Interventions to prevent urinary catheter-associated infections in children and neonates: a systematic review.

INTRODUCTION: Few data are available to inform strategies for the prevention of catheter-associated urinary tract infection (CAUTI) in children and neonates. Many recommendations are derived from studies in adults and cannot be applied to the paediatric population. OBJECTIVE: This study was aimed to identify all studies that measured the efficacy of an intervention for the prevention of CAUTI in children and neonates. METHODS: A systematic review using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) was conducted. Eligible studies published between January 1st, 1995 and December 31st, 2017, were identified in PubMed, the Cochrane Database of Systematic Reviews, LILACS, SciELO and DOAJ if applying an intervention with the aim of CAUTI prevention in inpatient children, infants or neonates. The following study designs were included: controlled and non-controlled before-and-after studies, (controlled) interrupted time series analyses and randomized controlled trials. Quantitative or qualitative studies on interventions in both adults and children were eligible if data on children could be extracted. Reviews, case series, letters, notes, conference abstracts and opinion articles were excluded. RESULTS: Of 99 articles identified, six were included in the final analysis, after consensus from three independent investigators. Four studies used a multimodal strategy (using at least four or more different components at the same time) as follows: aseptic rules during catheter insertion and removal; cleaning the urethral meatus with sterile water; use of a new silicone catheter per insertion with a closed sterile drainage system by a sterile technique; daily evaluation of catheter requirement; placement of indwelling urinary catheters only for approved indications; reducing of urinary catheter days and positioning of the patient and collection device to assist in urine drainage. One study tested periurethral cleaning intervention to reduce CAUTI. One study described the association of the presence of a physician safety champion with urinary catheter device utilization ratios. Catheter-associated UTI reduction rates were reported in four studies; three achieved statistically significant decreases in CAUTI rates. Positive results were achieved only when a multimodal strategy was used with at least four or more components. This strategy could be adopted for paediatric healthcare institutions to reduce CAUTI rates in children and neonates. CONCLUSION: Evidence exists to support the use of a multimodal strategy for CAUTI reduction in hospitalized children and neonates

Neuroimaging auditory verbal hallucinations in schizophrenia patient and healthy populations

BACKGROUND: Auditory verbal hallucinations (AVH) are a cardinal feature of schizophrenia, but they can also appear in otherwise healthy individuals. Imaging studies implicate language networks in the generation of AVH; however, it remains unclear if alterations reflect biologic substrates of AVH, irrespective of diagnostic status, age, or illness-related factors. We applied multimodal imaging to identify AVH-specific pathology, evidenced by overlapping gray or white matter deficits between schizophrenia patients and healthy voice-hearers. METHODS: Diffusion-weighted and T1-weighted magnetic resonance images were acquired in 35 schizophrenia patients with AVH (SCZ-AVH), 32 healthy voice-hearers (H-AVH), and 40 age- and sex-matched controls without AVH. White matter fractional anisotropy (FA) and gray matter thickness (GMT) were computed for each region comprising ICBM-DTI and Desikan-Killiany atlases, respectively. Regions were tested for significant alterations affecting both SCZ-AVH and H-AVH groups, relative to controls. RESULTS: Compared with controls, the SCZ-AVH showed widespread FA and GMT reductions; but no significant differences emerged between H-AVH and control groups. While no overlapping pathology appeared in the overall study groups, younger (<40 years) H-AVH and SCZ-AVH subjects displayed overlapping FA deficits across four regions (p < 0.05): the genu and splenium of the corpus callosum, as well as the anterior limbs of the internal capsule. Analyzing these regions with free-water imaging ascribed overlapping FA abnormalities to tissue-specific anisotropy changes. CONCLUSIONS: We identified white matter pathology associated with the presence of AVH, independent of diagnostic status. However, commonalities were constrained to younger and more homogenous groups, after reducing pathologic variance associated with advancing age and chronicity effects

Paradoxical relationship between proton pump inhibitors and COVID-19: A systematic review and meta-analysis

BACKGROUND The proton pump inhibitors (PPIs), used to reduce gastric acid secretion, represent one of the most widely used pharmaceutical classes in the world. Their consumption as a risk factor for the evolution of severe forms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been investigated patients. These risks also appear to be linked to the duration and the dosage. On the other hand, several studies have emerged with regard to the protective or therapeutic effects of these drugs. More and more evidence underlines the immunomodulatory and anti-fibrotic role of PPIs. In addition, their ability to alkalize the contents of endosomes and lysosomes serves as an obstacle to the entry of the virus into the host cells.AIMTo identify studies on the relationship between the intake of PPIs and coronavirus disease 2019 (COVID-19) in patients affected by SARS-CoV-2 infection, with the main objective of evaluating the outcomes related to severity and mortality. METHODS A literature review was performed in November 2020. The MEDLINE/PubMed, Cochrane Library, EMBASE and Google Scholar databases were searched for all relevant articles published in English on this topic. The search terms were identified by means of controlled vocabularies, such as the National Library of Medicine’s MESH (Medical Subject Headings) and keywords. The MESH terms and keywords used were as follows: “COVID-19”, “proton pump inhibitors”, ”PPIs”, “SARS-CoV-2”, “outcomes”, “severity” and “mortality”. The inclusion criteria regarding the studies considered in our analysis were: meta-analysis, casecontrol, hospital-based case-control, population-based case-control, retrospective studies, online survey, as well as cohort-studies, while articles not published as full reports, such as conference abstracts, case reports and editorials were excluded. We tried to summarize and pool all the data if available. RESULTS A total of 9 studies were found that described the use of PPIs, of which only 5 clearly reported the severity and mortality data in SARS-CoV-2 patients. Our pooled incidence analysis of severe events did not differ between patients with and without PPIs (odds ratio 1.65, 95% confidence interval: 0.62-4.35) (P = 0.314), or for mortality (odds ratio 1.77, 95% confidence interval: 0.62-5.03) (P = 0.286). CONCLUSION Detailed and larger case studies are needed to accurately understand the role of PPIs in this viral infection

MutLα heterodimers modify the molecular phenotype of Friedreich ataxia

This article has been made available through the Brunel Open Access Publishing Fund.Background: Friedreich ataxia (FRDA), the most common autosomal recessive ataxia disorder, is caused by a dynamic GAA repeat expansion mutation within intron 1 of FXN gene, resulting in down-regulation of frataxin expression. Studies of cell and mouse models have revealed a role for the mismatch repair (MMR) MutS-heterodimer complexes and the PMS2 component of the MutLα complex in the dynamics of intergenerational and somatic GAA repeat expansions: MSH2, MSH3 and MSH6 promote GAA repeat expansions, while PMS2 inhibits GAA repeat expansions. Methodology/Principal Findings: To determine the potential role of the other component of the MutLα complex, MLH1, in GAA repeat instability in FRDA, we have analyzed intergenerational and somatic GAA repeat expansions from FXN transgenic mice that have been crossed with Mlh1 deficient mice. We find that loss of Mlh1 activity reduces both intergenerational and somatic GAA repeat expansions. However, we also find that loss of either Mlh1 or Pms2 reduces FXN transcription, suggesting different mechanisms of action for Mlh1 and Pms2 on GAA repeat expansion dynamics and regulation of FXN transcription. Conclusions/Significance: Both MutLα components, PMS2 and MLH1, have now been shown to modify the molecular phenotype of FRDA. We propose that upregulation of MLH1 or PMS2 could be potential FRDA therapeutic approaches to increase FXN transcription. © 2014 Ezzatizadeh et al.This article has been made available through the Brunel Open Access Publishing Fund

Expressão de DNA metiltransferases em blastocistos bovinos produzidos in vivo e in vitro.

Nos mamiferos, a metilação do DNA é essencial na regulação da expressão gênica e na diferenciação celular. Uma proporção elevada de embriões produzidos por transferência nuclear (TN) é incapaz de estabelecer e sustentar a gestação a termo. Há grande consenso que alterações epigenéticas, primariamente causadas por alterações nos padrões de metilação do DNA, resultam em expressão gênica anormal em embriões e fetos clonados, tomando os indices de sucesso da clonagem frustrantes. Este trabalho objetivou analisar os padrões de expressão das DNA metiltransferases (DNMT) I, 3A e 3B em blastocistos bovinos produzidos in vivo (grupo IV) ou in vilro por FIV (grupo FlV) e transferência nuclear a partir de fibroblastos submetidos à privação de soro fetal bovino (SFB) durante o cultivo (grupo TN-S), ou cultivados até a confluência (grupo TN-C). Uma vez que a linhagem celular doadora de núcleo era proveniente de uma fêmea, os blastocistos dos grupos IV e FIV foram sexados por PCR e somente aqueles do sexo feminino foram utilizados nas etapas posteriores. Após remoção da zona pelucida em PBS pH 2,5, os blastocistos foram individualmente submetidos a um ciclo de amplificação linear do RNA mensageiro utilizando o "Superscript RNA amplification system" (L-l 016, Invitrogen). A transcrição reversa de volume correspondente a I/IOdo RNA de um embrião foi realizada com 6,75JlM de hexâmeros randômicos e transcriptase reversa (Improm-lI Reverse Transcriptase, Promega) seguindo instruções do fabricante. Os ensaios de quantificação relativa dos transcritos dos genes DNMTI, DNMT3A e DNMT3B foram realizados por PCR em tempo real com sistema de detecção TaqMan* (Applied Biosystems); utilizando o gliceraldeido-3-fosfato-desidrogenase (GAPDH) como controle endógeno. Foram utilizados oito embriões por grupo, amplificados em quadruplicata. A eficiência média das amplificações por PCR foi estimada para cada gene utilizando-se uma regressão linear do logaritmo da tluorescência a cada ciclo (Ramakers et aI., Neurosci. Lett., 339:62, 2003); e as razões de expressão calculadas de acordo com metodologia descrita por Livak e Schmittgen (Methods, 25:402, 2001). Para verificar as diferenças significativas foi utilizado o "Pair wise fixed reallocation randomization tes(' (Pfaffi et ai., Nucleic Acids Res., 30:e36. 2002). Todas as razões de expressão foram normalizadas pelo GAPDH e calibradas em função do grupo IV. Não foram detectados transcritos da DNMTI nos blastocistos do grupo TN-S, em contra partida. não se verificaram diferenças estatisticas (P>0,05) entre as razões de expressão dos grupos FIV (0,95) e TN-C (0,77). comparados ao grupo IV. Os grupos de transferência nuclear (TN-C e TN-S) apresentaram razões de expressão numericamente superiores para a DNMT3A (1,89 e 1,99; respectivamente) e para a DNMT3B (1,31 e 2,08; respectivamente) quando comparados aos grupos fertilizados (IV e FIV: 1,00 e 1,50 para DNMT3A; e 1,00 e 1,29 para DNMT3B; respectivamente). no entanto, sem diferenças significativas (P>0,05). A ausência de expressão da DNMTI no grupo TN com fibroblastos submetidos à privação de SFB nos leva a sugerir que embriões clonados a partir deste protocolo sejam menos viáveis do que aqueles oril,lndos de fibroblastos cultivados até confluência. A falta de DNMTl compromete a metilação do DNA a cada ciclo celular e toma os embriões inaptos a manterem as marcações epigcnéticas após cada mitose e sustentar o desenvolvimento fetal

Efeito do protocolo de sincronização celular na produção de clones bovinos.

Os métodos de sincronização da célula doadora de núcleo para uso em clonagem baseiam-se no bloqueio reverslvel do ciclo celular em pontos especlficos. Idealmente, espera-se que esse bloqueio não provoque prejulzo à viabilidade do embrião reconstituldo após a transferência de núcleo. Este trabalho teve por objetivo avaliar a eficiência do processo de clonagem (taxa de eletrofusão, produção de blastocistos e estabelecimento de prenhez) a partir de dois protocolos de sincronização celular: privação de soro fetal bovino (SFB) ou cultivo celular até confluência. Oócitos bovinos foram recuperados por aspiração folicular postmortem e maturados in vitro (MIV) por 18h em TCM-199 suplementado com 10% de SFB, 1 ug/mL FSH, 50ug/ mL hCG, 1 ug/mL estradiol, 0,2mM piruvato de sódio e 83,4~g/mL amicacina em atmosfera úmida de 5% de CO2 em ar a 38,5°C. Oócitos apresentando extrusão do primeiro corpúsculo polar foram selecionados, corados com 10ug/mL de Hoechst 33342 e enucleados em fluido sintético de oviduto (SOF) tamponado com HEPES, suplementado com 10% de SFB e 7,5ug/mL de citocalasina B. A reconstituição oocitâria foi realizada com dois grupos de fibroblastos bovinos: Grupo A - cultivados sob privação de SFB por 3 a 5 dias (Dulbecco's Modified Eagle Medium -DMEM suplementado com 0,5% de SFB); ou Grupo B -cultivados até confluência (DMEM suplementado com 10% de SFB). Conjuntos citoplasto+fibroblasto foram eletrofundidos em solução de manitol 0,28M, com dois pulsos de corrente direta de 2,OKv/cm e duração de 20s cada. A ativação foi realizada por exposição à ionomicina (5 minutos, 5~M) seguida de incubação em SOF suplementado com 20mM cloreto de estrôncio e .\ O~g/mL de citocalasina B por 6 horas. Os provâveis zigotos foram co-cultivados com células da granulosa em SOF suplementado com 2,5% de SFB e 0,5% de BSA em atmosfera úmida de 5% de CO2 em ar a 38,5°C por 7 dias. Alguns blastocistos de cada grupo foram transferidos para fêmeas receptoras previamente sincronizadas. As taxas de eletrofusão e produção de blastocistos dos dois grupos foram submetidas à ANOVA, com nlvel de significância de 5%. Houve diferença signiticativaentre os grupos A e B quanto às taxas de eletrofusão: 3,66o/a:!:137,% (549 fundido sem 1631 reconstituidos) contra 40,07% % 11,95% (696 fundidos em 1737 reconstituidos), respectivamente; e quanto ao desenvolvimento até blastocisto: 20,58% % 13,84% (113 blastocistos em 549) contra 34,77o/a:!:1 0,47% (242 blastocistos em 696), respectivamente. Tais diferenças proporcionaram produção média de 5,65 e 12,74 blastocistos por sessão de micromanipulação nos grupos A e B, respectivamente. No grupo A não foram diagnosticadas prenhezes aos 30 dias em 25 receptoras inovuladas; no grupo B foram diagnosticadas 4 gestações a partir de II inovulações (36,4%). Embora a privação de SFB permita o desenvolvimento a termo de clones bovinos (Campbell et al., Nature, 380:64, 1996), existem relatos de maior fragmentação de DNA após utilização da privação (Gibbons et aI., Biol Reprod, 66:895, 2002). Ainda, as menores taxas de eletrofusão, produção de blastocistos e estabelecimento de prenhez observadas no grupo A em comparação ao B, indicam que o uso de fibrob'astos submetidos à privação de SFB não é justiticâvel para o procedimento de clonagem em bovinos

Parametrization of the Davis Growth Model using data of crossbred Zebu cattle.

The system of differential equations proposed by Oltjen et al. [1986, named Davis Growth Model (DGM)] to represent cattle growth has been parameterized with data from Bos taurus (British) and Bos indicus (Nellore) breeds. The DGM has been successfully used for simulation and decision support in the United States. However, the effect of about 30 years of genetic improvement and the use of different breeds may affect the model parameter values, which also may need to be re-estimated for crossbred animals. The aim of this study was to estimate parameter values and confidence intervals for the DGM with growth and body composition data from Zebu crossbred animals. Confidence intervals and asymptotic distribution were generated through nonparametric bootstrap with data from a field experiment conducted in Brazil. The parameters showed normal probability distribution for most scenarios. The rate constant for deoxyribonucleic acid (DNA) synthesis had a minimum increase of 156 % and the maximum of 389 %, compared to the original values and the maintenance requirement had a minimum increase of 126 % and maximum of 160 % compared to the original values. Lower limits of 95 % confidence intervals for the parameters related to maintenance and protein accretion rates were higher than the original estimates of the DGM, evidencing genetic differences of the Zebu crossbred animals in relation to the original DGM parameters

BeefTader (part I): optimal economical endpoint identification using mixed modeling approach decreases greenhouse gases emission and other pollutants for livestock farmers.

The current study is the first from three sequential abstracts based on BeefTrader DSS to maximize profitability of farmers and the meat industry.Coordenador: Roberto Giolo de Almeida. II SIGEE

BeefTrader (part II): optimal economical endpoint identification using nonparametric bootstrapping technique decreases greenhouse gases emission and other pollutants in feedlots.

The current study is the second from three sequential abstracts based on BeefTrader DSS to maximize profitability of farmers and the meat industry.Coordenador: Roberto Giolo de Almeida. II SIGEE

BeefTrader (part III): meat industry opportunity to improve its profitability reducing greenhouse gases emission and pollutants based on optimal economical endpoint identification.

The aim of this study was evaluate the economic and environmental benefits to meat packers based on OEE individual identification.Coordenador: Roberto Giolo de Almeida. II SIGEE