Optimized Synthesis of Poly(Lactic Acid) Nanoparticles for the Encapsulation of Flutamide

Biopolymeric nanoparticles (NPs) have gained significant attention in several areas as an alternative to synthetic polymeric NPs due to growing environmental and immunological concerns. Among the most promising biopolymers is poly(lactic acid) (PLA), with a reported high degree of biocompatibility and biodegradability. In this work, PLA NPs were synthesized according to a controlled gelation process using a combination of single-emulsion and nanoprecipitation methods. This study evaluated the influence of several experimental parameters for accurate control of the PLA NPs' size distribution and aggregation. Tip sonication (as the stirring method), a PLA concentration of 10 mg/mL, a PVA concentration of 2.5 mg/mL, and low-molecular-weight PLA (Mw = 5000) were established as the best experimental conditions to obtain monodisperse PLA NPs. After gelification process optimization, flutamide (FLU) was used as a model drug to evaluate the encapsulation capability of the PLA NPs. The results showed an encapsulation efficiency of 44% for this cytostatic compound. Furthermore, preliminary cell viability tests showed that the FLU@PLA NPs allowed cell viabilities above 90% up to a concentration of 20 mg/L. The comprehensive findings showcase that the PLA NPs fabricated using this straightforward gelification method hold promise for encapsulating cytostatic compounds, offering a novel avenue for precise drug delivery in cancer therapy.

Impact of annual TB screening on stone quarry workers in high-incidence Portuguese municipalities

SETTING

The Portuguese municipalities of Penafiel and Marco de Canaveses are high TB incidence areas, where stone quarry workers represent a vulnerable population.

OBJECTIVE

To assess the annual rate of TB infection (ARI) in stone quarry workers and to compare it with the TB notification rate in the general community.

DESIGN

An annual TB infection screening strategy using interferon-gamma release assay (IGRA) was implemented in 2018 for workers from high-risk stone quarries. A prospective cohort was enrolled and workers screened in periods of 2 years were included. IGRA-positive workers were referred for preventive treatment. ARI was calculated as the proportion of workers with IGRA conversion.

RESULTS

Of the 232 IGRA-negative workers in 2018, 20 tested positive in 2019 (8.6% ARI). Of 171 IGRA-negative workers in 2019, eight tested positive in 2021 (4.7% in 2 years). Two of the 150 IGRA-negative workers in 2021 tested positive in 2022 (1.3% ARI). ARI decreased by 84.9% between 2019 and 2022. In the two municipalities, the TB notification rate declined 23.9% between 2018 and 2021.

CONCLUSION

A more pronounced reduction in ARI was observed among stone quarry workers regularly screened for TB infection compared to the notification rate among the general population in high-incidence municipalities. A screening strategy for high-risk populations, together with enforced community measures, could foster risk reduction in the community..

Carbon Dots: A Bright Future as Anticounterfeiting Encoding Agents

Counterfeit products and data vulnerability present significant challenges in contemporary society. Hence, various methods and technologies are explored for anticounterfeiting encoding, with luminescent tracers, particularly luminescent carbon dots (CDs), emerging as a notable solution. CDs offer promising contributions to product security, environmental sustainability, and the circular economy. This critical review aims to highlight the luminescence responsiveness of CDs to physical and chemical stimuli, achieved through nanoengineering their chemical structure. The discussion will delve into the various tunable luminescence mechanisms and decay times of CDs, investigating preferential excitations such as up-conversion, delayed fluorescence, fluorescence, room temperature phosphorescence, persistent luminescence, energy and charge transfer, as well as photo-chemical interactions. These insights are crucial for advancing anticounterfeiting solutions. Following this exploration, a systematic review will focus on the research of luminescent CDs' smart encoding applications, encompassing anticounterfeiting, product tracing, quality certification, and information encryption. Finally, the review will address key challenges in implementing CDs-based technology, providing specific insights into strategies aimed at maximizing their stability and efficacy in anticounterfeiting encoding applications.

Synergistic Remediation of Organic Dye by Titanium Dioxide/Reduced Graphene Oxide Nanocomposite

In this work, nanocomposites based on titanium dioxide and reduced graphene oxide (TiO2@rGO) with different weight percentages of rGO (4, 8, and 16 wt%) were prepared by the hydrothermal/solvothermal synthesis method and thermally treated at 300 °C. The prepared nanocomposites were explored for the removal of methylene blue dye (MB) in the presence of simulated solar illumination as well as natural sunlight. The structural, morphological, chemical, and optical properties of the as-synthesized TiO2@rGO nanocomposites were characterized. The obtained results of the graphene-based nanocomposite materials indicated the existence of interactions between TiO2 and rGO, i.e., the Ti-O-C bond, which confirmed the successful integration of both components to form the TiO2@rGO nanocomposites. The addition of rGO increased the specific surface area, decreased the band gap energy, and increased the photocatalytic degradation efficiency of MB from water compared to TiO2 nanoparticles. The results of photocatalytic activity indicated that the amount of rGO in the prepared TiO2@rGO nanocomposites played a significant role in the application of different photocatalytic parameters, including the initial dye concentration, catalyst concentration, water environment, and illumination source. Our studies show that the reinforcement of the nanocomposite with 8 wt% of rGO allowed us to obtain the maximum photocatalytic decomposition performance of MB (10 mg·L-1) with a removal percentage of 99.20 after 2 h. Additionally, the obtained results show that the prepared TiO2@rGO_8 wt% nanocomposite can be used in three consecutive cycles while maintaining photocatalytic activity over 90%.

Drones for litter monitoring on coasts and rivers: suitable flight altitude and image resolution

Multirotor drones can be efficiently used to monitor macro-litter in coastal and riverine environments. Litter on beaches, dunes and riverbanks, along with floating litter on coastal and river waters, can be spotted and mapped from aerial drone images. Items detection and classification are prone to image resolution, which is expressed in terms of Ground Sampling Distance (GSD). The GSD is determined by drone flight altitude and camera properties. This paper investigates what is a suitable GSD value for litter survey. Drone flight altitude and camera setup should be chosen to obtain a GSD between 0.5 cm/px and 1.25 cm/px. Within this range, the lowest GSD allows litter categorization and classification, whereas the highest value should be adopted for a coarser litter census. In the vision of drawing up a global protocol for drone-based litter surveys, this work sets the ground for homogenizing data collection and litter assessments.

Customizing 3D Structures of Vertically Aligned Carbon Nanotubes to Direct Neural Stem Cell Differentiation

Neural tissue-related illnesses have a high incidence and prevalence in society. Despite intensive research efforts to enhance the regeneration of neural cells into functional tissue, effective treatments are still unavailable. Here, a novel therapeutic approach based on vertically aligned carbon nanotube forests (VA-CNT forests) and periodic VA-CNT micropillars produced by thermal chemical vapor deposition is explored. In addition, honeycomb-like and flower-like morphologies are created. Initial viability testing reveals that NE-4C neural stem cells seeded on all morphologies survive and proliferate. In addition, free-standing VA-CNT forests and capillary-driven VA-CNT forests are created, with the latter demonstrating enhanced capacity to stimulate neuritogenesis and network formation under minimal differentiation medium conditions. This is attributed to the interaction between surface roughness and 3D-like morphology that mimics the native extracellular matrix, thus enhancing cellular attachment and communication. These findings provide a new avenue for the construction of electroresponsive scaffolds based on CNTs for neural tissue engineering.

Cancer Models on Chip: Paving the Way to Large-Scale Trial Applications

Cancer kills millions of individuals every year all over the world (Global Cancer Observatory). The physiological and biomechanical processes underlying the tumor are still poorly understood, hindering researchers from creating new, effective therapies. Inconsistent results of preclinical research, in vivo testing, and clinical trials decrease drug approval rates. 3D tumor-on-a-chip (ToC) models integrate biomaterials, tissue engineering, fabrication of microarchitectures, and sensory and actuation systems in a single device, enabling reliable studies in fundamental oncology and pharmacology. This review includes a critical discussion about their ability to reproduce the tumor microenvironment (TME), the advantages and drawbacks of existing tumor models and architectures, major components and fabrication techniques. The focus is on current materials and micro/nanofabrication techniques used to manufacture reliable and reproducible microfluidic ToC models for large-scale trial applications.

The octopus pot on the North Atlantic Iberian coast: A plague of plastic on beaches and dunes

This baseline focuses on the octopus pot, a litter item found on the North Atlantic Iberian coast. Octopus pots are deployed from vessels in ropes, with several hundred units, and placed on the seabed, to capture mostly Octopus Vulgaris. The loss of gears due to extreme seas state, bad weather and/or fishing-related unforeseen circumstances, cause the octopus pots contaminating beaches and dunes, where they are transported by sea current, waves and wind actions. This work i) gives an overview of the use of octopus pot on fisheries, ii) analyses the spatial distribution of this item on the coast, and iii) discusses the potential measures for tackling the octopus pot plague on the North Atlantic Iberian coast. Overall, it is urgent to promote conducive policies and strategies for a sustainable waste management of octopus pots, based on Reduce, Reuse and Recycle hierarchical framework.

Impacts of a massive beach music festival on a coastal ecosystem - A showcase in Portugal

Beach music festivals are numerous and popular worldwide. The concerns about the environmental sustainability of these events have been increasing among scientists, coastal managers and local communities. Nevertheless, the negative effects of beach music festivals on the coastal environment have been poorly studied. This work identified, analysed and discussed the eco-geomorphological impacts of a massive beach music festival held on a Portuguese beach-dune system over three days in July 2022. Drone-based orthophotos and pictures collected in the field were analysed to evaluate the impact of pre- and post-festival works, which turned the beach into a construction site over about twenty days. Digital Surface Model (DSM) analysis showed that beach configuration was approximately restored to the pre-festival configuration after the event. In contrast, the comparison of Normalized Difference Vegetation Index (NDVI) maps revealed that 18,500 m² of embryonic dune vegetation, which represented 35 % of the existing plant community, was removed by works on the beach and by trampling of festival attendees. To authors' knowledge, this is the first work that evaluates the eco-geomorphological impact of a massive beach music festival on the delicate coastal ecosystem. Overall, it contributes in raising awareness for making these events more respectful of the coastal environment.

Safety assessment of new nanodiamonds@corrole hybrids addressed by the response of RAW-264.7 macrophages

Safety assessment of carbon nanomaterials is of paramount importance since they are on the frontline for applications in sensing, bioimaging and drug delivery. The biocompatibility and safety of functionalized nanodiamonds (NDs) are here addressed through the study of the pro-inflammatory response of RAW-264.7 macrophages exposed to new nanodiamonds@corrole hybrids. The corrole unit selected is as a prototype for a hydrophobic organic molecule that can function as a NIR fluorophore reporter, an optical sensor, a photodynamic therapy agent or a photocatalyst. The new functional nanohybrids containing detonated nanodiamonds (NDs) were obtained through esterification using carboxylated NDs and glycol corroles. The success of the covalent functionalization via carbodiimide activation was confirmed through X-ray photoelectron spectroscopy (XPS), Raman and Fourier transform infrared (FTIR) spectroscopy. The UV-vis absorption and emission spectra of the hybrids are additive with respect to the corrole features. The cellular uptake, localization, cell viability and effects on immune cell activation of the new hybrids and of the precursors were carefully investigated using RAW-264.7 macrophages. Overall results showed that the ND@corrole hybrids had no pro-inflammatory effects on the RAW-264.7 macrophage cell line, making them an ideal candidate for a wide range of biomedical applications.

Age-at-death assessed with Lamendin's original and population-specific models in a modern Brazilian osteological collection

BACKGROUND

Estimating the age at death is a common procedure in the fields of forensic human identification and anthropological/archaeological investigations. Root translucency and periodontosis are regressive parameters used to estimate the age of adults, more specifically in Lamendin's method - established in 1992 in a French population. This study aimed to test the applicability and validity of Lamendin's method in a Brazilian osteological collection.

METHODS

The sample consisted of 74 single-rooted teeth obtained from 50 skeletal remains (mean age: 53.20 ± 16.17 years) from Southeast Brazil. Lamendin's method was applied to enable a comparison between chronological (CA) and estimated ages (EA). A new population-specific equation was designed for the studied sample and the outcomes were compared with those obtained with Lamendin's original equation.

RESULTS

The original methods led to a general underestimation of 11.32 years (8.83 years in males and 15.91 years in females). The method had a better performance among individuals between 40 and 59 years (mean differences between CA and EA: 4.8 years). The population-specific equation led to a mean overestimation of -2.04 years in males, and a mean underestimation of 3.77 years in females. Underestimations were considerably higher in other age groups.

CONCLUSION

Despite the apparent improvements, both the original and the population-specific equations revealed coefficients of concordance that were constantly low between CA and EA. These outcomes suggest restrictions to the application of Lamendin's method in the forensic field, especially for human identification. The method, however, seems to be applicable for anthropological/archaeological applications.

Beach litter survey by drones: Mini-review and discussion of a potential standardization

The abundance of beach litter has been increasing globally during the last decades, and it is an issue of global concern. A new survey strategy, based on uncrewed aerial vehicles (UAV, aka drones), has been recently adopted to improve the monitoring of beach macro-litter items abundance and distribution. This work identified and analysed the 15 studies that used drone for beach litter surveys on an operational basis. The analysis of technical parameters for drone flight deployment revealed that flight altitude varied between 5 and 40 m. The analysis of final assessments showed that, through manual and/or automated items detection on images, most of studies provided litter bulk characteristics (type, material and size), along with litter distribution maps. The potential standardization of drone-based litter survey would allow a comparison among surveys, however it seems difficult to propose a standard set of flight parameters, given the wide variety of coastal environments, the different devices available, and the diverse objectives of drone-based litter surveys. On the other hand, in our view, a set of common outcomes can be proposed, based on the grid mapping process, which can be easily generated following the procedure indicated in the paper. This work sets the ground for the development of a standardized protocol for drone litter data collection, analysis and assessments. This would allow the provision of broad scale comparative studies to support coastal management at both national and international scales.

Sustainable Synthesis of Highly Biocompatible 2D Boron Nitride Nanosheets

2D ultrafine nanomaterials today represent an emerging class of materials with very promising properties for a wide variety of applications. Biomedical fields have experienced important new achievements with technological breakthroughs obtained from 2D materials with singular properties. Boron nitride nanosheets are a novel 2D layered material comprised of a hexagonal boron nitride network (BN) with interesting intrinsic properties, including resistance to oxidation, extreme mechanical hardness, good thermal conductivity, photoluminescence, and chemical inertness. Here, we investigated different methodologies for the exfoliation of BN nanosheets (BNNs), using ball milling and ultrasound processing, the latter using both an ultrasound bath and tip sonication. The best results are obtained using tip sonication, which leads to the formation of few-layered nanosheets with a narrow size distribution. Importantly, it was observed that with the addition of pluronic acid F127 to the medium, there was a significant improvement in the BN nanosheets (BNNs) production yield. Moreover, the resultant BNNs present improved stability in an aqueous solution. Cytotoxicity studies performed with HeLa cells showed the importance of taking into account the possible interferences of the nanomaterial with the selected assay. The prepared BNNs coated with pluronic presented improved cytotoxicity at concentrations up to 200 μg mL^-1 with more than 90% viability after 24 h of incubation. Confocal microscopy also showed high cell internalization of the nanomaterials and their preferential biodistribution in the cell cytoplasm.

Development of an IEEE 1451 Plug-and-Play Module for Smart Transducers in Industrial Environments

The use of Sensors and Actuators is ubiquitous in an industrial environment. The advent of the Industrial Internet-of-Things (IIoT) and the 4th industrial revolution demands new, more intelligent and more efficient ways to be able to connect, read and control transducers at the plant floor level. Newer control and data science techniques also largely benefit from structured information endpoints available at the edge of the network. The IEEE 1451 standard presents architecture and methodology to solve these problems with the usage of smart transducers, introducing into edge devices concepts such as self-identification and standardization of data communication. In this work, a transducer interface module is developed using the IEEE 1451 standard focused on flexibility, ease of integration and plug-and-play features. Furthermore, a system architecture, based on IEEE 1451.0 is presented, and development and implementation features are explained. This system is then released as an open-source platform to help and motivate the usage of smart transducer systems. At last, the system is tested, results are collected, and a methodology and metrics are defined for comparison between different smart transducer systems.

A Plug-and-Play Solution for Smart Transducers in Industrial Applications Based on IEEE 1451 and IEC 61499 Standards

In a cyberphysical production system, the connectivity between the physical entities of a production system with the digital component that controls and monitors that system takes fundamental importance. This connectivity has been increasing from the transducers' side, through gathering new functionalities and operating increasingly independently, taking the role of smart transducers, and from the applications' side, by being developed in a distributed and decentralized paradigm. This work presents a plug-and-play solution capable of integrating smart transducers compliant with the IEEE 1451 standard in industrial applications based on the IEC 61499 standard. For this, we implemented the NCAP module of the smart transducer defined in IEEE 1451, which, when integrated with 4diac IDE and DINASORE (development and execution tools compliant with IEC 61499), enabled a solution that presented automatically the smart sensors and actuators in the IDE application and embedded their functionalities (access to data and processing functions) in the runtime environment. In this way, a complete plug-and-play solution was presented from the connection of the transducer to the network until its integration into the application.

Role of Sedation and Analgesia during Noninvasive Ventilation: Systematic Review of Recent Evidence and Recommendations

Aim

This systematic review aimed to investigate the drugs used and their potential effect on noninvasive ventilation (NIV).

Background

NIV is used increasingly in acute respiratory failure (ARF). Sedation and analgesia are potentially beneficial in NIV, but they can have a deleterious impact. Proper guidelines to specifically address this issue and the recommendations for or against it are scarce in the literature. In the most recent guidelines published in 2017 by the European Respiratory Society/American Thoracic Society (ERS/ATS) relating to NIV use in patients having ARF, the well-defined recommendation on the selective use of sedation and analgesia is missing. Nevertheless, some national guidelines suggested using sedation for agitation.

Methods

Electronic databases (PubMed/Medline, Google Scholar, and Cochrane library) from January 1999 to December 2019 were searched systematically for research articles related to sedation and analgosedation in NIV. A brief review of the existing literature related to sedation and analgesia was also done.

Review results

Sixteen articles (five randomized trials) were analyzed. Other trials, guidelines, and reviews published over the last two decades were also discussed. The present review analysis suggests dexmedetomidine as the emerging sedative agent of choice based on the most recent trials because of better efficacy with an improved and predictable cardiorespiratory profile.

Conclusion

Current evidence suggests that sedation has a potentially beneficial role in patients at risk of NIV failure due to interface intolerance, anxiety, and pain. However, more randomized controlled trials are needed to comment on this issue and formulate strong evidence-based recommendations.

How to cite this article

Karim HMR, Šarc I, Calandra C, Spadaro S, Mina B, Ciobanu LD, et al. Role of Sedation and Analgesia during Noninvasive Ventilation: Systematic Review of Recent Evidence and Recommendations. Indian J Crit Care Med 2022;26(8):938–948.

Graphene Oxide/Polyethylenimine Aerogels for the Removal of Hg(II) from Water

This article reports the synthesis of an aerogel involving reduced graphene oxide (rGO) and polyethylenimine (PEI), and describes its potential application as an effective sorbent to treat Hg(II) contaminated water. The rGO/PEI sorbent was synthetized using a supercritical CO₂ method. N₂ physisorption, electron microscopy, and elemental mapping were applied to visualize the meso/macroporous morphology formed by the supercritical drying. The advantages of the synthetized materials are highlighted with respect to the larger exposed GO surface for the PEI grafting of aerogels vs. cryogels, homogeneous distribution of the nitrogenated amino groups in the former and, finally, high Hg(II) sorption capacities. Sorption tests were performed starting from water solutions involving traces of Hg(II). Even though, the designed sorbent was able to eliminate almost all of the metal from the water phase, attaining in very short periods of time residual Hg(II) values as low as 3.5 µg L⁻¹, which is close to the legal limits of drinking water of 1–2 µg L⁻¹. rGO/PEI exhibited a remarkably high value for the maximum sorption capacity of Hg(II), in the order of 219 mg g⁻¹. All of these factors indicate that the designed rGO/PEI aerogel can be considered as a promising candidate to treat Hg(II) contaminated wastewater.

Operational use of multispectral images for macro-litter mapping and categorization by Unmanned Aerial Vehicle

The use of Unmanned Aerial Systems (UAS, aka drones) has shown to be feasible to perform marine litter surveys. We operationally tested the use of multispectral images (5 bands) to classify litter type and material on a beach-dune system. For litter categorization by their multispectral characteristics, the Spectral Angle Mapping (SAM) technique was adopted. The SAM-based categorization of litter agreed with the visual classification, thus multispectral images can be used to fasten and/or making more robust the manual RGB image screening. Fully automated detection returned an F-score of 0.64, and a reasonable categorization of litter. Overall, the image-based litter density maps were in line with the manual detection. Assessments were promising given the complexity of the study area, where different dunes plants and partially-buried items challenged the UAS-based litter detection. The method can be easily implemented for both floating and beached litter, to advance litter survey in the environment.

High-Flow Nasal Oxygen Therapy in Acute Hypoxemic Respiratory Failure: Concise Review on Technology and Initial Methodology

High-flow nasal cannula oxygen therapy (HFNCOT) system consists of an air/oxygen supply system capable of delivering up to 100% humidified and heated oxygen at a flow rate of up to 80 L/min. The system includes a blender, active humidifier, single heated tube, and nasal cannula. HFNCOT has many physiological advantages compared with other standard oxygen therapies, such as anatomical dead space washout, more constant fraction of inspired oxygen, positive end-expiratory (PEEP) effect, supplement of adequate humidification and maintenance of muco-ciliary function. HFNCOT is mostly used for hypoxemic acute respiratory failure, although it also has other indications. HFNCOT is a common choice of physicians as its technology makes it more silent and comfortable. Though HFNCOT is used in many clinical settings, there is a lack of publications addressing devices and initial settings. We present a review on HFNCOT, with focus on device and application methodology.

Preparedness in a public health emergency: determinants of willingness and readiness to respond in the onset of the COVID-19 pandemic

OBJECTIVES

Healthcare professionals' high risk of infection and burnout in the first months of the COVID-19 pandemic probably hindered their much-needed preparedness to respond. We aimed to inform how individual and institutional factors contributed for the preparedness to respond during the first months of a public health emergency.

STUDY DESIGN

Cross-sectional study.

METHODS

We surveyed healthcare workers from a Local Health Unit in Portugal, which comprises primary health care centers and hospital services, including public health units and intensive care units, in the second and third months of the COVID-19 epidemic in Portugal. The 460 answers, completed by 252 participants (about 10% of the healthcare workers), were analyzed using descriptive statistics and multiple logistic regressions. We estimated adjusted odds ratios for the readiness and willingness to respond.

RESULTS

Readiness to respond was associated with the perception of adequate infrastructures (aOR = 4.04, P < 0.005), lack of access to personal protective equipment (aOR = 0.26, P < 0.05) and organization (aOR = 0.31, P < 0.05). The willingness to act was associated with the perception of not being able to make a difference (aOR = 0.05, P < 0.005), risk of work-related burnout (aOR = 21.21, P < 0.01) and experiencing colleagues or patients' deaths due to COVID-19 (aOR = 0.24, P < 0.05).

CONCLUSIONS

Adequate organization, infrastructures, and access to personal protective equipment may be crucial for workers' preparedness in a new public health emergency, as well workers' understanding of their roles and expected impact. These factors, together with the risk of work-related burnout, shall be taken into account in the planning of the response of healthcare institutions in future public health emergencies.

Is coastal erosion a source of marine litter pollution? Evidence of coastal dunes being a reservoir of plastics

This baseline reports scientific evidence of marine litter items embedded in the dune volume at two study sites on the North Atlantic Portuguese coast. We described how stranded litter participate in the sand dune growth/erosion processes on a natural beach-dune system. From the storm-eroded foredunes on the urbanized beach, we documented exhumed plastics with age up to 38 years. Whether litter burial was due to beach-dune morphodynamic processes, or to irresponsible and/or illegal dumping in the past, this work emphasises the need of improving buried litter census and monitoring on coastal dunes. Coastal erosion processes may further exhume litter buried in dune volumes and on other coastal environments over short- and long-term, re-exposing items into the marine environment. Thus, coastal erosion can be accounted as a secondary diffuse source of littering pollution, beside the multiple sources already identified in the environment.

Serum TSH as a predictor of malignancy in indeterminate thyroid nodules

INTRODUCTION

Thyroid nodules are lesions that are radiologically distinct from the thyroid parenchyma. Cervical ultrasound diagnoses 19-67% of nodules and is crucial in identifying those that lack cytological characterisation. Approximately 25% of biopsies reveal an indeterminate cytological result (Bethesda III), in which the risk of malignancy is variable (5-15%). The clinical importance of the diagnostic strategy used for thyroid nodules results from the need to exclude malignancy. The aim of this study was to evaluate the usefulness of serum thyroid-stimulating hormone (TSH) levels as a predictor of malignancy in cytologically indeterminate thyroid nodules.

METHODS

Our retrospective study included 40 patients with cytologically indeterminate thyroid nodules seen in our hospital between January 2013 and December 2017. Clinical parameters were reviewed, including age, gender, serum TSH levels, family history of thyroid carcinoma, radiation exposure and some sonographic features of the nodules. Statistical analysis was performed using SPSS. Statistical significance was defined as p<0.05.

RESULTS

Female gender was predominant (85%) and the mean (SD) age was 53.3 (15) years. Thyroid carcinoma was confirmed in 28% of patients. Median TSH levels were higher in patients with malignant (2.73µIU/ml) compared with benign (1.56µIU/ml) nodules (p<0.05). We demonstrated an increased risk of malignancy in patients with TSH levels of 2.68µIU/ml or above (p<0.05).

CONCLUSION

Higher serum TSH levels are associated with an increased risk of thyroid carcinoma in cytologically indeterminate nodules. TSH can become a fundamental diagnostic tool in stratifying the risk of malignancy and assist in diagnostic and therapeutic approaches to these nodules.

Ultrafast Interface Charge Separation in Carbon Nanodot-Nanotube Hybrids

Carbon dots are an emerging family of zero-dimensional nanocarbons behaving as tunable light harvesters and photoactivated charge donors. Coupling them to carbon nanotubes, which are well-known electron acceptors with excellent charge transport capabilities, is very promising for several applications. Here, we first devised a route to achieve the stable electrostatic binding of carbon dots to multi- or single-walled carbon nanotubes, as confirmed by several experimental observations. The photoluminescence of carbon dots is strongly quenched when they contact either semiconductive or conductive nanotubes, indicating a strong electronic coupling to both. Theoretical simulations predict a favorable energy level alignment within these complexes, suggesting a photoinduced electron transfer from dots to nanotubes, which is a process of high functional interest. Femtosecond transient absorption confirms indeed an ultrafast (<100 fs) electron transfer independent of nanotubes being conductive or semiconductive in nature, followed by a much slower back electron transfer (≈60 ps) from the nanotube to the carbon dots. The high degree of charge separation and delocalization achieved in these nanohybrids entails significant photocatalytic properties, as we demonstrate by the reduction of silver ions in solution. The results are very promising in view of using these "all-carbon" nanohybrids as efficient light harvesters for applications in artificial photocatalysis and photosynthesis.

Biomimetic Graphene/Spongin Scaffolds for Improved Osteoblasts Bioactivity via Dynamic Mechanical Stimulation

Biomimetics offers excellent prospects for design a novel generation of improved biomaterials. Here the controlled integration of graphene oxide (GO) derivatives with a 3D marine spongin (MS) network is explored to nanoengineer novel smart bio-based constructs for bone tissue engineering. The results point out that 3D MS surfaces can be homogeneously coated by layer-by-layer (LbL) assembly of oppositely charged polyethyleneimine (PEI) and GO. Notably, the GOPEI@MS bionanocomposites present a high structural and mechanical stability under compression tests in wet conditions (shape memory). Dynamic mechanically (2 h of sinusoidal compression cyclic interval (0.5 Hz, 0-10% strain)/14 d) stimulates GOPEI@MS seeded with osteoblast (MC3T3-E1), shows a significant improvement in bioactivity, with cell proliferation being two times higher than under static conditions. Besides, the dynamic assays show that GOPEI@MS bionanocomposites are able to act as mechanical stimulus-responsive scaffolds able to resemble physiological bone extracellular matrix (ECM) requirements by strongly triggering mineralization of the bone matrix. These results prove that the environment created by the system cell-GOPEI@MS is suitable for controlling the mechanisms regulating mechanical stimulation-induced cell proliferation for potential in vivo experimentation.

Drones for litter mapping: An inter-operator concordance test in marking beached items on aerial images

Unmanned aerial systems (UAS, aka drones) are being used to map macro-litter on the environment. Sixteen qualified researchers (operators), with different expertise and nationalities, were invited to identify, mark and categorize the litter items (manual image screening, MS) on three UAS images collected at two beaches. The coefficient of concordance (W) among operators varied between 0.5 and 0.7, depending on the litter parameter (type, material and colour) considered. Highest agreement was obtained for the type of items marked on the highest resolution image, among experts in litter surveys (W = 0.86), and within territorial subgroups (W = 0.85). Therefore, for a detailed categorization of litter on the environment, the MS should be performed by experienced and local operators, familiar with the most common type of litter present in the target area. This work provides insights for future operational improvements and optimizations of UAS-based images analysis to survey environmental pollution.

Spatial and size distribution of macro-litter on coastal dunes from drone images: A case study on the Atlantic coast

This work analyses the cross-shore (80 m) and long-shore (200 m) spatial and size distribution of macro-litter on coastal dunes, employing a mapping framework based on an Unmanned Aerial System (UAS, aka drone) and a GIS mobile application. Over the cross-shore, plastic percentage increased from 60% to 90% landwards. The largest items (processed wood) were found on the embryo dune. Plastic bottles and paper napkins were trapped by the foredune grass, while the largest fishing-related items were intercepted by the low scrub plant community on the backdune. Over the long-shore, plastic percentage and items size increased from the urbanized area towards the natural dunes. This work assessed the abundance of marine litter on coastal dune sectors, underlining the role of distinct vegetation types in trapping items of different size. The mapping framework can promote further marine litter monitoring programs and support specific strategies for protecting the dune ecosystems.

Detecting stranded macro-litter categories on drone orthophoto by a multi-class Neural Network

The use of Unmanned Aerial Systems (UAS, aka drones) images for mapping macro-litter in the environment have been exponentially increasing in the recent years. In this work, we developed a multi-class Neural Network (NN) to automatically identify stranded plastic litter categories on an UAS-derived orthophoto. The best results were assessed for items that did not have substantial intra-class colour variability, such as octopus pots and fishing ropes (F-score = 61%, on average). Instead, performance was poor (37%) for plastic bottles and fragments, due to their changing intra-class colours. On average, the performance improved 24% when the binary detection (litter/non-litter, F-Score = 73%) was considered, however this approach did not discriminate the litter categories. This work gives a new perspective for the automated litter detection on drone images, suggesting that colour-based approach can be used to improve the categorization of stranded litter on UAS orthophoto.

Non-invasive ventilation in patients with an altered level of consciousness. A clinical review and practical insights

Non-invasive ventilation has gained an increasingly pivotal role in the treatment of acute hypoxemic and/or hypercapnic respira-tory failure and offers multiple advantages over invasive mechanical ventilation. Some of these advantages include the preserva-tion of airway defense mechanisms, a reduced need for sedation, and an avoidance of complications related to endotracheal intubation. Despite its advantages, non-invasive ventilation has some contraindications that include, among them, severe encephalopathy. In this review article, the rationale, evidence, and drawbacks of the use of noninvasive ventilation in the context of hypercapnic and non-hypercapnic patients with an altered level of consciousness are analyzed.

High affinity of 3D spongin scaffold towards Hg(II) in real waters

This study focuses on the ability of commercial natural bath sponges, which are made from the skeletons of marine sponges, to sorb Hg from natural waters. The main component of these bath sponges is spongin, which is a protein-based material, closely related to collagen, offering a plenitude of reactive sites from the great variety of amino acids in the protein chains, where the Hg ions can sorb. For a dose of 40 mg L^-1 and initial concentration of 50 μg L^-1 of Hg(II), marine spongin (MS) removed ~90% of Hg from 3 water matrixes (ultrapure, bottled, and seawater), corresponding to a residual concentration of ~5 μg L^-1, which tends to the recommend value for drinking water of 1 μg L^-1. This value was maintained even by increasing the MS dosage, suggesting the existence of a gradient concentration threshold below which the Hg sorption mechanism halts. Kinetic modelling showed that the Pseudo Second-Order equation was the best fit for all the water matrixes, which indicates that the sorption mechanism relies most probably on chemical interactions between the functional groups of spongin and the Hg ions. This material can also be regenerated in HNO₃ and reused for Hg sorption, with marginal losses in efficiency, at least for 3 consecutive cycles.

Beach-dune morphodynamics and marine macro-litter abundance: An integrated approach with Unmanned Aerial System

This work shows an integrated approach for coastal environmental monitoring, which aimed to understand the relation between beach-dune morphodynamics, marine litter abundance and environmental forcing. Three unmanned aerial system (UAS) flights were deployed on a beach-dune system at the Atlantic Portuguese coast to assess two main goals: (i) quantifying the morphological changes that occurred among flights, with focus on dune erosion, and (ii) mapping the changes of marine macro-litter abundance on the shore. Two most vulnerable-to-erosion sectors of the beach were identified. In the northern sector, the groin affected the downdrift shoreline, with dune erosion of about 1 m. In the central part of the beach, the dunes recessed about 4 m during the winter, being more exposed to environmental forcing due to the absence of dune vegetation. Marine litter occupation area on the beach decreased from 25% to 20% over the winter, with octopus pots (13%) and fragments (69%) being the most abundant items on average. Litter distribution varied in relation to swash elevation, wind speed and direction. With low swash elevation, the wind played a predominant role in moving the stranded items northwards, whereas high swash elevation concentrated the items at the dune foot. This study emphasizes the potential of UAS in allowing an integrated approach for coastal erosion monitoring and marine litter mapping, and set the ground for marine litter dynamic modelling on the shore.

Completeness of TB notification in Portugal, 2015: an inventory and capture-recapture study

BACKGROUND: Despite the steady decline in the last few decades, Portugal remains the Western European country with the highest TB notification rates. The aim of this study was to estimate the completeness of notification to the National Tuberculosis Programme (NTP) Surveillance System (SVIG-TB) in 2015.METHODS: We implemented an inventory study and a three-source log-linear capture-recapture analysis using two additional data sources that were deterministic and probabilistically linked: the national notifiable diseases surveillance system (Sistema Nacional de Vigilância Epidemiológica SINAVE) and the national hospital discharge database (Grupos de Diagnósticos Homogéneos GDH).RESULTS: We identified 2328 unique probable/confirmed TB cases across the three data sources. We found a positive dependency between SVIG-TB and SINAVE (incidence rate ratio IRR 8.9, 95%CI 6.6-12.0) and between GDH and SINAVE (IRR 2.6, 95%CI 2.0-3.4). After adjusting for these dependencies, we estimated that 266 cases (95%CI 198-358) were not reported, indicating a notification (to SVIG-TB) completeness rate of 77.0%.CONCLUSION: True incidence rate of TB in Portugal in 2015 could have been as high as 26.1 per 100 000. This could be an overestimation because of false-positive cases recorded in both SINAVE and GDH or on a smaller scale, false non-matches. Studies aimed at validating potentially false-positive cases should be implemented to address these limitations.

Mapping marine litter on coastal dunes with unmanned aerial systems: A showcase on the Atlantic Coast

Marine litter pollution on coastal dunes has received limited scientific attention when compared with sandy shores. This paper proposes a new framework based on the combined use of Unmanned Aerial Systems (UAS) and a mobile application to map and quantify marine macro-litter (>2.5 cm) accumulation on coastal dunes. The first application on a dune area of 200 m × 80 m at the north-east Atlantic Portuguese coast is shown. Nine different marine litter categories were found, with styrofoam fragments (23% of the total amount) and plastic bottles (20%) being the most abundant items. Plastic was the most common material (76%). The highest number of items (272) was found on the backdune, mostly related with fishing activities (octopus pots and Styrofoam fragments). In contrast, the highest density (0.031 items/m²) was found on the foredune, with the most abundant items associated with human recreational activities (for example, plastic bottles, bags, papers and napkins). Three major marine litter hotspots (~0.1 items/m²) were identified in correspondence of dune blowouts. The recognition of the primary marine litter pathways highlighted the main role that wind and overwash events play on dune contamination, and suggests that the dune ridge restoration can act as a mitigation measure for preventing marine litter accumulation on the backdune. This study shows how UAS offer the possibility of a detailed non-intrusive survey, and gives a new impulse to coastal dune litter monitoring, where the long residence time of marine debris may threaten the bio-ecological equilibrium of these ecosystems.

Tuberculosis: where and how fast are stone quarry workers infected?

Background

In 2018 an annual tuberculosis (TB) screening program targeting stone quarry workers was implemented in two municipalities in Northern Portugal. These have been hotspots for TB (76 and 59 cases per 100 000 population per year in 2012-2016, well above the 18 cases per 100 000 population observed in Portugal in 2016), with 30% of active TB cases occurring among stone quarry workers. Screening in this setting is recommended by the World Health Organization, as exposure to silica and silicosis increase the risk of TB. Occupational health services, TB outpatient centers, the hospital, a laboratory, primary health care and public health services work closely together with employers, employees, municipal council and the community promoting meetings and continuous training.

Screening activities included a symptom questionnaire, chest X-ray and sputum exam; and, after exclusion of active TB, interferon-gamma release assay (IGRA) for latent tuberculosis infection (LTBI). Preventive treatment was offered.

Objective

Assess annual rate of TB infection

Methods

Workers without history of TB/LTBI were IGRA tested in 2018, and retested in 2019. Annual rate of infection was calculated as the proportion of workers IGRA negative in 2018 becoming positive in 2019.

Results

In 2018-2019, 274 workers were screened yearly. In 2018, 22 were diagnosed with LTBI and 26 had previous history of TB/LTBI. Out of 226 IGRA negative workers in 2018, 19 tested positive in 2019 (8.4% annual rate of infection). These individuals were not identified as close contacts of any new TB case and no cases of active TB were reported in their stone quarries. Some active TB cases were regular customers of specific bars.

Conclusions

Active transmission of TB seems to be occurring among stone quarry workers. Workers that converted from IGRA negative to positive had no co-workers with active TB in the study period, suggesting they could have been infected away from the workplace, possibly in community public places.

Key messages

Stone quarry workers in a high-risk TB sub-region were infected at an 8.4% annual rate, and could have been infected in community public places such as bars. Besides screening close contacts and at workplace, more efforts should be made identifying social contacts of active TB cases.

Green Graphene-Chitosan Sorbent Materials for Mercury Water Remediation

The development of new graphene-based nanocomposites able to provide synergistic effects for the adsorption of toxic heavy metals in realistic conditions (environment) is of higher demand for future applications. This work explores the preparation of a green nanocomposite based on the self-assembly of graphene oxide (GO) with chitosan (CH) for the remediation of Hg(II) in different water matrices, including ultrapure and natural waters (tap water, river water, and seawater). Starting at a concentration of 50 μg L^-1, the results showed that GO-CH nanocomposite has an excellent adsorption capacity of Hg (II) using very small doses (10 mg L^-1) in ultrapure water with a removal percentage (% R) of 97 % R after only two hours of contact time. In the case of tap water, the % R was 81.4% after four hours of contact time. In the case of river and seawater, the GO-CH nanocomposite showed a limited performance due the high complexity of the water matrices, leading to a residual removal of Hg(II). The obtained removal of Hg(II) at equilibrium in river and seawater for GO-CH was 13% R and 7% R, respectively. Our studies conducted with different mimicked sea waters revealed that the removal of mercury is not affected by the presence of NO₃^- and Na⁺ (>90% R of Hg(II)); however, in the presence of Cl^-, the mercury removal was virtually nonexistent (1% R of Hg(II)), most likely because of the formation of very stable chloro-complexes of Hg(II) with less affinity towards GO-CH.

Large mucinous cystic neoplasm of the pancreas during pregnancy: a case report

Mucinous cystic neoplasms (MCNs) of the pancreas occurring during pregnancy constitute a rare condition requiring special management due to its large size, malignant potential and the risk of fetal growth restriction. The key points to manage MCNs are to perform a correct diagnosis, accurately evaluate the grade of malignant potential in order to establish the right time for pancreatic surgery and to choose the most appropriate fetal mode of delivery. We describe a case of an incidental abdominal mass detected in a third-trimester pregnant woman. At surgery, a huge pancreatic cystic tumour was found and a distal pancreatectomy with splenic preservation was performed. The histopathological analysis revealed an MCN of the pancreas with low-grade dysplasia. To our knowledge, this is the largest pancreatic MCN detected in a pregnant woman reported in the literature and one of the few successfully resected after vaginal delivery.

Mapping marine litter with Unmanned Aerial Systems: A showcase comparison among manual image screening and machine learning techniques

Recent works have shown the feasibility of Unmanned Aerial Systems (UAS) for monitoring marine pollution. We provide a comparison among techniques to detect and map marine litter objects on an UAS-derived orthophoto of a sandy beach-dune system. Manual image screening technique allowed a detailed description of marine litter categories. Random forest classifier returned the best-automated detection rate (F-score 70%), while convolutional neural network performed slightly worse (F-score 60%) due to a higher number of false positive detections. We show that automatic methods allow faster and more frequent surveys, while still providing a reliable density map of the marine litter load. Image manual screening should be preferred when the characterization of marine litter type and material is required. Our analysis suggests that the use of UAS-derived orthophoto is appropriate to obtain a detailed geolocation of marine litter items, requires much less human effort and allows a wider area coverage.

Mapping marine litter using UAS on a beach-dune system: a multidisciplinary approach

The amount of marine litter, mainly composed by plastic materials, has become a global environmental issue in coastal environments. Traditional monitoring programs are based on in-situ visual census, which require human effort and are time-demanding. Therefore, it is crucial to implement innovative mapping strategies to improve the environmental monitoring of marine litter on the coast. This work presents a procedure for an automated Unmanned Aerial System (UAS)-based marine litter mapping on a beach-dune system. A multidisciplinary framework, which comprises photogrammetry, geomorphology, machine learning and hydrodynamic modelling, was developed to process a block of UAS images. The work shows how each of these scientific methodologies can be complementary to improve and making more efficient the mapping of marine litter items with UAS on coastal environment. The very high-resolution orthophoto produced from UAS images was automatically screened by random forest machine learning method, in order to characterize the marine litter load on beach and dune areas, distinctively. The marine litter objects were identified with a F-test score of 75% when compared to manual procedure. The location of major marine litter loads within the monitored area was found related to beach slope and water level dynamics on the beach profiles, suggesting that UAS flight deployment and post-processing for beach litter mapping can be optimized based on these environmental parameters. The described UAS-based marine litter detection framework is intended to support scientists, engineers and decision makers aiming at monitoring marine and coastal pollution, with the additional aim of optimizing and automating beach clean-up operations.

Conductive polysaccharides-based proton-exchange membranes for fuel cell applications: The case of bacterial cellulose and fucoidan

Conductive natural-based separators for application in polymer electrolyte fuel cells (PEFCs) were fabricated by combining a bacterial polysaccharide, i.e. bacterial cellulose (BC), and an algae sulphated polysaccharide, i.e. fucoidan (Fuc). The diffusion of fucoidan aqueous solution containing a natural-based cross-linker, viz. tannic acid, into the wet BC nanofibrous three-dimensional network, followed by thermal cross-linking, originated fully bio-based proton exchange membranes (PEMs). The PEMs present thermal-oxidative stability in the range of 180-200 °C and good dynamic mechanical performance (storage modulus ≥ 460 MPa). Additionally, the BC/Fuc membranes exhibit protonic conductivity that increases with increasing relative humidity (RH), which is a typical feature for numerous water-mediated proton conductors. The traditional Arrhenius-type plots demonstrate a linear behaviour with a maximum protonic conductivity of 1.6 mS cm-1 at 94 °C and 98 % RH. The results showed that these fully bio-based conductive membranes have potential as eco-friendly alternatives to other PEMs for application in PEFCs.

Bacterial cellulose/graphene oxide aerogels with enhanced dimensional and thermal stability

We present a novel method for processing bacterial cellulose/graphene oxide (BC/GO) aerogels with multifunctional properties. The addition of a small amount of dimethyl sulfoxide (DMSO) to the aqueous dispersion of the nanomaterials during the gelification process affected the water freezing temperature of the system and thereby affecting the porous structure of the aerogel obtained after liophilization. The possibility to obtain small and elongated pore with axial orientation allowed a significant improvement of the structural stability of the aerogels. Moreover, the aerogels reduction by thermal treatment with ammonia gas induced crosslinking between the different nanophases, thus given an incremental factor for the mechanical performance of the aerogels under harsh conditions. The resulting aerogels also showed significant improvements in terms of thermal stability and electrical conductivity. These multifunctional BC/GO aerogels present high potential as sustainable and ecological alternative materials for lightweight packaging, filters for atmosphere and water treatment, or energy applications.

Eco-friendly profile of pegylated nano-graphene oxide at different levels of an aquatic trophic chain

Nanographene oxide (nGO) has been recently proposed as a new antitumoral therapeutic agent, drug delivery carrier and gene transfection vehicle, among others. Treatment is carried out by hyperthermia induced by infrared irradiation. After treatment, the nanosystems will be inevitably excreted and released to the environment. To understand the potential impacts of pegylated nGO (nGO-PEG), three key species from different trophic levels were used: the green micro-algae Raphidocelis subcapitata (growth inhibition test), the cladocera Daphnia magna (acute and chronic tests), and the fish Danio rerio (fish embryo test). Besides a regular standard procedure to assess toxicity, and considering the mode of action of nGO-PEG in cancer treatment, a simultaneous infrared lamp exposure was carried out for D. magna and D. rerio. Additionally, and taking advantage of the phenotypic transparency of D. magna, nGO-PEG was fluorescently tagged to evaluate the potential uptake of nGO-PEG. The R. subcapitata growth inhibition test showed effects during the first 48 h, recovering till the end of the test (96 h). No acute or chronic effects were observed for D. magna, under standard or infrared light exposures although confocal microscope images showed nGO-PEG uptake. Very small percentages of mortality and abnormalities were observed in D. rerio exposed with and without the infrared lamp. Although low hazard may be expected for nGO-PEG in aquatic ecosystems, further studies with species with different life traits should be accomplished, in order to derive more accurate conclusions.

Selective two-photon absorption in carbon dots: a piece of the photoluminescence emission puzzle

Carbon nanodots (Cdots) are now emerging as promising nonlinear fluorophores for applications in biological environments. A thorough and systematic approach to the two-photon induced emission of Cdots that could provide design guidelines to control their nonlinear emission properties is still missing. In this work, we address the nonlinear optical spectroscopy of Cdots prepared by controlled chemical cutting of graphene oxide (GO). The two-photon absorption in the 700-1000 nm region and the corresponding emission spectrum are carefully investigated. The highest two-photon absorption cross-section estimated was 130 GM at 720 nm. This value is comparable with the one reported for graphene nanoribbons with push-pull architecture. The emission spectrum depends on the excitation mode. At the same excitation energy, nonlinear excitation results in excitation-wavelength independent emission, while upon linear excitation the emission is excitation-wavelength dependent. The biphotonic interaction seems to be selective towards sp2 clusters bearing electron donor and acceptor groups found in push-pull architectures. Both linear and nonlinear emission can be understood based on the existence of isolated sp2 clusters involved in π-π stacking interactions with clusters in adjacent layers.

Rubella antibodies in cord blood sera in Portugal: association with maternal age and vaccination status

This study evaluated the impact of maternal vaccination against rubella on the levels of specific rubella IgG (rIgG) in 198 newborn cord sera samples. Detailed maternal vaccination data were available. Specific rIgG was measured using a commercial enzyme immunoassay. Most mothers (78.8%) had been vaccinated against rubella at least once in their lives. In 15 (7.6%) cord sera samples, the concentration of specific rIgG was below 11 IU/ml, which was classified as seronegative. Statistical analysis using multiple logistic regression (n = 198) showed that newborns of mothers born between 1986 and 1995, and those born to unvaccinated mothers, were more likely to be seronegative (odds ratio (ORs) 5.2 and 4.9, respectively, adjusted for sex and gestational age). For vaccinated mothers (n = 156), those born between 1986 and 1995 were more likely to have seronegative newborns (OR 11.5 adjusting for sex, gestational age and time since last vaccination). Mothers of the 15 (7.6%) seronegative newborns might have been susceptible to rubella during pregnancy. Checking the vaccination status therefore recommended.