Production and concentration of keratinases and application of fermentation residual in removing hexavalent chromium.

The production of keratinases was evaluated in submerged fermentation with Aspergillus niger and by pigs' swine hair in a batch bioreactor. Experimental planning was performed to assess the interaction between different variables. The enzyme extract produced was characterized at various pH and temperatures and subjected to enzyme concentration using a biphasic aqueous system and salt/solvent precipitation techniques. In addition, the substrate's potential in reducing hexavalent chromium from synthetic potassium dichromate effluent with an initial concentration of 20 mg L-1 of chromium was evaluated. The resulting enzyme extract showed 89 ± 2 U mL-1 of keratinase. The enzyme concentration resulted in a purification factor of 1.3, while sodium chloride/acetone and ammonium sulfate/acetone resulted in a purification factor of 1.9 and 1.4, respectively. Still using the residual substrate of swine hair from the fermentation, a 94% reduction of hexavalent chromium concentration occurred after 9 h of reaction. Thus, the study proved relevant for producing keratinases, with further environmental applicability and the possibility of concentrating the extract via low-cost processes.

Trichoderma koningiopsis fermentation in airlift bioreactor for bioherbicide production.

During scaling of fermentations, choosing a bioreactor is fundamental to ensure the product's quality. This study aims to produce bioherbicides using Trichoderma koningiopsis fermentation, evaluating process parameters in an Airlift bioreactor. As a response, we quantified the production of enzymes involved in the bioherbicide activity (amylase, cellulase, laccase, lipase, and peroxidase). In addition, it evaluated the agronomic efficiency of the fermented extract optimized through tests that promoted soybean growth and nodulation, soybean seed germination, and in vitro phytopathogen control. As a result of optimizing the scaling bioprocess, it was possible to obtain an adequate fermentation condition, which, when applied to soybean seeds, had beneficial effects on their growth. It allowed the production of an enzyme cocktail. These results add a crucial biotechnological potential factor for the success of the optimized formulation in the Airlift bioreactor, in addition to presenting relevant results for the scientific community.

Study and characterization of a product based on a vegetable extract of quinoa fermented with water kefir grains.

This work aimed to study and characterize a product based on vegetable extract of quinoa (WVEQ) fermented with water kefir grains. The effect of sucrose concentration (SC), inulin concentration (IC), and xanthan gum (XG) concentration were evaluated using a central composite design (CCD) 23. They were subsequently characterized regarding cellular growth of the grains, beverage yield, pH, soluble solids, carbon dioxide (CO2) production, lactic acid, and ethanol production. Therefore, for the final stage, two formulations (F1 and F8) of the CCD were chosen to be characterized in terms of proximate composition, microbiological composition of the kefir culture, analysis of organic compounds, sensory analysis, and enzymatic and microbiological characterization before and after simulation of in vitro gastrointestinal digestion. In the two chosen products, one can see that fermentation optimized the bioavailability of proteins due to the high proteolytic activity of the microorganisms in kefir and the increase in lipid content. In identifying microorganisms, there was a prevalence of Saccharomyces sp. yeasts. In the sensory analysis, the F8 formulation showed better results than the F1 formulation. In vitro, gastrointestinal digestion showed reduced lactic acid bacteria and yeast and increased acetic acid bacteria in the liquid phase for both formulations. In the enzymatic profile, there was a reduction in all enzymes analyzed for both formulations, except for amylase in F1, which went from 14.05 U/mL to 39.41 U/mL. Therefore, it is concluded that using WVEQ as a substrate for the product appears to be a viable alternative with nutritional and technological advantages for serving a specific market niche.

Value of CTA/MRA in the setting of intraparenchymal hemorrhage in the emergency department.

PURPOSE: To assess the diagnostic yield of computed tomography angiography (CTA)/magnetic resonance angiography (MRA) brain and neck ordered in the emergency department (ED) for patients who have intraparenchymal hemorrhage (IPH) on their initial noncontrast CT (NCCT) of the head. METHODS: In this retrospective study, we reviewed 156 patients presenting to the ED with nontraumatic IPH, documented on NCCT. We assessed if the subsequent CTA/MRA was positive, and collected data regarding the location of the bleed, patients' age group, and presence/absence of associated SAH/IVH. Two neuroradiologists were asked to predict, based on age and NCCT appearance, whether the CTA/MRA would be positive or negative for demonstrating a vascular etiology of the hemorrhage. RESULTS: The yield of CTA/MRA head for patients above 75 years old was 2% (1/49), as the etiology for IPH in such age group was more commonly related to hypertensive bleed or amyloid angiopathy. The concomitant presence of subarachnoid hemorrhage (SAH) and intraventricular hemorrhage (IVH), particularly in patients younger than 75 years, correlated with a higher likelihood of a positive CTA. Statistically, the neuroradiologists were able to exclude a vascular source of the IPH based on CT appearance, bleed location, and patient's age in over 92% of cases. CONCLUSION: CTA/MRA for IPH has a lower yield in patients at older age and with deep gray matter distribution without SAH. Neuroradiologists were accurate at excluding a vascular source of the IPH in most cases. This study suggests that CTA/MRA can be omitted in certain scenarios, thereby preventing overutilization, and leading to optimal use of health care resources.

Fungus-based bioherbicides on circular economy.

This review aimed to show that bioherbicides are possible in organic agriculture as natural compounds from fungi and metabolites produced by them. It is discussed that new formulations must be developed to improve field stability and enable the commercialization of microbial herbicides. Due to these bottlenecks, it is crucial to advance the bioprocesses behind the formulation and fermentation of bio-based herbicides, scaling up, strategies for field application, and the potential of bioherbicides in the global market. In this sense, it proposed insights for modern agriculture based on sustainable development and circular economy, precisely the formulation, scale-up, and field application of microbial bioherbicides.

The bioherbicidal potential of isolated fungi cultivated in microalgal biomass.

This study evaluated the bioherbicidal potential of wild fungi grown on microalgal biomass from the digestate treatment of biogas production. Four fungal isolates were used and the extracts were evaluated for the activity of different enzymes and characterized by gas chromatography coupled with mass spectrometry. The bioherbicidal activity was assessed by application on Cucumis sativus, and the leaf damage was visually estimated. The microorganisms showed potential as agents producing an enzyme pool. The obtained fungal extracts presented different organic compounds, most acids, and when applied to Cucumis sativus, showed high levels of leaf damage (80-100 ± 3.00%, deviation relative to the observed average damage). Therefore, the microbial strains are potential biological control agents of weeds, which, together with the microalgae biomass, offer the appropriate conditions to obtain an enzyme pool of biotechnological relevance and with favorable characteristics to be explored as bioherbicides, addressing aspects within the environmental sustainability.

Extremophile Microbial Communities and Enzymes for Bioenergetic Application Based on Multi-Omics Tools.

Genomic and proteomic advances in extremophile microorganism studies are increasingly demonstrating their ability to produce a variety of enzymes capable of converting biomass into bioenergy. Such microorganisms are found in environments with nutritional restrictions, anaerobic environments, high salinity, varying pH conditions and extreme natural environments such as hydrothermal vents, soda lakes, and Antarctic sediments. As extremophile microorganisms and their enzymes are found in widely disparate locations, they generate new possibilities and opportunities to explore biotechnological prospecting, including biofuels (biogas, hydrogen and ethanol) with an aim toward using multi-omics tools that shed light on biotechnological breakthroughs.

Advanced oxidation processes applied for color removal of textile effluent using a home-made peroxidase from rice bran.

Enzymes are becoming tools in industrial processes because of several advantages, including activity in mild environmental conditions, and high specificity. Peroxidase, for one, stably oxidizes several substrates. The present study aimed to develop advanced oxidation processes (AOP), using non-commercial rice bran peroxidase to remove color and toxicity of synthetic textile wastewater. Using a microwave and shaker system, we obtained 38.9% and 100% of effluent color removal after peroxidase treatment, respectively. In addition, the shaker system decants residual dye particles through filtration, providing the textile industry with an economical and environmentally viable alternative to effluent treatment. In toxicity tests results, both treatment systems damaged the used genetic material. This damage occurs because of industrial discharge of wastewater into water bodies; effluent dilution reduced this damage. The data suggest that peroxidase as a textile effluent treatment has potential uses in industrial processes, because rice bran peroxidase has demonstrated affinity with dyes.

A review on alternative bioprocesses for removal of emerging contaminants.

Emerging contaminants (ECs) include endocrine-disrupting compounds, pharmaceuticals (lipid regulators, antibiotics, diuretics, non-steroid anti-inflammatory drugs, stimulant drugs, antiseptics, analgesic, beta blockers), detergents, disinfectants, and personal care products. The residues from these compounds have become a concerning because of their bioactive presence on environmental matrices, especially water bodies. The development of technologies, aiming the secure and efficient removal of these compounds from the environment or event to remove them before they achieve the environment, is necessary. In these context, the present review is about promising eco-friendly, low-cost and specially applied, including biological processes using microalgae, bacteria, enzymes produced by fungi, and adsorbent materials such as those recycled from other processes waste. The processes where revised considering the removal mechanism and the efficiency rate.

Ethical Dilemmas in Radiology: Survey of Opinions and Experiences.

OBJECTIVE. The aim of this study was to assess trainees' and practicing radiologists' perceptions and experiences in handling ethical situations. We sought to identify frequently encountered ethical dilemmas and how they are addressed in daily practice. MATERIALS AND METHODS. A questionnaire on ethics was sent by email invitation to 1569 radiologists and radiology trainees in an institutional database maintained for continuing medical education purposes on three separate occasions between September 17, 2016, and October 31, 2016. The link to the survey was also posted on social media sites via the authors' and institutional accounts on Facebook, Twitter, Instagram, and Aunt Minnie as well as on American College of Radiology and Radiological Society of North America web blogs. RESULTS. A total of 424 radiologists and trainees responded to the survey, for a response rate of 27% (424/1569). Of them, 363 responded to a question asking whether they had witnessed an ethical dilemma; 203 (56%) had. The wording of reports when a miss was discovered was not handled in a consistent fashion. Regarding disclosure, trainees were more likely than practicing radiologists to report theirs and others' errors to the patient. Of the 362 respondents who responded to a question about whether they would report a negligent act by a colleague to the group director, 292 (81%) stated that they would, but trainees were less likely than practicing radiologists to do so. CONCLUSION. This study found many common ethical dilemmas in radiology practices remain without an appropriate, objective, and unified approach to effectively guide the radiologist's actions. These results highlight a need to provide more uniform recommendations to assist radiologists in addressing ethical issues in an appropriate manner.

Unsafe storage of household medicines: results from a cross-sectional study of four-year-olds from the 2004 Pelotas birth cohort (Brazil).

BACKGROUND: Unintentional child poisoning represents a significant public health problem across the globe, placing a substantial burden on health services emergency departments. Around the world, every year, thousands of children die as a result of physical injuries, most of which involve children under 5 years old. Medicines are the main products involved in poisoning, and children under 5 years old are the most vulnerable age group. The objective of this study was to measure the prevalence of unsafe storage of medicines in households with a 4-year-old child. METHODS: We used data from the follow-up of 4-year-old in the 2004 Pelotas Birth Cohort Study in Brazil (N = 3799). "Unsafe storage" was considered present when medicines were stored unlocked and within reach of children (at a height below the eye level of the average adult). Independent variables included maternal and family socioeconomic and demographic characteristics and the child's health care. All information was collected during household interviews with the mothers using a standardized questionnaire. The overall prevalence rate with a 95% confidence interval (95% CI) and the prevalence associated with various independent variables were determined. RESULTS: The storage of medicines in unlocked areas was reported by 80.9% of the mothers, and, within reach of children for 26.5%. The overall prevalence rate of unsafe storage of medicines was 21.4% (20.1-22.7%). The main storage locations used were the kitchen (57.0%) and bedroom (53.3%). CONCLUSIONS: The results indicate that medicines were unsafely stored in a 21.4% number of homes, which can contribute to the vulnerability of children to poisoning from medicines. To minimize this risk, education about the safe storage of medicines should be reinforced by health professionals.

Cellulolytic enzyme production from agricultural residues for biofuel purpose on circular economy approach.

This study evaluated the production of cellulolytic enzymes from different agricultural residues. The crude enzyme extract produced was characterized and applied for saccharification of some agricultural residues. Maximum cellulolytic activities were obtained using soybean hulls. All enzymatic activities were highly stable at 40 °C at a pH range of 4.5-5.5. For stability at low temperatures, the enzyme extract was stored at freezing temperature and cooling for about 290 days without major loss of activity. The Km values found for total cellulase (FPase), endoglucanase (CMCase), and xylanase were 19.73 mg ml-1, 0.65 mg ml-1, and 22.64 mg ml-1, respectively, and Vmax values were 0.82 mol min-1 mg-1, 0.62 mol min-1 mg-1, and 104.17 mol min-1 mg-1 to cellulose, carboxymethyl cellulose, and xylan, respectively. In the saccharification tests, the total amount of total reducing sugars (TRS) released from 1 g of soybean hulls catalyzed by the enzymes present in the crude enzyme extract was 0.16 g g-1 dry substrate.

Efficient and low-cost alternative of lipase concentration aiming at the application in the treatment of waste cooking oils.

In this study, we evaluated the concentration of lipases from Aspergillus niger using efficient and low-cost methods aiming at application in the treatment of waste cooking oils. The change in ionic strength of the medium by the addition of salt and precipitation with ethanol increased the specific activity from 2.90 to 28.50 U/mg, resulting in a purification factor of 9.82-fold. The use of acetone resulted in a specific activity of 33.63 U/mg, resulting in a purification factor of 11.60-fold. After that, the concentrated lipase was used in the hydrolysis of waste cooking oil and 753.07 and 421.60 µmol/mL of free fatty acids were obtained for the enzyme precipitated with ethanol and acetone, respectively. The hydrolysis of waste cooking oil catalyzed by homemade purified lipase in ultrasonic media can be considered a pretreatment of oil by converting a significant amount of triglycerides into free fatty acids.

Radiology and Ethics Education.

OBJECTIVE: The purpose of this study is to assess medical ethics knowledge among trainees and practicing radiologists through an online survey that included questions about the American College of Radiology Code of Ethics and the American Medical Association Code of Medical Ethics. CONCLUSION: Most survey respondents reported that they had never read the American Medical Association Code of Medical Ethics or the American College of Radiology Code of Ethics (77.2% and 67.4% of respondents, respectively). With regard to ethics education during medical school and residency, 57.3% and 70.0% of respondents, respectively, found such education to be insufficient. Medical ethics training should be highlighted during residency, at specialty society meetings, and in journals and online resources for radiologists.

Discrimination faced by radiology residents: an analysis of experiences and mitigation strategies.

RATIONALE AND OBJECTIVES: Literature shows that discrimination has been pervasive in the field of medicine. The aim of this study was to collect experiences related to discrimination among US radiology residents, including type and source, as well as the residents' perception on lectures about discrimination and harassment. We also explored the barriers to reporting, and suggested strategies to overcome them. MATERIAL AND METHODS: Following Institutional Review Board (IRB) approval, an online survey was sent to program directors and coordinators across the US, who were asked to forward the link to their radiology residents. A reminder email was sent over a period of 4 months. The participants were reassured the survey was confidential and anonymous. RESULTS: Among the respondents, the most reported types of discrimination were based in gender, race and nationality, the majority of which not being reported. The most common perpetrators were attending radiologists, co-residents, technologists, and patients. The main barriers for reporting were fear of retaliation, confidentiality concerns, and skepticism about a positive outcome. CONCLUSION: Our study examines some experiences of discrimination shared by residents during their training, with gender and race being the most common causes. This sheds light into a hidden and unspoken issue and highlights the need for more active discussions in radiology on microaggressions and implicit bias. Our data can guide future studies as well as residency programs to build effective strategies to address discrimination, aiming for sustainable changes.

Developing strategies to improve the sense of belonging and mitigate tokenism.

Despite the increase in DEI initiatives and the rising social awareness, diversity, equity, and inclusiveness are still scarce in many work environments. In the process of implementing a diverse group in the workplace and training programs, retention efforts should always follow recruitment strategies; it is crucial to establish an environment that offers recruited women and minorities a sense of belonging and inclusiveness. Literature shows that diversity and belonging benefit not only the individual, but also the organization, society, and health care system. Many strategies to foster a sense of belonging in the workplace have been suggested, including, but not limited to, mentorship, sponsorship, affinity groups, dashboards, and surveys. Leaderships should acknowledge DEI initiatives, promoting efforts to enhance inclusiveness and mitigate tokenism. Amid DEI criticism and backlash, it is important to continue to promote education and positive discussions and aim for cultural changes targeting rooted systemic racism and discrimination, which continue to impose an obstacle to DEIB achievements.

A review of hybrid enzymatic-chemical treatment for wastewater containing antiepileptic drugs.

Epilepsy is one of the most common neurological diseases worldwide and requires treatment with antiepileptic drugs for many years or for life. This fact leads to the need for constant production and use of these compounds, placing them among the four pharmaceutical classes most found in wastewater. Even at low concentrations, antiepileptics pose risks to human and environmental health and are considered organic contaminants of emerging concern. Conventional treatments have shown low removal of these drugs, requiring advanced and innovative approaches. In this context, this review covers the results and perspectives on (1) consumption and occurrence of antiepileptics in water, (2) toxicological effects in aquatic ecosystems, (3) enzymatic and advanced oxidation processes for degrading antiepileptics drugs from a molecular point of view (biochemical and chemical phenomena), (4) improvements in treatment efficiency by hybridization, and (5) technical aspects of the enzymatic-AOP reactors.

Is the Brazilian pharmaceutical policy ensuring population access to essential medicines?

BACKGROUND: To evaluate medicine prices, availability and affordability in Brazil, considering the differences across three types of medicines (originator brands, generics and similar medicines) and different types of facilities (private pharmacies, public sector pharmacies and "popular pharmacies"). METHODS: Data on prices and availability of 50 medicines were collected in 56 pharmacies across six cities in Southern Brazil using the World Health Organization / Health Action International methodology. Median prices obtained were divided by international reference prices to derive the median price ratio (MPR). RESULTS: In the private sector, prices were 8.6 MPR for similar medicines, 11.3 MRP for generics and 18.7 MRP for originator brands, respectively. Mean availability was 65%, 74% and 48% for originator brands, generics and similar medicines, respectively. In the public sector, mean availability of similar medicines was 2-7 times higher than that of generics. Mean overall availability in the public sector ranged from 68.8% to 81.7%. In "popular pharmacies", mean availability was greater than 90% in all cities. CONCLUSIONS: Availability of medicines in the public sector does not meet the challenge of supplying essential medicines to the entire population, as stated in the Brazilian constitution. This has unavoidable repercussions for affordability, particularly amongst the lower socio-economic strata.

[Affordability and availability of drugs for treatment of chronic diseases in the public health care system]. / Capacidade aquisitiva e disponibilidade de medicamentos para doenças crônicas no setor público.

OBJECTIVE: To assess the affordability by workers of drugs used for treatment of chronic diseases, as well as the availability of the reference, similar, or generic forms of these drugs in the public health care system. METHODS: We employed the methodology recommended by the World Health Organization (WHO) and Health Action International (HAI) for the standardized collection of information on selling prices in the private sector and availability in the public health care system of drugs in six cities in the state of Rio Grande do Sul, Brazil. Data were collected from November 2008 to January 2009. Affordability was estimated as the number of salary days required for a worker receiving the national minimum wage to buy, in a private pharmacy, the amount of medication required for one month of treatment. Availability was assessed by the presence of these drugs in public health care system facilities. RESULTS: Twenty-two public facilities and 30 private pharmacies were studied. Of 21 drugs used for the treatment of seven chronic disorders, only nine were available free of charge in the six cities. Mean availability ranged from 83.3% (São Leopoldo) to 97.6% (Caxias do Sul). Affordability ranged from 0.4 to 10.5 salary days for reference drugs, 0.2 to 8.4 salary days for similar drugs, and 0.3 to 3.8 salary days for generic drugs. CONCLUSIONS: The overall availability of the drugs surveyed was higher than the 80% recommended by WHO. However, some treatments were not available, or had limited availability in the public system. Concerning affordability, the number of salary days required to buy these drugs may affect the continuation of drug treatments for chronic diseases.

Neuroimaging in Pediatric Headache.

Headache represents one of the most common disorders in childhood and leads to nearly half a million visits to the physician's office or emergency department every year. Although the estimated prevalence is around 58.4%, the actual incidence of headache in the pediatric population might be underestimated, given only a percentage of cases seek medical attention. The first step in the evaluation of pediatric headache is a detailed clinical history and relevant clinical examinations. AAN and ACR do not recommend neuroimaging for patients with primary headache. However, neuroimaging becomes mandatory in presence of red flags to rule out the underlying cause.