Electroactive poly(vinylidene fluoride-trifluoroethylene)/graphene composites for cardiac tissue engineering applications

Electroactive materials are increasingly being used in strategies to regenerate cardiac tissue. These materials, particularly those with electrical conductivity, are used to actively recreate the electromechanical nature of the cardiac tissue. In the present work, we describe a novel combination of poly(vinylidene fluoride-trifluoroethylene) (P(VDF-TrFE)), a highly electroactive polymer, with graphene (G), exhibiting high electrical conductivity. G/P(VDF-TrFE) films have been characterized in terms of topographical, physico-chemical, mechanical, electrical, and thermal properties, and studied the response of cardiomyocytes adhering to them. The results indicate that the crystallinity and the wettability of the composites remain almost unaffected after G incorporation. In turn, surface roughness, Young modulus, and electric properties are higher in G/P(VDF-TrFE). Finally, the composites are highly biocompatible and able to support cardiomyocyte adhesion and proliferation, particularly surface treated ones, demonstrating the suitability of these materials for cardiac tissue engineering applications.

Evaluation of the Effects of Food Safety Training on the Microbiological Load Present in Equipment, Surfaces, Utensils, and Food Manipulator's Hands in Restaurants

Training food handlers is essential to ensure food safety. However, the efficacy of training programs relying solely on theoretical information remains uncertain and often fails to induce significant changes in inadequate food practices. Training programs in good hygiene and food safety practices that integrate theoretical and practical approaches have emerged as a vital tool, enabling food handlers to apply their knowledge during work hours and clarify doubts. This study aimed to assess the impact of food safety training based on theoretical and on-the-job training on the microbiological counts of equipment, surfaces, utensils, and food handler (FH) hands. The hygiene and food safety conditions of four restaurants were analyzed through facility checklists, employee questionnaires, and microbiological analyses conducted before and after training. Eight sample collection moments were conducted at each restaurant before and after training. The pre-training results indicate that 15% and 26% of analyses for Enterobacteriaceae and total mesophilic aerobic bacteria (TMB), respectively, did not comply with hygiene safety limits. Additionally, 31% and 64% of Enterobacteriaceae and TMB values, respectively, exceeded safety limits on food handler hands. Positive cases of coagulase-positive Staphylococcus (CoPS) resulted from unprotected wounds on some FH hands. The presence of Listeria monocytogenes in drains was also identified as a concern. Following training, significant differences in results were observed. In many cases, there was a reduction of over 80% in microbial load for Enterobacteriaceae and TMB collected from equipment, surfaces, utensils, and food handler hands. The presence of L. monocytogenes in drains was also eliminated after food safety training. In conclusion, this study underscores the importance of effective training in improving food safety practices.

Valorization of baobab seeds (Adansonia digitata) as a coffee-like beverage: evaluation of roasting time on bioactive compounds

The baobab tree (Adansonia digitata) can be found in sub-Saharan Africa, and its fruit presents high nutritional value. However, baobab seeds are often discarded and their potential remains underutilized. This study aimed to investigate the effect of roasting time (30/55/80/105 min at 200 °C) on the physical-chemical properties of baobab seeds and the bioactive compounds in a coffee-like beverage. The results showed a decrease in moisture, Aw (water activity), and hardness of baobab seeds with increasing roasting time. These changes resulted from moisture loss, caramelization, and Maillard reactions, which also affected appearance when compared with unroasted baobab seeds. The pH of the beverage decreased to a value of around 6.01 after 105 min of roasting. The total phenolic content and antioxidant activity of the beverage increased with roasting time, reaching 851.2 mg GAE/100 g (after 80 min) and 18.9 mmol Fe2+/100 g (after 55 min), respectively. The caffeine content remained stable around 16 mg/100 g from 55 to 105 min, lower than that of unroasted coffee beans and decaffeinated coffee. These findings suggest the potential for valorizing baobab seeds in the development of a new coffee-like beverage with lower caffeine content.

Enantioselectivity in ecotoxicity of pharmaceuticals, illicit drugs, and industrial persistent pollutants in aquatic and terrestrial environments: A review

At present, there is a serious concern about the alarming number of recalcitrant contaminants that can negatively affect biodiversity threatening the ecological status of marine, estuarine, freshwater, and terrestrial ecosystems (e.g., agricultural soils and forests). Contaminants of emerging concern (CEC) such as pharmaceuticals (PHAR), illicit drugs (ID), industrial persistent pollutants, such as polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) and chiral ionic solvents are globally spread and potentially toxic to non-target organisms. More than half of these contaminants are chiral and have been measured at different enantiomeric proportions in diverse ecosystems. Enantiomers can exhibit different toxicodynamics and toxicokinetics, and thus, can cause different toxic effects. Therefore, the enantiomeric distribution in occurrence cannot be neglected as the toxicity and other adverse biological effects are expected to be enantioselective. Hence, this review aims to reinforce the recognition of the stereochemistry in environmental risk assessment (ERA) of chiral CEC and gather up-to-date information about the current knowledge regarding the enantioselectivity in ecotoxicity of PHAR, ID, persistent pollutants (PCBs and PBDEs) and chiral ionic solvents present in freshwater and agricultural soil ecosystems. We performed an online literature search to obtain state-of-the-art research about enantioselective studies available for assessing the impact of these classes of CEC. Ecotoxicity assays have been carried out using organisms belonging to different trophic levels such as microorganisms, plants, invertebrates, and vertebrates, and considering ecologically relevant aquatic and terrestrial species or models organisms recommended by regulatory entities. A battery of ecotoxicity assays was also reported encompassing standard acute toxicity to sub-chronic and chronic assays and different endpoints as biomarkers of toxicity (e.g., biochemical, morphological alterations, reproduction, behavior, etc.). Nevertheless, we call attention to the lack of knowledge about the potential enantioselective toxicity of many PHAR, ID, and several classes of industrial compounds. Additionally, several questions regarding key species, selection of most appropriate toxicological assays and ERA of chiral CEC are addressed and critically discussed.

Beyond activity patterns: The complex process of activity management among individuals with chronic musculoskeletal pain after an orthopaedic trauma

CONTEXT

Individuals must change the way they perform activities in response to chronic pain. In the literature, three activity patterns are commonly described: avoidance, pacing, and persistence. Many studies have explored these activity patterns. However, little research has delved into the factors that lead people to adopt a particular activity behaviour. This study aimed to explore the relationship that people with chronic musculoskeletal pain have with activity and highlight the factors underlying their practices.

METHODS

The qualitative study was conducted by researchers in the social sciences, physiotherapy, psychology, and rehabilitation medicine. Observations of vocational workshops and semi-structured interviews were conducted with 33 persons undergoing rehabilitation for chronic musculoskeletal pain after an accident.

RESULTS

Patients' declarations and actions show that any one patient will alternate between activity patterns: the same person may adopt a strategy of avoidance, pacing or persistence depending on the context, the importance of the activity, personal objectives, and representations of self, pain, and activity. The decision to engage in a particular behaviour is based on a process of self-negotiation weighted by the circumstances, the nature of the activity, the importance attached to it, and the individual's perceived ability.

CONCLUSION

Our study emphasized the complexity of physical, social, and contextual factors that intervene in the relationship toward activity. Rather than favouring pacing, the therapist's role in rehabilitation might be to reinforce the reflexive process and the patient's adaptability in approaching the activity, to foster the capacity to find flexible solutions.

SIGNIFICANCE

Patients choose an activity pattern (avoidance, pacing, persistence) according to the challenges they face in their daily lives. Context, representations of self and activity, as well as goals sought influence these choices. Some patients report having learned to adapt their activity management strategies. Therefore, therapeutic approaches in the rehabilitation context could focus on these adaptive capacities to offer patients optimal pain and activity management and develop their ability to use different strategies according to the circumstance.

Progress for carbon dioxide geological storage in West Macedonia: A field and laboratory-based survey

Background: It is widely acknowledged that carbon dioxide (CO 2), a greenhouse gas, is largely responsible for climatic changes that can lead to warming or cooling in various places. This disturbs natural processes, creating instability and fragility of natural and social ecosystems. To combat climate change, without compromising technology advancements and maintaining production costs at acceptable levels, carbon capture and storage (CCS) technologies can be deployed to advance a non-disruptive energy transition. Capturing CO 2 from industrial processes such as thermoelectric power stations, refineries, and cement factories and storing it in geological mediums is becoming a mature technology. Part of the Mesohellenic Basin, situated in Greek territory, is proposed as a potential area for CO 2 storage in saline aquifers. This follows work previously done in the StrategyCCUS project, funded by the EU. The work is progressing under the Pilot Strategy, funded by the EU. Methods: The current investigation includes geomechanical and petrophysical methods to characterise sedimentary formations for their potential to hold CO 2 underground. Results: Samples were found to have both low porosity and permeability while the corresponding uniaxial strength for the Tsotyli formation was 22 MPa, for Eptechori 35 MPa and Pentalofo 74 MPa. Conclusions: The samples investigated indicate the potential to act as cap-rocks due to low porosity and permeability, but fluid pressure within the rock should remain within specified limits; otherwise, the rock may easily fracture and result in CO 2 leakage or/and deform to allow the flow of CO 2. Further investigation is needed to identify reservoir rocks as well more sampling to allow for statistically significant results.

Generating parallel representations of position and identity in the olfactory system

In Drosophila, a dedicated olfactory channel senses a male pheromone, cis-vaccenyl acetate (cVA), promoting female courtship while repelling males. Here, we show that separate cVA-processing streams extract qualitative and positional information. cVA sensory neurons respond to concentration differences in a 5-mm range around a male. Second-order projection neurons encode the angular position of a male by detecting inter-antennal differences in cVA concentration, which are amplified through contralateral inhibition. At the third circuit layer, we identify 47 cell types with diverse input-output connectivity. One population responds tonically to male flies, a second is tuned to olfactory looming, while a third integrates cVA and taste to coincidentally promote female mating. The separation of olfactory features resembles the mammalian what and where visual streams; together with multisensory integration, this enables behavioral responses appropriate to specific ethological contexts.

Allergic emergencies in the prehospital setting: a 5 year retrospective study

Summary

Background. Patients with severe allergic conditions often request support from the prehospital emergency services given the rapid, unexpected and potentially life-threatening nature of the reactions, such as anaphylaxis. Studies regarding prehospital incidents for allergic conditions are scarce. This study aimed to characterize prehospitalar medical requesting assistance due to suspected hypersensitivity reactions (HSR). Methods. Retrospective study of allergic-related requesting assistances between 2017-2022 of a Portuguese emergency dispatch centre - Emergency and Resuscitation Medical Vehicle (VMER), in Coimbra University Hospital. Demographic and clinical variables were analysed, including clinical manifestations, anaphylaxis severity grading, therapeutic interventions, and post-incident allergic work-up. Regarding anaphylactic events, three diagnosis timings were compared: on-site, hospital emergency department and Investigator-diagnosis based on data reviewed. Results. Out of 12689 VMER requesting assistances, 210 (1.7%) were classified as suspected HSR reactions. After on-site medical evaluation, 127 (60.5%) cases maintained the HSR classification (median age 53 years; 56% males) and the main diagnoses included HSR to Hymenoptera venom (29.9%), food allergy (29.1%), and pharmaceutical drugs (25.5%). Anaphylaxis was assumed on-site in 44 (34.7%) cases, in the hospital emergency department in 53 cases (41.7%) and by investigators in 76 (59.8%) cases. Regarding management, epinephrine was administered on-site in 50 cases (39.4%). Conclusions. The main reason for prehospital requesting assistance was HSR to Hymenoptera venom. A high proportion of incidents met the criteria for anaphylaxis and despite the inherent difficulties of the prehospital setting, many of the on-site diagnoses agreed with the criteria. Regarding management, epinephrine was underused in this setting. Referral to specialized consultation is crucial for the management of prehospital incidents.

Do flies dream of protein? How the gut regulates sleep depth

A recent study by Titos et al. in Cell shows that protein-rich diets are strong modulators of sleep depth in Drosophila and identifies the gut-secreted neuropeptide CCHa1 as the mediator of this effect. In the brain, CCHa1 controls dopamine release from a small set of neurons, thereby modulating arousability by integrating internal state with sensory information.

Improving the Performance of Paper-Based Dipole Antennas by Electromagnetic Flux Concentration

One of the essential issues in modern advanced materials science is to design and manufacture flexible devices, in particular in the framework of the Internet of Things (IoT), to improve integration into applications. An antenna is an essential component of wireless communication modules and, in addition to flexibility, compact dimensions, printability, low cost, and environmentally friendlier production strategies, also represent relevant functional challenges. Concerning the antenna's performance, the optimization of the reflection coefficient and maximum range remain the key goals. In this context, this work reports on screen-printed paper@Ag-based antennas and optimizes their functional properties, with improvements in the reflection coefficient (S₁₁) from -8 to -56 dB and maximum transmission range from 208 to 256 m, with the introduction of a PVA-Fe₃O₄@Ag magnetoactive layer into the antenna's structure. The incorporated magnetic nanostructures allow the optimization of the functional features of antennas with possible applications ranging from broadband arrays to portable wireless devices. In parallel, the use of printing technologies and sustainable materials represents a step toward more sustainable electronics.

Orchard Net Covers Improve Resistance to Cherry Cracking Disorder

Orchard net cover improves plant physiology, yield and fruit quality, pest and disease control, and anticipates fruit ripening. Moreover, this crop technology has been used to reduce natural cherry cracking (NCC). This is a serious physiological disorder that cracks the epidermis, the hypodermis, and the storage parenchyma layers of the fruit due to rainfall events near the harvest and it is related to low fruit osmotic potential and/or high fruit water permeability. This work aims to study the effect of orchard net cover on sweet cherry trees, cv. Early Bigi, in two harvesting years (2019 and 2021). The NCC, the induced cracking index (CI), and the cracking type incidence were determined. In addition, epicuticular and intra-cuticular wax content, biometric and physicochemical parameters were also evaluated. Net cover reduced the natural cracking index by 40%. High fruit weight values were observed in covered trees comparing to the control ones, with increases of 45% and 13%, in 2019 and 2021, respectively. A positive correlation was observed between CI and total soluble solids and a negative correlation between CI and wax content. Therefore, with forecasts of worsening heavy precipitation events near harvest, protecting cherry trees with nets will increase resistance to fruit cracking.

DESIGN AND STUDY OF DIFFERENT PVDF STRUCTURES

Introduction

Tissue engineering (TE) is a promising technology that can develop structures very similar to native tissues to improve or replace their biological functions. Polyvinylidene fluoride (PVDF) is a new thermoplastic polymer widely used in biomedical applications. Each structure of PVDF has different mechanical and biological characteristics depending on its morphology and the methodology employed.

Methods

Doctor blade, salt leaching, and electrospinning methodologies were used to design different PVDF structures, including films, porous membranes, and electrospun membranes, respectively. Furthermore, electrospun PVDF membranes were developed according to the direction of the strands, obtaining membranes that were oriented as well as with random orientation. All these morphologies were subjected to mechanical, cytotoxicity and degradation studies.

Results

All PVDF morphologies underwent a minimum modification of 16% with respect to their original size. The porous membranes were the most fragile structures, and the electrospun membranes were the most resistant. According to ISO standard 10993–5, a material is considered to be biocompatible when the values are higher than 70%, and all PVDF morphologies had cell viability values above the 70% threshold. Finally, results showed that there was no degradability, regardless of the method or structure designed.

Conclusions

PVDF is a material with good mechanical characteristics, given that structures designed with electrospinning can withstand more stress. In addition, this material is non-degradable and biocompatible, broadening the range of biomedical and TE applications.

DESIGN AND STUDY OF DIFFERENT SILK FIBROIN STRUCTURES

Introduction

Tissue engineering (TE) has the capacity to design structures very similar to native tissues in order to restore, maintain or improve their biological functions. Silk fibroin (SF) is a natural protein that has been used in a wide variety of TE applications. Each SF structure has different mechanical and biological characteristics depending on the morphology and methodology employed.

Methods

Bombyx mori silkworm cocoons were extracted and processed to obtain SF. Subsequently, films, porous membranes, and electrospun membranes were designed using doctor blade, salt leaching, and electrospinning methodologies, respectively. Furthermore, electrospun SF membranes were developed according to the direction of the strands, obtaining membranes that were oriented as well as with random orientation. All these morphologies were subjected to mechanical, cytotoxicity and degradation studies.

Results

The most fragile SF structures were the films and the porous membranes, which underwent a maximum modification of approximately 5% with respect to their original size. However, electrospun membranes underwent a change in size of more than 20%. All SF morphologies had biocompatibility values close to 100%. Finally, there was a degradability between 3–5% at 4 weeks in all structures.

Conclusions

SF has very good mechanical characteristics when designed by electrospinning techniques. Although SF is biocompatible, there is a degradation of the material, which may affect the mechanical properties of the designed structure.

Surface charge and dynamic mechanoelectrical stimuli improves adhesion, proliferation and differentiation of neuron-like cells

Neuronal diseases and trauma are among the current major health-care problems. Patients frequently develop an irreversible state of neuronal disfunction that lacks treatment, strongly reducing life quality and expectancy. Novel strategies are thus necessary and tissue engineering research is struggling to provide alternatives to current treatments, making use of biomaterials capable to provide cell supports and active stimuli to develop permissive environments for neural regeneration. As neuronal cells are naturally found in electrical microenvironments, the electrically active materials can pave the way for new and effective neuroregenerative therapies. In this work the influence of piezoelectric poly(vinylidene fluoride) with different surface charges and dynamic mechanoelectrical stimuli on neuron-like cells adhesion, proliferation and differentiation was addressed. It is successfully demonstrated that both surface charge and electrically active dynamic microenvironments can be suitable to improve neuron-like cells adhesion, proliferation, and differentiation. These findings provide new knowledge to develop effective approaches for preclinical applications.

Unintended intrapleural insertion of an epidural catheter in thoracic surgery: regional analgesia game over, or is there another way out?

In thoracic surgery, optimized pain control is crucial to prevent dysfunction in cardiorespiratory mechanics. Epidural anesthesia (EA) and paravertebral block (PVB) are the most popular techniques for analgesia. Unintended intrapleural insertion of an epidural catheter is a rare complication. Our report presents a case of a patient submitted to pulmonary tumor resection by video-assisted thoracoscopic surgery (VATS). There was difficulty in epidural insertion related to patient's obesity, but after general anesthesia induction, no additional intravenous analgesia was needed after epidural injection. Surgery required conversion to thoracotomy, with intrapleural identification of epidural catheter. At the end of surgery, surgeons reoriented catheter to paravertebral space, with leak absence confirmation after local anesthetic injection through the catheter. In postoperative period, pain control was efficient, with no complications. It was a successful case that shows that when we find unexpected complications, we can look for alternative solutions to give our patient the best treatment.

Prevalence and predictors of acquired long QT syndrome in the ER department

Introduction

Long QT syndrome (LQTS) is a rare heterogeneous syndrome that may be congenital or acquired, the latter being more common. Its real-world prevalence remains to be determined. We aimed to determine the prevalence of this syndrome in patients admitted to the emergency room (ER) and characterize the subset of patients with severely prolonged QT.

Methods

A retrospective analysis of ECG of all consecutively admitted patients in the ER of a tertiary hospital between the 28th of January and the 17th of March 2020 was made. All patients with Bazzett corrected QT interval greater than 470ms in men and 480ms in women were included. Repeated ECGs or with bad electrocardiographic quality, congenital LQTS, atrial fibrillation and pacemaker rhythm were excluded. Clinical data with a special focus on QT prolonging drugs and clinical factors were recorded. Statistical comparison was made between the groups with and without QT interval greater than 500ms.

Results

A total of 6280 ECGs of 5056 patients were analysed. After evaluation, 390 ECGs from 387 different patients were considered. Prevalence of LQTS at admission was 7.95%. Patients were more commonly men (53.1%) with an average age of 73.6±14.7 years old and mean QTc interval of 502.14±32.2ms. Only 20% of the patients were symptomatic, with the most common form of presentation being syncope (50%). No ventricular arrhythmias were recorded.

Regarding patients with a QT interval greater than 500ms, these were more frequently female (59.9% vs 37.2%, p<0.001), were more frequently on QT prolonging drugs (77.8% vs 67.3%; p=0.002). Presence of clinical risk factors was not a risk factor per se (p=0.811) but a greater number of risk factors was linked to more severely prolonged QT (p=0.040). The main contributing factor was intake of antibiotics (odds ratio (OR) 3.497; CI 95% 1.074–11.321; p=0.038) followed by female gender (OR 2.518; CI 95% 1.668–3.800; p<0.001) and use of antipsychotics (OR 1.960; CI 95% 1.159–3.316; p=0.012).

Conclusions

Acquired LQTS is particularly prevalent in the ER setting. The complex interaction of clinical factors and drug iatrogenesis and the unpredictability of its manifestations render its management and recognition difficult but essential. Female patients on antibiotics and antipsychotics are at particularly high risk. Efforts must be made in order to avoid, detect and treat acquired LQTS as early as possible.

Funding Acknowledgement

Type of funding sources: None.

Ionic liquid-based electroactive materials: a novel approach for cardiac tissue engineering strategies

Cardiac tissue regeneration strategies are increasingly taking advantage of electroactive scaffolds to actively recreate the tissue microenvironment. In this context, this work reports on advanced materials based on two different ionic liquids (ILs), 2-hydroxyethyl-trimethylammonium dihydrogen phosphate ([Ch][DHP]) and choline bis(trifluoromethylsulfonyl)imide ([Ch][TFSI]), combined with poly(vinylidene fluoride-co-trifluoroethylene) (P(VDF-TrFE)) for the development of ionic electroactive IL/polymer hybrid materials for cardiac tissue engineering (TE). The morphological, physico-chemical, thermal and electrical properties of the hybrid materials, as well as their potential use as scaffolds for cardiac TE applications, were evaluated. Besides inducing changes in surface topography, roughness and wettability of the composites, the incorporation of [Ch][DHP] and [Ch][TFSI] leads to the increase in surface (σ_surface) and volume (σ_volume) electrical conductivities. Furthermore, washing the hybrid samples with phosphate-buffered saline solution strongly decreases the σ_surface, whereas σ_surface and σ_volume of the composites remain almost unaltered after exposure to ultraviolet sterilization treatment. Additionally, it is verified that the incorporation of IL influences the P(VDF-TrFE) microstructure and crystallization process, acting as a defect during its crystallization. Cytotoxicity assays revealed that hybrid films based on [Ch][DHP] alone are not cytotoxic. These films also support H9c2 myoblast cell adhesion and proliferation, demonstrating their suitability for cardiac TE strategies based on electroactive microenvironments.

Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study

BACKGROUND

No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge.

METHODS

The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing.

FINDINGS

2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters.

INTERPRETATION

The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials.

FUNDING

UK Research and Innovation and National Institute for Health Research.

Electroactive functional microenvironments from bioactive polymers: A new strategy to address cancer

The present work reports on a new approach based on electroactive microenvironments to mitigate skeletal muscle cancer. For that, piezoelectric films based on poly(vinylidene fluoride) have been applied to evaluate the influence of mechano- and/or electrical stimuli on rhabdomyosarcoma (RMS) proliferation. Human embryonal rhabdomyosarcoma (RD) cells were cultured on PVDF pristine films with different surface charge (non-poled, poled+ and poled-) and magnetic composites (10% and 20% Fe₃O₄, and 20% CFO filler content) to allow magneto-mechanical and magnetoelectrical stimulation films. Electrospun PVDF pristine (oriented and randomly) and magnetic (10% Fe₃O₄) fiber mats were also evaluated to take into consideration the morphology effect on cell response. It was found that the mechanical stimuli enhance RMS proliferation whereas the mechano-electrical decreases it. It was also verified that the RD cells proliferate better on randomly oriented fibers, whereas myoblast cells do it better in oriented ones. The obtained results confirm that electroactive microenvironments can be used to develop novel and effective approaches to deal with RMS cancer, that can be extrapolated to others cancer types.

Greener Solvent-Based Processing of Magnetoelectric Nanocomposites

Polymer-based magnetoelectric (ME) nanocomposites are an enabling material technology for a wide range of applications in the area of digitalization strategies. Due to its highest piezoelectric response among polymers, poly(vinylidene fluoride-trifluoroethylene) (PVDF-TrFE) is the piezoelectric matrix most used in polymer-based ME materials with over 80% of the total reports, with the resulting composites typically processed from solutions with N,N-dimethylformamide (DMF), a toxic solvent. Nevertheless, environmentally friendlier approaches and sustainable technologies are increasingly being required. This work demonstrates that P(VDF-TrFE)/Co₂Fe₂O₄ nanocomposites can be successfully prepared from solution using three different environmentally friendlier solvents: dimethyl sulfoxide (DMSO), N,N'-dimethylpropyleneurea (DMPU), and triethyl phosphate (TEP) with different dipole moments. It is shown that the prepared composite films, with a maximum ME voltage coefficient of 35 mV cm^-1 Oe^-1 and a maximum sensitivity of 2.2 mV T^-1, are suitable for applications, highlighting the path for a new generation of more sustainable ME sensors.

Fly Cell Atlas: A single-nucleus transcriptomic atlas of the adult fruit fly

For more than 100 years, the fruit fly Drosophila melanogaster has been one of the most studied model organisms. Here, we present a single-cell atlas of the adult fly, Tabula Drosophilae, that includes 580,000 nuclei from 15 individually dissected sexed tissues as well as the entire head and body, annotated to >250 distinct cell types. We provide an in-depth analysis of cell type-related gene signatures and transcription factor markers, as well as sexual dimorphism, across the whole animal. Analysis of common cell types between tissues, such as blood and muscle cells, reveals rare cell types and tissue-specific subtypes. This atlas provides a valuable resource for the Drosophila community and serves as a reference to study genetic perturbations and disease models at single-cell resolution.

Bio-based composite granules with simultaneous biocontrol and phosphorus fertilization roles: outcomes from a lab-scale in-vitro assessment

The use of phosphate rocks as low-solubility phosphorus fertilizers has been promoted to reduce the environmental impacts of agriculture, but adequate nutrient uptake by plants depends on solubilization of the rock, driven by soil microorganisms. Here, investigation was made of the microbial solubilization of low-solubility phosphate rocks, together with simultaneous bioprotective action involving the biocontrol of microorganisms. The aim was to enhance function and value by delivering two effects using a single bio-based product, in accordance with the concept of a "bioreactor-in-a-granule" system. A composite structure was developed, based on a starch matrix, comprising a combination of Trichoderma asperelloides, as a biocontrol agent, and Aspergillus niger, as an acidulant. A significant increase of up to 150% in P solubilization was achieved, indicating the positive effect of the microorganism-composite interaction. In vitro assays showed that the ability of T. asperelloides to inhibit Fusarium oxysporum mycelial growth was maintained in the presence of A. niger. Moreover, the estimated cost of the composite granule (0.35 US$/kg of product on a dry basis) revealed competitive. The results indicated that the association of T. asperelloides and A. niger is an effective way to increase nutrient availability and to inhibit plant pathogens, opening up possibilities for the design of multifunctional bio-based fertilizer composites. This article is protected by copyright. All rights reserved.

Neuroscience: How the brain prioritizes behaviors

To optimize our choices, we need to prioritize among different goals. A recent study used a new Drosophila behavioral paradigm, bringing together conflicting behavioral choices in the context of different internal states and sensory cues, to provide foundational insights into the circuit mechanisms underlying how the brain prioritizes behavioral decisions.

Vertical flow constructed wetland as a green solution for low biodegradable and high nitrogen wastewater: A case study of explosives industry

The removal of nitrogen compounds from a pretreated explosives wastewater in vertical flow constructed wetland planted with Vetiveria zizanioides (0.24 m² × 0.70 m), filled with light expanded clay aggregates (Leca®NR 10/20), was studied. Experiments under constant hydraulic load, 50 ± 4 L m^-2 d^-1 and 83 ± 5 L m^-2 d^-1 without and with flooding level (25%), respectively, were made at different ammonium (3-48 mg NH₄⁺-N L^-1), nitrate (56-160 mg NO₃^--N L^-1) and nitrite (0.3-1.1 mg NO₂^--N L^-1) concentrations. Results indicate that without flooding level (unsaturated) the removal efficiencies obtained were 30 ± 9, 7 ± 1 and 96 ± 2%, respectively to NH₄⁺-N, NO₃^--N and NO₂^--N. When using flooding level and an external carbon source (C/N ratio from 1.3 ± 0.19 to 2.5 ± 0.20), the organic matter (COD) removal efficiencies were above 90%, 75% for NH₄⁺-N and 55% to NO₃^--N. Increasing the C/N ratio from 2.9 ± 0.21 to 4 ± 0.22 did not contributed to upgrade the efficiencies of COD, NH₄⁺-N and NO₃^--N removal. The denitrification process was occurred in aerobic conditions and nitrite production have ben occurred, probably due to the presence of aerobic conditions that inhibited partially denitrification.

Key elements in hypersensitivity reactions to chemotherapy: experience with rapid drug desensitization in gynaecological cancer in a tertiary hospital

Summary

Rapid drug desensitization (RDD) is a procedure performed when no alternative drug is considered equally effective. The aim of our study is to describe the experience with RDD to cytostatics in patients being treated for gynaecological cancer in a tertiary hospital, over a period of 5 years. In this paper, we review 22 cases and 107 episodes of RDD; 86.3% of patients had advanced disease and the mortality rate at the time of data collection was 50.0%. RDD was performed on 81.8% patients for platinum, 13.6% for taxanes, and 4.5% for anthracyclines. The reintroduction of antineoplastic drugs in all patients with a previous history of immediate hypersensitivity reaction demonstrated the safety and efficacy of this procedure. There was serious complication (anaphylaxis) in only one case.

Psychiatric disorders during acute hospital treatment of COVID-19 - a case series

Introduction

Coronavirus disease (COVID-19) has been associated with the development mental and behavioural symptoms and psychiatric disorders. This association is stronger in severe cases of the disease and in those needing inpatient treatment, particularly in intensive care units (ICU).

Objectives

To determine the incidence of psychiatric disorders in a Portuguese hospital-based sample of patients with COVID-19. To describe relevant demographic and clinical data.

Methods

We reviewed all COVID-19 inpatients assessed by liaison psychiatry at our hospital between April and September 2020. Patients admitted due to a psychiatric disorder were excluded from the analysis. We reviewed medical records and retrieved relevant clinical data. ICD-10 was used to classify diagnoses.

Results

We identified 36 cases with a mean age of 62.64 years-old (SD 19.23). The most common disorder was delirium, which occurred in 41.7% of our sample (15 patients), followed by adjustment disorder (22.2%, n=8), and depressive episode (16.7%, n=8). Most patients had no personal (61.1%, n=22) nor family (75%, n=27) history of a psychiatric disorder. Mean length of admission was 36.89 days (SD 28.91). Seventeen cases (47.22%) had at least one risk factor for severe COVID-19 disease and 14 (38.89%) were admitted at some point to the ICU.

Conclusions

In our sample, delirium was the main cause for mental or behavioural symptoms in COVID-19 patients. However, we observed a wide array of presentations in our center. A larger sample would allow to better characterize this often-overlooked symptoms and identify risk factors to psychiatric syndromes.

Disclosure

No significant relationships.

Preliminary Insights in Sensory Profile of Sweet Cherries

Sweet cherry (Prunus avium L.) is a fruit appreciated by consumers for its well-known physical and sensory characteristics and its health benefits. Being an extremely perishable fruit, it is important to know the unique attributes of the cultivars to develop cultivation or postharvest strategies that can enhance their quality. This study aimed to understand the influence of physicochemical characteristics of two sweet cherry cultivars, Burlat and Van, on the food quality perception. Several parameters (weight, dimensions, soluble solids content (SSC), pH, titratable acidity (TA), colour, and texture) were measured and correlated with sensory data. Results showed that cv. Van presented heavier and firmer fruits with high sugar content. In turn, cv. Burlat showed higher pH, lower TA, and presented redder and brightest fruits. The principal component analysis revealed an evident separation between cultivars. Van cherries stood out for their sensory parameters and were classified as more acidic, bitter, and astringent, and presented a firmer texture. Contrarily, Burlat cherries were distinguished as being more flavourful, succulent, sweeter, and more uniform in terms of visual and colour parameters. The results of the sensory analysis suggested that perceived quality does not always depend on and/or recognize the quality parameters inherent to the physicochemical characteristics of each cultivar.

T-cell Prolymphocytic Leukemia, Cerebriform Variant

T-cell prolymphocytic leukemia (T-PLL) is a very rare and aggressive lymphoproliferative disorder. We present a 70-year-old man with complaints of fatigue, low urinary output, and peripheral edema for one month. Objectively, he presented diminished respiratory sounds bilaterally and peripheral edema. Analytical study revealed mild anemia and mild lymphomonocytosis, acute kidney injury, and urinalysis with proteins, leukocytes, erythrocytes, and cylinders. Chest radiography was consistent with pleural effusion. Subsequent study showed new onset of thrombocytopenia with a progressive increase of lymphocytosis, in association with inguinal adenopathies and splenomegaly. Immunophenotypic study of peripheral blood and lymph node biopsy were compatible with the diagnosis of T-PLL. Negative serology for human T-cell lymphotropic virus type 1 (HTLV-1) excluded adult T-cell leukemia. Progressive changes in the peripheral blood smear were seen, finally showing the presence of lymphocytes with a cerebriform nucleus, revealing this variant. There was a rapid catastrophic progression, spontaneous tumor lysis syndrome, and death.

Experiments on the influence of spot fire and topography interaction on fire rate of spread

Spotting is thought to increase wildfire rate of spread (ROS) and in some cases become the main mechanism for spread. The role of spotting in wildfire spread is controlled by many factors including fire intensity, number of and distance between spot fires, weather, fuel characteristics and topography. Through a set of 30 laboratory fire experiments on a 3 m x 4 m fuel bed, subject to air flow, we explored the influence of manually ignited spot fires (0, 1 or 2), the presence or absence of a model hill and their interaction on combined fire ROS (i.e. ROS incorporating main fire and merged spot fires). During experiments conducted on a flat fuel bed, spot fires (whether 1 or 2) had only a small influence on combined ROS. Slowest combined ROS was recorded when a hill was present and no spot fires were ignited, because the fires crept very slowly downslope and downwind of the hill. This was up to, depending on measurement interval, 5 times slower than ROS in the flat fuel bed experiments. However, ignition of 1 or 2 spot fires (with hill present) greatly increased combined ROS to similar levels as those recorded in the flat fuel bed experiments (depending on spread interval). The effect was strongest on the head fire, where spot fires merged directly with the main fire, but significant increases in off-centre ROS were also detected. Our findings suggest that under certain topographic conditions, spot fires can allow a fire to overcome the low spread potential of downslopes. Current models may underestimate wildfire ROS and fire arrival time in hilly terrain if the influence of spot fires on ROS is not incorporated into predictions.

Portuguese adaptation of the S3-non-invasive ventilation (S3-NIV) questionnaire for home mechanically ventilated patients

Short, valid and easy to use tools are needed to monitor non-invasive ventilation in clinical practice and for organization of home mechanical ventilation services. The aim of this study was to develop a professional translation and cultural adaptation of the Portuguese S³ non-invasive ventilation questionnaire. 234 stable patients (128 male patients, 53.8%) with a mean age of 69.3 years under long-term home non-invasive ventilation were recruited from a single-center outpatient clinic. The most frequent diagnostic groups were obesity hypoventilation syndrome, chronic obstructive pulmonary disease and restrictive chest wall disorders. The Portuguese version of the questionnaire was obtained using translation back-translation process with two professional translators. Internal consistency for the total score was good (Cronbach's α coefficient of 0.76) as well as for the "respiratory symptoms" and the "sleep and side effects" domains (Cronbach's α coefficient=0.68 and Cronbach's α coefficient=0.72, respectively). An exploratory factor analysis was performed leading to an explained variance of 54.6%, and resulted in 3 components. The Portuguese version of the S3-NIV questionnaire is a simple and valid tool for the routine clinical assessment of patients receiving home NIV.

Cracking in Sweet Cherry Cultivars Early Bigi and Lapins: Correlation with Quality Attributes

Fruit cracking is one of the main concerns in sweet cherry production and is caused by a heavy rainfall before and during the harvest. This physiological disorder leads to severe economic losses, which can be more or less effective depending on the cracked region of the fruit: in the cheeks (side cracks), in the stylar scar region, or in the stem cavity region. Sweet cherry cracking can be affected by several factors such as cultivar, growing conditions, rootstock, fruit size, flesh osmotic potential, cuticular characteristics of the skin, and stage of fruit development. In this sense, the objective of this work was to evaluate the cracking incidence in two sweet cherry cultivars (Early Bigi and Lapins grafted on "Saint Lucie 64" rootstock) and correlate the cracking index with other quality parameters. Fruits were harvested on 2 May (cv. Early Bigi) and on 27 May (cv. Lapins) 2019 at their commercial ripening stage. In the field, the total yield and the trunk cross-sectional area were determined for each tree in order to calculate the yield efficiency. In the laboratory, the cracking index was determined in 150 fruits without visual defects. In addition, fruit size and weight, wax content, flesh firmness, epidermis rupture force, total soluble solids, pH, titratable acidity, and maturity index of 30 fruits were also evaluated. In general, all the analyzed quality parameters were influenced by the cultivar, being that cv. Lapins presented larger, heavier, firmer, and sweeter fruits, with more acidity and higher maturation index. However, cv. Lapins also presented higher cracking index, which was positively correlated with all the parameters above-mentioned and negatively correlated with the wax content. In fact, cv. Early Bigi presented a high wax content and simultaneously a low cracking index. The stylar scar region cracks were the most prevalent in both cultivars. These results allowed us to conclude that, in the North Portugal region, the Lapins cherries presented better quality attributes than the Early Bigi cherries. However, the latter are still very valuable to the region due to its early ripening. Additionally, it was also possible to conclude that bigger, firmer, more mature, and with lower wax content cherries were more sensitive to cracking than the smaller fruits, soft-fleshed, less mature, and with higher wax content.

Cellular metabolic reprogramming controls sugar appetite in Drosophila

Cellular metabolic reprogramming is an important mechanism by which cells rewire their metabolism to promote proliferation and cell growth. This process has been mostly studied in the context of tumorigenesis, but less is known about its relevance for nonpathological processes and how it affects whole-animal physiology. Here, we show that metabolic reprogramming in Drosophila female germline cells affects nutrient preferences of animals. Egg production depends on the upregulation of the activity of the pentose phosphate pathway in the germline, which also specifically increases the animal's appetite for sugar, the key nutrient fuelling this metabolic pathway. We provide functional evidence that the germline alters sugar appetite by regulating the expression of the fat-body-secreted satiety factor Fit. Our findings demonstrate that the cellular metabolic program of a small set of cells is able to increase the animal's preference for specific nutrients through inter-organ communication to promote specific metabolic and cellular outcomes.

Quality preservation of sweet cherry cv. 'staccato' by using glycine-betaine or Ascophyllum nodosum

Pre-harvest application of exogenous compounds has been employed in many crops, as a cultural practice, to promote their adaptation to a new climate-changing environment. Effect of foliar pre-harvest application of salicylic acid, glycine-betaine complex and seaweed extract (Ascophyllum nodosum) on the cherry quality from 'Staccato' cultivar was studied. Treatments significantly affected (p < 0.01) the fruit size, soluble solids content, pH, colour, polyphenols, vitamin C and antioxidant activity. Glycine-betaine and A. nodosum treated cherries presented higher dimensions, soluble solids content and pH and lower acidity. In addition, these cherries had a higher content of polyphenols and vitamin C and antioxidant capacity, but lower values of L*, C*ab and hue angle, meaning that both treatments can rise the fruit ripening process. Therefore, the pre-harvest application of glycine-betaine and A. nodosum can be a good alternative to promote the adaptation of sweet cherry tree to stressful environmental conditions, without compromising the fruit quality.

Metabolic cross-feeding in imbalanced diets allows gut microbes to improve reproduction and alter host behaviour

The impact of commensal bacteria on the host arises from complex microbial-diet-host interactions. Mapping metabolic interactions in gut microbial communities is therefore key to understand how the microbiome influences the host. Here we use an interdisciplinary approach including isotope-resolved metabolomics to show that in Drosophila melanogaster, Acetobacter pomorum (Ap) and Lactobacillus plantarum (Lp) a syntrophic relationship is established to overcome detrimental host diets and identify Ap as the bacterium altering the host's feeding decisions. Specifically, we show that Ap uses the lactate produced by Lp to supply amino acids that are essential to Lp, allowing it to grow in imbalanced diets. Lactate is also necessary and sufficient for Ap to alter the fly's protein appetite. Our data show that gut bacterial communities use metabolic interactions to become resilient to detrimental host diets. These interactions also ensure the constant flow of metabolites used by the microbiome to alter reproduction and host behaviour.

Nitrogen removal in vertical flow constructed wetlands: influence of bed depth and high nitrogen loadings

The aim of the study was to evaluate the nitrogen removal and its effects on the plant's growth and leaves morphology. using two subsurface vertical flow (VF bed), with different depths (0.24 m² × 0.70 m; 0.24 m² × 0.35 m) and nitrogen load increments. The VF bed were planted with Vetiveria zizanioides, filled with light expanded clay aggregates (Leca®NR 10/20) and fed in parallel mode with synthetic wastewater. High ammonium nitrogen concentration ([NH₄ ⁺-N] from 68 ± 3 to 290 ± 8 mg L^-1) was used without toxicity symptoms in plants, although the effects of ammonium nitrogen load were stopped the growth of the plants. Significant differences between ammonium nitrogen removed in each VF bed obtained for total nitrogen (TN_infl.) ≥ 27 ± 0.8 g m^-2 d^-1. The nitrification was contributed to ammonium nitrogen removal because was found higher values of nitrate and nitrite in the effluent. These values were more higher in VF bed 1 than in the VF bed 2, since ammonium nitrogen removal were also more higher in VF bed 1 than in the VF bed 2. Total nitrogen mass balance was carried out and the results show that the nitrification/denitrification process occurred with nitrogen plants uptake. It was observed that the VF bed depth has an influence on all nitrogen removal processes. As higher the depth root system it is seemed to favour the creation of zones with different oxidations conditions that allow the nitrogen compounds to be removed intensively.

Rhodococcus equi infection as inaugural manifestation of idiopathic CD4+ lymphopenia: A rare entity and a therapeutic challenge

We report a case of disseminated infection by Rhodococcus equi as the inaugural manifestation of idiopathic T-CD4⁺ lymphopenia. We aim to demonstrate our diagnostic and therapeutic approach and focus on the major dilemmas arising from the lack of scientific evidence regarding best clinical practice of this infection in humans.

A Taxonomy Proposal for the Assessment of the Changes in Soundscape Resulting from the COVID-19 Lockdown

Many countries around the world have chosen lockdown and restrictions on people's mobility as the main strategies to combat the COVID-19 pandemic. These actions have significantly affected environmental noise and modified urban soundscapes, opening up an unprecedented opportunity for research in the field. In order to enable these investigations to be carried out in a more harmonized and consistent manner, this paper makes a proposal for a set of indicators that will enable to address the challenge from a number of different approaches. It proposes a minimum set of basic energetic indicators, and the taxonomy that will allow their communication and reporting. In addition, an extended set of descriptors is outlined which better enables the application of more novel approaches to the evaluation of the effect of this new soundscape on people's subjective perception.

The diet-microbiome tango: how nutrients lead the gut brain axis

Nutrients and the microbiome have a profound impact on the brain by influencing its development and function in health and disease. The mechanisms by which they shape brain function have only started to be uncovered. Here we propose that the interaction of diet with the microbiome is at the core of most mechanisms by which gut microbes affect host brain function. The microbiome acts on the host by altering the nutrients in the diet and by using them as precursors for synthetizing psychoactive metabolites. Diet is also a major modulator of gut microbiome composition making this another key mechanism by which they affect the host brain. Nutrient-microbiome-host interactions therefore provide an overarching framework to understand the function of the gut-brain axis.