Classificação do atendimento pré-hospitalar pediátrico como instrumento para otimizar a alocação de recursos no atendimento do trauma na cidade de São Paulo, Brasil

PURPOSE: To evaluate the pediatric prehospital care in São Paulo, the databases from basic life support units (BLSU) and ALSU, and to propose a simple and effective method for evaluating trauma severity in children at the prehospital phase. METHODS: A single firemen headquarter coordinates all prehospital trauma care in São Paulo city. Two databases were analyzed for children from 0 to 18 years old between 1998 and 2001: one from the Basic Life Support Units (BLSU - firemen) and one from the Advanced Life Support Units (ALSU - doctor and firemen). During this period, advanced life support units provided medical reports from 604 victims, while firemen provided 12.761 reports (BLSU+ALSU). Pre-Hospital Pediatric Trauma Classification is based on physiological status, trauma mechanism and anatomic injuries suggesting high energy transfer. In order to evaluate the proposed classification, it was compared to the Glasgow Coma Score and to the Revised Trauma Score. RESULTS: There was a male predominance in both databases and the most common trauma mechanism was transport related, followed by falls. Mortality was 1.6% in basic life support units and 9.6% in ALSU. There was association among the proposed score, the Glasgow Coma Score and to the Revised Trauma Score (p<0.0001). CONCLUSION: Pre-Hospital Pediatric Trauma Classification is a simple and reliable method for assessment, triage and recruitment of pediatric trauma resources.OBJETIVO: Avaliar o atendimento pré-hospitalar de crianças e adolescentes em São Paulo, avaliar o banco de dados das Unidades de Suporte Básico (UR) e Avançado (USA) e propor um método simples e eficaz para a avaliação da gravidade do trauma pediátrico na fase pré-hospitalar. MÉTODOS: Uma única central do Corpo de Bombeiros (COBOM) coordena todo o atendimento pré-hospitalar em São Paulo. Dois bancos de dados foram analisados para crianças de 0 a 18 anos de idade, entre 1998 e 2001: um das Unidades de Suporte Básico de Vida (UR- bombeiros) e outra de Unidades de Suporte Avançado (USA - médico e bombeiros). Neste período, o Serviço de Atendimento Médico de Urgência do Estado de São Paulo (SAMU) forneceu relatórios médicos de 604 vítimas, enquanto os bombeiros forneceram relatórios de 12.761 vitimas (UR+USA). A classificação do trauma pré-hospitalar pediátrico é baseada na condição fisiológica, mecanismo de trauma e lesões anatômicas das vítimas. A classificação do trauma pré-hospitalar pediátrico foi comparada à Escala de Coma de Glasgow (GCS) e ao Escore de Trauma Revisado (RTS). RESULTADOS: Houve predominância do sexo masculino em ambos bancos de dados. O mecanismo de trauma mais freqüente foi relacionado a transporte, seguido de quedas. A mortalidade foi 1,6% nas Unidades Básicas e 9,6% no Suporte Avançado. Houve associação entre a classificação do trauma pré-hospitalar pediátrico, Escala de Coma de Glasgow (GCS) e ao Escore de Trauma Revisado (RTS) GCS e RTS (p<0,0001). CONCLUSÃO: A classificação do trauma pré-hospitalar pediátrico é um método simples e confiável para a avaliação, triagem e recrutamento de recursos para o atendimento pré-hospitalar do trauma pediátrico.Universidade Federal de São Paulo (UNIFESP) Department of SurgeryUNIFESP, Department of SurgerySciEL

Neuropathic Pain Phenotype Does Not Involve the NLRP3 Inflammasome and Its End Product Interleukin-1β in the Mice Spared Nerve Injury Model.

The NACHT, LRR and PYD domains-containing protein 3 (NLRP3) inflammasome is one of the main sources of interleukin-1β (IL-1β) and is involved in several inflammatory-related pathologies. To date, its relationship with pain has not been studied in depth. The aim of our study was to elucidate the role of NLRP3 inflammasome and IL-1β production on neuropathic pain. Results showed that basal pain sensitivity is unaltered in NLRP3-/- mice as well as responses to formalin test. Spared nerve injury (SNI) surgery induced the development of mechanical allodynia and thermal hyperalgesia in a similar way in both genotypes and did not modify mRNA levels of the NLRP3 inflammasome components in the spinal cord. Intrathecal lipopolysaccharide (LPS) injection increases apoptosis-associated speck like protein (ASC), caspase-1 and IL-1β expression in both wildtype and NLRP3-/- mice. Those data suggest that NLRP3 is not involved in neuropathic pain and also that other sources of IL-1β are implicated in neuroinflammatory responses induced by LPS

Evidence for a Common Mechanism of SIRT1 Regulation by Allosteric Activators

A molecule that treats multiple age-related diseases would have a major impact on global health and economics. The SIRT1 deacetylase has drawn attention in this regard as a target for drug design. Yet controversy exists around the mechanism of sirtuin-activating compounds (STACs). We found that specific hydrophobic motifs found in SIRT1 substrates such as PGC-1α and FOXO3a facilitate SIRT1 activation by STACs. A single amino acid in SIRT1, Glu[superscript 230], located in a structured N-terminal domain, was critical for activation by all previously reported STAC scaffolds and a new class of chemically distinct activators. In primary cells reconstituted with activation-defective SIRT1, the metabolic effects of STACs were blocked. Thus, SIRT1 can be directly activated through an allosteric mechanism common to chemically diverse STACs.Glenn Foundation for Medical ResearchEllison Medical FoundationJuvenile Diabetes Research Foundation InternationalUnited Mitochondrial Disease FoundationNational Institutes of Health (U.S.)National Institute of Allergy and Infectious Diseases (U.S.

Portfolio Vol. II N 2

Browne, Phil. Beaver ad Sawyer at Night . Picture. 2. Varney, Chester. To Dream Beyond . Prose. 3. West, Bill C. Admonition Poem. 6. West, Bill C. Insomnia Poem. 6. Barlow, Don. Heart Determines . Prose. 7. Gordon, Robert. From an Unknown Innocent to... Poem, 11. Black, James. Playing Around . Prose. 13. Parsons, Edith. The Turtle Baby . Picture. 14. Deeds, Ed. Raymond Scott - - Classic Swing . Prose. 15. Schrechkengost, Viktor. Black Sheep-The Creature God Forgot . Picture. 14. Smith, Bob. Review of New Recordings . Prose. 15. Saunders, Paul. Book Reviews and Comments . Prose. 16. Browne, Phil. to Patsy . Picture. 17. Sandor, Joseph. Meditation . Picture. 18. Maxwell, Kenneth. Unnamed. Poem. 18. Sweitzer, Harry J. Social Life at Denison . Prose. 19. Flory Doris. The Student Rationalizes . Poem. 20. Flory Doris. On Noisess . Poem. 20. Bethune, Don. Senior\u27s Lament . Poem. 20. Flory, Doris. Lines on Lines . Poem. 20. Beckham, Adela. My Man . Poem. 20

CGIAR GENDER Platform: Evaluation Report

The summative and formative evaluation of the GENDER (Generating Evidence and New Directions for Equitable Results) Platform assessed its progress from January 2020 to October 2022, to document lessons and best practices, to also provide forward-looking recommendations for the newly transitioned CGIAR GENDER Impact Platform. The evaluation was conducted between October 2022 – June 2023 by the external team, which was led by an evaluation expert and comprised of three subject matter experts to specifically address Evidence, Methods, and Alliances modules of the Platform. This evaluation employed theory-based, utilization-focused, participatory, and feminist approaches aligned with CGIAR’s Evaluation Framework and Policies. The Platform evaluation readiness was determined by an evaluability assessment jointly carried out by the GENDER platform team, with facilitation and quality assurance under IAES, following the CGIAR evaluability assessment guidelines. The presentation of approaches and methodology of the evaluation and its novelties was shared with the wider audiences at the 2023 gLOCAL event: How Evaluations Contribute to Addressing The Greater Societal Issues: Evaluation of the CGIAR GENDER Platform Additional detail on methodology is provided in the Annex. Seven key evaluation questions were framed along the five evaluation criteria: relevance, effectiveness, efficiency, coherence, and sustainability. Quality of Science evaluation criteria was integrated into the specific evaluation sub-questions of the Evidence module study, to pretest the evaluation guidelines CGIAR on evaluating QoR4D in process and performance evaluations. The evaluation used three kinds of triangulation: investigator triangulation, data triangulation, and methodological triangulation. Mixed methods were employed, including: online survey (119 respondents- see survey blog), key informant interviews (84 participants), and desk reviews on Platform indicator data, annual reports, module financial data, and other secondary documents. Executive summaries of three module reports are includes in the Annex, complementing the Platform-wide evidence and conclusions. Responding to the key stakeholder groups, the evaluation made 11 recommendations for: the GENDER Platform and CGIAR management. Complementing lessons from other platform evaluations of Excellence in Breeding Platform and Big Data in Agriculture, lessons learnt from this evaluation of the GENDER platform that would apply to new CGIAR impact platforms. Please read the evaluation report with stand-alone annexes, and Management Response to the evaluation. Stay tuned for other knowledge management products

Molecular Population Structure for Feral Swine in the United States

Feral swine (Sus scrofa) have invaded most of the United States and continue to expand throughout North America. Given the ecological and economic threats posed by increasing feral swine abundance, it is imperative to develop an understanding of their patterns of natural range expansion and human-mediated introductions. Towards this goal, we used molecular markers to elucidate the genetic structure of feral swine populations throughout the United States and evaluated the association between historical introductions and contemporary patterns of genetic organization. We used STRUCTURE and discriminant analysis of principal components (DAPC) to delineate genetic clusters for 959 individuals genotyped at 88 single nucleotide polymorphism loci. We identified 10 and 12 genetic clusters for the 2 clustering approaches, respectively. We observed strong agreement in clusters across approaches, with both describing clusters having strong geographic association at regional levels reflecting past introduction and range expansion patterns. In addition, we evaluated patterns of isolation by distance to test for and estimate spatial scaling of population structure within western, central, and eastern regions of North America. We found contrasting spatial patterns of genetic relatedness among regions, suggesting differences in the invasion process, likely as a result of regional variation in landscape heterogeneity and the influence of human mediated introductions. Our results indicate that molecular analyses of population genetic structure can provide reliable insights into the invasion processes of feral swine, thus providing a useful basis for management focused on minimizing continued range expansion by this problematic species

Shaping Neonatal Immunization by Tuning the Delivery of Synergistic Adjuvants via Nanocarriers

Adjuvanted nanocarrier-based vaccines hold substantial potential for applications in novel early-life immunization strategies. Here, via mouse and human age-specific in vitro modeling, we identified the combination of a small-molecule STING agonist (2′3′-cyclic GMP-AMP, cGAMP) and a TLR7/8 agonist (CL075) to drive the synergistic activation of neonatal dendritic cells and precision CD4 T-helper (Th) cell expansion via the IL-12/IFNγaxis. We further demonstrate that the vaccination of neonatal mice with quadrivalent influenza recombinant hemagglutinin (rHA) and an admixture of two polymersome (PS) nanocarriers separately encapsulating cGAMP (cGAMP-PS) and CL075 (CL075-PS) drove robust Th1 bias, high frequency of T follicular helper (TFH) cells, and germinal center (GC) B cells along with the IgG2c-skewed humoral response in vivo. Dual-loaded cGAMP/CL075-PSs did not outperform admixed cGAMP-PS and CL075-PS in vivo. These data validate an optimally designed adjuvantation system via age-selected small-molecule synergy and a multicomponent nanocarrier formulation as an effective approach to induce type 1 immune responses in early life

Race and gender-based perceptions of older septuagenarian adults

OBJECTIVES: Older adults face racism, sexism, and ageism. As the U.S. population ages, it is important to understand how the current population views older adults. METHODS: Participants recruited through Amazon\u27s Mechanical Turk provided perceptions of older Black and White models\u27 photographs. Using mixed-effect models, we assessed interactions between race and gender of participants and models. RESULTS: Among Participants of Color and White participants ( DISCUSSION: Participants had few biases toward older Black and White models, while gender biases favored men