Search

Abstract Although COVID-19 is a disease consisting of mostly upper and lower respiratory symptoms, a subset of patients develop cardiac sequelae including myocarditis and pericarditis. For these patients, a standardized set of diagnostic imaging techniques and treatments has not been established. While there have been numerous case reports on this topic, there are few reviews that evaluate the effectiveness of different treatment modalities with a significant number of cases. We reviewed 146 cases of patients (ages ranging from 2 months old to mid 80 s) obtained from searches on PubMed, Google Scholar, and several case report journals. ECG abnormalities, elevated inflammatory markers, and reduced left ventricular ejection fraction were most associated with COVID-19 myocarditis. While classic symptoms of COVID-19 include upper respiratory symptoms, a subset of patients diagnosed with COVID-19 displayed no signs of respiratory disease at all. In 22% of cases, cardiac sequelae was not present until after the patient recovered from COVID-19. Steroids were given in 57.5% of cases. Cardiac MRI was used in 40.4% of cases for diagnosis of myocarditis. Of all the patients who were treated with ECMO, 82.1% of these patients were able to fully recover. The use of cardiac MRI and transthoracic echocardiogram for diagnosis of COVID-19 myocarditis should be heavily considered in any patient with COVID-19 infection. ECMO, IVIG, steroids, and anticoagulants should also be heavily considered. A randomized controlled trial should be conducted to better associate treatments with outcomes.

Abstract Background Longitudinal work on the impact of COVID-19 on population mental health and resilience beyond the first year of the pandemic is lacking. We aimed to understand how mental health and resilience evolved during the pandemic (2020) and two years later (2022) in a multi-ethnic Singaporean population. In addition, we assessed what characteristics were associated with mental health and resilience scores. Methods We surveyed and analysed two balanced panel samples up to four times between 30th April 2020 and 11th July 2022. One panel assessed psychological distress (Kessler-10) and well-being (short Warwick Edinburgh Mental Well-being scale) n = 313, and one panel assessed resilience (10-item Connor-Davidson Resilience Scale©) n = 583. A linear panel regression model with random effects assessed the temporal patterns for psychological distress, well-being, and resilience. Results Mean psychological distress scores (Kessler-10) were relatively stable over time and were not statistically significantly worse than baseline at any follow-up. Well-being scores improved over time and were significantly better than baseline by the third survey (22nd Jul-18th Aug 2020) (0.54 p = 0.007, Cohen’s d 0.12). Scores had worsened by the last survey (27th June-11th July 2022) but were not significantly different from baseline 0.20 p = 0.30. Resilience scores declined over time. Scores at both follow-ups (14th Aug- 4th Sep 2020 and 27th June-11th July 2022) were statistically significantly lower than baseline: -1.69 p

Abstract Carbapenemase-producing Enterobacteriaceae (CPE) are a group of drug-resistant Gram-negative pathogens that are classified as a critical threat by the World Health Organization (WHO). Conventional methods of detecting antibiotic-resistant pathogens do not assess the resistance mechanism and are often time-consuming and laborious. We have developed a magnetic digital microfluidic (MDM) platform, known as MDM Carba, for the identification of CPE by measuring their ability to hydrolyze carbapenem antibiotics. MDM Carba offers the ability to rapidly test CPE and reduce the amount of reagents used compared with conventional phenotypic testing. On the MDM Carba platform, tests are performed in droplets that function as reaction chambers, and fluidic operations are accomplished by manipulating these droplets with magnetic force. The simple droplet-based magnetic fluidic operation allows easy system automation and simplified hands-on operation. Because of the unique “power-free” operation of MDM technology, the MDM Carba platform can also be operated manually, showing great potential for point-of-care testing in resource-limited settings. We tested 27 bacterial isolates on the MDM Carba platform, and the results showed sensitivity and specificity that were comparable to those of the widely used Carba NP test. MDM Carba may shorten the overall turnaround time for CPE identification, thereby enabling more timely clinical decisions for better clinical outcomes. MDM Carba is a technological platform that can be further developed to improve diagnostics for other types of antibiotic resistance with minor modifications.

ABSTRACT Zika virus (ZIKV) has reemerged in the population and caused unprecedented global outbreaks. Here, the transcriptomic consequences of ZIKV infection were studied systematically first in human peripheral blood CD14+ monocytes and monocyte-derived macrophages with high-density RNA sequencing. Analyses of the ZIKV genome revealed that the virus underwent genetic diversification, and differential mRNA abundance was found in host cells during infection. Notably, there was a significant change in the cellular response, with cross talk between monocytes and natural killer (NK) cells as one of the highly identified pathways. Immunophenotyping of peripheral blood from ZIKV-infected patients further confirmed the activation of NK cells during acute infection. ZIKV infection in peripheral blood cells isolated from healthy donors led to the induction of gamma interferon (IFN-γ) and CD107a—two key markers of NK cell function. Depletion of CD14+ monocytes from peripheral blood resulted in a reduction of these markers and reduced priming of NK cells during infection. This was complemented by the immunoproteomic changes observed. Mechanistically, ZIKV infection preferentially counterbalances monocyte and/or NK cell activity, with implications for targeted cytokine immunotherapies. IMPORTANCE ZIKV reemerged in recent years, causing outbreaks in many parts of the world. Alarmingly, ZIKV infection has been associated with neurological complications such as Guillain-Barré syndrome (GBS) in adults and congenital fetal growth-associated anomalies in newborns. Host peripheral immune cells are one of the first to interact with the virus upon successful transmission from an infected female Aedes mosquito. However, little is known about the role of these immune cells during infection. In this work, the immune responses of monocytes, known target cells of ZIKV infection, were investigated by high-density transcriptomics. The analysis saw a robust immune response being elicited. Importantly, it also divulged that monocytes prime NK cell activities during virus infection. Removal of monocytes during the infection changed the immune milieu, which in turn reduced NK cell stimulation. This study provides valuable insights into the pathobiology of the virus and allows for the possibility of designing novel targeted therapeutics.

Background The coronavirus-19 pandemic has impacted the delivery of medical education in dermatology, leading to decreased patient contact. There arose a need to pioneer innovative teaching tools to augment current methods for now and beyond the pandemic. Objectives We aimed to assess the utility of three-dimensional (3D) images in the learning and teaching of dermatology by analysing the perceptions of medical undergraduates and faculty members in a qualitative and quantitative study. Methods Medical undergraduates (n=119) and dermatology faculty members (n=20) were recruited on a voluntary basis to watch a showcase session using a portable 3D imaging system allowing 3D images of skin lesions to be examined and digitally manipulated. After the session, participants filled in an anonymous questionnaire evaluating their perceptions. Results Of the 119 learners, most (> 84%) strongly agreed/agreed that (i) they would have more confidence in the field of dermatology; (ii) their ability to describe skin lesions would increase; (iii) their understanding of common dermatological conditions would increase; (iv) 3D images allow a greater approximation to real-life encounters than 2D images; and (v) learning with this modality would be useful. Of the 20 faculty members, most (> 84%) strongly agreed/agreed that (i) it is easier to teach with the aid of 3D images, and (ii) they would want access to 3D images during teaching sessions. Skin tumours were perceived to be learnt best via this modality in terms of showcasing topography (P<0.01) and close approximation to real-life (P<0.001). Overall, thematic analysis from qualitative analysis revealed that conditions learnt better with 3D images were those with surface changes and characteristic topography. Conclusions Our results show that the greatest utility of 3D images lies in conditions where lesions have skin surface changes in the form of protrusions or depressions, such as in skin tumours or ulcers. As such, 3D images can be useful teaching tools in dermatology, especially in conditions where appreciation of surface changes and topography is important. [ABSTRACT FROM AUTHOR]

This article analyzes the working conditions of teachers in the Degree in Rural Education (LEdoC) at Campus Mazagão at the Federal University of Amapá (Unifap). Our study is scoped to the period since the implementation of this LEdoC, in 2014, until the moment of suspension of its face-to-face activities, in early 2020. The research problem is: what were the teaching working conditions at LEdoC, during its first years of existence? The examination of these conditions took place through oral history interviews and documentary research. The results show that the State, when executing educational policies for the LEdoC, did not guarantee a minimum structure to the Campus Mazagão and, as a result, the teaching work carried out there was precarious and intensified.

Introduction: This study aimed to characterise neonatal paediatric emergency department (PED) visits, analyse the main paediatric illnesses and establish associations of these demographics with the readmission rates and severity of their presentation. Methods: A retrospective analysis of neonates (aged <28 days) presenting to the PEDs of our hospital over seven months was performed. Associations between the clinical and demographic data of admissions to the PED and inpatient admissions were analysed. Results: In total, 1,200 neonates presented during the study period, 79.4% of whom presented at less than 15 days since birth. Length of stay in the PED was less than four hours for 94.0% of the neonates. Predominant triage categories comprised non-P1 cases (97.5%). The main diagnoses at the PED were neonatal jaundice (NNJ; 66.8%) and neonatal pyrexia (NNP; 14.6%), which corresponded to the main diagnoses upon discharge from the hospital: NNJ (68.4%) and NNP (19.6%). 48.2% of neonates were referred from polyclinics or other clinics. 57.7% of the neonates were admitted. Interestingly, 87.0% of the well babies who presented to the emergency department were brought in owing to parental concerns by the parents themselves, without prior consultation with the doctor. Conclusion: Outpatient management of NNJ can be considered. Caregivers should be provided better education regarding normal physiological characteristics of newborns through standardised educational materials. Other potential avenues for parents to seek medical advice, for example hotlines and ChatBots such as the recently piloted 'Urgent Paediatric Advice Line' online service, should be considered. [ABSTRACT FROM AUTHOR]

The present article analyzed as occasional by the use of buoys in discursive contexts regardless of the degree of formality. As methodological procedures, the different data found were tested through two different context: i) Indications of translation into Libras of the teaching subject of Phonology from the Letras Course of the Federal University of Santa Catarina (UFSC); ii) videos in Libras posted on the YouTube channel. To this end, three lexical items were selected: THIS, NOW and EXPLAIN. The analysis is limited to verifying the changes from the use of the buoy in conjunction with these signs in use and in speech. The use of buoys was verified, which necessarily implies lexological changes, for example, signs sometimes done with two hands but sometimes are done with one hand, with the function of the other being occupied with the buoy have the phonological articulation affected, different from when performing a lexical item with both hands simultaneously. In addition, the use of a buoy imposes on the signer strategies to accommodate the signals, which can lead to the triggering of the pointing, either as a fragmentation buoy or as a buoy with the purpose of resuming anaphoric referents.

An outbreak of Chagas disease, possibly involving its vector Triatoma brasiliensis brasiliensis, was identified in the state of Rio Grande do Norte (RN). Given the historical significance of this vector in public health, the study aimed to evaluate its role in the transmission dynamics of the protozoan Trypanosoma cruzi in an area undergoing desertification in the Seridó region, RN, Brazil. We captured triatomines in sylvatic and anthropic ecotopes. Natural vector infection was determined using parasitological and molecular methods and we identified discrete typing units (DTUs) of T. cruzi by analyzing the COII gene of mtDNA, 24Sα rDNA, and mini-exon gene. Their blood meals sources were identified by amplification and sequencing of the mtDNA cytochrome b gene. A total of 952 T. b. brasiliensis were captured in peridomestic (69.9%) and sylvatic ecotopes (30.4%). A wide range of natural infection rates were observed in peridomestic (36.0% - 71.1%) and sylvatic populations (28.6% - 100.0%). We observed the circulation of TcI and TcII DTUs with a predominance of Tcl in sylvatic and peridomestic environments. Kerodon rupestris, rocky cavy (13/39), Homo sapiens, human (8/39), and Bos taurus, ox (6/39) were the most frequently detected blood meals sources. Thus, Triatoma b. brasiliensis is invading and colonizing the human dwellings. Furthermore, high levels of natural infection, coupled with the detection of TcI and TcII DTUs, and also the detection of K. rupestris and H. sapiens as blood meals sources of infected T. b. brasiliensis indicate a risk of T. cruzi transmission to human populations in areas undergoing desertification. Author summary Chagas disease currently affects about six to seven million people worldwide, resulting in high morbidity, mortality, and economic burden in endemic countries of Latin America. Its etiological agent, Trypanosoma cruzi, circulates among a wide variety of mammalian and insect vectors. Triatoma brasiliensis brasiliensis is adapted to the dry and warm climate of the Caatinga biome, and is considered the main vector in the semi-arid areas of northeastern Brazil. Information on the infestation, natural infection rates, T. cruzi strains, and blood meals sources of this vector is crucial for understanding the dynamics of T. cruzi transmission in areas susceptible to desertification. Triatoma b. brasiliensis colonizes peridomestic structures, particularly in the stone walls of cattle corrals that emerge as a refuge for sylvatic populations where they access a variety of blood meals sources. The predominance of the TcI strain in the sylvatic and peridomestic environments shows an overlap of transmission cycles by T. cruzi mediated by T. b. brasiliensis. The high rates of natural infection and the evidence of their feeding on humans and the rodent K. rupestris are worrisome and indicate the threat this vector poses to human health in the area studied.

Triatoma brasiliensis brasiliensis Neiva, 1911 is one of the most important vectors of Chagas disease in the Brazilian semiarid regions in the north-east. The risk imposed by T. b. brasiliensis to the human populations, due to frequent invasions and/or colonization of the domiciles, demands constant monitoring and control actions as well as an understanding of its evolutionary process. In this context, the following research studies the pattern of shape adaptation over time using a large dataset from 102 years of specimen collections in order to identify the morphological plasticity of this vector in Brazil. This dataset was analyzed using geometric morphometrics tools and the timescale was divided into eight different groups, containing specimens from 1912 to 2014. Geometric morphometrics analysis showed an interesting morphological stasis in the wing shape of T. b. brasiliensis, which allowed us to understand the high capacity of adaptation to changes in climate condition through time, and the invasive status which Triatoma species have around the world. Moreover, these results showed novel findings as an interesting phenotypic pattern, with no modifications in more than 100 years, leading us to understand the shape evolution in Triatominae as a vector species of diseases.

This article presents some narratives about childhood and playfulness, from the historical perspective that allow a brief analysis of the use of games as a tool in the teaching and learning of Mathematics. From this perspective, this work aims to assess the implications and what the children's preference is, when using the game as a teaching tool, both in digital format using the Kahoot! As in the version of the same in unplugged form (manual). To this end, a game was applied in order to promote the development of mental calculus related to the four fundamental operations, in a class of the second year of Elementary School. The results indicate that regardless of the form of the game, the interests are related to the particularity of the situation and not to the presentation format. Regarding learning, the development of mental calculus was stimulated equally in both versions of the game, favoring group work, the development of problem-solving and decision-making skills.

O objetivo desse estudo foi ampliar o conhecimento sobre o parasitismo de carrapatos em aves silvestres na Amazônia Ocidental e fornecer registros adicionais de espécies de aves parasitadas por carrapatos no Estado do Acre. As aves foram capturadas com redes de neblina, durante os meses de setembro de 2016 a fevereiro de 2017 na Fazenda Experimental Catuaba, Senador Guiomard, Acre, identificadas e inspecionadas minuciosamente. Os carrapatos detectados foram removidos com auxílio de pinça e armazenados em coletores etiquetados, contendo álcool a 70% e identificados utilizando estereomicroscópio com iluminação incidente e chaves taxonômicas, no Departamento de Medicina Veterinária Preventiva e Saúde Animal da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo. No total, 203 aves silvestres foram capturadas, compreendendo nove ordens e 24 famílias. Destas, 24 aves (11,82%), pertencentes à 13 espécies estavam parasitadas por 44 carrapatos em diferentes estágios: 26 larvas de Amblyomma sp., 10 ninfas de Amblyomma nodosum, quatro ninfas de Amblyomma longirostre e quatro ninfas de Amblyomma humerale. O presente estudo relata, pela primeira vez, nove novas espécies de aves como hospedeiras de carrapatos do gênero Amblyomma no Estado do Acre: Monasa nigrifrons, Hypocnemis subflava, Dendrocincla fuliginosa, Sittasomus griseicapillus, Xiphorhynchus guttatoides, Poecilotriccus latirostris, Hemitriccus flammulatus, Ramphotrigon megacephalum e Turdus amaurochalinus. O presente trabalho, registra pela primeira vez os carrapatos A. nodosum parasitando R. megacephalum e A. humerale parasitando Momotus momota, S. griseicapillus e X. guttatoides.

Despite the increase in the number of Ironman competitions worldwide, thousands of athletes have been joining Ironman experience but only a few studies have been published on the effects of this competition on postural control. This study aims to investigate the ability to maintain a static posture in three different positions before and after an Ironman competition and the blood glucose level behavior. Forty-nine volunteers underwent balance evaluation using the force plate VSRTM Sport. The area of the center of gravity (ACOG) was assessed pre- and post-competition in the bipodal, unipodal, and tandem postures. Glucose levels were also assessed concurrently. The ACOG findings showed a significant post-competition increase in the three postures assessed, with no significant interaction between the postures. The glucose test showed an increase in the post-competition glycemic levels. The findings showed reduced postural control, suggesting that prolonged exercise stimulation could lead to a disturbance in postural control.

The objective of this study was to conduct coproparasitological examinations and hemoparasite investigations associated with a hemogram to evaluate the state of the parasitized animals before and after deworming, contribute to sanitary measures, and provide knowledge of Cuniculus paca hematological patterns. We performed these examinations in 20 animals aged between 2 and 10 years on different dates (day 0 and day 30) before and after deworming with a vermifuge based on albendazole + cobalt. The changes caused by endoparasites and hemoparasites were observed and whether there was a satisfactory effect on deworming was evaluated. Trichuris spp., Strongyloides spp., and non-sporulated Eimeria spp. oocytes were detected during the examinations. Trichuris spp. had the highest incidence. We found no hemoparasites in any blood smears. In the first sampling, the eosinophilia and leukocytosis in the hemogram indicated parasitism in the animals. In the second sampling, the number of eosinophils decreased and the number of eggs and oocysts nearly disappeared in the coproparasitological examinations. The vermifuge showed an acceptable effect on sanitary management, and the hemogram was consistent with animal hygiene.