Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in the Treatment of Gastric Cancer: Feasibility, Efficacy and Safety-A Systematic Review and Meta-Analysis.

Background: Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is an emerging technique for delivering chemotherapy directly to the peritoneum via a pressurized aerosol. Its growing attention stems from its effectiveness in treating peritoneal carcinomatosis (PC) originating from various primary tumors, with gastric cancer (GC) being among the most prevalent. This study aimed to systematically investigate PIPAC's therapeutic role in gastric cancer peritoneal metastasis (GCPM). Methods: The systematic review and meta-analysis followed the PRISMA 2020 guidelines, searching Pubmed, Web of Science, and SCOPUS databases. The meta-analysis of relative risks and mean differences compared patients undergoing one or two PIPAC sessions with those completing three or more, assessing various outcomes. Results: Eighteen studies underwent qualitative analysis, and four underwent quantitative analysis. Patients with three or more PIPAC procedures had shorter hospital stays (MD = -1.2; 95%CI (-1.9; -0.5); p < 0.001), higher rates of histopathological response (RR = 1.77, 95%CI 1.08; 2.90; p = 0.023), and significantly improved overall survival (MD = 6.0; 95%CI 4.2; 7.8; p < 0.001). Other outcomes showed no significant differences. Conclusions: PIPAC demonstrated efficacy in carefully selected patients, enhancing histopathologic response rates and overall survival without prolonging hospital stays. This study underscores the necessity for randomized controlled trials and precise selection criteria to refine PIPAC's implementation in clinical practice.

Cyanobacteria and cyanotoxins in the environment and water intakes: Reports, diversity of congeners, detection by mass spectrometry and their impact on health.

Cyanobacteria are aquatic microorganisms of high interest for research due to the production of secondary metabolites, among which the most popular are cyanotoxins, responsible for causing severe poisoning in humans and animals through ingestion or contact with contaminated water bodies. Monitoring the number of cyanobacteria in water and concentrations of secreted cyanotoxins with the aid of sensitive and reliable methods is considered the primary action for evaluating potentially toxic blooms. There is a great diversity of methods to detect and identify these types of micro contaminants in water, differing by the degree of sophistication and information provided. Mass Spectrometry stands out for its accuracy and sensitivity in identifying toxins, making it possible to identify and characterize toxins produced by individual species of cyanobacteria, in low quantities. In this review, we seek to update some information about cyanobacterial peptides, their effects on biological systems, and the importance of the main Mass Spectrometry methods used for detection, extraction, identification and monitoring of cyanotoxins.

Facilidades e dificuldades autorreferidas por trabalhadores de enfermagem para retorno ao trabalho após o diagnóstico de câncer / Self-reported facilities and difficulties by nursing workers for return to work after cancer diagnosis / Facilidades y dificultades autodeclaradas por trabajadores de enfermería para el regreso al trabajo después del diagnóstico de cáncer

Objetivo: analisar fatores facilitadores e dificultadores autorreferidos por trabalhadores da saúde para o retorno ao trabalho após o diagnóstico de câncer. Método: estudo descritivo transversal realizado com trabalhadores de enfermagem submetidos a tratamento de câncer, de dois hospitais públicos entre março e dezembro de 2019. Coletara-se dados sociodemográficos, do Índice para Capacidade de Trabalho e do Functional Assessment of Cancer Illness Therapy ­ General, analisados por estatística descritiva. Protocolo aprovado pelo Comitê de Ética em Pesquisa. Resultados: entre os participantes, 81,9% eram do sexo feminino e 54,6% técnicos de enfermagem. A dor foi o principal dificultador (81,9%) e, para todos, o apoio de chefes e colegas de trabalho o principal facilitador. Identificou-se excelente capacidade para o trabalho em 45,5% e qualidade de vida média de 56. Conclusão: para o retorno ao trabalho ser possível, é necessário oferecer suporte ao trabalhador, tanto em função dos efeitos do tratamento do câncer quanto da necessidade de apoio(AU)

Objective: to analyze facilitating and hindering factors self-reported by health workers in returning to work after a cancer diagnosis. Method: cross-sectional descriptive study carried out with nursing workers undergoing cancer treatment in two public hospitals between March and December 2019. Sociodemographic data were collected, from the Work Capacity Index and the Functional Assessment of Cancer Illness Therapy ­ General, analyzed by descriptive statistics. Protocol approved by the Research Ethics Committee. Results: among the participants, 81.9% were female and 54.6% were nursing technicians. Pain was the main obstacle (81.9%) and, for everyone, support from bosses and co-workers was the main facilitator. Excellent work capacity was identified in 45.5% and an average quality of life of 56. Conclusion: for a return to work to be possible, it is necessary to offer support to the worker, both due to the effects of cancer treatment and the need of support(AU)

Objetivo: analizar los factores facilitadores y obstaculizadores autodeclarados por trabajadores de la salud en el regreso al trabajo después de un diagnóstico de cáncer. Método: estudio descriptivo transversal realizado con trabajadores de enfermería en tratamiento oncológico, en dos hospitales públicos, entre marzo y diciembre de 2019. Se recolectaron datos sociodemográficos, del Functional Assessment of Cancer Illness Therapy ­ General (Evaluación Funcional de la Terapia para Enfermedad Oncológica), analizados mediante estadística descriptiva. El Comité de Ética en Investigación aprobó el Protocolo. Resultados: entre los participantes, el 81,9% consistía en mujeres y el 54,6% en técnicos de enfermería. El dolor fue el principal obstáculo (81,9%) y, para todos, el apoyo de jefes y compañeros de trabajo fue el principal facilitador. Se identificó una excelente capacidad de trabajo en un 45,5% y una calidad de vida promedio de 56. Conclusión: para que el retorno al trabajo sea posible, es necesario ofrecer soporte al trabajador, tanto por los efectos del tratamiento del cáncer como por la necesidad de apoyo(AU)

COVID-19 Pandemic: Analysis of Health Effects on Emergency Service Nursing Workers via a Qualitative Approach.

During the COVID-19 pandemic, longstanding issues involving nursing work, which has always involved significant risks of illness and infection, were intensified. It is necessary to acknowledge the risks and nurses' perceptions about the risks qualitatively during the period of the health crisis. The aim of this study was to examine the health repercussions perceived by nursing workers in emergency services during the outbreak of the COVID-19 pandemic in Brazil. This was a qualitative, descriptive, cross-sectional study. The settings of the study were emergency services with a national scope; the participants were nursing workers. Data were collected via face-to-face virtual calling interviews and analyzed via a content analysis technique, which was supported by IRAMUTEQ software. The formation of textual classes pointed in three thematic directions, from which three categories emerged: nursing workers' exposure, due to a lack of protective equipment, to the risk of being contaminated with, falling ill from, and transmitting the COVID-19 virus; changes in work environments, processes, and relations in response to the pandemic; and physical, mental, and psychosocial alterations perceived by emergency service nursing workers. The exposure to the virus, risk of contamination, and changes in the work environment and relations all resulted in health repercussions, which were perceived as physical, mental, and psychosocial alterations that were described as dietary disturbances, physical fatigue, burnout, increased smoking, anxiety, sleep alterations, fear, exhaustion, stress, social isolation, loneliness, distancing from relatives, and social stigma.

Dangerous Decibels Program in Elementary and Middle School Students: Effectiveness After a 6-Month Follow-Up.

PURPOSE: The purpose of this article was to assess the effectiveness of the Dangerous Decibels (DD) program in students in the short- and medium-term follow-ups (up to 6 months), including an online game. METHOD: A randomized trial was conducted between two interventions (DD and placebo). The research included 58 participants who were divided into two groups: the study group (SG) and the control group. The following phases were developed: intervention (DD or placebo), post-3-month assessment and availability of the online game, and post-6-month assessment. A questionnaire was administered to assess their performance. Overall total scores and category scores were obtained. RESULTS: Improved overall scores were found in the SG in the immediate post-intervention (p = .004), post-3-month (p = .022), and post-6-month (p = .002) questionnaires, as well as the knowledge and behavior categories. CONCLUSIONS: The DD program effectively improved the knowledge and behavior of 10- to 12-year-old children regarding noise in the short- and medium-term follow-ups. However, no significant changes were achieved in terms of barriers only by using the program and the online game. Adding a second intervention (the online game) to the program seems to be a good option to maintain the changes achieved with the interactive class.

Moringa oleifera seed oil extracted by pressurized n-propane and its effect against Staphylococcus aureus biofilms.

Staphylococcus aureus is often associated worldwide with foodborne illnesses, and the elimination of biofilms formed by this bacterium from industrial surfaces is very challenging. To date, there have been few attempts to investigate plant oils obtained by recent green technologies, applied against biofilms on usual surfaces of the food industry and bacteria isolated from such environment. Therefore, this study evaluated the activity of Moringa oleifera seed oil (MOSO), extracted with pressurized n-propane, against standard and environmental S. aureus biofilms. Additionally, a genotypic and phenotypic study of the environmental S. aureus was proposed. It was found that this bacterium was a MSSA (methicillin-sensitive S. aureus), a carrier of icaA and icaD genes that has strong adhesion (OD550=1.86 ± 0.19) during biofilm formation. The use of pressurized n-propane as a solvent was efficient in obtaining MOSO, achieving a yield of 60.9%. Gas chromatography analyses revealed the presence of a rich source of fatty acids in MOSO, mainly oleic acid (62.47%), behenic acid (10.5%) and palmitic acid (7.32%). On polystyrene surface, MOSO at 0.5% and 1% showed inhibitory and bactericidal activity, respectively, against S. aureus biofilms. MOSO at 1% allowed a maximum reduction of 2.38 log UFC/cm² of S. aureus biofilms formed on PVC (polyvinyl chloride) surface. Scanning electron microscopy showed disturbances on the surface of S. aureus after exposure to MOSO. These unprecedented findings suggest that MOSO extracted with pressurized n-propane is potentially capable of inhibiting biofilms of different S. aureus strains, thus, contributing to microbiological safety during food processing.

Okara and okara modified and functionalized with iron oxide nanoparticles for the removal of Microcystis aeruginosa and cyanotoxin.

Eutrophicating compounds promote the growth of cyanobacteria, which has the potential of releasing toxic compounds. Alternative raw materials, such as residues, have been used in efficient adsorption systems in water treatment. The aim of the present study was to apply the residue Okara in its original form and modified by hydrolysis with immobilization of magnetic nanoparticles as an adsorbent. For the removal, the cyanobacteria Microcystis aeruginosa was chosen, as well as its secondary metabolites, L-amino acids leucine and arginine (MC-LR microcystin), from aqueous solutions. The adsorbents presented a negative surface charge, and the x-ray diffraction (DRX) outcomes successfully demonstrated the immobilization of iron oxide nanoparticles on the adsorbents. The adsorbent with the best result was the Okara hydrolyzed and functionalized with iron oxide, which showed a 47% (qe = 804.166 cel/g) and 85% (qe = 116.94 µg/L) removal for the cyanobacteria cells and chlorophyll-a, respectively. The kinetics study demonstrated a pseudo-first-order adsorption with maximal adsorption in 480 minutes, removing 761 µg/L of chlorophyll-a. In this trial, a low organic material removal has occurred, with a removal rate of 5% (qe = 0.024 mg/g) in the analysis of compounds in absorbance by ultraviolet light (UV) monitored by optical density determination in 254 nm (OD254). Nevertheless, the reaction system with the presence of organic material removed 53,28% of the MC-LR toxin, with adsorption capacities of 2.84 µg/L in a preliminary trial conducted for two hours, arising as a potential and alternative adsorbent with a capacity of removing cyanobacteria and cyanotoxin cells simultaneously.

Avaliação do conhecimento e do manejo clínico bucal de endocrinologistas frente a pacientes que estejam em rastreamento ou em tratamento para diabetes mellitus / Evaluation of endocrinologists' knowledge and oral clinical management of patients being examined or treated for diabetes mellitus / Evaluación de los conocimientos de los endocrinólogos y de la gestión clínica oral de los pacientes examinados o tratados por diabetes mellitus

Introdução: Diabetes Mellitus é uma doença crônica resultante de defeitos na secreção do hormônio insulina e/ou de sua ação prejudicada no organismo. Indivíduos diabéticos podem apresentar complicações bucais significativas como, por exemplo, a doença periodontal. Objetivo: Avaliar o conhecimento dos endocrinologistas cadastrados/ativos no Conselho Regional de Medicina da Paraíba quanto ao manejo clínico bucal de pacientes em rastreamento e tratamento para diabetes. Materiais e Métodos: Estudo transversal, no qual 47 endocrinologistas participaram por meio de formulário estruturado, baseado nas diretrizes conjuntas da Sociedade Brasileira de Periodontologia e da Sociedade Brasileira de Endocrinologia e Metabologia (2022). Todas as análises foram conduzidas com auxílio do software IBM SPSS Statistics versão 20.0 e as variáveis do estudo foram analisadas por meio do teste Qui-quadrado de Pearson (p<0,05). As variáveis consideradas relevantes para o desfecho foram avaliadas usando o algoritmo CHAID (Chi-squared Automatic Interaction Detector). Resultados: A maioria dos participantes tinha até 40 anos (55,3%), era do sexo feminino (91,5%) e tinha, no máximo, 10 anos de tempo de experiência (55,3%). A partir da análise multivariada, por meio da Árvore de Decisão (CHAID), verificou-se a associação entre possuir manejo clínico bucal adequado endocrinologistas com faixa etária >40 anos e com conhecimento sobre os sinais clínicos da doença periodontal. Conclusões: Apesar do conhecimento teórico dos endocrinologistas ser relativamente satisfatório, ainda existe uma lacuna entre conhecimento teórico e prática clínica na conduta da maioria desses profissionais, que ainda se distancia do que é preconizado pelas evidências científicas e diretrizes atuais.

Introduction: Diabetes Mellitus is a chronic disease resulting from defects in insulin hormone secretion and/or its impaired action in the body. Diabetic individuals may present significant oral complications such as periodontal disease. Objective: To evaluate the knowledge of endocrinologists registered/active in the Regional Council of Medicine of Paraíba regarding the clinical oral management of patients in screening and treatment for diabetes. Materials and Methods: Cross-sectional study, in which 47 endocrinologists participated by means of a structured form, based on the joint guidelines of the Brazilian Society of Periodontology and the Brazilian Society of Endocrinology and Metabology (2022). All analyses were conducted using IBM SPSS Statistics version 20.0 software and the study variables were analyzed using Pearson's chi-square test (p<0.05). Variables considered relevant to the outcome were evaluated using the CHAID (Chi-squared Automatic Interaction Detector) algorithm. Results: Most participants were up to 40 years old (55.3%), female (91.5%), and had a maximum of 10 years of experience time (55.3%). From multivariate analysis, using the Decision Tree (CHAID), an association was found between having adequate clinical oral management endocrinologists aged >40 years and having knowledge about the clinical signs of periodontal disease. Conclusions: Although the theoretical knowledge of endocrinologists is relatively satisfactory, there is still a gap between theoretical knowledge and clinical practice in the conduct of most of these professionals, which is still far from what is recommended by scientific evidence and current guidelines.

Introducción: La Diabetes Mellitus es una enfermedad crónica que resulta de defectos en la secreción de la hormona insulina y/o de su acción alterada en el organismo. Los individuos diabéticos pueden presentar importantes complicaciones orales como la enfermedad periodontal. Objetivo: Evaluar el conocimiento de los endocrinólogos registrados/activos en el Consejo Regional de Medicina de Paraíba sobre el manejo clínico oral de pacientes en screening y tratamiento de diabetes. Materiales y Métodos: Estudio transversal, en el cual participaron 47 endocrinólogos por medio de formulario estructurado, basado en las directrices conjuntas de la Sociedad Brasileña de Periodoncia y de la Sociedad Brasileña de Endocrinología y Metabología (2022). Todos los análisis se realizaron con el software IBM SPSS Statistics versión 20.0 y las variables del estudio se analizaron mediante la prueba de chi cuadrado de Pearson (p<0,05). Las variables consideradas relevantes para el resultado se evaluaron mediante el algoritmo CHAID (Chi-squared Automatic Interaction Detector). Resultados: La mayoría de los participantes tenían hasta 40 años (55,3%), eran mujeres (91,5%) y tenían un máximo de 10 años de tiempo de experiencia (55,3%). A partir da análise multivariada, por meio da Árvore de Decisão (CHAID), verificou-se a associação entre possuir manejo clínico bucal adequado endocrinólogos com faixa etária >40 anos e com conhecimento sobre os sinais clínicos da doença periodontal. Conclusões: Embora os conhecimentos teóricos dos endocrinólogos sejam relativamente satisfactórios, ainda existe uma brecha entre os conhecimentos teóricos e a prática clínica na conduta da maioria destes profissionais, ainda distante do que é recomendado pela evidência científica e pelas orientações vigentes.

Effect of the addition of the probiotic Bifidobacterium animalis subsp. Lactis (BB-12) in free and microencapsulated form and the prebiotic inulin to synbiotic dry coppa.

The effect of the addition of the prebiotic inulin and free and microencapsulated Bifidobacterium animalis subsp. Lactis (BB-12) strains to synbiotic dry coppa formulations was evaluated during 45 days of ripening. The following formulations were made: control C without probiotic and prebiotic; PROB with free probiotic; SYNB with free probiotic and inulin; ENPROB with microencapsulated probiotic, and ENSYNB with microencapsulated probiotic and inulin. The incorporation of BB-12 with inulin provided adequate physicochemical characteristics (proximate composition, weight loss, pH, water activity (aw), and instrumental color). The treatments PRO and SYNB showed lower lipid and protein oxidation levels. The treatments PROB, SYNB, ENPROB, and ENSYNB had viable cell counts above 109 CFU/g and can be considered probiotic. In the in vitro gastrointestinal simulation, the BB-12 strain showed survival and growth capacity in saline solution and at low pH values for all treatments. The sample SYNB was the most accepted by the assessors in the sensory evaluation. Therefore, dry coppa can be used as a vehicle for the development of a synbiotic fermented meat product.

Removal of copper ions from alembic cachaça using agro-industrial residues as biosorbents.

Cachaça is a typical Brazilian distilled beverage made from fermented sugarcane juice. The copper levels in alembic cachaça are of great concern among producers, and the removal of this contaminant is important for the quality of the product. The present study aimed to remove copper ions from alembic cachaça by adsorption. Sugarcane bagasse, okara, Moringa oleifera Lam., three different types of zeolites, and two types of commercial charcoal were tested as biosorbents. The heat-treated sugarcane bagasse removed 100% of the copper present in a cachaça sample, while other low-cost natural adsorbents had close to 50% removal as was observed for M. oleifera seeds and okara. All adsorbents had porous and fibrous structures, favorable to adsorption. A kinetic study showed that a pseudo-second-order model was appropriate, with equilibrium times of 15 h for heat-treated sugarcane bagasse, okara, and M. oleifera seeds used as adsorbents. The Langmuir model better fitted the experimental data, indicating monolayer adsorption. The maximum adsorption capacity was 17.00, 0.77, and 5.33 mg of Cu g-1 for the heat-treated sugarcane bagasse, M. oleifera seeds, and okara, respectively. The results presented here are promising indicating three agro-industrial residues were favorable to the adsorption of copper ions from alembic cachaça.

Noise Exposure, Headsets, and Auditory and Nonauditory Symptoms in Call Center Operators.

PURPOSE: This study evaluates the exposure of call center operators (CCOs) to occupational noise, its association with auditory and nonauditory symptoms, and the feasibility of monaural and binaural headsets. METHOD: We measured the noise exposure sound pressure levels (SPLs) with the microphone-in-real-ear technique and administered a questionnaire on auditory/nonauditory symptoms and headset preference. RESULTS: We assessed 79 CCOs with normal hearing. Overall, 98.7% of the participants reported at least one auditory symptom, and 88.6% reported at least one nonauditory symptom after using the headset. We found significant associations between the headset volume setting and the number of auditory and nonauditory symptoms and between sharp increases in sound level and tinnitus. The microphone-in-real-ear diffuse-field-related SPLs with monaural headsets (85.5 dBA) were significantly higher than those with binaural headsets (83.1 dBA). Binaural headsets were the preference of 84.8% of the subjects. The SPLs of the binaural headsets were significantly lower than those of the monaural headsets in the subjects who preferred the binaural headsets. CONCLUSIONS: CCOs with normal hearing reported auditory and nonauditory symptoms, highlighting the need for attention and further investigation. The binaural headsets were preferable, as they were associated with a lower SPL and a higher call quality. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.18361463.

Bilateral capacity is related to bilateral upper limb use after stroke: a study by behavioral maps, accelerometers and perceived amount of use.

PURPOSE: This study aimed to assess the following in individuals after stroke: (1) relationship between upper limb (UL) use by direct observation at home with use perceived and measured by accelerometers; (2) complementarity of these three measurements; and (3) relationship between UL bilateral capacity and bilateral use. MATERIALS AND METHODS: Thirty-one individuals with chronic hemiparesis participated in this cross-sectional study. UL use was assessed using a behavioral map (BM), the Motor Activity Log-Amount of Use (MAL-AOU), and accelerometers, while UL capacity was assessed using the Test d'Evaluation des Membres Supérieurs des Personnes Âgées (TEMPA). RESULTS: The BM was strongly correlated with perceived use (MAL-AOU, ρ = 0.76) and accelerometer (ρ = 0.70). Bilateral UL use (BM) was moderately (ρ = 0.65) correlated with bilateral MAL-AOU and bilateral use by accelerometers (ρ = 0.62). The BM aided our understanding of how the paretic UL was used. The correlation between bilateral capacity (TEMPA bilateral) and bilateral use (BM) was significant (ρ = 0.49), while that with bilateral MAL-AOU and accelerometer were ρ = 0.68 and ρ = 0.50, respectively. CONCLUSION: A BM is a valid way to quantify UL use and can complement information assessed regarding perceived use and by accelerometers.Implications for rehabilitationBehavioral maps may be valuable to complement information assessed by perceived UL use and accelerometers.Quantifying bilateral capacity will reflect in a better understanding of actual paretic UL use after stroke.Accelerometers can underestimate the amount of paretic UL use in asymmetrical bilateral tasks.

Involving society in science: Reflections on meaningful and impactful stakeholder engagement in fundamental research.

Open Science calls for transparent science and involvement of various stakeholders. Here are examples of and advice for meaningful stakeholder engagement.

Manual Dexterity Is Associated With Use of the Paretic Upper Extremity in Community-Dwelling Individuals With Stroke.

BACKGROUND AND PURPOSE: Regarding people with stroke, simple outcome measures in clinical settings capable of representing the actual use of the upper extremity (UE) would be useful to rehabilitation professionals for the purposes of goal setting. This study seeks to describe the relative levels of paretic UE use, investigate the association between manual dexterity and task-related UE use, and to establish the manual dexterity cutoff points that correspond to relative levels of paretic UE use. METHODS: Forty-six adults with chronic hemiparesis participated in this cross-sectional study. Behavioral mapping was employed to ascertain the actual amount of UE use by the identifying the unimanual and bimanual activities performed in the participants' homes within a 4-hour period. Participants were classified into 4 levels of paretic UE integration into activities considering the data from the behavioral mapping (activity, hand function, and type of grasp). The Box and Block Test (BBT) and the Nine Hole Peg Test (NHPT) were used to evaluate dexterity. The Spearman test was used to evaluate the correlations. In analyzing the receiver operating characteristic curve, we applied the Youden index to determine the cutoff points. RESULTS: Participants with full/almost full (n = 11), partial (n = 12), and limited (n = 12) integration of the paretic UE into activities and with little/no use (n = 11) were identified. Unimanual and total paretic UE activities were found to have a high correlation with the BBT scores. The boundaries between the integration levels were between full/almost full and partial integration, BBT greater than 30 blocks or NHPT of 41 seconds and less; between partial and limited, BBT greater than 16 blocks; and between limited and little/no use, BBT greater than 3 blocks. Both tests show good accuracy (≥0.81). DISCUSSION AND CONCLUSIONS: The BBT presents a positive high correlation with paretic UE use at home and was shown to be better able to identify "limited" and "partial" integration of the paretic UE. Both tests can identify when the paretic UE is fully/almost fully integrated into activities at home.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A354).

Systematic Review of Interventions to Prevent Occupational Noise-Induced Hearing Loss - A Follow-up. / Revisão sistemática de intervenções para prevenção da perda auditiva induzida por ruído ocupacional ­ uma atualização.

PURPOSE: To conduct a systematic review of the effectiveness of interventions to prevent occupational hearing loss, following up on the findings of the most recent version of Cochrane systematic review on the same topic. RESEARCH STRATEGY: Searches were carried out in PubMed, Web of Science and Scopus databases. SELECTION CRITERIA: The following interventions were considered: engineering/administrative controls; hearing protection devices (HPD); and audiological monitoring. DATA ANALYSIS: For bias risk analysis, each study was assessed according to randomization, allocation, blinding, outcomes, other sources of bias. RESULTS: 475 references were obtained. Of these, 17 studies met the inclusion criteria: one randomized, one interrupted time series, and 15 before and after studies. Most studies were conducted in industries; three in military and/or shooting training environments; one in an orchestra, and one in construction. Most studies showed a high risk of bias. Six studies found a reduction in short-term exposure to noise through engineering/administrative controls; one found a positive impact due to changes in legislation; five studies have found positive effects of HPD in reducing exposure to noise and of educational trainings in the use of HPD; lastly, two studies found a reduction in noise levels and an increase in the using of HPD due to the implementation of hearing conservation programs. CONCLUSÃO: Todos os estudos analisados concluíram que as intervenções utilizadas resultaram em efeitos positivos sobre a audição e/ou sobre a exposição ao ruído. Em relação aos efeitos de longo termo, a grande maioria dos estudos limitou-se a avaliar efeitos imediatos ou de curto termo, reforçando que estudos incluindo follow-up de longo termo devem ser desenvolvidos.

OBJETIVO: realizar uma revisão sistemática sobre a efetividade de intervenções para prevenção da perda auditiva induzida por ruído ocupacional, atualizando os achados da mais recente versão da revisão sistemática Cochrane do mesmo tema. ESTRATÉGIA DE PESQUISA: As buscas ocorreram nas bases PubMed, Web of Science e Scopus. CRITÉRIOS DE SELEÇÃO: Como intervenções, foram considerados: controles de engenharia/administrativos; dispositivos de proteção auditiva (DPA); vigilância auditiva e monitoramento audiológico. ANÁLISE DOS DADOS: Para a análise de risco de viés, cada estudo foi avaliado de acordo com a adoção de randomização, alocação, cegamento, desfecho, outras fontes de viés. RESULTADOS: Foram obtidas 475 referências no total. Destas, 17 estudos cumpriram os critérios de inclusão: um randomizado, um de série temporal interrompida e 15 de antes e depois. A maioria dos estudos foi realizada em indústrias; três em ambiente militar e/ou de treinamento de tiro; um em orquestra e outro em construção civil. A maioria dos estudos mostrou alto risco de viés. Seis estudos verificaram redução da exposição ao ruído a curto prazo por meio de controles de engenharia/administrativos; um verificou impacto positivo decorrente de mudança na legislação; cinco verificaram efeitos positivos dos DPA na diminuição da exposição ao ruído e dos treinamentos educacionais no uso do DPA; e dois encontraram redução dos níveis de ruído e aumento no uso do DPA decorrentes da implementação de programas de conservação auditiva. CONCLUSÃO: Todos os estudos analisados concluíram que as intervenções utilizadas resultaram em efeitos positivos sobre a audição e/ou sobre a exposição ao ruído. Em relação aos efeitos de longo termo, a grande maioria dos estudos limitou-se a avaliar efeitos imediatos ou de curto termo, reforçando que estudos incluindo follow-up de longo termo devem ser desenvolvidos.

Hearing loss, tinnitus, and hypertension: analysis of the baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

OBJECTIVES: To investigate the association among hypertension, tinnitus, and sensorineural hearing loss and evaluate the influence of other covariates on this association. METHODS: Baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were analyzed. Altogether, 900 participants were evaluated. The baseline assessment consisted of a 7-hour examination to obtain clinical and laboratory variables. Hearing was measured using pure-tone audiometry. RESULTS: Overall, 33.3% of the participants had hypertension. Participants with hypertension were more likely to be older, male, and diabetic compared to those without hypertension. The prevalence of tinnitus was higher among hypertensive participants and the odds ratio for tinnitus was higher in participants with hypertension than in those without hypertension. However, the difference was not significant after adjusting for age. Audiometric results at 250-8,000 Hz were worse in participants with hypertension than in those without hypertension in the crude analysis; however, the differences were not significant after adjustment for age, sex, diagnosis of diabetes, and exposure to noise. No significant difference was observed in hearing thresholds among participants having hypertension for <6 years, those having hypertension for ≥6 years, and individuals without hypertension. CONCLUSION: Hearing thresholds were worse in participants with hypertension. However, after adjusting for age, sex, diagnosis of diabetes, and exposure to noise, no significant differences were observed between participants with and without hypertension. A higher prevalence of tinnitus was observed in participants with hypertension compared to those without hypertension, but without significance after adjusting for age.

Functionalized magnetite nanoparticles with Moringa oleifera with potent antibacterial action in wastewater.

Contaminations by Staphylococcus aureus in food industry environments have been extended to industrial Effluent Treatment Plant (ETP). The methodologies used in ETP for bacterial removals and quality parameters adjustment commonly use products toxic to the environment, being mostly inefficient against virulent bacteria such as S. aureus. Seeds of Moringa oleifera Lam. (MO) have potential to be used in ETP as an alternative to harmful products, as it has both the ability to regulate the physicochemical parameters of water and has antibacterial action. Functionalization of MO with magnetite magnetic nano particles (Fe3O4) at nano scale focusing on coagulation and flocculation of wastewater has been gaining prominence. Therefore, the present study evaluated the potential use of the magnetic coagulant MO-Fe3O4 in the elimination of S. aureus in synthetic dairy effluent; concomitantly sought to adjust the quality levels of physicochemical parameters. MO-Fe3O4 added to synthetic dairy effluent at different concentrations amounted to 16 treatments, which were evaluated for removal of color, turbidity, UV254nm and S. aureus on the effluent surface and sludge after 30 min of sedimentation. The results confirmed the efficient elimination of S. aureus simultaneously with a significant reduction of the physicochemical values, with constant efficiency up to 30 min. Scanning electron microscopy images confirm the removal of S. aureus on the effluent surface and sludge. Thus, this study was able to present a natural coagulant capable of remove bacteria and adjust the quality levels of the effluent after 10 min of sedimentation, making this biotechnological innovation highly applicable to ETP.

Evaluation of Noise Reduction Interventions in a School.

INTRODUCTION: Noise in the school environment has been a major concern in many countries around the world. Students need a favorable signal-to-noise ratio in the classroom to ensure adequate speech intelligibility, which is directly dependent on the acoustics of the classroom and favorable noise levels in these environments. OBJECTIVE: To evaluate the effectiveness of physical, organizational, and educational interventions to achieve noise reduction in a school. METHODS: Presentations on the effects of noise were made to school administrators, teachers, and students (educational activities), and also to the students' families. Then, thermoacoustic treatment, changes in break times, equipment maintenance, and scheduling of students' departure were applied. Sound pressure levels were measured before and after interventions for the unoccupied and occupied classroom conditions (n = 11 classrooms) and of the school's outside areas (n = 4). Self-administered printed pre- and postintervention multiple-choice questionnaires were completed by the students in the classroom. Measures of the signal-to-noise ratio of the teachers' voice before and after the interventions were also conducted (n = 3 classrooms). The interventions included installation of an acoustic ceiling, installation of air-conditioning, and replacement of the existing furniture with wood furniture. RESULTS: Comparing the pre- and postintervention questionnaires, the Annoyance Index was reduced from 0.78 to 0.59. The tinnitus reported by the individuals increased significantly in the postintervention questionnaire (p < 0.001). Significant reductions in noise levels in both unoccupied and occupied classrooms were observed. There was also an improvement in the mean signal-to-noise ratio in the evaluated classrooms (n = 3) from +7.5 to +8.4 dB. CONCLUSION: Subjective measures and objective assessments demonstrated that both physical and educational interventions had a positive effect on short-term changes in habits and noise reduction in the school environment.

Hearing loss, tinnitus, and hypertension: analysis of the baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

OBJECTIVES: To investigate the association among hypertension, tinnitus, and sensorineural hearing loss and evaluate the influence of other covariates on this association. METHODS: Baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were analyzed. Altogether, 900 participants were evaluated. The baseline assessment consisted of a 7-hour examination to obtain clinical and laboratory variables. Hearing was measured using pure-tone audiometry. RESULTS: Overall, 33.3% of the participants had hypertension. Participants with hypertension were more likely to be older, male, and diabetic compared to those without hypertension. The prevalence of tinnitus was higher among hypertensive participants and the odds ratio for tinnitus was higher in participants with hypertension than in those without hypertension. However, the difference was not significant after adjusting for age. Audiometric results at 250-8,000 Hz were worse in participants with hypertension than in those without hypertension in the crude analysis; however, the differences were not significant after adjustment for age, sex, diagnosis of diabetes, and exposure to noise. No significant difference was observed in hearing thresholds among participants having hypertension for <6 years, those having hypertension for ≥6 years, and individuals without hypertension. CONCLUSION: Hearing thresholds were worse in participants with hypertension. However, after adjusting for age, sex, diagnosis of diabetes, and exposure to noise, no significant differences were observed between participants with and without hypertension. A higher prevalence of tinnitus was observed in participants with hypertension compared to those without hypertension, but without significance after adjusting for age.

Revisão sistemática de intervenções para prevenção da perda auditiva induzida por ruído ocupacional - uma atualização / Systematic Review of Interventions to Prevent Occupational Noise-Induced Hearing Loss - A Follow-up

Resumo Objetivo realizar uma revisão sistemática sobre a efetividade de intervenções para prevenção da perda auditiva induzida por ruído ocupacional, atualizando os achados da mais recente versão da revisão sistemática Cochrane do mesmo tema. Estratégia de pesquisa As buscas ocorreram nas bases PubMed, Web of Science e Scopus. Critérios de seleção Como intervenções, foram considerados: controles de engenharia/administrativos; dispositivos de proteção auditiva (DPA); vigilância auditiva e monitoramento audiológico. Análise dos dados Para a análise de risco de viés, cada estudo foi avaliado de acordo com a adoção de randomização, alocação, cegamento, desfecho, outras fontes de viés. Resultados Foram obtidas 475 referências no total. Destas, 17 estudos cumpriram os critérios de inclusão: um randomizado, um de série temporal interrompida e 15 de antes e depois. A maioria dos estudos foi realizada em indústrias; três em ambiente militar e/ou de treinamento de tiro; um em orquestra e outro em construção civil. A maioria dos estudos mostrou alto risco de viés. Seis estudos verificaram redução da exposição ao ruído a curto prazo por meio de controles de engenharia/administrativos; um verificou impacto positivo decorrente de mudança na legislação; cinco verificaram efeitos positivos dos DPA na diminuição da exposição ao ruído e dos treinamentos educacionais no uso do DPA; e dois encontraram redução dos níveis de ruído e aumento no uso do DPA decorrentes da implementação de programas de conservação auditiva. Conclusão Todos os estudos analisados concluíram que as intervenções utilizadas resultaram em efeitos positivos sobre a audição e/ou sobre a exposição ao ruído. Em relação aos efeitos de longo termo, a grande maioria dos estudos limitou-se a avaliar efeitos imediatos ou de curto termo, reforçando que estudos incluindo follow-up de longo termo devem ser desenvolvidos.

Abstract Purpose To conduct a systematic review of the effectiveness of interventions to prevent occupational hearing loss, following up on the findings of the most recent version of Cochrane systematic review on the same topic. Research strategy Searches were carried out in PubMed, Web of Science and Scopus databases. Selection criteria The following interventions were considered: engineering/administrative controls; hearing protection devices (HPD); and audiological monitoring. Data analysis For bias risk analysis, each study was assessed according to randomization, allocation, blinding, outcomes, other sources of bias. Results 475 references were obtained. Of these, 17 studies met the inclusion criteria: one randomized, one interrupted time series, and 15 before and after studies. Most studies were conducted in industries; three in military and/or shooting training environments; one in an orchestra, and one in construction. Most studies showed a high risk of bias. Six studies found a reduction in short-term exposure to noise through engineering/administrative controls; one found a positive impact due to changes in legislation; five studies have found positive effects of HPD in reducing exposure to noise and of educational trainings in the use of HPD; lastly, two studies found a reduction in noise levels and an increase in the using of HPD due to the implementation of hearing conservation programs. Conclusão Todos os estudos analisados concluíram que as intervenções utilizadas resultaram em efeitos positivos sobre a audição e/ou sobre a exposição ao ruído. Em relação aos efeitos de longo termo, a grande maioria dos estudos limitou-se a avaliar efeitos imediatos ou de curto termo, reforçando que estudos incluindo follow-up de longo termo devem ser desenvolvidos.