a nationwide Portuguese consensus

Introduction and objectives: We aimed to build a national consensus to optimize the use of oral corticosteroids (OCS) in severe asthma in Portugal. Material and methods: A modified 3-round Delphi including 65 statements (topics on chronic systemic corticotherapy, therapeutic schemes, asthma safety and monitoring) was performed via online platform (October-November 2019). A five-point Likert-type scale was used (1-‘strongly disagree’; 5-‘strongly agree’). Consensus threshold was established as a percentage of agreement among participants ≥90% in the 1st round and ≥85% in the 2nd and 3rd rounds. The level of consensus achieved by the panel was discussed with the participants (face-to-face meeting). Results: Forty-eight expert physicians in severe asthma (specialists in allergology and pulmonology) participated in the study. Almost half of the statements (28/65; 43.1%) obtained positive consensus by the end of round one. By the end of the exercise, 12 (18.5%) statements did not achieve consensus. Overall, 87% of physicians agree that further actions for OCS cumulative risk assessment in acute asthma exacerbations are needed. The vast majority (91.7%) demonstrated a favorable perception for using biological agents whenever patients are eligible. Most participants (95.8%) are more willing to accept some degree of lung function deterioration compared to other outcomes (worsening of symptoms, quality of life) when reducing OCS dose. Monitoring patients’ comorbidities was rated as imperative by all experts. Conclusions: : These results can guide an update on asthma management in Portugal and should be supplemented by studies on therapy access, patients’ adherence, and costs.publishersversionpublishe

Portuguese translation and validation of the Braden Q scale for predicting pressure ulcer risk in pediatric patients

OBJECTIVE: To translate and culturally adapt the Braden Q scale into a Portuguese version and to test its properties (reliability and validity). METHODS: The Braden Q scale was translated and adapted according to internationally accepted methodology. The instrument was forward and back translated, and the translations were reviewed by a multidisciplinary committee. In the cultural adaptation process, three groups of ten nurses each interpreted the Brazilian version of the Braden Q scale until they fully understood the instrument. In order to evaluate the reliability of the Brazilian version, two other nurses administered the tool to pediatric ICU patients at different time points; the first nurse administered the instrument also in a second time. Statistical analysis was performed using Cronbach's α to evaluate the internal consistency of the scale, and the Spearman and intra-class correlation coefficients were calculated as a measure of reliability. RESULTS: There were no differences between scales translated by different translators during the forward and back translation process. All items of the scale culturally adapted by the 30 nurses were considered relevant. Cronbach's α for internal consistency was 0.936; intra-class correlation coefficient for intra-rater reliability was 0.995 and for inter-rater reliability was 0.998, both indicating high reliability. CONCLUSIONS: The Braden Q scale was successfully translated and adapted, and demonstrated validity and reliability.OBJETIVO: Traduzir para a língua portuguesa, adaptar ao contexto cultural brasileiro e testar as propriedades de medidas, reprodutibilidade e validade da escala de Braden Q. MÉTODOS: A escala de Braden Q foi traduzida e adaptada de acordo com metodologia aceita internacionalmente. Realizou-se tradução e tradução reversa do instrumento, intercaladas de revisões feitas por comitê multisciplinar. Na fase de adaptação cultural, três grupos de dez enfermeiras avaliaram a versão brasileira da escala de Braden Q até obter seu entendimento integral. Na validação da reprodutividade, outras duas enfermeiras aplicaram a versão brasileira em crianças internadas na UTI em tempos diferentes, sendo que a primeira enfermeira avaliou também em um segundo momento. Na análise estatística, para testar a consistência interna da escala, foi calculado o α de Crombach e, para testar a reprodutividade, o teste intraclasse e a correlação de Spearman. RESULTADOS: No processo de tradução e retrotradução, não houve diferença nas escalas feitas pelos diferentes tradutores. Na adaptação cultural realizada pelas 30 enfermeiras, todos os itens da escala foram considerados relevantes. A consistência interna testada pelo α de Crombach foi de 0,936; a correlação intraclasse da reprodutividade intraobservador foi de 0,995 e da reprodutividade interobservador foi de 0,998, ambas apontadas como excelentes. CONCLUSÕES: A escala de Braden Q foi traduzida e adaptada com sucesso, demonstrando ser válida e reprodutível.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL

Time course changes of oxidative stress markers in a rat experimental glaucoma model

PURPOSE. To evaluate the relationship between oxidative stress arkers and increased intraocular pressure in experimental laucoma. METHODS. In vivo chemiluminescence (CL), total antioxidant apacity (TRAP), nitrite concentration (NC), and lipid peroxidation arkers (TBARS) were evaluated. Wistar rats (n = 18 for ach time point) underwent operation, and two episcleral eins were cauterized. ESULTS. Decreases of 22%, 35%, and 27% at 7, 15, and 30 days nd an increase of 22% at 60 days in CL were observed in laucomatous eyes. In optic nerve, TBARS values were 6.9 ± 0.5 nmol/mg protein (7 days), 9.4 ± 0.4 nmol/mg protein (15 ays), 18.0 ±1.2 nmol/mg protein (30 days), and 43.1 ± 5.3 nmol/mg protein (60 days) (control, 6.2 ± 0.4 nmol/mg protein; P < 0.001). NC was 37.0 ± 1.8 μM (7 days), 31.4 ± 1.2 μM (15 days), 39.6 ± 1.3 μM (30 days), and 40.0 ± 1.3 μM (60 days) (control, 21.1 ± 1.7 μM; P < 0.001). In glaucomatous vitreous humor, TRAP decreased by 42% at 15 days and 78% at 60 days (control, 414 ± 29 μM; P < 0.001). In glaucomatous aqueous humor, TRAP values were 75 ± 7 μM (7 days), 54 ±4 μM (15 days), 25 ± 4 μM (30 days), and 50 ± 3 μM (60 days) (control, 90 ±10 μM; P < 0.001). CONCLUSIONS. Reactive species were increased in glaucoma, as evidenced by the increases in CL, TBARS, and NC. The decrease in the antioxidant levels may be a consequence of an increase in oxidative processes.Fil: Ferreira, Sandra María. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Química Analítica y Fisicoquímica. Cátedra de Química General e Inorgánica; ArgentinaFil: Fabián Lerner, S.. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Química Analítica y Fisicoquímica. Cátedra de Química General e Inorgánica; ArgentinaFil: Brunzini, Ricardo. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Química Analítica y Fisicoquímica. Cátedra de Química General e Inorgánica; ArgentinaFil: Reides, Claudia Gabriela. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Química Analítica y Fisicoquímica. Cátedra de Química General e Inorgánica; ArgentinaFil: Evelson, Pablo Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Bioquímica y Medicina Molecular. Universidad de Buenos Aires. Facultad Medicina. Instituto de Bioquímica y Medicina Molecular; ArgentinaFil: Llesuy, Susana Francisca. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Bioquímica y Medicina Molecular. Universidad de Buenos Aires. Facultad Medicina. Instituto de Bioquímica y Medicina Molecular; Argentin

Measurement of the 70Ge(n,γ) cross section up to 300 keV at the CERN n_TOF facility

Neutron capture data on intermediate mass nuclei are of key importance to nucleosynthesis in the weak component of the slow neutron capture processes, which occurs in massive stars. The (n,γ) cross section on 70Ge, which is mainly produced in the s process, was measured at the neutron time-of-flight facility n_TOF at CERN. Resonance capture kernels were determined up to 40 keV neutron energy and average cross sections up to 300 keV. Stellar cross sections were calculated from kT =5 keV tokT =100 keV and are in very good agreement with a previous measurement by Walter and Beer (1985) and recent evaluations. Average cross sectionsareinagreementwithWalterandBeer(1985)overmostoftheneutronenergyrangecovered,whilethey aresystematicallysmallerforneutronenergiesabove150keV.Wehavecalculatedisotopicabundancesproduced in s-process environments in a 25 solar mass star for two initial metallicities (below solar and close to solar). While the low metallicity model reproduces best the solar system germanium isotopic abundances, the close to solar model shows a good global match to solar system abundances in the range of mass numbers A=60–80.Austrian Science Fund J3503Adolf Messer Foundation ST/M006085/1European Research Council ERC2015-StGCroatian Science Foundation IP-2018-01-857

HCV Genotypes, Characterization of Mutations Conferring Drug Resistance to Protease Inhibitors, and Risk Factors among Blood Donors in São Paulo, Brazil

Background: Hepatitis C virus (HCV) infection is a global health problem estimated to affect almost 200 million people worldwide. the aim of this study is to analyze the subtypes and existence of variants resistant to protease inhibitors and their association with potential HCV risk factors among blood donors in Brazil.Methods: Repeat anti-HCV reactive blood donors are systematically asked to return for retest, notification, and counseling in which they are interviewed for risk factors for transfusion-transmitted diseases. We analyzed 202 donors who returned for counseling from 2007 to 2010 and presented enzyme immunoassay-and immunoblot-reactive results. the HCV genotypes and resistance mutation analyses were determined by the direct sequencing of the NS5b and NS3 regions, respectively. the HCV viral load was determined using an in-house real-time PCR assay targeting the 5'-NCR.Results: HCV subtypes 1b, 1a, and 3a were found in 45.5%, 32.0%, and 18.0% of the donors, respectively. the mean viral load of genotype 1 was significantly higher than that of the genotype 3 isolates. Subtype 1a was more frequent among young donors and 3a was more frequent among older donors. Protease inhibitor-resistant variants were detected in 12.8% of the sequenced samples belonging to genotype 1, and a higher frequency was observed among subtype 1a (20%) in comparison to 1b (8%). There was no difference in the prevalence of HCV risk factors among the genotypes or drug-resistant variants.Conclusions: We found a predominance of subtype 1b, with an increase in the frequency of subtype 1a, in young subjects. Mutations conferring resistance to NS3 inhibitors were frequent in treatment-naive blood donors, particularly those infected with subtype 1a. These variants were detected in the major viral population of HCV quasispecies, have replicative capacities comparable to nonresistant strains, and could be important for predicting the response to antiviral triple therapy.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundacao Pro-Sangue/Hemocentro de São PauloFundacao Prosangue Hemoctr São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, Infect Dis Div DIPA, São Paulo, BrazilUniv São Paulo, Fac Med, Discipline Med Sci, São Paulo, BrazilHCFMUSP, Dept Pathol, LIM Lab Medice Lab 03, São Paulo, BrazilUniv Sao Joao del Rei, Divinopolis, MG, BrazilUniv São Paulo, Fac Med, Dept Infect Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Infect Dis Div DIPA, São Paulo, BrazilWeb of Scienc

Novozym 435 : the “perfect” lipase immobilized biocatalyst?

Novozym 435 (N435) is a commercially available immobilized lipase produced by Novozymes. It is based on immobilization via interfacial activation of lipase B from Candida antarctica on a resin, Lewatit VP OC 1600. This resin is a macroporous support formed by polyIJmethyl methacrylate) crosslinked with divinylbenzene. N435 is perhaps the most widely used commercial biocatalyst in both academy and industry. Here, we review some of the success stories of N435 (in chemistry, energy and lipid manipulation), but we focus on some of the problems that the use of this biocatalyst may generate. Some of these problems are just based on the mechanism of immobilization (interfacial activation) that may facilitate enzyme desorption under certain conditions. Other problems are specific to the support: mechanical fragility, moderate hydrophilicity that permits the accumulation of hydrophilic compounds (e.g., water or glycerin) and the most critical one, support dissolution in some organic media. Finally, some solutions (N435 coating with silicone, enzyme physical or chemical crosslinking, and use of alternative supports) are proposed. However, the N435 history, even with these problems, may continue in the coming future due to its very good properties if some simpler alternative biocatalysts are not developed

Developing and testing accelerated partner therapy for partner notification for people with genital Chlamydia trachomatis diagnosed in primary care: a pilot randomised controlled trial

Background Accelerated partner therapy (APT) is a promising partner notification (PN) intervention in specialist sexual health clinic attenders. To address its applicability in primary care, we undertook a pilot randomised controlled trial (RCT) of two APT models in community settings. Methods Three-arm pilot RCT of two adjunct APT interventions: APTHotline (telephone assessment of partner(s) plus standard PN) and APTPharmacy (community pharmacist assessment of partner(s) plus routine PN), versus standard PN alone (patient referral). Index patients were women diagnosed with genital chlamydia in 12 general practices and three community contraception and sexual health (CASH) services in London and south coast of England, randomised between 1 September 2011 and 31 July 2013. Results 199 women described 339 male partners, of whom 313 were reported by the index as contactable. The proportions of contactable partners considered treated within 6 weeks of index diagnosis were APTHotline 39/111 (35%), APTPharmacy 46/100 (46%), standard patient referral 46/102 (45%). Among treated partners, 8/39 (21%) in APTHotline arm were treated via hotline and 14/46 (30%) in APTPharmacy arm were treated via pharmacy. Conclusions The two novel primary care APT models were acceptable, feasible, compliant with regulations and capable of achieving acceptable outcomes within a pilot RCT but intervention uptake was low. Although addition of these interventions to standard PN did not result in a difference between arms, overall PN uptake was higher than previously reported in similar settings, probably as a result of introducing a formal evaluation. Recruitment to an individually randomised trial proved challenging and full evaluation will likely require service-level randomisation

Finite-size correction scheme for supercell calculations in Dirac-point two-dimensional materials

Modern electronic structure calculations are predominantly implemented within the super cell representation in which unit cells are periodically arranged in space. Even in the case of non-crystalline materials, defect-embedded unit cells are commonly used to describe doped structures. However, this type of computation becomes prohibitively demanding when convergence rates are sufficiently slow and may require calculations with very large unit cells. Here we show that a hitherto unexplored feature displayed by several 2D materials may be used to achieve convergence in formation- A nd adsorption-energy calculations with relatively small unit-cell sizes. The generality of our method is illustrated with Density Functional Theory calculations for different 2D hosts doped with different impurities, all of which providing accuracy levels that would otherwise require enormously large unit cells. This approach provides an efficient route to calculating the physical properties of 2D systems in general but is particularly suitable for Dirac-point materials doped with impurities that break their sublattice symmetry

Emergence of winner-takes-all connectivity paths in random nanowire networks

Nanowire networks are promising memristive architectures for neuromorphic applications due to their connectivity and neurosynaptic-like behaviours. Here, we demonstrate a self-similar scaling of the conductance of networks and the junctions that comprise them. We show this behavior is an emergent property of any junction-dominated network. A particular class of junctions naturally leads to the emergence of conductance plateaus and a “winner-takes-all” conducting path that spans the entire network, and which we show corresponds to the lowest-energy connectivity path. The memory stored in the conductance state is distributed across the network but encoded in specific connectivity pathways, similar to that found in biological systems. These results are expected to have important implications for development of neuromorphic devices based on reservoir computing