FIFA 11+ KIDS in the prevention of soccer injuries in children: a systematic review.

BACKGROUND: The "FIFA 11+" is an injury prevention program conceived for soccer athletes aged over 14. The use of FIFA 11+ Kids in soccer was associated with a reduction of the overall risk of injuries in children by 48%, and of 74% for serious injuries. However, to the best of our knowledge, a systematic review of the literature on the effects of FIFA 11+ Kids is still missing. Therefore, a systematic review was conducted to ascertain the benefits of the "FIFA 11+ KIDS" program in children who practice soccer. METHODS: This systematic review was conducted according to the PRISMA recommendations and prospectively registered in PROSPERO. The electronic search was conducted in the following databases: Web of Science, PubMed, Medline via Ovid, EMBASE and SportDiscuss via EBSCO. Database searches were performed in January 2024. This review included studies that evaluated the effects of the "FIFA 11+ KIDS" program. Eligible studies had to describe program implementation and the mean age of the children. RESULTS: A total of 11 articles were included in this systematic review from a pool of 8513 articles screened across various databases. These articles involved over 10,000 young participants from 8 countries, primarily aged 7-14 years, with the majority being soccer athletes. Study quality varied, with four categorized as high, four as good, and three as fair quality. Objectives varied across studies, with four focusing on FIFA 11+ Kids' efficacy in injury prevention, five examining its impact on performance and physical abilities, and two assessing its effects on children's focus and attention skills. Notably, injury prevention studies reported around a 50% reduction in overall injuries and nearly 60% in severe injuries, with a dose-response relationship observed with increased weekly sessions. Significant improvements were noted in physical and functional tests such as the Y balance, jump tests, and various soccer skills, along with positive effects on children's focus and attention, as indicated by 13-18% improvements in Attention Scale for Elementary School Children (ASESC) scores. CONCLUSION: The FIFA 11+ KIDS injury prevention program appears to be effective in reducing injuries in young football players. This can positively influence player and team overall performance and might support the long-term athlete development of these young athletes. These findings highlight the importance and necessity of injury prevention in young athletes.

A deep learning approach based on graphs to detect plantation lines.

Identifying plantation lines in aerial images of agricultural landscapes is re-quired for many automatic farming processes. Deep learning-based networks are among the most prominent methods to learn such patterns and extract this type of information from diverse imagery conditions. However, even state-of-the-art methods may stumble in complex plantation patterns. Here, we propose a deep learning approach based on graphs to detect plantation lines in UAV-based RGB imagery, presenting a challenging scenario containing spaced plants. The first module of our method extracts a feature map throughout the backbone, which consists of the initial layers of the VGG16. This feature map is used as an input to the Knowledge Estimation Module (KEM), organized in three concatenated branches for detecting 1) the plant positions, 2) the plantation lines, and 3) the displacement vectors between the plants. A graph modeling is applied considering each plant position on the image as vertices, and edges are formed between two vertices (i.e. plants). Finally, the edge is classified as pertaining to a certain plantation line based on three probabilities (higher than 0.5): i) in visual features obtained from the backbone; ii) a chance that the edge pixels belong to a line, from the KEM step; and iii) an alignment of the displacement vectors with the edge, also from the KEM step. Experiments were conducted initially in corn plantations with different growth stages and patterns with aerial RGB imagery to present the advantages of adopting each module. We assessed the generalization capability in the other two cultures (orange and eucalyptus) datasets. The proposed method was compared against state-of-the-art deep learning methods and achieved superior performance with a significant margin considering all three datasets. This approach is useful in extracting lines with spaced plantation patterns and could be implemented in scenarios where plantation gaps occur, generating lines with few-to-no interruptions.

Evaluation of surface roughness, wettability and adhesion of multispecies biofilm on 3D-printed resins for the base and teeth of complete dentures.

OBJECTIVE: This study evaluated the surface roughness, wettability and adhesion of multispecies biofilms (Candida albicans, Staphylococcus aureus and Streptococcus mutans) on 3D-printed resins for complete denture bases and teeth compared to conventional resins (heat-polymerized acrylic resin; artificial pre-fabricated teeth). METHODOLOGY: Circular specimens (n=39; 6.0 mm Ø × 2.0 mm) of each group were subjected to roughness (n=30), wettability (n=30) and biofilm adhesion (n=9) tests. Three roughness measurements were taken by laser confocal microscopy and a mean value was calculated. Wettability was evaluated by the contact angle of sessile drop method, considering the mean of the three evaluations per specimen. In parallel, microorganism adhesion to resin surfaces was evaluated using a multispecies biofilm model. Microbial load was evaluated by determining the number of Colony Forming Units (CFU/mL) and by scanning electron microscopy (SEM). Data were subjected to the Wald test in a generalized linear model with multiple comparisons and Bonferroni adjustment, as well as two-way ANOVA (α=5%). RESULTS: The roughness of the conventional base resin (0.01±0.04) was lower than that of the conventional tooth (0.14±0.04) (p=0.023) and 3D-printed base (0.18±0.08) (p<0.001). For wettability, conventional resin (84.20±5.57) showed a higher contact angle than the 3D-printed resin (60.58±6.18) (p<0.001). Higher microbial loads of S. mutans (p=0.023) and S. aureus (p=0.010) were observed on the surface of the conventional resin (S. mutans: 5.48±1.55; S. aureus: 7.01±0.57) compared to the 3D-printed resin (S. mutans: 4.11±1.96; S. aureus: 6.42±0.78). The adhesion of C. albicans was not affected by surface characteristics. The conventional base resin showed less roughness than the conventional dental resin and the printed base resin. CONCLUSION: The 3D-printed resins for base and tooth showed less hydrophobicity and less adhesion of S. mutans and S. aureus than conventional resins.

A nontoxic strontium nanoparticle that holds the potential to act upon osteocompetent cells: An in vitro and in vivo characterization.

Estrogen deficiency, long-term immobilization, and/or aging are commonly related to bone mass loss, thus increasing the risk of fractures. One option for bone replacement in injuries caused by either traumas or pathologies is the use of orthopedic cement based on polymethylmethacrylate (PMMA). Nevertheless, its reduced bioactivity may induce long-term detachment from the host tissue, resulting in the failure of the implant. In view of this problem, we developed an alternative PMMA-based porous cement (pPMMA) that favors cell invasion and improves osteointegration with better biocompatibility. The cement composition was changed by adding bioactive strontium-nanoparticles that mimic the structure of bone apatite. The nanoparticles were characterized regarding their physical-chemical properties, and their effects on osteoblasts and osteoclast cultures were assessed. Initial in vivo tests were also performed using 16 New Zealand rabbits as animal models, in which the pPMMA-cement containing the strontium nanoparticles were implanted. We showed that the apatite nanoparticles in which 90% of Ca2+ ions were substituted by Sr2+ (NanoSr 90%) upregulated TNAP activity and increased matrix mineralization. Moreover, at the molecular level, NanoSr 90% upregulated the mRNA expression levels of, Sp7, and OCN. Runx2 was increased at both mRNA and protein levels. In parallel, in vivo tests revealed that pPMMA-cement containing NanoSr 90%, upregulated two markers of bone maturation, OCN and BMP2, as well as the formation of apatite minerals after implantation in the femur of rabbits. The overall data support that strontium nanoparticles hold the potential to up-regulate mineralization in osteoblasts when associated with synthetic biomaterials.

Comparative analysis of the physical, chemical, and microbiological properties of Ti-6Al-4V disks produced by different methods and subjected to surface treatments.

STATEMENT OF PROBLEM: To improve the osseointegration of dental implants and reduce microbiological growth, different micro- and nanoscale surface topographies can be used. PURPOSE: The purpose of this in vitro study was to evaluate the influence of Ti-6Al-4V with 4 surfaces, machined (DU), machined+hydroxyapatite (DUHAp), machined+acid-alkali treatment (DUAA), and additive manufacturing (DMA), on the physical, chemical, and microbiological properties. MATERIAL AND METHODS: The topography of Ti-6Al-4V disks with the 4 surfaces was evaluated by scanning electron microscopy (SEM), the chemical composition by energy dispersive X-ray spectroscopy (EDS), and the crystalline structure by X-ray diffraction (XRD). Physical and chemical properties were analyzed by using wettability and surface free energy, roughness, and microbial adhesion against Staphylococcus aureus by colony forming units (CFU). One-way ANOVA analysis of variance and the Tukey multiple comparisons test were applied to evaluate the data, except CFU, which was submitted to the Kruskal-Wallis nonparametric test (α=.05). RESULTS: DU photomicrographs showed a topography characteristic of a polished machined surface, DUHAp and DUAA exhibited patterns corresponding to the surface modifications performed, and in DMA the presence of partially fused spherical particles was observed. The EDS identified chemical elements inherent in the Ti-6Al-4V, and the DUHAp and DUAA disks also had the ions from the treatments applied. XRD patterns revealed similarities between DU and DMA, as well as characteristic peaks of hydroxyapatite (HA) in the DUHAp disk and the DUAA. Compared with DU and DMA the DUHAp and DUAA groups showed hydrophilic behavior with smaller contact angles and higher surface free energy (P<.05). DMA showed a higher mean value of roughness, different from the others (P<.05), and a higher CFU for S. aureus (P=.006). CONCLUSIONS: DUHAp and DUAA showed similar behaviors regarding wettability, surface free energy, and bacterial adhesion. Among the untreated groups, DMA exhibited higher roughness, bacterial adhesion, and lower wettability and surface free energy.

Electrostimulable polymeric films with hyaluronic acid and lipid nanoparticles for simultaneous topical delivery of macromolecules and lipophilic drugs.

This study focused on developing electrically stimulable hyaluronic acid (HA) films incorporating lipid nanoparticles (NPs) designed for the topical administration of lipophilic drugs and macromolecules. Based on beeswax and medium-chain triglycerides, NPs were successfully integrated into silk fibroin/chitosan films containing HA (NP-HA films) at a density of approximately 1011 NP/cm2, ensuring a uniform distribution. This integration resulted in a 40% increase in film roughness, a twofold decrease in Young's modulus, and enhanced film flexibility and bioadhesion work. The NP-HA films, featuring Ag/AgCl electrodes, demonstrated the capability to conduct a constant electrical current of 0.2 mA/cm2 without inducing toxicity in keratinocytes and fibroblasts during a 15-min application. Moreover, the NPs facilitated the homogeneous distribution of lipophilic drugs within the film, effectively transporting them to the skin and uniformly distributing them in the stratum corneum upon film administration. The sustained release of HA from the films, following Higuchi kinetics, did not alter the macroscopic characteristics of the film. Although anodic iontophoresis did not noticeably affect the release of HA, it did enhance its penetration into the skin. This enhancement facilitated the permeation of HA with a molecular weight (MW) of up to 2 × 105 through intercellular and transcellular routes. Confocal Raman spectroscopy provided evidence of an approximate 100% increase in the presence of HA with a MW in the range of 1.5-1.8 × 106 in the viable epidermis of human skin after only 15 min of iontophoresis applied to the films. Combining iontophoresis with NP-HA films exhibits substantial potential for noninvasive treatments focused on skin rejuvenation and wound healing.

Evaluation of surface roughness, wettability and adhesion of multispecies biofilm on 3D-printed resins for the base and teeth of complete dentures

Abstract Studies evaluating the roughness, wettability and microbial adhesion of 3D-printed resins for complete denture bases and teeth are scarce. Objective This study evaluated the surface roughness, wettability and adhesion of multispecies biofilms (Candida albicans, Staphylococcus aureus and Streptococcus mutans) on 3D-printed resins for complete denture bases and teeth compared to conventional resins (heat-polymerized acrylic resin; artificial pre-fabricated teeth). Methodology Circular specimens (n=39; 6.0 mm Ø × 2.0 mm) of each group were subjected to roughness (n=30), wettability (n=30) and biofilm adhesion (n=9) tests. Three roughness measurements were taken by laser confocal microscopy and a mean value was calculated. Wettability was evaluated by the contact angle of sessile drop method, considering the mean of the three evaluations per specimen. In parallel, microorganism adhesion to resin surfaces was evaluated using a multispecies biofilm model. Microbial load was evaluated by determining the number of Colony Forming Units (CFU/mL) and by scanning electron microscopy (SEM). Data were subjected to the Wald test in a generalized linear model with multiple comparisons and Bonferroni adjustment, as well as two-way ANOVA (α=5%). Results The roughness of the conventional base resin (0.01±0.04) was lower than that of the conventional tooth (0.14±0.04) (p=0.023) and 3D-printed base (0.18±0.08) (p<0.001). For wettability, conventional resin (84.20±5.57) showed a higher contact angle than the 3D-printed resin (60.58±6.18) (p<0.001). Higher microbial loads of S. mutans (p=0.023) and S. aureus (p=0.010) were observed on the surface of the conventional resin (S. mutans: 5.48±1.55; S. aureus: 7.01±0.57) compared to the 3D-printed resin (S. mutans: 4.11±1.96; S. aureus: 6.42±0.78). The adhesion of C. albicans was not affected by surface characteristics. The conventional base resin showed less roughness than the conventional dental resin and the printed base resin. Conclusion The 3D-printed resins for base and tooth showed less hydrophobicity and less adhesion of S. mutans and S. aureus than conventional resins.

Effects of LED Lights on Bulk Fill Resin Polymerization

The present study analyzed the microhardness and degree of conversion of three Bulk Fill resins (M1 - Filtek Bulk Fill; M2 - Tetric N-Ceram Bulk Fill and M3 - Opus Bulk Fill) polymerized by single peak and polywave Light-emitting Diode Curing Lights. A total 90 test specimens (n=10) were obtained using a Teflon matrix for the purpose of testing microhardness; and for degree of conversion: 135 specimens (n=5) by using a 2 x 6 cm matrix. The specimens were light polymerized using 3 light sources (L1 - Optilight Max, L2 - Bluephase, L3 - VALO). They were kept in artificial saliva om an oven at 37±1°C during the experiment. The degree of conversion was measured by FTIR 24 h after obtaining each test specimen. The microhardness readouts were performed with a microdurometer at the time intervals of 48 hours (T0), 7 days (T1), 14 days (T2) and 21 days (T3). M1L3 was found to show the highest microhardness values in T2, and M1 showed the lowest degree of conversion in the deep third with L1. It was concluded that Filtek Bulk Fill resin showed the best results in comparison with the other resins.

El presente estudio analizó la microdureza y el grado de conversión de tres resinas Bulk Fill (M1 - Filtek Bulk Fill; M2 - Tetric N-Ceram Bulk Fill y M3 - Opus Bulk Fill) polimerizadas por lámparas de curado de diodo emisor de luz de pico único y polionda. Se obtuvieron un total de 90 especímenes de prueba (n=10) utilizando una matriz de teflón con el propósito de probar la microdureza; y para grado de conversión: 135 especímenes (n=5) utilizando una matriz de 2 x 6 cm. Las muestras se fotopolimerizaron utilizando 3 fuen- tes de luz (L1 - Optilight Max, L2 - Bluephase, L3 - VALO). Se mantuvieron en saliva artificial en estufa a 37 ±1°C durante el experimento. El grado de conversión se midió por FTIR 24 h después de obtener cada muestra de prueba. Las lecturas de microdureza se realizaron con un microdurómetro en los intervalos de tiempo de 48 horas (T0), 7 días (T1), 14 días (T2) y 21 días (T3). Se encontró que M1L3 mostraba los valores más altos de microdureza en T2, y M1 mostraba el grado más bajo de conversión en el tercio profundo con L1. Se concluyó que la resina Filtek Bulk Fill mostró los mejores resultados en comparación con las demás resinas.

Distribution of cases of congenital heart disease in a hospital in Oeste Paulista / Distribuição dos casos de cardiopatias congênitas em um hospital do Oeste Paulista

The aim of this research was to conduct a comprehensive spatial-temporal analysis of the population affected by congenital heart anomalies assisted at the Pediatric Cardiology Outpatient Department at the distinguished Western Paulista reference hospital. We conducted a retrospective study involving the analysis of electronic database records and patient medical charts for individuals diagnosed with congenital heart disease during the period from July 2013 to July 2018. A total of 298 medical records were selected for the analysis of variables encompassing the ICD-10 codes, gender, spatial distribution, and temporal trends. It was possible to observe that septal defects were the most prevalent congenital heart abnormalities, and there was no gender-based difference. An increase in diagnoses was noted from 2014, coinciding with the implementation of the "heart test," and 51% of the cases were from Presidente Prudente, with a higher concentration of cases in the industrial park area. There is an association between cardiac congenital malformations and an adverse environmental context. The findings can inform public health policies aimed at reducing the exposure of the most vulnerable population in pursuit of improving health indicators (AU).

O objetivo deste trabalho foi analisar a distribuição espaço-temporal dos pacientes com cardiopatias congênitas aten-didos no Ambulatório de Cardiologia Pediátrica do Hospital de referência do Oeste Paulista. Realizamos um estudo retrospectivo com análise de dados de base eletrônica e prontuários dos pacientes diagnosticados com cardiopatia congênita entre os períodos de julho de 2013 a julho de 2018. Foram selecionados 298 prontuários para análise das variáveis de CID-10, gênero, distribuição espacial e série temporal. Foi possível observar que os defeitos septais foram as cardiopatias mais prevalentes, não houve diferença entre os gêneros. Notou-se aumento do diagnóstico a partir de 2014, com implementação do teste do coraçãozinho e 51% dos casos eram da cidade de Presidente Prudente, com maior concentração de casos na região do parque industrial. Há uma relação na incidência das malformações cardíacas com o meio ambiente desfavorável. Os resultados encontrados podem guiar políticas de saúde pública, visando reduzir a exposição da população mais vulnerável, na busca da melhora nos índices de saúde (AU).

Annexin A5 stabilizes matrix vesicle-biomimetic lipid membranes: unravelling a new role of annexins in calcification.

Matrix vesicles are a special class of extracellular vesicles thought to actively contribute to both physiologic and pathologic mineralization. Proteomic studies have shown that matrix vesicles possess high amounts of annexin A5, suggesting that the protein might have multiple roles at the sites of calcification. Currently, Annexin A5 is thought to promote the nucleation of apatitic minerals close to the inner leaflet of the matrix vesicles' membrane enriched in phosphatidylserine and Ca2+. Herein, we aimed at unravelling a possible additional role of annexin A5 by investigating the ability of annexin A5 to adsorb on matrix-vesicle biomimetic liposomes and Langmuir monolayers made of dipalmitoylphosphatidylserine (DPPS) and dipalmitoylphosphatidylcholine (DPPC) in the absence and in the presence of Ca2+. Differential scanning calorimetry and dynamic light scattering measurements showed that Ca2+ at concentrations in the 0.5-2.0 mM range induced the aggregation of liposomes probably due to the formation of DPPS-enriched domains. However, annexin A5 avoided the aggregation of liposomes at Ca2+ concentrations lower than 1.0 mM. Surface pressure versus surface area isotherms showed that the adsorption of annexin A5 on the monolayers made of a mixture of DPPC and DPPS led to a reduction in the area of excess compared to the theoretical values, which confirmed that the protein favored attractive interactions among the membrane lipids. The stabilization of the lipid membranes by annexin A5 was also validated by recording the changes with time of the surface pressure. Finally, fluorescence microscopy images of lipid monolayers revealed the formation of spherical lipid-condensed domains that became unshaped and larger in the presence of annexin A5. Our data support the model that annexin A5 in matrix vesicles is recruited at the membrane sites enriched in phosphatidylserine and Ca2+ not only to contribute to the intraluminal mineral formation but also to stabilize the vesicles' membrane and prevent its premature rupture.

Intrauterine food restriction impairs the lipogenesis process in the mesenteric adipocytes from low-birth-weight rats into adulthood.

Background: Intrauterine food restriction (IFR) during pregnancy is associated with low birth weight (LBW) and obesity in adulthood. It is known that white adipose tissue (WAT) plays critical metabolic and endocrine functions; however, this tissue's behavior before weight gain and obesity into adulthood is poorly studied. Thus, we evaluated the repercussions of IFR on the lipogenesis and lipolysis processes in the offspring and described the effects on WAT inflammatory cytokine production and secretion. Methods: We induced IFR by providing gestating rats with 50% of the necessary chow daily amount during all gestational periods. After birth, we monitored the offspring for 12 weeks. The capacity of isolated fat cells from mesenteric white adipose tissue (meWAT) to perform lipogenesis (14C-labeled glucose incorporation into lipids) and lipolysis (with or without isoproterenol) was assessed. The expression levels of genes linked to these processes were measured by real-time PCR. In parallel, Multiplex assays were conducted to analyze pro-inflammatory markers, such as IL-1, IL-6, and TNF-α, in the meWAT. Results: Twelve-week-old LBW rats presented elevated serum triacylglycerol (TAG) content and attenuated lipogenesis and lipolysis compared to control animals. Inflammatory cytokine levels were increased in the meWAT of LBW rats, evidenced by augmented secretion by adipocytes and upregulated gene and protein expression by the tissue. However, there were no significant alterations in the serum cytokines content from the LBW group. Additionally, liver weight, TAG content in the hepatocytes and serum glucocorticoid levels were increased in the LBW group. Conclusion: The results demonstrate that IFR throughout pregnancy yields LBW offspring characterized by inhibited lipogenesis and lipolysis and reduced meWAT lipid storage at 12 weeks. The increased serum TAG content may contribute to the augmented synthesis and secretion of pro-inflammatory markers detected in the LBW group.

Diploid Nuclei Occur throughout the Life Cycles of Pucciniales Fungi.

Within Eukaryotes, fungi are the typical representatives of haplontic life cycles. Basidiomycota fungi are dikaryotic in extensive parts of their life cycle, but diploid nuclei are known to form only in basidia. Among Basidiomycota, the Pucciniales are notorious for presenting the most complex life cycles, with high host specialization, and for their expanded genomes. Using cytogenomic (flow cytometry and cell sorting on propidium iodide-stained nuclei) and cytogenetic (FISH with rDNA probe) approaches, we report the widespread occurrence of replicating haploid and diploid nuclei (i.e., 1C, 2C and a small proportion of 4C nuclei) in diverse life cycle stages (pycnial, aecial, uredinial, and telial) of all 35 Pucciniales species analyzed, but not in sister taxa. These results suggest that the Pucciniales life cycle is distinct from any cycle known, i.e., neither haplontic, diplontic nor haplodiplontic, corroborating patchy and disregarded previous evidence. However, the biological basis and significance of this phenomenon remain undisclosed. IMPORTANCE Within Eukaryotes, fungi are the typical representatives of haplontic life cycles, contrasting with plants and animals. As such, fungi thus contain haploid nuclei throughout their life cycles, with sexual reproduction generating a single diploid cell upon karyogamy that immediately undergoes meiosis, thus resuming the haploid cycle. In this work, using cytogenetic and cytogenomic tools, we demonstrate that a vast group of fungi presents diploid nuclei throughout their life cycles, along with haploid nuclei, and that both types of nuclei replicate. Moreover, haploid nuclei are absent from urediniospores. The phenomenon appears to be transversal to the organisms in the order Pucciniales (rust fungi) and it does not occur in neighboring taxa, but a biological explanation or function for it remains elusive.

Conservative management following patellar dislocation: a level I systematic review.

BACKGROUND: Patellar instability is a common and disabling clinical condition. Treatment of acute primary patellar dislocation aims to reduce the risk of recurrence or painful subluxation and improve function. However, the actual clinical efficacy of any management modality following an acute dislocation has never been demonstrated in prospective or retrospective studies, and the optimal way in which the various management modalities should be used is at best unclear. METHODS: A search was conducted in PubMed, Bireme and Embase databases. Inclusion criteria followed the acronym PICOS, (P) subjects with patellar instability, (I) therapeutic interventions, (C) placebo or control or surgical treatments, (O) rate of dislocations and function, and (S) clinical trials. The Medical Subject Headings (MeSH) terms used were: (("patellar instability") OR ("patellar dislocation")) AND ((physiotherapy) OR (rehabilitation) OR ("conservative treatment") OR (therapy) OR (therapeutic)). The risk of bias was analysed using the PeDRO scale. RESULTS: Seven randomized controlled trials including 282 patients were considered. The quality of studies detailing the results of conservative treatment was higher than that of surgical procedures, but all studies have relatively low methodological quality. Four studies compared physiotherapeutic interventions with surgical procedures, and three studies compared conservative intervention techniques. CONCLUSION: An unstructured lower limb physical therapy programme evidences similar outcomes to specific exercises. Surgical management is associated with a lower rate of re-dislocation; however, whether surgery produces greater functional outcomes than conservative management is still unclear. The use of a knee brace with a limited range of motion, stretching and neuromuscular exercises are the most commonly recommended physiotherapy methodologies.

Oxigenação por membrana extracorpórea conduzida por enfermeiros na pandemia por coronavírus em um centro especializado / Oxigenación por membrana extracorpórea realizada por enfermeras en la pandemia de coronavirus en centro especializado / Extracorporeal membrane oxygenation conducted by nurses in the coronavirus pandemic at a specialized center

Objetivo:analisar o impacto dos desafios na condução da oxigenação por membrana extracorpórea realizada pelo enfermeiro em paciente com infecção por coronavírus. Método: trata-se de um relato de caso com coleta de dados documental num Centro Especializado no Rio de Janeiro. O participante da pesquisa, possuía 30 anos, com diagnóstico de infecção por coronavírus foi submetido a oxigenação extracorpórea veno-venosa por 18 dias. Análise descritiva pautada na identificação dos desafios ao protocolo institucional do suporte circulatório e nas estratégias de enfrentamento com apoio das recomendações científicas vigentes. Resultados: os principais desafios foram restrição de mobilização, insuficiência de drenagem, distúrbios de coagulação e broncoscopia seriada. Conclusões: os impactos identificados nacondução do suporte foram a alta demanda para a enfermagem elevando o tempo e o quantitativo de profissionais necessários para a assistência segura com melhoria dos cuidados de enfermagem relacionados a mobilização e arevisão do protocolo de anticoagulação.

Objective: to analyze the impact of challenges in conducting extracorporeal membrane oxygenation performed by nurses in patients with coronavirus infection. Method: this is a case report with documentary data collection in a Specialized Center in Rio de Janeiro. The research participant was 30 years old, with a diagnosis of coronavirus infection was underwent veno-venous extracorporeal oxygenation for 18 days. Descriptive analysis based on the identification of challenges to the institutional protocol of circulatorysupport and coping strategies supported by current scientific recommendations. Results: the main challenges were restriction of mobilization, insufficiency of drainage, coagulation disorders and serial bronchoscopy. Conclusions: the impacts identified in the conduct of support were the high demand for nursing, increasing the time and number of professionals needed for safe care with improvement of nursing care related to mobilization and review of the anticoagulation protocol.

Objetivo: analizar el impacto de los desafíos en la realización de la oxigenación por membrana extracorpórea realizada por enfermeras en pacientes con infección por coronavirus. Método: es un informe de caso con recolección de datos documentales en un Centro Especializado en Río de Janeiro. El participantede la investigación tenía 30 años,con infección por coronavirus,se le realizó oxigenación extracorpórea veno-venosa durante 18 días. Análisis descriptivo basado en la identificación de desafíos al protocolo institucional de apoyo circulatorio y estrategias de afrontamiento sustentadas en recomendaciones científicas actuales. Resultados:los principales desafíos fueron: restricción de la movilización, insuficiencia de drenaje, trastornos de la coagulación y broncoscopia seriada. Conclusiones: los impactos identificados en la conducta de apoyo fueron: alta demanda de enfermería, aumentando el tiempo y número de profesionales necesarios para un cuidado seguro con mejora de los cuidados de enfermería relacionados con la movilización y revisión del protocolo de anticoagulación.

Hybrid Nanoparticles of Citrate-Coated Manganese Ferrite and Gold Nanorods in Magneto-Optical Imaging and Thermal Therapy.

The development of nanomaterials has drawn considerable attention in nanomedicine to advance cancer diagnosis and treatment over the last decades. Gold nanorods (GNRs) and magnetic nanoparticles (MNPs) have been known as commonly used nanostructures in biomedical applications due to their attractive optical properties and superparamagnetic (SP) behaviors, respectively. In this study, we proposed a simple combination of plasmonic and SP properties into hybrid NPs of citrate-coated manganese ferrite (Ci-MnFe2O4) and cetyltrimethylammonium bromide-coated GNRs (CTAB-GNRs). In this regard, two different samples were prepared: the first was composed of Ci-MnFe2O4 (0.4 wt%), and the second contained hybrid NPs of Ci-MnFe2O4 (0.4 wt%) and CTAB-GNRs (0.04 wt%). Characterization measurements such as UV-Visible spectroscopy and transmission electron microscopy (TEM) revealed electrostatic interactions caused by the opposing surface charges of hybrid NPs, which resulted in the formation of small nanoclusters. The performance of the two samples was investigated using magneto-motive ultrasound imaging (MMUS). The sample containing Ci-MnFe2O4_CTAB-GNRs demonstrated a displacement nearly two-fold greater than just using Ci-MnFe2O4; therefore, enhancing MMUS image contrast. Furthermore, the preliminary potential of these hybrid NPs was also examined in magnetic hyperthermia (MH) and photoacoustic imaging (PAI) modalities. Lastly, these hybrid NPs demonstrated high stability and an absence of aggregation in water and phosphate buffer solution (PBS) medium. Thus, Ci-MnFe2O4_CTAB-GNRs hybrid NPs can be considered as a potential contrast agent in MMUS and PAI and a heat generator in MH.

Collagen/κ-Carrageenan-Based Scaffolds as Biomimetic Constructs for In Vitro Bone Mineralization Studies.

Tissue engineering offers attractive strategies to develop three-dimensional scaffolds mimicking the complex hierarchical structure of the native bone. The bone is formed by cells incorporated in a molecularly organized extracellular matrix made of an inorganic phase, called biological apatite, and an organic phase mainly made of collagen and noncollagenous macromolecules. Although many strategies have been developed to replicate the complexity of bone at the nanoscale in vitro, a critical challenge has been to control the orchestrated process of mineralization promoted by bone cells in vivo and replicate the anatomical and biological properties of native bone. In this study, we used type I collagen to fabricate mineralized scaffolds mimicking the microenvironment of the native bone. The sulfated polysaccharide κ-carrageenan was added to the scaffolds to fulfill the role of noncollagenous macromolecules in the organization and mineralization of the bone matrix and cell adhesion. Scanning electron microscopy images of the surface of the collagen/κ-carrageenan scaffolds showed the presence of a dense and uniform network of intertwined fibrils, while images of the scaffolds' lateral sides showed the presence of collagen fibrils with a parallel alignment, which is characteristic of dense connective tissues. MC3T3-E1 osteoblasts were cultured in the collagen scaffolds and were viable after up to 7 days of culture, both in the absence and in the presence of κ-carrageenan. The presence of κ-carrageenan in the collagen scaffolds stimulated the maturation of the cells to a mineralizing phenotype, as suggested by the increased expression of key genes related to bone mineralization, including alkaline phosphatase (Alp), bone sialoprotein (Bsp), osteocalcin (Oc), and osteopontin (Opn), as well as the ability to mineralize the extracellular matrix after 14 and 21 days of culture. Taken together, the results described in this study shed light on the potential use of collagen/κ-carrageenan scaffolds to study the role of the structural organization of bone-mimetic synthetic matrices in cell function.

Influence of Er:YAG laser irradiation on surface properties of Ti-6Al-4V machined and hydroxyapatite coated.

Surface treatment by laser irradiation can change the topography of titanium; however, little is known about the changes it causes when applied to other coatings. This study aimed to evaluate the influence of Er:YAG laser irradiation on the surface properties of titanium-aluminum-vanadium (Ti-6Al-4V) discs. Four Ti-6Al-4V surfaces were evaluated (n = 10): CON-control, machined without surface treatment; LT-machined + laser treatment; HA-hydroxyapatite coating; and LT-HA-hydroxyapatite coating + laser treatment. For the laser treatment, an Er:YAG laser with a wavelength of 2940 nm, a frequency of 10 Hz, and an energy density of 12.8 J/cm2 was used. The morphology of the coating was investigated by scanning electron microscopy and the surface composition by energy-dispersive X-ray spectroscopy. The influence of laser irradiation treatment on roughness and wettability was also evaluated. The Er:YAG laser promoted a significant reduction in the roughness Sa (p < 0.05) and in the contact angle (p = 0.002) of the LT surface compared to the CON surface. On the LT-HA surface, a significant decrease in roughness was observed only for the Rz parameter (p = 0.015) and an increase in the contact angle (p < 0.001) compared to the HA surface. The use of the Er:YAG laser with the evaluated parameters decreased the surface roughness and improved the wetting capacity of machined without surface treatment. In the group with hydroxyapatite coating, the laser influenced the surface roughness only for the parameter Rz and reduced their wetting capacity.

NPP1 and TNAP hydrolyze ATP synergistically during biomineralization.

Matrix vesicles (MVs) are a special class of extracellular vesicles released by mineralizing cells during bone and tooth mineralization that initiate the precipitation of apatitic minerals by regulating the extracellular ratio between inorganic phosphate (Pi), a calcification promoter, and pyrophosphate (PPi), a calcification inhibitor. The Pi/PPi ratio is thought to be controlled by two ecto-phosphatases present on the outer leaflet of the MVs' membrane: ectonucleotide pyrophosphatase/phosphodiesterase 1 (NPP1) that produces PPi as well as Pi from ATP and tissue-nonspecific alkaline phosphatase (TNAP) that hydrolyzes both ATP and PPi to generate Pi. However, if and how these enzymes act in concert in MVs are still unclear. Herein, we investigated the role of NPP1 and TNAP in ATP hydrolysis during MV-mediated biomineralization using proteoliposomes as a biomimetic model for MVs. Proteoliposomes composed by 1,2-dipalmitoylphosphatidylcholine (DPPC) and harboring NPP1 alone, TNAP alone, or both together at different molar ratios (1:1, 10:1, and 1:10) were fabricated. After 48 h of incubation with ATP, TNAP-containing proteoliposomes consumed more ATP than NPP1-containing vesicles (270 and 210 nmol, respectively). Both types of vesicles comparatively formed ADP (205 and 201 nmol, respectively), while NPP1-containing vesicles hydrolyzed AMP less efficiently than TNAP-containing proteoliposomes (10 and 25 nmol, respectively). In vitro mineralization assays showed that in the presence of ATP, TNAP-harboring proteoliposomes mineralized through a sigmoidal single-step process, while NPP1-harboring vesicles displayed a two-step mineralization process. ATR-FTIR analyses showed that the minerals produced by TNAP-harboring proteoliposomes were structurally more similar to hydroxyapatite than those produced by NPP1-harboring vesicles. Our results with proteoliposomes indicate that the pyrophosphohydrolase function of NPP1 and the phosphohydrolase activity of TNAP act synergistically to produce a Pi/PPi ratio conducive to mineralization and the synergism is maximal when the two enzymes are present at equimolar concentrations. The significance of these findings for hypophosphatasia is discussed.

Shedding Light on the Role of Na,K-ATPase as a Phosphatase during Matrix-Vesicle-Mediated Mineralization.

Matrix vesicles (MVs) contain the whole machinery necessary to initiate apatite formation in their lumen. We suspected that, in addition to tissue-nonspecific alkaline phosphatase (TNAP), Na,K,-ATPase (NKA) could be involved in supplying phopshate (Pi) in the early stages of MV-mediated mineralization. MVs were extracted from the growth plate cartilage of chicken embryos. Their average mean diameters were determined by Dynamic Light Scattering (DLS) (212 ± 19 nm) and by Atomic Force Microcopy (AFM) (180 ± 85 nm). The MVs had a specific activity for TNAP of 9.2 ± 4.6 U·mg-1 confirming that the MVs were mineralization competent. The ability to hydrolyze ATP was assayed by a colorimetric method and by 31P NMR with and without Levamisole and SBI-425 (two TNAP inhibitors), ouabain (an NKA inhibitor), and ARL-67156 (an NTPDase1, NTPDase3 and Ecto-nucleotide pyrophosphatase/phosphodiesterase 1 (NPP1) competitive inhibitor). The mineralization profile served to monitor the formation of precipitated calcium phosphate complexes, while IR spectroscopy allowed the identification of apatite. Proteoliposomes containing NKA with either dipalmitoylphosphatidylcholine (DPPC) or a mixture of 1:1 of DPPC and dipalmitoylphosphatidylethanolamine (DPPE) served to verify if the proteoliposomes were able to initiate mineral formation. Around 69-72% of the total ATP hydrolysis by MVs was inhibited by 5 mM Levamisole, which indicated that TNAP was the main enzyme hydrolyzing ATP. The addition of 0.1 mM of ARL-67156 inhibited 8-13.7% of the total ATP hydrolysis in MVs, suggesting that NTPDase1, NTPDase3, and/or NPP1 could also participate in ATP hydrolysis. Ouabain (3 mM) inhibited 3-8% of the total ATP hydrolysis by MVs, suggesting that NKA contributed only a small percentage of the total ATP hydrolysis. MVs induced mineralization via ATP hydrolysis that was significantly inhibited by Levamisole and also by cleaving TNAP from MVs, confirming that TNAP is the main enzyme hydrolyzing this substrate, while the addition of either ARL-6715 or ouabain had a lesser effect on mineralization. DPPC:DPPE (1:1)-NKA liposome in the presence of a nucleator (PS-CPLX) was more efficient in mineralizing compared with a DPPC-NKA liposome due to a better orientation of the NKA active site. Both types of proteoliposomes were able to induce apatite formation, as evidenced by the presence of the 1040 cm-1 band. Taken together, the findings indicated that the hydrolysis of ATP was dominated by TNAP and other phosphatases present in MVs, while only 3-8% of the total hydrolysis of ATP could be attributed to NKA. It was hypothesized that the loss of Na/K asymmetry in MVs could be caused by a complete depletion of ATP inside MVs, impairing the maintenance of symmetry by NKA. Our study carried out on NKA-liposomes confirmed that NKA could contribute to mineral formation inside MVs, which might complement the known action of PHOSPHO1 in the MV lumen.

Y-TZP Physicochemical Properties Conditioned with ZrO2 and SiO2 Nanofilms and Bond Strength to Dual Resin Cement.

Commercial Yttria-tetragonal zirconia polycrystalline (Y-TZP) was subjected to surface treatments, and the bond strength of dual resin cement to Y-TZP and failure modes were evaluated. Disks (12 mm × 2 mm), cylinders (7 mm × 3.3 mm), and bars (25 mm × 5 mm × 2 mm) were milled from Y-TZP CAD-CAM blocks, divided into seven groups, and subjected to different surface treatments; silicatization was used as control. On the basis of the literature, this study evaluated modifications with films containing SiO2 nanoparticles and silane; SiO2+ZrO2­SiO2 (50%) and ZrO2 (50%) nanoparticles, SiO2+ZrO2/Silane-SiO2 (50%) and ZrO2 (50%) nanoparticles, and silane. Specimens were analyzed by wettability (n = 3), surface free energy (n = 3), X-ray diffraction (n = 1), Fourier transform infrared spectroscopy (FTIR) (n = 1), roughness (n = 5), shear bond test (n = 10), and dynamic modulus (n = 3). Specimens treated with hydrofluoric acid­HF 40% presented significantly higher contact angle and lowest surface free energy (p < 0.05). The SiO2/Silane presented crystalline SiO2 on the surface. The surface roughness was significantly higher for groups treated with nanofilms (p < 0.05). Shear bond strength was significantly higher for silicatization, HF 40%/silicatization, SiO2/Silane, and SiO2+ZrO2/Silane groups. The proposed treatments with nanofilms had potentially good results without prejudice to the physicochemical characteristics of zirconia. Generally, groups that underwent silica surface deposition and silanization had better bond strength (p < 0.005).