Whole-genome sequencing analysis of multidrug-resistant Serratia marcescens isolates in an intensive care unit in Brazil.

INTRODUCTION: Serratia marcescens is an opportunistic pathogen found ubiquitously in the environment and associated with a wide range of nosocomial infections. This multidrug-resistant bacterium has been a cause of concern for hospitals and healthcare facilities due to its ability to spread rapidly and cause outbreaks. Next generation sequencing genotyping of bacterial isolates has proven to be a valuable tool for tracking the spread and transmission of nosocomial infections. This has allowed for the identification of outbreaks and transmission chains, as well as determining whether cases are due to endogenous or exogenous sources. Evidence of nosocomial transmission has been gathered through genotyping methods. The aim of this study was to investigate the genetic diversity of carbapenemase-producing S. marcescens in an outbreak at a public hospital in Cuiaba, MT, Brazil. METHODOLOGY: Ten isolates of S. marcenses were sequenced and antibiotic resistance profiles analyzed over 12 days. RESULTS: The isolates were clonal and multidrug resistant. Gentamycin and tigecycline had sensitivity in 90% and 80% isolates, respectively. Genomic analysis identified several genes that encode ß-lactamases, aminoglycoside-modifying enzymes, efflux pumps, and other virulence factors. CONCLUSIONS: Systematic surveillance is crucial in monitoring the evolution of S. marcescens genotypes, as it can lead to early detection and prevention of outbreaks.

Unveiling the Structural Properties, Optical Behavior, and Thermoelectric Performance of 2D CsSn2Br5 Halide Obtained by Mechanochemistry.

Metal halide perovskites with a two-dimensional structure are utilized in photovoltaics and optoelectronics. High-crystallinity CsSn2Br5 specimens have been synthesized via ball milling. Differential scanning calorimetry curves show melting at 553 K (endothermic) and recrystallization at 516 K (exothermic). Structural analysis using synchrotron X-ray diffraction data, collected from 100 to 373 K, allows for the determination of Debye model parameters. This analysis provides insights into the relative Cs-Br and Sn-Br chemical bonds within the tetragonal structure (space group: I4/mcm), which remains stable throughout the temperature range studied. Combined with neutron data, X-N techniques permit the identification of the Sn2+ lone electron pair (5s2) in the two-dimensional framework, occupying empty space opposite to the four Sn-Br bonds of the pyramidal [SnBr4] coordination polyhedra. Additionally, diffuse reflectance UV-vis spectroscopy unveils an indirect optical gap of approximately ∼3.3 eV, aligning with the calculated value from the B3LYP-DFT method (∼3.2 eV). The material exhibits a positive Seebeck coefficient as high as 6.5 × 104 µV K-1 at 350 K, which evolves down to negative values of -3.0 × 103 µV K-1 at 550 K, surpassing values reported for other halide perovskites. Notably, the thermal conductivity remains exceptionally low, between 0.32 and 0.25 W m-1 K-1.

Cardiovascular Outcomes of Sodium-Glucose Cotransporter-2 Inhibitors Therapy in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Systematic Review and Updated Meta-Analysis.

BACKGROUND AND OBJECTIVES: The efficacy of sodium-glucose cotransporter-2 inhibitors (SGLT2i) may depend on renal function, and this raises theoretical concern over its effects on cardiovascular outcomes in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). METHODS: This systematic review and updated meta-analysis of randomized controlled trials (RCTs) compared cardiovascular outcomes of patients with T2DM and CKD treated with SGLT2i to placebo. PubMed, Embase, and Cochrane were systematically searched. Prespecified subgroup analyses were performed in strata of estimated glomerular filtration rate (eGFR) of <45 mL/min/1.73 m² and 45 to 59 mL/min/1.73 m². RESULTS: Nine RCTs comprising 29,146 patients were selected. Average follow-up ranged from 0.75 to 4.2 years. SGLT2i were shown to reduce the risk of all-cause mortality (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.79-0.97; p=0.01), the composite of cardiovascular mortality or hospitalizations for heart failure (HHF: HR, 0.71; 95% CI, 0.65-0.78; p<0.001), cardiovascular mortality (HR, 0.86; 95% CI, 0.76-0.98; p=0.02), HHF (HR, 0.62; 95% CI, 0.55-0.71; p<0.001), major adverse cardiovascular events (HR, 0.85; 95% CI, 0.77-0.94; p=0.002), stroke (HR, 0.76; 95% CI, 0.59-0.97; p=0.03), and myocardial infarction (HR, 0.78; 95% CI, 0.67-0.91; p=0.001). These findings were consistent over strata of eGFR, albeit with a lower incidence of stroke in patients treated with SGLT2i with eGFR <45 mL/min/1.73 m² (p-value for interaction=0.04). CONCLUSIONS: Compared with a placebo, patients with T2DM and CKD treated with SGLT2i experience a reduction in all-cause mortality, cardiovascular mortality, and HHF. TRIAL REGISTRATION: PROSPERO Identifier: CRD42023401081.

Effect of Testosterone on the Thyroarytenoid Muscle and Lamina Propria of Female Rat Vocal Folds.

OBJECTIVE: To analyze the effects of androgen therapy on the thyroarytenoid (TA) muscle, expression of androgen receptors (ARs) and hyaluronic acid (HA) concentration in the vocal folds (VFs) of adult female rats. METHODS: Twenty-one adult female Wistar rats were divided into experimental and control groups. The experimental group received weekly intramuscular injections of nandrolone decanoate for 9 weeks. Following euthanasia and dissection of the VFs, histomorphometric analysis of the TA muscle, immunohistochemical evaluation of ARs, and measurement of HA concentration using the ELISA-like fluorimetric method were performed. RESULTS: The experimental group exhibited a significantly larger mean fiber cross-sectional area in the TA muscle compared to the control group (434.3 ± 68.6 µm2 versus 305.7 ± 110.1 µm2; p = 0.029), indicating muscle hypertrophy. There was no significant difference in the number of muscle fibers. The experimental group showed higher expression of ARs in the lamina propria (62.0% ± 30.3% versus 22.0% ± 22.8%; p = 0.046) and in the TA muscle (45.0% ± 22.6% versus 18.3% ± 9.8%; p = 0.024). There was no significant difference in the concentration of HA. CONCLUSION: Exposure of adult female rats to androgen therapy resulted in hypertrophy of the TA muscle and increased expression of ARs in the VFs. The TA muscle seems to be the primary target of testosterone action in the VF, and the up-regulation of ARs might contribute to the persistent deepening of the voice. LEVEL OF EVIDENCE: NA Laryngoscope, 134:2316-2321, 2024.

Preliminary checklist of dragonflies (Insecta: Odonata) of the Santa Catarina State, Brazil / Checklist preliminar de libélulas (Insecta: Odonata) do Estado de Santa Catarina, Brasil

Abstract In this study, we provide a checklist of the species of Odonata (Insecta) from the state of Santa Catarina (southern Brazil), along with their location records in the municipalities across the state (whenever possible). We compiled 147 species from 60 genera and nine families, making Santa Catarina the second state with the most Odonata species recorded in southern Brazil. The families with the highest number of species were Libellulidae (54 species from 18 genera), followed by Coenagrionidae (36 species from 17 genera), Gomphidae (20 species from ten genera) and Aeshnidae (15 species from eight genera). Several regions of Santa Catarina are unexplored (mostly the westernmost and central regions of the state), whereas the knowledge in the southern coast and the subtropical highland grasslands remains restricted to sparse occurrence records. Moreover, the distribution records in the state show an enormous historical track associated with the establishment of late entomologists in the region. Our study highlights the role of Atlantic Forest biome in maintaining high levels of diversity of Odonata species richness in Brazil and also shows that many areas in subtropical forests in Brazil are not adequately sampled.

Resumo Neste estudo, fornecemos um checklist das espécies de Odonata (Insecta) do estado de Santa Catarina (sul do Brasil), juntamente com seus registros de localização nos municípios do estado (quando disponíveis na literatura). Compilamos 147 espécies distribuídas em 60 gêneros e nove famílias, tornando Santa Catarina o segundo estado com mais espécies de Odonata registradas na região Sul do Brasil. As famílias com maior número de espécies foram Libellulidae (54 espécies distribuídas em 18 gêneros), seguida por Coenagrionidae (36 espécies distribuídas em 17 gêneros), Gomphidae (20 espécies distribuídas em dez gêneros) e Aeshnidae (15 espécies distribuídas em oito gêneros). Diversas regiões de Santa Catarina seguem inexploradas (principalmente as regiões centrais e do extremo oeste do estado), enquanto conhecimento no litoral sul e campos de altitude subtropicais permanecem restritos a registros pontuais de ocorrência. Além disso, os registros de distribuição no estado mostram um enorme legado histórico associado à fixação de entomologistas tradicionalmente lotados na região. Nosso estudo destaca o papel do bioma Mata Atlântica na manutenção de altos níveis de diversidade da riqueza de espécies de Odonata no Brasil e também mostra que muitas áreas de florestas subtropicais no Brasil não são amostradas adequadamente.

Coronary Computed Tomography Angiography Versus Invasive Coronary Angiography in Stable Chest Pain: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: The efficacy of coronary computed tomography angiography (CCTA) versus invasive coronary angiography (ICA) among patients with stable chest pain has been studied in several trials with conflicting results. METHODS: We performed a systematic review and meta-analysis comparing CCTA first versus direct ICA among patients with stable chest pain, who were initially referred to ICA. PubMed, EMBASE, and Cochrane Central were searched for randomized controlled trials comparing the 2 strategies. Risk ratios (RRs) and mean differences with 95% CIs were computed for binary and continuous outcomes, respectively. RESULTS: Five randomized controlled trials with a total of 5727 patients were included, of whom 51.1% were referred to CCTA and 22.5% of patients had evidence of ischemia on a prior functional test. In the follow-up ranging from 1 to 3.5 years, 660 of the 2928 patients randomized to CCTA first underwent ICA (23%). Patients who underwent CCTA had lower rates of coronary revascularization (RR, 0.74 [95% CI, 0.66-0.84]; P<0.001) and stroke (RR, 0.50 [95% CI, 0.26-0.98]; P=0.043). Cardiovascular mortality (RR, 0.55 [95% CI, 0.24-1.23]; P=0.146), major adverse cardiovascular events (RR, 0.84 [95% CI, 0.64-1.10]; P=0.198), nonfatal myocardial infarction (RR, 1.09 [95% CI, 0.63-1.88]; P=0.768), and cardiovascular hospitalizations (RR, 0.91 [95% CI, 0.59-1.39]; P=0.669) did not differ significantly between groups. CONCLUSIONS: In patients with stable chest pain referred for ICA, CCTA avoided the need for ICA in 77% of patients otherwise referred for ICA. CCTA was associated with a reduction in the rates of coronary revascularization and stroke compared with direct ICA. REGISTRATION: URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42023383143.

Structural Features and Optical Properties of All-Inorganic Zero-Dimensional Halides Cs4PbBr6-xIx Obtained by Mechanochemistry.

Despite the great success of hybrid CH3NH3PbI3 perovskite in photovoltaics, ascribed to its excellent optical absorption properties, its instability toward moisture is still an insurmountable drawback. All-inorganic perovskites are much less sensitive to humidity and have potential interest for solar cell applications. Alternative strategies have been developed to design novel materials with appealing properties, which include different topologies for the octahedral arrangements from three-dimensional (3D, e.g., CsPbBr3 perovskite) or two-dimensional (2D, e.g., CsPb2Br5) to zero-dimensional (0D, i.e., without connection between octahedra), as the case of Cs4PbX6 (X = Br, I) halides. The crystal structure of these materials is complex, and their thermal evolution is unexplored. In this work, we describe the synthesis of Cs4PbBr6-xIx (x = 0, 2, 4, 6) halides by mechanochemical procedures with green credentials; these specimens display excellent crystallinity enabling a detailed structural investigation from synchrotron X-ray powder diffraction (SXRD) data, essential to revisit some features in the temperature range of 90-298 K. In all this regime, the structure is defined in the trigonal R3̅c space group (#167). The presence of Cs and X vacancies suggests some ionic mobility into the crystal structure of these 0D halides. Bond valence maps (BVMs) are useful in determining isovalent surfaces for both Cs4PbBr6 and Cs4PbI6 phases, unveiling the likely ionic pathways for cesium and bromide ions and showing a full 3D connection in the bromide phase, in contrast to the iodide one. On the other hand, the evolution of the anisotropic displacement parameters is useful to evaluate the Debye temperatures, confirming that Cs atoms have more freedom to move, while Pb is more confined at its site, likely due to a higher covalency degree in Pb-X bonds than that in Cs-X bonds. Diffuse reflectance ultraviolet-visible (UV-vis) spectroscopy shows that the optical band gap can be tuned depending on iodine content (x) in the range of 3.6-3.06 eV. From density functional theory (DFT) simulations, the general trend of reducing the band gap when Br is replaced by I is well reproduced.

Impact of environmental variables on some reproductive metrics of white-lipped peccaries (Tayassu pecari) raised in Atlantic Forest of Brazil.

Knowledge on male reproductive physiology is essential for the development of effective conservation strategies. This study investigated the influence of environmental variables on certain reproductive metrics in white-lipped peccaries (Tayassu pecari) raised in the Atlantic Forest. After anesthetization, testicular and cauda epididymis biometry were evaluated in nine adult male individuals subjected to electroejaculation. Semen was evaluated for volume, pH, concentration, total number of sperm, sperm morphology, membrane integrity, and kinematic parameters. Concurrently, environmental variables were collected from the day before, for the previous 14 days (estimated for sperm maturation in epididymis), and the period of 51-55 days (corresponding to the spermatogenic cycle) before semen collection. Overall, it was observed that rainfall is the most important environmental variable influencing the reproductive parameters of white-lipped peccaries, being positively correlated with the amplitude of lateral sperm head displacement (ρ = 0.62, P < 0.05) and the appearance of proximal cytoplasmic droplets in sperm (ρ = 0.62, P < 0.05). In addition, the testicular biometry of the species is influenced by the set of environmental variables of air temperature, rainfall, and relative humidity (ρ ≥ 0.60, P < 0.05). On the other hand, epididymal biometric data showed numerous correlations between cauda epididymis metrics and sperm parameters (ρ = 0.68, P < 0.05). This information will be useful to improving conservation strategies for these animals, contributing to their management in captivity and to reintroduction programs, especially in the Atlantic Forest where the species is declining.

Bet-hedgers commit to the hedge: Zooplankton in ephemeral semiarid wetlands of tropical Brazil that widely spread risk.

Bet-hedging is an ecological risk-aversion strategy in which a population does not commit all its effort toward a single reproductive event or specific environmental condition, and instead spreads the risk to include multiple reproductive events or conditions. For aquatic invertebrates in dry wetlands, this often takes the form of some propagules hatching in the first available flood, while remaining propagules hatch in subsequent floods (the "hedge"); this better ensures that a subset of propagules will hatch in a flood of sufficient duration to successfully complete development. Harsh environmental conditions are believed to promote an increased reliance on bet-hedging. Bet-hedging studies have typically been restricted to single sites or single populations. Community-level assessments may provide more robust support for the range of hatching strategies that exist in nature. Here, we tested whether freshwater zooplankton assemblages inhabiting ephemeral and unpredictable wetlands of a semiarid zone of tropical Brazil employ hatching strategies suggestive of bet-hedging; few efforts have addressed bet-hedging in the tropics where the unique conditions may influence the strategy. We collected dry sediments from six ephemeral wetlands, and flooded them across a sequence of three hydrations under similar laboratory conditions to assess whether hatching patterns conform to some of the predictions of the bet-hedging theory. We found that taxa showing hatching patterns akin to bet-hedging associated with delayed hatching numerically dominated the assemblages that emerged from dry sediments, although there was large heterogeneity in the hatching rate among sites and across taxa. While some populations distributed their hatching across all three floods and committed most of their hatching fraction to the first hydration, others committed as much or more effort to the second hydration (the "hedge") or the third hydration (another substantial "hedge"). Thus, in the harsh study wetlands, hatching patterns akin to bet-hedging associated with delayed hatching were common and occurred at multiple temporal scales. Our community assessment found that a commitment to the "hedge" was greater than the current theory would predict. Our findings have broader implications; bet-hedger taxa seem especially well equipped to tolerate stress if conditions become harsher as environments change.

Molecular adsorption on coinage metal subnanoclusters: A DFT+D3 investigation.

Gold and silver subnanoclusters with few atoms are prominent candidates for catalysis-related applications, primarily because of the large fraction of lower-coordinated atoms exposed and ready to interact with external chemical species. However, an in-depth energetic analysis is necessary to characterize the relevant terms within the molecular adsorption process that can frame the interactions within the Sabatier principle. Herein, we investigate the interaction between Agn and Aun subnanoclusters (clu, n = 2-7) and N2 , NO, CO, and O2 molecules, using scalar-relativistic density functional theory calculations within van der Waals D3 corrections. The onefold top site is preferred for all chemisorption cases, with a predominance of linear (≈180°) and bent (≈120°) molecular geometries. A larger magnitude of adsorption energy is correlated with smaller distances between molecules and clusters and with the weakening of the adsorbates bond strength represented by the increase of the equilibrium distances and decrease of molecular stretching frequencies. From the energetic decomposition, the interaction energy term was established as an excellent descriptor to classify subnanoclusters in the adsorption/desorption process concomitant with the Sabatier principle. The limiting cases: (i) weak molecular adsorption on the subnanoclusters, which may compromise the reaction activation, where an interaction energy magnitude close to 0 eV is observed (e.g., physisorption in N2 /Ag6 ); and (ii) strong molecular interactions with the subnanoclusters, given the interaction energy magnitude is larger than at least one of the individual fragment binding energies (e.g., strong chemisorption in CO/Au4 and NO/Au4 ), conferring a decrease in the desorption rate and an increase in the possible poisoning rate. However, the intermediate cases are promising by involving interaction energy magnitudes between zero and fragment binding energies. Following the molecular closed-shell (open-shell) electronic configuration, we find a predominant electrostatic (covalent) nature of the physical interactions for N2 ⋯clu and CO ⋯clu (O2 ⋯clu and NO⋯clu), except in the physisorption case (N2 /Ag6 ) where dispersive interaction is dominant. Our results clarify questions about the molecular adsorption on subnanoclusters as a relevant mechanistic step present in nanocatalytic reactions.

Pan-genomic analysis of Corynebacterium amycolatum gives insights into molecular mechanisms underpinning the transition to a pathogenic phenotype.

Corynebacterium amycolatum is a nonlipophilic coryneform which is increasingly being recognized as a relevant human and animal pathogen showing multidrug resistance to commonly used antibiotics. However, little is known about the molecular mechanisms involved in transition from colonization to the MDR invasive phenotype in clinical isolates. In this study, we performed a comprehensive pan-genomic analysis of C. amycolatum, including 26 isolates from different countries. We obtained the novel genome sequences of 8 of them, which are multidrug resistant clinical isolates from Spain and Tunisia. They were analyzed together with other 18 complete or draft C. amycolatum genomes retrieved from GenBank. The species C. amycolatum presented an open pan-genome (α = 0.854905), with 3,280 gene families, being 1,690 (51.52%) in the core genome, 1,121 related to accessory genes (34.17%), and 469 related to unique genes (14.29%). Although some classic corynebacterial virulence factors are absent in the species C. amycolatum, we did identify genes associated with immune evasion, toxin, and antiphagocytosis among the predicted putative virulence factors. Additionally, we found genomic evidence for extensive acquisition of antimicrobial resistance genes through genomic islands.

Complexation of a Polypeptide-Polyelectrolytes Bioparticle as a Biomaterial of Antibacterial Activity.

The development of biomaterials to enable application of antimicrobial peptides represents a strategy of high and current interest. In this study, a bioparticle was produced by the complexation between an antimicrobial polypeptide and the biocompatible and biodegradable polysaccharides chitosan-N-arginine and alginate, giving rise to a colloidal polyelectrolytic complex of pH-responsive properties. The inclusion of the polypeptide in the bioparticle structure largely increases the binding sites of complexation during the bioparticles production, leading to its effective incorporation. After lyophilization, detailed evaluation of colloidal structure of redispersed bioparticles evidenced nano or microparticles with size, polydispersity and zeta potential dependent on pH and ionic strength, and the dependence was not withdrawn with the polypeptide inclusion. Significant increase of pore edge tension in giant vesicles evidenced effective interaction of the polypeptide-bioparticle with lipid model membrane. Antibacterial activity against Aeromonas dhakensis was effective at 0.1% and equal for the isolated polypeptide and the same complexed in bioparticle, which opens perspectives to the composite material as an applicable antibacterial system.

Genome Report of Emergent Fish Pathogen Edwardsiella piscicida Recovered from Pseudoplatystoma corruscans in Brazil.

Edwardsiella piscicida is a Gram-negative bacteria belonging to the Hafniaceae family which affects several species of marine and freshwater fish. We present the complete genome of E. piscicida strain BEP80 recovered from the Brazilian catfish named Surubim (Pseudoplatystoma corruscans), consisting a chromosome of 3,883,256 bp and no plasmids.

Characterization of Multidrug-Resistant Staphylococcus aureus Isolates and Comparison of Methods of Susceptibility to Vancomycin.

S. aureus are among the main bacteria causing problems related to multidrug resistance in nosocomial infections. Therefore, it is necessary to carry out a reliable and rapid diagnosis for the identification of the bacteria and characterization of its susceptibility profile, especially vancomycin, which is an alternative treatment against multidrug-resistant (MDR) S. aureus. Thus, the goal of this study was to characterize isolates of S. aureus regarding the resistance and virulence and to check the susceptibility to vancomycin, through different methods, for comparative purposes. Seventeen antimicrobials were tested to assess the susceptibility profile. It was evaluated the presence of identification (nuc), resistance (mecA and blaZ), biofilm (icaA and icaD) and siderophore (sfaD and sbnD) genes. The susceptibility to vancomycin was evaluated by Minimum Inhibitory Concentration (MIC) by broth microdilution (BMD), E-test, commercial panel (Kit), and Phoenix equipment. Most S. aureus (93,33%) was classified as MDR. These isolates were 100% positive for nuc, mecA, icaA, icaD, and sfaD genes; 96.67% for sbnD and 33.33% for blaZ. In relation to BMD, all methods correctly classified the susceptibility of the isolates; however, regarding the exact MIC value for vancomycin, Phoenix showed agreement of 63.33%, E-test (33.33%) and Kit (26.66%). In conclusion, most of S. aureus was considered MDR. Also, they presented resistance, biofilm production, and siderophores genes, showing the pathogenic potential of these bacteria. Besides, the Phoenix test was considered the most effective, as it presents advantages, such as identification of the microorganism and a greater number of antimicrobials tested at a time.

Quantitative histology as a diagnostic tool for celiac disease in children and adolescents.

OBJECTIVE: To measure the villous height, the crypt depth, and the number of intraepithelial lymphocytes/100 enterocytes of the small intestinal mucosa of children and adolescents with celiac disease; and to classify these findings according to Q- Marsh and Q-histology scales. METHODS: Retrospective study of a database from the Department of Pathology of biopsies from the second portion of the duodenum of pediatric patients. According to the histological report, three groups were established: celiac disease at diagnosis (n = 50), controls (n = 26), giardiasis (n = 10). In each biopsy, software (cellSens and Image J) evaluated 5 villous heights, 5 crypt depth and the number of intraepithelial lymphocytes/100 enterocytes. RESULTS: The celiac group had the lowest mean villous height (197.83 µm) of all three groups (control = 477.70 µm; giardiasis = 397.04 µm. The celiac group's villous:crypt ratio (0.78) was significantly lower than the control group (1.89). The number of intraepithelial lymphocytes ≥25 was exclusive to the celiac group, with a sensitivity and specificity of 100 %. Only celiac patients were included in types 2 and 3 of the Q-histology classification. CONCLUSION: Celiac disease patients showed shorter villous height than other groups, and the number of intraepithelial lymphocytes ≥25 was the best parameter to differentiate celiac from controls and giardiasis groups. Intraepithelial lymphocytes ≥25/100 enterocytes associated with any degree of villous atrophy, the classic Marsh 3 type, set the histological parameters of celiac disease. Quantitative histology is a valuable tool for diagnosing celiac disease, enabling histological changes in a short time, and the Q-histology scale appears to be more suitable than the Q-Marsh scale.

The 8-Odorant Barcelona Olfactory Test (BOT-8): Validation of a New Test in the Spanish Population During the COVID-19 Pandemic.

BACKGROUND AND OBJECTIVE: Most smell tests are difficult to implement in daily clinical practice owing to their long duration. The aim of the present study was to develop and validate a short, easy-to-perform, and reusable smell test to be implemented during the COVID-19 pandemic. METHODS: The study population comprised 120 healthy adults and 195 patients with self-reported olfactory dysfunction (OD). The 8-Odorant Barcelona Olfactory Test (BOT-8) was used for detection, memory/recognition, and forced-choice identification. In addition, a rose threshold test was performed, and a visual analog scale was applied. The Smell Diskettes Olfaction Test (SDOT) was used for correlation in healthy volunteers, and the University of Pennsylvania Smell Identification Test (UPSIT) was used for patients with OD to establish cut-offs for anosmia and hyposmia. In order to take account of the COVID-19 pandemic, disposable cotton swabs with odorants were compared with the original test. RESULTS: In healthy persons, the mean (SD) BOT-8 score was 100% for detection, 94.5% (1.07) for memory/recognition, and 89.6% (0.86) for identification. In patients with OD, the equivalent values were 86% (32.8), 73.2% (37.9), and 77.1% (34.2), respectively. BOT-8 demonstrated good test-retest reliability, with agreement of 96.7% and a quadratic k of 0.84 (P<.001). A strong correlation was observed between BOT-8 and SDOT (r=0.67, P<.001) and UPSIT (r=0.86, P<.001). Agreement was excellent for disposable cotton swabs, with a k of 0.79 compared with the original test. The cut-off point for anosmia was ≤3 (area under the curve, 0.83; sensitivity, 0.673; specificity, 0.993). CONCLUSION: BOT-8 offers an efficient and fast method for assessment of smell threshold, detection, memory, and identification in daily clinical practice. Disposable cotton swabs with odorants proved to be useful and safe during the COVID-19 pandemic.

Healthcare-associated infections: a threat to the survival of patients with COVID-19 in intensive care units.

BACKGROUND: Wide variation in mortality rates among critically ill patients with coronavirus disease 2019 (COVID-19) has been reported. This study evaluated whether healthcare-associated infections (HAI) are a risk factor for death among patients with severe COVID-19 in the intensive care unit (ICU). METHODS: This retrospective cohort study included patients with severe COVID-19 hospitalized in the ICU of four hospitals in the city of Curitiba, Brazil. Patients with COVID-19 who died during ICU hospitalization were compared with those who were discharged. A second analysis compared patients who developed HAI in the ICU with those who did not. Multiple logistic regression models were used to control for confounders. RESULTS: In total, 400 patients were included, and 123 (31%) patients developed HAI. The most common HAI was lower respiratory tract infection (67%). Independent risk factors for death were: age [odds ratio (OR) 1.75, 95% confidence interval (CI) 1.43-2.15; P<0.0001]; clinical severity score (OR 2.21, 95% CI 1.70-2.87; P<0.0001); renal replacement therapy (OR 12.8, 95% CI 5.78-28.6; P<0.0001); and HAI (OR 5.9, 95% CI 3.31-10.5; P<0.0001). A longer interval between symptom onset and hospital admission was protective against death (OR 0.93, 95% CI 0.88-0.98; P=0.017). The only independent factors associated with HAI were high C-reactive protein and low PaO2/FiO2 ratio. CONCLUSIONS: No factors that could point to a high-risk group for HAI acquisition were identified. However, age, dialysis and HAI increased the risk of death in ICU patients with severe COVID-19; of these, HAI is the only preventable risk factor.

Non-Lethal Blood Sampling of Fish in the lab and Field With Methods for Dried Blood Plasma Spot Omic Analyses.

There is global acknowledgment that humane methods in animal research are a priority, but few environmental effects monitoring programs use nonlethal methods for fish. The goal of the present study was to determine the impacts of sampling small volumes of blood in larger-bodied fish on survival and healing. In addition to evaluating survival following blood sampling, we evaluated the utility of dried blood spots as an alternative for sample processing and storage in the field. In our approach, we housed 80 rainbow trout (Oncorhynchus mykiss) in our flow-through aquatic facility. We then anaesthetized using MS-222 and sampled 1 µl/g bw of blood via puncture of the caudal vasculature. We tested four different post-blood sampling treatments on the puncture wound: 1. application of liquid bandage; 2. a swab of betadine; 3. a swab of fish mucous; and 4. compared survival outcomes to a group where no post-treatment was performed (negative control). Overall, we observed 90% survival among all treatments, with the most effective approach being the negative control (100% survival). Based upon these results, we repeated the blood sampling with no-post treatment by housing 20 rainbow trout (not previously tested upon) in cages at a nearby creek and monitored survival for 2 weeks post sampling. The survival rate was 95% with full healing of the puncture site in all subjects. In addition to this, we tested the efficacy of dry blood spotting on proteomic, lipidomic and amino acid analysis as an alternative method for blood sample processing and storage. It was found that dried plasma spotting using parafilm in conjunction with a modified Bligh-Dyer extraction offered the best balance for good recovery of protein, lipid and amino acids relative to wet plasma and Noviplex dried plasma spot cards. In this article, we will present the detailed results of these combined studies and describe what we have determined to be the safest non-lethal blood sampling protocol.

Intramedullary Metastatic Endometrial Adenocarcinoma in a Goat.

A 7-year-old female goat developed progressive ataxia, which progressed to sternal recumbency. Clinical examination revealed a slight elevation in the sacral spine (S1-S2), tetraparesis, perineal hypoaesthesia and absent tail and anal reflexes. Due to unresponsiveness to treatment with corticosteroids, the goat was euthanized. At necropsy, a 4.0 × 5.7 × 2.5 cm tumour mass was found in the uterine body and right uterine horn. In the cauda equina (L6‒S2), a 3 cm tumour associated with a 2 cm ventral intraosseous sacral haematoma was also found. The tumours were characterized by neoplastic proliferation of columnar epithelial cells with a predominant tubular pattern. Neoplastic cells with glandular cytoplasm stained with acid Alcian blue and periodic acid‒Schiff. Other metastases were found in the lungs, right ovary, dura mater and nerve roots of the medullary cone. Neoplastic cells were immunolabelled for cytokeratin but were negative for vimentin, and the tumour was diagnosed as metastatic endometrial tubular adenocarcinoma. To our knowledge, this is the first report of intramedullary metastasis to the spinal cord of this tumour in any species except humans.

Detailed Structural Features of the Perovskite-Related Halide RbPbI3 for Solar Cell Applications.

All-inorganic lead halide perovskites like CsPbBr3, CsPbI3, or RbPbI3 are good replacements for the classical hybrid organic-inorganic perovskites like CH3NH3PbI3, susceptible to fast degradation in the presence of humid air. They also exhibit outstanding light absorption properties suitable for solar energy applications. Here, we describe the synthesis of RbPbI3 by mechanochemical procedures with green credentials, avoiding toxic or expensive organic solvents; this specimen exhibits excellent crystallinity. We report neutron powder diffraction data, essential to revisit some subtle structural features around room temperature (200-400 K). In all these regimes, the orthorhombic Pnma crystal structure is characterized by the presence along the b direction of the crystal of double rows of edge-sharing PbI6 octahedra. The lone electron pairs of Pb2+ ions have a strong stereochemical effect on the PbI6 octahedral distortion. The relative covalency of Rb-I versus Pb-I bonds shows that the Pb-I-related motions are more rigid than Rb-I-related vibrations, as seen in the Debye temperatures from the evolution of the anisotropic displacements. The optical gap, measured by diffuse reflectance UV-vis spectroscopy, is ∼2.51 eV and agrees well with ab initio calculations. The thermoelectric Seebeck coefficient is 3 orders of magnitude larger than that of other halide perovskites, with a value of ∼117,000 µV·K-1 at 460 K.