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Introduction: In March 2020, the Ontario-based Centre for Effective Practice (CEP) launched an online portal that would become the CEP COVID-19 Resource Centre (CRC), one of Ontario’s most well-known and best-used sources for primary care clinical and practice guidance during the COVID-19 pandemic. Description: Authors will describe how key principles of librarianship drove the development and evolution of the CRC, discuss their approach to literature searching and appraisal in a time of great uncertainty and scant evidence, and outline successes and challenges. Outcomes: With over 170,500 visitors since 2020, the CRC became an invaluable tool for primary care providers in Ontario, across Canada and internationally. 89% of site visitors reported that the CRC enhanced their knowledge of COVID-19 evidence, recommendations and policies. 87% of visitors reported that the Vaccine resource directly informed their practice. Discussion: Authors discuss challenges of the rapid-response format and skills formed by the demands of the pandemic.

IntroductionHuman trophoblastic cell lines, such as BeWo, are commonly used in 2D models to study placental Trypanosoma cruzi infections. However, these models do not accurately represent natural infections. Three-dimensional (3D) microtissue cultures offer a more physiologically relevant in vitro model, mimicking tissue microarchitecture and providing an environment closer to natural infections. These 3D cultures exhibit functions such as cell proliferation, differentiation, morphogenesis, and gene expression that resemble in vivo conditions.MethodsWe developed a 3D culture model using the human trophoblastic cell line BeWo and nonadherent agarose molds from the MicroTissues® 3D Petri Dish® system. Both small (12–256) and large (12–81) models were tested with varying initial cell numbers. We measured the diameter of the 3D cultures and evaluated cell viability using Trypan Blue dye. Trophoblast functionality was assessed by measuring β-hCG production via ELISA. Cell fusion was evaluated using confocal microscopy, with Phalloidin or ZO-1 marking cell edges and DAPI staining nuclei. T. cruzi infection was assessed by microscopy and quantitative PCR, targeting the EF1-α gene for T. cruzi and GAPDH for BeWo cells, using three parasite strains: VD (isolated from a congenital Chagas disease infant and classified as Tc VI), and K98 and Pan4 (unrelated to congenital infection and classified as Tc I).ResultsSeeding 1000 BeWo cells per microwell in the large model resulted in comparable cellular viability to 2D cultures, with a theoretical diameter of 408.68 ± 12.65 μm observed at 5 days. Functionality, assessed through β-hCG production, exceeded levels in 2D cultures at both 3 and 5 days. T. cruzi infection was confirmed by qPCR and microscopy, showing parasite presence inside the cells for all three tested strains. The distribution and progression of the infection varied with each strain.DiscussionThis innovative 3D model offers a simple yet effective approach for generating viable and functional cultures susceptible to T. cruzi infection, presenting significant potential for studying the placental microenvironment.

Extracellular ATP and its derivates mediate a signaling pathway that might be pharmacologically targeted to treat inflammatory conditions. Extracellular adenosine, the product of ATP hydrolysis by ectonucleotidase enzymes, plays a key role in halting inflammation while promoting immune tolerance. The rate-limiting ectoenzyme ENTPD1/CD39 and the ecto-5′-nucleotidase/CD73 are the prototype members of the ectonucleotidase family, being responsible for ATP degradation into immunosuppressive adenosine. The biological effects of adenosine are mediated via adenosine receptors, a family of G protein-coupled receptors largely expressed on immune cells where they modulate innate and adaptive immune responses. Inflammatory bowel disease (IBD) is a serious inflammatory condition of the gastrointestinal tract, associated with substantial morbidity and often refractory to currently available medications. IBD is linked to altered interactions between the gut microbiota and the immune system in genetically predisposed individuals. A wealth of studies conducted in patients and animal models highlighted the role of various adenosine receptors in the modulation of chronic inflammatory diseases like IBD. In this review, we will discuss the most recent findings on adenosine-mediated immune responses in different cell types, with a focus on IBD and its most common manifestations, Crohn’s disease and ulcerative colitis.

Abstract Objective: to map the scientific literature on the validity of instruments for evaluating the quality of services provided in primary health care for chronic diseases related to systemic arterial hypertension, diabetes mellitus, leprosy and tuberculosis. Method: scoping review, following the Joanna Briggs Institute method and described in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. 13 databases and gray literature were included. The selection of studies was carried out after removing duplicates and individual and paired evaluation. The data was extracted based on an elaborate script and presented in tables and charts. Results: the analysis of 28 selected studies showed that the majority were from Brazil, followed by China and Malaysia. Almost half of the validated instruments were generic, and the specific ones covered the evaluation of diabetes mellitus and leprosy. The types of validation carried out were content and construct. Conclusion: there is a need to construct specific instruments due to the scarcity of studies on the process of validating instruments for evaluating the quality of services provided by primary health care for chronic diseases.

Sono molti anni che diversi gruppi e singoli professionisti adottano formule che tengano conto dell’accessibilità alle cure psicologiche ma questa sensibilità non era mai giunta ad essere un movimento unitario di carattere nazionale. La distinzione tradizionale fra un servizio pubblico che ha nel suo statuto l’universalismo ed un privato, organizzazioni o singoli professionisti, che non si pone preoccupazioni di raggiungibilità, economica e culturale, è parte della nostra storia professionale e formativa.[...]

Abstract Recent disasters have shown that the failure of columns or shear walls exposed to fire is the main cause of building collapse. The cross-sectional thermal gradient (TG) of these structures justifies the degree of their heating and also justifies their mechanical damage, but the influence of the number of heated surfaces on their TG is not well known in the literature. A numerical FE analysis was proposed for RC columns and shear walls, assuming five fire cases in terms of the number of heated sides: only the (i) smallest and (ii) largest side, (iii) two, (iv) three and (v) four sides subjected to fire for 120 min. In order to validate the FE models, full-scale specimens were tested experimentally. Based on the number of sides hated, these structures can have an FRR of more than 120 min in relation to the values proposed by the standards.

En esta entrevista, el fotógrafo y artista gráfico George Lois ilustra cómo ha logrado establecer un papel significativo dentro de la revolución cultural de los años 60. Su contribución ha establecido un estándar innovador y provocativo en los ámbitos del diseño gráfico y la publicidad, empleando una potente fusión de texto e imágenes. Al explorar momentos clave de su crianza y extensa carrera, contextualizamos y reevaluamos la creación de algunas de sus portadas de revistas y campañas publicitarias icónicas, que han dejado un legado influyente y duradero en el ámbito creativo.

Este artigo relata a experiência de implementação de um ambiente seguro de aprendizagem no curso DoMM (Docentes Mentalidades Matemáticas), realizado em julho de 2023 em Vespasiano/MG, que valorizou o acolhimento do erro como recurso para o aprendizado profundo e conceitual em matemática. A metodologia de pesquisa utilizada foi qualitativa, de caráter exploratório e descritivo, com uma abordagem participativa, envolvendo educadores da rede municipal. Inspirada na abordagem de Mentalidades Matemáticas de Jo Boaler e na teoria crítica de Paulo Freire, a pesquisa investigou como o erro pode ser utilizado para promover uma aprendizagem significativa. Através de observações, entrevistas e relatos escritos, os dados foram coletados e analisados de forma indutiva, identificando padrões e temas emergentes. Os resultados destacaram que a valorização do erro contribuiu para a construção de um ambiente inclusivo e equitativo, melhorando o engajamento e a confiança dos alunos. A formação de grupos heterogêneos e a aplicação de atividades "piso baixo, teto alto" facilitaram a colaboração e a troca de conhecimentos entre os estudantes, promovendo um entendimento mais profundo dos conceitos matemáticos. A participação ativa dos educadores no desenvolvimento e implementação das práticas pedagógicas foi crucial para a relevância e eficácia das abordagens utilizadas. Conclui-se que políticas públicas que apoiem práticas pedagógicas equitativas são essenciais para a criação de um sistema educacional mais justo e eficaz.

Efficient control strategies for managing the mass flow rate (MFR) of heat transfer fluids (HTF) during cloud transients in Solar Tower receivers play a pivotal role in optimizing plant profitability and receiver durability. This study focuses on the performance and durability of Solar Tower receivers during cloud transients. It evaluates adaptive feedback and feedforward control methods, which adjust the flow rate of heat transfer fluids based on real-time measurements of direct normal irradiance (DNI), receiver outlet and receiver panel outlet temperatures. The effectiveness of an aggressive all-sky and conservative clear-sky control strategy is explored against a conventional PI controller, emphasizing energy efficiency and receiver longevity. Simulations using a thermal Modelica model resembling a 100 MWel Crescent Dunes-like solar tower plant reveal that both advanced controllers provide precise setpoint tracking, while the PI controller struggles. The conservative controller which has a cloud standby mode prevents overheating during cloud transients by using a clear sky mass flow rate, while the aggressive controller uses the receiver panel outlet temperatures to correct for upstream tube temperature variations allowing for fast tracking correction and disturbance rejection, albeit with slight overshoots. Furthermore, the controllers significantly decrease the creep-fatigue damage accumulated in the receiver panels during cloudy days, due to limiting the increase in wall temperature spikes when cloud events end. Overall, this study underscores the pivotal role of HTF mass flow rate control systems in influencing receiver system failure modes and longevity and offers a new tool in controller design and operation assessment.

There has been continuous progress in diabetes management over the last few decades, not least due to the widespread dissemination of continuous glucose monitoring (CGM) and automated insulin delivery systems. These technological advances have radically changed the daily lives of people living with diabetes, improving the quality of life of both children and their families. Despite this, hypoglycemia remains the primary side-effect of insulin therapy. Based on a systematic review of the available scientific evidence, this paper aims to provide evidence-based recommendations for recognizing, risk stratifying, treating, and managing patients with hypoglycemia. The objective of these recommendations is to unify the behavior of pediatric diabetologists with respect to the timely recognition and prevention of hypoglycemic episodes and the correct treatment of hypoglycemia, especially in patients using CGM or advanced hybrid closed-loop systems. All authors have long experience in the specialty and are members of the Italian Society of Pediatric Endocrinology and Diabetology. The goal of treating hypoglycemia is to raise blood glucose above 70 mg/dL (3.9 mmol/L) and to prevent further decreases. Oral glucose at a dose of 0.3 g/kg (0.1 g/kg for children using “smart pumps” or hybrid closed loop systems in automated mode) is the preferred treatment for the conscious individual with blood glucose

ObjectivesEvidence on the activity of patisiran therapy in specific subgroups of patients with hereditary transthyretin amyloidosis variant (ATTRv) is still scarce. This prospective real-world study was designed to provide the first in-depth clinical data on the effectiveness of patisiran in patients with ATTRv reporting the p.Ile88Leu variant, the most widespread variant in the Emilia-Romagna regional area, which has been less represented in previous clinical trials.Patients and methodsThis prospective study evaluated all the patients with genetically proven ATTRv (p.Ile88Leu) and polyneuropathy treated with patisiran in the Emilia-Romagna referral centers for ATTRv (Institute of Neurological Sciences in Bologna and Division of Neurology in Rimini) from March 2021 to April 2023. All subjects underwent clinical and neurological evaluations at baseline and after 9–12 months of treatment.ResultsA total of 22 patients were included in the study; the median age was 73 years (IQR: 9), the age at diagnosis was 72 years (IQR: 10), and the disease duration was 1.6 years (IQR: 2.3). We observed stability of all considered neurological and cardiological parameters at 9–12 months after the beginning of patisiran treatment.ConclusionOur findings support the clinical data regarding the effectiveness of patisiran in stabilizing the disease course and extend this activity to the subset of patients with the p.Ile88Leu variant.

En este artículo reflexionamos sobre las disputas contemporáneas en torno a la memoria de la dictadura militar brasileña (1964-1985) a partir del análisis de los diferentes caminos recorridos recientemente por una fotografía. Se trata de una imagen tomada por Evandro Teixeira el 21 de junio de 1968, el "Viernes Sangriento". Publicada al día siguiente del episodio en la portada de uno de los diarios de mayor circulación del país, esta imagen se convertiría en uno de los registros fotográficos más conocidos de este período de la historia brasileña, siendo continuamente reproducida en montajes y materiales gráficos en las redes sociales, en publicaciones en diarios y revistas, videos en Youtube y en parte importante de documentales televisivos o producciones independientes sobre la dictadura militar. En el ejercicio de análisis e interpretación de algunos de sus más recientes retomas, indagamos qué historias ella puede revelar y a cuales disputas da lugar en el contexto de tensión política que vivimos actualmente en el país.

Objective: To understand the susceptibility to single nucleotide polymorphisms in the promoter region of Interleukin-4 (IL-4) and Interleukin-13 (IL-13) in patients with and without periodontal disease. Thus, a systematic review of available studies on the subject was performed. Material and Methods: A protocol was conducted for registration in the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42021246646. For this search, studies were selected from the Scopus, Web of Science, Virtual Health Library, Embase, Cochrane Library, and PubMed databases. The selection criteria consisted of case-control and cohort studies published in English that had data on IL-4 and IL-13 genetic polymorphisms in patients with and without periodontal disease in the same study. The obtained studies were managed by EndNote Program™ X7 version and the Rayyan Platform. Regarding the risk of bias, we used the Newcastle-Ottawa Scale, which classified the studies using high-quality methodology. Results: After the selection process, three studies presented the eligibility criteria. No relation between IL-13 and susceptibility to periodontal disease was found. IL-4 gene (IL-4 -590C/T; IL-4-34C/T; rs2243248) was associated with susceptibility to the development of periodontitis. Conclusion: An association between IL-4 and the susceptibility of periodontitis was verified. Further case-control studies are needed to create more concrete conclusions on the subject.

En este artículo intentaremos reflexionar sobre los fundamentos de la res­ponsabilidad de los magistrados, en relación con la correspondencia entre poder y responsabilidad en el Estado de derecho, y en particular sobre la legitimación del poder judicial en el marco institucional actual. Se hará refe­rencia específica al ordenamiento jurídico italiano, intentando, sin embargo, permanecer en un nivel predominantemente abstracto, para llevar a cabo, en la medida de lo posible, consideraciones que también sean válidas a un nivel más general, relacionadas con la necesidad de más y mejores mecanismos de responsabilidad para los jueces y de reformas orgánicas para consolidar la credibilidad de los poderes públicos.

Tendo como pano de fundo o contexto brasileiro, o presente texto tem por objetivo tecer algumas reflexões sobre o cruzamento entre envelhecimento e cuidado no período pandêmico. Amparada por dados de uma pesquisa realizada no período que antecedeu a Covid-19 – 2019 – e por outras que aconteceram durante a pandemia, a proposta é pontuar os links de conexão entre esses dois momentos. Apesar da hiperexposição do idoso durante a pandemia de Covid-19, com destaque para a estigmatização e os diferentes níveis de violência, é possível perceber que se tratou de uma exacerbação da visibilidade, mas não de algo novo. No caso do cruzamento entre cuidado e velhice, podemos dizer que um grande segredo público veio à tona.

Abstract The availability of microbial biobanks for the storage of individual gut microbiota members or their derived and artificially assembled consortia has become fundamental for in vitro investigation of the molecular mechanisms behind microbe–microbe and/or microbe–host interactions. However, to preserve bacterial viability, adequate storage and processing technologies are required. In this study, the effects on cell viability of seven different combinations of cryoprotective agents were evaluated by flow cytometry for 53 bacterial species representing key members of the human gut microbiota after one and 3 months of cryopreservation at −80°C. The obtained results highlighted that no universal cryoprotectant was identified capable of guaranteeing effective recovery of intact cells after cryopreservation for all tested bacteria. However, the presence of inulin or skimmed milk provided high levels of viability protection during cryoexposure. These results were further corroborated by cryopreserving 10 artificial gut microbiota produced through in vitro continuous fermentation system technology. Indeed, in this case, the inclusion of inulin or skimmed milk resulted in a high recovery of viable cells, while also allowing consistent and reliable preservation of the artificial gut microbiota biodiversity. Overall, these results suggest that, although the efficacy of various cryoprotective agents is species‐specific, some cryoprotectants based on glycerol and the addition of inulin or skimmed milk are preferable to retain viability and biodiversity for both single bacterial species and artificial gut microbiota.