Tuna-step: Tunable Parallelized Step Emulsification for the Generation of Droplets with Dynamic Volume Control to 3D Print Functionally Graded Porous Materials

We present Tuna-step, a novel microfluidic module based on step emulsification that allows for reliable generation of droplets of different sizes. Until now, sizes of droplets generated with step emulsification were hard-wired into the geometry of the step emulsification nozzle. To overcome this, we incorporate a thin membrane underneath the step nozzle that can be actuated by pressure, enabling the tuning of the nozzle size on-demand. By controllably reducing the height of the nozzle, we successfully achieved a three-order-of-magnitude variation in droplet volume without any adjustment of the flow rates of the two phases. We further enhanced our system by developing and applying a new hydrophilic surface modification, ensuring long-term stability and preventing swelling of the device when generating Oil-in-Water droplets. We used our system in the manufacturing of functionally graded soft materials with adjustable porosity and material content. By combining our microfluidic device with a custom 3D printer, we generated and extruded Oil-in-Water emulsions in an agarose gel bath, allowing for the creation of unique self-standing 3D hydrogel structures with porosity decoupled from flow rate and with composition gradients of external phases. We upscaled Tuna-step by setting 14 actuatable nozzles in parallel, offering a step-emulsification-based single chip solution that can accommodate various requirements in terms of throughput, droplet volumes, flow rates, and surface chemistry

Phylogenomic analysis of the species of the Mycobacterium tuberculosis complex demonstrates that Mycobacterium africanum, Mycobacterium bovis, Mycobacterium caprae, Mycobacterium microti and Mycobacterium pinnipedii are later heterotypic synonyms of Mycobacterium tuberculosis

International audienc

Avaliação do aprendizado via educação a distância:: a visão dos docentes da saúde

A educação a distância é uma modalidade de educação em franco crescimento, na qual o professor assume novos papéis que vão além de ministrar aulas expositivas, interagindo como tutor do conhecimento. Observando a importância do papel do professor nesse novo paradigma educacional, é necessário um profissional com um perfil diferenciado, pois nem sempre o professor do ensino presencial tem perfil para exercer as funções docentes em educação a distância. A partir desses dados, realizou-se essa pesquisa que tem como objetivos: evidenciar a posição dos docentes do ensino presencial da área da saúde sobre a metodologia de educação à distância; avaliar os pontos fortes e fracos da metodologia na opinião dos docentes da área da saúde; avaliar a percepção dos docentes em relação às vantagens e desvantagens da metodologia de educação a distância em relação ao ensino presencial. Foi realizada uma pesquisa com questionários semi-estruturados com um grupo de 30 professores da área da saúde de uma Instituição de Ensino Superior no município de Montes Claros, Minas Gerais. Com relação aos resultados obtidos, a maioria dos professores possuem receios em relação ao ensino a distância, no entanto mostraram interesse em estar inseridos no novo modelo de instrução

Altered two-dimensional strain measures of the right ventricle in patients with Brugada syndrome and arrhythmogenic right ventricular dysplasia/cardiomyopathy

Aims: Brugada syndrome (BrS) is an inherited channelopathy that can be characterized by mild right ventricular (RV) abnormalities that are not detectable with conventional echocardiography. The aim of this study was to evaluate the presence of RV abnormalities in BrS patients when compared with controls and a group of patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) using two-dimensional (2D) strain analysis. Methods and results: We enrolled 25 BrS, 15 ARVD/C patients, and 25 controls. Right and left ventricular dimension and systo-diastolic function were evaluated by conventional echocardiography. Longitudinal systolic strain (sS) peak, systolic and early diastolic strain rate of lateral RV segments were evaluated by 2D speckle tracking analysis. Left ventricle global and segmental strain measures were also evaluated. A reduced basal or mid-RV lateral sS were the parameters mostly associated with both BrS and ARVD/C. In BrS patients the minimum sS observed in these segments was significantly lower than that of controls (-28.9±3.2% vs. -32.3±3.2%, P: 0.002) but significantly greater than that evaluated in ARVD/C patients (-24.6 ±6.7%, P < 0.001 both vs. BrS and controls). No differences were found between the BrS and the control group when left ventricular strain measures were analysed. Conclusion: By 2D strain technique it is possible to observe mild abnormalities in RV systolic and diastolic function of BrS patients that are less pronounced than those observed in ARVD/C patients. These results help to better define the phenotypic characteristics of BrS patients and represent the basis for future studies aimed at testing their clinical usefulness in BrS patients

Design and synthesis of phosphonoacetic acid (PPA) ester and amide bioisosters of ribofuranosylnucleoside diphosphates as potential ribonucleotide reductase inhibitors and evaluation of their enzyme inhibitory, cytostatic and antiviral activity.

Continuing our investigations on inhibitors of ribonucleotide reductase (RNR), the crucial enzyme that catalyses the reduction of ribonu-cleotides to deoxyribonucleotides, we have now prepared and evaluated 5′-phosphonoacetic acid, amide and ester analogues of adenosine, uridine and cytidine with the aim to verify both substrate specificity and contribution to biological activity of diphosphate mimic moieties. A molecular modelling study has been conducted on the RNR R1 subunit, in order to verify the possible interaction of the proposed bioisosteric moieties. The study compounds were finally tested on the recombinant murine RNR showing a degree of inhibition that ranged from 350 μM for the UDP analogue 5′-deoxy-5′- N-(phosphon-acetyl)uridine sodium salt (amide) to 600 μM for the CDP analogue 5′- O-[(diethyl-phosphon)acetyl]cytidine (ester). None of the tested compounds displayed noteworthy cytostatic activity at 100–500 μM concentrations, whereas ADP analogue 5′- N-[(diethyl-phosphon) acetyl]adenosine (amide) and 5′-deoxy-5′- N-(phos-phon-acetyl)adenosine sodium salt (amide) showed a moderate inhibitory activity (EC50: 48 μM) against HSV-2 and a modest inhibitory activity (EC50: 110 μM) against HIV-1, respectively

Developing an infrastructure for secure patient summary exchange in the EU context: Lessons learned from the KONFIDO project:

Background: The increase of healthcare digitalization comes along with potential information security risks. Thus, the EU H2020 KONFIDO project aimed to provide a toolkit supporting secure cross-border health data exchange. Methods: KONFIDO focused on the so-called "User Goals", while also identifying barriers and facilitators regarding eHealth acceptance. Key user scenarios were elaborated both in terms of threat analysis and legal challenges. Moreover, KONFIDO developed a toolkit aiming to enhance the security of OpenNCP, the reference implementation framework. Results: The main project outcomes are highlighted and the "Lessons Learned," the technical challenges and the EU context are detailed. Conclusions: The main "Lessons Learned" are summarized and a set of recommendations is provided, presenting the position of the KONFIDO consortium toward a robust EU-wide health data exchange infrastructure. To this end, the lack of infrastructure and technical capacity is highlighted, legal and policy challenges are identified and the need to focus on usability and semantic interoperability is emphasized. Regarding technical issues, an emphasis on transparent and standards-based development processes is recommended, especially for landmark software projects. Finally, promoting mentality change and knowledge dissemination is also identified as key step toward the development of secure cross-border health data exchange services

Comprehensive user requirements engineering methodology for secure and interoperable health data exchange

Background: Increased digitalization of healthcare comes along with the cost of cybercrime proliferation. This results to patients' and healthcare providers' skepticism to adopt Health Information Technologies (HIT). In Europe, this shortcoming hampers efficient cross-border health data exchange, which requires a holistic, secure and interoperable framework. This study aimed to provide the foundations for designing a secure and interoperable toolkit for cross-border health data exchange within the European Union (EU), conducted in the scope of the KONFIDO project. Particularly, we present our user requirements engineering methodology and the obtained results, driving the technical design of the KONFIDO toolkit. Methods: Our methodology relied on four pillars: (a) a gap analysis study, reviewing a range of relevant projects/initiatives, technologies as well as cybersecurity strategies for HIT interoperability and cybersecurity; (b) the definition of user scenarios with major focus on cross-border health data exchange in the three pilot countries of the project; (c) a user requirements elicitation phase containing a threat analysis of the business processes entailed in the user scenarios, and (d) surveying and discussing with key stakeholders, aiming to validate the obtained outcomes and identify barriers and facilitators for HIT adoption linked with cybersecurity and interoperability. Results: According to the gap analysis outcomes, full adherence with information security standards is currently not universally met. Sustainability plans shall be defined for adapting existing/evolving frameworks to the state-of-the-art. Overall, lack of integration in a holistic security approach was clearly identified. For each user scenario, we concluded with a comprehensive workflow, highlighting challenges and open issues for their application in our pilot sites. The threat analysis resulted in a set of 30 user goals in total, documented in detail. Finally, indicative barriers of HIT acceptance include lack of awareness regarding HIT risks and legislations, lack of a security-oriented culture and management commitment, as well as usability constraints, while important facilitators concern the adoption of standards and current efforts for a common EU legislation framework. Conclusions: Our study provides important insights to address secure and interoperable health data exchange, while our methodological framework constitutes a paradigm for investigating diverse cybersecurity-related risks in the health sector