Study on the Influence of UV Light on Selective Antibacterial Activity of Silver Nanoparticle Synthesized Utilizing Protein/Polypeptide-Rich Aqueous Extract from The Common Walkingstick, Diapheromera femorata.

Common walkingstick (Diapheromera femorata) aqueous extract (CWSAE) can induce the synthesis of useful bionanomaterials. CWSAE is rich in water-soluble organic compounds such as proteins and polypeptides that function as reducing/stabilizing agents for nanoparticle formation from Ag+ ion precursors. The synthesized AgNPs exhibited a moderately uniform size, with the majority falling within the range of 20-80 nm. These AgNPs were UV-treated and tested as antibacterial agents to inhibit the growth of four pathogenic bacteria (Burkholderia cenocepacia K-56, Klebsiella pneumoniae ST258, Pseudomonas aeruginosa PAO1, and Staphylococcus aureus USA300), as well as one common bacterium (Escherichia coli BW25113). The disk diffusion test demonstrated that the UV-treated AgNPs significantly and selectively inhibited the growth of Staphylococcus aureus USA300 and P. aeruginosa, while showing a small effect on the other two species. This suggests the potential application of green-chemically synthesized AgNPs as selective antibacterial agents. Furthermore, we studied the effects of short-term (1-2 min) and long-term (5-30 min) UV treatment on the selective cytotoxicity of the AgNPs and found that the cytotoxicity of the AgNPs could depend on the duration of UV exposure against certain bacteria.

Alterations of the cerebral microstructure in patients with noise-induced hearing loss: A diffusion tensor imaging study.

OBJECTIVE: To explore the changes in the cerebral microstructure of patients with noise-induced hearing loss (NIHL) using diffusion tensor imaging (DTI). METHOD: Overall, 122 patients with NIHL (mild [MP, n = 79], relatively severe patients [including moderate and severe; RSP, n = 32], and undetermined [lost to follow-up, n = 11]) and 84 healthy controls (HCs) were enrolled. All clinical data, including age, education level, hearing threshold, occupation type, noise exposure time, and some scale scores (including the Mini-Mental State Examination [MMSE], tinnitus handicap inventory [THI], and Hamilton Anxiety Scale [HAMA]), were collected and analyzed. All participants underwent T1WI3DFSPGR and DTI, and tract-based spatial statistics and region of interest (ROI) analysis were used for assessment. RESULTS: The final sample included 71 MP, 28 RSP, and 75 HCs. The HAMA scores of the three groups were significantly different (p < .05). The noise exposure times, hearing thresholds, and HAMA scores of the MP and RSP were significantly different (p < .05). The noise exposure time was positively correlated with the hearing threshold and negatively correlated with the HAMA scores (p < .05), whereas the THI scores were positively correlated with the hearing threshold (p < .05). DTI analysis showed that all DTI parameters (fractional anisotropy [FA], axial diffusivity [AD], mean diffusivity [MD], and radial diffusivity [RD]) were significantly different in the left inferior longitudinal fasciculus (ILF) and left inferior fronto-occipital fasciculus (IFOF) for the three groups (p < .05). In addition, the FA values were significantly lower in the bilateral corticospinal tract (CST), right fronto-pontine tract (FPT), right forceps major, left superior longitudinal fasciculus (temporal part) (SLF), and left cingulum (hippocampus) (C-H) of the MP and RSP than in those of the HCs (p < .05); the AD values showed diverse changes in the bilateral CST, left IFOF, right anterior thalamic radiation, right external capsule (EC), right SLF, and right superior cerebellar peduncle (SCP) of the MP and RSP relative to those of the HC (p < .05). However, there were no significant differences among the bilateral auditory cortex ROIs of the three groups (p > .05). There was a significant negative correlation between the FA and HAMA scores for the left IFOF/ILF, right FPT, left SLF, and left C-H for the three groups (p < .05). There was a significant positive correlation between the AD and HAMA scores for the left IFOF/ILF and right EC of the three groups (p < .05). There were significantly positive correlations between the RD/MD and HAMA scores in the left IFOF/ILF of the three groups (p < .05). There was a significant negative correlation between the AD in the right SCP and noise exposure time of the MP and RSP groups (p < .05). The AD, MD, and RD in the left ROI were significantly positively correlated with hearing threshold in the MP and RSP groups (p < .05), whereas FA in the right ROI was significantly positively correlated with the HAMA scores for the three groups (p < .05). CONCLUSION: The changes in the white matter (WM) microstructure may be related to hearing loss caused by noise exposure, and the WM structural abnormalities in patients with NIHL were mainly located in the syndesmotic fibers of the temporooccipital region, which affected the auditory and language pathways. This confirmed that the auditory pathways have abnormal structural connectivity in patients with NIHL.

Evaluating acidic gastroesophageal reflux with wireless pH monitoring in French bulldogs with sliding hiatal herniation.

BACKGROUND: Sliding hiatal herniation (SHH) and gastroesophageal reflux (GER) commonly occur in French bulldogs. Wireless pH monitoring can quantitatively assess acidic GER in dogs affected by SHH. HYPOTHESIS/OBJECTIVES: Measure acidic GER in French bulldogs with SHH, pre- and post-brachycephalic obstructive airway syndrome (BOAS) surgery, utilizing a wireless pH capsule (Bravo Calibration-free, Medtronic, Minnesota), and correlate with owners' observations of regurgitation. ANIMALS: Eleven French bulldogs diagnosed with SHH via swallowing fluoroscopy. METHODS: Prospective cohort study. A pH capsule was endoscopically placed in the esophagus. Up to 96 hours of data were acquired as the owner logged clinical signs. Spearman's correlation and Wilcoxon rank-sum tests evaluated factors correlated with acid exposure time (AET), defined by the % time pH < 4. In 4/11 dogs, Bravo monitoring was repeated 2-4 months after BOAS surgery. RESULTS: Medians (Q1-Q3) for age and weight were 21 months (17-35.5) and 10.0 kg (8.9-11.5). BOAS severity was mild (3), moderate (4), or severe (4). Medians (Q1-Q3) for AET and reflux events were 3.3% (2.6-6.4) and 70 (34-173). Clinical score (P = .82) and BOAS severity (P = .60) were not correlated with AET, but age was negatively correlated (rho = -.66, P = .03). Median probability (Q1-Q3) that regurgitation was associated with a reflux event was 72.5% (0-99). Percent AET numerically improved in all 4 dogs that underwent BOAS surgery although not statistically assessed. CONCLUSIONS AND CLINICAL IMPORTANCE: Wireless pH monitoring documented acidic GER in French bulldogs with SHH, captured subclinical events, and showed improvements after BOAS surgery.

Comparative Efficacy of Pyrethroid-Based Paints against Turkestan Cockroaches.

The Turkestan cockroach, Periplaneta lateralis (Walker), is an invasive urban pest prevalent in dry areas of the southwestern United States. Treatment with liquid spray formulations containing insecticides is the most conventional method to decrease Turkestan cockroach population abundance around buildings. Intensive application of insecticide treatments near natural environments has prompted concerns regarding the impacts on non-target aquatic and terrestrial ecosystems. Technologies embedding insecticides in a paint matrix have successfully been used for the long-term reduction in disease-vector populations in tropical areas. Here, we evaluated the potential effectiveness of three pyrethroid-based paints against Turkestan cockroach nymphs on common surfaces inhabited by this species. Turkestan cockroaches continuously exposed for 1 h to 1-month aged alphacypermethrin and deltamethrin paints applied to concrete, metal, or PVC caused moderate to high mortality. Evaluations using choice boxes indicated that deltamethrin and transfluthrin paints had combined lethal and repellent effects on cockroaches. Alphacypermethrin also caused repellency and killed cockroaches rapidly. We discuss the implications of these findings on cockroach control practices.

The anaerobic exposure time (AET) as a novel process parameter in the anaerobic side-stream reactor (ASSR)-based process for excess sludge minimization.

Minimization of excess sludge produced by wastewater treatment plants has become a topical theme nowadays. One of the most used approaches to achieve this aim is the anaerobic side-stream reactor (ASSR) process. This is considered affected by the hydraulic retention time (HRT) of the anaerobic reactor, the anaerobic sludge loading rate (ASLR) and the sludge interchange ratio (SIR), although, studies available in the literature did not reflect a clear relationship with the sludge minimization yields. To overcome this, a novel parameter namely anaerobic exposure time (AET) was defined and related to reduction of the observed yield coefficient (Yobs) in a lab-scale plant implementing the ASSR process. Furthermore, the AET was validated by performing a detailed and thorough review of previous literature. Excess sludge production was successfully reduced (10-60 %) with the increase of the AET (7.9-13 h/d), although maintaining the same HRT in the ASSR and a constant sludge interchange ratio (SIR) (100 %). A strong correlation (Pearson = 0.763) was found between the AET, and the Yobs reduction reported in previous studies, also indicating a linear relationship (R2 = 0.92) between these parameters. Contrarily, the correlation between the Yobs with the ASLR and the ASSR-HRT resulted moderate (Pearson = 0.186) or weak (Pearson=-0.346), respectively. Overall, while operating at low AET (< 6 h), maintenance and uncoupling metabolism were found the main sludge reduction mechanisms. Increasing the AET (>8 h) favoured the occurrence of extracellular polymeric substances (EPS) hydrolysis and endogenous decay mechanisms, which improved excess sludge reduction. To conclude, the AET could be considered a reliable parameter to be used for design or control purposes for the ASSR-based process.

Microplastics alter the equilibrium of plant-soil-microbial system: A meta-analysis.

Microplastics (MPs) are widely identified as emerging hazards causing considerable eco-toxicity in terrestrial ecosystems, but the impacts differ in different ecosystem functions among different chemical compositions, morphology, sizes, concentrations, and experiment duration. Given the close relationships and trade-offs between plant and soil systems, probing the "whole ecosystem" instead of individual functions must yield novel insights into MPs affecting terrestrial ecosystems. Here, a comprehensive meta-analysis was employed to reveal an unambiguous response of the plant-soil-microbial system to MPs. Results showed that in view of plant, soil, and microbial functions, the general response patterns of plant and soil functions to MPs were obviously opposite. For example, polyethylene (PE) and polyvinyl chloride (PVC) MPs highly increased plant functions, while posed negative effects on soil functions. Polystyrene (PS) and biodegradable (Bio) MPs decreased plant functions, while stimulating soil functions. Additionally, low-density polyethylene (LDPE), PE, PS, PVC, Bio, and granular MPs significantly decreased soil microbial functions. These results clearly revealed that MPs alter the equilibrium of the plant-soil-microbial system. More importantly, our results further revealed that MPs tended to increase ecosystem multifunctionality, e.g., LDPE and PVC MPs posed positive effects on ecosystem multifunctionality, PE, PS, and Bio MPs showed neutral effects on ecosystem multifunctionality. Linear regression analysis showed that under low MPs size (<100 µm), ecosystem multifunctionality was gradually reduced with the increased size of MPs. The response of ecosystem multifunctionality showed a concave shape pattern along the gradient of experimental duration which was lower than 70 days. More importantly, there was a threshold (i.e., 5% w/w) for the effects of MPs concentration on ecosystem multifunctionality, i.e., under low concentration (< 5% w/w), ecosystem multifunctionality was gradually increased with the increased concentration of MPs, while ecosystem multifunctionality was gradually decreased under high concentration (i.e., > 5% w/w). These findings emphasize the importance of studying the effects of MPs on plant-soil-microbial systems and help us identify ways to reduce the eco-toxicity of MPs and maintain environmental safety in view of an ecology perspective.

Thoracic spine X-ray examination of patients with back pain using different breathing technique and exposure times - A diagnostic study.

INTRODUCTION: The breathing and suspended inspiration techniques are often used interchangeably for spine X-ray examinations. However, these techniques are not always adequately supported by clinical evidence. This study aimed to determine the two techniques' diagnostic value and adverse image outcomes. METHODS: A total of 400 participants were examined on a Siemens Ysio Max system and randomized into four examination groups: suspended inspiration or breathing techniques with exposure times of 1, 2, and 3.2 s, respectively. Two consultant radiologists conducted the evaluation of the X-ray images. If disagreement was present, the radiologists collaboratively reviewed the X-ray images until a consensus was reached. RESULTS: The final 394 study population comprised 275 women and 119 men with a mean age of 64 years (range:18-96 years). The proportions of visually sharp reproduction of the endplates and trabecular structures did not differ significantly with regards to differences in exposure times between groups. The breathing technique groups had significantly higher proportions of blurring and motion artifacts (p < 0.001). However, adverse image outcomes (motions artifacts) were significantly lower in the 1-s exposure group. CONCLUSIONS: The suspended inspiration and breathing techniques performed equally well regarding visually sharp reproduction. However, the suspended inspiration technique was superior to the breathing technique. regarding adverse image outcomes, although the latter could be improved by using a shorter exposure time. IMPLICATIONS FOR PRACTICE: The suspended inspiration and breathing technique appeared to perform at equal diagnostic levels. The suspended inspiration technique should be preferred due to its reduced risk of adverse image outcomes. However, the risk could also be reduced using a short exposure time with the breathing technique.

Alterations of resting-state functional network connectivity in patients with noise-induced hearing loss: A study based on independent component analysis.

Functional reorganization is a response to auditory deficits or deprivation, and less is known about the overall brain network alterations involving resting-state networks (RSNs) and multiple functional networks in patients with occupational noise-induced hearing loss (NIHL). So this study evaluated resting-state functional network connectivity (FNC) alterations in occupational NIHL using an independent component analysis (ICA). In total, 79 mild NIHL patients (MP), 32 relatively severe NIHL patients (RSP), and 84 age- and education- matched healthy controls (HC) were recruited. All subjects were tested using the Mini-mental State Examination scale, the tinnitus Handicap Inventory scale, the Hamilton Anxiety scale (HAMA) and scanned by T1-3DFSPGR, resting-state functional magnetic resonance imaging sequence in 3.0 T and analysed by the ICA. Seven RSNs were identified, compared with the HC, the MP showed increased FNC within the executive control network (ECN) and enhanced FNC within the default mode network (DMN) and the visual network (VN); compared with the HC, the RSP showed decreased FNC within the ECN and auditory network (AUN), DMN and VN; no significant changes in FNC were found in the MP compared with the RSP. Furthermore, the correlation analysis between the noise exposure time and hearing loss level, HAMA were both negative, and there were no significant correlations between the abnormal RSNs and the hearing level, noise exposure time and HAMA. These findings indicate that different degrees of NIHL involve different alterations in RSNs connectivity and may reveal the neural mechanisms related to emotion-related features and functional abnormalities following long-term NIHL.

Optimizing the Antimicrobial Activity of Sodium Hypochlorite (NaClO) over Exposure Time for the Control of Salmonella spp. In Vitro.

Fish is a nutritionally rich product; however, it is easily contaminated by pathogenic microorganisms, such as Salmonella spp. Therefore, this study aimed to identify the best concentration of sodium hypochlorite (NaClO), exposure time, and water temperature that allow the most effective antimicrobial effect on the viable population of Salmonella spp. Thus, Salmonella Enteritidis ATCC 13076 and Salmonella Schwarzengrund were exposed to different time frames, ranging from 5 min to 38.5 min, temperatures between 5 and 38.5 °C, and NaClO concentrations ranging from 0.36 to 6.36 ppm, through a central composite rotational design experiment (CCRD). The results demonstrated that the ATCC strain exhibited a quadratic response to sodium hypochlorite when combined with exposure time, indicating that initial contact would already be sufficient for the compound's action to inhibit the growth of the mentioned bacteria. However, for S. Schwarzengrund (isolated directly from fish cultivated in aquaculture), both NaClO concentration and exposure time significantly influenced inactivation, following a linear pattern. This suggests that increasing the exposure time of NaClO could be an alternative to enhance Salmonella elimination rates in fish slaughterhouses. Thus, the analysis indicates that the Salmonella spp. strains used in in vitro experiments were sensitive to concentrations equal to or greater than the recommended ones, requiring a longer exposure time combined with the recommended NaClO concentration in the case of isolates from aquaculture.

Risk of tuberculosis among pulmonary tuberculosis contacts: the importance of time of exposure to index cases.

INTRODUCTION: The intensity of exposure to index cases of tuberculosis [TB] may increase the risk of TB in their contacts. The aim was to determine TB risk factors among contacts of TB index cases. METHODS: A cohort study was carried out in the contacts of pulmonary TB cases registered by the epidemiological surveillance network from 01/01/2019 to 06/30/2021. The factors associated with the risk of TB in contacts were determined using the adjusted odds ratio [aOR] and its 95% confidence interval [CI]. RESULTS: From 847 TB cases, 7087 contacts were identified. The prevalence of TB was 2.0% [145/7087] and was higher in < 5 years compared to those ≥ 65 years [4.4% versus 1.2%; p < 0.001], in those exposed ≥ 6 h daily [4%], and < 6 h daily [1.6%] with respect to weekly exposure of < 6 h [0.7%; p < 0.001]. Those contacts exposed ≥ 6 h daily [aOR= 6.9; 95%CI:2.1-22.1], < 5 years [aOR= 8.3; 95%CI:1.8-37.8] and immigrants [aOR= 1.7; 95%CI:1.1-2.7] had a higher risk of TB. CONCLUSIONS: The risk of TB increases with the time of exposure to the index case and this risk is also higher in < 5 years and immigrants. Contact tracing has a high yield for detecting new cases of TB.

Roles of swallowing and belching in different phenotypes of gastroesophageal reflux disease.

BACKGROUND: The contributions of swallowing and belching to specific gastroesophageal reflux disease (GERD) phenotypes are unclear. METHODS: This study retrospectively analyzed esophageal pH/impedance studies, comparing reflux events preceded by gastric belching (GB), supragastric belching (SGB), air swallowing, and liquid/solid swallowing based on reflux position, lower esophageal sphincter (LES) pressure, and acid exposure time (AET). KEY RESULTS: 20 GERD patients and 10 controls were studied. Upright GERD patients and controls had a higher proportion of reflux events with a preceding swallow or belch (0.64, 0.64) than the supine group (0.38, p = 0.043). The upright group and controls trended toward a higher proportion of reflux events preceded by overall swallowing (0.61, 0.50) and air swallowing (0.55, 0.48) than the supine group (0.32, 0.31 p = 0.064, p = 0.11), but the three groups had similar rates of liquid/solid swallowing (0.032, 0.024, 0.017, p = 0.69). LES pressure did not correlate with reflux events preceded by swallowing (R2 = 0.021, p = 0.44). There was a higher rate of events preceded by gastric belching in the control group (0.14) than in the upright (0.032) and supine groups (0.066, p = 0.049). LES pressure did not correlate with the rate of events preceded by belching (R2 = 0.000093, p = 0.96). Normal AET patients had a higher rate of events preceded by GB (0.12) than those with increased acid exposure (0.030, p = 0.0083), but the two groups had similar rates of preceding air (0.43, 0.47, p = 0.68), liquid/solid (0.018, 0.032, p = 0.30), and overall swallowing (0.44, 0.53, p = 0.38). CONCLUSIONS AND INFERENCES: Swallowing more than belching is a dominant mechanism for reflux irrespective of GERD position, LES pressure, and AET.

Cluster randomized trial designs for modeling time-varying intervention effects.

Stepped-wedge cluster randomized trials (SW-CRTs) are typically analyzed assuming a constant intervention effect. In practice, the intervention effect may vary as a function of exposure time, leading to biased results. The estimation of time-on-intervention (TOI) effects specifies separate discrete intervention effects for each elapsed period of exposure time since the intervention was first introduced. It has been demonstrated to produce results with minimum bias and nominal coverage probabilities in the analysis of SW-CRTs. Due to the design's staggered crossover, TOI effect variances are heteroskedastic in a SW-CRT. Accordingly, we hypothesize that alternative CRT designs will be more efficient at modeling certain TOI effects. We derive and compare the variance estimators of TOI effects between a SW-CRT, parallel CRT (P-CRT), parallel CRT with baseline (PB-CRT), and novel parallel CRT with baseline and an all-exposed period (PBAE-CRT). We also prove that the time-averaged TOI effect variance and point estimators are identical to that of the constant intervention effect in both P-CRTs and PB-CRTs. We then use data collected from a hospital disinvestment study to simulate and compare the differences in TOI effect estimates between the different CRT designs. Our results reveal that the SW-CRT has the most efficient estimator for the early TOI effect, whereas the PB-CRT typically has the most efficient estimator for the long-term and time-averaged TOI effects. Overall, the PB-CRT with TOI effects can be a more appropriate choice of CRT design for modeling intervention effects that vary by exposure time.

The Impacts of Intimate Partner Violence on Postpartum Depression: An Updated Meta-Analysis.

The associations between intimate partner violence (IPV) and postpartum depression (PPD) have been well established in previous reviews. However, none has explored potential differences between IPV subtypes or exposure times, which could help healthcare providers recognize the adverse impacts of various IPV subtypes and conduct comprehensive IPV screening. This study aimed to estimate the impacts of overall IPV and its subtypes (physical, psychological, and sexual) on PPD using an updated meta-analysis and to examine the potential role of IPV exposure time and regional income levels. Four English databases (Medline, PsycINFO, PubMed, and Web of Science) and two Chinese databases (China National Knowledge Infrastructure [CNKI] and Wanfang Database) were systematically searched. We included 76 studies with 388,966 samples. Random-effects models were used to pool the odds ratios (ORs) across studies. Overall, IPV and its subtypes had statistically significant impacts on PPD (overall: OR = 2.50, physical: OR = 2.31, psychological: OR = 2.22, sexual: OR = 1.75). A higher impact of IPV on PPD was observed in middle- and low-income regions (OR = 3.01) than in high-income regions (OR = 1.92). IPV during pregnancy (OR = 2.73) had a greater impact on PPD than lifetime IPV (OR = 2.24). This study provides updated evidence for the significant impact of IPV and its subtypes and exposure time on PPD. Women at risk of exposure to physical IPV, especially during pregnancy, are in urgent need of support to reduce the risk of PPD.

Impacts caused by the use of screens during the COVID-19 pandemic in children and adolescents: an integrative review / Impactos causados pelo uso de telas durante a pandemia da COVID-19 em crianças e adolescentes: uma revisão integrativa

ABSTRACT Objective: To identify the scientific evidence on the impacts caused by the use of screens during the COVID-19 pandemic in children and adolescents, raising reflections for future interventions with this public. Data source: This is an integrative literature review, conducted in the databases Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), United States National Library of Medicine (PubMed), Scopus, Web of Science, and Embase, published from March 2020 to January 2022, in Portuguese, English and Spanish. Data synthesis: The search strategies allowed retrieving 418 articles, of which 218 were duplicates. The analysis of titles and abstracts resulted in the maintenance of 62 studies. Of these, 31 were excluded from the reading of the full text, since they did not clearly present the phenomenon investigated. Thirty-one were eligible, resulting in five categories: eye consequences; increased sedentary behavior and weight; change in eating habits; implications for sleep quality and impacts on mental health. Conclusions: The excessive use of screens during the pandemic led to numerous consequences for children and adolescents, with a higher incidence of visual damage, sedentary lifestyle, inadequate eating habit and increased weight gain, in addition to impaired sleep quality and mental health. This study provides subsidy for health professionals to carry out continuing education focused on this theme, and elaborate effective interventions for this public in this transition to the post-pandemic period.

RESUMO Objetivo: Identificar as evidências científicas sobre os impactos causados pelo uso de telas durante a pandemia da COVID-19 em crianças e adolescentes, almejando reflexões para futuras intervenções com esse público. Fontes de dados: Trata-se de uma revisão integrativa da literatura, realizada nas bases de dados Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), United States National Library of Medicine (PubMed), Scopus, Web of Science e Embase, publicados de março de 2020 a janeiro de 2022, em português, inglês e espanhol. Síntese dos dados: As estratégias de busca possibilitaram recuperar 418 artigos, sendo 218 duplicados. A análise de títulos e resumos resultou na manutenção de 62 estudos. Destes, após a leitura do texto integral foram excluídos 31, uma vez que não apresentavam com clareza o fenômeno investigado. Foram elegíveis 31 estudos, emergindo cinco categorias: consequências oculares; aumento do comportamento sedentário e do peso; alteração dos hábitos alimentares; implicações na qualidade do sono e impactos na saúde mental. Conclusões: Percebe-se que o uso telas em excesso durante a pandemia trouxe inúmeras consequências para o público infantojuvenil, com maior incidência de acometimentos visuais, sedentarismo, alimentação inadequada e, por consequência, maior ganho de peso, além de prejuízos à qualidade do sono e à saúde mental. Este estudo fornece subsídios para que os profissionais da saúde realizem educação continuada voltada para essa temática e elaborem intervenções efetivas para esse público nesta transição para o período pós-pandêmico.

In Vitro Effect of Low-Level Lasers on Total Bilirubin Concentration in Human Blood Plasma Using 375 and 650 nm Lasers.

Background: The current research extends previous laboratory investigations by investigating the effects of low-level laser irradiation (LLLI) on human blood plasma. Total bilirubin is of special importance because of its potential biostimulatory and modulatory actions. Objective: This study aims to analyze changes in total bilirubin content as a consequence of LLLI on human blood plasma. This study aims to determine how changes in exposure duration and laser wavelength affect these adjustments. Methodology: Plasma was isolated from a healthy adult donor's whole blood using the anticoagulant ethylenediaminetetraacetic acid (EDTA). Plasma samples were exposed to LLLI at 375 and 650 nm for 5, 10, 15, 20, and 25 min. Total bilirubin concentrations were measured both before and after irradiation using spectrophotometric analysis. The difference between 375 and 630 nm lasers was also investigated. Results: Five, 10, 15, 20, and 25 min of exposure to LLLI at 375 and 650 nm wavelengths resulted in statistically significant differences in total bilirubin content (p ˂ 0.05, p ˂ 0.001, p ˂ 0.0001). There was no statistically significant difference in total bilirubin concentration between the 375 and 630 nm lasers. Conclusions: Human blood plasma total bilirubin levels were considerably lower following LLLI at 375 and 630 nm than controls. Multiple exposures provide the same results. These findings demonstrate the role of biostimulation by laser irradiation in blood plasma applications and suggest that low-level laser treatment may control total bilirubin levels, particularly at 375 and 630 nm.

Toxic effects of thallium (Tl+) on prokaryotic alga Microcystis aeruginosa: Short and long-term influences by potassium and humic acid.

Thallium (Tl) is a priority pollutant regulated by the US EPA. It is also a critical element commonly used in high technology industries; with an increasing demand for semiconductors nowadays, wastewater discharges from manufacturing plants or metal mining activities may result in elevated levels of thallium in receiving water harming aquatic organisms. Regarding the impact of thallium on freshwater algae, little attention has been paid to prokaryotic physiology through various exposure periods. In this bench-scale study, prokaryotic alga Microcystis aeruginosa PCC 7806 was cultured in modified BG11 medium and exposed to Tl+ (TlNO3) ranging from 250 to 1250 µg/L for 4 and 14 days. Throughout the experiment using flow cytometry assays, algal population, cell membrane integrity, oxidation stress level, and chlorophyll fluorescence were exacerbated following the exposure to 750 µg Tl/L (approximately 4-day effective concentration of Tl+ for reducing 50% of algal population). Potassium and humic acid (HA) (1-5 mg/L) were added to study their influences on the thallium toxicity. With the additions of potassium, thallium toxicities to algal population and physiology were not significantly changed within 4 days, while they were alleviated within 14 days. With the addition of HA at 1 mg/L, cell membrane integrity was significantly attenuated within 4 days; ameliorating effects on algal population and oxidative stress were not observed until day 14. Thallium toxicities on oxidative stress level and photosynthesis activity were exacerbated in the presence of HA at 3-5 mg/L. The study provides useful information for further studies on the mode of toxic action of Tl+ in prokaryotic algae; it also demonstrates the necessity of considering short and long-term exposure durations while incorporating water chemistry into assessment of thallium toxicity to algae.

Assessment of Radiation Exposure with Mandatory Two Fluoroscopic Views for Epidural Procedures.

BACKGROUND: Various regulations and practice patterns develop on the basis of Local Coverage Determination (LCD), which are variably perceived as guidelines and/or mandated polices/ regulations. LCDs developed in 2021 and effective since December 2021 mandated a minimum of 2 views for final needle placement with contrast injection which includes both anteroposterior (AP) and lateral or oblique view. Radiation safety has been a major concern for pain physicians and multiple tools have been developed to reduce radiation dose, along with improvement in technologies to limit radiation exposure while performing fluoroscopically guided interventional procedures, with implementation of principles of As Low As Reasonably Achievable (ALARA). The mandated 2 views of epidural injections have caused concern among some physicians, because of the potential of increased exposure to ionizing radiation, despite application of various principles to minimize radiation exposure. Others, including policymakers are of the opinion that it reduces potential abuse and improves safety. OBJECTIVE: To assess variations in the performance of epidural procedures prior to the implementation of the new LCD compared with after the implementation of the new LCD by comparing time and dosage for all types of epidural procedures. STUDY DESIGN: A retrospective, case controlled, comparative evaluation of radiation exposure during epidural procedures in interventional pain management. SETTING: An interventional pain management practice and a specialty referral center in a private practice setting in the United States. METHODS: The study was performed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. The main outcome measure was radiation exposure time measured in seconds and dose measured in mGy-kG2 (milligray to kilogray squared per procedure). RESULTS: Changes in exposure and dose varied by procedural type and location. Exposure time in seconds increased overall by 21%, whereas radiation dose mGy-kG increased 133%. Fluoroscopy time increased most for lumbar interlaminar epidural injections of 43%, followed by 29% for cervical interlaminar epidural injections, 20% for caudal epidural injections, and 14% for lumbar transforaminal epidural injections. In contrast, highest increases were observed in the radiation dose mGy of 191% for caudal epidural injections, followed by 173% for lumbar interlaminar epidural injections, 113% for lumbar transforaminal epidural injections, and the lowest being cervical interlaminar epidural injections of 94%. This study also shows lesser increases for cervical interlaminar epidural injections because an oblique view is utilized rather than a lateral view resulting in a radiation dosage increase of 94% compared to overall increase of 133%, whereas the duration of time of 29% was higher than the overall combined duration of all procedures which only increased by 21%. LIMITATIONS: A retrospective evaluation utilizing the experience of a single physician. CONCLUSION: The results of this study showed significant increases in radiation exposure time and dosage; however, increase of dosage was overall 21% median Interquartile Range (IQR) compared to 133% of radiation dose median IQR. In addition, the results also showed variations for procedure, overall showing highest increases for lumbar interlaminar epidural injections for time (43%) and caudal epidural injections for dosage (191%).

Is there a direct relationship between hiatal hernia size, esophageal body hypomotility and symptomatic perception of gastroesophageal reflux episodes?

Background: The esophagogastric junction (EGJ) is classified into 3 anatomical subtypes according to lower esophageal sphincter-crural diaphragm (LES-CD) separation. We aimed to assess their relationship to esophageal motility, reflux characteristics, and symptom perception. Methods: We analyzed data from 1740 consecutive patients with typical reflux symptoms, who underwent high resolution manometry and a 24-h pH-impedance study during a 13-year period. A diagnosis of gastroesophageal reflux disease (GERD) was made if acid exposure time (AET) was >6%. EGJ types were classified as 1, 2, or 3, if LES-CD separation was up to 1 cm, 1-3 cm, or ≥3 cm, respectively. Results: EGJ type distribution was 72.2%, 22.1% and 5.7%, for types 1, 2 and 3, respectively. GERD was diagnosed in 31.2% and was more common among patients with EGJ type 2/3 vs. 1 (P<0.001). Length of LES-CD separation significantly correlated with AET and number of reflux episodes. Patients with type 2 or 3 EGJ more often showed ineffective or absent peristalsis compared with type 1 (P=0.008 and P<0.001 respectively). In the multivariate analysis, EGJ type 2/3 correlated with AET (P=0.001) and reflux episodes (P=0.041) but not with positive symptomatic markers or with ineffective/absent peristalsis. Conclusions: Our study confirms that EGJ anatomical morphology is a strong risk factor for GERD and correlates with both AET and the number of reflux events, though the length of separation is more important than the type. The multivariate analysis revealed that EGJ type 2 or 3 was not correlated with symptom perception or esophageal hypomotility.

The Distinctness of Illusory and Non-Illusory Conjunctions in the Perception of Chinese Words: Assessing the Roles of Stimulus Exposure Time.

Previous studies of illusory conjunction (IC) mainly focused on alphabetic languages, while researchers have poorly understood the IC mechanism of Chinese words as an ideographic writing system. In the present study, we aimed to investigate the dynamic changes of IC effects for Chinese words under different stimulus exposure times and spatial arrangements. We conducted two experiments with a 3 (Condition: IC, non-IC-same, non-IC-different) × 3 (Exposure time: 38 ms, 88 ms, 138 ms) within-subject design. The results showed that in the IC condition, the two characters recombined regardless of exposure time as long as they could form an orthographically correct new word, demonstrating the universality of IC. In non-IC conditions, increasing exposure time decreased response time and significantly reduced error rate, indicating that attention played a decisive role in perceptual processing. The spatial arrangement had no impact on IC production. These findings support the feature confirmation account model, suggesting that attention modulates IC through top-down feature confirmation processes. These data expand an understanding of IC mechanisms, validate the role of attention in feature confirmation, and elucidate the inimitable mechanism of the Chinese word IC influenced by both low-level visual processing and high-level cognitive control.

Sample Size Calculations for Stepped Wedge Designs with Treatment Effects that May Change with the Duration of Time under Intervention.

The stepped wedge design is often used to evaluate interventions as they are rolled out across schools, health clinics, communities, or other clusters. Most models used in the design and analysis of stepped wedge trials assume that the intervention effect is immediate and constant over time following implementation of the intervention (the "exposure time"). This is known as the IT (immediate treatment effect) assumption. However, recent research has shown that using methods based on the IT assumption when the treatment effect varies over exposure time can give extremely misleading results. In this manuscript, we discuss the need to carefully specify an appropriate measure of the treatment effect when the IT assumption is violated and we show how a stepped wedge trial can be powered when it is anticipated that the treatment effect will vary as a function of the exposure time. Specifically, we describe how to power a trial when the exposure time indicator (ETI) model of Kenny et al. (Statistics in Medicine, 41, 4311-4339, 2022) is used and the estimand of interest is a weighted average of the time-varying treatment effects. We apply these methods to the ADDRESS-BP trial, a type 3 hybrid implementation study designed to address racial disparities in health care by evaluating a practice-based implementation strategy to reduce hypertension in African American communities.