Ethanol, acetaldehyde, and methanol in the gas phase and rainwater in different biomes and urban regions of Brazil.

In the context of the increasing global use of ethanol biofuel, this work investigates the concentrations of ethanol, methanol, and acetaldehyde, in both the gaseous phase and rainwater, across six diverse urban regions and biomes in Brazil, a country where ethanol accounts for nearly half the light-duty vehicular fuel consumption. Atmospheric ethanol median concentrations in São Paulo (SP) (12.3 ± 12.1 ppbv) and Ribeirão Preto (RP) (12.1 ± 10.9 ppbv) were remarkably close, despite the SP vehicular fleet being ∼13 times larger. Likewise, the rainwater VWM ethanol concentration in SP (4.64 ± 0.38 µmol L-1) was only 26 % higher than in RP (3.42 ± 0.13 µmol L-1). This work demonstrated the importance of evaporative emissions, together with biomass burning, as sources of the compounds studied. The importance of biogenic emissions of methanol during forest flooding was identified in campaigns in the Amazon and Atlantic forests. Marine air masses arriving at a coastal site led to the lowest concentrations of ethanol measured in this work. Besides vehicular and biomass burning emissions, secondary formation of acetaldehyde by photochemical reactions may be relevant in urban and non-urban regions. The combined deposition flux of ethanol and methanol was 6.2 kg ha-1 year-1, avoiding oxidation to the corresponding and more toxic aldehydes. Considering the species determined here, the ozone formation potential (OFP) in RP was around two-fold higher than in SP, further evidencing the importance of emissions from regional distilleries and biomass burning, in addition to vehicles. At the forest and coastal sites, the OFP was approximately 5 times lower than at the urban sites. Our work evidenced that transition from gasoline to ethanol or ethanol blends brings the associated risk of increasing the concentrations of highly toxic aldehydes and ozone, potentially impacting the atmosphere and threatening air quality and human health in urban areas.

Reactive oxygen species-dependent transient induction of genotoxicity by retene in human liver HepG2 cells.

Retene is a polycyclic aromatic hydrocarbon (PAH) emitted mainly by biomass combustion, and despite its ubiquity in atmospheric particulate matter (PM), studies concerning its potential hazard to human health are still incipient. In this study, the cytotoxicity and genotoxicity of retene were investigated in human HepG2 liver cells. Our data showed that retene had minimal effect on cell viability, but induced DNA strand breaks, micronuclei formation, and reactive oxygen species (ROS) formation in a dose- and time-dependent manner. Stronger effects were observed at earlier time points than at longer, indicating transient genotoxicity. Retene activated phosphorylation of Checkpoint kinase 1 (Chk1), an indicator of replication stress and chromosomal instability, which was in accordance with increased formation of micronuclei. A protective effect of the antioxidant N-acetylcysteine (NAC) towards ROS generation and DNA damage signaling was observed, suggesting oxidative stress as a key mechanism of the observed genotoxic effects of retene in HepG2 cells. Altogether our results suggest that retene may contribute to the harmful effects caused by biomass burning PM and represent a potential hazard to human health.

I-PASS Mentored Implementation Handoff Curriculum: Champion Training Materials.

Introduction: The I-PASS Handoff Program is a comprehensive handoff curriculum that has been shown to decrease rates of medical errors and adverse events during patient handoffs. I-PASS champions are a critical part of the implementation and sustainment of this curriculum, and therefore, a rigorous program to support their training is necessary. Methods: The I-PASS Handoff champion training materials were created for the original I-PASS Study and adapted for the Society of Hospital Medicine (SHM) I-PASS Mentored Implementation Program. The adapted materials embrace a flipped classroom approach and adult learning theory. The training includes an overview of I-PASS handoff techniques, an opportunity to practice evaluating handoffs with the I-PASS observation tools using a handoff video vignette, and other key implementation principles. Results: As part of the SHM I-PASS Mentored Implementation Program, 366 champions were trained at 32 sites across North America and participated in a total of 3,491 handoff observations. A total of 346 champions completed the I-PASS Champion Workshop evaluation form at the end of their training (response rate: 94.5%). After receiving the training, over 90% agreed/strongly agreed that it provided them with knowledge or skills critical to their patient care activities and that they were able to distinguish the difference between high- and poor-quality handoffs, competently use the I-PASS handoff assessment tools, and articulate the importance of handoff observations. Conclusion: The I-PASS champion training materials were rated highly by those trained and are an integral part of a successful I-PASS Handoff Program implementation.

Sempre por um triz.. / Always by a thread / Siempre por poco..

Este trabalho nasceu de uma conversa sobre uma situação clínica. Uma paciente que acabara de tornar-se avó pela primeira vez mostrava-se surpreendida e assustada pelas inesperadas sensações de desconforto e estranhamento que a invadiam. Acompanhando o fio de sua inquietude as autoras fazem uma reflexão sobre as circunstâncias existenciais que envolvem essa transição generacional e sugerem um olhar atento à especificidade desse momento, em que se faz necessário conjugar a continuidade da vida com a proximidade da morte.

This paper was conceived from a conversation regarding a clinical situation. A patient, who had just become a grandmother, was surprised and frightened by the unexpected sensations of discomfort and unfamiliarity which invaded her. Following the flow of her unease, both authors ponder the existential circumstances encompassing this generational transition, and suggest the need for an attentive regard to the uniqueness of this moment, when the continuity of life and the proximity of death must be associated.

Este trabajo nació de una conversación al respecto de una situación clínica. Una paciente que había acabado de convertirse en abuela por primera vez se mostraba sorprendida y asustada por los sentimientos inesperados de malestar y extrañeza que la invadían. Siguiendo el hilo de su preocupación, las autoras hacen una reflexión sobre las circunstancias existenciales en torno a este cambio generacional y sugieren prestar atención a la especificidad de este momento, en que es necesario conjugar la continuidad de la vida con la proximidad de la muerte.

O pequeno grande soldado: Quando as palavras chegam / The little big soldier: When the words arrive

Este trabalho procura enfocar a redescoberta, o reencontro de M. com as palavras. É a narrativa da experiência compartilhada no percurso da palavra vazia à palavra plena de sentido. Reencontrando gestos, feições, murmúrios, enfim, uma linguagem não-verbal e pré-verbal que ressoava e encontrava ressonância, veredas associativas foram construídas, criando ambiência para a circulação dos afetos, despertando o desejo pelo significado. A linguagem convencional, então, foi sendo transformada em linguagem própria, específica à sua interioridade

Staphylococcal food poisoning outbreaks in Säo Paulo (Brazil)

Foram investigados seis surtos de doenças de origem alimentar ocorridos em Säo Paulo, Brasil. Os alimentos implicados foram: bolo recheado com creme (4 surtos), nhoque (1 surto) e sorvete (1 surto). Os alimentos foram analisados, quanto à presença de Staphylococcus aureus e enterotoxinas estafilocócicas. As contagens de S. aureus, nos alimentos, variaram de 10(7) a 10(9) UFC/g, exceto para o sorvete, do qual näo se obteve o isolamento da bactéria. Os estafilococos isolados a partir dos alimentos mostraram-se produtores de enterotoxina A e todas as amostras, dos alimentos analisados, continham enterotoxina A, a mais comumente associada à intoxicaçäo alimentar estafilocócica

Campylobacter jejuni em carcaças de frangos, avaliaçäo da eficiência de meios de plaqueamento e enriquecimento seletivo no seu isolamento / Efficacy of direct plating and selective enrichment media for detecting Campylobacter jejuni in fresh eviscerated whole market chickens - São Paulo - Brazil

Com o fim de se testar a necessidade de enriquecimento seletivo para o isolamento de Campylobacter jejuni a partir de carcaças de frangos, foram empregadas duas metodologias, o plaqueamento direto em ágar Campy-BAP (CBAP) e ágar Vancomicina, trimetoprim, polimixina B - sulfato ferroso, metabissulfito de sódio e piruvato de sódio (VTP-FBP) e o enriqueciemtno seletivo em meio de Doyle-Roman (DR) e de Preston (P). Os resultados obtidos foram comparados estatisticamente através do teste x² fixando-se em 5 por cento o nível de rejeição. A significância das diferenças dos resultados obtidos, entre os dois meios de plaqueamento direto CBAP e ágar VTP-FBP ou após o enriquecimento seletivo nos meios de DR e P seguidos do plaqueamento em ágar CBAP, evidenciou não existir diferenças significativas. As combinações dos meios de enriquecimento seletivo DR E P com ágar VTP-FBP, mostraram haver diferenças estatisticamente significantes em relação aos demais procedimentos, exceto entre as associações P/CBAP e P/VTP-FBP. A combinação DR/VTP-FBP mostrou ser a menos eficiente. A DR/CBAP foi a que apresentou melhores resultados frente as demais associações e estaticamente foi tão eficiente quanto os meios de plaqueamento direto. Considerando-se que os resultados estatísticos mostraram não haver diferenças significantes entre a utilização do plaqueamento direto e o enriquecimento seletivo, concluímos não haver necessidade do enriquecimento seletivo para o isolamento de C. jejuni a partir de carcaças de frangos.