Discrimination faced by radiology residents: an analysis of experiences and mitigation strategies.

RATIONALE AND OBJECTIVES: Literature shows that discrimination has been pervasive in the field of medicine. The aim of this study was to collect experiences related to discrimination among US radiology residents, including type and source, as well as the residents' perception on lectures about discrimination and harassment. We also explored the barriers to reporting, and suggested strategies to overcome them. MATERIAL AND METHODS: Following Institutional Review Board (IRB) approval, an online survey was sent to program directors and coordinators across the US, who were asked to forward the link to their radiology residents. A reminder email was sent over a period of 4 months. The participants were reassured the survey was confidential and anonymous. RESULTS: Among the respondents, the most reported types of discrimination were based in gender, race and nationality, the majority of which not being reported. The most common perpetrators were attending radiologists, co-residents, technologists, and patients. The main barriers for reporting were fear of retaliation, confidentiality concerns, and skepticism about a positive outcome. CONCLUSION: Our study examines some experiences of discrimination shared by residents during their training, with gender and race being the most common causes. This sheds light into a hidden and unspoken issue and highlights the need for more active discussions in radiology on microaggressions and implicit bias. Our data can guide future studies as well as residency programs to build effective strategies to address discrimination, aiming for sustainable changes.

Trichoderma koningiopsis fermentation in airlift bioreactor for bioherbicide production.

During scaling of fermentations, choosing a bioreactor is fundamental to ensure the product's quality. This study aims to produce bioherbicides using Trichoderma koningiopsis fermentation, evaluating process parameters in an Airlift bioreactor. As a response, we quantified the production of enzymes involved in the bioherbicide activity (amylase, cellulase, laccase, lipase, and peroxidase). In addition, it evaluated the agronomic efficiency of the fermented extract optimized through tests that promoted soybean growth and nodulation, soybean seed germination, and in vitro phytopathogen control. As a result of optimizing the scaling bioprocess, it was possible to obtain an adequate fermentation condition, which, when applied to soybean seeds, had beneficial effects on their growth. It allowed the production of an enzyme cocktail. These results add a crucial biotechnological potential factor for the success of the optimized formulation in the Airlift bioreactor, in addition to presenting relevant results for the scientific community.

Study and characterization of a product based on a vegetable extract of quinoa fermented with water kefir grains.

This work aimed to study and characterize a product based on vegetable extract of quinoa (WVEQ) fermented with water kefir grains. The effect of sucrose concentration (SC), inulin concentration (IC), and xanthan gum (XG) concentration were evaluated using a central composite design (CCD) 23. They were subsequently characterized regarding cellular growth of the grains, beverage yield, pH, soluble solids, carbon dioxide (CO2) production, lactic acid, and ethanol production. Therefore, for the final stage, two formulations (F1 and F8) of the CCD were chosen to be characterized in terms of proximate composition, microbiological composition of the kefir culture, analysis of organic compounds, sensory analysis, and enzymatic and microbiological characterization before and after simulation of in vitro gastrointestinal digestion. In the two chosen products, one can see that fermentation optimized the bioavailability of proteins due to the high proteolytic activity of the microorganisms in kefir and the increase in lipid content. In identifying microorganisms, there was a prevalence of Saccharomyces sp. yeasts. In the sensory analysis, the F8 formulation showed better results than the F1 formulation. In vitro, gastrointestinal digestion showed reduced lactic acid bacteria and yeast and increased acetic acid bacteria in the liquid phase for both formulations. In the enzymatic profile, there was a reduction in all enzymes analyzed for both formulations, except for amylase in F1, which went from 14.05 U/mL to 39.41 U/mL. Therefore, it is concluded that using WVEQ as a substrate for the product appears to be a viable alternative with nutritional and technological advantages for serving a specific market niche.

Developing strategies to improve the sense of belonging and mitigate tokenism.

Despite the increase in DEI initiatives and the rising social awareness, diversity, equity, and inclusiveness are still scarce in many work environments. In the process of implementing a diverse group in the workplace and training programs, retention efforts should always follow recruitment strategies; it is crucial to establish an environment that offers recruited women and minorities a sense of belonging and inclusiveness. Literature shows that diversity and belonging benefit not only the individual, but also the organization, society, and health care system. Many strategies to foster a sense of belonging in the workplace have been suggested, including, but not limited to, mentorship, sponsorship, affinity groups, dashboards, and surveys. Leaderships should acknowledge DEI initiatives, promoting efforts to enhance inclusiveness and mitigate tokenism. Amid DEI criticism and backlash, it is important to continue to promote education and positive discussions and aim for cultural changes targeting rooted systemic racism and discrimination, which continue to impose an obstacle to DEIB achievements.

Fungus-based bioherbicides on circular economy.

This review aimed to show that bioherbicides are possible in organic agriculture as natural compounds from fungi and metabolites produced by them. It is discussed that new formulations must be developed to improve field stability and enable the commercialization of microbial herbicides. Due to these bottlenecks, it is crucial to advance the bioprocesses behind the formulation and fermentation of bio-based herbicides, scaling up, strategies for field application, and the potential of bioherbicides in the global market. In this sense, it proposed insights for modern agriculture based on sustainable development and circular economy, precisely the formulation, scale-up, and field application of microbial bioherbicides.

A review of hybrid enzymatic-chemical treatment for wastewater containing antiepileptic drugs.

Epilepsy is one of the most common neurological diseases worldwide and requires treatment with antiepileptic drugs for many years or for life. This fact leads to the need for constant production and use of these compounds, placing them among the four pharmaceutical classes most found in wastewater. Even at low concentrations, antiepileptics pose risks to human and environmental health and are considered organic contaminants of emerging concern. Conventional treatments have shown low removal of these drugs, requiring advanced and innovative approaches. In this context, this review covers the results and perspectives on (1) consumption and occurrence of antiepileptics in water, (2) toxicological effects in aquatic ecosystems, (3) enzymatic and advanced oxidation processes for degrading antiepileptics drugs from a molecular point of view (biochemical and chemical phenomena), (4) improvements in treatment efficiency by hybridization, and (5) technical aspects of the enzymatic-AOP reactors.

The bioherbicidal potential of isolated fungi cultivated in microalgal biomass.

This study evaluated the bioherbicidal potential of wild fungi grown on microalgal biomass from the digestate treatment of biogas production. Four fungal isolates were used and the extracts were evaluated for the activity of different enzymes and characterized by gas chromatography coupled with mass spectrometry. The bioherbicidal activity was assessed by application on Cucumis sativus, and the leaf damage was visually estimated. The microorganisms showed potential as agents producing an enzyme pool. The obtained fungal extracts presented different organic compounds, most acids, and when applied to Cucumis sativus, showed high levels of leaf damage (80-100 ± 3.00%, deviation relative to the observed average damage). Therefore, the microbial strains are potential biological control agents of weeds, which, together with the microalgae biomass, offer the appropriate conditions to obtain an enzyme pool of biotechnological relevance and with favorable characteristics to be explored as bioherbicides, addressing aspects within the environmental sustainability.

Value of CTA/MRA in the setting of intraparenchymal hemorrhage in the emergency department.

PURPOSE: To assess the diagnostic yield of computed tomography angiography (CTA)/magnetic resonance angiography (MRA) brain and neck ordered in the emergency department (ED) for patients who have intraparenchymal hemorrhage (IPH) on their initial noncontrast CT (NCCT) of the head. METHODS: In this retrospective study, we reviewed 156 patients presenting to the ED with nontraumatic IPH, documented on NCCT. We assessed if the subsequent CTA/MRA was positive, and collected data regarding the location of the bleed, patients' age group, and presence/absence of associated SAH/IVH. Two neuroradiologists were asked to predict, based on age and NCCT appearance, whether the CTA/MRA would be positive or negative for demonstrating a vascular etiology of the hemorrhage. RESULTS: The yield of CTA/MRA head for patients above 75 years old was 2% (1/49), as the etiology for IPH in such age group was more commonly related to hypertensive bleed or amyloid angiopathy. The concomitant presence of subarachnoid hemorrhage (SAH) and intraventricular hemorrhage (IVH), particularly in patients younger than 75 years, correlated with a higher likelihood of a positive CTA. Statistically, the neuroradiologists were able to exclude a vascular source of the IPH based on CT appearance, bleed location, and patient's age in over 92% of cases. CONCLUSION: CTA/MRA for IPH has a lower yield in patients at older age and with deep gray matter distribution without SAH. Neuroradiologists were accurate at excluding a vascular source of the IPH in most cases. This study suggests that CTA/MRA can be omitted in certain scenarios, thereby preventing overutilization, and leading to optimal use of health care resources.

Nitrous oxide emission in altered nitrogen cycle and implications for climate change.

Natural processes and human activities play a crucial role in changing the nitrogen cycle and increasing nitrous oxide (N2O) emissions, which are accelerating at an unprecedented rate. N2O has serious global warming potential (GWP), about 310 times higher than that of carbon dioxide. The food production, transportation, and energy required to sustain a world population of seven billion have required dramatic increases in the consumption of synthetic nitrogen (N) fertilizers and fossil fuels, leading to increased N2O in air and water. These changes have radically disturbed the nitrogen cycle and reactive nitrogen species, such as nitrous oxide (N2O), and have impacted the climatic system. Yet, systematic and comprehensive studies on various underlying processes and parameters in the altered nitrogen cycle, and their implications for the climatic system are still lacking. This paper reviews how the nitrogen cycle has been disturbed and altered by anthropogenic activities, with a central focus on potential pathways of N2O generation. The authors also estimate the N2O-N emission mainly due to anthropogenic activities will be around 8.316 Tg N2O-N yr-1 in 2050. In order to minimize and tackle the N2O emissions and its consequences on the global ecosystem and climate change, holistic mitigation strategies and diverse adaptations, policy reforms, and public awareness are suggested as vital considerations. This study concludes that rapidly increasing anthropogenic perturbations, the identification of new microbial communities, and their role in mediating biogeochemical processes now shape the modern nitrogen cycle.

Neuroimaging in Pediatric Headache.

Headache represents one of the most common disorders in childhood and leads to nearly half a million visits to the physician's office or emergency department every year. Although the estimated prevalence is around 58.4%, the actual incidence of headache in the pediatric population might be underestimated, given only a percentage of cases seek medical attention. The first step in the evaluation of pediatric headache is a detailed clinical history and relevant clinical examinations. AAN and ACR do not recommend neuroimaging for patients with primary headache. However, neuroimaging becomes mandatory in presence of red flags to rule out the underlying cause.

Seawater-based biorefineries: A strategy to reduce the water footprint in the conversion of lignocellulosic biomass.

Biorefineries are an essential step towards implementing a circular economy in the long term. They are based on renewable raw materials and must be designed holistically, recovering building blocks from being converted into several products. Lignocellulosic biomass is considered a critical pillar for a biologically based economy and a high value-added feedstock. The separation of the structural complexity that makes up the biomass allows the development of different product flows. Chemical, physical, and biological processes are evaluated for fractionation, hydrolysis, and fermentation processes in biorefineries; however, the volume of freshwater used affects water safety and increases the economic costs. Non-potable-resources-based technologies for biomass bioconversion are essential for biorefineries to become environmentally and economically sustainable systems. Studies are being carried out to substitute freshwater with seawater to reduce the water footprint. Accordingly, this review addresses a comprehensive discussion about seawater-based biorefineries focusing on lignocellulosic biomass conversion in biofuel and value-added products.

Diagnóstico e acompanhamento da tuberculose - diferenças entre população geral e populações vulnerabilizadas / Diagnosis and monitoring of tuberculosis - differences between the general population and those with vulnerabilities / Diagnóstico y seguimiento de la tuberculosis - diferencias entre la población general y grupos con vulnerabilidades

RESUMO Objetivo a realização de exames diagnósticos e do acompanhamento da tuberculose entre população geral e populações em situação de vulnerabilidade social no município de Belo Horizonte/MG. Método estudo epidemiológico dos casos de tuberculose do Sistema de Informação de Belo Horizonte - Brasil, 2001 a 2017. Realizou-se análise descritiva e comparação entre população geral, população em situação de rua e privada de liberdade. Resultados os exames diagnósticos e de acompanhamento foram realizados com mais frequência nas populações vulnerabilizadas em até 30%, com baixo uso do teste rápido molecular(média de 35,4%) e do tratamento observado, com 22% de realização na população de rua e 38% na privada de liberdade. Conclusão o estudo sinaliza para a necessidade de priorização do teste rápido e do tratamento observado, especialmente entre públicos vulnerabilizados. Disseminar o uso dessas ferramentas pode determinar a interrupção da cadeia de transmissão, a possibilidade da cura e a não ocorrência de resistência.

ABSTRACT Objective: to compare the performance of diagnostic exams and monitoring of tuberculosis between the general population and those in situations of social vulnerability from the municipality of Belo Horizonte/MG. Method an epidemiological study of the tuberculosis cases recorded between 2001 and 2017 in the Information System of Belo Horizonte - Brazil. A descriptive analysis and a comparison were performed between the general population and those in street situations and deprived of their freedom. Results diagnostic and follow-up tests were performed more frequently in vulnerable populations, in up to 30%, with low use of the rapid molecular test (mean of 35.4%) and of the observed treatment, with 22% of performance in the street population. and 38% in individuals deprived of freedom. Conclusion the study points to the need to prioritize the rapid test and the observed treatment, especially among vulnerable groups. Disseminating the use of these tools can determine interruption of the transmission chain, the possibility of a cure and non-occurrence resistance.

RESUMEN Objetivo: comparar la realización de pruebas de diagnóstico y de seguimiento de la tuberculosis entre la población general y grupos en situación de vulnerabilidad social en el municipio de Belo Horizonte/MG. Método estudio epidemiológico de los casos de tuberculosis registrados entre 2001 y 2017 en el Sistema de Información de Belo Horizonte - Brasil. Se realizó un análisis descriptivo y una comparación entre la población general y grupos de personas en situación de calle y privadas de su libertad. Resultados las pruebas diagnósticas y de seguimiento se realizaron con hasta un 30% mayor frecuencia en poblaciones vulnerables, con bajo uso de la prueba molecular rápida (media de 35,4%) y tratamiento observado, con un 22% de realización en la población en situación de calle y 38% en personas privadas de su libertad. Conclusión el estudio apunta a la necesidad de priorizar la prueba rápida y el tratamiento observado, especialmente entre los grupos vulnerables. Difundir el uso de estas herramientas puede determinar la interrupción de la cadena de transmisión, la posibilidad de cura y la ausencia de resistencia.

Hydrothermal pretreatment of lignocellulosic biomass for hemicellulose recovery.

The hemicellulosic fraction recovery is of interest for integrated processes in biorefineries, considering the possibility of high economic value products produced from their structural compounds of this polysaccharide. However, to perform an efficient recovery, it is necessary to use biomass fractionation techniques, and hydrothermal pretreatment is highlighted as a valuable technique in the hemicellulose recovery by applying high temperatures and pressure, causing dissolution of the structure. Considering the possibility of this pretreatment technique for current approaches to hemicellulose recovery, this article aimed to explore the relevance of hydrothermal pretreatment techniques (sub and supercritical water) as a strategy for recovering the hemicellulosic fraction from lignocellulosic biomass. Discussions about potential products to be generated, current market profile, and perspectives and challenges of applying the technique are also addressed.

One-step procedure for peroxidase concentration, dye separation, and color removal by aqueous two-phase system.

The aim of our study is to develop a one-step procedure to remove and degrade dyes from wastewater using a low-cost and efficient system based on aqueous two-phase system (ATPS), a well-known technique used to concentrate and recover enzymes. We investigated the catalytic proprieties of rice bran peroxidase (RBP) and found that this homemade enzyme can remain bound to its substrate for up to 5 days in controlled environments, without denaturing and while maintaining stable oxidation reduction potential (ORP) and pH. This biomolecule showed affinity for the ATPS technique prepared with polyethylene glycol and salt, which improved the relative activity up to 170%. The red dye separation in ATPS top phase was achieved in 3 min, in the RBP presence, with 100% of efficiency, and color removal of 87% was obtained in 24 h of enzymatic reaction. The process has promise to be scaled up to 10-fold and to reuse the reagents from the bottom phase of the ATPS.

Extremophile Microbial Communities and Enzymes for Bioenergetic Application Based on Multi-Omics Tools.

Genomic and proteomic advances in extremophile microorganism studies are increasingly demonstrating their ability to produce a variety of enzymes capable of converting biomass into bioenergy. Such microorganisms are found in environments with nutritional restrictions, anaerobic environments, high salinity, varying pH conditions and extreme natural environments such as hydrothermal vents, soda lakes, and Antarctic sediments. As extremophile microorganisms and their enzymes are found in widely disparate locations, they generate new possibilities and opportunities to explore biotechnological prospecting, including biofuels (biogas, hydrogen and ethanol) with an aim toward using multi-omics tools that shed light on biotechnological breakthroughs.

A review on alternative bioprocesses for removal of emerging contaminants.

Emerging contaminants (ECs) include endocrine-disrupting compounds, pharmaceuticals (lipid regulators, antibiotics, diuretics, non-steroid anti-inflammatory drugs, stimulant drugs, antiseptics, analgesic, beta blockers), detergents, disinfectants, and personal care products. The residues from these compounds have become a concerning because of their bioactive presence on environmental matrices, especially water bodies. The development of technologies, aiming the secure and efficient removal of these compounds from the environment or event to remove them before they achieve the environment, is necessary. In these context, the present review is about promising eco-friendly, low-cost and specially applied, including biological processes using microalgae, bacteria, enzymes produced by fungi, and adsorbent materials such as those recycled from other processes waste. The processes where revised considering the removal mechanism and the efficiency rate.

Pre-treatment Strategies for Value Addition in Poultry Litter.

We studied different pre-treatments of poultry litter aiming to add economic value to this residue. Strategies were applied to extract ammonium nitrogen with the aim of allowing its further use as fertilizer, and to promote the hydrolysis and solubilization of lignocellulosic components with the aim of facilitating its subsequent conversion to biogas. Ammonia extraction was performed by solubilization in water in a one-step process and by successive extraction steps (3 times 60 min). Successive extractions presented greater removal of total ammonia nitrogen than did one-step extraction, solubilizing about 36% of the ammonia in water. In parallel pre-treatment using ultrasound was performed to increase carbon bioavailability for anaerobic digestion. Using this tool, 24.7 g kg-1 of total organic carbon and 13.0 g kg-1 of total reducing sugars were solubilized, employing 10% dry mass sample amount, 100% amplitude ultrasound at frequency of 20 kHz amplitude and 2.5 min of treatment (energy input of 299 ± 7 kJ L-1; 3,822 ± 95 kJ kg-1). Anaerobic digestion of ultrassound pre-treated biomass was evaluated using a biological biogas production assay, and an increase of 10% of biogas production was obtained compared to untreated samples (147.9 and 163.0 mL g-1 for crude and pre-treated PL, respectively). The findings suggest that these are environmentally friendly and sustainable strategies to add economic value to poultry litter, reducing the environmental impacts of improper disposal.

Nutritional, Energy and Sanitary Aspects of Swine Manure and Carcass Co-digestion.

Renewable energy can assist the management of the effects of population growth and rapid economic development on the sustainability of animal husbandry. The primary aim of renewable energy is to minimize the use of fossil fuels via the creation of environmentally friendly energy products from depleted fossil fuels. Digesters that treat swine manure are extensively used in treatment systems; and inclusion of swine carcasses can increase the organic loading rate (OLR) thereby improving biogas yield and productivity on farms. However, the characteristics of the components including animal residues, proteins, lipids, remains of undigested feed items, antimicrobial drug residues, pathogenic microorganisms and nutrient contents, are complex and diverse. It is therefore necessary to manage the anaerobic process stability and digestate purification for subsequent use as fertilizer. Efficient methane recovery from residues rich in lipids is difficult because such residues are only slowly biodegradable. Pretreatment can promote solubilization of lipids and accelerate anaerobic digestion, and pretreatments can process the swine carcass before its introduction onto biodigesters. This review presents an overview of the anaerobic digestion of swine manure and carcasses. We analyze the characteristics of these residues, and we identify strategies to enhance biogas yield and process stability. We consider energy potential, co-digestion of swine manure and carcasses, physical, chemical, and biological pretreatment of biomass, sanitary aspects of swine manure and co-digestates and their recycling as fertilizers.

Fusarium oxysporum and Aspergillus sp. as Keratinase Producers Using Swine Hair From Agroindustrial Residues.

Technological processes mediated by microorganisms and enzymes are promising alternatives for treatment of recalcitrant residues. Keratinases hydrolyze keratin, the primary component of some wastes generated in many industrial activities. The present study was designed to evaluate strategies for obtaining keratinases produced by fungi using submerged fermentation and two residues as substrates, chicken feathers and swine hair. Two fungi isolated from feather residues showed potential for keratinase production, Fusarium oxysporum and Aspergillus sp. These were subjected to submerged fermentation using chicken feathers and swine hair prepared in three conditions (microbial concentration reduction, sterilization and hydrogen peroxide). The residual mass was quantified and tested for keratinase production. The most potent enzymatic extract was used in the precipitation technique with salts and organic solvents. The best results of enzymatic activity were obtained using F. oxysporum, on the 6thday of fermentation, obtaining 243.25 U mL-1 using sterilized swine hair as the substrate. Aspergillus sp. showed the highest keratinolytic activity on the 9thday, 113.50 U mL-1 using feathers as the substrate. The highest degradation percentage was 59.20% (w/w) in swine hair and the precipitation technique, with relative activities close to 50%. The results are promising for the application of residues and microorganisms in biotechnological processes of economic and environmental interest.

Advanced oxidation processes applied for color removal of textile effluent using a home-made peroxidase from rice bran.

Enzymes are becoming tools in industrial processes because of several advantages, including activity in mild environmental conditions, and high specificity. Peroxidase, for one, stably oxidizes several substrates. The present study aimed to develop advanced oxidation processes (AOP), using non-commercial rice bran peroxidase to remove color and toxicity of synthetic textile wastewater. Using a microwave and shaker system, we obtained 38.9% and 100% of effluent color removal after peroxidase treatment, respectively. In addition, the shaker system decants residual dye particles through filtration, providing the textile industry with an economical and environmentally viable alternative to effluent treatment. In toxicity tests results, both treatment systems damaged the used genetic material. This damage occurs because of industrial discharge of wastewater into water bodies; effluent dilution reduced this damage. The data suggest that peroxidase as a textile effluent treatment has potential uses in industrial processes, because rice bran peroxidase has demonstrated affinity with dyes.