Beach surface model construction: A strategy approach with structure from motion - multi-view stereo.

In contrast to traditional beach profiling methods like topographic surveys and GNSS, which pose significant challenges in terms of cost and time, this research underscores the efficiency, cost-effectiveness, and simplicity of terrestrial photogrammetry employing the Structure from Motion-Multi View Stereo (SfM-MVS) method. Notably, this approach enables the utilization of commonplace devices such as smartphones for data capture. The methodology integrates a 12-megapixel camera for image acquisition, processed through Agisoft Metashape Professional software, and validated for accuracy using ground control points (GCPs) and checkpoints (CKPs) calibrated via GNSS. Findings reveal substantial disparities in positional accuracy according to the Ground Control Points distribution. The study underscores the critical role of strategically distributing GCPs and CKPs in effectively mapping coastal areas, thus affirming the potential of SfM-MVS as a powerful and accessible tool for coastal monitoring initiatives. This research contributes significantly to advancing the efficiency and accessibility of beach profile monitoring, offering invaluable insights for researchers and practitioners in coastal management and environmental conservation efforts.•A simplified beach profile modeling methodology is proposed.•The method is faster and more cost-effective than traditional surveys (RTK GNSS, lidar, RPA).•The study highlights the importance of GCP and CKP distribution in enhancing SfM-MVS accuracy for coastal mapping.

Insights into the Serum Metabolic Adaptations in Response to Inspiratory Muscle Training: A Metabolomic Approach Based on 1H NMR and UHPLC-HRMS/MS.

Inspiratory muscle training (IMT) is known to promote physiological benefits and improve physical performance in endurance sports activities. However, the metabolic adaptations promoted by different IMT prescribing strategies remain unclear. In this work, a longitudinal, randomized, double-blind, sham-controlled, parallel trial was performed to investigate the effects of 11 weeks (3 days·week-1) of IMT at different exercise intensities on the serum metabolomics profile and its main regulated metabolic pathways. Twenty-eight healthy male recreational cyclists (30.4 ± 6.5 years) were randomized into three groups: sham (6 cm·H2O of inspiratory pressure, n = 7), moderate-intensity (MI group, 60% maximal inspiratory pressure (MIP), n = 11) and high-intensity (HI group, 85-90% MIP, n = 10). Blood serum samples were collected before and after 11 weeks of IMT and analyzed by 1H NMR and UHPLC-HRMS/MS. Data were analyzed using linear mixed models and metabolite set enrichment analysis. The 1H NMR and UHPLC-HRMS/MS techniques resulted in 46 and 200 compounds, respectively. These results showed that ketone body metabolism, fatty acid biosynthesis, and aminoacyl-tRNA biosynthesis were upregulated after IMT, while alpha linolenic acid and linoleic acid metabolism as well as biosynthesis of unsaturated fatty acids were downregulated. The MI group presented higher MIP, Tryptophan, and Valine levels but decreased 2-Hydroxybutyrate levels when compared to the other two studied groups. These results suggest an increase in the oxidative metabolic processes after IMT at different intensities with additional evidence for the upregulation of essential amino acid metabolism in the MI group accompanied by greater improvement in respiratory muscle strength.

New ruthenium-xanthoxylin complex eliminates colorectal cancer stem cells by targeting the heat shock protein 90 chaperone.

In this work, we describe a novel ruthenium-xanthoxylin complex, [Ru(phen)2(xant)](PF6) (RXC), that can eliminate colorectal cancer (CRC) stem cells by targeting the chaperone Hsp90. RXC exhibits potent cytotoxicity in cancer cell lines and primary cancer cells, causing apoptosis in HCT116 CRC cells, as observed by cell morphology, YO-PRO-1/PI staining, internucleosomal DNA fragmentation, mitochondrial depolarization, and PARP cleavage (Asp214). Additionally, RXC can downregulate the HSP90AA1 and HSP90B1 genes and the expression of HSP90 protein, as well as the expression levels of its downstream/client elements Akt1, Akt (pS473), mTOR (pS2448), 4EBP1 (pT36/pT45), GSK-3ß (pS9), and NF-κB p65 (pS529), implying that these molecular chaperones can be molecular targets for RXC. Moreover, this compound inhibited clonogenic survival, the percentage of the CRC stem cell subpopulation, and colonosphere formation, indicating that RXC can eliminate CRC stem cells. RXC reduced cell migration and invasion, decreased vimentin and increased E-cadherin expression, and induced an autophagic process that appeared to be cytoprotective, as autophagy inhibitors enhanced RXC-induced cell death. In vivo studies showed that RXC inhibits tumor progression and experimental metastasis in mice with CRC HCT116 cell xenografts. Taken together, these results highlight the potential of the ruthenium complex RXC in CRC therapy with the ability to eliminate CRC stem cells by targeting the chaperone Hsp90.

Kinetics of Torque Teno Virus Viral Load Is Associated with Infection and De Novo Donor Specific Antibodies in the First Year after Kidney Transplantation: A Prospective Cohort Study.

Torque teno virus (TTV) was recently identified as a potential biomarker for the degree of immunosuppression, and potentially as a predictor of rejection and infection in solid organ transplant patients. We evaluated TTV viral load in kidney transplant (KT) patients during the first year post-transplant to examine overall kinetics and their relationships with deleterious events, including episodes of infection and the formation of de novo donor-specific antibodies (DSAs). In a single-center, prospective observational cohort study, 81 KT patients were monitored at baseline, week 1, and month 1, 3, 6, 9 and 12, post-KT, and whenever required by clinical events. Kidney function, plasma TTV load, immunoglobulins and lymphocyte subpopulations were assessed at each time point. Twenty-six patients (32.1%) presented a total of 38 infection episodes post-KT. Induction immunosuppression with thymoglobulin, compared to basiliximab, was not associated with more infections (p = 0.8093). Patients with infectious events had lower T-cells (p = 0.0500), CD8+ T-cells (p = 0.0313) and B-cells (p = 0.0009) 1 month post-KT, compared to infection-free patients. Patients with infection also showed higher increases in TTV viral loads between week 1- month 1, post-KT, with TTV viral load variations >2.65 log10 cp/mL predicting the development of infectious events during the 12-month study period (p < 0.0001; sensitivity 99.73%; specificity 83.67%). Patients who developed de novo DSAs had lower TTV DNA viral loads at month 12 after KT, compared to patients who did not develop DSA (3.7 vs. 5.3 log10 cp/mL, p = 0.0023). Briefly, evaluating early TTV viremia is a promising strategy for defining infectious risk in the 1st year post-KT. The availability of standardized commercial real-time PCR assays is crucial to further validate this as an effective tool guiding immunosuppression prescription.

Development and validation of an instrument for the evaluation of HIV care in Primary Health Care.

OBJECTIVE: To develop and validate an instrument to evaluate the decentralization process of care for People Living with HIV in Primary Health Care. METHOD: Methodological study, developed in four stages: elaboration of the logical model based on the triad Structure-Process-Outcomes; development of the instrument; content validation by expert judges and technical reviewers; and semantic validation. Online questionnaires were used, and the Kappa index was used for analysis. RESULTS: The instrument with 68 items and 8 factors was submitted to validation by expert judges who recommended the exclusion of 3 items and the alteration of 2 factors. In the validation by technical reviewers, 2 items were excluded and 6 factors were highlighted; the agreement index was ≥0.75. In the semantic validation, 87.3% of the judges answered "totally agree" for the items presented. CONCLUSION: The instrument is validated for its content, has 63 items and has the potential to assess the care provided for people living with HIV in Primary Health Care.

Effectiveness of whole-body vibration on bone mineral density in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.

The present study observed significant effects of whole-body vibration (WBV) on bone mineral density (BMD) in postmenopausal women, with high-quality evidence for high-frequency, low-magnitude, and high-cumulative-dose use. The aim was to update a previous systematic review with meta-analysis to observe the effects of WBV on BMD in postmenopausal women. For the meta-analysis, the weighted mean difference between WBV and control groups, or WBV and conventional exercise, was used for the area of bone mineral density (aBMD) of the lumbar spine, femoral neck, total hip, trochanter, intertrochanter, and Ward's area, or volumetric trabecular bone mineral density (vBMDt) of the radius and tibia. Methodological quality was assessed using the PEDro scale and the quality of evidence using the GRADE system. In total, 23 studies were included in the systematic review and 20 in the meta-analysis. Thirteen studies showed high methodological quality. WBV compared with control groups showed significant effects on aBMD in the primary analysis (lumbar spine and trochanter), sensitivity (lumbar spine), side-alternating vibration (lumbar spine and trochanter), synchronous vibration (lumbar spine), low frequency and high magnitude (lumbar spine and trochanter), high frequency and low magnitude (lumbar spine), high frequency and high magnitude (lumbar spine, trochanter, and Ward's area), high cumulative dose and low magnitude (lumbar spine), low cumulative dose and high magnitude (lumbar spine and trochanter), and positioning with semi-flexed knees (trochanter). Of these results, only high frequency associated with low magnitude and high cumulative dose with low magnitude showed high-quality evidence. At this time, considering the high quality of evidence, it is possible to recommend WBV using high frequency (≈ 30 Hz), low magnitude (≈ 0.3 g), and high cumulative dose (≈ 7000 min) to improve lumbar spine aBMD in postmenopausal women. Other parameters, although promising, need to be better investigated, considering, when applicable, the safety of the participants, especially in vibrations with higher magnitudes (≥ 1 g).

Blood plasma and bone marrow interstitial fluid metabolomics of sickle cell disease patients with osteonecrosis: An exploratory study to dissect biochemical alterations.

Individuals with sickle cell disease (SCD) often experience numerous vaso-occlusive crisis events throughout their lives, which can progress to severe damage of several organs, including avascular necrosis, also known as osteonecrosis (ON). Osteonecrosis is one of the most devastating musculoskeletal clinical manifestations of sickle cell disease, afflicting up to 50% of the SCD patients. Herein, a NMR-based untargeted metabolomics approach was used to assess the metabolome alterations of blood plasma and bone marrow interstitial fluid (BMIF) samples of SCD patients with osteonecrosis. Furthermore, biochemical signatures associated with different osteonecrosis stages were assessed by analysing the metabolome of blood plasma and bone marrow interstitial fluid samples of SCD patients with different stages of the disease based on the Fiat and Arlet classification (FAC). Multivariate statistical analysis allowed a clear discrimination between the studied groups and it provided important insights into the different osteonecrosis stages. Citrate was pointed out as a possible biomarker to differentiate SCD patients with and without osteonecrosis. Acetate, creatinine, histidine, tyrosine, glucose, and NI5 seems to be key metabolites associated to different stages of the disease. Although this is a pioneer exploratory study, we acknowledge that fact that it is limited by the group sizes and absence of a validation cohort. Nevertheless, multivariate statistical analyses indicated that the metabolome of blood plasma and BMIF samples encompasses a complex metabolic regulation system for osteonecrosis.

Mortality predictors in a cohort of patients with COVID-19 admitted to a large tertiary hospital in the city of São Paulo, Brazil: a retrospective study

Abstract BACKGROUND: There is discrepant information across countries regarding the natural history of patients admitted to hospitals with coronavirus disease (COVID-19), in addition to a lack of data on the scenario in Brazil. OBJECTIVE: To determine the mortality predictors in COVID-19 patients admitted to a tertiary hospital in São Paulo, Brazil. DESIGN AND SETTING: A retrospective analysis of medical records of COVID-19 patients admitted to the Hospital Central da Irmandade da Santa Casa de Misericórdia of São Paulo. METHODS: Overall, 316 patients with laboratory-confirmed COVID-19 between March 1, 2020, and July 31, 2020, were included. The analysis included the baseline characteristics, clinical progression, and outcomes. RESULTS: The mortality rate of the sample was 51.27%. Age ≥ 60 years was determined as a risk factor after multivariate logistic regression analysis. Patients with an oxygen (O2) saturation ≤ 94% upon admission accounted for 87% of the deaths (P < 0.001). Vasoactive drugs were used in 92% (P < 0.001) of patients who progressed to death, and mechanical ventilation was employed in 88% (P < 0.001) of such patients. However, patients who received corticosteroids concomitantly with mechanical ventilation had a better prognosis than those who did not. The progressive degree of pulmonary involvement observed on chest computed tomography was correlated with a worse prognosis. The presence of thrombocytopenia has been considered as a risk factor for mortality. CONCLUSION: The main predictors of in-hospital mortality after logistic regression analysis were age, O2 saturation ≤ 94% upon admission, use of vasoactive drugs, and presence of thrombocytopenia.

Notificação de incidentes e a segurança do paciente em tempos de pandemia / Notificación de incidentes y la seguridad del paciente en tiempos de pandemia / Incident notification and patient safety in times of a pandemic

Resumo Objetivo Analisar as notificações de incidentes ocorridos durante a pandemia de COVID-19. Métodos Estudo com delineamento transversal de abordagem quantitativa do tipo descritivo exploratório. Foram analisadas 1.466 notificações à gerência de risco de um hospital privado, no período de setembro de 2020 a setembro de 2021. Utilizou-se a análise estatística descritiva, aplicando o teste Qui-quadrado de Pearson ou o teste da Razão de Verossimilhança. A margem de erro utilizada foi de 5%. Resultados Identificou-se como incidentes prevalentes a falha na comunicação (358 - 24,5%), falha no uso de sondas e cateteres (232 - 15,9%) e falha no uso de artigos e equipamentos (132 - 9,1%). A circunstância notificável totalizou (55,9%) dos relatos e destas, (33,4%) eram falha na comunicação. Os eventos adversos foram em número de 416 (28,6%) e a queda esteve relacionada a dano leve (43,9%); Infecção relacionada à assistência à saúde ao dano moderado (31%) e a falha no uso de medicamentos a (50%) como dano grave e óbito. Conclusão Falha na comunicação foi a circunstância de risco mais notificada, seguida de falha no uso de medicamentos como evento adverso com dano grave. A unidade de enfermaria evidenciou a possibilidade de maior número de eventos adversos; enquanto que nas unidades de terapia intensiva o grau de dano dos eventos adversos foi superior.

Resumen Objetivo Analizar las notificaciones de incidentes ocurridos durante la pandemia de COVID-19. Métodos Estudio con diseño transversal de enfoque cuantitativo del tipo descriptivo exploratorio. Se analizaron 1.466 notificaciones de la gestión de riesgo de un hospital privado, en el período de septiembre de 2020 a septiembre de 2021. Se utilizó el análisis estadístico descriptivo, aplicando la prueba χ2 de Pearson o la prueba de razón de verosimilitud. El margen de error utilizado fue del 5 %. Resultados Se identificaron como incidentes prevalentes la falla en la comunicación (358 - 24,5 %), falla en el uso de sondas y de catéteres (232 - 15,9 %) y falla en el uso de artículos y equipos (132 - 9,1 %). Las circunstancias que pueden ser notificadas totalizaron (55,9 %) de los relatos y, entre ellas, (33,4 %) era una falla en la comunicación. Los eventos adversos totalizaron 416 (28,6 %) y la disminución estuvo relacionada con el daño leve (43,9 %); infección relacionada con la atención a la salud al daño moderado (31 %) y a la falla al usar medicamentos (50 %) como daño grave y defunción. Conclusión La falla en la comunicación fue la circunstancia de riesgo más notificada, seguida de falla al usar medicamentos como evento adverso con daño grave. La unidad de enfermería evidenció la posibilidad de un número más elevado de eventos adversos; mientras que en las unidades de terapia intensiva el grado de daño de los eventos adversos fue superior.

Abstract Objective To review notification of incidents that occurred during the COVID-19 pandemic. Methods This is a cross-sectional, exploratory descriptive quantitative study. A total of 1,466 notifications to risk management of a private hospital were analyzed from September 2020 to September 2021. Descriptive statistical analysis was used, applying Pearson's chi-square test or the likelihood ratio test. The margin of error used was 5%. Results Communication failure (358 - 24.5%), probe and catheter use failure (232 - 15.9%) and article and equipment use failure (132 - 9.1%) were identified as prevalent incidents. The notifiable circumstance totaled 55.9% of reports, and, of these, 33.4% were communication failure. Adverse events were 416 (28.6%), and fall was related to mild damage (43.9%), health care-associated infections, to moderate harm (31%), and medication use failure (50%), to severe harm and death. Conclusion Communication failure was the most reported risk circumstance, followed by medication use failure as an adverse event with severe harm. The nursing unit showed the possibility of a greater number of adverse events, while in Intensive Care Units, the degree of harm from adverse events was higher.

Development and validation of an instrument for the evaluation of HIV care in Primary Health Care / Construcción y validación de un instrumento para la evaluación de la atención del VIH en la Atención Primaria de Salud / Construção e validação de instrumento avaliativo para atendimento ao HIV na Atenção Primária à Saúde

ABSTRACT Objective: To develop and validate an instrument to evaluate the decentralization process of care for People Living with HIV in Primary Health Care. Method: Methodological study, developed in four stages: elaboration of the logical model based on the triad Structure-Process-Outcomes; development of the instrument; content validation by expert judges and technical reviewers; and semantic validation. Online questionnaires were used, and the Kappa index was used for analysis. Results: The instrument with 68 items and 8 factors was submitted to validation by expert judges who recommended the exclusion of 3 items and the alteration of 2 factors. In the validation by technical reviewers, 2 items were excluded and 6 factors were highlighted; the agreement index was ≥0.75. In the semantic validation, 87.3% of the judges answered "totally agree" for the items presented. Conclusion: The instrument is validated for its content, has 63 items and has the potential to assess the care provided for people living with HIV in Primary Health Care.

RESUMEN Objetivo: Construir y validar un instrumento para la evaluación del proceso de descentralización de la atención a personas conviviendo con VIH en la Atención Primaria de Salud. Métodos: Es un estudio metodológico desarrollado en cuatro etapas: elaboración del modelo lógico basado en la tríada Estructura-Proceso-Resultados; construcción del instrumento; validación del contenido por jueces especialistas y revisores técnicos; y validación semántica. Se utilizaron cuestionarios en línea y el índice de Kappa para el análisis. Resultados: El instrumento con 68 ítems y 8 factores fue sometido a validación por jueces expertos que recomendaron la exclusión de 3 ítems y el cambio de 2 factores. En la validación por parte de los revisores técnicos, se excluyeron 2 ítems y se puntuaron 6 factores; el índice de acuerdo fue ≥0,75. En la validación semántica, el 87,3% respondió "totalmente de acuerdo" a los ítems presentados. Conclusiones: El instrumento se encuentra validado cuanto al contenido, posee 63 ítems y potencial para la evaluación de la atención de personas conviviendo con VIH en la Atención Primaria de Salud.

RESUMO Objetivo: construir e validar um instrumento de avaliação do processo de descentralização do atendimento às pessoas vivendo com HIV para Atenção Primária à Saúde. Métodos: estudo metodológico, desenvolvido em quatro etapas: elaboração do modelo lógico baseado na tríade Estrutura-Processo-Resultados; construção do instrumento; validação de conteúdo por juízes especialistas e revisores técnicos; e validação semântica. Utilizaram-se questionários on-line e, para análise, o índice de Kappa. Resultados: o instrumento, com 68 itens e 8 fatores, foi submetido à validação por juízes especialistas que recomendaram a exclusão de 3 itens e mudança de 2 fatores. Na validação por revisores técnicos, foram excluídos 2 itens e pontou-se 6 fatores, o índice de concordância foi ≥0,75. Na validação semântica 87,3% responderam "concordo totalmente" para os itens apresentados. Conclusões: O instrumento encontra-se validado quanto ao conteúdo, possui 63 itens e potencial para avaliação do atendimento às pessoas vivendo com HIV na Atenção Primária à Saúde.

Produção científica sobre qualidade e segurança na assistência obstétrica estudo bibliométrico / Scientific production on quality and safety in obstetric care: bibliometric study / Producción científica sobre calidad y seguridad en la atención obstétrica: estudio bibliométrico

Objetivo: analisar a frequência de palavras correlacionando com o título e resumo da produção científica sobre a qualidade e segurança na assistência obstétrica à luz da Lei de Zipf (frequência de palavras). Método: trata-se de um estudo bibliométrico, que possibilita compreender os padrões de produtividade científica ao longo dos anos. Realizaram-se buscas nas bases de dados LILACS, MEDLINE, Bdenf e SCOPUS (Elsivier) mediante utilização dos seguintes descritores oriundos do DeCS: obstetrícia/ obstetrics, segurança do paciente/ patient safety, qualidade dos serviços/ quality of health care; associou-se a esses termos o operador booleano AND. Resultados: após realizado o levantamento bibliométrico foram identificados 14 artigos relacionados que contemplaram à temática em estudo. Estes artigos estão publicados em 13 periódicos distintos. Conclusão: com base nos resultados apresentados, evidencia-se que, dentre os 14 artigos recrutados ­ desde 2014 a 2021, foram predominantes os estudos cuja abordagem relaciona-se intrinsecamente à temática qualidade e segurança na assistência obstétrica.

Objectives: to analyze the frequency of words correlating with the title and abstract of scientific production on quality and safety in obstetric care in the light of Zipf's Law (word frequency). Method: this is a bibliometric study, which makes it possible to understand the patterns of scientific productivity over the years. The databases LILACS, MEDLINE, Bdenf and SCOPUS (Elsivier) were searched using the following descriptors from DeCS: obstetrics, patient safety, quality of health care; the Boolean operator AND was associated with these terms. Results: after the bibliometric survey, 14 related articles were identified that covered the theme under study. These articles were published in 13 different journals. Conclusion: based on the results presented, it is evident that among the 14 articles recruited - from 2014 to 2021, there were predominant studies whose approach is intrinsically related to the theme of quality and safety in obstetric care.

Objetivos:analizar la frecuencia de palabras correlacionadas con el título y resumen de la producción científica sobre calidad y seguridad en la atención obstétrica a la luz de la Ley de Zipf (frecuencia de palabras). Método: se trata de un estudio bibliométrico, que permite comprender los patrones de productividad científica a lo largo de los años. Se realizaron búsquedas en las bases de datos LILACS, MEDLINE, Bdenf y SCOPUS (Elsivier) utilizando los siguientes descriptores del DeCS: obstetrics, patient safety, quality of health care; a estos términos se asoció el operador booleano AND. Resultados: tras el estudio bibliométrico, se identificaron 14 artículos relacionados que contemplaban el tema objeto de estudio. Estos artículos fueron publicados en 13 revistas diferentes. Conclusión: con base en los resultados presentados, se evidencia que, entre los 14 artículos reclutados - de 2014 a 2021, predominaron estudios cuyo abordaje está intrínsecamente relacionado con el tema calidad y seguridad en la atención obstétrica.

The Aging Process: A Metabolomics Perspective.

Aging process is characterized by a progressive decline of several organic, physiological, and metabolic functions whose precise mechanism remains unclear. Metabolomics allows the identification of several metabolites and may contribute to clarifying the aging-regulated metabolic pathways. We aimed to investigate aging-related serum metabolic changes using a metabolomics approach. Fasting blood serum samples from 138 apparently healthy individuals (20−70 years old, 56% men) were analyzed by Proton Nuclear Magnetic Resonance spectroscopy (1H NMR) and Liquid Chromatography-High-Resolution Mass Spectrometry (LC-HRMS), and for clinical markers. Associations of the metabolic profile with age were explored via Correlations (r); Metabolite Set Enrichment Analysis; Multiple Linear Regression; and Aging Metabolism Breakpoint. The age increase was positively correlated (0.212 ≤ r ≤ 0.370, p < 0.05) with the clinical markers (total cholesterol, HDL, LDL, VLDL, triacylglyceride, and glucose levels); negatively correlated (−0.285 ≤ r ≤ −0.214, p < 0.05) with tryptophan, 3-hydroxyisobutyrate, asparagine, isoleucine, leucine, and valine levels, but positively (0.237 ≤ r ≤ 0.269, p < 0.05) with aspartate and ornithine levels. These metabolites resulted in three enriched pathways: valine, leucine, and isoleucine degradation, urea cycle, and ammonia recycling. Additionally, serum metabolic levels of 3-hydroxyisobutyrate, isoleucine, aspartate, and ornithine explained 27.3% of the age variation, with the aging metabolism breakpoint occurring after the third decade of life. These results indicate that the aging process is potentially associated with reduced serum branched-chain amino acid levels (especially after the third decade of life) and progressively increased levels of serum metabolites indicative of the urea cycle.

Integrative perspective of the healthy aging process considering the metabolome, cardiac autonomic modulation and cardiorespiratory fitness evaluated in age groups.

The aging process causes changes at all organic levels. Although metabolism, cardiac autonomic modulation (CAM), and cardiorespiratory fitness (CRF) are widely studied as a function of age, they are mainly studied in isolation, thus making it difficult to perceive their concomitant variations. This study aimed to investigate the integrated changes that occur in the metabolome, CAM, and CRF throughout aging in apparently healthy individuals. The subjects (n = 118) were divided into five groups according to age (20-29, 30-39, 40-49, 50-59, and 60-70 years old) and underwent blood collection, autonomic assessment, and a cardiopulmonary exercise test for metabolomics analysis using mass spectrometry and nuclear magnetic resonance, cardiac autonomic modulation analysis, and CRF by peak oxygen consumption analysis, respectively. The Tukey's post hoc and effect size with confidence interval were used for variables with a significant one-way ANOVA effect (P < 0.01). The main changes were in the oldest age group, where the CRF, valine, leucine, isoleucine, 3-hydroxyisobutyrate, and CAM reduced and hippuric acid increased. The results suggest significant changes in the metabolome, CAM, and CRF after the age of sixty as a consequence of aging impairments, but with some changes in the metabolic profile that may be favorable to mitigate the aging deleterious effects.

Contenidos representacionales de profesionales de la red de atención a la salud sobre el HIV en el asesoramiento / Conteúdos representacionais de profissionais da rede de atenção à saúde sobre o HIV no aconselhamento / Representational content of professionals of the health care network about HIV in counseling

Objetivo: Analizar el contenido representacional de los profesionales de la red de atención de salud sobre el virus de la inmunodeficiencia humana en el asesoramiento.Método: Estudio de representaciones sociales con enfoque procedimental descriptivo-exploratorio realizado con 30 profesionales de asesoramiento de 17 puntos de la red de atención de salud de junio de 2017 a febrero de 2018 de acuerdo con el COREQ. Los datos fueron recolectados utilizando técnicas de entrevista y observación. El corpus fue elaborado y sometido a análisis de contenido por categorías temáticas apoyado en el software ATLAS.ti 8.0.Resultados: Emergieron las siguientes categorías: prejuicios sociales que comprometen el secreto y la privacidad en la recepción; vulnerabilidades que consolidan el asesoramiento previo a la prueba; y el estado serológico y el tratamiento que hacen que las pruebas sean urgentes. Los contenidos representacionales sobre el virus de la inmunodeficiencia humana, como los prejuicios sociales, las vulnerabilidades, el estado serológico y el tratamiento están relacionados con las dificultades para garantizar la confidencialidad y privacidad de las prácticas de recepción, el énfasis en el asesoramiento previo a la prueba, la urgencia de la prueba según el punto de atención.Conclusión: El análisis de contenido representacional reveló que la comunicación del diagnóstico de VIH debe ser guiada por las perspectivas de promoción de la salud y atención en red. En cuanto a las implicaciones para la Enfermería, se considera que proporciona orientaciones y acciones que valoran el adecuado desempeño profesional, consecuentemente, mejorando el cuidado de las personas. Para que la comprensión de los aspectos intersubjetivos pueda sustentar condiciones favorables en el asesoramiento en todos los puntos de la red de atención a la salud. (AU)

Objetivo: Analisar os conteúdos representacionais de profissionais da rede de atenção à saúde sobre o vírus da imunodeficiência humana no aconselhamento. Método: Estudo de representações sociais com abordagem processual do tipo descritivo-exploratório realizado com 30 profissionais aconselhadores de 17 pontos da rede de atenção à saúde no período de junho de 2017 a fevereiro de 2018 em conformidade com o COREQ. Os dados foram coletados a partir das técnicas de entrevistas e observação. O corpus foi elaborado e submetidos à análise de conteúdo temático-categorial com suporte do software ATLAS.ti 8.0.Resultados: Emergiram as categorias: preconceitos sociais que comprometem o sigilo e a privacidade no acolhimento; vulnerabilidades que consolidam o aconselhamento pré-teste; e condição sorológica e tratamento que imprimem urgência a testagem. Os conteúdos representacionais sobre o vírus da imunodeficiência humana, como preconceitos sociais, vulnerabilidades, condição sorológica e tratamento, relacionam-se às dificuldades em garantir o sigilo e a privacidade das práticas de acolhimento, à ênfase do aconselhamento pré-teste a urgência da testagem de acordo com o ponto de atenção. Conclusão: A análise dos conteúdos representacionais revelou que a comunicação do diagnóstico do HIV deve ser balizada pelas perspectivas de promoção da saúde e da atenção à saúde em rede. Quanto as implicações para a Enfermagem, considera-se que proporciona direcionamentos e ações que valorizem a adequada atuação profissional, consequentemente, melhorando a assistência as pessoas. A fim de que a compreensão dos aspectos intersubjetivos possa subsidiar condições favoráveis no aconselhamento em todos os pontos da rede de atenção à saúde. (AU)

Objective: To analyze the representational contents of health care professionals about human immunodeficiency virus in counseling. Method: Study of social representations with a procedural approach of the descriptive-exploratory type conducted with 30 professional counselors from 17 points of the health care network in the period from June 2017 to February 2018 in accordance with the COREQ. Data were collected from the techniques of interviews and observation. The corpus was elaborated and submitted to thematic-categorical content analysis with support from the ATLAS.ti 8.0 software. Results: The following categories emerged: social prejudices that compromise the confidentiality and privacy in the reception; vulnerabilities that consolidate pre-test counseling; and serological condition and treatment that impose urgency to testing. The representational contents about the human immunodeficiency virus, such as social prejudices, vulnerabilities, serological condition, and treatment, are related to the difficulties in ensuring confidentiality and privacy in the welcoming practices, the emphasis of pre-test counseling, and the urgency of testing according to the care point. Conclusion: The analysis of the representational contents revealed that the communication of the diagnosis of HIV should be guided by the perspectives of health promotion and network health care. As for the implications for Nursing, it is considered that it provides directions and actions that enhance the appropriate professional performance, consequently improving the assistance to people. In order that the understanding of intersubjective aspects can subsidize favorable conditions in counseling at all points of the health care network. (AU)

Mortality predictors in a cohort of patients with COVID-19 admitted to a large tertiary hospital in the city of São Paulo, Brazil: a retrospective study.

BACKGROUND: There is discrepant information across countries regarding the natural history of patients admitted to hospitals with coronavirus disease (COVID-19), in addition to a lack of data on the scenario in Brazil. OBJECTIVE: To determine the mortality predictors in COVID-19 patients admitted to a tertiary hospital in São Paulo, Brazil. DESIGN AND SETTING: A retrospective analysis of medical records of COVID-19 patients admitted to the Hospital Central da Irmandade da Santa Casa de Misericórdia of São Paulo. METHODS: Overall, 316 patients with laboratory-confirmed COVID-19 between March 1, 2020, and July 31, 2020, were included. The analysis included the baseline characteristics, clinical progression, and outcomes. RESULTS: The mortality rate of the sample was 51.27%. Age ≥ 60 years was determined as a risk factor after multivariate logistic regression analysis. Patients with an oxygen (O2) saturation ≤ 94% upon admission accounted for 87% of the deaths (P < 0.001). Vasoactive drugs were used in 92% (P < 0.001) of patients who progressed to death, and mechanical ventilation was employed in 88% (P < 0.001) of such patients. However, patients who received corticosteroids concomitantly with mechanical ventilation had a better prognosis than those who did not. The progressive degree of pulmonary involvement observed on chest computed tomography was correlated with a worse prognosis. The presence of thrombocytopenia has been considered as a risk factor for mortality. CONCLUSION: The main predictors of in-hospital mortality after logistic regression analysis were age, O2 saturation ≤ 94% upon admission, use of vasoactive drugs, and presence of thrombocytopenia.

Impact of acute schistosomiasis mansoni and long-term ethanol intake on mouse liver pathology.

While the effect of ethanol and schistosomiasis mansoni on liver injury has been well-documented, the influence of comorbidity on liver pathology remains unclear. To address this gap, schistosomiasis-infected mice were given one daily dose of 18% ethanol for 28 consecutive days, from day 35 post-infection. Mice were assigned to four groups: A. control; B. uninfected/ethanol gavage; C. infected; and D. infected/ethanol gavage. At day 64 post-infection, mice were euthanized by CO2 asphyxiation, livers were excised, fixed in 10% buffered formalin, paraffin embedded and cut into 5 µm sections. These were stained with hematoxylin and eosin (HE), Lennert's Giemsa and picrosirius red (for polarization microscopy) to assess histopathological and stereological changes. Group B showed alcoholic liver disease (ALD), including microsteatosis, hepatocyte karyopyknosis, karyorrhexis, karyolysis, increased frequency of Kupffer cells, hydropic degeneration of hepatocyte, thickened plasma membrane and binucleated hepatocytes. Infected mice showed typical exudative and exudative-productive hepatic granulomas, and destruction of the adjacent hepatic parenchyma, resulting in necrotic tissue and periovular leukocyte infiltrate. Group D showed hyperemia (parenchymal panlobular lesions), and liquefactive necrosis in hepatic abscess area. There was also reduced liver collagen deposition (-76%; p = 0.0001) and reduced microsteatosis (-80%, p = 0.0079) compared to group C and group B, respectively. In conclusion, comorbidity exacerbated liver damage.

Glucose-6-phosphate dehydrogenase immobilized onto magnetic beads (G6PDH-Mb) as a generator system for production of NADPH: Development and application in metabolism studies.

Reduced nicotinamide adenine dinucleotide phosphate (NADPH) participates in several anabolic and catabolic pathways, being essential in numerous biochemical reactions involving energy release. Most of these reactions require a high amount of NADPH, which can be expensive from an industry point of view. Thus, biotechnology industries developed a great interest in NADPH production. Currently, there are different ways to obtain NADPH in situ, however, the most common is by enzymatic reactions, known as generator systems. Although this approach can be beneficial in terms of cost, the major drawback is the impossibility of reusing the enzyme. To overcome this, enzyme immobilization is a proven alternative. Herein, we report the use of glucose-6-phosphate dehydrogenase immobilized onto magnetic beads (G6PDH-Mb) through glutaraldehyde coupling to produce high amounts of NADPH. The G6PDH-Mbs were kinetically characterized showing a sigmoidal curve. Besides, the stability was evaluated, and their reuse was demonstrated for a period superior to 40 days. The G6PDH-Mb was used to in situ production of the NADPH metabolism experiments, using human liver microsome solutions and either albendazole or fiscalin B as model targets. The production of in vitro metabolites from albendazole and fiscalin B was evaluated by comparing the use of NADPH generated in situ with those obtained by commercial NADPH. Moreover, the activity of the G6PDH-Mb was monitored after using it for five consecutive albendazole metabolism reactions, with only a minor decrease in the enzyme activity (3.58 ± 1.67%) after the fifth time of use. The higher concentration obtained when using the designed G6PDH-Mb generator system demonstrated proof of the concept and its applicability.

Chromatography Conditions Development by Design of Experiments for the Chemotype Differentiation of Four Bauhinia Species.

The extensive use of medicinal herbs to traditionally treat disease persists for generations, and scientific evidence on plant-derived extracts has indicated their numerous biological activities. The Bauhinia, popular known as cow's paw ("pata de vaca"), with more than 60 native species, are extensively used in Brazilian popular medicine for the control of diabetes. Therefore, in 2009, B. forficata, B. variegata and/or B. affinis were included in the Brazilian National List of Medicinal Plants of Interest to SUS (RENISUS - Brazil). In this context, this work reports the results of the chemical differentiation of B. forficata, B. variegata, B. longifolia, and B. affinis using liquid chromatography coupled to high-resolution mass spectrometry and unsupervised chemometric tools. Chromatographic conditions were optimized by using the design of experiments (DoE) and chromatographic knowledge. Furthermore, the chemical profile of the studied species was analyzed by principal component analysis (PCA) and hierarchical cluster analysis that differentiated the four species of Bauhinia, and 55 compounds were also inferred by MS2 experiments, some of them for the first time in B. affinis. In this manner, this work provides important information that could be used in quality control, development of new pharmaceuticals, and food products based on Bauhinia leaves, as well as to explain ethnomedicinal properties, pharmacological and toxicological actions.

Development of a New Integrated System for Vital Sign Monitoring in Small Animals.

Monitoring the vital signs of mice is an essential practice during imaging procedures to avoid populational losses and improve image quality. For this purpose, a system based on a set of devices (piezoelectric sensor, optical module and thermistor) able to detect the heart rate, respiratory rate, body temperature and arterial blood oxygen saturation (SpO2) in mice anesthetized with sevoflurane was implemented. Results were validated by comparison with the reported literature on similar anesthetics. A new non-invasive electrocardiogram (ECG) module was developed, and its first results reflect the viability of its integration in the system. The sensors were strategically positioned on mice, and the signals were acquired through a custom-made printed circuit board during imaging procedures with a micro-PET (Positron Emission Tomography). For sevoflurane concentration of 1.5%, the average values obtained were: 388 bpm (beats/minute), 124 rpm (respirations/minute) and 88.9% for the heart rate, respiratory rate and SpO2, respectively. From the ECG information, the value obtained for the heart rate was around 352 bpm for injectable anesthesia. The results compare favorably to the ones established in the literature, proving the reliability of the proposed system. The ECG measurements show its potential for mice heart monitoring during imaging acquisitions and thus for integration into the developed system.

Potentially inappropriate medication use in hospitalized elderly patients.

OBJECTIVE: This study aimed to assess the prevalence of potentially inappropriate medication prescription in hospitalized elderly patients according to the 2019 American Geriatrics Society Beers Criteria. METHODS: This study is a prospective analysis of electronic medical records of elderly patients admitted to the Department of Medicine, Hospital Central da Irmandade da Santa Casa de Misericórdia de São Paulo, between 1 September 2020 and 30 April 2021. RESULTS: A total of 142 patients (85 women and 57 men) with a mean age of 74.5±7.3 years (65-99 years) were assessed. Of these, 108 (76.1%) were elderly (age ≥65 years and <80 years) and 34 (23.9%) long-lived (age ≥80 years). The average length of stay found in the sample was 25.3±28.7 days (between 2 and 235 days), and 102 out of the 140 patients assessed remained in the hospital for up to 29 days. Sixteen drugs considered potentially inappropriate medication were found in the patients' prescriptions, with at least one potentially inappropriate medication having been prescribed to 141 (99.3%) patients. Elderly patients had a mean of 2.57±0.94 potentially inappropriate medication prescribed versus 2.56±0.89 among long-lived patients. The most prescribed potentially inappropriate medication were as follows: regular human insulin as required (85.2%), and omeprazole (73.9%) and metoclopramide as required (61.3%). CONCLUSION: The study sample showed significant percentages of potentially inappropriate medication prescriptions for the elderly admitted to the hospital.