Frequency of isolation and phenotypic antimicrobial resistance of fecal Salmonella enterica recovered from dairy cattle in Canada.

Salmonellosis is one of the leading causes of gastrointestinal infections in humans. In Canada, it is estimated that approximately 87,500 cases of salmonellosis occur every year in humans, resulting in 17 deaths. In the United States, it is estimated that 26,500 hospitalizations and 420 deaths occur every year. In dairy cattle, infections caused by nontyphoidal Salmonella enterica can cause mild to severe disease, including enteritis, pneumonia, and septicemia. Our study objectives were to determine the proportion of fecal samples positive for Salmonella in dairy cattle in Canada and determine the resistance pattern of these isolates. We used data collected through the Canadian Dairy Network for Antimicrobial Stewardship and Resistance (CaDNetASR). Pooled fecal samples from preweaning calves, postweaning heifers, lactating cows, and manure storage were cultured for Salmonella, and the isolates were identified using matrix-assisted laser desorption/ionization-time of flight mass spectrometry. Antimicrobial susceptibilities were determined using the minimum inhibitory concentration test, and resistance interpretation was made according to the Clinical and Laboratory Standards Institute. A 2-level, multivariable logistic regression model was built to determine the probability of recovering Salmonella from a sample, accounting for province, year, and sample source. The proportion of farms with at least one positive sample were 12% (17/140), 19% (28/144), and 17% (24/144) for the sampling years 2019, 2020, and 2021, respectively. Out of the 113 Salmonella isolates, 23 different serovars were identified. The occurrence of Salmonella appeared to be clustered by farms and provinces. The most common serovars identified were Infantis (14%) and Typhimurium (14%). Overall, 21% (24/113) of the Salmonella isolates were resistant to at least one antimicrobial. Resistance to tetracycline was commonly observed (17%); however, very limited resistance to category I antimicrobials (categorization according to Health Canada that includes third-generation cephalosporins, fluoroquinolones, polymyxins, and carbapenems) was observed, with one isolate resistant to amoxicillin and clavulanic acid. The proportion of Salmonella isolates resistant to 2 and 3 antimicrobial classes was 3.5% and 8.8%, respectively. Our study provided valuable information on the proportion of fecal samples positive for Salmonella, the serovars identified, and the associated resistance patterns across CaDNetASR herds, at regional and national levels.

Short-term complications after onlay versus preperitoneal mesh repair of umbilical hernias: a prospective randomized double-blind trial.

PURPOSE: To compare the incidence of surgical site occurrences (SSOs) following onlay versus preperitoneal mesh placement in elective open umbilical hernia repairs. METHODS: This study presents a secondary analysis of a randomized double-blind trial conducted on female patients with primary umbilical hernias admitted to a general hospital, in a residency training program setting. Fifty-six subjects were randomly assigned to either onlay (n=30) or preperitoneal (n=26) mesh repair group. Data on baseline demographics, past medical history, perioperative details, postoperative pain (visual analogue scale (VAS)), wound-related complications, and recurrence were assessed using a standardized protocol. RESULTS: No statistically significant differences were observed between groups regarding patients' demographics, comorbidities, or defect size. Operative time averaged 67.5 (28-110) min for onlay and 50.5 (31-90) min for preperitoneal repairs, p=.03. The overall rate of SSOs was 21.4% (n=12), mainly in the onlay group (33% vs 7.7%; p=0.02, 95% CI 0.03-0.85) and mostly due to seromas. There were no between-group significant differences in postoperative VAS scores at all timepoints. After a maximum follow-up of 48 months, one recurrence was reported in the onlay group. By logistic regression, the onlay technique was the only independent risk factor for SSOs. CONCLUSION: The presented data identified a decreased wound morbidity in preperitoneal umbilical hernia repairs, thus contributing to the limited body of evidence regarding mesh place selection in future guidelines. Further cases from this ongoing study and completion of follow-up are expected to also compare both techniques in terms of long-term outcomes. TRIAL REGISTRATION NUMBER: Brazilian Registry of Clinical Trials (ReBEC) UTN code: U1111-1205-0065 (date of registration: March 27, 2018).

Prolene Hernia System Maximum Repair: A New Concept in Sports Hernia Surgery.

OBJECTIVE: To describe and present the clinical results of a new surgical treatment for sports hernia. DESIGN: Retrospective cohort study. SETTING: Tertiary hospital. PATIENTS: Athletes who underwent sports hernia repair using the proposed technique between July 2006 and June 2020. INTERVENTION: The surgery consists of a combination of a mini-open incision and preperitoneal placement of a three-dimensional bilayer permanent mesh (PHS). MAIN OUTCOME MEASURES: The main clinical outcomes of the procedure were reviewed, including incidence of complications, long-term results, and recurrence rate. RESULTS: Ninety-two sports hernia repairs were performed on 87 patients (79 male and 8 female patients, median age 30.2 ± 7.8 years). No intraoperative complications were observed. The mean follow-up was 15 months. Seventy-seven patients (88.5%) successfully resumed preinjury physical activities within 8 weeks; 80 patients (91.9%) within 12 weeks; and 83 (95.4%) within 6 months (median time of 10 weeks). Only one patient reported recurrence of symptoms. CONCLUSION: Mini-open incision PHS repair seems to be a safe and effective method for treatment of sports hernia, resulting in early return to physical activities, with few complications, and low recurrence rate.

Encouraging outcomes of using a small-donor single graft in pediatric kidney transplantation.

BACKGROUND: The use of small pediatric kidneys as single grafts for transplantation is controversial, due to the potential risk for graft thrombosis and insufficient nephron mass. METHODS: Aiming to test the benefits of transplanting these kidneys, 375 children who underwent kidney transplantation in a single center were evaluated: 49 (13.1%) received a single graft from a small pediatric donor (≤ 15 kg, SPD group), 244 (65.1%) from a bigger pediatric donor (> 15 kg, BPD group), and 82 (21.9%) from adult living donors (group ALD). RESULTS: Groups had similar baseline main characteristics. After 5 years of follow-up, children from the SPD group were comparable to children from BPD and ALD in patient survival (94%, 96%, and 98%, respectively, p = 0.423); graft survival (89%, 88%, and 93%, respectively, p = 0.426); the frequency of acute rejection (p = 0.998); the incidence of post-transplant lymphoproliferative disease (p = 0.671); the odds ratio for severely increased proteinuria (p = 0.357); the rates of vascular thrombosis (p = 0.846); and the necessity for post-transplant surgical intervention prior to discharge (p = 0.905). The longitudinal evolution of eGFR was not uniform among groups. The three groups presented a decrease in eGFR, but the slope of the curve was steeper in ALD children. At 5 years, the eGFR of the ALD group was 10 ml/min/1.73m2 inferior to the others. At that time, the eGFR from the SPD group was statistically similar to the BPD group (p = 0.952). CONCLUSION: In a specialized transplant center, the use of a single small pediatric donor kidney for transplantation is as successful as bigger pediatric or adult living donors, after 5 years of follow-up. A higher resolution version of the Graphical abstract is available as Supplementary information.

The relation of the multifocal electroretinographic response to macular layer volume.

PURPOSE: To determine the association of the multifocal electroretinographic (mfERG) response amplitude with the volumes of the inner, postreceptor, and photoreceptor retinal layers in the region stimulated by each mfERG element. METHODS: Sixteen healthy, young adult control subjects were studied. Each of the 103 hexagonal elements of the standard, scaled mfERG were aligned, where possible, with patches of retina imaged using optical coherence tomography. Stimuli falling on the fovea and on the optic nerve head were excluded. Linear mixed-effects modeling was then used to derive estimated coefficients (voltage/volume) for the mfERG response throughout the full 80 ms standard epoch. The resulting predicted response amplitudes originating in each layer were then compared to pharmacologically "dissected" mfERGs obtained from other studies in monkey eyes. RESULTS: Across the duration of the response, the amplitude of the modeled contribution from (1) the inner retina was small-to-modest, (2) the postreceptor retina was larger and contained two prominent peaks, and (3) the photoreceptor response was the largest and most closely paralleled the overall (i.e., intact) response, including late-appearing oscillations. The significance of each layer's contribution was greatest when the absolute amplitude of that layer's response was largest. The contribution of the inner retina was maximally significant in the interval between the prominent troughs and peaks of the intact response. The contributions of the postreceptor and photoreceptor responses were maximally significant at the prominent troughs and peaks of the intact response. CONCLUSIONS: The results of the model were in good overall agreement with previous interpretations of the cellular contributions to the mfERG. There was also fair agreement with pharmacologically dissected monkey mfERG responses. Thus, the estimations of the contributions of the retinal layers to the mfERG so produced appeared plausible.

Isolated subcutaneous emphysema of the abdominal wall following endoscopic retrograde cholangiopancreatography.

Isolated subcutaneous emphysema without retroperitoneal perforation is a rare complication of endoscopic retrograde cholangiopancreatography (ERCP). We present the case of an 87-year-old female who developed extensive subcutaneous emphysema following ERCP for choledocholithiasis. Abdominal computed tomography showed air perfectly dissecting the abdominal wall muscle layers and no evidence of an air leak in the pleural, mediastinal, or peritoneal spaces.

EVALUATION OF A LARYNGEAL MASK AIRWAY AS AN ALTERNATIVE TO OROTRACHEAL INTUBATION FOR MAINTAINING AIRWAY PATENCY DURING INHALANT ANESTHESIA UNDER SPONTANEOUS VENTILATION IN CAPYBARAS (HYDROCHOERUS HYDROCHAERIS).

Orotracheal intubation carries greater difficulty in rodents than in most domestic species. The human laryngeal mask airway (LMA) was compared with an endotracheal tube (ETtube) for maintaining airway patency in anesthetized capybaras (Hydrochoerus hydrochaeris). Six capybaras (24-52 kg) were remotely darted with intramuscular ketamine, midazolam, and acepromazine on two occasions (≥7-day intervals). After isoflurane mask induction for random placement of an ETtube or a LMA during each episode, anesthesia was maintained with isoflurane in oxygen under spontaneous ventilation for 90-120 min. Computed tomography of the pharynx and larynx was performed in two of six animals and three of six animals with the ETtube and LMA, respectively. End-tidal isoflurane [median (range)] was not significantly different between ETtube [0.6% (0.5-1.5%)] and LMA [0.6% (0.4-0.9%)]. Heart rate [67 ± 11 beats/min (ETtube) and 67 ± 18 beats/min (LMA)], mean arterial pressure [74 ± 13 mm Hg (ETtube) and 74 ± 14 mm Hg (LMA)], arterial CO2 tension [41 ± 2 mm Hg (ETtube) and 43 ± 4 mm Hg (LMA)], and arterial O2 tension [360 ± 59 mm Hg (ETtube) and 360 ± 63 mm Hg (LMA)] were not significantly different between treatment groups. Computed tomography showed gas in the esophagus with the LMA (three of three animals); the fit of the LMA to the larynx was adequate in two of three animals and fair in one of three animals. Recovery from anesthesia was uneventful. The LMA is a feasible alternative to the ETtube for maintaining airway patency during inhalant anesthesia in spontaneously breathing capybaras. However, the LMA may be dislodged during movement of the animal.

The efficacy of hepatitis B treatments in achieving HBsAg seroclearance: A systematic review and meta-analysis.

Current therapies for chronic hepatitis B (CHB) include nucleos(t)ide analogues (NAs) and interferon (IFN), but their relative efficacy as monotherapy or in combination has not been examined systematically for HBsAg loss (functional cure). Hence, we systematically reviewed the evidence for HBsAg loss in CHB patients treated with IFN, NA or the combination. We searched PubMed, EMBASE and abstracts from EASL, Asia Pacific Association for study of the Liver and American Association for the Study of Liver Disease for randomized controlled trials of CHB patients, comparing NA, IFN or the combination. The Cochrane Risk of Bias tool v2.0 and GRADE method were used. Analyses were stratified by NA genetic barrier, cirrhosis, type of combination therapy, HBeAg, treatment naivety, IFN dosage/duration and outcome duration. Sensitivity analysis was performed for selected strata, and HBsAg loss was measured at the end-of-study (EOS), end-of-treatment (EOT) or end-of-follow-up (EOF). Effects were reported as risk differences (RD) with 95% confidence intervals (CI) using a random-effects model. Forty-five studies were included, all with low risk of bias. For HBsAg loss at EOS, when comparing combination vs IFN, RD = 1%, 95%CI-1%, 2%; combination vs NA, RD = 5%, 95%CI 3%,7%; IFN vs NA, RD = 3%, 95%CI 2%,5%. Subgroup analysis showed a significant effect of standard IFN dose vs nonstandard; IFN duration ≥48 weeks vs <48 weeks, and loss of efficacy >2 years of follow-up. Similar findings were seen in HBsAg seroconversion, but only three studies reported HBsAg seroreversion. In conclusion, IFN monotherapy/combination had a small but significant increase in HBsAg loss over NA, associated with standard dose of IFN and ≥48 weeks of therapy, although this effect faded over time.

A possible solution to model nonlinearity in elimination and distributional clearances with α2 -adrenergic receptor agonists: Example of the intravenous detomidine and methadone combination in sedated horses.

The alpha(α)2 -agonist detomidine is used for equine sedation with opioids such as methadone. We retrieved the data from two randomized, crossover studies where detomidine and methadone were given intravenously alone or combined as boli (STUDY 1) (Gozalo-Marcilla et al., 2017, Veterinary Anaesthesia and Analgesia, 2017, 44, 1116) or as 2-hr constant rate infusions (STUDY 2) (Gozalo-Marcilla et al., 2019, Equine Veterinary Journal, 51, 530). Plasma drug concentrations were measured with a validated tandem Mass Spectrometry assay. We used nonlinear mixed effect modelling and took pharmacokinetic (PK) data from both studies to fit simultaneously both drugs and explore their nonlinear kinetics. Two significant improvements over the classical mammillary two-compartment model were identified. First, the inclusion of an effect of detomidine plasma concentration on the elimination clearances (Cls) of both drugs improved the fit of detomidine (Objective Function Value [OFV]: -160) and methadone (OFV: -132) submodels. Second, a detomidine concentration-dependent reduction of distributional Cls of each drug further improved detomidine (OFV: -60) and methadone (OFV: -52) submodel fits. Using the PK data from both studies (a) helped exploring hypotheses on the nonlinearity of the elimination and distributional Cls and (b) allowed inclusion of dynamic effects of detomidine plasma concentration in the model which are compatible with the pharmacology of detomidine (vasoconstriction and reduction in cardiac output).

Structural and Thermal Behavior of Meglumine-Based Supra-Amphiphiles in Bulk and Assembled in Water.

Supra-amphiphiles are a new class of building blocks that are fabricated by means of noncovalent forces. In this work, we studied the formation of supra-amphiphiles by combining hydrophilic meglumine (MEG) with hydrophobic maleated castor oils (MACO). Spectroscopic analysis demonstrated that ionic interactions are the main driving force in the fabrication of these materials. Subsequently, supra-amphiphile/water systems were examined for their structure and water behavior by polarized optical microscopy (POM), small-angle X-ray scattering (SAXS), and differential scanning calorimetry (DSC). Micellar and lamellar liquid crystalline phases were observed. Finally, we observed that the supra-amphiphiles produced using an excess of MEG retain a large amount of water. As bound water plays an important role in biointerfacial interactions, we anticipate that these materials will display a pronounced potential for biomedical applications.

Denervation impairs regeneration of amputated zebrafish fins.

BACKGROUND: Zebrafish are able to regenerate many of its tissues and organs after damage. In amphibians this process is regulated by nerve fibres present at the site of injury, which have been proposed to release factors into the amputated limbs/fins, promoting and sustaining the proliferation of blastemal cells. Although some candidate factors have been proposed to mediate the nerve dependency of regeneration, the molecular mechanisms involved in this process remain unclear. RESULTS: We have used zebrafish as a model system to address the role of nerve fibres in fin regeneration. We have developed a protocol for pectoral fin denervation followed by amputation and analysed the regenerative process under this experimental conditions. Upon denervation fins were able to close the wound and form a wound epidermis, but could not establish a functional apical epithelial cap, with a posterior failure of blastema formation and outgrowth, and the accumulation of several defects. The expression patterns of genes known to be key players during fin regeneration were altered upon denervation, suggesting that nerves can contribute to the regulation of the Fgf, Wnt and Shh pathways during zebrafish fin regeneration. CONCLUSIONS: Our results demonstrate that proper innervation of the zebrafish pectoral fin is essential for a successful regenerative process, and establish this organism as a useful model to understand the molecular and cellular mechanisms of nerve dependence, during vertebrate regeneration.

Differentiated skeletal cells contribute to blastema formation during zebrafish fin regeneration.

The origin of cells that generate the blastema following appendage amputation has been a long-standing question in epimorphic regeneration studies. The blastema is thought to originate from either stem (or progenitor) cells or differentiated cells of various tissues that undergo dedifferentiation. Here, we investigate the origin of cells that contribute to the regeneration of zebrafish caudal fin skeletal elements. We provide evidence that the process of lepidotrichia (bony rays) regeneration is initiated as early as 24 hours post-amputation and that differentiated scleroblasts acquire a proliferative state, detach from the lepidotrichia surface, migrate distally, integrate into the blastema and dedifferentiate. These findings provide novel insights into the origin of cells in epimorphic appendage regeneration in zebrafish and suggest conservation of regeneration mechanisms between fish and amphibians.

[Profile of patients seen at an outpatient hypertension facility: are there gender differences?]. / Perfil de pacientes atendidos em um ambulatório de hipertensão arterial: há diferença entre sexos?

The objective of this study was to find out whether there are gender dierences regarding socio-demographic characteristics and associated risk factors in adults monitored in an outpatient hypertension facility. Retrospective analysis of records of patients seen at the outpatient hypertension clinic in 2009-2010, in a hospital specialized in cardiology, in southern Brazil. All patients were beneficiaries from the Brazilian Unified Healthcare System (SUS). The variables considered were socio-demographicprofile, anthropometric measurements and risk factors for hypertension. For statistical analysis, a signficance level of 5% (p < 0.05) was adopted. Of the 209 patient records assessed most belonged to female patients (66%), 65.9% of them were married 71.6% were white, with mean age 53.5 +/- 13.8 years, and 70.1% had a sedentary behavior Regarding risk factors, waist circumference and alcohol use were higher among men (p = 0.04). It was concluded that there was no gender difference concerning the assessed variables, except for the use of alcohol.

Polymersomes as the Next Attractive Generation of Drug Delivery Systems: Definition, Synthesis and Applications.

Polymersomes are artificial nanoparticles formed by the self-assembly process of amphiphilic block copolymers composed of hydrophobic and hydrophilic blocks. They can encapsulate hydrophilic molecules in the aqueous core and hydrophobic molecules within the membrane. The composition of block copolymers can be tuned, enabling control of characteristics and properties of formed polymersomes and, thus, their application in areas such as drug delivery, diagnostics, or bioimaging. The preparation methods of polymersomes can also impact their characteristics and the preservation of the encapsulated drugs. Many methods have been described, including direct hydration, thin film hydration, electroporation, the pH-switch method, solvent shift method, single and double emulsion method, flash nanoprecipitation, and microfluidic synthesis. Considering polymersome structure and composition, there are several types of polymersomes including theranostic polymersomes, polymersomes decorated with targeting ligands for selective delivery, stimuli-responsive polymersomes, or porous polymersomes with multiple promising applications. Due to the shortcomings related to the stability, efficacy, and safety of some therapeutics in the human body, polymersomes as drug delivery systems have been good candidates to improve the quality of therapies against a wide range of diseases, including cancer. Chemotherapy and immunotherapy can be improved by using polymersomes to deliver the drugs, protecting and directing them to the exact site of action. Moreover, this approach is also promising for targeted delivery of biologics since they represent a class of drugs with poor stability and high susceptibility to in vivo clearance. However, the lack of a well-defined regulatory plan for polymersome formulations has hampered their follow-up to clinical trials and subsequent market entry.

Applying enhanced recovery principles to emergency laparotomy in penetrating abdominal trauma: a case-matched study.

PURPOSE: The implementation of enhanced recovery after surgery programs (ERPs) has significantly improved outcomes within various surgical specialties. However, the suitability of ERPs in trauma surgery remains unclear. This study aimed to (1) design and implement an ERP for trauma laparotomy patients; (2) assess its safety, feasibility, and efficacy; and (3) compare the outcomes of the proposed ERP with conventional practices. METHODS: This case-matched study prospectively enrolled hemodynamically stable patients undergoing emergency laparotomy after penetrating trauma. Patients receiving the proposed ERP were compared to historical controls who had received conventional treatment from two to eight years prior to protocol implementation. Cases were matched for age, sex, injury mechanism, extra-abdominal injuries, and trauma scores. Assessment of intervention effects were modelled using regression analysis for outcome measures, including length of hospital stay (LOS), postoperative complications, and functional recovery parameters. RESULTS: Thirty-six consecutive patients were enrolled in the proposed ERP and matched to their 36 historical counterparts, totaling 72 participants. A statistically significant decrease in LOS, representing a 39% improvement in average LOS was observed. There was no difference in the incidence of postoperative complications. Opioid consumption was considerably lower in the ERP group (p < 0.010). Time to resumption of oral liquid and solid intake, as well as to the removal of nasogastric tubes, urinary catheters, and abdominal drains was significantly earlier among ERP patients (p < 0.001). CONCLUSION: The implementation of a standardized ERP for the perioperative care of penetrating abdominal trauma patients yielded a significant reduction in LOS without increasing postoperative complications. These findings demonstrate that ERPs principles can be safely applied to selected trauma patients.

3D Construction Printing Standing for Sustainability and Circularity: Material-Level Opportunities.

Three-dimensional Cementitious materials Printing (3DCP) is a cutting-edge technology for the construction industry. Three-dimensional printed buildings have shown that a well-developed automated technology can foster valuable benefits, such as a freeform architectural design without formworks and reduced human intervention. However, scalability, commercialization and sustainability of the 3DPC technology remain critical issues. The current work presents the ecological fragility, challenges and opportunities inherent in decreasing the 3DCP environmental footprint at a material level (cementitious materials and aggregates). The very demanding performance of printable mixtures, namely in a fresh state, requires high dosages of cement and supplementary cementitious materials (SCM). Besides the heavy carbon footprint of cement production, the standard SCM availability might be an issue, especially in the longer term. One exciting option to decrease the embodied CO2 of 3DCP is, for example, to incorporate alternative and locally available SCM as partial cement replacements. Those alternative SCM can be wastes or by-products from industries or agriculture, with no added value. Moreover, the partial replacement of natural aggregate can also bring advantages for natural resource preservation. This work has highlighted the enormous potential of 3DCP to contribute to reducing the dependence on Portland cement and to manage the current colossal wastes and by-products with no added value, shifting to a Circular Economy. Though LCA analysis, mixture design revealed a critical parameter in the environmental impact of 3DCP elements or buildings. Even though cement significantly affects the LCA of 3DCP, it is crucial to achieving adequate fresh properties and rheology. From the literature survey, mixtures formulated with alternative SCM (wastes or by-products) are still restricted to rice husk ash, Municipal Solid Waste ashes and recycled powder from construction and demolition wastes. Natural aggregate replacement research has been focused on recycled fine sand, mine tailing, copper tailing, iron tailing, ornamental stone waste, recycled glass, crumb rubber, rubber powder and granules, recycled PET bottles and steel slag. However, flowability loss and mechanical strength decrease are still critical. Research efforts are needed to find low-carbon cement replacements and mix-design optimization, leading to a more sustainable and circular 3DCP while ensuring the final product performance.

Three new naphthoquinones from the tubers of Sinningia mauroana.

Three new naphthoquinones, 5,6,7-trimethoxydunnione (1), 6,7-dimethoxy-α-dunnione (2), and 5,6,7-trimethoxydunniol (3) were isolated from the tubers of Sinningia mauroana Chautems, together with eleven known compounds: 5-hydroxy-6,7-dimethoxy-α-dunnione (4), 6-hydroxy-7-methoxy-α-dunnione (5), 7-hydroxy-6-methoxy-α-dunnione (6), cedrol (7), tectoquinone (8), plantainoside A (9), calceolarioside A (10), calceolarioside B (11), sanangoside (12), allo-calceolarioside A (13), and conandroside (14). The known compounds 4, 7-9 and 11-13 are being reported for the first time in this species. Hexane, ethyl acetate and ethanol extracts were tested for antioxidant activity by the ORAC-FL method, and the antioxidant capacity was measured as trolox equivalent (TE). The ethyl acetate (8808 µg TE g-1) and ethanol (7911 µg TE g-1) extracts showed high antioxidant capacity, while the hexane extract displayed weak antioxidant capacity (860 µg TE g-1).

Akkermansia muciniphila Encapsulated in Calcium-Alginate Hydrogelated Matrix: Viability and Stability over Aerobic Storage and Simulated Gastrointestinal Conditions.

Akkermansia muciniphila is considered a next-generation probiotic to be incorporated in new food and pharmaceutical formulations. Effective delivery systems are required to ensure high probiotic viability and stability during product manufacture, shelf-life, and post-consumption, namely, throughout digestion. Hydrogelated matrices have demonstrated promising potential in this dominion. Hence, this work aimed to evaluate the effect of a calcium-alginate hydrogelated matrix on A. muciniphila viability during 28-days refrigerated aerobic storage and when exposed to simulated gastrointestinal conditions, in comparison with that of free cells. Akkermansia muciniphila was successfully encapsulated in the calcium-alginate matrix via extrusion (60% encapsulation yield). Furthermore, encapsulated A. muciniphila exhibited high stability (a loss in viability lower than 0.2 log-cycle) after 28-days of refrigerated aerobic storage, maintaining its viability around 108 CFU/g. Prominently, as the storage time increased, encapsulated A. muciniphila revealed higher viability and stability regarding in vitro gastrointestinal conditions than free cells. This suggests that this encapsulation method may attenuate the detrimental effects of prolonged aerobic storage with a subsequent gastrointestinal passage. In conclusion, encapsulation via extrusion using a calcium-alginate hydrogelated matrix seems to be a promising and adequate strategy for safeguarding A. muciniphila from adverse conditions encountered during refrigerated aerobic storage and when exposed to the gastrointestinal passage.

Trauma surgery workforce in the state of Rio Grande do Sul, Brazil.

OBJECTIVE: to describe the current scope of certified trauma surgeons trained in the state of Rio Grande do Sul, including demographic data, geographic distribution, remuneration, and perspectives related to this specialty. METHOD: cross-sectional survey based on information collected through an electronic questionnaire sent to potential participants. RESULTS: the response rate was 64% (n=75). There was a predominance of males (72%) with a mean age of 43 years. Most surgeons graduated from the Hospital de Pronto Socorro de Porto Alegre, and work in referral centers for trauma surgery in the capital and metropolitan region. More than 60% did not have any other training in a surgical subspecialty, though only a third stated that trauma surgery is their main source of income. CONCLUSION: trauma centers are poorly distributed and most surgeons work in referral hospitals in the metropolitan region of Porto Alegre. Due to the lack of recognition, limited financial income and shift work patterns, the career in trauma surgery care is unattractive, with only one third of surgeons performing most of their activities in this specialty.