Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The effects of co-exposure of graphene oxide and copper under different pH conditions in Manila clam Ruditapes philippinarum

Carbon nanomaterials (CNM), such as graphene oxide (GO), have been the focus of study in several areas of science mostly due to their physical-chemical properties. However, data concerning the potential toxic effects of these CNM in bivalves are still scarce. When present in the aquatic systems, the combination with other contaminants, as well as pH environmental variations, can influence the behavior of these nanomaterials and, consequently, their toxicity. Thus, the main goal of this study was to evaluate the effect of exposure of clam Ruditapes philippinarum to GO when acting alone and in the combination with copper (Cu), under two pH levels (control 7.8 and 7.3). A 28-day exposure was performed and metabolism and oxidative stress-related parameters were evaluated. The effects caused by GO and Cu exposures, either isolated or co-exposed, showed a direct and dependent relationship with the pH in which the organisms were exposed. In clams maintained at control pH (7.8), Cu and GO + Cu treatments showed lower lipid peroxidation (LPO) and lower electron transport system (ETS) activity, respectively. In clams maintained at low pH, glutathione-S-transferases (GSTs) activities were increased in Cu and Cu + GO treatments, whereas reduced glutathione (GSH) levels were increased in Cu treatment and ETS activity was higher in GO + Cu. Thus, it can be observed that clams responses to Cu and GO were strongly modulated by pH in terms of their defense system and energy production, although this does not result into higher LPO levels.publishe

Biopersistence of PEGylated Carbon Nanotubes Promotes a Delayed Antioxidant Response after Infusion into the Rat Hippocampus.

Carbon nanotubes are promising nanomaterials for the diagnosis and treatment of brain disorders. However, the ability of these nanomaterials to cross cell membranes and interact with neural cells brings the need for the assessment of their potential adverse effects on the nervous system. This study aimed to investigate the biopersistence of single-walled carbon nanotubes functionalized with polyethylene glycol (SWCNT-PEG) directly infused into the rat hippocampus. Contextual fear conditioning, Y-maze and open field tasks were performed to evaluate the effects of SWCNT-PEG on memory and locomotor activity. The effects of SWCNT-PEG on oxidative stress and morphology of the hippocampus were assessed 1 and 7 days after infusion of the dispersions at 0.5, 1.0 and 2.1 mg/mL. Raman analysis of the hippocampal homogenates indicates the biopersistence of SWCNT-PEG in the hippocampus 7 days post-injection. The infusion of the dispersions had no effect on the acquisition or persistence of the contextual fear memory; likewise, the spatial recognition memory and locomotor activity were not affected by SWCNT-PEG. Histological examination revealed no remarkable morphological alterations after nanomaterial exposure. One day after the infusion, SWCNT-PEG dispersions at 0.5 and 1.0 mg/mL were able to decrease total antioxidant capacity without modifying the levels of reactive oxygen species or lipid hydroperoxides in the hippocampus. Moreover, SWCNT-PEG dispersions at all concentrations induced antioxidant defenses and reduced reactive oxygen species production in the hippocampus at 7 days post-injection. In this work, we found a time-dependent change in antioxidant defenses after the exposure to SWCNT-PEG. We hypothesized that the persistence of the nanomaterial in the tissue can induce an antioxidant response that might have provided resistance to an initial insult. Such antioxidant delayed response may constitute an adaptive response to the biopersistence of SWCNT-PEG in the hippocampus

Enhanced Mechanical Stability of Gold Nanotips through Carbon Nanocone Encapsulation

Gold is a noble metal that, in comparison with silver and copper, has the advantage of corrosion resistance. Despite its high conductivity, chemical stability and biocompatibility, gold exhibits high plasticity, which limits its applications in some nanodevices. Here, we report an experimental and theoretical study on how to attain enhanced mechanical stability of gold nanotips. The gold tips were fabricated by chemical etching and further encapsulated with carbon nanocones via nanomanipulation. Atomic force microscopy experiments were carried out to test their mechanical stability. Molecular dynamics simulations show that the encapsulated nanocone changes the strain release mechanisms at the nanoscale by blocking gold atomic sliding, redistributing the strain along the whole nanostructure. The carbon nanocones are conducting and can induce magnetism, thus opening new avenues on the exploitation of transport, mechanical and magnetic properties of gold covered by sp(2) carbon at the nanoscale.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Effect of SWCNT-PEG dispersions on lipid peroxidation (LPO) in the hippocampus (A) 1 and (B) 7 days after infusion.

<p>Values are expressed as the mean ± SEM, n = 4–6. No significant difference in LPO levels was observed between the groups (<i>p</i>>0.05).</p

Effect of SWCNT-PEG dispersions on (A) acquisition and (B) persistence of contextual fear memory.

<p>Schematics of the procedures used in the experiments are presented above the graphs. Values are expressed as the mean ± SEM, n = 10–12. No significant difference in time spent in freezing was observed between the groups (<i>p</i>>0.05).</p

Raman spectroscopy of rat hippocampal homogenates 1 and 7 days after SWCNT-PEG dispersions infusion.

<p>(A) Raman spectrum acquired from SWCNT-PEG dispersion at 2.1 mg/mL. (B) Detection curve of SWCNT-PEG based on radial breath mode (RBM). Raman spectra in hippocampal homogenates (C) 1 and (D) 7 days after infusion. Dotted squares indicate the RBM region. Ct+: positive control; Ct-: negative control.</p

Effect of SWCNT-PEG on the number of crossings in open field task.

<p>Values expressed as the mean ± SEM (n = 6). Animals tested at 30 min were subjected to another test-session at 1 day. No significant differences were observed between the groups (<i>p</i>>0.05).</p><p>Effect of SWCNT-PEG on the number of crossings in open field task.</p