Characterization of bergamot essential oil: chemical, microbiological and colloidal aspects.

Citrus bergamia is a citric species known as bergamot. The species is widely used due to its derivatives, such as juices, extracts, and essential oil. Specifically, the bergamot essential oil (BEO) is of great interest, with a chemical composition rich in terpenes and esters. Considering its chemical composition, bioactivity, and great economic potential, the characterization of BEO should be studied. However, this essential oil is almost unexplored in terms of a characterization associated with colloids. Chemical characterization was carried out by gas-chromatography coupled to a mass spectrometer and by gas-chromatography coupled to a flame ionization detector. Antibacterial activity against Staphylococcus aureus and Escherichia coli was carried out to confirm the bioactivity of this important essential oil. Dynamic light scattering analysis was performed to create a pattern of droplet size distribution of BEO. Major compounds of BEO were linalyl acetate, limonene, and linalool. The BEO was active against E. coli and presented a MIC value of 2.000 µg/mL, while values of MIC and MBC higher than 2.000 µg/mL were observed for S. aureus. The dynamic light scattering analysis revealed a mean hydrodynamic diameter of 65.7 ± 2.2 nm. After a 1:10 dilution it was observed reduction of mean diameter and enhancement of the percentagem of low size droplets, resepctively 44.1 ± 1.2 nm and 14.5 ± 0.5 nm (28.8 ± 1.2%). Higher droplets and reduced polydispersity index were observed after 1:100 dilution. In the present study, the chemical characterization was in accordance with the species, as the characteristic chemical markers of the species were found. Moreover, it has presented antibacterial activity as expected for the BEO. The analysis of the colloid showed a pattern of droplet size distribution following the Ostwald ripening mechanism after dilution.

Migrants on the Move and Food (In)security: A Call for Research.

Food insecurity contributes to negative outcomes for health and wellbeing, and its impact may be exacerbated during periods of vulnerability. While food insecurity is both a driver and a consequence of migration, anecdotal evidence indicates that it is also common during migration when people are 'on the move', although its prevalence and severity during these periods are largely undocumented. Food security monitoring is critical to ensuring the universal right to food for migrants, and instruments must be designed which capture the unique challenges faced during these 'extra-ordinary' periods of mobility, including in the context of emergencies such as the COVID-19 pandemic. This paper reviews knowledge on food security in migrants on the move and examines how active mobility intersects with food security and its measurement. Considering the potential consequences on health and wellbeing, we call for interdisciplinary research using standard instruments to document food insecurity in migrants on the move.

Assessing air pollution in European cities to support a citizen centered approach to air quality management.

European cities have made significant progress over the last decades towards clean air. Despite this progress, several cities are still facing acute air pollution episodes, with various urban areas frequently exceeding air quality levels allowed by the European legal standards and WHO guidelines. In this paper, six European cities/ regions (Bristol, UK; Amsterdam, NL; Sosnowiec, PL; Ljubljana, SI; Aveiro, PT; Liguria, IT) are studied in terms of air quality, namely particulate matter, nitrogen dioxide and ozone. The concentrations trends from 2008 to 2017 in the different typology of monitoring stations are addressed, together with the knowledge of daily, weekly and seasonal pollution patterns to better understand the city specific profiles and to characterize pollutant dynamics and variations in multiple locations. Additionally, an analysis of the duration and severity of air pollution episodes is also discussed, followed by an analysis of the fulfillment of the legislated limit values. Each of our 6 case study locations face different air pollution problems, but all these case studies have made some progress in reducing ambient concentrations. In Bristol, there have been strong downward trends in many air pollutants, but the levels of NO2 remain persistently high and of concern. In recent years, decreasing concentration levels point to some success of Amsterdam air quality policies. PM10 exceedances are a seasonal pollution problem in Ljubljana, Sosnowiec and Aveiro region (even if with different levels of severity). While, exceedances of NO2 and O3 concentrations are still problematic in Liguria region. The main findings of this paper are particular relevant to define and compare future citizen-led strategies and policy initiatives that may be implemented to improve and fulfill the EU legislation and the WHO guidelines.

How important are maritime emissions for the air quality: At European and national scale.

Due to its dependence on fossil fuel combustion, emissions from the marine transport sector can significantly contribute to air pollution. This work aims to evaluate the impact of maritime transport emissions on air quality in Portugal using a numerical air quality modelling approach, with high-resolution emission data. Emissions from the European TNO inventory were compiled and pre-processed at hourly and high spatial (∼3 × 3 km2) resolutions. Scenarios with and without these maritime emissions were then simulated with the WRF-CHIMERE modelling system, extensively tested and validated for Portugal domain, in order to evaluate their impact on air quality. A simulation was performed for one year (2016) and the resulting differences were analysed in terms of spatial distribution, time series and deltas. The main deltas for NO2 and PM10 are located over international shipping routes and major ports, while O3 concentrations are impacted in a larger area. The modelling results also indicate that shipping emissions are responsible for deltas in the concentration of NO2 higher than 20% over specific urban areas located in the west coast of Portugal, and less than 5% for PM10. For O3 the relative contribution is low (around 2%) but this contribution is also observed at locations more than 50 km from the coast.

Multimodal strategy to improve the adherence to hand hygiene and self-assessment of the institution for the promotion and practice of hand hygiene.

Background: Hand hygiene (HH) has a low rate of adherence worldwide. This study aimed to estimate the HH adherence rate before and after the implementation of the multimodal strategy and to perform a self-assessment of an institution for promotion and practice of HH. Methods: Before and after study, conducted in a university hospital. Professionals of the medical and nursing staff were included. Data collection was from October 2013 to July 2015, through observations of the HH opportunities and application of the HH self-assessment instrument for the institution. Descriptive and univariate analysis were performed. Results: A total of 9500 HH opportunities were observed. The rate of adherence to HH in pre-intervention period was 20.8%, compared to 16.2% and 15.7% in post-intervention. Regarding the evaluation of the institution, it did not have an established ongoing program of training of professionals, no feedback of HH rates to professionals. Conclusion: The low rate of HH adherence reflected the evaluation of the institution in relation to its investment in the practice and promotion of HH, showing that the investment policy for HH adherence needs to be reviewed, considering that before the study the hospital has not been trained in the 'My Five Moments for HH'.

A cost-efficiency and health benefit approach to improve urban air quality.

When ambient air quality standards established in the EU Directive 2008/50/EC are exceeded, Member States are obliged to develop and implement Air Quality Plans (AQP) to improve air quality and health. Notwithstanding the achievements in emission reductions and air quality improvement, additional efforts need to be undertaken to improve air quality in a sustainable way - i.e. through a cost-efficiency approach. This work was developed in the scope of the recently concluded MAPLIA project "Moving from Air Pollution to Local Integrated Assessment", and focuses on the definition and assessment of emission abatement measures and their associated costs, air quality and health impacts and benefits by means of air quality modelling tools, health impact functions and cost-efficiency analysis. The MAPLIA system was applied to the Grande Porto urban area (Portugal), addressing PM10 and NOx as the most important pollutants in the region. Four different measures to reduce PM10 and NOx emissions were defined and characterized in terms of emissions and implementation costs, and combined into 15 emission scenarios, simulated by the TAPM air quality modelling tool. Air pollutant concentration fields were then used to estimate health benefits in terms of avoided costs (external costs), using dose-response health impact functions. Results revealed that, among the 15 scenarios analysed, the scenario including all 4 measures lead to a total net benefit of 0.3M€·y(-1). The largest net benefit is obtained for the scenario considering the conversion of 50% of open fire places into heat recovery wood stoves. Although the implementation costs of this measure are high, the benefits outweigh the costs. Research outcomes confirm that the MAPLIA system is useful for policy decision support on air quality improvement strategies, and could be applied to other urban areas where AQP need to be implemented and monitored.

Increased serum levels of eotaxin/CCL11 in late-stage patients with bipolar disorder: An accelerated aging biomarker?

BACKGROUND: Bipolar disorder (BD) is commonly comorbid with many medical disorders including atopy, and appears characterized by progressive social, neurobiological, and functional impairment associated with increasing number of episodes and illness duration. Early and late stages of BD may present different biological features and may therefore require different treatment strategies. Consequently, the aim of this study was to evaluate serum levels of eotaxin/CCL11, eotaxin-2/CCL24, IL-2, IL-4, IL-6, IL-10, IL-17, TNF-α, IFNγ, BDNF, TBARS, carbonyl, and GPx in a sample of euthymic patients with BD at early and late stages compared to controls. METHODS: Early-stage BD patients, 12 late-stage patients, and 25 controls matched for sex and age were selected. 10mL of peripheral blood was drawn from all subjects by venipuncture. Serum levels of BDNF, TBARS, carbonyl content, glutathione-peroxidase activity (GPx), cytokines (IL-2, IL-4, IL-6, IL-10, IL-17, TNF-α and IFNγ), and chemokines (eotaxin/CCL11 and eotaxin-2/CCL24) were measured. RESULTS: There were no demographic differences between patients and controls. No significant differences were found for any of the biomarkers, except chemokine eotaxin/CCL11, whose serum levels were higher in late-stage patients with BD when compared to controls (p=0.022; Mann-Whitney U test). LIMITATIONS: Small number of subjects and use of medication may have influenced in our results. CONCLUSION: The present study suggests a link between biomarkers of atopy and eosinophil function and bipolar disorder. These findings are also in line with progressive biological changes partially mediated by inflammatory imbalance, a process referred to as neuroprogression.

Brain-derived neurotrophic factor and inflammatory markers in school-aged children with early trauma.

OBJECTIVE: The impact of childhood trauma (CT) on brain-derived neurotrophic factor (BDNF) and cytokines levels remains unclear. We investigated the association between CT and changes in BDNF and cytokines plasma levels in children. METHOD: We recruited 36 children with trauma (CT+) and 26 children without trauma (CT-). The presence of CT was based on a clinical interview and by Criteria A of DSM-IV criteria for PTSD. Blood samples were drawn from all children to assess BDNF and cytokines. ancova was performed with psychiatric symptoms and BMI as covariates to evaluate group differences in plasma levels. RESULTS: CT+ showed increased levels of BDNF and TNF-α after excluding children with history of inflammatory disease (P<0.05) when compared with those CT-. IL-12p70, IL-6, IL-8, IL-10, and IL-1ß levels were not statistically different between groups. CONCLUSION: CT+ showed increased BDNF and proinflammatory cytokines levels. The increase in BDNF levels may be an attempt to neutralize the negative effects of CT, while an increase in TNF-a levels be associated with a proinflammatory state after CT. How these changes associated with trauma relate to other biological changes and illness trajectory later in life remain to be further studied.

Confirmation of sexual dimorphism in Hoplias aimara (Valenciennes, 1847) (Erythrinidae: Characiformes) proposed by local expertise in Amapá, Brazil.

Fishes may show sexual dimorphism according to their reproductive strategies. In some species, this differentiation is already well known. However, with the findings obtained from recent studies, the number of species for which sex can be determined without dissection has increased. Thus far, the presence of external secondary sexual characteristics in Hoplias aimara, a very well-studied species, has not been reported. Traditional knowledge evidenced through riparian people observations indicated the possibility of sexual dimorphism in this species, which was studied in 2 conservation units, Sustainable Development Reserve of Iratapuru River and Tumucumaque Mountains National Park, in the state of Amapá, Brazil. Fishes were captured, and their anal fins were examined when they were still fresh; the sex of the fishes was confirmed by dissection. The same procedure was used for formalin-fixed fishes. By assessing the shape of the anal fin in fresh or fixed fishes, it was possible to determine the sex of the fish, which was then confirmed by dissection. H. aimara shows sexual dimorphism expressed in the morphology of their anal fin. Thus, the sex of fishes deposited in collections can be identified without any dissection, thereby providing important biological information about the specimens.

Staging systems in bipolar disorder: an International Society for Bipolar Disorders Task Force Report.

OBJECTIVE: We discuss the rationale behind staging systems described specifically for bipolar disorders. Current applications, future directions and research gaps in clinical staging models for bipolar disorders are outlined. METHOD: We reviewed the literature pertaining to bipolar disorders, focusing on the first episode onwards. We systematically searched data on staging models for bipolar disorders and allied studies that could inform the concept of staging. RESULTS: We report on several dimensions that are relevant to staging concepts in bipolar disorder. We consider whether staging offers a refinement to current diagnoses by reviewing clinical studies of treatment and functioning and the potential utility of neurocognitive, neuroimaging and peripheral biomarkers. CONCLUSION: Most studies to date indicate that globally defined late-stage patients have a worse overall prognosis and poorer response to standard treatment, consistent with patterns for end-stage medical disorders. We believe it is possible at this juncture to speak broadly of 'early'- and 'late'-stage bipolar disorder. Next steps require further collaborative efforts to consider the details of preillness onset and intermediary stages, and how many additional stages are optimal.

Staging bipolar disorder: clinical, biochemical, and functional correlates.

OBJECTIVE: There are several models of staging in bipolar disorder (BD), but none has been validated. The aims of this study were to empirically investigate clinical variables that may be useful to classify patients in clusters according to stage and study the association with biomarkers as biological validators. METHOD: This was a historical cohort study. Patients (n = 115) diagnosed with BD and not in an acute episode and first-degree relatives of patients diagnosed with BD (n = 25) were recruited. Sociodemographic, clinical, and functional data were collected. Serum cytokines, brain-derived neurotrophic factor, and biomarkers of lipid and protein oxidation were assessed. Cluster analysis was carried out to build a model of staging, and logistic regression was conducted to study associations between the model and biomarkers. RESULTS: Cluster analysis divided the sample into two equitable groups, denominated early and late stage, with empirical cutoffs for the Functioning Assessment Short Test score, number of episodes, age at onset of the disorder, and time elapsed since first episode. In the logistic regression, IL-6 was associated with late stage (P = 0.029). CONCLUSION: This study supports that clinical, functional, and biochemical variables may help to define a classification of staging in BD.

Omega-3 prevents behavior response and brain oxidative damage in the ketamine model of schizophrenia.

Supplementation with omega-3 has been identified as an adjunctive alternative for the treatment of psychiatric disorders, in order to minimize symptoms. Considering the lack of understanding concerning the pathophysiology of schizophrenia, the present study hypothesized that omega 3 prevents the onset of symptoms similar to schizophrenia in young Wistar rats submitted to ketamine treatment. Moreover, the role of oxidative stress in this model was assessed. Omega-3 (0.8g/kg) or vehicle was given by orogastric gavage once daily. Both treatments were performed during 21days, starting at the 30th day of life in young rats. After 14days of treatment with omega-3 or vehicle, a concomitant treatment with saline or ketamine (25mg/kg ip daily) was started and maintained until the last day of the experiment. We evaluated the pre-pulse inhibition of the startle reflex, activity of antioxidant systems and damage to proteins and lipids. Our results demonstrate that supplementation of omega-3 prevented: decreased inhibition of startle reflex, damage to lipids in the hippocampus and striatum and damage to proteins in the prefrontal cortex. Furthermore, these changes are associated with decreased GPx in brain tissues evaluated. Together, our results suggest the prophylactic role of omega-3 against the outcome of symptoms associated with schizophrenia.

Increased annexin-V and decreased TNF-α serum levels in chronic-medicated patients with schizophrenia.

Schizophrenia (SZ) is a chronic severe mental disorder. Increased inflammatory processes have been shown in acute and chronic SZ. Apoptotic processes may alter the neuronal network and are involved in the pathogenesis of several neurodegenerative diseases, such as SZ. Annexin-V seems to have a role on inhibition of pro-inflammatory activities during apoptosis. Tumor necrosis factor (TNF-alpha) is a cytokine involved in systemic inflammation and is a member of a group of cytokines which stimulate acute phase reactions. A chronic immune activation in SZ has been shown. The aim of this study was to compare annexin-V and TNF-alpha serum levels in chronic medicated patients with SZ and healthy controls. Thirty-eight outpatients from the HCPA Schizophrenia Program and 38 healthy controls were enrolled to this study protocol. Annexin-V and TNF-alpha serum levels were measured with ELISA. Serum annexin-V levels were significantly higher in patients with SZ than in controls (p<0.001) and TNF-alpha significantly lower (p<0.001). The present result of increased annexin-V and decreased serum levels of TNF-alpha compared to controls may be a result of the stabilization phase of psychosis and a reduction in metabolic brain aggression. In this complex picture, increased levels of annexin-V and decreased levels of TNF-alpha in our sample would be explained by illness stability and chronic treatment. Our findings support the hypothesis of a state dependant process of inflammation in SZ. Further prospective studies to clarify the findings described in this paper are needed.

Pathways underlying neuroprogression in bipolar disorder: focus on inflammation, oxidative stress and neurotrophic factors.

There is now strong evidence of progressive neuropathological processes in bipolar disorder (BD). On this basis, the current understanding of the neurobiology of BD has shifted from an initial focus on monoamines, subsequently including evidence of changes in intracellular second messenger systems and more recently to, incorporating changes in inflammatory cytokines, corticosteroids, neurotrophins, mitochondrial energy generation, oxidative stress and neurogenesis into a more comprehensive model capable of explaining some of the clinical features of BD. These features include progressive shortening of the inter-episode interval with each recurrence, occurring in consort with reduced probability of treatment response as the illness progresses. To this end, emerging data shows that these biomarkers may differ between early and late stages of BD in parallel with stage-related structural and neurocognitive alterations. This understanding facilitates identification of rational therapeutic targets, and the development of novel treatment classes. Additionally, these pathways provide a cogent explanation for the efficacy of seemingly diverse therapies used in BD, that appear to share common effects on oxidative, inflammatory and neurotrophic pathways.

Improved stress response in bipolar affective disorder with adjunctive spironolactone (mineralocorticoid receptor antagonist): case series.

The psychopathologies underlying affective disorders are thought to involve persistent changes in the expression and function of both mineralocorticoid receptors and glucocorticoid receptors in the hippocampus. In addition, exposure to stressful stimuli can precipitate episodes in vulnerable individuals. The aim of this study is to determine if spironolactone as an adjunctive therapy is effective in improving residual symptoms in bipolar disorder. Four cases of euthymic bipolar disorder (BD) patients were treated with spironolactone as an adjunctive therapy in a private treatment sector. All patients met the DSM-IV diagnosis criteria for bipolar disorder. Clinical response was assessed retrospectively using the Clinical Global Impression Scale for Improvement. Spironolactone was effective in all patients. The four cases illustrate a clinical response to residual symptoms and improvement in stress response after use of spironolactone as an adjunctive therapy in BD. This pilot case series suggests reducing in residual symptoms, with spironolactone as an adjunctive therapy in these DSM-IV BD patients. Mineralocorticoid receptors antagonists' role in reducing stress-induced symptoms deserves further investigation through placebo-controlled trials.

Prevalence of overweight and associated factors in southern Brazilian adolescents.

OBJECTIVE: The aim of this study was to determine the prevalence of overweight in adolescents in a southern Brazilian city, and ascertain gender differences and association with socio-economic and demographic conditions, family factors and individual behaviours. METHODS: Cross-sectional population-based study with random cluster sampling of households, including 722 adolescents (10-19 years), from a city in southern Brazil. Body mass index (BMI) was calculated based on the National Center for Health and Statistics reference curve, defining overweight as BMI 85th percentile. RESULTS: Prevalence of overweight was 17% in girls and 19% in boys. In multivariate Poisson regression, chronic illness in parent(s) and household of up to four people were associated with overweight in boys, whereas low fibre intake, more hours spent watching television and regular exercise were associated with overweight in girls. CONCLUSION: The prevalence of overweight in Brazilian adolescents is high, with gender differences in associated factors. Health workers in schools and public health services should be aware of these differences in order to improve preventive and therapeutic strategies in this age group.

Increased serum S100B protein in schizophrenia: a study in medication-free patients.

S100B protein, a calcium binding protein produced and released by glial cells, has been used as a sensitive marker of brain damage. Previous studies have found alterations in peripheral S100B levels in schizophrenic patients on medication. We compared serum S100B levels of 20 medication-free DSM-IV schizophrenic patients and 20 age-gender matched healthy controls. Schizophrenic patients presented higher serum S100B levels (mean 0.120 ng/ml+/-S.D. 0.140) compared to controls (mean 0.066 ng/ml+/-S.D. 0.067; P=0.014) and there was a negative correlation with illness duration (r=-0.496, P=0.031). The results of this study indicate that serum S100B levels may be a state marker of a limited neurodegenerative process, particularly in the early course of schizophrenia or, at least, in a subgroup of schizophrenic patients.

Pregnancy and the dialysis patient.

Pregnancy in the dialysis patient is a rare occurrence. When pregnancy does occur, the risk of spontaneous abortion, stillbirth and neonatal complications such as prematurity and growth retardation are fairly high. This paper discusses issues surrounding pregnancy and the dialysis patient. It also follows the pregnancy of one hemodialysis patient at The Toronto Hospital. Guidelines for the care of pregnant dialysis patients are reviewed.

Stenting of unprotected left main coronary artery in a patient with cardiogenic shock.

A 64-year-old female presented with pulmonary edema and cardiogenic shock after coronary arteriography that showed severe suboclusive lesion in the left main coronary artery (LMCA) in a dominant left coronary system. The patient succesfully underwent urgent angioplasty with stent deployment in the LMCA. After an uneventful period, the patient was discharged at day six.