Nearly Complete Genome Sequences of Enterovirus 96 and Enterovirus 99 Strains Isolated in the Northern Region of Brazil.

In this study, we report the nearly complete genome sequences of one enterovirus 96 (EV-C96) isolate (strain 3499/BRA-PA/2010) and two enterovirus 99 (EV-C99) isolates (strains 3291/BRA-PA/2010 and 3944/BRA-PA/2011). The genetic characterization of different enterovirus strains allows for a better understanding of their molecular epidemiology and viral evolution.

Natural infection by Culex flavivirus in Culex quinquefasciatus mosquitoes captured in Cuiabá, Mato Grosso Mid-Western Brazil.

New species of insect-specific viruses (ISV) have been reported worldwide. In the present study, the complete genome of Culex flavivirus (CxFV) and partial sequences of other ISVs in Culex quinquefasciatus Say 1823 females (n = 3425) sampled in 200 urban areas census tracts of Cuiaba, state of Mato Grosso, were identified via reverse transcriptase-polymerase chain reaction for a NS5 region of flaviviruses, nucleotide and high-throughput sequencing, and viral isolation in C6/36 cells. CxFV was detected in 16 of 403 mosquito pools; sequences found in the study presented a high similarity with isolates from São Paulo, Brazil and other countries in Latin American that belong to genotype II, supporting the geographical influence on CxFV evolution. The monthly maximum likelihood estimation for CxFV ranged from 1.81 to 9.94 per 1000 mosquitoes. In addition to the CxFV complete genome, one pool contained an ORF1 sequence (756 bp) that belongs to a novel Negevirus from the Sandewavirus supergroup most similar to the Santana virus (77.1%) and another pool presented an RNA-dependent RNA polymerase sequence (1081 bp) of a novel Rhabdovirus most similar to Wuhan mosquito virus 9 (44%). After three passages in C6/36 cells, only CxFV was isolated from these co-infected pools. The importance of ISVs relies on their possible ability to interfere with arbovirus replication in competent vectors.

Author Correction: Comparison of 1D and 3D Models for the Estimation of Fractional Flow Reserve.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.

Comparison of 1D and 3D Models for the Estimation of Fractional Flow Reserve.

In this work we propose to validate the predictive capabilities of one-dimensional (1D) blood flow models with full three-dimensional (3D) models in the context of patient-specific coronary hemodynamics in hyperemic conditions. Such conditions mimic the state of coronary circulation during the acquisition of the Fractional Flow Reserve (FFR) index. Demonstrating that 1D models accurately reproduce FFR estimates obtained with 3D models has implications in the approach to computationally estimate FFR. To this end, a sample of 20 patients was employed from which 29 3D geometries of arterial trees were constructed, 9 obtained from coronary computed tomography angiography (CCTA) and 20 from intra-vascular ultrasound (IVUS). For each 3D arterial model, a 1D counterpart was generated. The same outflow and inlet pressure boundary conditions were applied to both (3D and 1D) models. In the 1D setting, pressure losses at stenoses and bifurcations were accounted for through specific lumped models. Comparisons between 1D models (FFR1D) and 3D models (FFR3D) were performed in terms of predicted FFR value. Compared to FFR3D, FFR1D resulted with a difference of 0.00 ± 0.03 and overall predictive capability AUC, Acc, Spe, Sen, PPV and NPV of 0.97, 0.98, 0.90, 0.99, 0.82, and 0.99, with an FFR threshold of 0.8. We conclude that inexpensive FFR1D simulations can be reliably used as a surrogate of demanding FFR3D computations.

Avaliação clínica inicial de novo balão farmacológico com sirolimus e nano partículas no tratamento de lesões reestenóticas / Initial clinical evaluation of a new sirolimus and nanoparticle pharmacological balloon in the treatment of restenosis lesions

INTRODUÇÃO: Recentemente, o conceito dos chamados balões farmacológicos tem sido testado no tratamento da reestenose intra stent, como uma alternativa de tratamento sem implante adicional de outra camada de metal no sítio previamente tratado. Ainda que os balões farmacológicos com paclitaxel tenham se mostrado eficazes para esta finalidade, esta tecnologia ainda apresenta alguns desafios: o paclitaxel é sabidamente menos efetivo e mais tóxico que outros fármacos anti-proliferativos, em especial quando comparado ao sirolimus e seus análogos/derivados. No presente estudo avaliamos um novo balão-farmacológico (Magic Touch), que utiliza sirolimus na dose de 1,27µg/mm2 , depositado em solução excipiente (nano partícula), na concentração de 1:1. MÉTODOS: Estudo prospectivo, multicêntrico, de braço único, incluindo pacientes com reestenose tanto de stents nãofarmacológicos como farmacológicos, tratados com balão Magic Touch. Não foram incluídas reestenoses do tipo oclusiva. Os pacientes foram submetidos a avaliação angiográfica e com ultrassom (USIC) aos seis meses. O desfecho primário foi a avaliação do grau de supressão neointinamal aos seis meses pela angiografia (perda luminal) e USIC (% de obstrução luminal). RESULTADO: Um total de 17 pacientes foram incluídos, sendo a maioria do sexo masculino (59%), com média de idade de 58 anos e com 60% de diabéticos. Metade da população tratada apresentava reestenose de stents farmacológicos e em 62% dos casos a reestenose era do tipo difusa/proliferativa. Sucesso angiográfico foi obtido em 100% dos casos. Aos 6 meses, a mediana da perda luminal tardia intra stent foi de 0,21mm [0,07; 0,51] ao passo que ao USIC, o% de obstrução luminal foi de 20% [18; 24]. Do ponto de vista clínico, ocorreu apenas um óbito, de causa não cardíaca. CONCLUSÃO: Neste estudo inicial em humanos, o balão farmacológico com sirolimus e nano partículas mostrou-se eficaz em reduzir a proliferação neointimal em pacientes com reestenose prévia de stents não-farmacológicos e/ou farmacológicos. (AU)

Fast method for the determination of short-chain-length polyhydroxyalkanoates (scl-PHAs) in bacterial samples by In Vial-Thermolysis (IVT).

A new method based on the GC-MS analysis of thermolysis products obtained by treating bacterial samples at a high temperature (above 270°C) has been developed. This method, here named "In-Vial-Thermolysis" (IVT), allowed for the simultaneous determination of short-chain-length polyhydroxyalkanoates (scl-PHA) content and composition. The method was applied to both single strains and microbial mixed cultures (MMC) fed with different carbon sources. The IVT procedure provided similar analytical performances compared to previous Py-GC-MS and Py-GC-FID methods, suggesting a similar application for PHA quantitation in bacterial cells. Results from the IVT procedure and the traditional methanolysis method were compared; the correlation between the two datasets was fit for the purpose, giving a R2 of 0.975. In search of further simplification, the rationale of IVT was exploited for the development of a "field method" based on the titration of thermolyzed samples with sodium hydrogen carbonate to quantify PHA inside bacterial cells. The accuracy of the IVT method was fit for the purpose. These results lead to the possibility for the on-line measurement of PHA productivity. Moreover, they allow for the fast and inexpensive quantification/characterization of PHA for biotechnological process control, as well as investigation over various bacterial communities and/or feeding strategies.

Establishment and cryptic transmission of Zika virus in Brazil and the Americas.

Transmission of Zika virus (ZIKV) in the Americas was first confirmed in May 2015 in northeast Brazil. Brazil has had the highest number of reported ZIKV cases worldwide (more than 200,000 by 24 December 2016) and the most cases associated with microcephaly and other birth defects (2,366 confirmed by 31 December 2016). Since the initial detection of ZIKV in Brazil, more than 45 countries in the Americas have reported local ZIKV transmission, with 24 of these reporting severe ZIKV-associated disease. However, the origin and epidemic history of ZIKV in Brazil and the Americas remain poorly understood, despite the value of this information for interpreting observed trends in reported microcephaly. Here we address this issue by generating 54 complete or partial ZIKV genomes, mostly from Brazil, and reporting data generated by a mobile genomics laboratory that travelled across northeast Brazil in 2016. One sequence represents the earliest confirmed ZIKV infection in Brazil. Analyses of viral genomes with ecological and epidemiological data yield an estimate that ZIKV was present in northeast Brazil by February 2014 and is likely to have disseminated from there, nationally and internationally, before the first detection of ZIKV in the Americas. Estimated dates for the international spread of ZIKV from Brazil indicate the duration of pre-detection cryptic transmission in recipient regions. The role of northeast Brazil in the establishment of ZIKV in the Americas is further supported by geographic analysis of ZIKV transmission potential and by estimates of the basic reproduction number of the virus.

Complete Genome Sequence of the BeAn 58058 Virus Isolated from Oryzomys sp. Rodents in the Amazon Region of Brazil.

Here, we report the complete genome sequence of the BeAn 58058 virus (prototype) strain, isolated from a wild rodent Oryzomys sp. in the Utinga forest, Belém, state of Pará, Brazil in 1963. The genome of this virus showed similarity to the Poxviridae family, suggesting its inclusion in a possible new genus.

Caesarean delivery in a pregnant woman with epidermolysis bullosa: anaesthetic challenges.

Epidermolysis bullosa is a heterogeneous group of hereditary diseases characterised by extreme fragility of skin and mucosa, with blister and lesion formation spontaneously or in response to trauma. Anaesthetic management of these patients is challenging with respect to positioning, monitoring, use of medical devices and airway management. These challenges are increased when managing labour. We report an elective caesarean delivery in a nulliparous woman with autosomal recessive dystrophic epidermolysis bullosa, managed successfully with spinal anaesthesia.

A head-to-head comparison between CT- and IVUS-derived coronary blood flow models.

The goal of this work is to compare coronary hemodynamics as predicted by computational blood flow models derived from two imaging modalities: coronary computed tomography angiography (CCTA) and intravascular ultrasound integrated with angiography (IVUS). Criteria to define boundary conditions are proposed to overcome the dissimilar anatomical definition delivered by both modalities. The strategy to define boundary conditions is novel in the present context, and naturally accounts for the flow redistribution induced by the resistance of coronary vessels. Hyperemic conditions are assumed to assess model predictions under stressed hemodynamic environments similar to those encountered in Fractional Flow Reserve (FFR) calculations. As results, it was found that CCTA models predict larger pressure drops, higher average blood velocity and smaller FFR. Concerning the flow rate at distal locations in the major vessels of interest, it was found that CCTA predicted smaller flow than IVUS, which is a consequence of a larger sensitivity of CCTA models to coronary steal phenomena. Comparisons to in-vivo measurements of FFR are shown.

A computational framework to characterize and compare the geometry of coronary networks.

This work presents a computational framework to perform a systematic and comprehensive assessment of the morphometry of coronary arteries from in vivo medical images. The methodology embraces image segmentation, arterial vessel representation, characterization and comparison, data storage, and finally analysis. Validation is performed using a sample of 48 patients. Data mining of morphometric information of several coronary arteries is presented. Results agree to medical reports in terms of basic geometric and anatomical variables. Concerning geometric descriptors, inter-artery and intra-artery correlations are studied. Data reported here can be useful for the construction and setup of blood flow models of the coronary circulation. Finally, as an application example, similarity criterion to assess vasculature likelihood based on geometric features is presented and used to test geometric similarity among sibling patients. Results indicate that likelihood, measured through geometric descriptors, is stronger between siblings compared with non-relative patients. Copyright © 2016 John Wiley & Sons, Ltd.

Crude glycerol as feedstock for polyhydroxyalkanoates production by mixed microbial cultures.

The increase in global biodiesel production makes imperative the development of sustainable processes for the use of its main by-product, crude glycerol. In this study the feasibility of polyhydroxyalkanoates (PHA) production by a mixed microbial community using crude glycerol as feedstock was investigated. The selected culture had the ability to consume both glycerol and methanol fraction present in the crude. However, glycerol seemed to be the only carbon source contributing for the two biopolymers stored: poly-3-hydroxybutyrate (PHB) and glucose biopolymer (GB). In this work the culture reached a maximum PHB content of 47% (cdw) and a productivity of 0.27 g X/L.d, with an aerobic mixed cultures and a real waste substrate with non-volatile fatty acids (VFA) organic matter. The overall PHA yield on total substrate obtained was in the middle range of those reported in literature. The fact that crude glycerol can be used to produce PHA without any pre-treatment step, makes the overall production process economically more competitive, reducing polymer final cost.

CMA y financiación: una perspectiva internacional / Financing Day Surgery - an international perspective

La financiación de la cirugía ambulatoria es una cuestión clave para el desarrollo de esta modalidad asistencial en todo el mundo. Enviamos un cuestionario sobre aspectos económicos a diferentes países, especialmente a los países miembros de la International Association for Ambulatory Surgery (IAAS). El cuestionario se centraba sobre aspectos generales de la financiación del Sistema Nacional de Salud, costes corrientes, costes labores y de personal y sobre el sistema de financiación para una serie de procesos de cirugía sin ingreso. Dieciocho de veintinueve países (62,1 %) contestaron el cuestionario. Los países que participaron en el estudio presentaban datos económicos y de riqueza muy heterogéneos. Sin embargo, como regla general, los países mantuvieron la misma posición relativa en el estudio: es cierto que los países más ricos presentan costes mayores, pero al mismo tiempo financian mejor los procesos quirúrgicos que los países pobres. Más aún, los países con un estímulo económico institucional hacia la cirugía ambulatoria (Dinamarca, Reino Unido, etc.) presentan tasas más altas de cirugía sin ingreso comparados con países en los que no hay ningún estímulo, como Alemania. Hay significativos ahorros potenciales, además de otras ventajas, cuando el Sistema Nacional de Salud fomenta la cirugía sin ingreso a través de estímulos económicos (AU)

Financing day surgery activity is critical for the development of day surgery programmes all over the world. A questionnaire on economical issues was sent to several countries of the world, especially to those countries that are members of the International Association for Ambulatory Surgery (IAAS).The questionnaire asked for general information about financing national health services , costs of current needs, costs of labour and health staff, and the reimbursement system for a list of common surgical procedures undertaken on a day surgery basis, whatever the surgical regimen used. Eighteen out of 29 countries (62.1%) answered the questionnaire. There was a great heterogeneity in the wealth and the economic potential of the countries involved. However, usually the countries do maintain their relative position for different purposes: those that are wealthier have increased costs, but do reimburse better the surgical activity than those countries that are poorer. More importantly, those countries that have a strong financial incentive (e.g., Denmark, United Kingdom, etc) achieve a high percentage of day surgery activity compared to other countries where there is no financial incentive at all towards this surgical regimen, as in Germany. There are significant potential savings among other advantages when NHS maximize day surgery practice through financial incentives (AU)