Knowledge and perception of middle school students regarding COVID-19 disease at the start of the pandemic.

Facing recent threats of coronavirus disease (COVID-19), an educational strategy was designed and applied to middle school students in order to reinforce related knowledge and behaviors. A group of 65 middle school students (14-18 years old) developed several designed online curricular activities. After the intervention, students answered a questionnaire to assess if they: (a) were familiar with the terms COVID 19 and SARS-CoV-2; (b) were conscious about the importance of preventive measures to stop the spread of this disease; (c) were engaged in these activities; (d) were motivated to research on health-related issues. This study was a first to attempt to evaluate student's perceptions about SARS-CoV-2 infection and support education regarding COVID-19, mainly on the reinforcement of preventive measures.

The Role of Phage Therapy in Burn Wound Infections Management: Advantages and Pitfalls.

Burn wound infections are often the source of bacteria responsible for systemic infections, including bloodstream infections and pneumonia that ultimately can result in multisystem organ failure and death. Any rapid change in the burn wound appearance or the clinical condition of the burn patient may herald burn wound infection or sepsis. The revival of phage therapy, either in single mode or in combination with conventional antibiotics may represent a valuable alternative, to treat specific bacterial infections such as burn wound infections, including those caused by multidrug-resistant organisms. This systematic review addresses the: 1) general characteristics of bacteriophages; 2) activity of bacteriophages vs conventional antibiotics; 3) activity of bacteriophages against biofilms; 4) bacteriophage administration; and 5) use of bacteriophages in burn wound infections. Although several scientific organizations/societies recognized that phage therapy could be of key value in modern wound care, specific aspects are critical for a burn surgeon and might represent pitfalls discouraging phage therapy adoption in burn wound management; in particular, the unavailability of consensual therapeutic guidelines/regulatory policies and the lack of laboratorial support that might be predictive of its efficacy. The availability of a product/formulation convenient to use, with adequate stability and shelf half-life is also a key condition.

Innovative, integrative, and interactive in-class activity on metabolic regulation: Evaluating educational impacts.

Medical students tend to have difficulties in developing a holistic view of metabolic pathway and hormone regulation. To address this issue, an interactive activity was implemented for first-year medical students at the School of Medicine, University of Minho, Portugal. Students' previous knowledge on metabolic pathways was evaluated by a pre-test followed by an interactive activity. In the supervised activity, students were challenged to elaborate a diagrammatic representation regarding enzymes, co-factors, and hormonal metabolic regulation in early fasting during the night, as well as in well-fed conditions. The activity was concluded with a post-test to determine the students' learning gains and a few days later students were evaluated by a final exam. Afterwards, students evaluated the activity by filling a questionnaire. Results from four different cohorts showed that the activity resulted in significant learning gains, particularly favoring students who have less prior knowledge. The comparison between the pre-test and the final exam also revealed significant learning gains for low achievers students. On the questionnaires, the majority of the students rated the activity as good or very good. Students agreed that this activity promotes: (a) reactivation of previous knowledge; (b) a better understanding of the interconnections between the metabolic pathways; (c) the application of learned concepts in real scenarios; and (d) sharing knowledge with peers. This study describes an active, unpretentious, and easily implemented activity available for early medical and biochemical curricula.

Microbes and Cancer: Friends or Faux?

Cancer is one of the most aggressive and deadly diseases in the world, representing the second leading cause of death. It is a multifactorial disease, in which genetic alterations play a key role, but several environmental factors also contribute to its development and progression. Infections induced by certain viruses, bacteria, fungi and parasites constitute risk factors for cancer, being chronic infection associated to the development of certain types of cancer. On the other hand, susceptibility to infectious diseases is higher in cancer patients. The state of the host immune system plays a crucial role in the susceptibility to both infection and cancer. Importantly, immunosuppressive cancer treatments increase the risk of infection, by decreasing the host defenses. Furthermore, alterations in the host microbiota is also a key factor in the susceptibility to develop cancer. More recently, the identification of a tumor microbiota, in which bacteria establish a symbiotic relationship with cancer cells, opened a new area of research. There is evidence demonstrating that the interaction between bacteria and cancer cells can modulate the anticancer drug response and toxicity. The present review focuses on the interaction between microbes and cancer, specifically aiming to: (1) review the main infectious agents associated with development of cancer and the role of microbiota in cancer susceptibility; (2) highlight the higher vulnerability of cancer patients to acquire infectious diseases; (3) document the relationship between cancer cells and tissue microbiota; (4) describe the role of intratumoral bacteria in the response and toxicity to cancer therapy.

Hard-to-heal wounds, biofilm and wound healing: an intricate interrelationship.

Hard-to-heal wounds are a major public health problem that incur high economic costs. A major source of morbidity, they can have an overwhelming impact on patients, caregivers and society. In contrast to acute wound healing, which follows an 'orderly and timely reparative process', the healing of hard-to-heal wounds is delayed because the usual biological progression is interrupted. This article discusses hard-to-heal wounds, the impact they have on patients and healthcare systems, and how biofilms and other factors affect the wound-healing process. Controlling and preventing infection is of utmost importance for normal wound healing. Rational use of anti-infectious agents is crucial and is particularly relevant in the context of rising healthcare costs. Knowledge of the complex relationship between hard-to-heal wounds, biofilm formation and wound healing is vital for efficient management of hard-to-heal wounds.

Assessing the impact of Medical Microbiology classes using active strategies on short- and long-term retention on medical students: an innovative study.

One of teachers' concerns, with students in general and medical students in particular, is to ensure as much as possible that information goes from students' short-term memories to their long-term memories. The present study focuses on knowledge retention in Medical Microbiology and assesses the effectiveness of some strategies implemented for short- and long-term retention. A pre- and post-test was used to assess student's learning. This study involved students of Porto University (test group). Test group participants were all attending the third year of the Medicine Degree Program. The results of post-test 1 were considered very positive and support the importance of these applied active activities and/or methodologies in Medical Microbiology for short-term retention. However, the results obtained in post-test 2 showed that knowledge retention after 9 months, despite substantial, decreases.

Continuous Enhancement of Science Teachers' Knowledge and Skills through Scientific Lecturing.

INTRODUCTION: Due to their importance in transmitting knowledge, teachers can play a crucial role in students' scientific literacy acquisition and motivation to respond to ongoing and future economic and societal challenges. However, to conduct this task effectively, teachers need to continuously improve their knowledge, and for that, a periodic update is mandatory for actualization of scientific knowledge and skills. This work is based on the outcomes of an educational study implemented with science teachers from Portuguese Basic and Secondary schools. We evaluated the effectiveness of a training activity consisting of lectures covering environmental and health sciences conducted by scientists/academic teachers. MATERIAL AND METHODS: The outcomes of this educational study were evaluated using a survey with several questions about environmental and health scientific topics. Responses to the survey were analyzed before and after the implementation of the scientific lectures. RESULTS: Our results showed that Basic and Secondary schools teachers' knowledge was greatly improved after the lectures. The teachers under training felt that these scientific lectures have positively impacted their current knowledge and awareness on several up-to-date scientific topics, as well as their teaching methods. LEARNING OUTCOMES: This study emphasizes the importance of continuing teacher education concerning knowledge and awareness about health and environmental education.

Genesis of Azole Antifungal Resistance from Agriculture to Clinical Settings.

Azole fungal resistance is becoming a major public health problem in medicine in recent years. However, it was known in agriculture since several decades; the extensive use of these compounds results in contamination of air, plants, and soil. The increasing frequency of life-threatening fungal infections and the increase of prophylactical use of azoles in high-risk patients, taken together with the evolutionary biology evidence that drug selection pressure is an important factor for the emergence and spread of drug resistance, can result in a dramatic scenario. This study reviews the azole use in agricultural and medical contexts and discusses the hypothetical link between its extensive use and the emergence of azole resistance among human fungal pathogens.

Impact of an educational hands-on project on the antimicrobial, antitumor and anti-inflammatory properties of plants on Portuguese students' awareness, knowledge, and competences.

Promoting environmental and health education is crucial to allow students to make conscious decisions based on scientific criteria. The study is based on the outcomes of an Educational Project implemented with Portuguese students and consisted of several activities, exploring pre-existent Scientific Gardens at the School, aiming to investigate the antibacterial, antitumor and anti-inflammatory properties of plant extracts, with posterior incorporation in soaps and creams. A logo and a webpage were also created. The effectiveness of the project was assessed via the application of a questionnaire (pre- and post-test) and observations of the participants in terms of engagement and interaction with all individuals involved in the project. This project increased the knowledge about autochthonous plants and the potential medical properties of the corresponding plant extracts and increased the awareness about the correct design of scientific experiments and the importance of the use of experimental models of disease. The students regarded their experiences as exciting and valuable and believed that the project helped to improve their understanding and increase their interest in these subjects and in science in general. This study emphasizes the importance of raising students' awareness on the valorization of autochthonous plants and exploitation of their medicinal properties.

Assessing the impact of a school intervention to promote students' knowledge and practices on correct antibiotic use.

The clinical efficacy of antibiotics depends on their correct use. Widespread ignorance and inappropriate attitudes to antibiotic use have been identified among consumers. In order to improve the knowledge of middle-school students on antibiotics and their correct use, 82 ninth-grade students were enrolled in a teaching activity. The teaching activity consisted of a slide show presentation followed by discussion in a regular class. To evaluate the impact of the teaching activity the students were asked to answer a questionnaire before and after the activity. This study aimed: (1) to evaluate knowledge on the use of antibiotics in students of two schools in the north of Portugal and (2) to evaluate the efficacy of the school intervention in improving students' knowledge on correct antibiotic use. We found lack of knowledge among students regarding antibiotic spectra and indications and incorrect attitudes in the pre-test. Significant increases in knowledge were observed after implementation of the teaching activity. Knowledge of the correct use of antibiotics for bacterial diseases rather than viral diseases rose from 43% to 76% in the post-test (p < 0.01). Knowledge of the risk of bacterial resistance to antibiotics from their incorrect use rose from 48% to 74% in the post-test (p < 0.05). We believe that it is important to reinforce the teaching activities on microbiology and antibiotic use at the middle school level.

Portuguese students' knowledge of antibiotics: a cross-sectional study of secondary school and university students in Braga.

BACKGROUND: Recent surveys show that the knowledge of the general public about the correct use of antibiotics is limited. This contributes to the problem of inappropriate antibiotic use, leading to a progressive loss of bacterial sensitivity to these drugs and the spreading of resistant strains of bacteria. METHODS: In this cross-sectional study, a questionnaire about antibiotic use was given to a sample of students in the 9(th) and 12(th) grades of secondary school and in the first year of university in the north of Portugal. RESULTS: 349 students returned completed questionnaires. Deficits were found in the students' knowledge of antibiotics and their correct use. Only 4% of 9(th) grade students were aware that antibiotics are used to treat bacteria only, while 14% of 12(th) grade students and 29% of first-year university students were aware of this. Fewer students were aware that antibiotics are used to treat tuberculosis. There were deficiencies in the knowledge of timing and duration of therapy. However close to 70% of these students are aware that inappropriate use of antibiotics can contribute to resistance to these drugs. CONCLUSION: This study has observed a lack of general knowledge on correct antibiotic use in Portugal, as has been found in other countries. Since this may be due to a lack of formal education on this subject, we believe that a teaching unit on infectious diseases should be included in the 9(th) and 12(th) grades, in all curricular areas, with emphasis on bacterial and viral pathogens and correct antibiotic use. In addition, education on the correct use of medications may need to begin at much earlier ages.

Metal stress induces programmed cell death in aquatic fungi.

Aquatic hyphomycetes are a group of fungi that play a key role in organic matter turnover in both clean and metal-polluted streams. We examined the ability of Cu or Zn to induce programmed cell death (PCD) in three aquatic hyphomycete species through the evaluation of typical apoptotic markers, namely reactive oxygen species (ROS) accumulation, caspase-like activity, nuclear morphological alterations, and the occurrence of DNA strand breaks assessed by TUNEL assay. The exposure to both metals induced apoptotic events in all tested aquatic fungi. The most tolerant fungi either to Zn (Varicosporium elodeae) or Cu (Heliscussubmersus) exhibited higher levels of PCD markers, suggesting that PCD processes might be linked to fungal resistance/tolerance to metal stress. Moreover, different patterns of apoptotic markers were found, namely a PCD process independent of ROS accumulation in V. elodeae exposed to Cu, or independent of caspase-like activity in Flagellospora curta exposed to Zn, or even without the occurrence of DNA strand breaks in F. curta exposed to Cu. This suggests that a multiplicity of PCD pathways might be operating in aquatic hyphomycetes. The occurrence of a tightly regulated cell death pathway, such as PCD, in aquatic hyphomycetes under metal stress might be a part of the mechanisms underlying fungal acclimation in metal-polluted streams, because it would allow the rapid removal of unwanted or damaged cells sparing nutrients and space for the fittest ones.

Responses of antioxidant defenses to Cu and Zn stress in two aquatic fungi.

Aquatic hyphomycetes are fungi that play a key role in plant litter decomposition in streams. Even though these fungi occur in metal-polluted streams, the mechanisms underlying their tolerance to metals are poorly documented. We addressed the effects of Zn and Cu in Varicosporium elodeae and Heliscus submersus by examining metal adsorption to cell walls, plasma membrane integrity and production of reactive oxygen species at metal concentrations inhibiting biomass production in 50% or 80%. The activity of the enzymes catalase, superoxide dismutase and glucose-6-phosphate dehydrogenase was measured to elucidate their role in coping with oxidative stress induced by metals at short- (14 h) and long- (8 days) term exposure. Results show that V. elodeae was more susceptible to the toxic effects induced by Cu and Zn than H. submersus, as indicated by more extensive inhibition of biomass production. Both metals, particularly Cu, induced oxidative stress in the two fungal species, as shown by the noticeable recovery of biomass production in the presence of an antioxidant agent. In both fungi, Cu induced a more severe disruption of plasma membrane integrity than Zn. Our studies on antioxidant defenses showed that catalase had a greater role alleviating stress induced by Zn and Cu than superoxide dismutase. Chronic metal stress also stimulated the production of NADPH, via the pentose phosphate pathway by increasing the activity of glucose-6-phosphate dehydrogenase. Our results suggest that the tolerance of aquatic hyphomycetes to Cu and Zn is associated with the ability of these fungi to initiate an efficient antioxidant defense system.