"Comparison between high-flow nasal cannula (HFNC) therapy and noninvasive ventilation (NIV) in children with acute respiratory failure by bronchiolitis: a randomized controlled trial".

BACKGROUND: The objective of this study was to compare HFNC therapy to noninvasive ventilation (NIV/BiPAP) in children with bronchiolitis who developed respiratory failure. We hypothesized that HFNC therapy would not be inferior to NIV. METHODS: This was a noninferiority open-label randomized single-center clinical trial conducted at a tertiary Brazilian hospital. Children under 2 years of age with no chronic conditions admitted for bronchiolitis that progressed to mild to moderate respiratory distress (Wood-Downes-Férres score < 8) were randomized to either the HFNC group or NIV (BiPAP) group through sealed envelopes. Vital signs, FiO2, Wood-Downes-Férres score and HFNC/NIV parameters were recorded up to 96 h after therapy initiation. Children who developed respiratory failure despite receiving initial therapy were intubated. Crossover was not allowed. The primary outcome analyzed was invasive mechanical ventilation requirement. The secondary outcomes were sedation usage, invasive mechanical ventilation duration, the PICU LOS, the hospital LOS, and mortality rate. RESULTS: A total of 126 patients were allocated to the NIV group (132 randomized and 6 excluded), and 126 were allocated to the HFNC group (136 randomized and 10 excluded). The median age was 2.5 (1-6) months in the NIV group and 3 (2-7) months in the HFNC group (p = 0,07). RSV was the most common virus isolated in both groups (72% vs. 71.4%, NIV and HFNC, respectively). Thirty-seven patients were intubated in the NIV group and 29 were intubated in the HFNC group (29% vs. 23%, p = 0.25). According to the Farrington-Manning test, with a noninferiority margin of 15%, the difference was 6.3% in favor of HFNC therapy (95% confidence interval: -4.5 to 17.1%, p < 0.0001). There was no significant difference in the PICU LOS or sedation duration. Sedation requirement, hospital LOS and invasive mechanical ventilation duration were lower in the HFNC group. CONCLUSION: HFNC therapy is noninferior to NIV in infants admitted with mild to moderate respiratory distress caused by bronchiolitis that progresses to respiratory failure. TRIAL REGISTRATION NUMBERS: U1111-1262-1740; RBR-104z966s. Registered 03/01/2023 (retrospectively registered). ReBEC: https://ensaiosclinicos.gov.br/rg/RBR-104z966s .

Photographic scale for the characterization of actinic keratosis through reflectance confocal microscopy: a quantitative approach to cellular transformation.

Background: Actinic keratosis (AK) is a highly prevalent pre-cancerous skin lesion that often leads to cutaneous squamous cell carcinoma. There are different stages of evolution of the disease and several features that characterize keratosis. This study aimed to develop a qualitative and quantitative visual diagnostic tool to facilitate the identification of the characteristics and severity of the main cellular attributes of AK and to show its applicability in evaluating the evolution or treatment through image analysis. Methods: Literature research on the main scientific databases and in the institute's database was carried out to gather all the different levels of cellular transformation. To validate the scale, a preliminary characterization study was carried out with 21 subjects who had clinically diagnosed AK lesions to classify the attributes in each skin layer and test the accuracy of the diagnosis of the scale. Afterward, and to show the possibility of a follow-up with a topical treatment, the subjects were divided into two treatment groups, receiving either a cream formulation containing retinoic acid, or a placebo formula. The evaluation was carried out through confocal reflectance microscopy and a digital camera with dermoscopic quality before and after 90 days of treatment. Results: A table detailing the 18 attributes of AK, and a photographic scale containing RCM images graded by scores established for each characteristic and the frequency of spreading were developed. The results of the validation presented good repeatability, correlation with clinical evaluation, and capacity for differentiating treatments demonstrated by the significant improvement after topical treatment by the reduction of the score for 10 out of the 18 attributes. The preliminary study, evaluated by the detailed transformation scale highlights important differences in the subclinical approach that allows a deeper evaluation of the aspects of the lesion's re-incidence even after fully treated skin sites. Conclusion: This study brings an innovative method based on RCM, to assist in the quantification of cell transformation level, provide early diagnosis, and deliver a powerful treatment evaluation tool to provide smoother treatment, as well as prevent re-incidence in the cases.

Breastfeeding at discharge and in the third stage of the Kangaroo Mother Care among hospitalized preterm infants.

OBJECTIVE: To identify the type of feeding and analyze the sociodemographic and clinical factors associated with exclusive breastfeeding at hospital discharge, in the first and in the last follow-up visit of the third stage of the Kangaroo Mother Care among infants admitted to the kangaroo unit. METHOD: Longitudinal and retrospective study. A total of 186 infants of gestational age <37 weeks admitted to the kangaroo unit in 2018 and 2019 was included. Data collected from medical records and subjected to inferential analysis and the Poisson regression model (P < 0.05). RESULTS: Exclusive breastfeeding rate was 73.1% at discharge, with a drop at the last follow-up visit (68.1%). At discharge, there was a greater probability of exclusive breastfeeding in younger mothers, with higher education, infants born with higher birth weight and who received exclusive human milk during hospitalization; in the first follow-up visit, in a younger mother and infant who received only human milk during hospitalization; and in the last follow-up visit, a young mother, infant who received only human milk and suckled at the breast for the first time in the kangaroo unit. CONCLUSION: Most infants hospitalized in the second stage of the Kangaroo Mother Care were exclusively breastfed and presented maternal and clinical factors related to breastfeeding. This fact can help manage the challenges of the method and promote breastfeeding.

A comprehensive physical functional assessment of survivors of critical care unit stay due to COVID-19.

OBJECTIVE: To examine the physical function and respiratory muscle strength of patients - who recovered from critical COVID-19 - after intensive care unit discharge to the ward on Days one (D1) and seven (D7), and to investigate variables associated with functional impairment. METHODS: This was a prospective cohort study of adult patients with COVID-19 who needed invasive mechanical ventilation, non-invasive ventilation or high-flow nasal cannula and were discharged from the intensive care unit to the ward. Participants were submitted to Medical Research Council sum-score, handgrip strength, maximal inspiratory pressure, maximal expiratory pressure, and short physical performance battery tests. Participants were grouped into two groups according to their need for invasive ventilation: the Invasive Mechanical Ventilation Group (IMV Group) and the Non-Invasive Mechanical Ventilation Group (Non-IMV Group). RESULTS: Patients in the IMV Group (n = 31) were younger and had higher Sequential Organ Failure Assessment scores than those in the Non-IMV Group (n = 33). The short physical performance battery scores (range 0 - 12) on D1 and D7 were 6.1 ± 4.3 and 7.3 ± 3.8, respectively for the Non-Invasive Mechanical Ventilation Group, and 1.3 ± 2.5 and 2.6 ± 3.7, respectively for the IMV Group. The prevalence of intensive care unit-acquired weakness on D7 was 13% for the Non-IMV Group and 72% for the IMV Group. The maximal inspiratory pressure, maximal expiratory pressure, and handgrip strength increased on D7 in both groups, but the maximal expiratory pressure and handgrip strength were still weak. Only maximal inspiratory pressure was recovered (i.e., > 80% of the predicted value) in the Non-IMV Group. Female sex, and the need and duration of invasive mechanical were independently and negatively associated with the short physical performance battery score and handgrip strength. CONCLUSION: Patients who recovered from critical COVID-19 and who received invasive mechanical ventilation presented greater disability than those who were not invasively ventilated. However, they both showed marginal functional improvement during early recovery, regardless of the need for invasive mechanical ventilation. This might highlight the severity of disability caused by SARS-CoV-2.

Green synthesis of silver nanoparticle using pollen extract from Tetragonisca angustula a stingless bee.

This study explores the green synthesis of silver nanoparticles (AgNPs) using a methanolic extract of fermented pollen from Tetragonisca angustula, a species of stingless bees. The AgNPs exhibit spherical morphology, low charge values, and suspension stability, with their unique composition attributed to elements from the pollen extract. Antioxidant assays show comparable activity between the pollen extract and AgNPs, emphasizing the retention of antioxidant effects. The synthesized AgNPs demonstrate antimicrobial activity against multidrug-resistant bacteria, highlighting their potential in combating bacterial resistance. The AgNPs exhibit no toxic effects on Drosophila melanogaster and even enhance the hatching rate of eggs. The study underscores the innovative use of stingless bee pollen extract in green synthesis, offering insights into the varied applications of AgNPs in biomedicine.

Mixture of pesticides based on dimethylamine and imidacloprid affects locomotion of adult zebrafish.

Numerous chemical compounds are found in aquatic environments; among them are pesticides. Pesticides are widely used worldwide, and this use has progressively increased in recent decades, resulting in the accumulation of potentially toxic compounds in surface waters. Dimethylamine-based herbicides (DBH) and imidacloprid-based insecticides (IBI) have low soil absorption and high water solubility, facilitating the arrival of these compounds in aquatic environments. In this study, our objective was to analyze whether two pesticides, DBH and IBI at environmentally relevant concentrations of 320 µg/L for each compound, and their mixtures impact the behavioral and endocrine parameters of adult zebrafish, verifying the effect of pesticides on exploratory behavior and social and analyzing hormonal parameters related to stress. Acute exposure to the mixture of pesticides reduced fish locomotion. Pesticides alone and in combination did not affect cortisol levels in exposed animals. Pesticides, when tested together, can cause different effects on non-target organisms, and the evaluation of mixtures of these compounds is extremely important.

A comprehensive physical functional assessment of survivors of critical care unit stay due to COVID-19 / Avaliação físico-funcional abrangente de sobreviventes de internação em unidade de terapia intensiva devido à COVID-19

ABSTRACT Objective: To examine the physical function and respiratory muscle strength of patients - who recovered from critical COVID-19 - after intensive care unit discharge to the ward on Days one (D1) and seven (D7), and to investigate variables associated with functional impairment. Methods: This was a prospective cohort study of adult patients with COVID-19 who needed invasive mechanical ventilation, non-invasive ventilation or high-flow nasal cannula and were discharged from the intensive care unit to the ward. Participants were submitted to Medical Research Council sum-score, handgrip strength, maximal inspiratory pressure, maximal expiratory pressure, and short physical performance battery tests. Participants were grouped into two groups according to their need for invasive ventilation: the Invasive Mechanical Ventilation Group (IMV Group) and the Non-Invasive Mechanical Ventilation Group (Non-IMV Group). Results: Patients in the IMV Group (n = 31) were younger and had higher Sequential Organ Failure Assessment scores than those in the Non-IMV Group (n = 33). The short physical performance battery scores (range 0 - 12) on D1 and D7 were 6.1 ± 4.3 and 7.3 ± 3.8, respectively for the Non-Invasive Mechanical Ventilation Group, and 1.3 ± 2.5 and 2.6 ± 3.7, respectively for the IMV Group. The prevalence of intensive care unit-acquired weakness on D7 was 13% for the Non-IMV Group and 72% for the IMV Group. The maximal inspiratory pressure, maximal expiratory pressure, and handgrip strength increased on D7 in both groups, but the maximal expiratory pressure and handgrip strength were still weak. Only maximal inspiratory pressure was recovered (i.e., > 80% of the predicted value) in the Non-IMV Group. Female sex, and the need and duration of invasive mechanical were independently and negatively associated with the short physical performance battery score and handgrip strength. Conclusion: Patients who recovered from critical COVID-19 and who received invasive mechanical ventilation presented greater disability than those who were not invasively ventilated. However, they both showed marginal functional improvement during early recovery, regardless of the need for invasive mechanical ventilation. This might highlight the severity of disability caused by SARS-CoV-2.

RESUMO Objetivo: Examinar a função física e a força muscular respiratória de pacientes que se recuperaram da COVID-19 grave após a alta da unidade de terapia intensiva para a enfermaria nos Dias 1 e 7 e investigar as variáveis associadas ao comprometimento funcional. Métodos: Trata-se de estudo de coorte prospectivo de pacientes adultos com COVID-19 que necessitaram de ventilação mecânica invasiva, ventilação mecânica não invasiva ou cânula nasal de alto fluxo e tiveram alta da unidade de terapia intensiva para a enfermaria. Os participantes foram submetidos aos testes Medical Research Council sum-score, força de preensão manual, pressão inspiratória máxima, pressão expiratória máxima e short physical performance battery. Os participantes foram agrupados em dois grupos conforme a necessidade de ventilação mecânica invasiva: o Grupo Ventilação Mecânica Invasiva (Grupo VMI) e o Grupo Não Ventilação Mecânica Invasiva (Grupo Não VMI). Resultados: Os pacientes do Grupo VMI (n = 31) eram mais jovens e tinham pontuações do Sequential Organ Failure Assessment mais altas do que os do Grupo VMI (n = 33). As pontuações do short physical performance battery (intervalo de zero a 12) nos Dias 1 e 7 foram 6,1 ± 4,3 e 7,3 ± 3,8, respectivamente para o Grupo Não VMI, e 1,3 ± 2,5 e 2,6 ± 3,7, respectivamente para o Grupo VMI. A prevalência de fraqueza adquirida na unidade de terapia intensiva no Dia 7 foi de 13% para o Grupo Não VMI e de 72% para o Grupo VMI. A pressão inspiratória máxima, a pressão expiratória máxima e a força de preensão manual aumentaram no Dia 7 em ambos os grupos, porém a pressão expiratória máxima e a força de preensão manual ainda eram fracas. Apenas a pressão inspiratória máxima foi recuperada (ou seja, > 80% do valor previsto) no Grupo Não VMI. As variáveis sexo feminino, e necessidade e duração da ventilação mecânica invasiva foram associadas de forma independente e negativa à pontuação do short physical performance battery e à força de preensão manual. Conclusão: Os pacientes que se recuperaram da COVID-19 grave e receberam ventilação mecânica invasiva apresentaram maior incapacidade do que aqueles que não foram ventilados invasivamente. No entanto, os dois grupos de pacientes apresentaram melhora funcional marginal durante a fase inicial de recuperação, independentemente da necessidade de ventilação mecânica invasiva. Esse resultado pode evidenciar a gravidade da incapacidade causada pelo SARS-CoV-2.

Breastfeeding at discharge and in the third stage of the Kangaroo Mother Care among hospitalized preterm infants / Lactancia materna al alta y en la tercera etapa del Método Madre Canguro en recién nacidos prematuros hospitalizados / Aleitamento materno na alta e na terceira etapa do Método Canguru entre recém-nascidos prematuros hospitalizados

ABSTRACT Objective: To identify the type of feeding and analyze the sociodemographic and clinical factors associated with exclusive breastfeeding at hospital discharge, in the first and in the last follow-up visit of the third stage of the Kangaroo Mother Care among infants admitted to the kangaroo unit. Method: Longitudinal and retrospective study. A total of 186 infants of gestational age <37 weeks admitted to the kangaroo unit in 2018 and 2019 was included. Data collected from medical records and subjected to inferential analysis and the Poisson regression model (P < 0.05). Results: Exclusive breastfeeding rate was 73.1% at discharge, with a drop at the last follow-up visit (68.1%). At discharge, there was a greater probability of exclusive breastfeeding in younger mothers, with higher education, infants born with higher birth weight and who received exclusive human milk during hospitalization; in the first follow-up visit, in a younger mother and infant who received only human milk during hospitalization; and in the last follow-up visit, a young mother, infant who received only human milk and suckled at the breast for the first time in the kangaroo unit. Conclusion: Most infants hospitalized in the second stage of the Kangaroo Mother Care were exclusively breastfed and presented maternal and clinical factors related to breastfeeding. This fact can help manage the challenges of the method and promote breastfeeding.

RESUMEN Objetivo: Identificar el tipo de alimentación y analizar los factores sociodemográficos y clínicos asociados a la lactancia materna exclusiva al alta hospitalaria, en el primero y en la última visita de seguimiento de la tercera etapa del Método Madre Canguro entre los recién nacidos ingresados en la unidad canguro. Método: Estudio longitudinal y retrospectivo. Se incluyeron 186 neonatos en edad gestacional <37 semanas ingresados en la unidad canguro en 2018 y 2019. Datos recopilados de historias clínicas sometidas a análisis inferencial y modelo de regresión de Poisson (p < 0,05). Resultados: La tasa de lactancia materna exclusiva fue del 73,1% al alta, con descenso en la última visita de seguimiento (68,1%). Al alta hubo mayor probabilidad de lactancia materna exclusiva en madres más jóvenes, con mayor escolaridad, recién nacidos con mayor peso al nacer y que recibieron leche materna exclusiva durante la internación; en la primera visita de seguimiento, en una madre más joven y un recién nacido que recibió únicamente leche materna durante la hospitalización; y en la última visita de seguimiento, una madre joven, recién nacido que recibió sólo leche humana y con la primera succión del pecho en la unidad canguro. Conclusión: La mayoría de los recién nacidos hospitalizados en la segunda etapa del Método Madre Canguro fueron amamantados exclusivamente y presentaron factores maternos y médicos relacionados con la lactancia materna, que pueden ayudar a gestionar los desafíos del método y promover la lactancia materna.

RESUMO Objetivo: Identificar o tipo de alimentação e analisar os fatores sociodemográficos e clínicos associados ao aleitamento exclusivo na alta hospitalar, no primeiro e no último retorno da terceira etapa do Método Canguru entre neonatos internados na unidade canguru. Método: Estudo longitudinal e retrospectivo. Incluídos 186 neonatos com idade gestacional <37 semanas admitidos na unidade canguru em 2018 e 2019. Dados coletados do prontuário submetidos à análise inferencial e ao modelo de regressão Poisson (p < 0,05). Resultados: Taxa de aleitamento exclusivo foi de 73,1% na alta, com queda no último retorno (68,1%). Na alta, houve maior probabilidade de aleitamento exclusivo em mãe mais jovem, com escolaridade superior, neonato nascido com maior peso e que recebeu leite humano exclusivo durante internação; no primeiro retorno, em mãe mais jovem e neonato que recebeu apenas leite humano na internação; e no último retorno, mãe jovem, neonato que recebeu apenas leite humano e com primeira sucção na mama na unidade canguru. Conclusão: A maioria dos neonatos internados na segunda etapa do Método Canguru estava em aleitamento exclusivo e apresentou fatores maternos e clínicos relacionados ao aleitamento, podendo auxiliar no manejo dos desafios do método e na promoção da amamentação.

Temporal validation of the MMCD score to predict kidney replacement therapy and in-hospital mortality in COVID-19 patients.

BACKGROUND: Acute kidney injury has been described as a common complication in patients hospitalized with COVID-19, which may lead to the need for kidney replacement therapy (KRT) in its most severe forms. Our group developed and validated the MMCD score in Brazilian COVID-19 patients to predict KRT, which showed excellent performance using data from 2020. This study aimed to validate the MMCD score in a large cohort of patients hospitalized with COVID-19 in a different pandemic phase and assess its performance to predict in-hospital mortality. METHODS: This study is part of the "Brazilian COVID-19 Registry", a retrospective observational cohort of consecutive patients hospitalized for laboratory-confirmed COVID-19 in 25 Brazilian hospitals between March 2021 and August 2022. The primary outcome was KRT during hospitalization and the secondary was in-hospital mortality. We also searched literature for other prediction models for KRT, to assess the results in our database. Performance was assessed using area under the receiving operator characteristic curve (AUROC) and the Brier score. RESULTS: A total of 9422 patients were included, 53.8% were men, with a median age of 59 (IQR 48-70) years old. The incidence of KRT was 8.8% and in-hospital mortality was 18.1%. The MMCD score had excellent discrimination and overall performance to predict KRT (AUROC: 0.916 [95% CI 0.909-0.924]; Brier score = 0.057). Despite the excellent discrimination and overall performance (AUROC: 0.922 [95% CI 0.914-0.929]; Brier score = 0.100), the calibration was not satisfactory concerning in-hospital mortality. A random forest model was applied in the database, with inferior performance to predict KRT requirement (AUROC: 0.71 [95% CI 0.69-0.73]). CONCLUSION: The MMCD score is not appropriate for in-hospital mortality but demonstrates an excellent predictive ability to predict KRT in COVID-19 patients. The instrument is low cost, objective, fast and accurate, and can contribute to supporting clinical decisions in the efficient allocation of assistance resources in patients with COVID-19.

Effects of glyphosate exposure on western diet-induced non-alcoholic fatty liver disease in mice.

We evaluated whether glyphosate promotes western diet (WD)-induced non-alcoholic fatty liver disease (NAFLD). Male C57BL/6J mice were fed WD and received intragastrical glyphosate (0.05, 5 or 50 mg/kg) for 6 months. Glyphosate did not promote WD-induced obesity, hypercholesterolemia, glucose intolerance, hepatic steatosis, and fibrosis. Nonetheless, the higher dose (50 mg) enhanced hepatic CD68+ macrophage density, p65, TNF-α, and IL-6 protein levels. Furthermore, this dose decreased hepatic Nrf2 levels, while enhancing lipid peroxidation in the liver and adipose tissue. Hepatic transcriptome revealed that glyphosate at 50 mg upregulated 212 genes and downregulated 731 genes. Genes associated with oxidative stress and inflammation were upregulated, while key cell cycle-related genes were downregulated. Our results indicate that glyphosate exposure - in a dose within the toxicological limits - impairs hepatic inflammation/redox dynamics in a NAFLD microenvironment.

Functional Training and Dual-Task Training Improve the Executive Function of Older Women.

Functional training (FT) is a type of multicomponent training with emphasis on activities of daily living that stimulate different physical capacities in only one session. Dual-task training (DTT) is a type of training that simultaneously applies cognitive and motor stimuli. We investigated the effects of sixteen weeks of FT and DTT and eight weeks of detraining on older women's inhibitory control, working memory, and cognitive flexibility. Sixty-two older women (66.9 ± 5.4 years; 27.7 ± 3.9 kg/m2) completed a 16-week intervention program comprising the FT (n = 31) and DTT (n = 31), and 43 returned after the detraining period. We used the Stroop Color Word Color test to evaluate inhibitory control, the Corsi Block Test to assess working memory, and the Trail Making Test to evaluate cognitive flexibility. Only DTT reduced the congruent response time between the pre-test and post-test (d= -0.64; p < 0.001), with no difference between the post-test and the detraining values (d = 1.13; p < 0.001). Both groups reduced the incongruent response time between the pre-test and post-test (FT: d = -0.61; p = 0.002; DTT: d= -0.59; p = 0.002) without a difference between groups. There were no significant differences in working memory and cognitive flexibility. Sixteen weeks of FT and DTT increased the inhibitory control of older women but not the working memory and cognitive flexibility, and these effects persisted after eight weeks of detraining.

Genetic Modulation of the Erythrocyte Phenotype Associated with Retinopathy of Prematurity-A Multicenter Portuguese Cohort Study.

The development of retinopathy of prematurity (ROP) may be influenced by anemia or a low fetal/adult hemoglobin ratio. We aimed to analyze the association between DNA methyltransferase 3 ß (DNMT3B) (rs2424913), methylenetetrahydrofolate reductase (MTHFR) (rs1801133), and lysine-specific histone demethylase 1A (KDM1A) (rs7548692) polymorphisms, erythrocyte parameters during the first week of life, and ROP. In total, 396 infants (gestational age < 32 weeks or birth weight < 1500 g) were evaluated clinically and hematologically. Genotyping was performed using a MicroChip DNA on a platform employing iPlex MassARRAY®. Multivariate regression was performed after determining risk factors for ROP using univariate regression. In the group of infants who developed ROP red blood cell distribution width (RDW), erythroblasts, and mean corpuscular volume (MCV) were higher, while mean hemoglobin and mean corpuscular hemoglobin concentration (MCHC) were lower; higher RDW was associated with KDM1A (AA), MTHFR (CC and CC + TT), KDM1A (AA) + MTHFR (CC), and KDM1A (AA) + DNMT3B (allele C); KDM1A (AA) + MTHFR (CC) were associated with higher RDW, erythroblasts, MCV, and mean corpuscular hemoglobin (MCH); higher MCV and MCH were also associated with KDM1A (AA) + MTHFR (CC) + DNMT3B (allele C). We concluded that the polymorphisms studied may influence susceptibility to ROP by modulating erythropoiesis and gene expression of the fetal/adult hemoglobin ratio.

Complete blood count parameters as biomarkers of retinopathy of prematurity: a Portuguese multicenter study.

PURPOSE: To evaluate complete blood count (CBC) parameters in the first week of life as predictive biomarkers for the development of retinopathy of prematurity (ROP). METHODS: Multicenter, prospective, observational study of a cohort of preterm infants born with gestational age (GA) < 32 weeks or birth weight < 1500 g in eight Portuguese neonatal intensive care units. All demographic, clinical, and laboratory data from the first week of life were collected. Univariate logistic regression was used to assess risk factors for ROP and then multivariate regression was performed. RESULTS: A total of 455 infants were included in the study. The median GA was 29.6 weeks, and the median birth weight was 1295 g. One hundred and seventy-two infants (37.8%) developed ROP. Median values of erythrocytes (p < 0.001), hemoglobin (p < 0.001), hematocrit (p < 0.001), mean corpuscular hemoglobin concentration (p < 0.001), lymphocytes (p = 0.035), and platelets (p = 0.003) of the group of infants diagnosed with ROP any stage were lower than those without ROP. Mean corpuscular volume (MCV) (p = 0.044), red blood cell distribution width (RDW) (p < 0.001), erythroblasts (p < 0.001), neutrophils (p = 0.030), neutrophils-lymphocytes ratio (p = 0.028), and basophils (p = 0.003) were higher in the ROP group. Higher values of MCV, erythroblasts, and basophils remained significantly associated with ROP after multivariate regression. CONCLUSION: In our cohort, the increase in erythroblasts, MCV, and basophils in the first week of life was significantly and independently associated with the development of ROP. These CBC parameters may be early predictive biomarkers for ROP.

Carbon nanotube-cellulose ink for rapid solvent identification.

In this work, a conductive ink based on microfibrillated cellulose (MFC) and multiwalled carbon nanotubes (MWCNTs) was used to produce transducers for rapid liquid identification. The transducers are simple resistive devices that can be easily fabricated by scalable printing techniques. We monitored the electrical response due to the interaction between a given liquid with the carbon nanotube-cellulose film over time. Using principal component analysis of the electrical response, we were able to extract robust data to differentiate between the liquids. We show that the proposed liquid sensor can classify different liquids, including organic solvents (acetone, chloroform, and different alcohols) and is also able to differentiate low concentrations of glycerin in water (10-100 ppm). We have also investigated the influence of two important properties of the liquids, namely dielectric constant and vapor pressure, on the transduction of the MFC-MWCNT sensors. These results were corroborated by independent heat flow measurements (thermogravimetric analysis). The proposed MFC-MWCNT sensor platform may help paving the way to rapid, inexpensive, and robust liquid analysis and identification.

Risk of violence and frailty syndrome among older adults treated at a hospital service.

OBJECTIVES: to assess the association between risk of violence and frailty syndrome among hospitalized older adults. METHODS: quantitative, analytical and cross-sectional research, carried out with older adults in two university hospitals. Data collection was performed using the Brazil Old Age Schedule, Hwalek-Sengstock Elder Abuse Screening Test and Edmonton Frail Scale instruments. It was analyzed using descriptive statistics and inferential statistics. RESULTS: risk of violence was higher among women (68.9%), over 70 years old (64.7%), with more than 3 years of study (68.9%), without relationship (67.1%), who do not work (65.1%) and with income above 1 minimum wage (65.2%). There is a significant association between risk of violence and frailty (72.3%; p<0.001) and a positive correlation between the instrument scores (r=0.350; p-value<0.001). CONCLUSIONS: risk of violence was associated with being female and frailty. The study is expected to encourage further discussions related to the theme and nursing practice.

Bacteria, yeasts, and fungi associated with larval food of Brazilian native stingless bees.

Stingless bees are a diverse group with a relevant role in pollinating native species. Its diet is rich in carbohydrates and proteins, by collecting pollen and nectar supplies the development of its offspring. Fermentation of these products is associated with microorganisms in the colony. However, the composition of microorganisms that comprise this microbiome and its fundamental role in colony development is still unclear. To characterize the colonizing microorganisms of larval food in the brood cells of stingless bees Frieseomelitta varia, Melipona quadrifasciata, Melipona scutellaris, and Tetragonisca angustula, we have utilized molecular and culture-based techniques. Bacteria of the phyla Firmicutes, Proteobacteria, Actinobacteria, and fungi of the phyla Ascomycota, Basidiomycota, Mucoromycota, and Mortierellomycota were found. Diversity analysis showed that F. varia had a greater diversity of bacteria in its microbiota, and T. angustula had a greater diversity of fungi. The isolation technique allowed the identification of 189 bacteria and 75 fungi. In summary, this research showed bacteria and fungi associated with the species F. varia, M. quadrifasciata, M. scutellaris, and T. angustula, which may play an essential role in the survival of these organisms. Besides that, a biobank with bacteria and fungus isolates from LF of Brazilian stingless bees was created, which can be used for different studies and the prospection of biotechnology compounds.

Effects of twenty-eight months of detraining imposed by the COVID-19 pandemic on the functional fitness of older women experienced in concurrent and functional training.

PURPOSE: To assess the impacts of 28 months of detraining imposed by the COVID-19 pandemic on the functional fitness of older women practicing functional or concurrent training. MATERIAL AND METHODS: A clinical trial was conducted with 16 weeks of intervention and 28 months of detraining imposed by the COVID-19 pandemic. Ninety-five participants were allocated to functional training (FT - 32), concurrent training (CT - 31), or the control group (CG - 32). All the dependent variables were measured pre-training, post-training, and after the detraining period. The functional fitness was assessed by the put on and take off a t-shirt (PTS - upper limbs), timed up and go (TUG - dynamic balance), five times sit-to-stand (FTSST - lower-limb muscle power), gallon-jug shelf-transfer (GJST - global function), and 10 m walk (W10 m - walking ability) tests. RESULTS: Sixty-three women remained after the detraining period, twenty-four in the FT (66.0 ± 3.8 years), twenty in the CT (65.0 ± 4.3 years), and nineteen in the CG (69.6 ± 5.9 years). Comparing the detraining vs. the pre-intervention, the FT and CT showed a smaller reduction than CG for the PTS (ßFT = -2.296; ßCT = -1.914), timed up and go (ßFT = -0.705; ßCT = -0.600), five times sit-to-stand (ßFT = -1.970; ßCT = -2.970), gallon-jug shelf-transfer (ßFT = -1.512; ßCT = -1.003), without differences in the 10 m walk. Also, the concurrent training showed a smaller reduction than the functional training in the FTSST (ß = 1.000). CONCLUSION: Even after a long detraining period imposed by the COVID-19 pandemic, FT and CT practices were effective strategies for maintaining the functional fitness of older women.

Supplementation with okra combined or not with exercise training is able to protect the heart of animals with metabolic syndrome.

The metabolic syndrome (MetS) is a clinical manifestation strongly associated with cardiovascular disease, the main cause of death worldwide. In view of this scenario, many therapeutic proposals have appeared in order to optimize the treatment of individuals with MetS, including the practice of exercise training (ET) and the consumption of okra (O). The aim of the present study was to evaluate the effect of O consumption and/or ET in animals with MetS. In all, 32 male Zucker rats (fa/fa) at 10 weeks old were randomly distributed into four groups of 8 animals each: MetS, MetS+O, MetS+ET and MetS+ET+O, and 8 lean Zucker rats (fa/ +) comprised the control group. Okra was administered by orogastric gavage 2x/day (morning and night, 100 mg/kg), 5 days/week, for 6 weeks. The ET was performed on a treadmill 1x/day (afternoon), 5 days/week, 60 min/day, in an intensity of 70% of maximal capacity, for the same days of O treatment. It was found that, O consumption alone was able to promote improved insulin sensitivity (MetS 93.93 ± 8.54 mg/dL vs. MetS+O 69.95 ± 18.7 mg/dL, p ≤ 0.05, d = 1.65, CI = 50.32 -89.58, triglyceride reduction (MetS 492.9 ± 97.8 mg/dL vs. MetS+O 334.9 ± 98.0 mg/dL, p ≤ 0.05, d = 1.61, CI = 193.2-398.7). In addition, it promoted a reduction in systolic blood pressure (MetS 149.0 ± 9.3 mmHg vs. MetS+O 132.0 ± 11.4 mmHg, p ≤ 0.05, d = 1.63, CI = 120-140), prevented an increase in cardiac collagen (MetS 12.60 ± 2.08% vs. MetS+O 7.52 ± 0.77%, p ≤ 0.05, d = 3.24, CI = 6.56-8.49). When associated with ET, the results were similar. Thus, we conclude that O consumption combined or not with aerobic ET can have a protective effect on the cardiac tissue of rats with MetS.

Characterization of unconventional pathogenic Escherichia coli isolated from bloodstream infection: virulence beyond the opportunism.

Extraintestinal pathogenic Escherichia coli (ExPEC) is the leading cause of urinary tract infection worldwide and a critical bloodstream infection agent. There are more than 50 virulence factors (VFs) related to ExPEC pathogenesis; however, many strains isolated from extraintestinal infections are devoid of these factors. Since opportunistic infections may occur in immunocompromised patients, E. coli strains that lack recognized VFs are considered opportunist, and their virulence potential is neglected. We assessed eleven E. coli strains isolated from bloodstream infections and devoid of the most common ExPEC VFs to understand their pathogenic potential. The strains were evaluated according to their capacity to interact in vitro with human eukaryotic cell lineages (Caco-2, T24, HEK293T, and A549 cells), produce type 1 fimbriae and biofilm in diverse media, resist to human sera, and be lethal to Galleria mellonella. One strain displaying all phenotypic traits was sequenced and evaluated. Ten strains adhered to Caco-2 (colon), eight to T24 (bladder), five to HEK-293 T (kidney), and four to A549 (lung) cells. Eight strains produced type 1 fimbriae, ten adhered to abiotic surfaces, nine were serum resistant, and seven were virulent in the G. mellonella model. Six of the eleven E. coli strains displayed traits compatible with pathogens, five of which were isolated from an immune-competent host. The genome of the EC175 strain, isolated from a patient with urosepsis, reveals that the strain belonged to ST504-A, and serotype O11:H11; harbors thirteen VFs genes, including genes encoding UpaG and yersiniabactin as the only ExPEC VFs identified. Together, our results suggest that the ExPEC pathotype includes pathogens from phylogroups A and B1, which harbor VFs that remain to be uncovered.

Risco de violência, doenças autorreferidas e fragilidade em pessoas idosas hospitalizadas / Risk of violence, self-reported diseases and frailty in hospitalized older adults / Risk of violence, self-reported diseases and frailty in hospitalized older adults / Riesgo de violencia, enfermedades autodeclaradas y fragilidad en adultos mayores hospitalizados

Resumo Objetivo Analisar a relação do risco de violência com doenças autorreferidas e síndrome da fragilidade em pessoas idosas atendidas em instituições hospitalares. Métodos Estudo transversal, multicêntrico, realizado com 323 pessoas idosas em dois hospitais universitários da Paraíba. Foram utilizados os instrumentos Hwalek-Sengstock Elder Abuse Screening Test, um questionário de doença autorreferida e o Edmonton Frail Scale. Os dados foram analisados mediante estatística descritiva e inferencial, utilizando o teste Qui-quadrado e Regressão Logística Múltipla. Resultados O risco de violência foi associado em pessoas idosas com depressão (p=0,001), artrite ou reumatismo (p<0,001), osteoporose (p<0,001), síndrome da fragilidade (p<0,001). Ademais, aqueles com artrite e síndrome da fragilidade apresentaram, respectivamente, 2,37 [IC= 1,43-3,91] e 3,07 [IC=1,88-4,92] maior probabilidade de sofrerem risco de violência. Conclusão Pessoas idosas com doenças crônicas e síndrome da fragilidade estão mais susceptíveis ao risco de violência. Assim, a discussão sobre a temática durante a formação de futuros enfermeiros se faz essencial no que tange os cuidados de enfermagem gerontológicos frente a esse fenômeno.

Resumen Objetivo Analizar la relación entre el riesgo de violencia con enfermedades autodeclaradas y el síndrome de fragilidad en adultos mayores atendidos en instituciones hospitalarias. Métodos Estudio transversal, multicéntrico, realizado con 323 adultos mayores en dos hospitales universitarios del estado de Paraíba. Se utilizaron los instrumentos Hwalek-Sengstock Elder Abuse Screening Test, un cuestionario sobre enfermedades autodeclaradas, y el Edmonton Frail Scale. Los datos se analizaron a través de estadística descriptiva e inferencial, utilizando la prueba χ2 de Pearson y Regresión Logística Múltiple. Resultados El riesgo de violencia en adultos mayores estuvo asociado con depresión (p=0,001), artritis o reumatismo (p<0,001), osteoporosis (p<0,001), síndrome de fragilidad (p<0,001). Además, los que tienen artritis y síndrome de fragilidad presentaron, respectivamente, 2,37 [IC= 1,43-3,91] y 3,07 [IC=1,88-4,92] más probabilidades de sufrir riesgo de violencia. Conclusión Adultos mayores con enfermedades crónicas y síndrome de fragilidad están más susceptibles a riesgo de violencia. De esa forma, la discusión sobre la temática durante la formación de futuros enfermeros es esencial en lo que se refiere a los cuidados de enfermería gerontológicos ante ese fenómeno.

Abstract Objective To analyze the relationship between the risk of violence and self-reported illnesses and the frailty syndrome in older adults treated at hospitals. Methods This is a cross-sectional, multicenter study, carried out with 323 older adults in two university hospitals in Paraíba. The Hwalek-Sengstock Elder Abuse Screening Test instruments, a self-reported illness questionnaire and the Edmonton Frail Scale were used. Data were analyzed using descriptive and inferential statistics, using the chi-square test and Multiple Logistic Regression. Results The risk of violence was associated in older adults with depression (p=0.001), arthritis or rheumatism (p<0.001), osteoporosis (p<0.001), frailty syndrome (p<0.001). Furthermore, those with arthritis and frailty syndrome had, respectively, 2.37 [CI= 1.43-3.91] and 3.07 [CI=1.88-4.92] greater probability of being at risk of violence. Conclusion Older adults with chronic diseases and frailty syndrome are more susceptible to the risk of violence. Thus, the discussion on the subject during the training of future nurses becomes essential with regard to gerontological nursing care in the face of this phenomenon.