Critical assessment of restrictive socioeconomic measures taken during the SARS-CoV-2 pandemic and their impact on air quality worldwide

The ongoing global pandemic of the coronavirus disease 2019 has been a public health emergency of international concern. Countries have adopted several restriction measures. Because of this fateful moment, it was possible to assess the effect of anthropogenic activities on air pollutants in an unprecedented way. This work aims to outline changes in the air quality levels of several cities worldwide after the COVID-19 pandemic. Data on the criteria pollutants found in these cities before and during the pandemic were used to evaluate air quality performance. The collection of most of the data was possible thanks to the constant monitoring methods applied in some countries. The severe limitation of people’s movements significantly reduced pollutants concentration, mainly due to the traffic of vehicles. Carbon monoxide, sulfur dioxide, nitrogen dioxide, particulate matter 2.5 μm, and particulate matter 10 μm (CO, SO2, NO2, PM2.5, and PM10) concentration reductions were observed due to more restrictive or flexible lockdowns. In almost all cities evaluated, WHO’s air quality guidelines have been achieved, except for tropospheric ozone, which has been increasing with the reduction of nitric oxides (NOx) emissions. The increment in the concentrations of the pollutants immediately after the end of the restrictions is an indication that control strategies must be implemented to improve air quality.A pandemia global em curso da doença de coronavírus 2019 tem sido uma emergência de saúde pública de interesse internacional. Os países adotaram várias medidas de restrição. Este momento fatídico permitiu avaliar o efeito das atividades antrópicas sobre os poluentes atmosféricos de forma inédita. Este trabalho tem como objetivo apresentar a variação dos níveis de qualidade do ar de várias cidades do mundo após a chegada da pandemia do COVID-19. Critérios de dados de poluentes dessas cidades antes da pandemia e durante seu curso foram adotados para avaliar o desempenho da qualidade do ar. A coleta da maioria dos dados foi possível graças aos métodos de monitoramento constante aplicados em alguns países. A severa limitação dos movimentos das pessoas reduziu significativamente a concentração de poluentes, principalmente em razão do tráfego de veículos. As reduções das concentrações de CO, SO2, NO2, MP2,5 e MP10 foram observadas pelo bloqueio mais restritivo ou flexível. Em quase todas as cidades avaliadas, as diretrizes de qualidade do ar da Organização Mundial da Saúde foram alcançadas, exceto para os níveis de ozônio troposférico, que vêm aumentando com a redução das emissões de NOx. O incremento nas concentrações dos poluentes imediatamente após o fim das restrições é um indicativo de que estratégias de controle devem ser implementadas para melhorar a qualidade do ar

Bipartite medial cuneiform: a potential cause of midfoot pain - case report

Bipartite medial cuneiform is a rare variant of the tarsal bones. The condition can be a potential source for non-traumatic midfoot pain and a possible misdiagnosis cause of several foot disorders, such as the anterior and posterior tibialis tendon disorder. We present the case of a patient with midfoot pain with signs and symptoms suggestive of tibialis anterior tendinopathy. Imaging tests, however, elucidated a bipartite medial cuneiform. The conservative treatment using a removable boot for six weeks effectively relieved symptoms, temporarily promoting pain and limp-free gait, but symptoms relapsed were observed at the last visit

Luminescence imaging and toxicity assessment of graphene quantum dots using in vitro models

Graphene quantum dots (GQDs) have been of high interest due to their size and optical characteristics, which improves when functional groups are added to their borders and defects. In this work, the in vitro toxicity of aqueous dispersion of GQDs (w/wo amino-functionalization) was investigated in two different cellular models (S. cerevisiae and H9c2 cell line). Results in yeast suggest that when at up to 25 % volume concentration, the effect of all tested GQDs was only inhibitory, and, in both cellular models, the toxic effect is rigorously dose-dependent. The comparison of IC50 values of all the tested GQDs reveals no significant variations among them, pointing to non-carbonized citric acid as the more toxic precursor. The obtained data suggest that functionalization makes GQDs less toxic, being the one functionalized with thioacetamide slightly more toxic, followed by the ones functionalized with thiourea and glutathione, respectively. Results confirm that their toxicity is characteristics as a whole, and not as the sum of the toxicity of the precursors. In both models, concentrations up to 2 % showed no significant toxicity. Finally, fluorescence microscopy images suggest that GQDs interact with the cellular membrane and enter in the cell, manifesting fluorescent properties

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine