Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients.

PURPOSE: Although the prevalence of community-acquired respiratory bacterial coinfection upon hospital admission in patients with coronavirus disease 2019 (COVID-19) has been reported to be < 5%, almost three-quarters of patients received antibiotics. We aim to investigate whether procalcitonin (PCT) or C-reactive protein (CRP) upon admission could be helpful biomarkers to identify bacterial coinfection among patients with COVID-19 pneumonia. METHODS: We carried out a multicentre, observational cohort study including consecutive COVID-19 patients admitted to 55 Spanish intensive care units (ICUs). The primary outcome was to explore whether PCT or CRP serum levels upon hospital admission could predict bacterial coinfection among patients with COVID-19 pneumonia. The secondary outcome was the evaluation of their association with mortality. We also conducted subgroups analyses in higher risk profile populations. RESULTS: Between 5 February 2020 and 21 December 2021, 4076 patients were included, 133 (3%) of whom presented bacterial coinfection. PCT and CRP had low area under curve (AUC) scores at the receiver operating characteristic (ROC) curve analysis [0.57 (95% confidence interval (CI) 0.51-0.61) and 0.6 (95% CI, 0.55-0.64), respectively], but high negative predictive values (NPV) [97.5% (95% CI 96.5-98.5) and 98.2% (95% CI 97.5-98.9) for PCT and CRP, respectively]. CRP alone was associated with bacterial coinfection (OR 2, 95% CI 1.25-3.19; p = 0.004). The overall 15, 30 and 90 days mortality had a higher trend in the bacterial coinfection group, but without significant difference. PCT ≥ 0.12 ng/mL was associated with higher 90 days mortality. CONCLUSION: Our study suggests that measurements of PCT and CRP, alone and at a single time point, are not useful for ruling in or out bacterial coinfection in viral pneumonia by COVID-19.

From Cu(I) and Cu(I)-Cu(II) mixed-valence clusters to 2D Cu(II) and Cu(I) coordination polymers supported by a flexible bis-tetrazole organosulfur ligand.

Three coordination compounds from the reaction of copper(II) bromide with the flexible bis-tetrazole organosulfur ligand, 1,2-bis(1-methyl-1H-tetrazole-5-ylthio)ethane (bmtte) have been isolated and characterised. The identification of polymeric 2∞Cu2Br4(bmtte) (1), trinuclear [Cu3Br4(bmtte)2] (2) and tetranuclear [Cu2Br2(bmtte)]2 (3) compounds shows that the reaction conditions have a significant influence on the structure of the complexes formed. Moreover, two polymorphs of the 2D Cu(II)-coordination polymer 1 have been isolated and these crystallise in the monoclinic C2/m (1m) and the triclinic P1̄ (1t) space groups. The thermal stabilities and behaviour in aqueous media of compounds 1-3 were investigated along with the reactivity of compound 2 with CuBr2 and KI. The solid-state reaction between mixed-valence compound 2 with KI or the direct reaction of CuI and bmtte under microwave irradiation allowed the preparation of the polymeric 2∞Cu4I4(bmtte)2 (4). The redox behaviour of complexes 2 and 3 was analysed by cyclic voltammetry.

Cancer patients in Palliative Care: occurrences related to venipuncture and hypodermoclysis. / Pacientes oncológicos sob cuidados paliativos: ocorrências relacionadas à punção venosa e hipodermóclise.

OBJECTIVE: to identify the occurrences related to peripheral venipuncture and hypodermoclysis among patients hospitalized in a general hospital and in an exclusive hospital institution for the care of patients in palliative cancer care. METHOD: an observational, descriptive and multicenter study. The consecutive and non-probabilistic sample consisted of 160 cancer patients hospitalized in Palliative Care. The outcome variable corresponded to the occurrences and complications related to each type of puncture. A questionnaire containing the sociodemographic and clinical variables and a structured script for monitoring and daily evaluation of the puncture were used. Descriptive statistics were employed for data analysis. RESULTS: the occurrences related to venipuncture at a general hospital were blood soiling at catheter insertion (17.4%) and expired use period (15.8%), while at a specific service for the care of patients under palliative care they were expired use period (32%) followed by infiltration (18.9%). As for hypodermoclysis, there were two subcutaneous punctures with phlogistic signs (1.0%) at the general hospital and a hematoma at the catheter insertion site (0.5%). At the specific service for the care of patients under palliative care there were three subcutaneous punctures with phlogistic signs (5.7%). CONCLUSION: the number of occurrences related to peripheral venipuncture was higher than those related to hypodermoclysis.

Minimal invasive fluorescence methods to quantify advanced glycation end products (AGEs) in skin and plasma of humans.

Advanced glycation end products (AGEs) are non-enzymatic modifications of proteins and lipids, which are spontaneously produced in the body in relation with several human diseases. Their relevance on protein functions alteration, either structural or enzymatic is under study, but their value as biomarkers or predictors of disease progression and clinical outcomes is unquestionable. The heterogeneity and amplitude of these modifications make their analysis difficult, although, different methods have been developed for specific AGEs based on colorimetric reactions, immunoassays or chromatography. However, for a massive application on human population, methods based on the autofluorescence of some AGEs stand out. Several qualities of these methods such as label-free measurement, rapidity, cost-effectiveness, and minimal invasiveness make them very useful for periodic measurements in critically ill patients and for the analysis of large populations. Here we explain the rationale of these methods, and we present a step-by-step protocol and the equipment requirements to carry out the estimation of AGE content in skin and plasma. AGE plasma content and skin accumulation are temporally related, so AGE plasmatic levels are a possible predictor of skin AGE content. On the other hand, AGE skin accumulation is a surrogate or an indicator of past AGE levels in plasma and in the rest of the body. AGE levels or their variations have shown to be related with prognosis of several diseases, so they can be used as predictor biomarkers for clinicians.

Pacientes oncológicos sob cuidados paliativos: ocorrências relacionadas à punção venosa e hipodermóclise / Cancer patients in Palliative Care: occurrences related to venipuncture and hypodermoclysis / Pacientes con cáncer en cuidados paliativos: eventos relacionados con la venopunción y la hipodermoclisis

Resumo Objetivo: identificar as ocorrências relacionadas à punção venosa periférica e à hipodermóclise entre pacientes internados em um hospital geral e em um hospital exclusivo de assistência a pacientes em cuidados paliativos oncológicos. Método: estudo observacional, descritivo e multicêntrico. A amostra do tipo consecutiva e não probabilística foi constituída por 160 pacientes oncológicos internados sob cuidados paliativos. A variável desfecho correspondeu às ocorrências e complicações relacionadas a cada tipo de punção. Utilizou-se um questionário contendo as variáveis sociodemográficas e clínicas e um roteiro estruturado para acompanhamento e avaliação diária da punção. Foram utilizadas estatísticas descritivas para a análise dos dados. Resultados: as ocorrências relacionadas à punção venosa no hospital geral foram sujidade de sangue na inserção do cateter (17,4 %) e prazo de uso expirado (15,8%), enquanto no serviço específico para atendimento a pacientes sob cuidados paliativos foram prazo de uso expirado (32%) seguido de infiltração (18,9%). Quanto à hipodermóclise, foram duas punções subcutâneas com sinais flogísticos (1,0%) no hospital geral e um hematoma no local de inserção do cateter (0,5%). No serviço específico para atendimento a pacientes sob cuidados paliativos foram três punções subcutâneas com sinais flogísticos (5,7%). Conclusão: as ocorrências relacionadas à punção venosa periférica foram superiores às relacionadas à hipodermóclise.

Abstract Objective: to identify the occurrences related to peripheral venipuncture and hypodermoclysis among patients hospitalized in a general hospital and in an exclusive hospital institution for the care of patients in palliative cancer care. Method: an observational, descriptive and multicenter study. The consecutive and non-probabilistic sample consisted of 160 cancer patients hospitalized in Palliative Care. The outcome variable corresponded to the occurrences and complications related to each type of puncture. A questionnaire containing the sociodemographic and clinical variables and a structured script for monitoring and daily evaluation of the puncture were used. Descriptive statistics were employed for data analysis. Results: the occurrences related to venipuncture at a general hospital were blood soiling at catheter insertion (17.4%) and expired use period (15.8%), while at a specific service for the care of patients under palliative care they were expired use period (32%) followed by infiltration (18.9%). As for hypodermoclysis, there were two subcutaneous punctures with phlogistic signs (1.0%) at the general hospital and a hematoma at the catheter insertion site (0.5%). At the specific service for the care of patients under palliative care there were three subcutaneous punctures with phlogistic signs (5.7%). Conclusion: the number of occurrences related to peripheral venipuncture was higher than those related to hypodermoclysis.

Resumen Objetivo: identificar los eventos relacionados con la venopunción periférica y la hipodermoclisis en pacientes hospitalizados en un hospital general y en un hospital que atiende exclusivamente a pacientes en cuidados paliativos oncológicos. Método: estudio observacional, descriptivo y multicéntrico. La muestra consecutiva y no probabilística estuvo compuesta por 160 pacientes oncológicos hospitalizados que reciben cuidados paliativos. La variable resultado correspondió a los eventos y complicaciones relacionados con cada tipo de punción. Se utilizó un cuestionario con variables sociodemográficas y clínicas y una guía estructurada para el seguimiento diario y la evaluación de la punción. Se utilizó estadística descriptiva para el análisis de datos. Resultados: los eventos relacionados con la venopunción en un hospital general fueron contaminación de sangre en la inserción del catéter (17,4%) y catéter vencido (15,8%), mientras que en un hospital específico que atiende exclusivamente a pacientes en cuidados paliativos oncológicos fueron catéter vencido (32%) seguido de infiltración (18,9%). En cuanto a la hipodermoclisis, hubo dos punciones subcutáneas con signos flogísticos (1,0%) en hospital general y un hematoma en el lugar de inserción del catéter (0,5%). En el hospital en un hospital que atiende exclusivamente a pacientes en cuidados paliativos oncológicos hubo tres punciones subcutáneas con signos flogísticos (5,7%). Conclusión: los eventos relacionados con la venopunción periférica fueron mayores que los relacionados con la hipodermoclisis.

Thyroid hormone resistance index and mortality in euthyroid subjects: Di@bet.es study.

OBJECTIVE: It has been proposed that a mild form of acquired resistance to thyroid hormone may occur in the general population. Its clinical significance remains largely unknown. The objective of the study was to explore whether a newly described thyroid hormone resistance index is associated with the risk of mortality in a sample of community-dwelling euthyroid subjects representative of the adult population of Spain. DESIGN: Longitudinal observational study including 3750 individuals, free of thyroid disease, TPO antibodies-negative (<50 IU/mL) and with TSH levels within the euthyroid range (≥0.5 and ≤5.0 mUI/mL) participating in the nationwide study Di@bet.es (2008-2010). METHODS: We used the Thyroid Feedback Quantile-based Index (TFQI) as a marker of resistance to thyroid hormone. The study population was grouped into categories according to their TFQI values at baseline. Fatal events were ascertained from the national death registry (end of follow-up December 2016). RESULTS: A total of 231 deaths were recorded during an average follow-up of 7.3 years. Compared with the category with the highest sensitivity to free thyroxine (TFQI ≤ p5) (reference), the relative risk of mortality in the categories with TFQI > p5 and ≤p25; >p25 and ≤p50; >p50 and ≤p75; >p75 and ≤p95 and >p95 were 1.01, (0.47-2.19), 1.42 (0.68-2.97), 1.54 (0.74-3.22), 1.47 (0.70-3.11) and 2.61 (1.16-5.89), respectively (P for trend 0.003). The association remained significant after multivariate adjustment of the data (P for trend 0.017). CONCLUSIONS: A thyroid hormone resistance index focused on deviations of the average pituitary response to thyroid hormones may be associated with all-cause mortality independently of other conventional risk factors and comorbidities.

[New approach in the Screening Program for the early detection of cervical cancer in Galicia.] / Nuevo enfoque en el Programa de cribado para la detección precoz del cáncer de cérvix en Galicia.

Cervical cancer (CUC) is the fourth most common gynaecological malignancy worldwide, the second most common in low- and middle-income countries. The human papilloma virus (HPV) is the main cause of CUU and considered a necessary but not sufficient cause for its development. In Spain, Pap smear and HPV testing are the main screening strategies for UCC. Since the 1980s, opportunistic (on-demand) screening has been carried out in most autonomous communities by performing conventional cytology on women between 25 and 65 years of age. The assessment of the presence of HPV infection in the early diagnosis of cervical cancer has a higher sensitivity and better predictive value than cervical cytology, especially in women over 30 years of age, with a minimal loss of specificity. Galicia, in accordance with the new recommendations available, has established the "New Galician Program for the early detection of cervical cancer" population screening based on the detection of High Risk HPV in women between 35 and 65 years of age and is preparing to launch a pilot study, to be carried out in 2021 in the region of Lugo. The midwife, in the Primary Health System, is emerging as the professional of reference in the prevention and early diagnosis of UCC, leading UCC screening in Spain.

El cáncer de cuello uterino (CCU) es la cuarta neoplasia ginecológica más frecuente a nivel mundial, la segunda en países con bajo y medio nivel de ingresos. El virus del papiloma humano (VPH) es la causa principal del CCU, considerándose causa necesaria pero no suficiente para su desarrollo. En España, la citología vaginal y la prueba de VPH representan las principales estrategias de tamizaje para el CCU. Desde los años 80, en la mayoría de las comunidades autónomas se realiza un cribado oportunista (a demanda), mediante la realización de la citología convencional a mujeres entre los 25 y los 65 años. La valoración de la presencia de infección por VPH en el diagnóstico precoz del CCU, presenta una mayor sensibilidad y un mejor valor predictivo que la citología cervical, especialmente en las mujeres mayores de 30 años, con una pérdida mínima de especificidad. Galicia, atendiendo a las nuevas recomen-daciones disponibles, establece el "Nuevo Programa Gallego para la detección precoz del cáncer de cérvix", cribado poblacional basado en la detección del VPH de Alto Riesgo en mujeres comprendidas entre los 35 y los 65 años; y se prepara para la puesta en marcha de un estudio piloto, que se llevará a cabo en el año 2021 en la comarca de Lugo. La matrona, desde la consulta de Atención Primaria, se perfila como el profesional de referencia en la prevención y diagnóstico precoz del CCU, liderando su cribado en España.

Transplante de células-tronco hematopoiéticas como aproximação para a reflexão discente sobre a integralidade em saúde / Hematopoietic stem cell transplantation as an approach for student reflection on integrality in health care

A integralidade que se espera da assistência em saúde deve ser alicerçada na graduação. Objetiva-se relacionar a taxa de sobrevida global às condições sociodemográficas em uma amostra de pacientes submetidos ao transplante de células-tronco hematopoiéticas, oportunizando ao estudante de medicina mais uma forma de aproximação com os determinantes sociais do processo de saúde e doença. Trata-se de um estudo exploratório-descritivo, retrospectivo e com abordagem quantitativa baseado em análise de prontuários. Aplicados o teste exato de Fisher, qui-quadrado de Pearson, regressão logística multivariada e análise de sobrevivência (curvas de Kaplan-Meyer), considerando nível mínimo de significância de 5% e poder de teste mínimo de 90%. Realizados 103 procedimentos e 22,2% dos pacientes foram a óbito, com diminuição da sobrevida até 21 meses. As discentes puderam analisar várias realidades sociais e as condições adequadas de moradia foram as que proporcionaram um tempo de sobrevida maior, porém sem influenciar a taxa de sobrevida global.

The integrality expected from health care must be built since undergraduate studies. This study aims at associating the overall survival rate with sociodemographic conditions in a sample of patients undergoing hematopoietic stem cell transplantation, providing the medical student with yet another way of approaching the social determinants of the health and disease process. This is an exploratory-descriptive, retrospective study with a quantitative approach based on the analysis of medical records. Fisher's exact test, Pearson chi-square, multivariate logistic regression, and survival analysis (Kaplan-Meier curves), considering a minimum significance level of 5% and a minimum test power of 90%. One-hundred and three procedures were performed and 22.2% of the patients died, with a decrease in survival of up to 21 months. Students were able to analyze various social realities and adequate housing conditions were those that allowed a longer survival time without influencing the overall survival rate.

La integralidad esperada de la atención médica debe basarse en la graduación. El objetivo es vincular la tasa de supervivencia global con las condiciones sociodemográficas en una muestra de pacientes sometidos a un trasplante de células madre hematopoyéticas, lo que permite una mayor aproximación del estudiante de medicina a los factores sociales determinantes del proceso de salud y enfermedad. Es un estudio exploratorio-descriptivo, retrospectivo con enfoque cuantitativo basado en análisis de los registros médicos. Se aplicaron la prueba exacta de Fisher, el chi-cuadrado de Pearson, la regresión logística multi variante y el análisis de supervivencia (curvas de Kaplan-Meyer), considerando un nivel de importancia mínimo del 5% y una potencia de prueba mínima del 90%. 22,2% de los 103 pacientes fallecieron, con disminución de la supervivencia de hasta 21 meses. Fue posible analizar cuales condiciones de vivienda adecuadas permitieron un mayor tiempo de supervivencia, pero sin influir en la tasa global

Insights into Paraben Adsorption by Metal-Organic Frameworks for Analytical Applications.

Metal-organic frameworks (MOFs) are attractive materials used as sorbents in analytical microextraction applications for contaminants of emerging concern (CECs) from environmental liquid matrices. The demanding specs for a sorbent in the analytical application can be comprehensively studied by considering the interactions of the target analytes with the frameworks by the use of single-crystal X-ray diffraction, computational analysis, and adsorption studies, including the kinetic ones. The current study intends a better understanding of the interactions of target CECs (particularly, propylparaben (PPB) as a model) and three Zn-based layered pillared MOFs: CIM-81 [Zn2(tz)2(bdc)] (Htz = 1,2,4-triazole and H2bdc = 1,4-benzenedicarboxylic acid) and their amino derivatives [Zn2(NH2-tz)2(bdc)] CIM-82 and [Zn2(tz)2(NH2-bdc)] CIM-83 (NH2-Htz = 3-amino-1,2,4-triazole and NH2-H2bdc = 2-amino-1,4-benzenedicarboxylic acid). The crystal structures of the two solvate compounds (dma@CIM-81 (dma = dimethylacetamide) and acetone@CIM-81) were solved by single-crystal X-ray diffraction to determine the points of interaction between the framework and the guest molecules. They also served as a starting point for the computational modeling of the PPB@CIM-81 compound, showing that up to two PPB molecules can be hosted in one of the pores, while only one can be trapped in the second pore type, leading to a maximum theoretical capacity of 291.9 mg g-1. This value is close to the value obtained by the adsorption isotherm experiment for CIM-81 (283 mg g-1). This value is, by far, higher than those previously reported for other materials for the removal of PPB from water, and also higher than the experimental values obtained for CIM-82 (54 mg g-1) and CIM-83 (153 mg g-1). The kinetics of adsorption is not very fast, with uptake of about 40% in 3 h, although a 70% release in methanol is achieved in 1 h. In addition, a further comparison of performance in analytical microextraction (requiring only 10 mg of CIM-81) was carried out together with chromatographic analysis to support all insights attained, with the method being able to monitor CECs as low as µg L-1 levels in complex environmental water samples, thus performing successfully for water monitoring even in multicomponent scenarios.

Fast track triage for COVID-19 based on a population study: The soda score.

BACKGROUND: Healthcare systems are under prominent stress due to the COVID-19 pandemic. A fast and simple triage is mandatory to screen patients who will benefit from early hospitalization, from those that can be managed as outpatients. There is a lack of all-comers scores, and no score has been proposed for western-world population. AIMS: To develop a fast-track risk score valid for every COVID-19 patient at diagnosis. METHODS: Single-center, retrospective study based on all the inhabitants of a healthcare area. Logistic regression was used to identify simple and wide-available risk factors for adverse events (death, intensive care admission, invasive mechanical ventilation, bleeding > BARC3, acute renal injury, respiratory insufficiency, myocardial infarction, acute heart failure, pulmonary emboli, or stroke). RESULTS: Of the total healthcare area population, 447.979 inhabitants, 965 patients (0.22%), were diagnosed with COVID-19. A total of 124 patients (12.85%) experienced adverse events. The novel SODA score (based on sex, peripheral O2 saturation, presence of diabetes, and age) demonstrated good accuracy for adverse events prediction (area under ROC curve 0.858, CI: 0.82-0.98). A cut-off value of ≤2 points identifies patients with low risk (positive predictive value [PPV] for absence of events: 98.9%) and a cut-off of ≥5 points, high-risk patients (PPV 58.8% for adverse events). CONCLUSIONS: This quick and easy score allows fast-track triage at the moment of diagnosis for COVID-19 using four simple variables: age, sex, SpO2, and diabetes. SODA score could improve preventive measures taken at diagnosis in high-risk patients and also relieve resources by identifying very low-risk patients.

Complicações relacionadas à punção venosa periférica e à hipodermóclise em pacientes oncológicos sob cuidados paliativos / Complications related to peripheral venipuncture and hypodermoclysis in cancer patients under palliative care / Complicaciones relacionadas con la venopunción periférica y la hipodermoclisis en pacientes oncológicos en cuidados paliativos

Objetivo: identificar complicações relacionadas à punção venosa periférica e à hipodermóclise em pacientes oncológicos hospitalizados sob cuidados paliativos. Método: estudo descritivo e longitudinal. Foi utilizado questionário para caracterização sociodemográfica e clínica dos participantes, roteiro para a avaliação e acompanhamento da punção. Os dados foram analisados por meio da estatística descritiva. Resultados: participaram do estudo 70 pacientes, sendo 54,3% (n=38) do sexo feminino e com idade média de 68,8 anos (DP = 15,0), cujas principais doenças oncológicas de base foram câncer de cabeça e pescoço e de pulmão. Ademais, 90% das punções avaliadas foram endovenosas e as complicações mais frequentes foram dor local, extravasamento e cateter dobrado ou tracionado. Conclusão: as complicações observadas no período do estudo foram relacionadas apenas às punções venosas. Houve predominância da punção venosa periférica em detrimento da via subcutânea, uma alternativa viável e recomendada para os pacientes oncológicos sob cuidados paliativos.

Objective: to identify complications related to peripheral venipuncture and hypodermoclysis in cancer patients hospitalized under palliative care. Method: this is a descriptive and longitudinal study. A questionnaire was used for the sociodemographic and clinical characterization of participants, a script for puncture assessment and monitoring. The data were ran through descriptive statistics. Results: seventy patients participated in the study, 54.3% (n=38) of whom were female and with a mean age of 68.8 years (SD = 15.0), whose main underlying oncological diseases were head cancer and neck and lung. Furthermore, 90% of assessed punctures were intravenous and the most frequent complications were localized pain, extravasation and a bent or pulled catheter. Conclusion: the complications observed during the study period were related only to venipunctures. There was a predominance of peripheral venipuncture due to the subcutaneous route, a viable and recommended alternative for cancer patients under palliative care.

Objetivo: identificar las complicaciones relacionadas con la venopunción periférica y la hipodermoclisis en pacientes con cáncer hospitalizados bajo cuidados paliativos. Método: estudio descriptivo y longitudinal. Se utilizó un cuestionario para la caracterización sociodemográfica y clínica de los participantes, un guión para la valoración y seguimiento de la punción. Los datos fueron analizados utilizando estadística descriptiva. Resultados: en el estudio participaron 70 pacientes, de los cuales el 54,3% (n=38) eran mujeres y con una edad media de 68,8 años (DE=15,0), cuyas principales patologías oncológicas de base fueron cabeza y cuello y pulmón. Además, el 90% de las punciones evaluadas fueron intravenosas y las complicaciones más frecuentes fueron dolor local, extravasación y catéter doblado o tirado. Conclusión: las complicaciones observadas durante el período de estudio se relacionaron únicamente con las punciones venosas. Predominó la punción venosa periférica en detrimento de la vía subcutánea, alternativa viable y recomendada para pacientes oncológicos en cuidados paliativos.

Repercussions of the COVID-19 pandemic from the childrens' perspective / Repercusiones de la pandemia de la covid-19 desde la perspectiva de los niños / Repercussões da pandemia da covid-19 na perspectiva das crianças

ABSTRACT Objective: To understand the repercussions of Coronavirus Disease 19 (COVID-19) from the perspective of schoolchildren. Materials and method: A qualitative study, of the participant action type, based on Paulo Freire's theoretical and methodological precepts. The participants were 10 children living in the coastal area of Santa Catarina, Brazil, from a virtual culture circle held in July 2020. An analogy was made with the colored pencil to go through the stages of the research itinerary. Results: Two generative themes emerged for discussion: the good things of the COVID-19 pandemic and the "cannots" of the pandemic. In the first theme, they highlighted more time with the family and strengthening family ties, proximity to pets, and self-care. In the second, they pointed out the impossibility of playing with friends, celebrating birthdays and hugging people. Conclusions: The children identified positive and negative points experienced during the pandemic and unveiled the challenges of transforming moments of social isolation into spaces of family proximity, although restricted to their homes.

RESUMEN Objetivo: comprender las repercusiones de la Coronavirus Disease19 (covid-19) desde la perspectiva de niños en edad escolar. Materiales y método: estudio cualitativo, tipo acción participante, fundamentado en los supuestos teórico-metodológicos de Paulo Freire. Participaron 10 niños residentes en la costa de Santa Catarina, Brasil, a partir de un círculo de cultura virtual realizado en julio de 2020. Se realizó analogía con el lápiz de color para recorrer las etapas del itinerario de investigación. Resultados: han emergido dos temas generadores para la discusión: las cosas buenas de la pandemia de la covid-19 y los "nos" de la pandemia. En el primer tema, destacaron más tiempo con la familia y fortalecimiento de los vínculos familiares, cercanía con mascotas y autocuidado. En el segundo, señalaron la imposibilidad de jugar con los amigos, celebrar los cumpleaños y abrazar a las personas. Conclusiones: los niños identificaron puntos positivos y negativos vividos durante la pandemia y desvelaron los retos de transformar los momentos de aislamiento social en espacios de cercanía familiar, aun restrictos a sus hogares.

RESUMO Objetivo: compreender as repercussões da Coronavirus Disease 19 (covid-19) na perspectiva de crianças em idade escolar. Materiais e método: estudo qualitativo, tipo ação participante, fundamentado nos preceitos teórico-metodológicos de Paulo Freire. Participaram 10 crianças residentes no litoral de Santa Catarina, Brasil, a partir de um círculo de cultura virtual realizado em julho de 2020. Realizou-se analogia com o lápis de cor para percorrer as etapas do itinerário de pesquisa. Resultados: emergiram dois temas geradores para a discussão: as coisas boas da pandemia da covid-19 e os "nãos" da pandemia. No primeiro tema, destacaram maior tempo com a família e fortalecimento dos laços familiares, proximidade com animais de estimação e autocuidado. No segundo, apontaram a impossibilidade de brincar com os amigos, comemorar os aniversários e abraçar as pessoas. Conclusões: as crianças identificaram pontos positivos e negativos vividos durante a pandemia e desvelaram os desafios de transformar os momentos de isolamento social em espaços de aproximação familiar, embora restritas às suas residências.

First-Days Reduction of Plasma and Skin Advanced Glycation End Products is Related to Outcome in Septic Patients.

BACKGROUND: Advanced glycation end products (AGEs) are a result of nonenzymatic glycation of proteins and lipids, which can attach to either their cell surface receptor (RAGE) or its soluble form (sRAGE). Evidence exists for the implication of AGE-RAGE axis in sepsis, but data are still insufficient and conflicting. We aimed to analyze the kinetics of plasma and skin AGEs and sRAGE during sepsis, and their association with outcome in septic patients. METHODS: We performed a prospective observational study. We enrolled 90 consecutive patients with severe sepsis or septic shock, within the first 24 h of Intensive Care Unit admission. During the first 5 days of sepsis, we measured plasma autofluorescence (PAF) and skin autofluorescence (SAF) as surrogates of circulating and skin AGEs, respectively. sRAGE was measured on days 1, 3, and 5. Delta values were defined as the difference between the PAF, SAF, or sRAGE on a specific day and the value on day 1. RESULTS: 28-day mortality was 18%. Bivariate analysis found that ΔPAF3-1, ΔPAF4-1, ΔPAF5-1, and ΔSAF5-1 were significantly associated with 28-day mortality. Additionally, sRAGE1 was inversely correlated to ΔPAF4-1 (r = -0.250, P = 0.019) and ΔPAF5-1 (r = -0.246, P = 0.024), and significantly associated with 28-day mortality. In an adjusted multivariate logistic regression analysis, ΔPAF2-1, ΔPAF3-1, ΔPAF4-1, ΔPAF5-1, and ΔSAF5-1 were associated with 28-day mortality. CONCLUSIONS: Kinetics of plasma and skin AGEs during the first days of sepsis are independently associated with mortality, where a decrease of plasma and skin AGEs are related to higher mortality.

Mixed Functionalization of Organic Ligands in UiO-66: A Tool to Design Metal-Organic Frameworks for Tailored Microextraction.

The mixed-ligand strategy was selected as an approach to tailor a metal-organic framework (MOF) with microextraction purposes. The strategy led to the synthesis of up to twelve UiO-66-based MOFs with different amounts of functionalized terephthalate ligands (H-bdc), including nitro (-NO2) and amino (-NH2) groups (NO2-bdc and NH2-bdc, respectively). Increases of 25% in ligands were used in each case, and different pore environments were thus obtained in the resulting crystals. Characterization of MOFs includes powder X-ray diffraction, infrared spectroscopy, and elemental analysis. The obtained MOFs with different degrees and natures of functionalization were tested as sorbents in a dispersive miniaturized solid-phase extraction (D-µSPE) method in combination with high-performance liquid chromatography (HPLC) and diode array detection (DAD), to evaluate the influence of mixed functionalization of the MOF on the analytical performance of the entire microextraction method. Eight organic pollutants of different natures were studied, using a concentration level of 5 µg· L-1 to mimic contaminated waters. Target pollutants included carbamazepine, 4-cumylphenol, benzophenone-3, 4-tert-octylphenol, 4-octylphenol, chrysene, indeno(1,2,3-cd)pyrene, and triclosan, as representatives of drugs, phenols, polycyclic aromatic hydrocarbons, and disinfectants. Structurally, they differ in size and some of them present polar groups able to form H-bond interactions, either as donors (-NH2) or acceptors (-NO2), permitting us to evaluate possible interactions between MOF pore functionalities and analytes' groups. As a result, extraction efficiencies can reach values of up to 60%, despite employing a microextraction approach, with four main trends of behavior being observed, depending on the analyte and the MOF.

A Review on Biological Processes for Pharmaceuticals Wastes Abatement-A Growing Threat to Modern Society.

Over the last decades, the production and consumption of pharmaceuticals and health care products grew manifold, allowing an increase in life expectancy and a better life quality for humans and animals, in general. However, the growth in pharmaceuticals production and consumption comes with an increase in waste production, which creates a number of challenges as well as opportunities for the waste management industries. The conventional current technologies used to treat effluents have shown to be inefficient to remove or just to reduce the concentrations of these types of pollutants to the legal limits. The present review provides a thorough state-of-the-art overview on the use of biological processes in the rehabilitation of ecosystems contaminated with the pharmaceutical compounds most commonly detected in the environment and eventually more studied by the scientific community. Among the different biological processes, special attention is given to biosorption and biodegradation.

Recovery of Rare Earth Elements from Wastewater Towards a Circular Economy.

The use of rare earth elements is a growing trend in diverse industrial activities, leading to the need for eco-friendly approaches to their efficient recovery and reuse. The aim of this work is the development of an environmentally friendly and competitive technology for the recovery of those elements from wastewater. Kinetic and equilibria batch assays were performed with zeolite, with and without bacterial biofilm, to entrap rare earth ions from aqueous solution. Continuous assays were also performed in column setups. Over 90% removal of lanthanum and cerium was achieved using zeolite as sorbent, with and without biofilm, decreasing to 70% and 80%, respectively, when suspended Bacillus cereus was used. Desorption from the zeolite reached over 60%, regardless of the tested conditions. When in continuous flow in columns, the removal yield was similar for all of the rare earth elements tested. Lanthanum and cerium were the elements most easily removed by all tested sorbents when tested in single- or multi-solute solutions, in batch and column assays. Rare earth removal from wastewater in open setups is possible, as well as their recovery by desorption processes, allowing a continuous mode of operation.

Ambient temperature and prevalence of diabetes and insulin resistance in the Spanish population: Di@bet.es study.

Objective The activity of brown adipose tissue is sensitive to changes in ambient temperature. A lower exposure to cold could result in an increased risk of developing diabetes at population level, although this factor has not yet been sufficiently studied. Design We studied 5072 subjects, participants in a national, cross-sectional population-based study representative of the Spanish adult population (Di@bet.es study). All subjects underwent a clinical, demographic and lifestyle survey, a physical examination and blood sampling (75 g oral glucose tolerance test). Insulin resistance was estimated with the homeostasis model assessment (HOMA-IR). The mean annual temperature (°C) in each individual municipality was collected from the Spanish National Meteorology Agency. Results Linear regression analysis showed a significant positive association between mean annual temperature and fasting plasma glucose (ß: 0.087, P < 0.001), 2 h plasma glucose (ß: 0.049, P = 0.008) and HOMA-IR (ß: 0.046, P = 0.008) in multivariate adjusted models. Logistic regression analyses controlled by multiple socio-demographic variables, lifestyle, adiposity (BMI) and geographical elevation showed increasing odds ratios for prediabetes (WHO 1999), ORs 1, 1.26 (0.95-1.66), 1.08 (0.81-1.44) and 1.37 (1.01-1.85) P for trend = 0.086, diabetes (WHO 1999) ORs 1, 1.05 (0.79-1.39), 1.20 (0.91-1.59) and 1.39 (1.02-1.90) P = 0.037, and insulin resistance (HOMA-IR ≥75th percentile of the non-diabetic population): ORs 1, 1.03 (0.82-1.30), 1.22 (0.96-1.55), 1.26 (0.98-1.63) (P for trend = 0.046) as the mean annual temperature (into quartiles) rose. Conclusions Our study reports an association between ambient temperature and the prevalence of dysglycemia and insulin resistance in Spanish adults, consistent with the hypothesis that a lower exposure to cold could be associated with a higher risk of metabolic derangements.

Application of a Pillared-Layer Zn-Triazolate Metal-Organic Framework in the Dispersive Miniaturized Solid-Phase Extraction of Personal Care Products from Wastewater Samples.

The pillared-layer Zn-triazolate metal-organic framework (CIM-81) was synthesized, characterized, and used for the first time as a sorbent in a dispersive micro-solid phase extraction method. The method involves the determination of a variety of personal care products in wastewaters, including four preservatives, four UV-filters, and one disinfectant, in combination with ultra-high performance liquid chromatography and UV detection. The CIM-81 MOF, constructed with an interesting mixed-ligand synthetic strategy, demonstrated a better extraction performance than other widely used MOFs in D-µSPE such as UiO-66, HKUST-1, and MIL-53(Al). The optimization of the method included a screening design followed by a Doehlert design. Optimum conditions required 10 mg of CIM-81 MOF in 10 mL of the aqueous sample at a pH of 5, 1 min of agitation by vortex and 3 min of centrifugation in the extraction step; and 1.2 mL of methanol and 4 min of vortex in the desorption step, followed by filtration, evaporation and reconstitution with 100 µL of the initial chromatographic mobile phase. The entire D-µSPE-UHPLC-UV method presented limits of detection down to 0.5 ng·mL-1; intra-day and inter-day precision values for the lowest concentration level (15 ng·mL-1)-as a relative standard deviation (in %)-lower than 8.7 and 13%, respectively; average relative recovery values of 115%; and enrichment factors ranging from ~3.6 to ~34. The reuse of the CIM-81 material was assessed not only in terms of maintaining the analytical performance but also in terms of its crystalline stability.

Influence of Ligand Functionalization of UiO-66-Based Metal-Organic Frameworks When Used as Sorbents in Dispersive Solid-Phase Analytical Microextraction for Different Aqueous Organic Pollutants.

Four metal-organic frameworks (MOFs), specifically UiO-66, UiO-66-NH2, UiO-66-NO2, and MIL-53(Al), were synthesized, characterized, and used as sorbents in a dispersive micro-solid phase extraction (D-µSPE) method for the determination of nine pollutants of different nature, including drugs, phenols, polycyclic aromatic hydrocarbons, and personal care products in environmental waters. The D-µSPE method, using these MOFs as sorbents and in combination with high-performance liquid chromatography (HPLC) and diode-array detection (DAD), was optimized. The optimization study pointed out to UiO-66-NO2 as the best MOF to use in the multi-component determination. Furthermore, the utilization of isoreticular MOFs based on UiO-66 with the same topology but different functional groups, and MIL-53(Al) to compare with, allowed us for the first time to evaluate the influence of such functionalization of the ligand with regards to the efficiency of the D-µSPE-HPLC-DAD method. Optimum conditions included: 20 mg of UiO-66-NO2 MOF in 20 mL of the aqueous sample, 3 min of agitation by vortex and 5 min of centrifugation, followed by the use of only 500 µL of acetonitrile as desorption solvent (once the MOF containing analytes was separated), 5 min of vortex and 5 min of centrifugation. The validation of the D-µSPE-HPLC-DAD method showed limits of detection down to 1.5 ng·L-1, average relative recoveries of 107% for a spiked level of 1.50 µg·L-1, and inter-day precision values with relative standard deviations lower than 14%, for the group of pollutants considered.