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1.
ACS Omega ; 9(12): 13840-13851, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38559922

RESUMO

The survivability of encapsulated and nonencapsulated probiotics consisting of Lactobacillus acidophilus and Lacticaseibacillus casei and the nutritional, physicochemical, and sensorial features of cottage cheese were investigated under refrigeration storage at 4 °C for 28 days. Microbeads of L. acidophilus and L. casei were developed using 2% sodium alginate, 1.5% sodium alginate and 0.5% carrageenan, and 1% sodium alginate and 1% carrageenan using an encapsulation technique to assess the probiotic viability in cottage cheese under different gastrointestinal conditions (SGF (simulated gastric juice), SIF (simulated intestinal fluid)), and bile salt) and storage conditions. Scanning electron microscopy (SEM) elucidated the stable structure of microbeads, Fourier transform infrared spectroscopy (FTIR) confirmed the presence probiotics in the microcapsules, and X-ray diffraction (XRD) demonstrated the amorphous state of microbeads. Furthermore, the highest encapsulation efficiency was observed for alginate 1% and carrageenan 1% microbeads (T3), i.e., 95%. Likewise, viability was recorded in T3 against SGF, SIF, and bile salt solution, i.e., 8.5, 8.8, and 8.9 log CFU/g at 80 min of exposure, compared to the control. The results of pH showed a significant (p < 0.05) decline that ultimately increased the titratable acidity. Nutritional analysis of cottage cheese revealed the highest levels of ash, protein, and total solids in T3, exhibiting mean values of 3.2, 22, and 43.2 g/100 g, respectively, after 28 days of storage. The sensory evaluation of cottage cheese demonstrated better color, flavor, and textural attributes in T3. Conclusively, synergistic addition of L. acidophilus and L. casei encapsulated with alginate-carrageenan gums was found to be more effective in improving the viability of probiotics in cottage cheese than noncapsulated cells while carrying better magnitudes of ash and protein, lower acidity, and pleasant taste.

2.
J Am Coll Emerg Physicians Open ; 5(2): e13141, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38571489

RESUMO

Suicide is a leading cause of death among youth, and emergency departments (EDs) play an important role in caring for youth with suicidality. Shortages in outpatient and inpatient mental and behavioral health capacity combined with a surge in ED visits for youth with suicidal ideation (SI) and self-harm challenge many EDs in the United States. This review highlights currently identified best practices that all EDs can implement in suicide screening, assessment of youth with self-harm and SI, care for patients awaiting inpatient psychiatric care, and discharge planning for youth determined not to require inpatient treatment. We will also highlight several controversies and challenges in implementation of these best practices in the ED. An enhanced continuum of care model recommended for youth with mental and behavioral health crises utilizes crisis lines, mobile crisis units, crisis receiving and stabilization units, and also maximizes interventions in home- and community-based settings. However, while local systems work to enhance continuum capacity, EDs remain a critical part of crisis care. Currently, EDs face barriers to providing optimal treatment for youth in crisis due to inadequate resources including the ability to obtain emergent mental health consultations via on-site professionals, telepsychiatry, and ED transfer agreements. To reduce ED utilization and better facilitate safe dispositions from EDs, the expansion of community- and home-based services, pediatric-receiving crisis stabilization units, inpatient psychiatric services, among other innovative solutions, is necessary.

3.
Environ Monit Assess ; 196(5): 412, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38565815

RESUMO

Cadmium (Cd) is a highly toxic metal that frequently contaminates our environment. In this study, the bioflocculant-producing, cadmium-resistant Escherichia fergusonii ZSF-15 was characterized from Paharang drain, Bawa Chak, Faisalabad, Pakistan. The Cd-resistant E. fergusonii was used to determine the bioflocculant production using yeast-peptone-glycerol medium (pH 6.5) supplemented with 50 mg L-1 of Cd. The culture was incubated for 3 days at 37 °C in a rotary shaker at 120 rpm. The fermentation broth was centrifuged at 4000 g for 10 min after the incubation period. The maximum flocculating activity by isolate ZSF-15 was found to be 71.4% after 48 h of incubation. According to the Fourier transform infrared spectroscopy analysis, the bioflocculant produced by strain ZSF-15 was comprised of typical polysaccharide and protein, i.e. hydroxyl, carboxyl, and amino groups. The strain ZSF-15 exhibited bioflocculant activity at range of pH (6-8) and temperature (35-50℃). Maximum flocculation activity (i.e. 71%) was observed at 47℃, whereas 63% flocculation production was observed at pH 8. In the present study, antioxidant enzyme profile of ZSF-15 was also evaluated under cadmium stress. A significant increase in antioxidant enzymes including superoxide dismutase (118%) and ascorbate peroxidase (28%) was observed, whereas contents of catalase (86%), glutathione transferase (13%), and peroxidase (8%) were decreased as compared to control.


Assuntos
Antioxidantes , Cádmio , Escherichia , Cádmio/toxicidade , Concentração de Íons de Hidrogênio , Monitoramento Ambiental , Floculação
4.
Plants (Basel) ; 13(7)2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38611473

RESUMO

Brassica napus (B. napus) is susceptible to multiple abiotic stresses that can affect plant growth and development, ultimately reducing crop yields. In the past, many genes that provide tolerance to abiotic stresses have been identified and characterized. Peroxidase (POD) proteins, members of the oxidoreductase enzyme family, play a critical role in protecting plants against abiotic stresses. This study demonstrated a comprehensive investigation of the POD gene family in B. napus. As a result, a total of 109 POD genes were identified across the 19 chromosomes and classified into five distinct subgroups. Further, 44 duplicate events were identified; of these, two gene pairs were tandem and 42 were segmental. Synteny analysis revealed that segmental duplication was more prominent than tandem duplication among POD genes. Expression pattern analysis based on the RNA-seq data of B. napus indicated that BnPOD genes were expressed differently in various tissues; most of them were expressed in roots rather than in other tissues. To validate these findings, we performed RT-qPCR analysis on ten genes; these genes showed various expression levels under abiotic stresses. Our findings not only furnish valuable insights into the evolutionary dynamics of the BnPOD gene family but also serve as a foundation for subsequent investigations into the functional roles of POD genes in B. napus.

5.
Sci Rep ; 14(1): 8563, 2024 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-38609487

RESUMO

Heavy metal accumulation increases rapidly in the environment due to anthropogenic activities and industrialization. The leather and surgical industry produces many contaminants containing heavy metals. Cadmium, a prominent contaminant, is linked to severe health risks, notably kidney and liver damage, especially among individuals exposed to contaminated wastewater. This study aims to leverage the natural cadmium resistance mechanisms in bacteria for bioaccumulation purposes. The industrial wastewater samples, characterized by an alarming cadmium concentration of 29.6 ppm, 52 ppm, and 76.4 ppm-far exceeding the recommended limit of 0.003 ppm-were subjected to screening for cadmium-resistant bacteria using cadmium-supplemented media with CdCl2. 16S rRNA characterization identified Vibrio cholerae and Proteus mirabilis as cadmium-resistant bacteria in the collected samples. Subsequently, the cadmium resistance-associated cadA gene was successfully amplified in Vibrio species and Proteus mirabilis, revealing a product size of 623 bp. Further analysis of the identified bacteria included the examination of virulent genes, specifically the tcpA gene (472 bp) associated with cholera and the UreC gene (317 bp) linked to urinary tract infections. To enhance the bioaccumulation of cadmium, the study proposes the potential suppression of virulent gene expression through in-silico gene-editing tools such as CRISPR-Cas9. A total of 27 gRNAs were generated for UreC, with five selected for expression. Similarly, 42 gRNA sequences were generated for tcpA, with eight chosen for expression analysis. The selected gRNAs were integrated into the lentiCRISPR v2 expression vector. This strategic approach aims to facilitate precise gene editing of disease-causing genes (tcpA and UreC) within the bacterial genome. In conclusion, this study underscores the potential utility of Vibrio species and Proteus mirabilis as effective candidates for the removal of cadmium from industrial wastewater, offering insights for future environmental remediation strategies.


Assuntos
Cólera , Infecções Urinárias , Vibrio , Humanos , Proteus mirabilis/genética , Cádmio/toxicidade , Sistemas CRISPR-Cas/genética , RNA Ribossômico 16S , Águas Residuárias , RNA Guia de Sistemas CRISPR-Cas , Vibrio/genética
6.
Environ Pollut ; 346: 123691, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38431245

RESUMO

The excessive accumulation of heavy metals, particularly lead (Pb) in agricultural soils, is a growing problem worldwide and needs urgent attention. This study aimed to prepare green silicon (Si) NPs using extract of Chenopodium quinoa leaves and evaluated their effects on Pb uptake and growth of maize (Zea mays L.). The results indicated that Pb exposure negatively affected the growth and chlorophyll contents of maize varieties, while SiNPs positively affected these attributes. Pb alone increased the electrolyte-leakage (EL), hydrogen-peroxide (H2O2) and selected antioxidant enzyme activities in leaves, whereas SiNPs decreased EL and H2O2 concentrations and further enhanced the enzyme activities as compared to their respective treatments without SiNPs. Pb-only treatments led to an increase in Pb concentrations and total Pb uptake in both shoots and roots. In contrast, SiNPs resulted in reduced Pb concentrations, with a concurrent decrease in total Pb uptake in shoots compared to the control treatment. The findings demonstrated that foliar application of SiNPs can mitigate the toxic effects of Pb in maize plants by triggering the antioxidant enzyme system and reducing the oxidative stress. Taken together, SiNPs have the potential to enhance maize production in Pb-contaminated soils. However, future research and application efforts should prioritize key aspects such as optimizing NPs synthesis, understanding positive mechanisms of green-synthesized NPs, and conducting multiple crop tests and real-world field trials.


Assuntos
Nanopartículas , Poluentes do Solo , Zea mays , Antioxidantes/farmacologia , Silício/farmacologia , Chumbo/toxicidade , Peróxido de Hidrogênio/farmacologia , Nanopartículas/toxicidade , Solo , Poluentes do Solo/análise
7.
Children (Basel) ; 11(3)2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38539340

RESUMO

Bullying remains a pervasive issue that affects many children worldwide, with devastating consequences that ripple through their lives and communities [...].

8.
Funct Plant Biol ; 512024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38347662

RESUMO

Plant growth and development is adversely affected by environmental constraints, particularly salinity and drought. Climate change has escalated the effect of salinity and drought on crops in varying ways, affecting agriculture and most importantly crop productivity. These stressors influence plants across a wide range of levels, including their morphology and physiological, biochemical, and molecular processes. Plant responses to salinity and drought stress have been the subject of intense research being explored globally. Considering the importance of the impact that these stresses can have on agriculture in the short term, novel strategies are being sought and adopted in breeding programs. Better understanding of the molecular, biochemical, and physiological responses of agriculturally important plants will ultimately help promote global food security. Moreover, considering the present challenges for agriculture, it is critical to consider how we can effectively transfer the knowledge generated with these approaches in the laboratory to the field, so as to mitigate these adversities. The present collection discusses how drought and salinity exert effects on plants.


Assuntos
Secas , Salinidade , Melhoramento Vegetal , Produtos Agrícolas/fisiologia , Desenvolvimento Vegetal
9.
Environ Sci Pollut Res Int ; 31(15): 22790-22801, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38413521

RESUMO

Arsenic is a highly toxic metal that causes cancer even at a low concentration and its removal from water resources is challenging. Herein, carbon extracted from waste onion bulbs is activated to cater for porosity and functionalized with magnetite (Fe3O4) nanoparticles (named MCK6) to address the challenge of As(III) removal. Synthesized MCK6 was highly mesoporous having a surface area of 208 m2/g, where magnetite nanoparticles (≤ 10 nm) are homogeneously distributed within a porous network. The developed adsorbent inherited functional groups from the biosource and magnetic property from magnetite making it ideal for removal of As(III). Further, MCK6 showed a maximum monolayer adsorption capacity (qm) of 10.2 mg/g at 298 K and pH 7. The adsorption thermodynamics delineates a non-spontaneous and endothermic reaction, where the kinetics followed pseudo 2nd order (R2 value of 0.977), while monolayer formation is explained by the Langmuir model. Moreover, MCK6 efficiently works to remove As(III) in a competitive metal ions system including Pb+2, Cd+2, and Ca+2, making it a suitable adsorbent to tackle contaminated water.


Assuntos
Nanopartículas de Magnetita , Poluentes Químicos da Água , Purificação da Água , Água/química , Óxido Ferroso-Férrico , Porosidade , Carbono , Poluentes Químicos da Água/análise , Adsorção , Cinética , Concentração de Íons de Hidrogênio , Nanopartículas de Magnetita/química
10.
Physiol Plant ; 176(1): e14213, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38353135

RESUMO

Brassica napus is an important oil crop and cold stress severely limits its productivity. To date, several studies have reported the regulatory genes and pathways involved in cold-stress responses in B. napus. However, transcriptome-scale identification of the regulatory genes is still lacking. In this study, we performed comparative transcriptome analysis of cold-tolerant C18 (CT - C18) and cold-sensitive C6 (CS - C6) Brassica napus genotypes under cold stress for 7 days, with the primary purpose of identifying cold-responsive transcription in B. napus. A total of 6061 TFs belonging to 58 families were annotated in the B. napus genome, of which 3870 were expressed under cold stress in both genotypes. Among these, 451 TFs were differentially expressed (DE), with 21 TF genes expressed in both genotypes. Most TF members of the MYB (26), bHLH (23), and NAC (17) families were significantly expressed in the CT - C18 genotype compared with the CS - C6 B. napus genotype. GO classification showed a significant role in transcription regulation, DNA-binding transcription factor activity, response to chitin, and the ethylene-activated signaling pathway. KEGG pathway annotation revealed these TFs are involved in regulating more pathways, resulting in more tolerance. In conclusion, the results provide insights into the molecular regulation mechanisms of B. napus in response to freezing treatment, expanding our understanding of the complex molecular mechanisms in plants' response to freezing stress.


Assuntos
Brassica napus , Transcriptoma , Humanos , Transcriptoma/genética , Brassica napus/metabolismo , Fatores de Transcrição/metabolismo , Regulação da Expressão Gênica de Plantas/genética , Perfilação da Expressão Gênica/métodos , Genótipo
12.
Int J Biol Macromol ; 261(Pt 2): 129947, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38316326

RESUMO

The present research investigates the effectiveness of nano-emulsified coatings (C-1, C-2, and C-3) in preserving the kiwifruit at a temperature of 10 ± 2 °C with 90-95 % relative humidity (RH) for 30 days. The nano-emulsions were prepared from varied carboxymethyl cellulose (CMC) concentrations with different combinations of essential oils such as thyme, clove, and cardamom. Dynamic light scattering investigation with Zeta Sizer revealed that C-1, C-2, and C-3 nano-emulsions have nano sizes of 81.3 ± 2.3, 115.3 ± 4.2, and 63.2 ± 3.2 nm, respectively. The scanning electron microscopy images showed that the nanoemulsion of C-1 had homogenous spherical globules, C-2 had voids, and C-3 showed a non-porous structure with uniform dispersion. The X-ray diffraction analysis indicated that C-1, C-2, and C-3 nano-emulsion exhibited distinct crystallinity and peaks. The nano-emulsion C-1 had reduced crystallinity, while C-2 had lower intensity peaks, and C-3 had increased crystallinity. The results documented that compared to control kiwifruit samples, the samples coated with C-3 nano-emulsion have decreased weight loss, decay incidence, soluble solids, maturity index activity, ethylene production, total bacterial count, and increased titratable acid, and firmness attributes. The results of current research are promising and would be applicable in utilization in industrial applications.


Assuntos
Filmes Comestíveis , Óleos Voláteis , Conservação de Alimentos/métodos , Carboximetilcelulose Sódica/química , Temperatura , Emulsões/química
14.
Biotechnol Appl Biochem ; 71(2): 402-413, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38287712

RESUMO

Malonyl-CoA serves as the main building block for the biosynthesis of many important polyketides, as well as fatty acid-derived compounds, such as biofuel. Escherichia coli, Corynebacterium gultamicum, and Saccharomyces cerevisiae have recently been engineered for the biosynthesis of such compounds. However, the developed processes and strains often have insufficient productivity. In the current study, we used enzyme-engineering approach to improve the binding of acetyl-CoA with ACC. We generated different mutations, and the impact was calculated, which reported that three mutations, that is, S343A, T347W, and S350W, significantly improve the substrate binding. Molecular docking investigation revealed an altered binding network compared to the wild type. In mutants, additional interactions stabilize the binding of the inner tail of acetyl-CoA. Using molecular simulation, the stability, compactness, hydrogen bonding, and protein motions were estimated, revealing different dynamic properties owned by the mutants only but not by the wild type. The findings were further validated by using the binding-free energy (BFE) method, which revealed these mutations as favorable substitutions. The total BFE was reported to be -52.66 ± 0.11 kcal/mol for the wild type, -55.87 ± 0.16 kcal/mol for the S343A mutant, -60.52 ± 0.25 kcal/mol for T347W mutant, and -59.64 ± 0.25 kcal/mol for the S350W mutant. This shows that the binding of the substrate is increased due to the induced mutations and strongly corroborates with the docking results. In sum, this study provides information regarding the essential hotspot residues for the substrate binding and can be used for application in industrial processes.


Assuntos
Acetil-CoA Carboxilase , Streptomyces antibioticus , Acetil-CoA Carboxilase/genética , Acetil-CoA Carboxilase/metabolismo , Streptomyces antibioticus/metabolismo , Acetilcoenzima A/genética , Simulação de Acoplamento Molecular , Mutação , Saccharomyces cerevisiae/metabolismo , Escherichia coli/metabolismo
15.
Simul Healthc ; 19(1S): S23-S31, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38240615

RESUMO

ABSTRACT: This systematic review was performed to assess the effectiveness of in situ simulation education. We searched databases including MEDLINE and Embase for studies comparing in situ simulation with other educational approaches. Two reviewers screened articles and extracted information. Sixty-two articles met inclusion criteria, of which 24 were synthesized quantitatively using random effects meta-analysis. When compared with current educational practices alone, the addition of in situ simulation to these practices was associated with small improvements in clinical outcomes, including mortality [odds ratio, 0.66; 95% confidence interval (CI), 0.55 to 0.78], care metrics (standardized mean difference, -0.34; 95% CI, -0.45 to -0.21), and nontechnical skills (standardized mean difference, -0.52; 95% CI, -0.99 to -0.05). Comparisons between in situ and traditional simulation showed mixed learner preference and knowledge improvement between groups, while technical skills showed improvement attributable to in situ simulation. In summary, available evidence suggests that adding in situ simulation to current educational practices may improve patient mortality and morbidity.


Assuntos
Atenção à Saúde , Treinamento por Simulação , Humanos , Assistência ao Paciente
16.
Environ Sci Pollut Res Int ; 31(8): 12446-12466, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38231326

RESUMO

Magnesium oxide nanoparticles (MgO NPs) have great potential to enhance the crop productivity and sustainability of agriculture. Still, a thorough understanding is lacking about its essentiality or toxicity and precise dose for the safe cultivation of oilseed crops. Thus, we assessed the dual effects of MgO NPs (control, 5, 10, 20, 40, 80, and 200 mg/L) on the seed germination, growth performance, photosynthesis, total soluble protein, total carbohydrates, oxidative stress markers (hydrogen peroxide as H2O2 and superoxide anion as O2•‒), lipid peroxidation as MDA, and antioxidant defence machinery (SOD, CAT, APX, and GR activities, and GSH levels) of seven different oilseeds (Brassica napus L.) cultivars (ZY 758, ZD 649, ZD 635, ZD 619, GY 605, ZD 622, and ZD 630). Our findings revealed that low doses of MgO NPs (mainly at 10 mg/L) markedly boosted the seed germination, plant growth (shoot and root lengths) (15‒22%), and biomass (fresh and dry) (11‒19%) by improving the levels of photosynthetic pigments (14‒27%), net photosynthetic rate, stomatal conductance, photosynthetic efficiency (Fv/Fm), total soluble protein and total carbohydrates (16‒36%), antioxidant defence, and reducing the oxidative stress in B. napus tissues. Among all B. napus cultivars, these beneficial effects of MgO NPs were pronounced in ZD 635. ile, elevated levels of MgO NPs (particularly at 200 mg/L) induced oxidative stress, impaired antioxidant scavenging potential, photosynthetic inhibition, protein oxidation, and carbohydrate degradation and lead to inhibit the plant growth attributes. These inhibitory effects were more pronounced in ZD 622. Collectively, low-dose MgO NPs reinforced the Mg contents, protected the plant growth, photosynthesis, total soluble carbohydrates, enzyme activities, and minimized the oxidative stress. While, the excessive MgO NP levels impaired the above-reported traits. Overall, ZD 622 was highly susceptible to MgO NP toxicity and ZD 635 was found most tolerant to MgO NP toxicity.


Assuntos
Brassica napus , Nanopartículas , Antioxidantes/metabolismo , Óxido de Magnésio/farmacologia , Peróxido de Hidrogênio/metabolismo , Estresse Oxidativo , Carboidratos
17.
Biodegradation ; 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-38289541

RESUMO

Microplastics pose significant challenges to ecosystems and organisms. They can be ingested by marine and terrestrial species, leading to potential health risks and ecological disruptions. This study aims to address the urgent need for effective remediation strategies by focusing on the biodegradation of microplastics, specifically polyvinyl chloride (PVC) derivatives, using the bacterial strain Bacillus albus. The study provides a comprehensive background on the accumulation of noxious substances in the environment and the importance of harnessing biodegradation as an eco-friendly method for pollutant elimination. The specific objective is to investigate the enzymatic capabilities of Bacillus albus, particularly the alpha/beta hydrolases (ABH), in degrading microplastics. To achieve this, in-silico studies were conducted, including analysis of the ABH protein sequence and its interaction with potential inhibitors targeting PVC derivatives. Docking scores of - 7.2 kcal/mol were obtained to evaluate the efficacy of the interactions. The study demonstrates the promising bioremediation prospects of Bacillus albus for microplastics, highlighting its potential as a key player in addressing microplastic pollution. The findings underscore the urgent need for further experimental validation and practical implementation of Bacillus albus in environmental remediation strategies.

18.
JAMA Pediatr ; 178(1): 55-64, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37955907

RESUMO

Importance: Febrile infants at low risk of invasive bacterial infections are unlikely to benefit from lumbar puncture, antibiotics, or hospitalization, yet these are commonly performed. It is not known if there are differences in management by race, ethnicity, or language. Objective: To investigate associations between race, ethnicity, and language and additional interventions (lumbar puncture, empirical antibiotics, and hospitalization) in well-appearing febrile infants at low risk of invasive bacterial infection. Design, Setting, and Participants: This was a multicenter retrospective cross-sectional analysis of infants receiving emergency department care between January 1, 2018, and December 31, 2019. Data were analyzed from December 2022 to July 2023. Pediatric emergency departments were determined through the Pediatric Emergency Medicine Collaborative Research Committee. Well-appearing febrile infants aged 29 to 60 days at low risk of invasive bacterial infection based on blood and urine testing were included. Data were available for 9847 infants, and 4042 were included following exclusions for ill appearance, medical history, and diagnosis of a focal infectious source. Exposures: Infant race and ethnicity (non-Hispanic Black, Hispanic, non-Hispanic White, and other race or ethnicity) and language used for medical care (English and language other than English). Main Outcomes and Measures: The primary outcome was receipt of at least 1 of lumbar puncture, empirical antibiotics, or hospitalization. We performed bivariate and multivariable logistic regression with sum contrasts for comparisons. Individual components were assessed as secondary outcomes. Results: Across 34 sites, 4042 infants (median [IQR] age, 45 [38-53] days; 1561 [44.4% of the 3516 without missing sex] female; 612 [15.1%] non-Hispanic Black, 1054 [26.1%] Hispanic, 1741 [43.1%] non-Hispanic White, and 352 [9.1%] other race or ethnicity; 3555 [88.0%] English and 463 [12.0%] language other than English) met inclusion criteria. The primary outcome occurred in 969 infants (24%). Race and ethnicity were not associated with the primary composite outcome. Compared to the grand mean, infants of families that use a language other than English had higher odds of the primary outcome (adjusted odds ratio [aOR]; 1.16; 95% CI, 1.01-1.33). In secondary analyses, Hispanic infants, compared to the grand mean, had lower odds of hospital admission (aOR, 0.76; 95% CI, 0.63-0.93). Compared to the grand mean, infants of families that use a language other than English had higher odds of hospital admission (aOR, 1.08; 95% CI, 1.08-1.46). Conclusions and Relevance: Among low-risk febrile infants, language used for medical care was associated with the use of at least 1 nonindicated intervention, but race and ethnicity were not. Secondary analyses highlight the complex intersectionality of race, ethnicity, language, and health inequity. As inequitable care may be influenced by communication barriers, new guidelines that emphasize patient-centered communication may create disparities if not implemented with specific attention to equity.


Assuntos
Infecções Bacterianas , Etnicidade , Lactente , Criança , Recém-Nascido , Humanos , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estudos Transversais , Idioma , Barreiras de Comunicação , Antibacterianos/uso terapêutico
19.
J Am Coll Emerg Physicians Open ; 4(6): e13073, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38045015

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic posed new challenges in health care delivery for patients of all ages. These included inadequate personal protective equipment, workforce shortages, and unknowns related to a novel virus. Children have been uniquely impacted by COVID-19, both from the system of care and socially. In the initial surges of COVID-19, a decrease in pediatric emergency department (ED) volume and a concomitant increase in critically ill adult patients resulted in re-deployment of pediatric workforce to care for adult patients. Later in the pandemic, a surge in the number of critically ill children was attributed to multisystem inflammatory syndrome in children. This was an unexpected complication of COVID-19 and further challenged the health care system. This article reviews the impact of COVID-19 on the entire pediatric emergency care continuum, factors affecting ED care of children with COVID-19 infection, including availability of vaccines and therapeutics approved for children, and pediatric emergency medicine workforce innovations and/or strategies. Furthermore, it provides guidance to emergency preparedness for optimal delivery of care in future health-related crises.

20.
Front Chem ; 11: 1287599, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38116103

RESUMO

Background: Bacterial metabolites play a crucial role in human health and have proven effective in treating various diseases. In this study, the 16S rRNA method and streaking were employed to isolate and molecularly identify a bacterial strain, with the goal of characterizing bioactive volatile metabolites extracted using nonpolar and polar solvents. Methods: Gas chromatography-mass spectrometry (GC-MS) analysis was conducted to identify 29 compounds in the bacterial metabolites, including key compounds associated with Bacillus spp. The main compounds identified included 2-propanone, 4,4-ethylenedioxy-1-pentylamine, 1,2-benzenedicarboxylic acid, 1,1-butoxy-1-isobutoxy-butane, and 3,3-ethoxycarbonyl-5-hydroxytetrahydropyran-2-one. Results: The literature indicates the diverse biological and pharmacological applications of these compounds. Different concentrations of the metabolites from Bacillus species were tested for biological activities, revealing significant inhibitory effects on anti-diabetic activity (84.66%), anti-inflammatory activity (99%), antioxidant activity (99.8%), and anti-hemolytic activity (90%). Disc diffusion method testing also demonstrated a noteworthy inhibitory effect against tested strains. Conclusion: In silico screening revealed that 1,2-benzenedicarboxylic acid exhibited anticancer activity and promising drug-designing properties against epithelial glioblastoma cancer genes. The study highlights the potential of Bacillus spp. as a valuable target for drug research, emphasizing the significance of bacterial metabolites in the production of biological antibacterial agents.

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