Social and clinical predictors of perianal colonisation by multidrug-resistant bacteria for geriatric patients in the internal medicine service.

BACKGROUND: Colonisation by multidrug-resistant (MDR) bacteria is a global health issue. The identification of patients with a higher risk of colonisation is essential. Patients admitted to internal medicine services might represent a vulnerable population with a high risk of colonisation. This study was the first to assess social and clinical variables associated with a higher risk of perianal colonisation by MDR bacteria in a Spanish cohort of patients admitted to internal medicine service. METHODS: Patients admitted to an internal medicine service during 12 months of recruitment (1 March 2022 to 1 March 2023) were included in the study. Perianal swabs were performed at admission to identify the presence of MDR bacteria. Social and clinical variables were collected following a directed acyclic graph. A cluster analysis was performed to identify clinical profiles of higher risk. Bivariate analyses and multivariable logistic regression models were fitted to identify potential predictors of MDR bacteria colonisation. RESULTS: A total of 245 patients, according to the required sample size, were included. Of them, 46 (18.8%) were colonised by MDR bacteria in perianal swabs. Female sex, age > 80 years, dependency on activities of daily living, cognitive deterioration and living in long-term care facilities constituted the highest risk clinical profile. After adjustments, living in long-term care facilities and malnutrition remained the main risk factors identified. CONCLUSION: Patients admitted to internal medicine services presented a high frequency of perianal colonisation by MDR bacteria. Social and clinical variables associated with bio-psycho-social susceptibility were associated with colonisation. Special surveillance is needed in internal medicine services to control the transmission.

Retrospective analysis of epidemiologic features and clinical course of COVID-19 patients and comparison between vaccinated and unvaccinated patients.

At our Pneumology Department, we dealt with three waves of COVID-19 pandemics. The purpose of this study is to compare patients' epidemiological and clinical characteristics across waves and to assess the effect of vaccination on clinical presentation, course, and prognosis. From March 2020 to March 2022, a retrospective cohort study was conducted to compare patient characteristics. Based on the time of hospital admission, data from 456 patients were collected and divided into three groups (IW, IIW, and IIIW). In addition, we looked at the link between vaccination and clinical presentation and hospitalization outcome. The average age and comorbidities of patients increased, as did the worsening of respiratory conditions at admission (PaO2/FiO2 median 207 in IW, 95.5 in IIW, and 99 in IIIW). Continuous positive airway pressure (CPAP) was the primary respiratory support during the first wave, but an increase in the use of high flow nasal cannula and noninvasive ventilation was later observed, resulting in a higher hospital discharge rate and a lower intubation rate. Vaccinated patients had less severe COVID-19-related respiratory failure, a better clinical course, and a higher hospital discharge rate (71.4% in V-group vs 44.7% in NV-group, p<0.001). Patients' characteristics changed over the three waves, possibly due to virus mutations. The advancement of clinical and therapeutic management knowledge has contributed to a reduction in the severity of respiratory failure. The vaccination campaign improved the clinical course and reduced mortality.

The preparation of stable spherical alkali lignin nanoparticles with great thermal stability and no cytotoxicity.

In order to further develop the potential applications of lignin biomass, the research on lignin nanoparticles (LNPs) and their nanocomposites has attracted increasing attention. In this study, a facile and no chemical modification approach to prepare stable alkali lignin nanospheres is presented. The nanospheres around 85-125 nm were prepared through the π-π interactions between molecules in the self-assembly process. Lignin alkali was dissolved in ethylene glycol at different initial concentrations and subsequently ultrasound and dialysis treatment were conducted to prepare LNPs. The prepared LNPs had zeta potentials between -20 mV and -40 mV, and they were electrostatically stable over the pH range of 3 to 12 in aqueous solution. The chemical structure of LNPs was not significantly modified compared to lignin. Meanwhile the increased content of carboxyl and aliphatic hydroxyl groups in the LNPs structure was observed. Furthermore, the thermal stability and solubility in organic solvents (ethanol, acetone and THF) of LNPs were enhanced compared to those of lignin. In vitro cell viability evaluation indicated that the prepared LNPs had no cytotoxicity and excellent biocompatibility with mouse fibroblast. Therefore, we proposed here the production of high-quality and renewable LNPs, which will provide a novel perspective for multifunctional applications of bio-based nanomaterials.

Specialization of the photoreceptor transcriptome by Srrm3-dependent microexons is required for outer segment maintenance and vision.

Retinal photoreceptors have a distinct transcriptomic profile compared to other neuronal subtypes, likely reflecting their unique cellular morphology and function in the detection of light stimuli by way of the ciliary outer segment. We discovered a layer of this molecular specialization by revealing that the vertebrate retina expresses the largest number of tissue-enriched microexons of all tissue types. A subset of these microexons is included exclusively in photoreceptor transcripts, particularly in genes involved in cilia biogenesis and vesicle-mediated transport. This microexon program is regulated by Srrm3, a paralog of the neural microexon regulator Srrm4. Despite the fact that both proteins positively regulate retina microexons in vitro, only Srrm3 is highly expressed in mature photoreceptors. Its deletion in zebrafish results in widespread down-regulation of microexon inclusion from early developmental stages, followed by other transcriptomic alterations, severe photoreceptor defects, and blindness. These results shed light on the transcriptomic specialization and functionality of photoreceptors, uncovering unique cell type-specific roles for Srrm3 and microexons with implications for retinal diseases.

European aerosol phenomenology - 8: Harmonised source apportionment of organic aerosol using 22 Year-long ACSM/AMS datasets.

Organic aerosol (OA) is a key component of total submicron particulate matter (PM1), and comprehensive knowledge of OA sources across Europe is crucial to mitigate PM1 levels. Europe has a well-established air quality research infrastructure from which yearlong datasets using 21 aerosol chemical speciation monitors (ACSMs) and 1 aerosol mass spectrometer (AMS) were gathered during 2013-2019. It includes 9 non-urban and 13 urban sites. This study developed a state-of-the-art source apportionment protocol to analyse long-term OA mass spectrum data by applying the most advanced source apportionment strategies (i.e., rolling PMF, ME-2, and bootstrap). This harmonised protocol was followed strictly for all 22 datasets, making the source apportionment results more comparable. In addition, it enables quantification of the most common OA components such as hydrocarbon-like OA (HOA), biomass burning OA (BBOA), cooking-like OA (COA), more oxidised-oxygenated OA (MO-OOA), and less oxidised-oxygenated OA (LO-OOA). Other components such as coal combustion OA (CCOA), solid fuel OA (SFOA: mainly mixture of coal and peat combustion), cigarette smoke OA (CSOA), sea salt (mostly inorganic but part of the OA mass spectrum), coffee OA, and ship industry OA could also be separated at a few specific sites. Oxygenated OA (OOA) components make up most of the submicron OA mass (average = 71.1%, range from 43.7 to 100%). Solid fuel combustion-related OA components (i.e., BBOA, CCOA, and SFOA) are still considerable with in total 16.0% yearly contribution to the OA, yet mainly during winter months (21.4%). Overall, this comprehensive protocol works effectively across all sites governed by different sources and generates robust and consistent source apportionment results. Our work presents a comprehensive overview of OA sources in Europe with a unique combination of high time resolution (30-240 min) and long-term data coverage (9-36 months), providing essential information to improve/validate air quality, health impact, and climate models.

Authentication of recycled plastic content in water bottles using volatile fingerprint and chemometrics.

The environment is threatened by the continuously increasing volume of plastic residue. Plastic recycling is an interesting alternative to mitigate this problem. However, recycled plastic products may have pollutants from their recycling process, collecting system and/or previous life which may hurt consumers health, thus making it key to authenticate and characterize recycled materials. An innovative non-targeted methodology by means of static headspace gas chromatography-mass spectrometry (SHS-GC-MS) has been developed to measure the volatile organic profile of virgin polyethylene terephthalate (PET) and with diverse content of recycled PET samples. A home-made MS database, with 161 organic compounds characteristics from plastic materials based on the literature, was made. Seventeen of those compounds were found in the studied samples and identified by matching their MS spectra with MS database libraries. These compounds are mainly aldehydes (pentanal, hexanal, heptanal, octanal, nonanal and decanal), and benzene derivatives (styrene, p-xylene, benzaldehyde, methylbenzene, and 1,2-dichlorobenzene) which we found to be the common in the samples of recycled PET. The combination of the dataset consisting in the peak area of the detected species by SHS-GC-MS and the use of chemometrics shown to be a valuable methodology for the discrimination between virgin PET samples and those with different recycled PET content based on their volatile profile. In addition, a novel strategy applying a statistical model based on partial least squares (PLS) regression was proposed, for the first time, to quantify the recycled plastic content in the PET samples.

Gold, Silver, and Iron Oxide Nanoparticle Incorporation into Silk Hydrogels for Biomedical Applications: Elaboration, Structure, and Properties.

Silk fibroin (SF) is a versatile material with biodegradable and biocompatible properties, which make it fit for broad biomedical applications. In this context, the incorporation of nanosized objects into SF allows the development of a variety of bionanocomposites with tailored properties and functions. Herein, we report a thorough investigation on the design, characterization, and biological evaluation of SF hydrogels incorporating gold, silver, or iron oxide nanoparticles. The latter are synthesized in aqueous media using a biocompatible ligand allowing their utilization in various biomedical applications. This ligand seems to play a pivotal role in nanoparticle dispersion within the hydrogel. Results show that the incorporation of nanoparticles does not greatly influence the mechanism of SF gelation and has a minor impact on the mechanical properties of the so-obtained bionanocomposites. By contrast, significant changes are observed in the swelling behavior of these materials, depending on the nanoparticle used. Interestingly, the main characteristics of these bionanocomposites, related to their potential use for biomedical purposes, show the successful input of nanoparticles, including antibacterial properties for gold and silver nanoparticles and magnetic properties for iron oxide ones.

Silk Polymers and Nanoparticles: A Powerful Combination for the Design of Versatile Biomaterials.

Silk fibroin (SF) is a natural protein largely used in the textile industry but also in biomedicine, catalysis, and other materials applications. SF is biocompatible, biodegradable, and possesses high tensile strength. Moreover, it is a versatile compound that can be formed into different materials at the macro, micro- and nano-scales, such as nanofibers, nanoparticles, hydrogels, microspheres, and other formats. Silk can be further integrated into emerging and promising additive manufacturing techniques like bioprinting, stereolithography or digital light processing 3D printing. As such, the development of methodologies for the functionalization of silk materials provide added value. Inorganic nanoparticles (INPs) have interesting and unexpected properties differing from bulk materials. These properties include better catalysis efficiency (better surface/volume ratio and consequently decreased quantify of catalyst), antibacterial activity, fluorescence properties, and UV-radiation protection or superparamagnetic behavior depending on the metal used. Given the promising results and performance of INPs, their use in many different procedures has been growing. Therefore, combining the useful properties of silk fibroin materials with those from INPs is increasingly relevant in many applications. Two main methodologies have been used in the literature to form silk-based bionanocomposites: in situ synthesis of INPs in silk materials, or the addition of preformed INPs to silk materials. This work presents an overview of current silk nanocomposites developed by these two main methodologies. An evaluation of overall INP characteristics and their distribution within the material is presented for each approach. Finally, an outlook is provided about the potential applications of these resultant nanocomposite materials.

Factores de riesgo nutricionales y culturales asociados a anemia en mujeres embarazadas en Somotillo / Nutritional and cultural risk factors associated with anemia in pregnant women in Somotillo / Fatores de risco nutricionais e culturais associados à anemia em mulheres grávidas em Somotillo

Objetivo: identificar los factores de riesgo nutricional y culturales asociados a anemia en mujeres embarazadas en Somotillo. Método: estudio de casos y controles anidados, con mujeres embarazadas entre agosto y noviembre de 2016 en centros de salud cabecera. Los factores se identificaron mediante el cálculo de odds ratio a través del programa estadístico SPSS versión 22. Resultados: la mayoría de las embarazadas se encuentran entre 14 a 24 años, con estado civil de unión libre, nivel académico universitario, en la ocupación amas de casa, con religión católica y procedencia urbana, con antecedente preconcepcional del IMC mayor de 23. Conclusión: se concluyó que de las variables nutricionales que se comportaron como factor de riesgo fue el no consumir los suplementos de ácido fólico y hierro, y de la variable de los factores culturales que se comportó como factor de riesgo fue el inapropiado consumo de tacos, pozol, chicha de maíz como alimentos de costumbre.

Objective: to identify nutritional and cultural risk factors associated with anemia in pregnant women in Somotillo. Method: study of nested cases and controls, with pregnant women between August and November of 2016 in health centers. Factors were identified by the calculation of odds ratio through the statistical program SPSS version 22. Results: the majority of pregnant women are between 14 and 24 years of age, with a marital status of free union, university academic level, occupation of housewives, with catholic religion and urban origin, with a preconceptional antecedent of the BMI greater than 23. Conclusion: it was concluded that of the nutritional variables that behaved as a risk factor was not to take supplements of folic acid and iron, and the variable of cultural factors that behaved as a risk factor was the inappropriate consumption of tacos, pozol, Corn chicha as usual food.

Objetivo: identificar os fatores de risco nutricional e culturais associados à anemia em mulheres grávidas em Somotillo. Método: estudo de caso-controle aninhado, com mulheres grávidas entre agosto e novembro de 2016, no centros primários de saúde. Os fatores foram identificados calculando odds ratio através SPSS 22. Resultados: a maioria das mulheres grávidas estão entre 14 e 24 anos, com estado civil de união livre, em nível acadêmico da universidade, na casa de ocupação amor com a religião católica e origem urbana, com a história de preconceito de IMC maior que 23. Conclusão: concluiu-se que as variáveis nutricionais que se comportaram como fator de risco foi o não consumo dos suplementos de ácido fólico e ferro, e da variável dos fatores culturais que se comportaram como um fator de risco foi o inapropriado consumo de tacos, pozol, chicha de milho como alimentos de costume.

Tratamento atípico da biprotrusão dentoalveolar / Atipical treatment of dentoalveolar biprotrusion ­ a case report

A biprotrusão dentoalveolar é caracterizada pelo posicionamento mais anterior dos incisivos superiores e inferiores, o que traz como consequência um selamento labial deficiente e um perfil convexo, comprometendo a estética facial do paciente e fazendo com que este busque no tratamento ortodôntico a sua correção. O plano de tratamento destes casos, na sua maioria, envolve a realização de extrações, porém, quando já previamente ao tratamento o paciente apresenta ausências dentárias, o planejamento é simplificado, já que a retração anterior necessária pode ser direcionada para estes espaços sem que haja necessidade de extrações nestas regiões. O objetivo deste trabalho foi apresentar um caso clínico que promoveu a correção da biprotrusão e, consequentemente, da estética do sorriso e facial da paciente, através da realização da exodontia de apenas dois primeiros pré-molares superiores e retração anteroinferior redirecionada para os espaços já existentes, em consequência da perda do molar inferior esquerdo e devido à agenesia do incisivo lateral inferior direito. Além disso, no controle de sete anos pós-tratamento, observou-se estabilidade oclusal e manutenção da estética facial.

Dental biprotrusion is characterized by greater buccal tipping of the upper and lower incisors, rendering poor lip closure and convex profile, compromising the patient's facial esthetics and making him/her to seek orthodontic treatment for correction. In these cases the treatment plan, mostly involves performing extractions, but when already prior to treatment the patient has missing teeth, the treatment plan becomes simplified, since the anterior retraction required might be directed to these areas with no need for removal. The goal of this study is to show a case that promoted the correction of biprotrusion and consequently the patient smile and facial esthetics by performing the extraction of only two first maxillary premolars and anterior retraction redirected for the existing spaces as a result of the mandibular left molar loss and due to agenesis of the right lateral incisor. In addition, the 7-year follow-up control demonstrated occlusal stability and maintenance of the facial esthetics.

Mordida cruzada posterior invertida – tratamento em paciente adulto / Reverse posterior crossbite: treatment of an adult patient

A mordida cruzada posterior invertida, também conhecida como “Síndrome de Brodie” ou “mordida em tesoura”, caracteriza-se pela relação transversal posterior acentuada, com excesso de vestibularização dos molares superiores e/ou excesso de lingualização dos molares inferiores, uni ou bilateralmente. Este tipo de má oclusão pode ser corrigido com tratamento ortodôntico, cirúrgico ou de uma maneira combinada, dependendo de sua origem: dentoalveolar ou esquelética e da fase em que se realiza o tratamento. A terapia ortodôntica geralmente relaciona-se à utilização de elásticos interarcos cruzados, necessitando de muita colaboração por parte dos pacientes quanto ao uso. E a terapia cirúrgica nem sempre é aceita pelo paciente. Deste modo, este trabalho apresenta uma abordagem simples e eficaz de tratamento ortodôntico da mordida cruzada posterior invertida em um paciente adulto, que possibilitou não só a correção da mordida cruzada posterior invertida como também a melhora da simetria facial.

The reversed posterior crossbite, also known as “Brodie Syndrome” or scissors-bite”, is characterized by posterior transverse relationship with excessive buccal tipping of maxillary molars and / or excessive lingual tipping of mandibular molars, unilaterally or bilaterally. These malocclusions can be corrected with orthodontic treatment, surgery or a combined manner, depending on their etiology: dentoalveolar or skeletal, and the stage at which treatment takes place. The orthodontic treatment generally relates to the use of interarch cross elastic, requiring a lot of cooperation from patients about the use of elastics, and patients often refuse a surgical therapy. Thus, this paper presents a simple and effective approach to orthodontic treatment of reversed posterior crossbite in an adult patient, which allowed not only the correction of reversed posterior crossbite as well as the improvement of facial symmetry.

Biocompatibility of intracortical microelectrodes: current status and future prospects.

Rehabilitation of sensory and/or motor functions in patients with neurological diseases is more and more dealing with artificial electrical stimulation and recording from populations of neurons using biocompatible chronic implants. As more and more patients have benefited from these approaches, the interest in neural interfaces has grown significantly. However an important problem reported with all available microelectrodes to date is long-term viability and biocompatibility. Therefore it is essential to understand the signals that lead to neuroglial activation and create a targeted intervention to control the response, reduce the adverse nature of the reactions and maintain an ideal environment for the brain-electrode interface. We discuss some of the exciting opportunities and challenges that lie in this intersection of neuroscience research, bioengineering, neurology and biomaterials.