Digital technology in national curricula: a dialogue among Iberoamerican countries.

Introduction: In today's world, digital technologies have become pervasive, impacting every aspect of our lives. Even in subjects such as Health and Physical Education (HPE), which traditionally emphasizes experiential, active, and corporeal learning, there is a growing interest in the role and influence of new technologies. These technologies not only have the potential to transform human movement and health cultures, but they also offer valuable tools to facilitate teachers' work and enhance student learning. Considering the context of the Research Network on Interactive Digital Didactic Materials, which includes researchers from Iberoamerican countries, this research examines how media and digital technologies are considered in the official Physical Education and curriculum documents from Brazil, Uruguay, Chile, Colombia, and Spain. Methods: The research comprises a content analysis of official National Curricular Proposals of the selected countries. Considering the specificities of each country to publish their curricula policies, we selected eight different documents from five countries (Brazil, Uruguay, Spain, Colombia, and Chile). We looked for indicators expressed by terms such as "media," "digital culture," and "technology" in the documents, all of them related to Physical Education. Results: The findings show arguments and proposals for using technology in Physical Education in all documents. However, the curricula trigger this theme in different forms, as an autonomous or transversal character integrated into subjects such as HPE. This fact may be highlighted by the goals of learning areas, which sometimes trigger teaching themes through technology. Discussion: Under the Media-Education theory lens, we argue that there is no standard for educational investment in curricula in media and technology. Some documents point to the technology use dimension, while others point to the critical or productive dimension that technology makes possible. The literature highlights the need for an organic approach between these dimensions, and educators and policymakers are asked to rethink their curriculum proposals.

Healthcare Students' Perceptions About Approaching Spirituality in Their Training and Patient Care: Online, Cross-Sectional Survey.

Objective: Recent scientific literature points out that religiosity and spirituality play a relevant role in many aspects of life, including health issues. We aimed to evaluate the healthcare students' perceptions about approaching spirituality in their training and patient care in Brazilian universities. Methods: A cross-sectional observational study was conducted following the STROBE guidelines. Through an anonymous online survey, adult healthcare students from two universities in the city of Pelotas (Brazil) answered a questionnaire about their perceptions on approaching spirituality in their training and patient care. Chi-squared tests were performed, and P ≤ .05 was considered statistically significant. Results: A total of 163 students were included in the analysis. Most believed that spirituality is important for their training (74.8%) and patient care (84%). However, a minority had had contact with the theme of spirituality during their training (48.5%) or had experienced a situation in which the spiritual aspects of a patient were addressed (47.2%). The students from the private university had more contact with the theme of spirituality in healthcare during their training. Nursing students had significantly more contact with the theme of spirituality in healthcare (P = .008) and had experienced more situations in which the spiritual aspects of a patient were addressed (P = .031) than other students. Conclusion: Most students believed that the theme of spirituality in healthcare is important for their training and patient care. However, they still had insufficient contact with it during their education. More studies with greater statistical power are needed to better understand this situation globally.

Advanced renal cell carcinoma management: the Latin American Cooperative Oncology Group (LACOG) and the Latin American Renal Cancer Group (LARCG) consensus update.

PURPOSE: Renal cell carcinoma is an aggressive disease with a high mortality rate. Management has drastically changed with the new era of immunotherapy, and novel strategies are being developed; however, identifying systemic treatments is still challenging. This paper presents an update of the expert panel consensus from the Latin American Cooperative Oncology Group and the Latin American Renal Cancer Group on advanced renal cell carcinoma management in Brazil. METHODS: A panel of 34 oncologists and experts in renal cell carcinoma discussed and voted on the best options for managing advanced disease in Brazil, including systemic treatment of early and metastatic renal cell carcinoma as well as nonclear cell tumours. The results were compared with the literature and graded according to the level of evidence. RESULTS: Adjuvant treatments benefit patients with a high risk of recurrence after surgery, and the agents used are pembrolizumab and sunitinib, with a preference for pembrolizumab. Neoadjuvant treatment is exceptional, even in initially unresectable cases. First-line treatment is mainly based on tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs); the choice of treatment is based on the International Metastatic Database Consortium (IMCD) risk score. Patients at favourable risk receive ICIs in combination with TKIs. Patients classified as intermediate or poor risk receive ICIs, without preference for ICI + ICIs or ICI + TKIs. Data on nonclear cell renal cancer treatment are limited. Active surveillance has a place in treating favourable-risk patients. Either denosumab or zoledronic acid can be used for treating metastatic bone disease. CONCLUSION: Immunotherapy and targeted therapy are the standards of care for advanced disease. The utilization and sequencing of these therapeutic agents hinge upon individual risk scores and responses to previous treatments. This consensus reflects a commitment to informed decision-making, drawn from professional expertise and evidence in the medical literature.

Profile of Antimicrobial Consumption in Patients Assisted by a Palliative Care Team During the COVID-19 Pandemic in Brazil.

BACKGROUND: This study aimed to evaluate the profile of antimicrobial consumption in patients assisted by a palliative care (PC) team during the COVID-19 pandemic. METHODS: A retrospective observational study was conducted in a quaternary hospital. Patients assisted by the PC team in 2020 were selected. The clinical and demographic characteristics, as well as the outcomes, were assessed using electronic records. RESULTS: A total of 181 patients were included in the study, of whom 93.4% had used antimicrobials and 24.3% had had COVID-19. COVID-19 patients were more likely to receive at least one course of antimicrobial therapy. Patients who received polytherapy in the first course of treatment were more likely to die and to be still receiving antimicrobials at death. There was no significant difference in the length of hospital stay, new hospitalization in 12 months, nor the time to death among patients who received monotherapy or polytherapy during the first course of antimicrobial therapy. CONCLUSIONS: There was a large amount of PC patients receiving antimicrobial therapy during the COVID-19 pandemic. SARS-CoV-2-positive patients were more likely to receive antimicrobial therapy.

Palliative Care in the state of Rio de Janeiro (Brazil): characteristics of the services.

This research explores the status of Palliative Care (PC) services in the state of Rio de Janeiro (RJ), Brazil, by identifying the number of services and their respective characteristics. Through an observational, cross-sectional, descriptive, and quantitative approach, this study examines a textual and numerical database about professionals who provide palliative care assistance in Rio de Janeiro. Out of the existing palliative care services analyzed, fourteen were evaluated, twelve of which were located in the RJ metropolitan region. The majority of professionals worked with private funding within hospitals. The PC teams were most commonly composed of physicians, with only 17.1% of the professionals having formal PC training. Palliative Care services in Rio de Janeiro seem to follow a similar pattern to Brazil and Latin America. However, the characteristics of this pattern may not adequately address the significant needs of middle-income countries.

The use of chitosan oligosaccharide to improve artemisinin yield in well-watered and drought-stressed plants.

Introduction: Artemisinin is a secondary metabolite well-known for its use in the treatment of malaria. It also displays other antimicrobial activities which further increase its interest. At present, Artemisia annua is the sole commercial source of the substance, and its production is limited, leading to a global deficit in supply. Furthermore, the cultivation of A. annua is being threatened by climate change. Specifically, drought stress is a major concern for plant development and productivity, but, on the other hand, moderate stress levels can elicit the production of secondary metabolites, with a putative synergistic interaction with elicitors such as chitosan oligosaccharides (COS). Therefore, the development of strategies to increase yield has prompted much interest. With this aim, the effects on artemisinin production under drought stress and treatment with COS, as well as physiological changes in A. annua plants are presented in this study. Methods: Plants were separated into two groups, well-watered (WW) and drought-stressed (DS) plants, and in each group, four concentrations of COS were applied (0, 50,100 and 200 mg•L-1). Afterwards, water stress was imposed by withholding irrigation for 9 days. Results: Therefore, when A. annua was well watered, COS did not improve plant growth, and the upregulation of antioxidant enzymes hindered the production of artemisinin. On the other hand, during drought stress, COS treatment did not alleviate the decline in growth at any concentration tested. However, higher doses improved the water status since leaf water potential (YL) improved by 50.64% and relative water content (RWC) by 33.84% compared to DS plants without COS treatment. Moreover, the combination of COS and drought stress caused damage to the plant's antioxidant enzyme defence, particularly APX and GR, and reduced the amount of phenols and flavonoids. This resulted in increased ROS production and enhanced artemisinin content by 34.40% in DS plants treated with 200 mg•L-1 COS, compared to control plants. Conclusion: These findings underscore the critical role of ROS in artemisinin biosynthesis and suggest that COS treatment may boost artemisinin yield in crop production, even under drought conditions.

Improving Salicornia ramosissima photochemical and biochemical resilience to extreme heatwaves through rhizosphere engineering with Plant Growth-Promoting Bacteria.

The anticipated rise in the length, frequency, and intensity of heatwaves (HW) in the Mediterranean region poses a danger to the crops, as these brief but high-intensity thermal stress events halt plant productivity. This arises the need to develop new eco-friendly sustainable strategies to overcome food demand. Halophytes such as Salicornia ramosissima appear as cash crop candidates, alongside with new biofertilization approaches using Plant Growth Promoting Bacteria (PGPB). In the present work, S. ramosissima plants exposed to heatwave (HW) treatments with and without marine PGPB inoculation is studied to evaluate the physiological responses behind eventual thermal adaptation conditions. Plants exposed to HW inoculated with ACC deaminase and IAA-producing PGPB showed a 50% reduction in the photochemical energy dissipation, when compared to their non-inoculated counterparts, indicating higher light-use efficiency. The observed concomitant increase (76-234%) in several pigments indicates improved inoculated HW-exposed individuals' light harvesting and photoprotection under stressful conditions. This reduction of the physiological stress levels in inoculated plants was also evident by the significant reduction of several antioxidant enzymes as well as of membrane lipid peroxidation products. Additionally, improved membrane stability could also be observed, through the regulation of fatty acid unsaturation levels, decreasing the excessive fluidity imposed by HW treatment. All these improved physiological traits associated with specific PGP traits highlight a key potential of the use of these PGPB consortiums as biofertilizers for S. ramosissima cash crop production in the Mediterranean, where increasing frequency in HW-events is a major drawback to plant production, even to warm-climate plants.

Evaluation of a New Triage Protocol for Palliative Care for Patients with COVID-19 in Brazil.

Objectives: To evaluate the implementation of a triage protocol for palliative care (PC) during the COVID-19 pandemic (PALI-COVID) at a referral center in Brazil. Methods: A retrospective observational study was conducted. Based on the triage protocol, patients were classified into a red group, a yellow group, and a green group (GG). Patients should receive PC as recommended for each group. Results: A total of 1517 patients were included in the analysis. About 11% (n = 162) of patients received PC. About 35% (n = 529) of all patients died. There was a significant difference in the mortality rate between the groups; the GG had the highest mortality rate. Most patients who died (77.1%) did not receive PC. Conclusion: PALI-COVID was effective in identifying patients who had a higher risk of death and needed end-of-life support. Despite the protocol, few patients received PC.

Untargeted Metabolomics Reveals Antidepressant Effects in a Marine Photosynthetic Organism: The Diatom Phaeodactylum tricornutum as a Case Study.

The increased use of antidepressants, along with their increased occurrence in aquatic environments, is of concern for marine organisms. Although these pharmaceutical compounds have been shown to negatively affect marine diatoms, their mode of action in these non-target, single-cell phototrophic organisms is yet unknown. Using a Fourier-transform ion cyclotron-resonance mass spectrometer (FT-ICR-MS) we evaluated the effects of fluoxetine in the metabolomics of the model diatom Phaeodactylum tricornutum, as well as the potential use of the identified metabolites as exposure biomarkers. Diatom growth was severely impaired after fluoxetine exposure, particularly in the highest dose tested, along with a down-regulation of photosynthetic and carbohydrate metabolisms. Notably, several mechanisms that are normally down-regulated by fluoxetine in mammal organisms were also down-regulated in diatoms (e.g., glycerolipid metabolism, phosphatidylinositol signalling pathway, vitamin metabolism, terpenoid backbone biosynthesis and serotonin remobilization metabolism). Additionally, the present work also identified a set of potential biomarkers of fluoxetine exposure that were up-regulated with increasing fluoxetine exposure concentration and are of high metabolic significance following the disclosed mode of action, reinforcing the use of metabolomics approaches in ecotoxicology.

Ecotoxicological Effects of the Anionic Surfactant Sodium Dodecyl Sulfate (SDS) in Two Marine Primary Producers: Phaeodactylum tricornutum and Ulva lactuca.

Sodium Dodecyl Sulfate (SDS) is an anionic surfactant, extensively used in detergents, household and personal care products, as well as in industrial processes. The present study aimed to disclose the potential toxicological effects of SDS exposure under environmentally relevant concentrations (0, 0.1, 1, 3, and 10 mg L-1) on the physiology and biochemistry (photosynthesis, pigment, and lipid composition, antioxidative systems, and energy balance) of two marine autotrophs: the diatom Phaeodactylum tricornutum and the macroalgae Ulva lactuca. A growth rate (GR) reduction in P. tricornutum was observed with a classic dose-response effect towards the highest applied concentration, while a GR increase occurred in U. lactuca. Regarding photochemistry, the decrease in the fluorescence of the OJIP curves and laser-induced fluorescence allowed a better separation between SDS treatments in U. lactuca compared with P. tricornutum. Although all pigments significantly decreased in U. lactuca at the highest concentrations (except for antheraxanthin), no significant variations occurred in P. tricornutum. On the other hand, changes in fatty acid content were observed in P. tricornutum but not in U. lactuca. In terms of classical biomarker assessment, a dose-effect relationship of individual biomarkers versus SDS dose applied; U. lactuca displayed a higher number of biomarker candidates, including those in distinct metabolic pathways, increasing its usefulness for ecotoxicological applications. By evaluating the potential application of optical and biochemical traits, it was evident that the fatty acid profiles of the different exposure groups are excellent candidates in P. tricornutum, concomitant with the characteristics of this anionic surfactant. On the other hand, the results presented by laser-induced fluorescence and some parameters of PAM fluorometry in U. lactuca may be an advantage in the field, offering non-invasive, fast, easy-to-use, high-throughput screening techniques as excellent tools for ecotoxicology assessment.

A Six-Minute Walk Test: Oxygen Uptake and Distance Predicted / Prueba de Caminata de Seis Minutos: Consumo de Oxígeno y Distancia Predicha

Abstract Background: Maximum oxygen consumption is an indicator of cardiorespiratory fitness. Aim: The purpose was, first, to relate and compare the V̇O2max as the dependent variable with the estimated distance in the six-minute walk test (SMWT) as the independent variable in university students and, secondly, to relate the distance (dependent) with demographic and anthropometric variables (independents). Methodology: A correlational, descriptive, and quantitative study with a non-experimental design was conducted on 110 university students. In the study, basic anthropometry and vital signs were measured. A direct method of V̇O2max (Bruce test) on a treadmill was applied. Then, the distance covered in the SMWT was evaluated with two equations available in the scientific literature. Differences between men and women were measured in the tests, the correlation between the distances estimated with V̇O2max and anthropometric variables, and repeated ANOVA measurement tests between V̇O2max and estimated distance were analyzed with the SPSS v.22 program (p<0.05). Results: Significant correlations were found between V̇O2max and estimated distances (p<0.05) in the total sample, men and women, and in some cases, the distance correlated with gender, age, weight, height, and BMI (p<0.05). However, there were differences between V̇O2max and distances estimated in the SMWT (p<0.001). Conclusions: The V̇O2max measurement method is different from the distance prediction equations, although they have a significant relationship.

Resumen Antecedentes: El consumo máximo de oxígeno es un indicador de la aptitud cardiorrespiratoria. Objetivo: El objetivo fue relacionar y comparar el V̇O2máx. como variable dependiente con la distancia estimada en la prueba de caminata de seis minutos (PC6M) como variable independiente en estudiantes universitarios, a la vez relacionar la distancia (dependiente) con variables demográficas y antropométricas (independientes). Metodología: Estudio cuantitativo, no experimental, transversal, y descriptivo-correlacional en el que participaron 110 estudiantes universitarios. Se midió antropometría básica y signos vitales, y se aplicó un método directo de V̇O2máx. (Test de Bruce) en cinta rodante, luego se estimó la distancia recorrida en PC6M con dos ecuaciones disponibles en la literatura. Diferencias entre hombres y mujeres en las pruebas aplicadas, correlación entre las distancias estimadas con el V̇O2máx. y variables antropométricas, y la prueba de ANOVA de medidas repetidas entre el V̇O2máx. y las distancias estimadas fueron utilizadas con el programa SPSS v.22 (p<0,05). Resultados: Se encontró correlaciones significativas entre el V̇O2máx. y distancias estimadas (p<0,05) en la muestra, en hombres y mujeres, y en algunos casos la distancia se correlacionó con el sexo, la edad, el peso, la estatura y el IMC (p<0,05). Sin embargo, hubo diferencias entre el V̇O2máx. y las distancias estimadas en la PC6M (p<0,001). Conclusiones: El método directo de V̇O2máx. es distinto de las ecuaciones de predicción de distancia, aunque tienen relación significativa.

Resumo Antecedentes: O consumo máximo de oxigênio é um indicador de aptidão cardiorrespiratória. Objetivo: O objetivo é relacionar e comparar a V̇O2 máx. como variável dependente com a distância estimada no teste de caminhada de seis minutos (TC6M) como uma variável independente em estudantes universitários, ao mesmo tempo, relacionar a distância (dependente) com variáveis demográficas e antropométricas (independente). Metodologia: Estudo quantitativo, não-experimental, transversal, descritivo-correlativo, no qual participaram 110 estudantes universitários. Antropometria básica e sinais vitais foram medidos, e um método direto de V̇O2 máx. (teste Bruce) foi aplicado na esteira, então a distância coberta em TC6M foi estimada com duas equações disponíveis na literatura. Diferenças entre homens e mulheres nos testes aplicados, correlação entre distâncias estimadas com V̇O2 máx. e variáveis antropométricas, e medidas repetidas teste ANOVA entre V̇O2 máx. e distâncias estimadas foram usadas com SPSS v.22 (p<0,05). Resultados: Foram encontradas correlações significativas entre V̇O2 máx. e distâncias estimadas (p<0,05) na amostra, em homens e mulheres, e em alguns casos a distância correlacionada com sexo, idade, peso, altura e IMC (p<0,05). Entretanto, houve diferenças entre V̇O2 máx. e distâncias estimadas em TC6M (p<0,001). Conclusões: O método direto de V̇O2 máx. é diferente das equações de previsão de distância, embora elas tenham relações significativas.

Effects of Glyphosate-Based Herbicide on Primary Production and Physiological Fitness of the Macroalgae Ulva lactuca.

The use of glyphosate-based herbicides (GBHs) worldwide has increased exponentially over the last two decades increasing the environmental risk to marine and coastal habitats. The present study investigated the effects of GBHs at environmentally relevant concentrations (0, 10, 50, 100, 250, and 500 µg·L-1) on the physiology and biochemistry (photosynthesis, pigment, and lipid composition, antioxidative systems and energy balance) of Ulva lactuca, a cosmopolitan marine macroalgae species. Although GBHs cause deleterious effects such as the inhibition of photosynthetic activity, particularly at 250 µg·L-1, due to the impairment of the electron transport in the chloroplasts, these changes are almost completely reverted at the highest concentration (500 µg·L-1). This could be related to the induction of tolerance mechanisms at a certain threshold or tipping point. While no changes occurred in the energy balance, an increase in the pigment antheraxanthin is observed jointly with an increase in ascorbate peroxidase activity. These mechanisms might have contributed to protecting thylakoids against excess radiation and the increase in reactive oxygen species, associated with stress conditions, as no increase in lipid peroxidation products was observed. Furthermore, changes in the fatty acids profile, usually attributed to the induction of plant stress response mechanisms, demonstrated the high resilience of this macroalgae. Notably, the application of bio-optical tools in ecotoxicology, such as pulse amplitude modulated (PAM) fluorometry and laser-induced fluorescence (LIF), allowed separation of the control samples and those treated by GBHs in different concentrations with a high degree of accuracy, with PAM more accurate in identifying the different treatments.

Effect Biomarkers of the Widespread Antimicrobial Triclosan in a Marine Model Diatom.

The present-day COVID-19 pandemic has led to the increasing daily use of antimicrobials worldwide. Triclosan is a manmade disinfectant chemical used in several consumer healthcare products, and thus frequently detected in surface waters. In the present work, we aimed to evaluate the effect of triclosan on diatom cell photophysiology, fatty acid profiles, and oxidative stress biomarkers, using the diatom Phaeodactylum tricornutum as a model organism. Several photochemical effects were observed, such as the lower ability of the photosystems to efficiently trap light energy. A severe depletion of fucoxanthin under triclosan application was also evident, pointing to potential use of carotenoid as reactive oxygen species scavengers. It was also observed an evident favouring of the peroxidase activity to detriment of the SOD activity, indicating that superoxide anion is not efficiently metabolized. High triclosan exposure induced high cellular energy allocation, directly linked with an increase in the energy assigned to vital functions, enabling cells to maintain the growth rates upon triclosan exposure. Oxidative stress traits were found to be the most efficient biomarkers as promising tools for triclosan ecotoxicological assessments. Overall, the increasing use of triclosan will lead to significant effects on the diatom photochemical and oxidative stress levels, compromising key roles of diatoms in the marine system.

Underuse of Catheter Ablation as First-Line Therapy for Supraventricular Tachycardia.

Background Catheter ablation (CA) is a safe, effective, cost-effective technique and may be considered a first-line strategy for the treatment of symptomatic supraventricular tachycardias (SVT). Despite the high prospect of cure and the recommendations of international guidelines in considering CA as a first-line treatment strategy, the average time between diagnosis and the procedure may be long. The present study aims to evaluate predictors related to non-referral for CA as first-line treatment in patients with SVT. Methods and Results The model was derived from a retrospective cohort of patients with SVT or ventricular pre-excitation referred for CA in a tertiary center. Clinical and demographical features were used as independent variables and non-referral for CA as first-line treatment the dependent variable in a stepwise logistic regression analysis. Among 20 clinical-demographic variables from 350 patients, 10 were included in initial logistic regression analysis: age, women, presence of pre-excitation on ECG, palpitation, dyspnea and chest discomfort, number of antiarrhythmic drugs before ablation, number of concomitant symptoms, symptoms' duration and evaluations in the emergency room due to SVT. After multivariable adjusted analysis, age (odds ratio [OR], 1.2; 95% CI 1.01-1.32; P=0.04), chest discomfort during supraventricular tachycardia (OR, 2.7; CI 1.6-4.7; P<0.001) and number of antiarrhythmic drugs before ablation (OR, 1.8; CI 1.4-2.3; P<0.001) showed a positive independent association for non-referral for CA as SVT first-line treatment. Conclusions The independent predictors of non-referral for CA as first-line treatment in our logistic regression analysis indicate the existence of biases in the decision-making process in the referral process of patients who would benefit the most from catheter ablation. They very likely suggest a skewed medical decision-making process leading to catheter ablation underuse.

Estimated Oxygen Consumption with the Abbreviated Method and Its Association with Vaccination and PCR Tests for COVID-19 from Socio-Demographic, Anthropometric, Lifestyle, and Morbidity Outcomes in Chilean Adults.

COVID-19 causes cardiovascular and lung problems that can be aggravated by confinement, but the practice of physical activity (PA) could lessen these effects. The objective of this study was to evaluate the association of maximum oxygen consumption (V˙O2max) with vaccination and PCR tests in apparently healthy Chilean adults. An observational and cross-sectional study was performed, in which 557 people from south-central Chile participated, who answered an online questionnaire on the control of COVID-19, demographic data, lifestyles, and diagnosis of non-communicable diseases. V˙O2max was estimated with an abbreviated method. With respect to the unvaccinated, those who received the first (OR:0.52 [CI:0.29;0.95], p = 0.019) and second vaccine (OR:0.33 [CI:0.18;0.59], p = 0.0001) were less likely to have an increased V˙O2max. The first vaccine was inversely associated with V˙O2max (mL/kg/min) (ß:−1.68 [CI:−3.06; −0.3], p = 0.017), adjusted for BMI (ß:−1.37 [CI:−2.71; −0.03], p = 0.044) and by demographic variables (ß:−1.82 [CI:−3.18; −0.46], p = 0.009); similarly occur for the second vaccine (ß: between −2.54 and −3.44, p < 0.001) on models with and without adjustment. Having taken a PCR test was not significantly associated with V˙O2max (mL/kg/min). It is concluded that vaccination significantly decreased V˙O2max, although it did not indicate cause and effect. There is little evidence of this interaction, although the results suggest an association, since V˙ O2max could prevent and attenuate the contagion symptoms and effects.

Impact of COVID-19 on the efficacy of meeting the transfusion demand by a Brazilian blood banks network.

One of the effects of the pandemic in the hemotherapy services was the reduction in the attendance of blood donors and production of blood components. It is relevant to investigate how the capacity to meet the demand for blood components was affected, especially in blood centers located in the regions most affected by the pandemic, such as Brazil. This study aimed to describe the impact of the pandemic on the capacity to meet the demand for different types of blood components by a Brazilian blood center in 2020, compared to the historical series of 2016-2019 and to discuss the measures adopted to mitigate the effects of the pandemic. Retrospective cross-sectional study was carried out with comparative analysis of the blood components requested and attended in the period from 2016 to 2020. Data analysis was performed by Graphpad Prism 5. The spread of COVID-19 cases since March 2020 had impact on the blood components production and transfusions. The reduction in the production of blood components was observed prior to the restriction measures, in March 2020. In comparison to 2016-2019, there was a reduction in the number of transfusions performed in all months of 2020. The results suggest that the measures adopted in a Brazilian blood center to face the COVID-19 pandemic resulted in reasonable regularity in the supply of blood components. The sharing of experiences between blood banks in different regions, social and epidemiological contexts can contribute to the improvement of strategies to reduce the impact of COVID-19 in transfusion medicine.

The HEV Ventilator: at the interface between particle physics and biomedical engineering.

A high-quality, low-cost ventilator, dubbed HEV, has been developed by the particle physics community working together with biomedical engineers and physicians around the world. The HEV design is suitable for use both in and out of hospital intensive care units, provides a variety of modes and is capable of supporting spontaneous breathing and supplying oxygen-enriched air. An external air supply can be combined with the unit for use in situations where compressed air is not readily available. HEV supports remote training and post market surveillance via a Web interface and data logging to complement standard touch screen operation, making it suitable for a wide range of geographical deployment. The HEV design places emphasis on the ventilation performance, especially the quality and accuracy of the pressure curves, reactivity of the trigger, measurement of delivered volume and control of oxygen mixing, delivering a global performance which will be applicable to ventilator needs beyond the COVID-19 pandemic. This article describes the conceptual design and presents the prototype units together with a performance evaluation.

Cytogenotoxic evaluation of the acetonitrile extract, citrinin and dicitrinin-A from Penicillium citrinum.

Endophytic fungi are promising sources of bioactive substances; however, their secondary metabolites are toxic to plants, animals, and humans. This study aimed toevaluate the toxic, cytotoxic, mutagenic and oxidant/antioxidant activities of acetonitrile extract (AEPc), citrinin (CIT) and dicitrinin-A (DIC-A) of Penicillium citrinum. For this, the test substances at 0.5; 1.0; 1.5 and 2 µg/mLwere exposed for 24 and 48 h in Artemia salina, and 48 h in Allium cepa test systems. The oxidant/antioxidant test was evaluated in pre-, co- and post-treatment with the stressor hydrogen peroxide (H2O2) in Saccharomyces cerevisiae. The results suggest that the AEPc, CIT and DIC-A at 0.5; 1.0; 1.5 and 2 µg/mL showed toxicity in A. saline, with LC50 (24 h) of 2.03 µg/mL, 1.71 µg/mL and 2.29 µg/mL, and LC50 (48 h) of 0.51 µg/mL, 0.54 µg/mL and 0.54 µg/mL, respectively.In A. cepa, the test substances also exerted cytotoxic and mutagenic effects. The AEPc, CIT and DIC-A at lower concentrations modulated the damage induced by H2O2 in the proficient and mutant strains of S. cerevisiae for cytoplasmic and mitochondrial superoxide dismutase. Moreover, the AEPc at 2 µg/mL and CIT at the two highest concentrations did not affect the H2O2-induced DNA damage in the test strains. In conclusion, AEPc, CIT and DIC-A of P. citrinum may exert their toxic, cytotoxic and mutagenic effects in the test systems possibly through oxidative stress induction pathway.

Effects of prolonged use of over-the-counter bleaching agents on enamel: An in vitro study.

This study evaluated the effects of four over-the-counter (OTC) bleaching products on the properties of enamel. Extracted human molars were randomly assigned into four groups (n = 5): PD: Poladay (SDI), WG: White Teeth Global (White Teeth Global), CW: Crest3DWhite (Procter & Gamble), and HS: HiSmile (HiSmile). The hydrogen peroxide (H2 O2 ) content in each product was analyzed via titration. Twenty teeth were sectioned into quarters, embedded in epoxy resin, and polished. Each quarter-tooth surface was treated with one of the four beaching times: T0: control/no-bleaching, T14: 14 days, T28: 28 days, and T56: 56 days. Materials were applied to enamel surfaces as recommended. Enamel surfaces were examined for ultramicrohardness (UMH), elastic modulus (EM), superficial roughness (Sa), and scanning electron microscopy (SEM). Ten additional teeth were used to evaluate color and degree of demineralization (DD) (n = 5). Data were statistically tested by two-way ANOVA and Tukey's tests (α = 5%). Enamel surfaces treated with PD and WG presented UMH values significantly lower than the controls (p < .05). Elastic modulus (E) was significantly reduced at T14 and T28 for PD, and at T14 for HS (p < .05). A significant increase in Sa was observed for CW at T14 (p < .05). Color changes were observed in the PD and WG groups. Additionally, DD analysis showed significant demineralization at T56 for CW. Overall, more evident morphological alterations were observed for bleaching products with higher concentrations of H2 O2 (p < .05), PD, and WG. Over-the-counter bleaching products containing H2 O2 can significantly alter enamel properties, especially when application time is extended.