Essential oils are natural products capable of being used as novel agrochemical products. In order to fill knowledge gaps, this work evaluates the bioherbicidal potential of Schinus terebinthifolia ...fruit essential oil (EOsST) emulsions on germination parameters of Lactuca sativa and Urochloa brizantha seeds. The hydrodynamic size distribution of the emulsions was evaluated by dynamic light scattering (DLS), scanning electron microscopy (SEM), and Fourier-transform infrared spectroscopy (FTIR). Also, the chemical composition of EOsST was performed by gas chromatography coupled to mass spectrometry (GC-MS). DLS results suggest nanoemulsion (NE) particle sizes smaller than 735 nm and SEM images showed spherical and cuboid shapes. FTIR spectra indicate peaks at 1640 cm−1 and 1440 cm−1, referring to the benzene ring, and the C–H stretching band from 2970 cm−1–2870 cm−1 indicates the interaction between EOsST and TX-100. GC-MS reveals that the major compounds present on EOsST were α-pinene, germacrene-D, and β-pinene. U. brizantha seed germination was reduced at doses >2 mg mL−1 and completely inhibited at 32 mg mL−1. For L. sativa there was a reduction in germination which was dose-dependent and no dose caused total inhibition. Moreover, a decrease in photosynthetic pigments, flavonoids, phenolics, and total tannins was observed. Enzyme activity was altered, with reduction to catalase and peroxidase.
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•Pre-emergent bioherbicidal activity of Schinus terebinthifolia Raddi essential oil was evaluated.•Morphophysiological damages were studied.•The photosynthetic pigments were strongly influenced by their presence in the nanoemulsion.•The enzymatic activity demonstrated the mode of action of the nanoemulsions.
Children with Autism Spectrum Disorders (ASD) frequently receive poorer health care then the general population. Frequently the speech-language pathologist is the only health professional that ...follows the child's everyday life and therefore is the only resource for guidance regarding basic health habits. Poor oral health may result in severe discomfort and other health problems that can be prevented by simple routine habits and adequate professional follow-up. The aim of the present study was to gather information about oral hygiene and dental care habits of children with ASD and their families. The hypothesis was that these children have poorer oral care habits than their families.
Participants were parents of 120 children with autism, aged 4 to 12 years in two different cities of the state of Sao Paulo. They answered to a simple questionnaire about oral hygiene and health care habits.
Indicated that there is a significant difference (
< 0.001) between the children and their families regarding basic oral hygiene habits, such as brushing and flossing, as well as routine visits to the dentist.
This information clearly indicates the need for education programs aiming to encourage the inclusion children with ASD in the basic habits of oral care carried-out by the families.
Autism disorder, oral hygiene habits, oral health.
Coagulase-negative staphylococci (CNS) are among the main responsible agents for mastitis in sheep. Cure rates can be reduced due to several causes, such as those related to virulence factors ...presented by microorganisms. This study aims at characterizing the virulence and resistance factors to antimicrobial agents in different CNS species isolated from sheep milk. After collecting milk samples, the samples were analyzed and the CNS species were identified. After identification, the susceptibility-sensitivity profile was examined using the disk diffusion technique for 10 antimicrobial agents. The DNA was extracted to detect the presence of the mecA gene, biofilm (icaADBC, bap, and bhp) and toxin genes (sea, seb, sec, sed, tst, and luk-PV) by PCR. Samples carrying toxin genes had their expression assessed using the reverse-transcription PCR technique. The biofilm production was assessed using the adherence method on a polystyrene plate. One hundred twelve CNS samples were isolated, 53 (47.3%) from animals with subclinical mastitis and 59 (52.7%) from healthy animals. Drugs tested have shown to be efficient for most CNS samples. The largest resistance percentage of CNS was found for the penicillin (17.0%) and tetracycline (10.7%) and 4 samples carried the mecA gene. As for the biofilm genes, the icaADBC operon was found in 10 (8.9%) samples, the bap gene was found in 16 (14.3%), and the bhp gene was found in 3 (2.7%). In addition, 69 (61.6%) samples produced biofilm. The survey of toxin genes has shown that 70 (62.5%) samples showed some toxin-encoding gene. However, none of the samples has expressed any of the genes from those toxins studied.
Background: Key performance indicators (KPIs) are quantifiable measures of quality. There are no published, systematically derived clinical pharmacy KPIs (cpKPIs). Objective: A group of hospital ...pharmacists aimed to develop national cpKPIs to advance clinical pharmacy practice and improve patient care. Methods: A cpKPI working group established a cpKPI definition, 8 evidence-derived cpKPI critical activity areas, 26 candidate cpKPIs, and 11 cpKPI ideal attributes in addition to 1 overall consensus criterion. Twenty-six clinical pharmacists and hospital pharmacy leaders participated in an internet-based 3-round modified Delphi survey. Panelists rated 26 candidate cpKPIs using 11 cpKPI ideal attributes and 1 overall consensus criterion on a 9-point Likert scale. A meeting was facilitated between rounds 2 and 3 to debate the merits and wording of candidate cpKPIs. Consensus was reached if 75% or more of panelists assigned a score of 7 to 9 on the consensus criterion during the third Delphi round. Results: All panelists completed the 3 Delphi rounds, and 25/26 (96%) attended the meeting. Eight candidate cpKPIs met the consensus definition: (1) performing admission medication reconciliation (including best-possible medication history), (2) participating in interprofessional patient care rounds, (3) completing pharmaceutical care plans, (4) resolving drug therapy problems, (5) providing in-person disease and medication education to patients, (6) providing discharge patient medication education, (7) performing discharge medication reconciliation, and (8) providing bundled, proactive direct patient care activities. Conclusions: A Delphi panel of hospital pharmacists was successful in determining 8 consensus cpKPIs. Measurement and assessment of these cpKPIs will serve to advance clinical pharmacy practice and improve patient care.
Despite initial responses to hormone treatment, metastatic prostate cancer invariably evolves to a lethal state. To characterize the intra-patient evolutionary relationships of metastases that evade ...treatment, we perform genome-wide copy number profiling and bespoke approaches targeting the androgen receptor (AR) on 167 metastatic regions from 11 organs harvested post-mortem from 10 men who died from prostate cancer. We identify diverse and patient-unique alterations clustering around the AR in metastases from every patient with evidence of independent acquisition of related genomic changes within an individual and, in some patients, the co-existence of AR-neutral clones. Using the genomic boundaries of pan-autosome copy number changes, we confirm a common clone of origin across metastases and diagnostic biopsies, and identified in individual patients, clusters of metastases occupied by dominant clones with diverged autosomal copy number alterations. These autosome-defined clusters are characterized by cluster-specific AR gene architectures, and in two index cases are topologically more congruent than by chance (p-values 3.07 × 10
and 6.4 × 10
). Integration with anatomical sites suggests patterns of spread and points of genomic divergence. Here, we show that copy number boundaries identify treatment-selected clones with putatively distinct lethal trajectories.
Abstract
Background
Transthyretin-mediated (ATTR) amyloidosis is a rapidly progressive, debilitating, and fatal disease caused by misfolded TTR accumulating in multiple organs and tissues. Patients ...with hereditary (hATTR) amyloidosis (also known as ATTRv amyloidosis) or wild-type (wtATTR) amyloidosis with cardiomyopathy exhibit decreased survival. Patisiran, an IV RNAi therapeutic that inhibits synthesis of wt and variant TTR, was approved for the treatment of hATTR amyloidosis with polyneuropathy. Exploratory analyses of a predefined cardiac subpopulation in the APOLLO study demonstrated the potential for patisiran to improve the manifestations of cardiomyopathy in patients with hATTR amyloidosis with polyneuropathy.
Objective
To investigate the safety and efficacy of patisiran in patients with ATTR amyloidosis with cardiomyopathy in the ongoing APOLLO-B study (NCT03997383).
Material & Methods
Patients were 18–85 years of age with evidence of cardiac amyloidosis by echocardiography (end-diastolic interventricular wall thickness >12 mm), and either ATTR amyloid deposition on tissue biopsy or fulfilling nonbiopsy diagnostic criteria for ATTR amyloidosis with cardiomyopathy. Patients had a medical history of heart failure (HF) due to ATTR amyloidosis with at least 1 prior hospitalization for HF, or current clinical evidence of HF. Patients were randomized (1:1) to receive patisiran IV 0.3 mg/kg or placebo Q3W for 12 months. After the double-blind, placebo-controlled period, all patients may receive patisiran in an open-label extension period for up to 36 months. The primary endpoint was change from baseline in 6-MWT at Month 12 with patisiran treatment, compared with placebo. Secondary endpoints evaluated the effect of patisiran vs placebo at Month 12 on QOL (KCCQ-OS score) as well as two sets of composite endpoints: 1) All-cause mortality, frequency of CV events (CV hospitalizations and urgent HF visits) and change from baseline in 6-MWT; and 2) All-cause mortality and frequency of all-cause hospitalizations and urgent HF visits. The pharmacodynamic effect of patisiran on serum TTR level (change from baseline through Month 12) was also assessed.
Results & Discussion
Enrollment completed (359 patients) in May 2021. About 80% of patients have wtATTR amyloidosis. Primary and secondary endpoint data will be presented, including change in 6-MWT and KCCQ-OS score at Month 12, in addition to safety data.
Summary & Conclusion
The primary results of the APOLLO-B study will inform the potential of patisiran as a treatment for the cardiomyopathy of ATTR amyloidosis. APOLLO-B will continue to investigate the efficacy and safety of patisiran on ATTR amyloidosis in an open-label extension period.
RESUMEN Objetivo: demostrar la aplicabilidad de la herramienta Healthcare Failure Mode and Effect Analysis para analizar, de forma preventiva, los riesgos relacionados con el proceso de inserción, ...mantenimiento y retirada de catéteres intravenosos periféricos. Método: estudio teórico, realizado de agosto a noviembre de 2022, en São Paulo-SP, Brasil, cuyo proceso fue mapeado en etapas/actividades, detallando los modos de falla, utilizando la herramienta. Se calculó el Número de Prioridad de Riesgo, se elaboró la matriz de severidad y probabilidad, adaptada a la salud por DeRosier y colaboradores, y se propusieron acciones para reducir los modos de falla. Resultados: Los principales riesgos identificados fueron: “realizar la antisepsia de la zona a puncionar con un bastoncillo con alcohol” y “desinfectar el conector con un bastoncillo con alcohol”, recomendándose como principales estrategias de mitigación la formación y el uso de kits de materiales. Conclusión: Conocer los riesgos asociados al catéter intravenoso periférico sienta las bases para la aplicación de estrategias preventivas, minimizando la aparición de daños y los costes sanitarios derivados de los mismos.
ABSTRACT Objective: to demonstrate the applicability of the Healthcare Failure Mode and Effect Analysis tool to analyze, preventively, the risks related to the process of insertion, maintenance, and removal of peripheral intravenous catheters. Method: theoretical study, conducted from August to November 2022, in São Paulo-SP, Brazil, whose process was mapped in stages/activities, detailing the failure modes, using the tool. The Risk Priority Number was calculated, the severity and probability matrix was elaborated, adapted to health by DeRosier and collaborators, and actions were proposed to reduce failure modes. Results: The major risks identified were: “perform antisepsis of the area to be punctured with an alcohol swab” and “disinfect the connector with an alcohol swab”, and were recommended training and use of kit materials as the main mitigation strategies. Conclusion: knowing the risks associated with peripheral intravenous catheters is the basis for the implementation of preventive strategies, minimizing the occurrence of damage and the associated healthcare costs.
RESUMO Objetivo: demonstrar a aplicabilidade da ferramenta Healthcare Failure Mode and Effect Analysis para analisar, preventivamente, os riscos relativos ao processo de inserção, manutenção e retirada de cateter intravenoso periférico. Método: estudo teórico, realizado de agosto a novembro de 2022, em São Paulo-SP, Brasil, cujo processo foi mapeado em etapas/atividades, detalhando-se os modos de falha, com o uso da ferramenta. Calculou-se o Risk Priority Number, elaborou-se a matriz de severidade e probabilidade, adaptada à saúde por DeRosier e colaboradores, e propuseram-se as ações para reduzir os modos de falha. Resultados: identificaram-se como maiores riscos: “realizar antissepsia da área a ser puncionada com swab de álcool” e “desinfecção do conector com swab de álcool” sendo recomendados treinamentos e uso de kit de materiais como principais estratégias de mitigação. Conclusão: conhecer os riscos associados ao cateter intravenoso periférico, fundamenta a implementação de estratégias preventivas, minimizando a ocorrência de danos e os custos assistenciais deles decorrentes.
Objetivo. Evaluar los niveles de mediadores químicos inflamatorios como la interleucina- 1α (IL-1α), interleucina-1β (IL-1β), factor de necrosis tumoral-α (TNF-α) y los parámetros clínicos en ...pacientes diagnosticados con periodontitis crónica o agresiva, antes y después de la terapia periodontal no quirúrgica (TPNQ). Métodos. Se tomaron muestras de fluido gingival crevicular (FGC) en 11 pacientes diagnosticados con periodontitis y 11 controles sanos para evaluar niveles de IL-1α, IL-1β, TNF-α antes y después de la TPNQ, mediante la técnica de ELISA (Enzyme-Linked Immuno Sorbent Assay). Resultados. En el grupo con periodontitis se observó disminución significativa de los parámetros clínicos después del tratamiento (p<0,05). En FGC, IL-1β presentó los niveles más elevados, seguido de IL-1α y TNF-α. Posterior a la TPNQ, IL-1β disminuyó 17 veces su concentración e IL-1α 4 veces en relación a los valores iniciales, sin embargo, solo se observó una relación estadísticamente significativa para TNF-α. Las mayores correlaciones con los parámetros clínicos de la enfermedad periodontal se observaron para IL-1β (p<0,01), seguido por IL-1α (p<0,05) y una baja correlación con TNF-α. Conclusiones. En este trabajo, el grupo de pacientes con periodontitis presentó mayores niveles de IL-1α, IL-1β y TNF-α en FGC, siendo IL-1β la citocina más elevada. Posterior al TPNQ, se observó disminución significativa de los valores clínicos periodontales. Así mismo, las interleucinas redujeron sus valores promedios, sin alcanzar los del grupo control. Las correlaciones observadas entre los índices periodontales y los mediadores sugieren mayor correlación de IL-1β con los signos clínicos de la enfermedad periodontal.
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