The profile of changes in airway driving pressure (dP
) induced by positive-end expiratory pressure (PEEP) might aid for individualized protective ventilation. Our aim was to describe the dP
versus ...PEEP curves behavior in ARDS from COVID-19 patients.
Patients admitted in three hospitals were ventilated with fraction of inspired oxygen (FiO
) and PEEP initially adjusted by oxygenation-based table. Thereafter, PEEP was reduced from 20 until 6 cmH
O while dP
was stepwise recorded and the lowest PEEP that minimized dP
(PEEPmin_dP
) was assessed. Each dP
vs PEEP curve was classified as J-shaped, inverted-J-shaped, or U-shaped according to the difference between the minimum dP
and the dP
at the lowest and highest PEEP. In one hospital, hyperdistention and collapse at each PEEP were assessed by electrical impedance tomography (EIT).
184 patients (41 including EIT) were studied. 126 patients (68%) exhibited a J-shaped dP
vs PEEP profile (PEEPmin_dP
of 7.5 ± 1.9 cmH
O). 40 patients (22%) presented a U (PEEPmin_dP
of 12.2 ± 2.6 cmH
O) and 18 (10%) an inverted-J profile (PEEPmin_dP
of 14,6 ± 2.3 cmH
O). Patients with inverted-J profiles had significant higher body mass index (BMI) and lower baseline partial pressure of arterial oxygen/FiO
ratio. PEEPmin_dP
was associated with lower fractions of both alveolar collapse and hyperinflation.
A PEEP adjustment procedure based on PEEP-induced changes in dP
is feasible and may aid in individualized PEEP for protective ventilation. The PEEP required to minimize driving pressure was influenced by BMI and was low in the majority of patients.
Describe a case series of vaccine-induced immune thrombotic thrombocytopenia (VITT) after COVID-19 vaccination in Brazil that included ChAdOx1 nCoV-19, Ad26.COV2.S and BNT162b2 vaccines, describing ...their clinical and laboratory characteristics.
Descriptive case series study using Bio-Manguinhos/Fiocruz/AstraZeneca Brazil and National Immunization Program/Ministry of Health (NIP/MoH) data on COVID-19 AEFI surveillance.
We obtained patient-level data from pharmacovigilance for AEFI surveillance and used both the NIP/MoH and Bio-Manguinhos/Fiocruz pharmacovigilance databases to create the study database.
Thirty-nine cases of suspect VITT were included, 36 after ChAdOx1 nCoV-19, one after BNT162b2 and two after Ad26.COV2.S vaccine. All cases were based on meeting the Brighton Collaboration criteria for VITT. The primary outcomes were clinical and laboratory features, site of thrombosis, and anti-PF4 ELISA, when available.
Thirty-nine cases met the criteria, 38 of which were classified as level 1 and one as level 3 according to Brighton Collaboration. Most cases had the central nervous system (CNS) as the main site of thrombosis (21/39) and happened after the vaccine first dose (34/39). The median age of the cases was 41 years old (23 to 86 yo). Most of the cases (61.5%) occurred in women. The median interval between vaccination and onset of symptoms was 8 days (0–37 days). The platelet count and D-dimer count had median values of 34,000/µL and 19,235 µg FEU/L, respectively. The ELISA anti-PF4 antibody was positive in 18 samples. The overall mortality rate was 51% and was higher in cases of CNS thrombosis with intracerebral bleeding.
Our case series shows that Brazilian VITT cases have similar clinical and laboratory profiles as demonstrated in the literature. Brazil has administered more than 300 million doses of COVID-19 vaccines (more than 110 million from ChAdOx1 nCoV-19). VITT seems to be a very rare but serious adverse event following COVID-19 immunization, especially adenoviral vector immunization.
Sympatry can lead to higher competition under climate change and other environmental pressures, including in South Georgia, Antarctica, where the two most common octopod species, Adelieledone ...polymorpha and Pareledone turqueti, occur side by side. Since cephalopods are typically elusive animals, the ecology of both species is poorly known. As beaks of cephalopods are recurrently found in top predator's stomachs, we studied the feeding ecology of both octopods through the evaluation of niche overlapping and specific beak adaptations that both species present. A multidisciplinary approach combining carbon (δ13C) and nitrogen (δ15N) stable isotope signatures, mercury (Hg) analysis and biomaterials' engineering techniques was applied to investigate the beaks. An isotopic niche overlap of 95.6% was recorded for the juvenile stages of both octopod species, dropping to 19.2% for the adult stages. Both A. polymorpha and P. turqueti inhabit benthic ecosystems around South Georgia throughout their lifecycles (δ13C: −19.21 ± 1.87‰, mean ± SD for both species) but explore trophic niches partially different during adult life stages (δ15N: 7.01 ± 0.40‰, in A. polymorpha, and 7.84 ± 0.65‰, in P. turqueti). The beaks of A. polymorpha are less dense and significantly less stiff than in P. turqueti. Beaks showed lower mercury concentration relative to muscle (A. polymorpha - beaks: 0.052 ± 0.009 μg g−1, muscle: 0.322 ± 0.088 μg g−1; P. turqueti - beaks: 0.038 ± 0.009 μg g−1; muscle: 0.434 ± 0.128 μg g−1). Overall, both octopods exhibit similar habitats but different trophic niches, related to morphology/function of beaks. The high Hg concentrations in both octopods can have negative consequences on their top predators and may increase under the present climate change context.
Sponges occur ubiquitously in the marine realm and in some deep-sea areas they dominate the benthic communities forming complex biogenic habitats – sponge grounds, aggregations, gardens and reefs. ...However, deep-sea sponges and sponge-grounds are still poorly investigated with regards to biotechnological potential in support of a Blue growth strategy. Under the scope of this study, five dominant North Atlantic deep-sea sponges, were characterized to elucidate promising applications in human health, namely for bone tissue engineering approaches.
Geodia barretti
(Gb),
Geodia atlantica
(Ga),
Stelletta normani
(Sn),
Phakellia ventilabrum
(Pv), and
Axinella infundibuliformis
(Ai), were morphologically characterized to assess macro and microstructural features, as well as chemical composition of the skeletons, using optical and scanning electron microscopy, energy dispersive x-ray spectroscopy and microcomputed tomography analyses. Moreover, compress tests were conducted to determine the mechanical properties of the skeletons. Results showed that all studied sponges have porous skeletons with porosity higher than 68%, pore size superior than 149 μm and higher interconnectivity (>96%), thus providing interesting models for the development of scaffolds for tissue engineering. Besides that, EDS analyses revealed that the chemical composition of sponges, pointed that demosponge skeletons are mainly constituted by carbon, silicon, sulfur, and oxygen combined mutually with organic and inorganic elements embedded its internal architecture that can be important features for promoting bone matrix quality and bone mineralization. Finally, the morphological, mechanical, and chemical characteristics here investigated unraveled the potential of deep-sea sponges as a source of biomaterials and biomimetic models envisaging tissue engineering applications for bone regeneration.
The n-type titanate heterojunction with p-type transition metal oxides reduces the recombination effect (e−/h+) and improves the magnetic, electronic, and luminescent properties. Based on these ...related properties, the synthesis of nanocomposite sodium-cobalt titanate nanotube and iron oxide (Co-NaTiNT@FeO) was performed using titanium dioxide (polymorphic mixture: brookite, anatase and rutile), cobalt nitrate hexahydrate and iron oxide (FeO). The synthesized materials were characterised by X-ray diffraction (XRD), Raman and infrared (IR) spectroscopies, thermogravimetry and differential (TG-dTG), transmission electron microscopy (TEM) and scanning (SEM), X-ray photoelectron spectroscopy (XPS), adsorption/desorption of N2 by Brunauer-Emmett-Teller (BET) method, Ultraviolet–Visible (UV–Vis) by diffuse reflectance spectroscopy (DRS), photoluminescence (PL), and vibrating sample magnetometer (VSM). The results revealed the presence of Co2+ ions in the lamellar region of the nanotubes, in addition to verifying that there was no collapse of the nanotubes before and after the anchoring of the FeO nanoparticles. Using the XPS technique, the presence of 2.49 wt% of Fe (2p), as well as 1.55 wt% of Co (2p), was identified; these elements favoured the band gap reduction from 3.61 to 2.66 eV compared to sodium titanate nanotube (NaTiNT); in addition, they favoured the emergence of emissions associated with the red, yellow, and orange colours, described through PL. The surface area of the composite changed from 197.00 to 210.46 m2 g−1, possibly due to the homogeneous presence of anchored superparamagnetic FeO nanoparticles. Finally, the results were consistent with the proposal for the synthesis of Co-NaTiNT@FeO, which had improvements in its properties, especially its magnetic properties.
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•TiO2 nanoparticles with phases mixture: anatase, rutile, brookite.•Direct synthesis of Co-doped Sodium Titanate Nanotubes (Co-NaTiTN) via alkaline hydrothermal method.•Superparamagnetic heterojunction of Co-NaTiNT with FeO nanoparticles.•Photocatalytic activity of heterojunction Co-NaTiNT@FeO.•Magnetic behaviour of heterojunction Co-NaTiNT@FeO.
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