Synthesis and properties of silk fibroin/Konjac glucomannan blend beads

Silk fibroin (SF) and konjac glucomannan (KGM) are promising materials in the biomedical field due to their low toxicity, biocompatibility, biodegradability and low immune response. Beads of these natural polymers are interesting scaffolds for biomedical applications, but their fabrication is a challenge due to their low stability and the necessary adaptation of their chemical and mechanical properties to be successfully applied. In that sense, this study aimed to synthesize a blend of silk fibroin and konjac glucomannan (SF/KGM) in the form of porous beads obtained through dripping into liquid nitrogen, with a post-treatment using ethanol. Intermolecular hydrogen bonds promoted the integration of SF and KGM. Treated beads showed higher porous size, crystallinity, and stability than untreated beads. Characterization analyses by Fourier-transform infrared spectroscopy (FTIR), thermogravimetric (TGA), and X-ray diffraction (XDR) evidenced that ethanol treatment allows a conformational transition from silk I to silk II in SF and an increase in the KGM deacetylation. Those chemical changes significantly enhanced the mechanical resistance of SF/KGM beads in comparison to pure SF and KGM beads. Moreover, samples showed cytocompatibility with HaCaT and BALB/c 3T3 cell

Evaluation of obstructive sleep apnea in non-cystic fibrosis bronchiectasis: A crosssectional study

The relationship between sleep disorders and bronchiectasis has not been well described. We hypothesize that, due to the irreversible dilatation of the bronchi, the presence of secretions, and airflow obstruction, patients with non-cystic fibrosis bronchiectasis may be predisposed to hypoxemia during sleep, or to symptoms that may lead to arousal. A cross-sectional observational study was performed involving 49 patients with a clinical diagnosis of non-cystic fibrosis bronchiectasis (NCFB). All patients underwent clinical evaluation, spirometry, and polysomnography, and were evaluated for the presence of excessive daytime sleepiness (EDS) and risk of obstructive sleep apnea (OSA). The mean age of the participants was 50.3 +/- 13.6 years51.1% of patients were male and had a mean body mass index of 23.8 +/- 3.4 kg/m(2). The mean total sleep time (TST) was 325.15 +/- 64.22 min with a slight reduction in sleep efficiency (84.01 +/- 29.2%). Regarding sleep stages, stage 1 sleep and REM sleep were abnormal. OSA was present in 40.82% of the patients. The mean arousal index was 5.6 +/- 2.9/h and snoring was observed in 71.43% of the patients. The oxygen desaturation index (ODI) was 14.35 +/- 15.36/h, mean minimum oxygen saturation (SpO(2) nadir) was 83.29 +/- 7.99%, and mean TST with an SpO(2) less than 90% was 30.21 +/- 60.48 min. EDS was exhibited by 53.06% of the patients and 55.1% were at high risk of developing OSA. The patients infected by Pseudomonas aeruginosa had higher apnea-hypopnea indices, ODI, and TST with SpO(2) < 90%, and lower values of SpO(2) nadir. Adult patients with clinically stable NCFB, especially those infected by Pseudomonas aeruginosa, display EDS and a high prevalence of OSA, associated with considerable oxygen desaturation during sleep.Nove de Julho University (Sao Paulo, Brazil)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) [313053/2014-6]JJUEAPASSCAPESSanta Casa Sao Paulo Sch Med Sci, FCMSCSP, Masters Degree & PhD Program Surg Res, Sao Paulo, SP, BrazilNove de Julho Univ UNINOVE, Rehabil Sci Masters Degree & PhD Program, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Pulm Rehabil Ctr, UNIFESP, Sao Paulo, BrazilNatl Res Council Italy, Inst Biomed & Mol Immunol Alberto Monroy, Palermo, SI, ItalyUniv Ctr Anapolis UniEVANGELICA, Med Sch, Anapolis, Go, BrazilUniv Fed Sao Paulo, Pulm Rehabil Ctr, UNIFESP, Sao Paulo, BrazilCNPq: 313053/2014-6Web of Scienc

Augmentation mammoplasty and mastopexy with somersault flap from reverse abdominoplasty

Introduction: The breasts and abdomen undergo significant morphological changes with massive weight loss. Breast augmentation is one of the most commonly performed procedures in plastic surgery, unlike reverse abdominoplasty, which has been little described. However, in patients with upper abdominal flaccidity who want breast augmentation, breast augmentation through reverse abdominoplasty (AMBRA) makes it possible to improve the breasts and abdominal contour simultaneously. This work aims to describe a case of breast augmentation and mastopexy using a somersault flap from reverse abdominoplasty. Case Report: Female patient, brown, with a history of massive weight loss and previous mammoplasty and abdominoplasty, evolved with breast ptosis and lipodystrophy in the upper abdomen. She underwent reverse abdominoplasty using an epigastric dermofat flap for breast projection. The patient had a good postoperative evolution, with satisfactory surgical results. Discussion: Massive weight loss can result in deformities in the breasts and abdomen that require reparative surgery. Breast remodeling is arduous and may require the use of adjacent tissues. Abdominoplasty, in turn, is the most established technique for rejuvenating the trunk; however, when sagging mainly affects the upper abdomen, reverse abdominoplasty becomes an option. In cases where the desire for breast augmentation is associated with excess supraumbilical volume, AMBRA should be considered. Breast augmentation using reverse abdominoplasty proved to be a viable technique in this case, with a satisfactory final result

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Evaluation the influence of pH and ionic strength of hyaluronic acid and chitosan multilayer nanofilms assembled by layer-by-layer dipping for antibacterial applications

Orientador: Marisa Masumi BeppuTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia QuímicaResumo: A obtenção de superfícies antibacterianas que possam revestir diversos substratos, como alimentos, tecidos e dispositivos biomédicos é de grande relevância para evitar a sua contaminação por bactérias patogênicas. Nos últimos anos, estes revestimentos, principalmente à base de quitosana, têm sido desenvolvidos visando evitar infecções nosocomiais. A técnica de deposição layer-by-layer (LbL) é uma técnica simples e versátil que pode ser empregada na construção de tais revestimentos, principalmente a partir de interações eletrostáticas entre polieletrólitos de cargas opostas. Neste trabalho, nanofilmes de ácido hialurônico (HA) e quitosana (CHI), dois polímeros naturais biocompatíveis e biodegradáveis, foram construídos pela técnica de deposição LbL de imersão em diferentes condições de pH e força iônica (FI) visando a obtenção de superfícies resistentes à adesão e proliferação de duas bactérias patogênicas humanas importantes, sendo estas: Pseudomonas aeruginosa, gram-negativa, e Staphylococcus aureus, gram-positiva. Os resultados mostraram que a modificação dos parâmetros de construção, pH e FI, foi fundamental para a obtenção de nanofilmes com características distintas, como ângulo de contato, espessura, rugosidade e disponibilidade de grupos funcionais dos polieletrólitos. O efeito de inibição bacteriana dos nanofilmes de HA/CHI foi avaliado pelo método de plaqueamento de superfície e os resultados indicaram que o efeito de inibição do crescimento bacteriano está diretamente relacionado com a quantidade de grupos amino livres da CHI na superfície dos nanofilmes. A redução bacteriana foi mais efetiva contra S. aureus com diminuição de aproximadamente 3, 4 e 1,5 ciclos decimais em 4, 8 e 24 horas, respectivamente. Contra P. aeruginosa, os nanofilmes apresentaram uma redução bacteriana inferior a 1 ciclo decimal nos tempos avaliados. Portanto, o efeito de inibição bacteriana contra S. aureus até 24 horas sugere que os revestimentos de HA/CHI construídos pela técnica de deposição LbL podem proteger diversos substratos, como dispositivos biomédicos, os quais são suscetíveis a proliferação bacterianaAbstract: Fabrication of antibacterial surfaces available to coat several substrates, such as food, textiles, and biomedical devices is of great relevance to prevent contamination by bacteria. In recent years, particularly chitosan-based coatings have been developed to prevent nosocomial infections. The layer-by-layer deposition technique (LbL) is a simple and versatile technique that can be employed in the construction of those coatings mainly from electrostatic interactions between oppositely charged polyelectrolyte. In this work, nanofilms of hyaluronic acid (HA) and chitosan (CHI), two biocompatible and biodegradable natural polymers, were assembled by LbL using different conditions of pH and ionic strength (IS) in order to obtain resistant surfaces to avoid the adhesion and proliferation of two important human pathogenic bacteria: Pseudomonas aeruginosa and Staphylococcus aureus, gram-negative and gram-positive bacteria, respectively. The obtained results indicated that pH and IS were key synthesis variables for obtaining different features, such as wettability, thickness, roughness and the availability of functional groups in nanofilms. The antibacterial effect of HA/CHI nanofilms was evaluated by the spread plate method for both bacteria strains; the results showed that the microbial inhibition is directly related with the amount of free amino groups on the surface of CHI nanofilms. The antibacterial effect was more effective against S. aureus with a reduction of approximately 3, 4, and 1.5 log reduction for 4, 8 and 24 hours of culture time, respectively. In the case of P. aeruginosa, the nanofilms presented a lower bacterial reduction: 1 log reduction in times evaluated. In conclusion, the results of the antibacterial effect against S. aureus in 24 hours, suggest that the HA/CHI nanofilms assembled by LbL can protect several substrates, such as biomedical devices, against bacterial proliferationDoutoradoCiencia e Tecnologia de MateriaisDoutor em Engenharia Química0165/2012FAPEA