Manual blood exchange transfusion does not significantly contribute to parasite clearance in artesunate-treated individuals with imported severe Plasmodium falciparum malaria

Background: Exchange transfusion (ET) has remained a controversial adjunct therapy for the treatment of severe malaria. In order to assess the relative contribution of ET to parasite clearance in severe malaria, all patients receiving ET as an adjunct treatment to parenteral quinine or to artesunate were compared with patients treated with parenteral treatment with quinine or artesunate but who did not receive ET. ET was executed using a standardized manual isovolumetric exchange protocol. Methods. All patients in the Rotterdam Malaria Cohort treated for severe P. falciparum malaria at the Institute for Tropical Diseases of the Harbour Hospital between 1999 and 2011 were included in this retrospective follow-up study. Both a two-stage approach and a log-linear mixed model approach were used to estimate parasite clearance times

EDTA assisted phytorremediation of a Pb contamined soil: metal leaching and uptake by jack beans Lixiviação e absorção de Pb pelo feijão-de-porco assistido pela aplicação de EDTA no solo

Lead (Pb) is one of the main soil contaminants. It is also of difficult phytoremediation due to its low solubility and high retention on soil particles. EDTA application to soil is a strategy to increase heavy metal phytoextraction, but such chelants usually cause phytotoxicity and metal leaching side effects. Therefore, these research work objectives were to evaluate the effects of single (0.5 g kg-1) and split (0.25 + 0.25 g kg-1) EDTA application on Pb uptake by jack beans (Canavalia ensiformis L.) as well as on Pb vertical movement in a Pb contaminated soil material. Two sets of experiments were carried out under greenhouse conditions: in the first one, plants were grown in 3L-pots filled with a Pb-contaminated soil to evaluate Pb uptake by plants; for the second experiment, PVC-columns (42 cm height) were used to evaluate soil Pb leaching: the upper half-column (20 cm) was filled up with Pb-contaminated soil (1800 mg kg-1) whereas the lower half-column (20 cm) was filled with clean soil. Ten 60 mm-rainfalls with a duration of five hours were simulated by dropping distilled water on the top of columns, and leachates were collected for chemical analysis. Plants did not show any visual Pb toxicity symptoms or reduction in dry matter yield. Nevertheless, Pb uptake by jack beans regarded as total plant Pb accumulation was higher in EDTA-treated plants. Vertical Pb movement was observed mostly for the single EDTA application. EDTA addition to the soil favor Pb-phytoextraction by jack beans and the split EDTA application decrease the metal leaching, indicating less risk of environmental contamination.<br>O chumbo (Pb) é um dos principais contaminantes de solo. Os processos de remediação são dificultados devido à alta retenção do elemento às partículas do solo. A utilização do EDTA para aumentar a fitoextração dos metais do solo tem apresentado bons resultados. Contudo, os quelantes podem causar efeitos indesejáveis como a fitotoxidez e a lixiviação do metal. Nesse sentido, avaliou-se o efeito da aplicação única (0,5 g kg-1) e parcelada de EDTA (0,25 + 0,25 g kg-1) na absorção de Pb pelas plantas de feijão-de-porco (Canavalia ensiformis L.) e na movimentação vertical de Pb em solo contaminado, sob condições de casa de vegetação. Em um experimento, as plantas foram crescidas em vasos contendo 3 L de solo contaminado por Pb. No outro, utilizaram-se colunas de PVC com 42 cm de altura, preenchendo-se os primeiros 20 cm com solo contaminado com 1800 mg kg-1de Pb, seguido de outros 20 cm, com amostra de solo não contaminado. Nesse experimento, foram feitas dez lixiviações com água em volume equivalente a uma chuva de 60 mm cada. As plantas não apresentaram sintomas visuais de toxicidade de Pb, nem diferença na produção de massa seca do feijão em função dos tratamentos aplicados. No entanto, a absorção de Pb foi superior para as plantas que receberam EDTA. Houve movimentação vertical de Pb no solo, principalmente devido à aplicação única de EDTA. A adição de EDTA ao solo auxilia a fitoextração de Pb por plantas de feijão-de-porco e que o parcelamento do EDTA diminui a lixiviação do metal, mostrando se menos agressivo ao ambiente

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was$216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with$195 for low FiO2 leading to a −$11 (95$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was$1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this