Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Structure, synthesis of hierridin C and discovery of prevalent alkylresorcinol biosynthesis in picocyanobacteria

Small, single-celled planktonic cyanobacteria are ubiquitous in the world’s oceans yet tend not to to be perceived as biosynthetically-prolific organisms. Here we report the isolation and structure elucidation of hierridin C, an antiplasmodial halogenated alkylresorcinol produced in very low amounts by the picocyanobacterium Cyanobiumsp. LEGE 06113. We describe a simple, straightforward synthetic route to the scarcely-produced hierridins that relies on a key, highly regioselective halogenation step. In addition, we show that these compounds originate from a type III PKS pathway and that similar biosynthetic gene clusters are found in a variety of bacterial genomes, most notably those of the globally-distributed picocyanobacteria genera Prochlorococcus, Cyanobiumand Synechococcus.publishersversionpublishe

Uma microanálise de cartas oficiais Norte-rio-grandenses

RESUMO Entre variação e mudança, como sabemos, não só as línguas, mas os textos, com suas estruturas, também sofrem mudanças ao longo do tempo. Este artigo tem como objetivo analisar mudanças textuais observadas em cartas dos séculos XVIII, XIX e XX. Esses documentos integram o corpus denominado cartas oficiais norte-rio-grandenses, ligado ao projeto regional História do Português Brasileiro no Rio Grande do Norte (PHPB-RN) e ao projeto nacional Para a História do Português Brasileiro – PHPB. Realizamos uma microanálise sobre essas cartas, partindo das ideias de base coseriana advindas dos estudos sobre as Tradições Discursivas (KOCH, 1997; KABATEK, 2006), dentre as quais a de que os textos se configuram de modo a seguirem suas próprias tradições (COSERIU, 2007). Após uma breve incursão sobre a natureza do gênero “carta”, no que respeita à sua macroestrutura, concentramos nossa atenção na microestrutura clausula (fecho). Em nosso percurso, observamos que as dinâmicas textuais constituídas nos documentos analisados refletiam, de modo significativo, processos de mudança nas dinâmicas sociais

Conhecimento sobre atividade física dos estudantes de uma cidade do sul do Brasil Knowledge about physical activity of students in a city in southern Brazil

O presente estudo avaliou o conhecimento dos escolares sobre atividade física (AF) e sua associação com fatores socioeconômicos, demográficos, comportamental, nutricional e de saúde. Foi realizado um estudo transversal de base escolar na cidade de Pelotas/RS com 1233 adolescentes, 54% do sexo feminino, com idades entre 13 e 19 anos. A coleta de dados foi feita através de questionário com questões fechadas. O desfecho foi analisado de forma contínua (0 a 22) e a média de acertos foi de 14.1. Mais de 60% dos adolescentes associaram corretamente AF como fator de prevenção de doenças como hipertensão, hipercolesterolemia, osteoporose e depressão. Classes sociais mais elevadas, cor da pele branca, maiores faixas etárias e anos de estudo associaram-se a maiores níveis de conhecimento. Com base nos achados, programas de educação para a saúde devem ser desenvolvidos aos jovens na tentativa de ajudar a minimizar o sedentarismo e suas morbidades associadas.<br>This study evaluated the knowledge about physical activity and its relation to the prevention of chronic diseases and effect on the human body in adolescents who attend classes in high school in the urban area of Pelotas. It was conducted a cross-sectional, school-based survey was carried out among 1233 individuals aged 13 to 19 years. The questionnaire originated a score (range 0-22 points). Mean score for the sample was 14.1 (SD = 3.0). More than 60% of adolescents associated physical activity to the prevention of chronic diseases like high blood pressure, high cholesterol, osteoporosis and depression. The knowledge was positively associated to social strata, white color and age and grade. Among women, those who had a self-perceived health the good and excellent also had the knowledge. Education programs for health must be desenvolved to in for young people about the influence of the risk behavior in an attempt to minimize the sendentary behavior and possibly the number of obese in adolescence and adulthood