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Great efforts have been made to choose between bypass surgery and angioplasty as the first choice for revascularisation in chronic limb threatening ischaemia (CLTI). Endovascular therapy predominates despite limited evidence for its advantages. The purpose of this observational cohort study was to investigate outcomes after open and endovascular infrapopliteal revascularisation in extensive infrainguinal arterial disease. The medical records of 1 427 patients who underwent infrainguinal revascularisation exclusively for CLTI in the period January 2014 to February 2019 were reviewed. After detailed analysis, only infrapopliteal revascularisations classified as GLASS stage II or III were considered, resulting in 326 procedures. In total, 127 patients underwent endovascular therapy and 199 patients underwent bypass graft surgery (BGS). The primary endpoints included amputation free survival (AFS) and overall survival (OS). Secondary endpoints included the analyses of multiple factors related to long term AFS. Regarding the primary endpoint, AFS was 75.2% and 65.2% at one and three years, respectively. OS at one and three years was 91.2% and 83.1%, respectively. In the univariable analysis, the hazard of the combined endpoint of major amputation or death was higher after bypass surgery than after endovascular therapy (hazard ratio [HR] 1.80, 95% confidence interval [CI] 1.13 – 2.89; p =.013). After either revascularisation method, TASC II femoropopliteal D was associated with a higher risk of amputation or death (HR 1.69, 95% CI 1.10 – 2.58; p =.015). Multivariable Cox regression analysis revealed no association between the variables analysed for AFS. Patients with CLTI submitted to infrapopliteal revascularisation and classified as GLASS II and III had satisfactory AFS and OS rates after an individualised team conference decision. Furthermore, the revascularisation modality (endovascular or open) did not influence the AFS results. [ABSTRACT FROM AUTHOR]

The simulated patient method is becoming increasingly popular in health services research to observe the behaviour of healthcare practitioners in a naturalistic setting. This method involves sending a trained individual (simulated patient among other names), who is indistinguishable from a regular consumer, into a healthcare setting with a standardised scripted request. This paper provides an overview of the method, a brief history of its use in health services research, comparisons with other methods, ethical considerations, and considerations for the development of studies using the simulated patient method in health services research, with examples from pharmacy and other fields. Methods of analysis, mixed-methods, and the use of simulated patients with feedback are also discussed. [ABSTRACT FROM AUTHOR]

We sought to evaluate the impact of surgical aortic annulus enlargement (ARE) on the perioperative outcomes of surgical aortic valve replacement. Databases were searched for articles published by October 2019 in order to carry out a systematic review followed by meta-analysis. Thirteen studies with 40,447 patients (aortic valve replacement [AVR] with aortic annulus enlargement [AAE]: 4686 patients; AVR without AAE: 35,761 patients) were included. The total rate of AAE was 11.6%, ranging from 4.1%-28.1%. The overall unadjusted odds ratio (OR) (95% confidence interval [CI]) for operative mortality showed a statistically significant difference between the groups, with higher risk in the "AVR with AAE" group (OR 1.388; 95% CI 1.049-1.836, P < 0.001), but not for isolated AVR+AAE (OR 1.341; 95% CI 0.920-1.956, P = 0.127) and also not in matched populations (OR 1.003; 95% CI 0.773-1.300, P = 0.984). The "AVR with AAE" group showed an overall lower risk of significant patient-prosthesis mismatch (PPM) (OR 0.567; 95% CI 0.376-0.854, P = 0.007) and a higher overall difference in means of indexed effective orifice area (iEOA) (random effect model: 0.058 cm2/m2; 95% CI 0.024-0.092, P < 0.001). The overall ORs for myocardial infarction, stroke, complete heart block/permanent pacemaker implantation and reoperation for bleeding showed no statistically significant difference between the groups. AAE is a useful adjunct to AVR, but the benefit of reduced PPM must be balanced against a possibly higher risk of perioperative mortality. [ABSTRACT FROM AUTHOR]

• An unusual 5,7-dihydroxychromone-3α- d - C -glucoside (macrolobin) was isolated from Macrolobium latifolium. • Macrolobin exhibited a significant inhibition of AChE and the extracts showed antimicrobial activities. • Steroids, triterpenes, apigenin and fatty acids were also identified in M. latifolium. This work describes the chemical and biological investigations of leaves and stems of Macrolobium latifolium (Vogel). The DCM, EtOAc soluble fractions obtained by liquid-liquid partition the crude methanolic extract of this species were submitted to usual chromatographic techniques which permitted to isolate an unusual 5,7-dihydroxychromone-3α- d - C -glucoside, named macrolobin, along with the known compounds identified as β-taraxerol, friedelin, stigmasterol, β-sitosterol, campesterol, and apigenin. The structures of all compounds were elucidated by 1H, 13C, HSQC and HMBC NMR spectra, IR spectra data analysis, and MS. Furthermore, the chemical profile from fatty acids and/or triglycerides fraction was also determined after transesterification. The reaction products were subjected to GC-FID and GC–MS permitted to detected methyl palmitate as the main fatty acid derivate present in the oil and, lauric (7.52 %), octadecanoic (17.15 %), docosanoic (5.36 %), tricosanoic (11.83 %) and tetracosanoic as minor methyl esters. Concerning the biological activities, the organic soluble fractions and macrolobin displayed antimicrobial activity against Salmonella enterica , Staphylococcus aureus , Pseudomonas aeruginosa and Escherichia coli (MIC values 125−1000 μg.mL−1) and, macrolobin exhibited significant acetylcholinesterase inhibition (IC 50 0.8 μM). These findings indicate M. latifolium can contribute with the development of new bioactive compounds, especially the AChE inhibition. [ABSTRACT FROM AUTHOR]

Abstract Marijuana, a drug derived from the Cannabis sativa L. plant, is the world's most consumed illicit drug. In this paper, a total of 156 marijuana samples seized in the state of Espírito Santo (ES), Brazil were studied and analysed by proton nuclear magnetic resonance (1H NMR) spectroscopy to identify the major cannabinoids present. A crude extract of all samples was purified using high performance liquid chromatography so that these compounds could serve as reference substances. Nine fractions were obtained and analysed by 1H NMR and gas chromatography–mass spectrometry (GC–MS), with five presented cannabinoids. ∆9-THC (Δ9- trans -tetrahydrocannabinol), ∆9-THCA (∆9-tetrahydrocannabinolic acid), ∆8-THC (∆ 8- tetrahydrocannabinol), 11-hydroxycannabinol, CBV (cannabivarin), and CBN (cannabinol) were found, and their chemical structures were confirmed by GC–MS. The latter compound was obtained with high purity (≈100%), while the others were obtained as less complex mixtures with purity higher than 75% (except for Δ8-THC). Principal component analysis (PCA) was used on the 1H NMR spectra of the 156 samples, and it was found that the samples were grouped according to the months, differentiating into two groups (from July 2014 to January 2015 and from February 2015 to July 2015), where non-grouping was observed from four macro-regions of the ES state (North, Central, Metropolitan, and South). The chemical profile of the seized samples was correlated to the 1H NMR spectrum of an isolated CBN sub-fraction, in which the group formed by samples seized in the year 2015 presented lower CBN content in the chemical composition. From the PCA score plot, two groups of samples were confirmed using the partial least squares discriminant analysis and orthogonal projections to latent structures classification methods. Graphical abstract Unlabelled Image Highlights • A total of 156 marijuana samples were studied and analysed by 1H NMR. • A crude extract of all samples was submitted to HPLC with the purpose to purify cannabinoids. • ∆9-THC, ∆9-THCA, ∆8-THC, 11-hydroxycannabinol, CBV and CBN were found and detected. • 1H NMR spectra of the samples were submitted to PCA, differentiating into two groups. • The group formed by samples seized in the 2015 year presented a lower CBN content. [ABSTRACT FROM AUTHOR]

Background: Self-care, and hence self-medication, is becoming an increasingly popular practice worldwide. Community pharmacies are an important destination for those seeking non-prescription medicines, and pharmacists and their staff are in a prime position to facilitate appropriate and safe self-medication.Purpose: To determine what modifications (for example, a change in brand, change in drug, or non-supply) pharmacy staff make when presented with a request for a non-prescription medicine, and to determine what factors influence whether a modification is made.Methods: Sixty-one third year Bachelor of Pharmacy students from The University of Sydney were trained as mystery shoppers to make 9 visits once a week to 36 community pharmacies in the metropolitan region of Sydney, Australia from March-October 2015. Students presented to a different, pre-allocated pharmacy once a week with a direct product request for a non-prescription medicine relating to a common ailment (e.g. asthma, insomnia, allergic rhinitis) for 9 weeks. Student mystery shoppers audio-recorded each visit and collected the details of the interaction and product sold. Descriptive statistics, chi-squared analyses, and binary logistic regression were performed to find factors influencing modifications made by pharmacy staff to the simulated patient initial request.Results: Of 540 completed visits, 497 were eligible for analysis. Modification (change in brand, intra/interclass change, companion sale, or no product supplied) occurred in 49% (n = 245) of visits. Whether the product requested was deemed "not appropriate" given the scenario outline was the only significant predictor of whether a modification to the request occurred (42% modification, "appropriate" scenarios vs. 57% modification, "not appropriate" scenarios; χ2 = 8.90; p < 0.01).Conclusions: Modification from the original non-prescription medicine request occurred in approximately half the reported requests. A request for a product that was considered "not appropriate" was more likely to elicit a modification than a request for an "appropriate" non-prescription medicine. [ABSTRACT FROM AUTHOR]

Cardiac surgery is highly demanding and the ideal teaching method to reach competency is widely debated. Some studies have shown that surgical trainees can safely perform full operations with equivocal outcomes compared with their consultant colleagues while under supervision. We aimed to compare outcomes after cardiac surgery with supervised trainee involvement versus consultant-led procedures. We systematically reviewed databases (PubMed/MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov , Google Scholar) and reference lists of relevant articles for studies that compared outcomes of cardiac surgery performed by trainees versus consultants. Primary end points included: operative mortality, coronary events, neurological/renal complications, reoperation, permanent pacemaker implantation, and sternal complications. Secondary outcomes included cardiopulmonary bypass and aortic cross-clamp times and intensive care/in-hospital length of stay. Random effects meta-analysis was performed. Thirty-three observational studies that reported on a total of 81,616 patients (trainee: 20,154; consultant: 61,462) were included. There was a difference favoring trainees in terms of operative mortality in the main analysis and in an analysis restricted to propensity score-matched samples, whereas other outcomes were not consistently different in both analyses. Overall cardiopulmonary bypass and aortic cross-clamp times were longer in the trainee group but did not translate in longer intensive care unit or hospital stay. In the right conditions, good outcomes are possible in cardiac surgery with trainee involvement. Carefully designed training programs ensuring graduated hands-on operative exposure as primary operator with appropriate supervision is fundamental to maintain high-quality training in the development of excellent cardiac surgeons. [Display omitted] [ABSTRACT FROM AUTHOR]

The administration of plasma to foals with failed transfer of passive immunity is of utmost importance. Transporting refrigerated or frozen plasma to farms can be costly and complicated. Lyophilized plasma can facilitate transport and storage by improving and spreading the technology. Lyophilization is the most commonly used method for preparing dehydrated proteins, which must have adequate stability for an extended storage period at room temperature. This work aimed to evaluate the IgG concentration of fresh equine plasma (EP) and post-lyophilization. Plasma was collected from 6 healthy male horses, age 4±2 years, 356±62kg. An aliquot of EP was lyophilized. The lyophilization process was carried out at the Research Support Center of the Federal Rural University of Pernambuco. Before being lyophilized, samples were frozen at -80°C for 24 h and then processed, in an Alpha 1-4 LD Plus Christ apparatus, a drying chamber temperature of -27°C and vacuum of 0.52 mbar, for 24 hours. The lyophilized EP obtained was stored in well-sealed microtubes and frozen at -4°C for further analysis. The lyophilized EP was resuspended in deionized water to maintain the original volume. The concentration of IgG in fresh EP and lyophilized and resuspended EP was measured. Samples were evaluated using Simple Radial Immunodiffusion kits (IDRS) commercially available forequine serum and colostrum: IDRING® Horse IgG Test, by IDBiotech (Issoire/France). Horse IgG test plates contain an agar gel with a specific antiserum against horse IgG. Plate wells are filled with standards of 200, 100, 50, and 25 μg/mL of horse IgG and the EP and lyophylised EP samples. During diffusion on the agar gel, the antibodies specifically react with the antigen to form a precipitation ring. A linear calibration curve is established to determine the samples' IgG concentrations from the measured diameters to known concentrations in the standard calibration set. The homogeneity of the variance between treatments was verified by the Shapiro-Wilk test. The results were subjected to analysis of variance (ANOVA) to determine the effects of lyophilization on the IgG concentrations. Significance was declared at P<0.05. When significant differences were tested using the Tukey, significance was set at P<0.05. The IgG concentration in fresh plasma was 8.9±3.2 g/L; after lyophilization, the plasma showed an IgG concentration of 7.1±2.2 g/L. No significant differences were found in the plasma IgG concentrations (P>0.05). The results suggest that lyophilization can be an alternative for conserving EP, since it is a very efficient process to maintain IgG concentration. Further studies should be carried out regarding the administration of plasma in the foal and the transfer of immunity. [ABSTRACT FROM AUTHOR]

Facial injuries frequently occur in traffic accidents involving motorcycles. The purpose of this study was to determine the prevalence of facial injuries among motorcycle drivers who perform motorcycle taxi service. The study design was cross-sectional. A total of 210 participants who served as motorcycle taxi drivers in a city in northeastern Brazil completed a survey concerning their experience of accidents involving facial injuries and consequent hospitalization and absenteeism from work. The motorcycle drivers included in the study were randomly selected from a list provided by the city. Out of the respondents, 165 (78.6%) who were involved in traffic accidents in the last 12 months, 15 (9.1%) reported facial injuries. The types of facial injury most frequently reported involved soft tissues (n = 8; 53.3%), followed by simple fracture (n = 4; 26.7%) and dentoalveolar fracture (n = 3; 20%). We found an association between facial injuries and absenteeism, as well as an association between the presence of facial injury and the need for hospitalization for a period of 2 days or more. Respondents reported that they had accidents, but due to the use of full face motorcycle helmet the number of facial injuries was low. For most of them, absenteeism was observed for a period of one month or more. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Coagulation abnormalities are frequent in patients with severe infections. However, the predictive value of d-dimer and of the presence of associated coagulation derangements in severe community-acquired pneumonia (CAP) remains to be thoroughly evaluated. The aim of this study was to investigate the predictive value of coagulation parameters in patients with severe CAP admitted to the intensive care unit. Methods: d-Dimer, antithrombin, International Society of Thrombosis and Hemostasis score, clinical variables, Sequential Organ Failure Assessment (SOFA), The Acute Physiology and Chronic Health Evaluation II (APACHE II) and the CURB-65 score were measured in the first 24 hours. Results are shown as median (25%-75% interquartile range). The main outcome measure was hospital mortality. Results: Ninety patients with severe CAP admitted to the intensive care unit were evaluated. Overall hospital mortality was 15.5%. d-Dimer levels in nonsurvivors were higher than those in survivors. In the univariate analysis, d-dimer, SOFA, and APACHE II scores were predictors of death. The discriminative ability of d-dimer (area under receiver operating curve = 0.75 [95% confidence interval, 0.64-0.83]; best cutoff for d-dimer was 1798 ng/mL) for in-hospital mortality was comparable with APACHE II and SOFA and better than C-reactive protein. Moreover, the addition of d-dimer to APACHE II or SOFA score increased the discriminative ability of both scores (area under the receiver operating curve = 0.82 [0.72-0.89] and 0.84 [0.75-0.91], respectively). Conclusions: d-Dimer levels are good predictors of outcome in severe CAP and may augment the predictive ability of scoring systems as APACHE II and SOFA. [Copyright &y& Elsevier]

Abstract: Introduction: Our aim was to evaluate the impact of corticosteroids on clinical course and outcomes of patients with severe community-acquired pneumonia (CAP) requiring invasive mechanical ventilation. Methods: This was a cohort study of patients with severe CAP from 2 intensive care units in tertiary hospitals in Brazil and Portugal. Results: A total of 111 patients were included (median age, 69 years; 56% men; 34% hospital mortality). Corticosteroids were prescribed in 61 (55%) patients. Main indications for their use were bronchospasm (52.5%) and septic shock (36%). Mortality rate of patients treated with and without corticosteroids was comparable (29.5% vs 32%, P = .837). No significant differences were observed on clinical course from day 1 to day 7 as assessed by the Sequential Organ Failure Assessment score (P = .95). Furthermore, C-reactive protein declined similarly in both groups (P = .147). In a multivariate analysis, mortality was associated with older age and higher Acute Physiology and Chronic Health Evaluation II score. Conclusions: In patients with severe CAP requiring invasive mechanical ventilation, adjunctive therapy with corticosteroids did not influence intensive care unit and hospital mortality. In addition, no changes were observed on weaning from vasopressors, on recovery from organ failure/dysfunction as assessed by the Sequential Organ Failure Assessment score, as well as on C-reactive protein course. [Copyright &y& Elsevier]

Abstract: The Bocaina Plateau, which is situated on the eastern flank of the continental rift of southeastern Brazil, is the highest part of the Serra do Mar. Topographic relief in this area is suggested to be closely related to its complex tectono-magmatic evolution since the breakup of Western Gondwana and opening of the South Atlantic Ocean. Apatite fission track ages and track length distributions from 27 basement outcrops were determined to assess these hypotheses and reconstruct the denudation history of the Bocaina Plateau. The ages range between 303±32 and 46±5Ma, and are significantly younger than the stratigraphic ages. Mean track lengths vary from 13.44±1.51 to 11.1±1.48μm, with standard deviations between 1.16 and 1.83μm. Contrasting ages within a single plateau and similar ages at different altitudes indicate a complex regional tectonothermal evolution. The thermal histories inferred from these data imply three periods of accelerated cooling related to the Early Cretaceous continental breakup, Early Cretaceous alkaline magmatism, and the Paleogene evolution of the continental rift of southeastern Brazil. The oldest fission track ages (>200Ma) were obtained in the Serra do Mar region, suggesting that these areas were a long-lived source of sediments for the Paraná, Bauru, and Santos basins. [Copyright &y& Elsevier]

Objective: To evaluate plasma levels of interleukin (IL)-1β, IL-6, IL-8, IL-10, and tumor necrosis factor (TNF)-α in newborn infants immediately before and after 2 hours of mechanical ventilation. Study design: Term and late preterm neonates with no history of mechanical ventilation and/or ventilatory support were studied prospectively. Exclusion criteria were congenital malformations, congenital infections, use of nitric oxide, resuscitation with positive-pressure ventilation, and any procedure in the delivery room or neonatal intensive care unit that resulted in tracheal intubation. Blood samples for IL-1β, IL-6, IL-8, IL-10, and TNF-α levels were collected before intubation and mechanical ventilation and 2 hours later. Results: Nineteen newborn infants with gestational age 35.8 ± 1.9 weeks and birth weight 2280 ± 370 g were included. Pro-inflammatory cytokines increased: IL-8 (2.5-fold), IL-1β (7.5-fold), and TNF-α (10-fold), and the anti-inflammatory cytokine IL-10 decreased by 90%. Although median IL-6 levels were similar between before and after ventilation, IL-6 increased in 89.4% of infants. Conclusions: A short period of mechanical ventilation promotes an imbalance of plasma levels of pro-inflammatory and anti-inflammatory cytokines. The systemic alteration of cytokines in response to mechanical ventilation may lead to ventilator-induced lung injury. [Copyright &y& Elsevier]

Abstract: A study was conducted on the effects of acute administration of aminophylline on physiological variables in purebred Arabian horses submitted to incremental exercise test. Twelve horses were submitted to two physical tests separated by a 10-day interval in a crossover study. These horses were divided into two groups: control (C, n = 12) and aminophylline (AM, n = 12). The drug at 10 mg/kg body weight or saline was given intravenously, 30 minutes before the incremental exercise test. The treadmill exercise test consisted of an initial warmup followed by gradually increasing physical exigency. Blood samples were assayed for lactic acid, glucose, and insulin. Maximal lactic acidemia was greater (P = .0238) in the AM group. Both V2 and V4 (velocities at which lactate concentrations were 2 and 4 mmol/L, respectively) were reduced in the AM group by 15.85% (P = .0402) and 17.76% (P = .0109), respectively. At rest as well as at 4 minutes, insulinemia was greater in the AM group (P = .0417 and .0393). Glycemia was statistically lower in the AM group at times 8 (P = .0138) and 10 minutes (P = .0432). Use of aminophylline in horses during incremental exercise does not seem to be beneficial, because this drug has a tendency to cause hypoglycemia and to increase dependence on anaerobic glucose metabolism. [Copyright &y& Elsevier]

Abstract: The aim of this work was to characterize the distribution of myofibers in the gluteus medius muscle of inactive horses of the Brasileiro de Hipismo (BH) breed at different ages by means of histochemical analyses, according to sex and depth of the biopsy. A total of 78 inactive horses (9 castrated males, 35 stallions, and 34 females) of the BH breed, aged 1 to 4 years, were used. A percutaneous muscle biopsy was obtained with a 6.0-mm Bergström-type needle, which allowed the removal of muscle fragments at depths of 20 and 60 mm. Myofiber types were determined based on myofibrillar adenosine triphosphatase (mATPase) and nicotinamide dinucleotide tetrazolium reductase (NADH-TR) techniques. Morphometry of the fibers was determined based on cross-sectional area (CSA), mean frequency (F), and relative cross-sectional area (RCSA). The current study demonstrated that BH horses 3 and 4 years of age show a greater percentage of, and area occupied by, type IIA fibers and lower percentage of type IIX fibers in the gluteus medius muscle compared with horses 1 and 2 years of age. No difference was found between sexes in the frequency of and area occupied by the different fiber types at any of the depths and ages studied. In this study, females showed a greater CSA for all fibers in comparison with males, at 1 year of age. The results of the current study indicate that the gluteus medius muscle of inactive BH horses shows modifications in its structural and biochemical composition during the growth of the animals, leading to a better oxidative capacity. [Copyright &y& Elsevier]

Abstract: The aim of the study was to determine the effect of clenbuterol on the anaerobic threshold of horses on a treadmill with increasing physical stress, measuring heart rate (HR) and blood levels of lactate, glucose, and insulin. Twelve Arabian horses were submitted to two physical tests separated by a 10-day interval. Clenbuterol (CL) at 0.8 μg/kg or saline (control—C) was administered intravenously 30 minutes before the test. The treadmill exercise test consisted of an initial warmup followed by a gradually increasing effort. There was no statistical difference in either V2 or V4 (velocity at which plasma lactate concentration reached 4 and 2 mmol/L, respectively) between the two experimental groups. For the CL group, V200, V180, V160, and V140 (velocity at which the rate heart is 140, 160, 180, and 200 beats/minute, respectively) decreased significantly. At rest as well as times 4, 6, and 10 minutes, insulin levels were higher in the group that received clenbuterol (P < .05). Contrary to what was expected, apparently, there was no improvement in aerobic metabolism in animals when given a therapeutic dose of the bronchodilator. The elevated heart rate observed could have been attributable to the stimulation of cardiac β1 adrenoceptors and the increased insulin levels to the stimulation of pancreatic β2 receptors. [Copyright &y& Elsevier]

Summary: Objectives: We assessed the contribution of the surgical approach and the NNIS system''s surgical component variables to surgical site infection (SSI) risk after diagnostic exploration of the abdominal cavity. Methods: Retrospective cohort study with prospective data collection (1993–2006) in five private, non-universitary, secondary or tertiary healthcare facilities. Outcome variable was SSI development within 30 days after surgery. Explanatory variables were age, gender, surgical approach (laparoscopic/open), elective/emergency/trauma procedure, hospital, surgeon, year, additional procedures, wound class, operation duration and ASA-PS score. Results: Consecutive in-patients (6761) were included. Mean age was 38.1 (±14.1) years and 87.3% were female; 68% procedures were laparoscopic. Postdischarge follow-up was obtained for 57.7% patients. Patients operated on laparoscopically had reduced adjusted overall risk of SSI (OR=0.40, 95% CI=0.28–0.56), incisional infection (OR=0.43, 95% CI=0.29–0.62) and organ/space infection (OR=0.19, 95% CI=0.07–0.49). Older age, longer procedures, emergency or trauma procedures, medium- or high-risk surgeons and year ≤1999 increased the adjusted risk of incisional infection. Adjusted risk of organ/space infection was higher in older patients, emergency or trauma procedures, additional procedures and procedures performed by high-risk surgeons. Conclusions: Laparoscopy was associated with lower risk of incisional and organ/space infection. NNIS system''s surgical component variables contributed variably to SSI risk. [Copyright &y& Elsevier]

Abstract: Platelet-activating factor (PAF) is a proinflammatory mediator that plays a central role in acute lung injury (ALI). PAF- acetylhydrolases (PAF-AHs) terminate PAF''s signals and regulate inflammation. In this study, we describe the kinetics of plasma and bronchoalveolar lavage (BAL) PAF-AH in the early phase of ALI. Six pigs with oleic acid induced ALI and two healthy controls were studied. Plasma and BAL samples were collected every 2h and immunohistochemical analysis of PAF-AH was performed in lung tissues. PAF-AH activity in BAL was increased at the end of the experiment (BAL PAF-AH Time 0=0.001±0.001nmol/ml/min/g vs Time 6=0.031±0.018nmol/ml/min/g, p=0.04) while plasma activity was not altered. We observed increased PAF-AH staining of macrophages and epithelial cells in the lungs of animals with ALI but not in healthy controls. Our data suggest that increases in PAF-AH levels are, in part, a result of alveolar production. PAF-AH may represent a modulatory strategy to counteract the excessive pro-inflammatory effects of PAF and PAF-like lipids in lung inflammation. [Copyright &y& Elsevier]

Background: We report on nosocomial infections (NIs), causative organisms, and antimicrobial susceptibility patterns in neonates who were admitted to neonatal intensive care units (NICUs), and assess the performance of birth weight (BW) as a variable for risk-stratified NI rate reporting. Methods: A prospective, 10-year follow-up, open cohort study that involved six Brazilian NICUs was conducted. The NI incidence rates were calculated using different denominators. Results: Six thousand two hundred forty-three newborns and 450 NICU-months of data were available for analysis. This included 3603 NIs that occurred in 2286 newborns over 121,008 patient-days. The most frequent NIs were primary bloodstream infection (pBSI; 45.9%), conjunctivitis (12.1%), skin infections (9.6%), and pneumonia (6.8%). Only the pBSI (but not pneumonia or central venous catheter–related pBSI) rate distribution differed significantly with varying BW. Gram-negative rods (mainly Klebsiella sp. and Escherichia coli) were responsible for 51.6% episodes of pBSI. Gram-positive organisms (mainly coagulase-positive staphylococci) accounted for 37.4%. Candida sp. was the fourth isolated organism. A high resistance to third-generation cephalosporins was recorded in K pneumoniae and E coli isolates. Conclusions: This report highlights the burden of NI, and identifies the major focus for future NI control and prevention programs. Except for pBSI, BW had a poor performance as a variable for risk-stratified NI rate reporting. [Copyright &y& Elsevier]

Abstract: The goal of this study was to investigate by means of an ultrasound examination the composition of the longissimus dorsi muscle in 12 purebred Arabian horses submitted to aerobic training for 90 days, with and without creatine supplementation. Creatine supplementation was carried out by daily administration of 75 g creatine monohydrate mixed into the ration during 90 days of training. Physical conditioning was conducted on a high-performance treadmill, and training intensity was stipulated by calculating the velocity at which blood lactate reaches 4 mmol/l, determined monthly for each animal. The individual intensity of physical force was established at 80% of velocity that resulted in a blood lactate level of 4 mmol/l. The cross-sectional area and the thickness of the layer of fat of the longissimus dorsi muscle were measured for each group at the end of 8 months of inactivity and after 30, 60, and 90 days of training without (control groups) or with creatine supplementation (experimental groups). The results showed that aerobic training combined with or without creatine supplementation caused significant longissimus dorsi hypertrophy and reduction in the thickness of the fat layer. No beneficial effect from prolonged creatine supplementation on the body composition of horses was detected. [Copyright &y& Elsevier]

[Display omitted] • Effect of Ni crystallite size and oxygen mobility of the support on carbon formation. • The amount of carbon formed during DRM achieved a maximum at around 20−30 nm. • Carbon deposition was negligeable below 10 nm and above 100 nm. • Coordinatively unsaturated sites (small Ni particle sizes) inhibit carbon formation. • On very large Ni particles, the CH 4 dissociation rate is so low that carbon reacts. This work investigates the effect of Ni crystallite size and oxygen vacancies of the support on the formation of carbon over Ni/CeO 2 catalysts for dry reforming of methane at 1073 K. A large crystallite size variation is achieved by using different Ni loading (5 and 10 wt%) and calcination temperatures (673, 873, 1073 and 1473 K). In situ XRD and XANES experiments reveal that the increase in calcination temperature increases the Ni crystallite size, whereas the amount of oxygen vacancies decreases. The amount of carbon formed during DRM increases as Ni crystallite size increases, achieving a maximum at around 20−30 nm and then, it continuously decreases. However, carbon deposition is negligeable below 10 nm and above 100 nm. For the catalysts with very large Ni crystallite sizes, the CH 4 dissociation rate is likely so low that carbon species formed reacts and carbon accumulation does not take place. However, the oxygen vacancies of ceria do not contribute to the carbon removal from the Ni surface due to the low metal-support interface on these large Ni particles. [ABSTRACT FROM AUTHOR]

[Display omitted] • Pt embedded catalysts are highly stable in the dry reforming of methane reaction. • The embedded structure promotes the oxygen mobility over support. • The incorporation of Zr improves the oxygen mobility in the material. • The embedded structure presents high oxygen lattice species responsible for coke gasification. This work investigated the effect of Pt nanoparticles embedded into CeO 2 (Pt@CeO 2) and CeZrO 2 (Pt@CeZrO 2) on the carbon removal mechanism for the dry reforming of methane, in comparison to impregnated Pt/CeO 2. Morphological and structural characterization by TEM and Raman spectroscopy showed that Pt sintering is suppressed on both structures and the doping with Zr led to the CeZrO 2 solid solution formation. A combination of TPR, oxygen isotopic exchange and DRIFTS measurements demonstrated that embedded Pt nanoparticles interact more strongly with ceria than supported Pt, and as a consequence, reactive lattice oxygen becomes more abundant on the catalyst surface, promoting the mechanism of carbon gasification over Pt nanoparticle. The low availability of oxygen species on Pt/CeO 2 resulted in higher carbon formation, as demonstrated by TPO analysis. Therefore, the Pt@CeO 2 and Pt@CeZrO 2 catalysts were more resistant to coke formation due to the higher presence of reactive oxygen species at the metal-support interface, promoting the balance between the rates of carbon formation and carbon gasification over Pt nanoparticle. [ABSTRACT FROM AUTHOR]

• Na,Ca-based catalysts supported on activated carbon were studied. • The catalysts were produced by heat treatments at different temperatures. • Na 2 CO 3 and Na 2 CO 3.CaCO 3 were identified as the dominant active phases. • The catalysts were tested in biodiesel production from soybean oil • Low leaching of Na and Ca in the synthesized biodiesel was observed. Catalysts containing Na and Ca compounds dispersed in a porous carbon support were prepared by a wet chemical route followed by heat treatments and their catalytic performance in the transesterification reaction of soybean oil with methanol was investigated. The chemical composition and the structural properties of the Na,Ca-based catalysts were modified by means of heat treatments at temperatures ranging from 500 to 800 °C. The chemical nature of the Na,Ca-containing phases was studied by X-ray diffraction and solid-state 23Na nuclear magnetic resonance (NMR) spectroscopy, among other methods. The as-prepared material was found to be composed of a mixture of Ca(OH) 2 and Na 2 CO 3 ; the heat treatment at 500 °C led to the formation of the double carbonate, Na 2 CO 3.CaCO 3 , whereas at high temperatures the dominant phases were CaO and Na 2 CO 3. The best catalytic efficiency was achieved for the catalysts prepared at 700 and 800 °C. An important advantage of the prepared catalysts was the low concentration of Ca and Na leached into the produced biodiesel samples. It was found that the best heat treatment temperatures to prevent metal leaching were 700 and 800 °C. These results show that the simple method of wet impregnation followed by heat treatments is an efficient route for the production of carbon-supported Na,Ca-based catalysts with high porosity, good catalytic efficiency and that allow the synthesis of biodiesel samples with low metal contents. [ABSTRACT FROM AUTHOR]