Search

Introduction: Drowning is a public health problem. Interrupting the drowning process as soon as possible and starting cardiopulmonary resuscitation (CPR) can improve survival rates. Inflatable rescue boats (IRBs) are widely used worldwide to rescue drowning victims. Performing CPR in special circumstances requires adjusting the position based on the environment and space available. The aim of this study was to assess the quality of over-the-head resuscitation performed by rescuers aboard an IRB in comparison to standard CPR. Methods: A quasi-experimental, quantitative, cross-sectional pilot study was conducted. Ten professional rescuers performed 1 min of simulated CPR on a QCPR Resuscy Anne manikin (Laerdal, Norway) sailing at 20 knots using two different techniques: 1) standard CPR (S-CPR) and 2) over-the-head CPR (OTH-CPR). Data were recorded through the APP QCPR Training (Laerdal, Norway). Results: The quality of CPR was similar between S-CPR (61%) and OTH-CPR (66%), with no statistically significant differences (p = 0.585). Both the percentage of compressions and the percentage of correct ventilations did not show significant differences (p > 0.05) between the techniques. Conclusion: The rescuers can perform CPR maneuvers with acceptable quality in the IRB. The OTH-CPR technique did not show inferiority compared to S-CPR, making it a viable alternative when boat space or rescue conditions do not allow the conventional technique to be performed. Universidade de Vigo/CISUG

Among invasive species known to occur in South America, the bivalve mollusc Limnoperna fortunei, which the presence is linked to several environmental and economic problems. Early detection and mitigation actions are needed to limit its impact in the remaining L. fortunei-free areas. PCR-based molecular methods have become the gold standard methodology for L. fortunei detection. However, PCR-based methods require complex logistics from field sampling to laboratory processing. Thus, the use of methods that can be directly applied in the field can speed up the detection process. This work aimed to establish, for the first time, the loop-mediated isothermal amplification (LAMP) method for the detection of L. fortunei, with perspectives for in situ application. A set of primers designed for LAMP was tested for amplification of DNA from L. fortunei adult tissues and environmental samples containing bivalve larvae. The test showed a limit of detection as low as 0.01 ng of DNA obtained from adult tissue samples and a minimum reaction time of 60 min. The set of primers used seems to be specific for L. fortunei, since there was no cross-amplification with other bivalve or invasive molluscs that co-occur with the golden mussel in the same environment. The LAMP technique also proved to be efficient in amplifying DNA derived from L. fortunei larvae, demonstrating it to be a robust method regarding potential environmental reaction inhibitors. Although the results obtained here were acquired under controlled laboratory conditions, the LAMP method is a promising tool to integrate L. fortunei invasion monitoring protocols.

Since a great number of infant cardiopulmonary arrests occur outside of the hospital, it is crucial to train laypersons in cardiopulmonary resuscitation techniques, especially those professionals that will work with infants and children. The main objective of this study was to evaluate the efectiveness of ventilations performed by professional training students. The secondary objective was to analyze the preference between different ventilation and chest-compression methods. The sample consisted of 32 professional training students, 15 preschool students, and 17 physical education students. The activity was conducted separately for each group, and we provided a 10 min theoretical training about infant basic life support followed by a 45 min practical training using a Laerdal Little Anne QCPR CPR manikin. A practical test in pairs was organized to record the ventilation as performed by the participants, establishing the difference between the efficacious and the non-efficacious ones. Furthermore, we handed out a survey before and after training to evaluate their knowledge. More than 90% of the students completely agreed with the importance of learning cardiopulmonary resuscitation techniques for their professional future. More than half of the sample considered that they perform the rescue breathings with the mouth-to-mouth method better. We observed that through mouth-to-mouth-nose ventilations, the number of effective ventilations was significantly higher than the effective ventilations provided by a self-inflating bag and mask (EffectiveMtoMN 6.42 ± 4.27 vs. EffectiveMask 4.75 ± 3.63 (p = 0.007)), which was the preferred method. In terms of the compression method, hands encircling the chest was preferred by more than 85% of students. Mouth-to-mouth nose ventilation is more efficient than bag-face-mask ventilation in CPR as performed by professional training and physical activity students. This fact must be considered to provide higher-quality training sessions to professional training students.

Introduction: The severe acute respiratory syndrome coronavirus 2 pandemic caused a negative impact on transplantation worldwide. One of the complexities is the management of the immunosuppression and anti-viral medication in transplant recipients. Herein we describe our experience managing five patients with coronavirus disease 2019 (COVID-19) immediately after kidney transplant. Description: we describe a series of five transplant recipients. Two were submitted to a low immunological risk induction immunosuppression: one developed severe disease, the other developed critical disease. The remaining three were submitted to a high immunologic risk immunosuppression: one developed mild disease, but approximately two months after diagnosis developed moderate COVID-19; another developed severe COVID-19; the remaining patient developed critical illness and perished. Both patients with critical COVID-19 developed bacterial and fungal superinfections in the Intensive Care Unit. All eligible patients were submitted to remdesivir and dexamethasone. The anti-metabolite was reduced or suspended. Despite worsening kidney function during the acute phase, kidney replacement therapy was only needed in one patient and the average serum creatinine at the time of discharge was lower that the pre-COVID-19 nadir. Discussion: There is still no definitive answer on whether solid organ transplant recipients carry a higher risk for morbimortality. Risk factors for the general population can also affect their outcome. The prolonged viral shedding in recipients may explain the irregular evolution of the patient who developed COVID-19 months after the initial diagnosis. The reduction of immunosuppression can be problematic in early post-transplant, but no apparent signs of rejection were noted. Literature addressing this specific context is scarce and studies are needed to clarify the optimal management of these patients.

Background Limnoperna fortunei is a freshwater bivalve mollusc originally from southern Asia that invaded South America in the 1990’s. Due to its highly efficient water pumping and filtering, and its capacity to form strong adhesions to a variety of substrates by byssus thread, this invasive species has been able to adapt to several environments across South America, causing significant ecological and economic damages. By gaining a deeper understanding of the biological and ecological aspects of L. fortunei we will be able to establish more effective strategies to manage its invasion. The gills of the mollusc are key structures responsible for several biological functions, including respiration and feeding. In this work, we characterized the ultrastructure of L. fortunei gills and its ciliary epithelium using light microscopy, transmission and scanning electron microscopies. This is the first report of the morphology of the epithelial cells and cilia of the gill of L. fortunei visualized in high resolution. Results The analysis showed highly organized and abundant ciliary structures (lateral cilia, laterofrontal cirri and frontal cilia) on the entire length of the branchial epithelium. Mitochondria, smooth endoplasmic reticulum and glycogen granules were abundantly found in the epithelial cells of the gills, demonstrating the energy-demanding function of these structures. Neutral mucopolysaccharides (low viscosity mucus) were observed on the frontal surface of the gill filaments and acid mucopolysaccharides (high viscosity mucus) were observed to be spread out, mainly on the lateral tract. Spherical vesicles, possibly containing mucus, could also be observed in these cells. These findings demonstrate the importance of the mucociliary processes in particle capture and selection. Conclusions Our data suggest that the mechanism used by this mollusc for particle capture and selection could contribute to a better understanding of key aspects of invasion and also in the establishment of more efficient and economically viable strategies of population control.

Breast size alteration is the most common aesthetic surgical procedure worldwide. This study aimed to assess the correlation between breast volume and BMI or age.The analyses were conducted utilizing 400 patients selected by a retrospective review of the archives at our institution. Epidemiological data and medical history were assessed. Adjusting for the age and BMI of patient from previously described cohorts, we calculated mean breast volumes per side and differences from the upper and lower percentiles to the mean volumes.The patients had a median BMI of 23.5 (range: 14.7-45.6) and a median age of 51 (range: 24-82). The average total breast volume increased strongly with BMI (r=0.834, p0.01) and moderately with age (r=0.305, p0.01). Within a BMI range of 18-24, breast volumes in the 8th and 18th percentile differ on average by about 50 ml. One BMI unit increase in women with breast sizes in the 10th percentile accounts for a breast volume difference of about 30 ml.BMI strongly correlates with breast size. To achieve natural results, preoperative consultation and planning of aesthetic and reconstructive breast surgery must recognize BMI as a major determinant of average breast size.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Synthetic polymers scaffolds often need to be coated with extracellular matrix (ECM) proteins to improve cell adhesion. For cultivated meat applications, coating should be avoided since it is necessary to eliminate expensive and animal-derived components. As cellulose acetate nanofibers is a low-cost cellulose-derived material, that induces cell adhesion and proliferation, we investigated its use associated with a bioactive annatto extract, a food-dye and potential meat preservative, as scaffolds for cultivated meat. Here, the bioactive electrospun nanofibers were evaluated through morphological, mechanical and biological characterizations. The results revealed that the scaffolds were porous with no specific alignment and average fiber diameter of 420±212 nm. Molecular analyzes revealed that in contrast to cellulose acetate scaffold, annatto-loaded cellulose acetate scaffold favor a proliferative state of C2C12 mouse skeletal myoblasts. SEM microscopy images suggests that the nanofiber substrates can sustain long-term culture of the cells, up to 28 days. These results suggest that the combination of cellulose acetate fibers loaded with annatto extract may be an interesting economical alternative for support long-term muscle cells culture with potential application as a scaffold for cultivated meat and muscle tissue engineering.

BACKGROUND AND AIMS Patients on renal replacement therapy are reported to have altered humoral immunity, which is demonstrated by a decreased response to different vaccines. However, in kidney transplant (KT) patients, vaccines are even less immunogenic in terms of antibody response. Therefore, these patients have a higher risk of critical infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which makes them eligible for early vaccination. The aim of this study was to compare the humoral response after complete vaccination against SARS-CoV-2 between KT patients and peritoneal dialysis (PD) patients. METHOD We conducted a single-center, retrospective study, which included 67 KT recipients and 49 prevalent PD patients. Patients were excluded if they had previously known SARS-CoV-2 infection or positive anti-nucleocapsid IgG or IgM antibodies. Completion of vaccination was defined as two doses of a messenger RNA vaccine (BNT162b2 messenger RNA vaccine [Pfizer-BioNTech] or messenger RNA-1273 [Moderna]), two doses of viral vector vaccine ChadOx1 nCoV-19/AZD1222 (AstraZeneca) or one dose of JNJ-78 436 735 (Janssen) vaccine. Anti-spike (anti-S) IgG antibodies were measured, at least, 21 days after the completion of vaccination and before receiving a `booster’ dose. A value of anti-S >0.8 U/mL was considered positive. Immunogenicity of the vaccine, measured by anti-spike IgG antibodies, was compared between KT recipients and PD patients. RESULTS The mean age of the population was 58.8 ± 13.6 years and 62.0% were males (similar between the two groups). The median interval between completion of vaccination and serologic analysis was 4.1 months in KT patients and 7.1 months in PD patients. In KT patients, the median anti-S level was 1.50 U/mL (IQR 0.0–27.3) versus 97.0 U/mL (IQR 34.5–447.0) in PD patients (P < .001). In the KT group, there were 31 (46.3%) non-responders (patients without detectable levels of anti-S), while in the second there were only two (4.1%). In KT patients, anti-S levels were not associated with time since transplant or immunosuppressive induction therapy. In PD patients, anti-S levels were not associated with time since the beginning of PD. In both groups, anti-S levels were not associated with age, gender, type of administered vaccine or interval between completion of vaccination and serologic analysis. CONCLUSION We found a significant difference in humoral responses to the vaccine between PD and KT transplant patients with no previous exposure to SARS-CoV-2. In PD patients, the vaccine seemed to be effective. On the contrary, KT patients had a significantly weaker rising of anti-S titers, with a high proportion of patients not responding to the vaccine. This study emphasizes the negative impact of immunosuppression on humoral responses, reinforcing the need for a `booster’ dose in this group of patients.

Although originally discovered inducing important biological functions in the nervous system, repulsive guidance molecule a (RGMa) has now been identified as a player in many other processes and diseases, including in myogenesis. RGMa is known to be expressed in skeletal muscle cells, from somites to the adult. Functional in vitro studies have revealed that RGMa overexpression could promote skeletal muscle cell hypertrophy and hyperplasia, as higher efficiency in cell fusion was observed. Here, we extend the potential role of RGMa during C2C12 cell differentiation in vitro. Our results showed that RGMa administrated as a recombinant protein during late stages of C2C12 myogenic differentiation could induce myoblast cell fusion and the downregulation of different myogenic markers, while its administration at early stages induced the expression of myogenic markers with no detectable morphological effects. We also found that RGMa effects on skeletal muscle hyperplasia are performed via neogenin receptor, possibly as part of a complex with other proteins. Additionally, we observed that RGMa-neogenin is not playing a role as an inhibitor of the BMP signalling in skeletal muscle cells. This work contributes to placing RGMa as a component of the mechanisms that determine skeletal cell fusion via neogenin receptor.

Background Allograft renal vein thrombosis can cause graft loss during the early postoperative period. This diagnosis is sometimes elusive, requiring a strong suspicion. On the other hand, several authors have recognized risk factors for allograft renal vein thrombosis, but neither a preventive approach nor a treatment have been recommended for this complication. Case presentation We present a case report of early allograft renal vein thrombosis, preceded by femoral common deep vein thrombosis in a recipient of a third kidney transplant. Despite femoral common deep vein thrombosis treatment with low-molecular-weight heparin and progressive improvement of renal function to a nadir serum creatinine of 0.51 mg/dL, the patient experienced a sudden episode of anuria on postoperative day 5. Doppler ultrasonography strongly suggested the diagnosis of allograft renal vein thrombosis. The patient underwent balloon catheter and aspiration venous thrombectomy, followed by unfractionated heparin perfusion. After 4 days of anuria and multiple blood transfusions, when allograft nephrectomy was contemplated, diuresis suddenly resumed. After 1 year of follow-up, the patient still has a normal renal function. Conclusion This case report shows successful treatment of allograft renal vein thrombosis associated with deep vein thrombosis in the first week of transplantation, using balloon catheter and aspiration venous thrombectomy followed by perfusion of unfractionated heparin. The authors suggest this technique as a treatment option for transplant renal vein thrombosis. However, they reinforce the importance of individualized treatment and they remind that a delay may jeopardize the potential benefit of the procedure.

Background The repulsive guidance molecule a (RGMa) is a GPI-anchor axon guidance molecule first found to play important roles during neuronal development. RGMa expression patterns and signaling pathways via Neogenin and/or as BMP coreceptors indicated that this axon guidance molecule could also be working in other processes and diseases, including during myogenesis. Previous works from our research group have consistently shown that RGMa is expressed in skeletal muscle cells and that its overexpression induces both nuclei accretion and hypertrophy in muscle cell lineages. However, the cellular components and molecular mechanisms induced by RGMa during the differentiation of skeletal muscle cells are poorly understood. In this work, the global transcription expression profile of RGMa-treated C2C12 myoblasts during the differentiation stage, obtained by RNA-seq, were reported. Results RGMa treatment could modulate the expression pattern of 2,195 transcripts in C2C12 skeletal muscle, with 943 upregulated and 1,252 downregulated. Among them, RGMa interfered with the expression of several RNA types, including categories related to the regulation of RNA splicing and degradation. The data also suggested that nuclei accretion induced by RGMa could be due to their capacity to induce the expression of transcripts related to ‘adherens junsctions’ and ‘extracellular-cell adhesion’, while RGMa effects on muscle hypertrophy might be due to (i) the activation of the mTOR-Akt independent axis and (ii) the regulation of the expression of transcripts related to atrophy. Finally, RGMa induced the expression of transcripts that encode skeletal muscle structural proteins, especially from sarcolemma and also those associated with striated muscle cell differentiation. Conclusions These results provide comprehensive knowledge of skeletal muscle transcript changes and pathways in response to RGMa.

(1) Background: The aim was screening the performance of nine Early Warning Scores (EWS), to identify patients at high-risk of premature impairment and to detect intensive care unit (ICU) admissions, as well as to track the 2-, 7-, 14-, and 28-day mortality in a cohort of patients diagnosed with an acute neurological condition. (2) Methods: We conducted a prospective, longitudinal, observational study, calculating the EWS [Modified Early Warning Score (MEWS), National Early Warning Score (NEWS), VitalPAC Early Warning Score (ViEWS), Modified Rapid Emergency Medicine Score (MREMS), Early Warning Score (EWS), Hamilton Early Warning Score (HEWS), Standardised Early Warning Score (SEWS), WHO Prognostic Scored System (WPSS), and Rapid Acute Physiology Score (RAPS)] upon the arrival of patients to the emergency department. (3) Results: In all, 1160 patients were included: 808 patients were hospitalized, 199 cases (17%) required ICU care, and 6% of patients died (64 cases) within 2 days, which rose to 16% (183 cases) within 28 days. The highest area under the curve for predicting the need for ICU admissions was obtained by RAPS and MEWS. For predicting mortality, MREMS obtained the best scores for 2- and 28-day mortality. (4) Conclusions: This is the first study to explore whether several EWS accurately identify the risk of ICU admissions and mortality, at different time points, in patients with acute neurological disorders. Every score analyzed obtained good results, but it is suggested that the use of RAPS, MEWS, and MREMS should be preferred in the acute setting, for patients with neurological impairment.

Ovarian tissue cryopreservation is emerging as a promising alternative for fertility preservation of cancer survivors. To date, more than a hundred couples have successfully had babies using this procedure, although it is still considered experimental and demands further investigation. In this work, we evaluated the effects of vitrification, warming and autotransplantation procedures on the morphology and gene expression of murine ovaries. Ovaries were removed from adult female C57BL6 mice (n = 15), vitrified, warmed and autotransplanted (vitrified group), additionally, ovaries were autotransplanted without vitrification (control group, n = 15). After twenty days, grafted ovaries were harvested and used for histological and ultrastructural analysis, germinal vesicle (GV) oocyte collection, RNA sequencing, and Transmission Electron Microscopy (TEM). All classes of follicles and GV were observed in both control and vitrified/warmed transplanted ovaries, and the numbers of primordial, antral and atretic follicles were not different (p > 0.05). Using RNA-seq, we detected 16,602 vs 13,527 expressed genes in vitrified and control ovaries, respectively; and 623 significantly dysregulated genes (fold change >1.5; 332 up-regulated and 291 down-regulated). Cellular membranes, cytoskeletons, and extracellular matrices were found as the main functions of the differentially expressed genes. Moreover, vitrified samples also presented ultrastructural alterations in the cytoskeleton, cell junctions, and endoplasmic reticulum. Taken together, this work showed for the first time that ovarian cells might trigger a compensatory gene regulation mechanism to maintain cellular structure and folliculogenesis progression after vitrification and autotransplantation.

Limnoperna fortunei, the golden mussel, is a bivalve mollusc native to Southeast Asia, which was introduced to South America via ballast water from commercial cargo ships from China and South Korea. In Brazil, the golden mussel is considered an invasive species, which has caused enormous economic and environmental damage. This is mainly due to the obstruction of pipes carrying water for the cooling systems within hydroelectric power plants. The presence of this invasive species also negatively impacts native fauna and flora. Early detection and rapid response during the early stages of infestation for this invasive species is essential to effectively control populations and prevent new infestations from forming. Techniques within molecular biology allow for more efficient detection of the golden mussel in all stages of development. In addition, the analysis of the genome, transcriptome and proteome of this species makes it possible to identify targets of biotechnological interest, which may be useful for the control of the golden mussel or for the generation of products of technological innovation. This review presents an overview of molecular studies involving this species and the perspectives on the prevention, control and combat of the golden mussel using these approaches.

Intrauterine growth restriction (IUGR) is a serious condition which impairs the achievement of the fetus' full growth potential and occurs in a natural and severe manner in pigs as a result of placental insufficiency. Reduced skeletal muscle mass in the fetus with IUGR persists into adulthood and may contribute to increased metabolic disease risk. To investigate skeletal muscle postnatal development, histomorphometrical patterns of the semitendinosus muscle, myosin heavy chain (MyHC; embryonic I, IIA, IIB and IIX isoforms) fiber composition and the relative expression of genes related to myogenesis, adipogenesis and growth during three specific periods: postnatal myogenesis (newborn to 100 days old), hypertrophy (100–150 days old), and postnatal development (newborn to 150 days old) were evaluated in female pigs with IUGR and normal birth weight (NW) female littermates. NW females presented higher body weights compared to their IUGR counterparts at all ages evaluated (P

The calpain system is the central player for meat tenderization and the calpastatin activity plays an important role in beef tenderness of Bos taurus indicus cattle. This study investigated whether dietary vitamin D3 induced gene expression of μ-calpain (CAPN1), total calpastatin (CAST T), and their variants (CAST I and II). Animals received none or 2 × 106 IU of vitamin D3 for either 2 or 8 days before slaughter and were submitted to different conditions during feedlot: sun exposure or artificial shade. Steaks from Longissimus lumborum were fabricated, aged for 1, 7, and 21 days post-mortem, and later used for the analyses of shear force and the myofibrillar fragmentation index. Vitamin D3 did not influence mRNA abundance; however, it induced a greater CAST II transcript in animals supplemented 8 days before slaughter. There was a negative association between CAST II abundance and the shear force, which revealed an important modulation of the calpain system expression due to vitamin D supplementation. This result is an important tool for strategies to improve beef tenderness. Resumo Uma vez que o sistema calpaína é central para o amaciamento da carne e dada a importância da atividade de calpastatina na determinação da maciez de bifes de bovinos Bos taurus indicus, o objetivo do presente estudo foi determinar se a expressão do gene de μ-calpaína (CAPN1), calpastatina total (CAST T), e suas variantes (CAST I e II) foi induzido pela inclusão de vitamina D3 na dieta. Os animais receberam nenhuma ou 2 × 106 UI dose de vitamina D3 por 2 ou 8 dias antes do abate, e foram submetidos a diferentes condições durante o confinamento: exposição solar ou sombreamento artificial. Bifes do Longissimus lumborum foram fabricados e submetidos a maturação por 1, 7, e 21 dias post-mortem e posteriormente usados para determinação da força de cisalhamento e do índice de fragmentação miofibrilar. Vitamina D3 não influenciou a abundância de RNAm, exceto para maior abundância de transcritos de CAST II em animais que foram suplementados por 8 dias antes do abate. Foi encontrada associação negativa entre a abundância de CAST II e a força de cisalhamento. Essa contradição revela uma importante modulação da expressão do sistema calpaína resultado da suplementação com vitamina D que pode ser importante na determinação de estratégias para melhorar a maciez da carne.

Producción Científica, Background: The aim of this study was to examine the attitudes, fears, and anxiety level of nursing students faced with a critical clinical simulation (cardiopulmonary reanimation) with and without personal protective equipment (PPE). Methods: A pilot before–after study as conducted from 21 to 25 June 2021, with 24 students registered in the nursing degree of the Faculty of Health Sciences of the Castilla-La Mancha University (UCLM) in the city of Talavera de la Reina (Toledo, Spain). From 520 possible participants, only 24 were selected according to the exclusion and inclusion criteria. The STAI Manual for the State-Trait Anxiety Inventory, a self-evaluation questionnaire, was used to study trait STAI (basal anxiety), trait STAI before CPR, state STAI after CPR, total STAI before CPR, and total STAI after CPR as the main variables. A t-test was used to study the STAI variables according to sex and the physiological values related to the anxiety level of participants. An ANOVA statistical test was used to perform a data analysis of the STAI variables. Results: A total of 54.2% of participants (IC 95% 35.1–72.1) suffered from global anxiety before the cardiopulmonary reanimation maneuvers (CPR). The results of the STAI before CPR maneuvers showed significant differences according to gender in state anxiety (p = 0.04), with a higher level of anxiety in women (22.38 ± 7.69 vs. 15.82 ± 7.18). Conclusions: This study demonstrates different levels of anxiety in terms of gender suffered by nursing students in high-pressure environments, such as a CPR situation.

Low levels of 25-hydroxyvitamin D [25(OH)D] are frequent in chronic kidney disease and are associated with adverse outcomes. The aim of this 5-year prospective study was to evaluate the effects of cholecalciferol supplementation on mineral metabolism, inflammation and cardiac parameters in hemodialysis (HD) patients.The study included 97 patients. Cholecalciferol was given after HD according to 25(OH)D baseline levels measured twice (end of winter and of summer). The 25(OH)D levels, circulating bone metabolism, inflammation parameters, brain natriuretic peptide (BNP), pulse pressure (PP), and left ventricular mass index (LVMI) were evaluated before and after supplementation.There was a significant increase in 25(OH)D levels after supplementation (p 0.001); however, serum calcium (p = 0.02), phosphorus (p = 0.018), and iPTH (p = 0.03) were decreased. Magnesium levels increased during the study (p = 0.03). A reduction in the number of patients under active vitamin D (p 0.001) and in the dose and number of patients treated with darbepoetin (p = 0.02) was observed. Serum albumin increased (p 0.001), and C-reactive protein decreased (p = 0.01). BNP (p 0.001), PP (p = 0.007), and LVMI (p = 0.02) were significantly reduced after supplementation.Long-term cholecalciferol supplementation allowed correction of 25(OH)D deficiency, improved mineral metabolism with less use of active vitamin D, attenuated inflammation, reduced the dose of the erythropoiesis-stimulating agent, and improved cardiac dysfunction.

Previous pilot experience has shown the ability of visually impaired and blind people (BP) to learn basic life support (BLS), but no studies have compared their abilities with blindfolded people (BFP) after participating in the same instructor-led, real-time feedback training. Twenty-nine BP and 30 BFP participated in this quasi-experimental trial. Training consisted of a 1 h theoretical and practical training session with an additional 30 min afterwards, led by nurses with prior experience in BLS training of various collectives. Quantitative quality of chest compressions (CC), AED use and BLS sequence were evaluated by means of a simulation scenario. BP’s median time to start CC was less than 35 s. Global and specific components of CC quality were similar between groups, except for compression rate (BFP: 123.4 + 15.2 vs. BP: 110.8 + 15.3 CC/min, p = 0.002). Mean compression depth was below the recommended target in both groups, and optimal CC depth was achieved by 27.6% of blind and 23.3% of blindfolded people (p = 0.288). Time to discharge was significantly longer in BFP than BP (86.0 + 24.9 vs. 66.0 + 27.0 s, p = 0.004). Thus, after an adapted and short training program, blind people were revealed to have abilities comparable to those of blindfolded people in learning and performing the BLS sequence and CC.

Animals with muscle hypertrophy phenotype are targeted by the broiler industry to increase the meat production and the quality of the final product. Studies characterizing the molecular machinery involved with these processes, such as quantitative trait loci studies, have been carried out identifying several candidate genes related to this trait; however, validation studies of these candidate genes in cell culture is scarce. The aim of this study was to evaluate SAP30 as a candidate gene for muscle development and to validate its function in cell culture in vitro. The SAP30 gene was downregulated in C2C12 muscle cell culture using siRNA technology to evaluate its impact on morphometric traits and gene expression by RNA-seq analysis. Modulation of SAP30 expression increased C2C12 myotube area, indicating a role in muscle hypertrophy. RNA-seq analysis identified several upregulated genes annotated in muscle development in treated cells (SAP30-knockdown), corroborating the role of SAP30 gene in muscle development regulation. Here, we provide experimental evidence of the involvement of SAP30 gene as a regulator of muscle cell hypertrophy.

The ability of COVID-19 to compromise the respiratory system has generated a substantial proportion of critically ill patients in need of invasive mechanical ventilation (IMV). The objective of this paper was to analyze the prognostic ability of the pulse oximetry saturation/fraction of inspired oxygen ratio (SpO2/FiO2) and the ratio of SpO2/FiO2 to the respiratory rate–ROX index–as predictors of IMV in an emergency department in confirmed COVID-19 patients. A multicenter, retrospective cohort study was carried out in four provinces of Spain between March and November 2020. The discriminative power of the predictive variable was assessed through a prediction model trained using a derivation sub-cohort and evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) on the validation sub-cohort. A total of 2040 patients were included in the study. The IMV rate was 10.1%, with an in-hospital mortality rate of 35.3%. The performance of the SpO2/FiO2 ratio was better than the ROX index–AUC = 0.801 (95% CI 0.746–0.855) and AUC = 0.725 (95% CI 0.652–0.798), respectively. In fact, a direct comparison between AUCs resulted in significant differences (p = 0.001). SpO2 to FiO2 ratio is a simple and promising non-invasive tool for predicting risk of IMV in patients infected with COVID-19, and it is realizable in emergency departments.

Background: The repulsive guidance molecule a (RGMa) is a GPI-anchor axon guidance molecule first found to play important roles during neuronal development. RGMa expression patterns and signalling pathways via Neogenin and/or as BMP coreceptors indicated that this axon guidance molecule could also be working in other processes and diseases, including during myogenesis. Previous works have consistently shown that RGMa is expressed in skeletal muscle cells and that its overexpression induces both nuclei accretion and hypertrophy in muscle cell lineages. However, the cellular components and molecular mechanisms induced by RGMa during the differentiation of skeletal muscle cells are poorly understood. In this work, the global transcription expression profile of RGMa-treated C2C12 myoblasts during the differentiation stage, obtained by RNA-seq, were reported. Results: RGMa treatment could modulate the expression pattern of 2,195 transcripts in C2C12 skeletal muscle, with 943 upregulated and 1,252 downregulated. Among them, RGMa interfered with the expression of several RNA types, including categories related to the regulation of RNA splicing and degradation. The data also suggested that RGMa hyperplasia effects could be due to their capacity to induce the expression of transcripts related to cell-cell adhesion, while RGMa effects on muscle hypertrophy might be due to (i) the activation of the mTOR-Akt independent axis and (ii) the regulation of the expression of transcripts related to atrophy. Finally, RGMa induced the expression of transcripts that encode skeletal muscle structural proteins and members of the signalling pathways associated with GEF and Rho/Rac, common secondary signals of skeletal muscle hypertrophy, and the canonical pathway of the RGMa/Neogenin signalling. Conclusions: These results provide comprehensive knowledge of skeletal muscle transcript changes and pathways in response to RGMa.

Introduction: Kidney transplant recipients are a subgroup of patients at higher risk of critical forms of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection and poor outcomes due to immunosuppression treatment. Herein, we present data from a single center cohort of kidney transplant recipients with SARS-CoV-2 infection. Methods: In a prospective study, baseline characteristics, clinical features, antiviral and immunosuppression management were compared between outpatients and hospitalized patients, during a one-year period. Results: Seventy-seven kidney transplant recipients were analyzed, including outpatients and hospitalized patients, with a median age of 57.7 (IQR 49.7-64.9) years. Twenty-eight (36.4%) were managed as outpatients, while 49 (63.6%) patients required hospital admission. Among hospitalized patients, 18.4% were admitted in ICU, 49% had AKI, and 20.4% died. Immunosuppression adjustments were performed in 95.9% of hospitalized patients, with dose of anti-metabolites adjusted in 83.7%, mTOR inhibitors in 14.3%, calcineurin inhibitors in 12.2%, and corticosteroid therapy in 81.6%. Conclusion: Among hospitalized patients, immunosuppression management included reduction or withdrawal of anti-metabolite and increase of corticosteroid dose. AKI occurred in almost half of patients and mortality in hospitalized patients reached 20%, reflecting greater disease severity than the general population.

Dissertação (mestrado)—Universidade de Brasília, Instituto de Relações Internacionais, Programa de Pós-Graduação em Relações Internacionais, 2021. Neste trabalho, buscou-se aplicar métodos qualitativos para entender de que maneira a estratégia brasileira para segurança e defesa cibernética está estruturada. Partindo-se do princípio de que ameaças cibernéticas são fundamentalmente híbridas e transversais, optou-se por recorte que examina como se organizam países nórdicos e Estônia nesse campo. Identificou-se que a abordagem whole of society é pilar importante de suas respectivas estratégias, de maneira que não se vislumbra o enfrentamento eficiente desses novos desafios cibernéticos, principalmente da interferência híbrida, sem profunda e constante coordenação multinível entre diferentes setores do governo, da iniciativa privada e da sociedade civil. Conclui-se que, ao traçar diagnóstico parcial do que são ameaças cibernéticas e não implementar medidas efetivas de coordenação nem mesmo no âmbito governamental, o Brasil se coloca de maneira vulnerável frente a desafio que se estenderá pelas próximas décadas, sob risco, inclusive, de militarizar a tratativa da questão. In this work, we sought to employ qualitative methods in order to understand how the Brazilian strategy for cyber security and defense is structured. Assuming cyber threats are fundamentally hybrid and transversal, we chose an approach that examines how Nordic countries and Estonia are organized in this area. It was identified that the whole of society concept is an important pillar of their respective strategies, so much so it hardly seems efficient to face these new cyber challenges, mainly hybrid interference, without deep and constant multilevel coordination between different sectors of the government, private businesses and civil society. It is concluded that, by making a partial diagnosis of what cyber threats are and not implementing effective coordination measures, even at the governmental level, Brazil puts itself in a vulnerable position when it comes to a challenge that will stretch well into the next decades, even risking militarizing its handling of the issue.

The progresses in the therapy and methods of diagnosis of malignancies led to a prolonged survival and, consequently, to an increase in secondary tumors in cancer survivor patients [1-7]. We report the case of a 64-year-old patient who was diagnosed with a second primary adenocarcinoma in the gastric conduit, more than two years after the esophagectomy with gastric pull-up. We performed a resection of the gastric conduit and reconstructed with an ileocolon interposition.

A agenesia lobar hepática é uma condição incomum, observada em 1/19000 autopsias e podendo ser mais rara em se tratando do lobo direito, com números próximos de 40 casos relatados na literatura. O seu diagnóstico se baseia na não identificação do ducto hepático, das veias hepática e portal correspondentes. Descrevemos um caso de uma agenesia do lobo direito hepático como achado em exames de imagem abdominais em uma mulher de 63 anos com queixa de desconforto abdominal difuso crônico e apresentando laboratorialmente discreta elevação das enzimas hepáticas.

Given a linear ordinary differential equation (ODE) on $\RE$ and a set of interface conditions at a finite set of points $I \subset \RE$, we consider the problem of determining another differential equation whose {\it global} solutions satisfy the original ODE on $\RE \backslash I $, and the interface conditions at $I $. Using an extension of the product of distributions with non-intersecting singular supports presented in [L. H\"ormander, The Analysis of Linear Partial Diffe\-rential Operators I, Springer-Verlag, 1983], we determine an {\it intrinsic} solution of this problem, i.e. a new ODE, satisfying the required conditions, and strictly defined within the space of Schwartz distributions. Using the same formalism, we determine a singular perturbation formulation for the $n$-th order derivative operator with interface conditions., Comment: 23 pages, to appear in J. Math Anal. Appl

The thermal decomposition reaction of benzaldehyde diperoxide (DFT; 0.001 mol L-1) in nitromethane solution studied in the temperature range of 130.0-166.0 °C, follows a first-order kinetic law up to at least 60% DFT conversion. The organic products observed were benzaldheyde and benzoic acid. A stepwise mechanism of decomposition was proposed where the first step is the homolytic unimolecular rupture of the O-O bond. The activation enthalpy and activation entropy for DFT in nitromethane were calculated (DH# = 106.3 ± 1.0 kJ mol-1 and DS# = -58.6 ± 1.1 J mol-1K-1) and compared with those obtained in other solvents to evaluate the solvent effect. Fil: Bordón, Alexander Germán. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; Argentina Fil: Pila, Andrea Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Modelado e Innovación Tecnológica. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas Naturales y Agrimensura. Instituto de Modelado e Innovación Tecnológica; Argentina Fil: Profeta, Mariela Inés. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; Argentina Fil: Jorge, Maria Josefa. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; Argentina Fil: Jorge, Lilian Cristina. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; Argentina Fil: Romero, Jorge Marcelo. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; Argentina Fil: Jorge, Nelly Lidia. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; Argentina