Background Composting is an important technique for environment-friendly degradation of organic material, and is a microbe-driven process. Previous metagenomic studies of composting have presented a general description of the taxonomic and functional diversity of its microbial populations, but they have lacked more specific information on the key organisms that are active during the process. Results Here we present and analyze 60 mostly high-quality metagenome-assembled genomes (MAGs) recovered from time-series samples of two thermophilic composting cells, of which 47 are potentially new bacterial species; 24 of those did not have any hits in two public MAG datasets at the 95% average nucleotide identity level. Analyses of gene content and expressed functions based on metatranscriptome data for one of the cells grouped the MAGs in three clusters along the 99-day composting process. By applying metabolic modeling methods, we were able to predict metabolic dependencies between MAGs. These models indicate the importance of coadjuvant bacteria that do not carry out lignocellulose degradation but may contribute to the management of reactive oxygen species and with enzymes that increase bioenergetic efficiency in composting, such as hydrogenases and N2O reductase. Strong metabolic dependencies predicted between MAGs revealed key interactions relying on exchange of H+, NH3, O2 and CO2, as well as glucose, glutamate, succinate, fumarate and others, highlighting the importance of functional stratification and syntrophic interactions during biomass conversion. Our model includes 22 out of 49 MAGs recovered from one composting cell data. Based on this model we highlight that Rhodothermus marinus, Thermobispora bispora and a novel Gammaproteobacterium are dominant players in chemolithotrophic metabolism and cross-feeding interactions. Conclusions The results obtained expand our knowledge of the taxonomic and functional diversity of composting bacteria and provide a model of their dynamic metabolic interactions.
Background: Monitoring vital signs such as oximetry, blood pressure, and heart rate is important to follow the evolution of patients. Smartwatches are a revolution in medicine allowing the collection of such data in a continuous and organic way. However, it is still a challenge to make this information available to health care professionals to make decisions during clinical follow-up.Objective: This study aims to build a digital solution that displays vital sign data from smartwatches, collected remotely, continuously, reliably, and from multiple users, with trigger warnings when abnormal results are identified.Methods: This is a single-center prospective study following the guidelines "Evaluating digital health products" from the UK Health Security Agency. A digital platform with 3 different applications was created to capture and display data from the mobile phones of volunteers with smartwatches. We selected 80 volunteers who were followed for 24 weeks each, and the synchronization interval between the smartwatch and digital solution was recorded for each vital sign collected. Results: In 14 weeks of project progress, we managed to recruit 80 volunteers, with 68 already registered in the digital solution. More than 2.8 million records have already been collected, without system downtime. Less than 5% of continuous heart rate measurements (bpm) were synchronized within 2 hours. However, approximately 70% were synchronized in less than 24 hours, and 90% were synchronized in less than 119 hours. Conclusions:The digital solution is working properly in its role of displaying data collected from smartwatches. Vital sign values are being monitored by the research team as part of the monitoring of volunteers. Although the digital solution proved unsuitable for monitoring urgent events, it is more than suitable for use in outpatient clinical use. This digital solution, which is based on cloud technology, can be applied in the future for telemonitoring in regions lacking health care professionals. Accuracy and reliability studies still need to be performed at the end of the 24-week follow-up.
BACKGROUND Monitoring vital signs such as oximetry, blood pressure and heart rate is important to follow the evolution of patients. Smartwatches are a revolution in medicine, allowing the collection of such data in a continuous and organic way. However, it is still a challenge to make this information available to healthcare professionals in clinical follow-up to make decisions. OBJECTIVE Build a digital solution that displays vital signs data from smartwatches, collected remotely, continuously, reliably and from multiple users, with trigger warnings when abnormal results are identified. METHODS This is a single-centre prospective study following the guidelines “Evaluating digital health products” from UK Health Security Agency. A digital platform was built following information security standards. 80 volunteers were selected for this clinical trial and followed by 24 weeks each and divided in two groups, one with previous diagnosis of Covid-19, and a control groups without previous diagnosis Covid-19. Synchronization rate with the platform, accuracy and precision of the equipment under domestic conditions were evaluated to simulate remote home monitoring. RESULTS In 35 weeks of clinical study, more than 11.2 million records have been collected, without system downtimes. 66% of continuous beats per minute were synchronized within 24 hours (79% within 2 days; 91% within a week). At LoA analysis, the mean difference of oxygen saturation, diastolic BP, systolic BP and heart rate were respectively: -1.280 (±5.679) %, -1.399 (±19.112) mmHg, -1.536 (±24.244) mmHg, 0.566 (±3.114) bpm. The user experience shows that 69% of volunteers agreed that feel like the smartwatch is embedded in their body. Finally, there was no difference in the two groups of study regarding the data analysis (neither using the smartwatch nor the gold-standard devices), but it should be noted that all volunteers from the Covid-19 group were already been cured from the infection and highly functional at their daily work life. CONCLUSIONS Based on the observed results and the synchronization reliability, the proposed solution (smart watch + digital platform) provides clinically relevant data to support medical decision during remote monitoring of outpatients in real life (free-living conditions) and non-urgent scenarios. This study indicates that there is a wide acceptance/adherence for the use of the smart watch, which may allow us to suggest and consider this solution as a suitable tool to follow chronic disease patients. CLINICALTRIAL This project was submitted to the Ethics and Research Committee of the Hospital das Clinicas, The Faculdade de Medicina of University of São Paulo under number CAAE: 51711921.3.0000.0068 and Opinion number: 4,975,512.
À minha família, que criou a base para que hoje fosse possível ter a oportunidade de cursar a pós-graduação.À minha esposa Silvia, pelo companheirismo, apoio e suporte nessa jornada. Agradeço também a sua família (agora minha também), meus sogros Marina e Silvio e cunhada Susan, sempre próximos e receptivos, dispostos a participar e ajudar em tudo.À minha querida avó Mique, que com sua sede de conhecimento inspira a todos nós. À minha mãe Ana, exemplo de positividade e energia infinita. Em memória do meu pai Reinaldo, que sempre acreditou nos estudos como o caminho para uma vida melhor. Aos meus irmãos, Hamilton e Heloisa, pela parceria de sempre.Aos meus tios, tias e primas, por estarem sempre por perto, e tornar a vida em família mais completa e feliz.Aos meus amigos, que desde o início me apoiaram nesse desafio (e em muitos outros) e acompanharam todos os passos, com destaque:Ao André Delgado, entusiasta da área acadêmica entre os amigos, sempre dando dicas e acompanhando o processo.Ao Denis Rosa, de colega de trabalho a grande amigo, exemplo de dedicação, determinação e foco. Ninguém segura.Ao Eduardo Amuri, pelas muitas conversas e discussões sobre assuntos variados e complexos, parceiro e pau para toda obra. Nossos encontros nos cafés já geraram muito ciúmes na sociedade.À Tamara Fonseca, que tem uma visão ímpar da vida e da sociedade, faz um belo contraponto e nos ajuda a entender outros pontos de vista. Agora com o Cleber, é uma dupla imbatível.À turma do Setulab, pelos aprendizados e bons exemplos. Infelizmente não foi possível para mim conviver com todos o quanto eu gostaria, mas já valeu (e muito) a pena. Destaque ao Carlos Morais pelo suporte na infraestrutura, ao Robson Pontes por auxiliar nos testes e melhorias do software, e a todos que me ajudaram fornecendo os resultados/dados dos seus próprios trabalhos: Ana Carolina Soares, Livia Moura, Raquel Riyuzo e Suzana Guima.Ao Professor Setubal, por toda sua disponibilidade, dedicação, paciência e envolvimento no projeto e trabalhos realizados.Esse trabalho não é só meu, é uma conquista de todos nós.
BACKGROUND Vital signs monitoring such as oximetry, blood pressure and heart rate are important to follow-up the evolution of patients, alerting the need for clinical intervention and adjustments in the therapeutic process, avoiding worsening of the clinical picture, new hospitalizations and the expansion of the disabling condition. And the possibility of measuring continuously and naturally through wearable devices, such as smart watches, is a revolution in medicine through mobile health (m-health) and digital health (e-health). OBJECTIVE Build a digital solution that captures vital signs data from smart watches in a continuous, secure and reliable way. METHODS This is a single-centre prospective study following the guidelines “Evaluating digital health products” from UK Health Security Agency. A digital solution was created to capture and display data from mobile phone of the volunteers with the smartwatches. 80 volunteers were selected for this clinical trial, divided by the previous diagnosis of Covid-19 in two groups, and are followed by 24 weeks each. RESULTS In 14 weeks of project progress, we managed to recruit 80 volunteers, with 68 already registered in the digital solution. More than 2.8 million records have already been collected. CONCLUSIONS The digital solution is working properly in its role of collecting data from the smart watches of research volunteers. Vital sign values are being monitored by the research team as part of monitoring the health of volunteers. Accuracy and reliability studies still need to be performed at the end of the 24-week follow-up of volunteers. CLINICALTRIAL This project was submitted to the Ethics and Research Committee of the Hospital das Clínicas, Faculty of Medicine, University of São Paulo under number CAAE: 51711921.3.0000.0068 and Opinion No. 4,975,512. Its opinion was approved on September 15, 2021 without the need for consideration by CONEP.
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