation. Worrying levels of anthracene-9,10-dione have been detected in wastewater, atmospheric air, soil, food packaging and more recently, in actual foodstuffs. Recent investigations aiming to identify the anthracene-9,10-dione contamination sources in teas highlighted the packaging, leaves processing, anthracene metabolism, reactions between tea constituents and deposition from the environment. In this context, this review seeks to highlight the uses, sources, biological effects, analytical and regulatory aspects of anthracene-9,10-dione.

Prevalence of radiographic findings in chronic osteomyelitis.

BACKGROUND: Simple radiography in conjunction with pertinent medical history and a comprehensive physical examination is typically adequate for diagnosing chronic osteomyelitis (CO). However, radiographic manifestations of CO lack specificity; therefore, the concordance among specialists in this regard has not been systematically assessed. This study aimed to compare and evaluate the proficiency of orthopedic surgeons and radiologists in identifying radiographic indicators present in simple radiographs for diagnosing CO. METHODS: This cross-sectional study was a correlational investigation utilizing plain radiographs obtained from a cohort of 60 patients diagnosed with CO. Comprehensive assessments of the demographic and clinical characteristics, comorbidities, and microbiological parameters were conducted. Additional variables included the anatomical location of the CO, existence of fistulas, disease duration, and presence of pseudoarthrosis. This study meticulously documented the presence or absence of six specific findings: bone destruction, which incorporates erosion and radiolucencies around implants; bone sclerosis; cortical thinning concomitant with erosion; cortical thickening; sequestrum formation; and soft-tissue swelling. RESULTS: Most patients were men (75%), with a mean age of 45.1 years. Hematogenous etiology of CO represented 23%. Bone sclerosis (71.3%) and cortical thickening (67.7%) were the most common radiographic findings, followed by soft-tissue swelling (51.3%), sequestration (47.3%), bone destruction (33.3%), and cortical erosion (30.3%). The mean agreement was 74.2%, showing a marked disagreement rate of 25.8% among all radiographic findings. The presence or absence of soft tissue edema, a prominent radiographic finding that was more important than the other findings, showed the greatest disagreement. CONCLUSIONS: Radiographic findings in CO were universally observed in all patients, demonstrating a high degree of concordance among specialists, with the exception of soft tissue swelling.

Indicators of functional fitness and cognitive commitment in elderly / Indicadores de aptitud funcional y compromiso cognitivo en ancianos / Indicadores de aptidão funcional e comprometimento cognitivo em idosos

ABSTRACT Introduction: Cognitive losses are among the most prevalent events in the elderly population and can cause functional deficits. Among the available non-drug prevention and treatment alternatives, the increase in functional fitness levels is presented as an important strategy suggesting improvements in the physical and cognitive function of the elderly triggered by exercise. Objective: To determine the predictive power of functional fitness indicators and establish their cutoff points as discriminators of cognitive impairment in the elderly. Methods: The sample comprised 310 elderly people who answered a questionnaire comprising sociodemographic information, lifestyle habits, hospitalization in the last 12 months, presence of comorbidity, and the Mini-Mental State Examination. Functional fitness was assessed using the Hand Grip Strength (HGS) and sitting and rising from a chair tests. To identify predictors of cognitive impairment, analysis of Receiver Operating Characteristic (ROC) curves was adopted, with a confidence interval of 95% (95%CI). Subsequently, the cut-off points with their respective sensitivities and specificities were identified. The analyses were performed respecting the significance level of 5%. Results: It was observed that some functional fitness indicators showed significant Area Under the Curve (AUC), and the sit-and-stand test (AUC=0.72; 95%CI: 0.64-0.77) showed the best results. The best cut-off points for the HGS and sit-and-stand tests were 18,8 kgf and eight repetitions, respectively. Conclusion: The results of the present study allow us to conclude that the sit-to-stand test is moderately efficient in discriminating the presence of cognitive impairment in the elderly. Level of Evidence III; Study Cross-sectional.

RESUMEN Introducción: Las pérdidas cognitivas se encuentran entre los eventos más prevalentes en la población anciana y pueden causar déficits funcionales. Entre las alternativas de prevención y tratamiento no farmacológico disponibles, el aumento de los niveles de condición física funcional se presenta como una estrategia importante que sugiere mejoras en la función física y cognitiva de los ancianos, desencadenada por la práctica de ejercicios. Objetivo: Determinar el poder predictivo de los indicadores de aptitud funcional y establecer sus puntos de corte como discriminadores del deterioro cognitivo en adultos mayores. Métodos: La muestra estuvo compuesta por 310 ancianos que respondieron un cuestionario que comprendía información sociodemográfica, hábitos de vida, hospitalización en los últimos 12 meses, presencia de comorbilidad y el Mini-Examen del Estado Mental. La condición física funcional se evaluó utilizando la fuerza de agarre manual (FAM) y las pruebas de sentarse y levantarse de una silla. Para identificar predictores de deterioro cognitivo, se adoptó el análisis de curvas Receiver Operating Characteristic (ROC), con intervalo de confianza del 95% (IC95%). Posteriormente se identificaron los puntos de corte con sus respectivas sensibilidades y especificidades. Los análisis se realizaron respetando el nivel de significancia del 5%. Resultados: Se observó que algunos indicadores de aptitud funcional mostraron un Área Bajo la Curva (ABC) significativa, y la prueba de sentarse y pararse (ABC=0,72; 95%IC: 0,64-0,77) mostró los mejores resultados. Los mejores puntos de corte para el test FAM y el sit-and-stand test fueron 18,8 kgf y 8 repeticiones, respectivamente. Conclusión: Los resultados del presente estudio permiten concluir que el test sit-to-stand es moderadamente eficiente para discriminar la presencia de deterioro cognitivo en adultos mayores. Nivel de Evidencia III; Estudio Transversal.

RESUMO Introdução: As perdas cognitivas estão entre os eventos mais prevalentes na população idosa, podendo causar déficits funcionais. Dentre as alternativas de prevenção e tratamento não medicamentosos disponíveis, o aumento dos níveis de aptidão funcional apresenta-se como uma estratégia importante sugerindo melhorias na função física e na função cognitiva de idosos, desencadeadas através da prática de exercícios. Objetivo: Determinar o poder preditivo dos indicadores de aptidão funcional e estabelecer seus pontos de corte como discriminadores do comprometimento cognitivo em idosos. Métodos: A amostra compreendeu 310 idosos que responderam a um questionário composto por informações sociodemográficas, hábitos de vida, hospitalização nos últimos 12 meses, presença de comorbidade e o Mini-Exame do Estado Mental. A aptidão funcional foi avaliada por meio dos testes de Força de Preensão Manual (FPM) e o de sentar e levantar da cadeira. Para identificação dos preditores do comprometimento cognitivo, foi adotada a análise das curvas Receiver Operating Characteristic (ROC), com intervalo de confiança de 95% (IC95%). Posteriormente, identificaram-se os pontos de corte com as respectivas sensibilidades e especificidades. As análises foram efetuadas respeitando-se o nível de significância de 5%. Resultados: Observou-se que alguns indicadores de aptidão funcional apresentaram Área Sob a Curva (ASC) significativas, sendo que o teste de sentar e levantar da cadeira (ASC=0,72; IC95%= 0,64-0,77) apresentou os melhores resultados. Os melhores pontos de corte para o teste de FPM e o teste de sentar e levantar da cadeira foram de 18,8 kgf e 8 repetições respectivamente. Conclusão: Os resultados do presente estudo permitem concluir que o teste de sentar e levantar da cadeira apresenta moderada eficiência para discriminar a presença de comprometimento cognitivo em idosos. Nível de Evidência III; Estudo Transversal.

Characterization of Physicochemical and Sensory Properties of Cheeses Added with Bovine Colostrum.

The objective of this study was to develop fresh and matured cheeses with different bovine colostrum levels, aiming to promote the consumption of dairy products with the addition of colostrum. Four different cheese formulations were produced with a mixture of 0:100, 15:85, 20:80, and 25:75, bovine colostrum:milk (v:v), and aged for 0, 10, 20, and 40 days. Milk, colostrum, and fresh and matured cheeses were submitted to physicochemical characterization. Moreover, microbiological quality, yield, texture profile, color, and sensory acceptance of cheese samples were evaluated. Colostrum supplementation favored low acidity, high moisture, a pH range of 5.0-6.2, and water activity of 0.94-99. Sensory attributes and overall evaluation of all cheese formulations achieved an Acceptability Index above 70, indicating good acceptability. Since cheese with colostrum presented the potential to be used as human food, assessing the presence of colostrum bioactive components in those dairy products is a promising goal for further research.

Distribution of cases of congenital heart disease in a hospital in Oeste Paulista / Distribuição dos casos de cardiopatias congênitas em um hospital do Oeste Paulista

The aim of this research was to conduct a comprehensive spatial-temporal analysis of the population affected by congenital heart anomalies assisted at the Pediatric Cardiology Outpatient Department at the distinguished Western Paulista reference hospital. We conducted a retrospective study involving the analysis of electronic database records and patient medical charts for individuals diagnosed with congenital heart disease during the period from July 2013 to July 2018. A total of 298 medical records were selected for the analysis of variables encompassing the ICD-10 codes, gender, spatial distribution, and temporal trends. It was possible to observe that septal defects were the most prevalent congenital heart abnormalities, and there was no gender-based difference. An increase in diagnoses was noted from 2014, coinciding with the implementation of the "heart test," and 51% of the cases were from Presidente Prudente, with a higher concentration of cases in the industrial park area. There is an association between cardiac congenital malformations and an adverse environmental context. The findings can inform public health policies aimed at reducing the exposure of the most vulnerable population in pursuit of improving health indicators (AU).

O objetivo deste trabalho foi analisar a distribuição espaço-temporal dos pacientes com cardiopatias congênitas aten-didos no Ambulatório de Cardiologia Pediátrica do Hospital de referência do Oeste Paulista. Realizamos um estudo retrospectivo com análise de dados de base eletrônica e prontuários dos pacientes diagnosticados com cardiopatia congênita entre os períodos de julho de 2013 a julho de 2018. Foram selecionados 298 prontuários para análise das variáveis de CID-10, gênero, distribuição espacial e série temporal. Foi possível observar que os defeitos septais foram as cardiopatias mais prevalentes, não houve diferença entre os gêneros. Notou-se aumento do diagnóstico a partir de 2014, com implementação do teste do coraçãozinho e 51% dos casos eram da cidade de Presidente Prudente, com maior concentração de casos na região do parque industrial. Há uma relação na incidência das malformações cardíacas com o meio ambiente desfavorável. Os resultados encontrados podem guiar políticas de saúde pública, visando reduzir a exposição da população mais vulnerável, na busca da melhora nos índices de saúde (AU).

The Impact in Intestines and Microbiota in BALB/c Mice Through Consumption of Milk Fermented by Potentially Probiotic Lacticaseibacillus casei SJRP38 and Limosilactobacillus fermentum SJRP43.

The present study aimed to evaluate the effect of consumption of milk fermented by Lacticaseibacillus (Lc.) casei SJRP38 and Limosilactobacillus (Lm.) fermentum SJRP43 on bacterial translocation, stool analysis, and intestinal morphology of healthy BALB/c mice. Potentially probiotic lactic acid bacteria, Lc. casei SJRP38, and Lm. fermentum SJRP43 were evaluated and analyzed for translocation, fecal analysis, and intestinal morphology of four groups of mice: water control (WC), milk control (MC), milk fermented by Lc. casei SJRP38 (FMLC), and milk fermented by Lm. fermentum SJRP43 (FMLF), in co-culture with Streptococcus thermophilus ST080. The results of the animal assay indicate that the population of Lactobacilli and Bidobacterium sp. in the gastrointestinal tract of BALB/c mice was greater than 6.0 log10 CFU/g, and there was no evidence of bacteremia due to the low incidence of bacterial translocation. Ingesting fermented milk containing Lc. casei SJRP38 and Lm. fermentum SJRP43 was found to promote a healthier microbiota, as it led to a reduction in Clostridium sp. and an increase in Lactobacilli and Bifidobacterium sp. in feces. Furthermore, the dairy treatments (MC, FMLC, and FMLF) resulted in taller intestinal villi and an increase in the frequency of goblet cells in the intestines. Overall, the consumption of fermented milk containing Lc. casei SJRP38 and Lm. fermentum SJRP43 strains was deemed safe and demonstrated beneficial effects on the intestines of BALB/c mice.

Ambient assisted living for frail people through human activity recognition: state-of-the-art, challenges and future directions.

Ambient Assisted Living is a concept that focuses on using technology to support and enhance the quality of life and well-being of frail or elderly individuals in both indoor and outdoor environments. It aims at empowering individuals to maintain their independence and autonomy while ensuring their safety and providing assistance when needed. Human Activity Recognition is widely regarded as the most popular methodology within the field of Ambient Assisted Living. Human Activity Recognition involves automatically detecting and classifying the activities performed by individuals using sensor-based systems. Researchers have employed various methodologies, utilizing wearable and/or non-wearable sensors, and employing algorithms ranging from simple threshold-based techniques to more advanced deep learning approaches. In this review, literature from the past decade is critically examined, specifically exploring the technological aspects of Human Activity Recognition in Ambient Assisted Living. An exhaustive analysis of the methodologies adopted, highlighting their strengths and weaknesses is provided. Finally, challenges encountered in the field of Human Activity Recognition for Ambient Assisted Living are thoroughly discussed. These challenges encompass issues related to data collection, model training, real-time performance, generalizability, and user acceptance. Miniaturization, unobtrusiveness, energy harvesting and communication efficiency will be the crucial factors for new wearable solutions.

Relation of the work ability index to fitness for work in healthcare and public employees in a region of Northeastern Italy.

PURPOSE: Work ability indicates an individual's capacity to match job demands according to his/her physical and mental conditions and work circumstances. Occupational physicians should take into consideration the global health status of a worker in order to correctly assess if he/she is fit for the job. The aim of this study was to verify the association between fitness for work evaluation and Work Ability Index scores, as well as individual factors (age, gender, and anthropometric characteristics) and work-related variables (job type, years of working duration). METHODS: A cross-sectional study was conducted within the occupational health surveillance of health and public employers in the Friuli-Venezia Giulia region (2018-2022). The participants voluntarily agreed to answer the standard Work Ability Index questionnaire. Data were investigated by univariable as well as multivariable regression analysis. RESULTS: The Work Ability Index of the workers included in the study (N = 6893) resulted negatively associated with age, female sex, and body mass index. It was averagely lower in nurses and assistive personnel, and the highest in medical doctors and public employers. The fitness for work assessments was also statistically related to WAI scores. The results obtained from the univariable and the multivariable analysis were consistent. CONCLUSIONS: The Work Ability Index is an efficient tool to measure an individual's capability to sustain job demands, and can be taken into account to produce a correct fitness for work evaluation and consequently preserve workers' health status.

The challenges of managing patients with cancer in the workplace: Needs, opportunities and perspectives of occupational physicians.

Cancer is a global major public health problem since it is a leading cause of death, accounting for nearly 10 million deaths in 2020 worldwide and the most recent epidemiological data suggested that its global impact is growing significantly. In this context, cancer survivors have to live for a long time often in a condition of disability due to the long-term consequences, both physical and psychological. These difficulties can seriously impair their working ability, limiting the employability. In this context, the occupational physician plays a key role in the implementation and enforcement of measures to support the workers affected by cancer, to address issues such as the information on health promotion, the analysis of work capacity and the management of disability at work and also promoting a timely and effective return to work and preserving their employability. Therefore, the aim of this study was to gather useful information to support the occupational physicians in the management of workers affected by cancer, through a survey on 157 Italian occupational physicians. Based on the interviewees' opinions, the most useful occupational safety and health professionals in terms of job retention and preservation of workers affected by cancer are the employers and the occupational physicians themselves, whose role is crucial in identifying and applying the most effective reasonable accommodations that should be provided to the workers affected by cancer. The provision of these accommodations take place on the occasion of mandatory health surveillance medical examination to which the worker affected by cancer is subjected when he returns to work. Results on training and information needs showed that the management of the workers affected by cancer is essentially centered on an appropriate fitness for work judgment and on the correct performance of health surveillance. However, an effective and successful management model should be based on a multidisciplinary and integrated approach that, from the earliest stages of the disease, involves the occupational physicians and employers.

Recurrent Network Solutions for Human Posture Recognition Based on Kinect Skeletal Data.

Ambient Assisted Living (AAL) systems are designed to provide unobtrusive and user-friendly support in daily life and can be used for monitoring frail people based on various types of sensors, including wearables and cameras. Although cameras can be perceived as intrusive in terms of privacy, low-cost RGB-D devices (i.e., Kinect V2) that extract skeletal data can partially overcome these limits. In addition, deep learning-based algorithms, such as Recurrent Neural Networks (RNNs), can be trained on skeletal tracking data to automatically identify different human postures in the AAL domain. In this study, we investigate the performance of two RNN models (2BLSTM and 3BGRU) in identifying daily living postures and potentially dangerous situations in a home monitoring system, based on 3D skeletal data acquired with Kinect V2. We tested the RNN models with two different feature sets: one consisting of eight human-crafted kinematic features selected by a genetic algorithm, and another consisting of 52 ego-centric 3D coordinates of each considered skeleton joint, plus the subject's distance from the Kinect V2. To improve the generalization ability of the 3BGRU model, we also applied a data augmentation method to balance the training dataset. With this last solution we reached an accuracy of 88%, the best we achieved so far.

Virulence factors and antimicrobial resistance of Escherichia coli isolated from commercialized fresh cheese in the south of Espírito Santo.

Cheeses are dairy products that can potentially contain a diverse range of harmful bacteria that could be consumed by humans, including the enteric pathogen Escherichia coli. This study aimed to characterize the presence of total coliforms, assess the antimicrobial susceptibility profiles of the main commercial antimicrobial classes and biocides, and evaluate the ability of 50 E. coli isolates obtained from fresh cheese sold in the southern region of Espírito Santo, Brazil, to produce biofilms. The counts of total coliforms + E. coli obtained averages of (A) 7.22 × 106 CFU/g, (B) 9.35 × 107 CFU/g, and (C) 1.16 × 106 CFU/g for different brands. All isolates were capable of forming biofilms, with 8%, 76%, and 16% of these isolates presenting high, moderate, and low adherence in biofilm formation, respectively. Most strains showed inhibition halos for the biocides chlorhexidine digluconate 2% (16 mm ± 4.34), iodopovidone 10% (7.14 mm ± 0.36), and sodium hypochlorite 2% (7.12 mm ± 0.33). Out of the 50 strains, 21 (42%) were resistant to at least one of the antimicrobials. Regarding the multiple resistance index, 3 (6%) strains were resistant to 3 or more antimicrobial classes. Furthermore, 2 (4%) were extended-spectrum beta-lactamases producers. Resistance to ampicillin and amoxicillin was observed in 20% and 40% of the strains, respectively. In contrast, gentamicin was the most effective antimicrobial, with a sensitivity rate of 100%. The findings indicate that E. coli present in fresh cheese may possess unique physiological characteristics that could be associated with their persistence, virulence, and multidrug resistance. These results raise significant public health concerns since contaminated food can pose risks to consumers' health, emphasizing the importance of reinforcing hygienic-sanitary controls at all stages of production.

Malolactic fermentation of lactic acid bacteria isolated from southern Brazilian red wine.

The objective was to isolate lactic acid bacteria (LAB) from southern Brazil's wines and investigate their potential as starter cultures for malolactic fermentation (MLF) in Merlot (ME) and Cabernet Sauvignon (CS) wines through the fermentative capacity. The LAB were isolated from CS, ME, and Pinot Noir (PN) wines in the 2016 and 2017 harvests and evaluated for morphological (color and shape of the colonies), genetic, fermentative (increase in pH, acidity reduction, preservation of anthocyanins, decarboxylation of L-malic acid, yield of L-lactic acid, and content of reduced sugars), and sensory characteristics. Four strains were identified as Oenococcus oeni [CS(16)3B1, ME(16)1A1, ME(17)26, and PN(17)65], one as Lactiplantibacillus plantarum [PN(17)75], and one as Paucilactobacillus suebicus [CS(17)5]. Isolates were evaluated in the MLF and compared to a commercial strain (O. oeni), as well as a control (without inoculation and spontaneous MLF), and standard (without MLF). CS(16)3B1 and ME(17)26 isolates finished the MLF for CS and ME wines, respectively, after 35 days, similar to the commercial strain, and CS(17)5 and ME(16)1A1 isolates ended the MLF in 45 days. In the sensory analysis, ME wines with isolated strains received better scores for flavor and overall quality than the control. Compared to the commercial strain, CS(16)3B1 isolate obtained the highest scores for buttery flavor and taste persistence. CS(17)5 isolate received the higher scores for a fruity flavor and overall quality and the lowest for a buttery flavor. The native LAB displayed MLF potential, regardless of the year and grape species from which they were isolated.

Cluster de doenças crônicas não transmissíveis e multimorbidade em trabalhadores da atençãoprimária à saúde / Cluster of chronic non-communicable diseases and multimorbidity in primary healthcare workers

Objetivo: Investigar a agregação das DCNT e a sua associação com as características sociodemográficas e os aspectos ocupacionais dos trabalhadores da APS. Métodos: Tratou-se de um estudo epidemiológico transversal que analisou os dados parciais de uma coorte retrospectiva realizada em Vitória da Conquista (BA) e em São Geraldo da Piedade (MG) no mês de janeiro de 2022 com 105 trabalhadores da Estratégia Saúde da Família (ESF), que preencheram um questionário eletrônico específico autoaplicável. As variáveis analisadas foram: sociodemográficas, caracterização do trabalho, presença de DCNT e de multimorbidade. Foram aplicados os seguintes procedimentos estatísticos: análise descritiva, análise de cluster, teste de qui-quadrado de Pearson e regressão logística binária. Resultados:As cinco DCNT mais prevalentes foram a rinite/sinusite (30,5%), a cefaleia/enxaqueca (26,7%), o colesterol alto (26,7%), a gastrite (19,0%) e a hipertensão arterial sistêmica (19,0%). A prevalência de multimorbidade foi de 26,7% e foram encontradas 11 combinações de cluster (34,4%), sendo o maior escore na combinação das cinco doenças mais prevalentes. Foi identificada a associação entre a presença de multimorbidade e o sexo, sendo a prevalência 24% menor entre os homens, e com a escolaridade, sendo a prevalência 26% maior nos indivíduos que não possuem ensino superior. Conclusão: Foram identificadas associações entre a presença de multimorbidade e o sexo feminino, e indivíduos que não concluíram o ensino superior. Observou-se, ainda, uma associação simultânea das cinco principais DCNT deste estudo com o nível de escolaridade (AU).

Objectives: Investigate the aggregation of NCDs and their association with sociodemographic characteristics and occupational aspects in primary healthcare workers. Methods: A cross-sectional study analyzed partial data from a cohort profile conducted in Vitória da Conquista (BA) and in São Geraldo da Piedade (MG) in January 2022 with 105 workers of "Estratégia de Saúde da Família (ESF)" who answered a self-report electronic questionnaire. The variables of this research were: sociodemographic characteristics, job aspects, and the presence of NCDs and multimorbidity. Data were analyzed with descriptive statistics, cluster analysis, chi-square test, and binary logistic regression. Results: The five NCDs more prevalent were: rhinitis/sinusitis (30,5%), headache/migraine (26,7%), hypercholesterolemia (26,7%), gastritis (19,0%), and hypertension (19,0%). The prevalence of multimorbidity was 26,7%, and 11 cluster combinations were found (34,4%) since the higher score was identified in the aggregation of the five more prevalent diseases. There was an association between the presence of multimorbidity and the sex (the prevalence is 24% smaller for men) and between the presence of multimorbidity and the level of education (the prevalence is 26% higher in people without a college degree). Conclusion: The prevalence of multimorbidity was associated with the female sex and with people without a college degree. Furthermore, an association was observed between the five more prevalent NCDs in this study and the level of education (AU).