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Mechanical ventilation can be a life-saving intervention, but its implementation requires a multidisciplinary approach, with an understanding of its indications and contraindications due to the potential for complications. The management of mechanical ventilation should be part of the curricula during clinical training; however, trainees and practicing professionals frequently report low confidence in managing mechanical ventilation, often seeking additional sources of knowledge. Review articles, consensus statements and clinical practice guidelines have become important sources of guidance in mechanical ventilation, and although clinical practice guidelines offer rigorously developed recommendations, they take a long time to develop and can address only a limited number of clinical questions. The Associação de Medicina Intensiva Brasileira and the Sociedade Brasileira de Pneumologia e Tisiologia sponsored the development of a joint statement addressing all aspects of mechanical ventilation, which was divided into 38 topics. Seventy-five experts from all regions of Brazil worked in pairs to perform scoping reviews, searching for publications on their specific topic of mechanical ventilation in the last 20 years in the highest impact factor journals in the areas of intensive care, pulmonology, and anesthesiology. Each pair produced suggestions and considerations on their topics, which were presented to the entire group in a plenary session for modification when necessary and approval. The result was a comprehensive document encompassing all aspects of mechanical ventilation to provide guidance at the bedside. In this article, we report the methodology used to produce the document and highlight the most important suggestions and considerations of the document, which has been made available to the public in Portuguese.

Objective: To conduct a systematic review and meta-analysis to verify the association of aspects of sports practice with health risk behaviors in adolescents., Data Source: A systematic search was conducted of electronic manuscripts from the United States National Library of Medicine (PubMed)/ Medical Literature Analysis and Retrieval System Online (MEDLINE), Web of Science, Science Direct, and Scientific Electronic Library Online (SciELO) published from January 2015 to December 2022. Studies examining the association between sport and health risk behaviors in adolescents aged 11 to 19 years were included. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42023392053., Data Synthesis: In total, 22 studies fulfilled the inclusion criteria. The association of sports practice with sedentary behavior showed odds ratio (OR) values ranging from 0,61 to 0,92, tobacco use from 0,35 to 0,73, illicit drugs from 0,40 to 0,91, and reduced inadequate sleep on weekdays of 0.57 (95% confidence interval - 95%CI 0.52-0.63) and weekends 0.79 (95%CI 0.69-0.89). In the meta-analysis, sports practice was significantly associated with alcohol consumption for boys (OR 1,36; CI95% 1,09-1,70), and was inversely associated with tobacco use for boys and girls (OR 0,59; CI95% 0,56-0,61)., Conclusions: Adolescents who practice sports tend to have lower occurrences of sedentary behavior, tobacco and illicit drug use, and adequate amounts of sleep; and, in the meta-analysis, boys present higher values for alcohol consumption and boys and girls present lower values for tobacco use.

Objective: To describe the 12-month mortality of Dutch COVID-19 intensive care unit patients, the total COVID-19 population and various subgroups on the basis of the number of comorbidities, age, sex, mechanical ventilation, and vasoactive medication use., Methods: We included all patients admitted with COVID-19 between March 1, 2020, and March 29, 2022, from the Dutch National Intensive Care (NICE) database. The crude 12-month mortality rate is presented via Kaplan-Meier survival curves for each patient subgroup. We used Cox regression models to analyze the effects of patient characteristics on 12-month mortality after hospital discharge., Results: We included 16,605 COVID-19 patients. The in-hospital mortality rate was 28.1%, and the 12-month mortality rate after intensive care unit admission was 29.8%. Among hospital survivors, 12-month mortality after hospital discharge was 2.5% (300/11,931). The hazard of death at 12 months after hospital discharge was greater in patients between 60 and 79 years (HR 4.74; 95%CI 2.23 - 10.06) and ≥ 80 years (HR 22.77; 95%CI 9.91 - 52.28) than in patients < 40 years of age; in male patients than in female patients (HR 1.38; 95%CI 1.07 - 1.78); and in patients with one (adjusted HR 1.95; 95%CI 1.5 - 2.53), two (adjusted HR 4.49; 95%CI 3.27 - 6.16) or more than two comorbidities (adjusted HR 4.99; 95%CI 2.62 - 9.5) than in patients with no comorbidities. Neither vasoactive medication use nor mechanical ventilation resulted in statistically significant results., Conclusion: For Dutch COVID-19 intensive care unit patients, most deaths occurred during their hospital stay. For hospital survivors, the crude 12-month mortality rate was low. Patient age (older than 60), sex and the number of comorbidities were associated with a greater hazard of death at 12 months after hospital discharge, whereas mechanical ventilation and vasoactive medication were not.

Our paper examines the political considerations in the intersectoral action that was evident during the SAR-COV-2 virus (COVID-19) pandemic through case studies of political and institutional responses in 16 nations (Australia, Belgium, Brazil, Ethiopia, India, New Zealand, Nigeria, Peru, South Africa, South Korea, Spain, Taiwan, Thailand, Vietnam, UK, and USA). Our qualitative case study approach involved an iterative process of data gathering and interpretation through the three Is (institutions, ideas and interests) lens, which we used to shape our understanding of political and intersectoral factors affecting pandemic responses. The institutional factors examined were: national economic and political context; influence of the global economic order; structural inequities; and public health structures and legislation, including intersectoral action. The ideas explored were: orientation of governments; political actors' views on science; willingness to challenge neoliberal policies; previous pandemic experiences. We examined the interests of political leaders and civil society and the extent of public trust. We derived five elements that predict effective and equity-sensitive political responses to a pandemic. Firstly, effective responses have to be intersectoral and led from the head of government with technical support from health agencies. Secondly, we found that political leaders' willingness to accept science, communicate empathetically and avoid 'othering' population groups was vital. The lack of political will was found in those countries stressing individualistic values. Thirdly, a supportive civil society which questions governments about excessive infringement of human rights without adopting populist anti-science views, and is free to express opposition to the government encourages effective political action in the interests of the population. Fourthly, citizen trust is vital in times of uncertainty and fear. Fifthly, evidence of consideration is needed regarding when people's health must be prioritized over the needs of the economy. All these factors are unlikely to be present in any one country. Recognizing the political aspects of pandemic preparedness is vital for effective responses to future pandemics and while intersectoral action is vital, it is not enough in isolation to improve pandemic outcomes., (© The Author(s) 2024. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)

A combined en bloc heart and liver transplant is a rare form of a combined dual organ transplant in which the donor heart and liver remain connected via the inferior caval vein both during procurement and during the transplant. We present a patient who underwent a combined en bloc heart and liver transplant due to heart failure and cirrhosis, after having previously undergone repair of complex biventricular congenital heart disease., (© The Author 2024. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Background/Objectives : Type 2 Diabetes Mellitus (T2DM) is characterized by hyperglycemia, increased risk of cardiovascular diseases, and oxidative imbalances. This study aimed to investigate the impact of dietary supplementations with 'Arinto' grape pomace flour (GPF) (WGPF) and 'Touriga Nacional' GPF (RGPF) in an animal model of T2DM. Methods : T2DM was induced by a high-fat diet (HFD) for 28 days and a single dose of streptozotocin (STZ) (35 mg/kg) on the 21st day. Forty adult male Wistar rats were divided into five groups: Control (CT), T2DM, T2DM + Metformin (250 mg/kg), T2DM + 10% 'Arinto' GPF (WGPF), and T2DM + 10% 'Touriga Nacional' GPF (RGPF). On the 21st day of the experimental protocol, animals were submitted to an oral glucose tolerance test. An oral glucose tolerance test, oxidative stress parameters, biochemical analysis, and pancreas histological analyses were performed. Results : T2DM impaired glucose tolerance, elevated serum triglycerides and cholesterol, increased oxidative damage in the liver, and induced pancreatic histological abnormalities. However, supplementation with WGPF and RGPF demonstrated positive effects, mitigating glycemic and lipid disruptions, ameliorating oxidative stress, and protecting pancreatic Islets β-cells. Conclusions : Our findings highlight the protective effects of WGPF and RGPF in the adverse impacts of T2DM. Additionally, our study emphasizes the innovative use of grape pomace, a winemaking by-product, promoting sustainability by transforming waste into functional foods with significant health benefits.

Homocysteine (Hcy) is produced through methionine transmethylation. Elevated Hcy levels are termed Hyperhomocysteinemia (HHcy) and represent a risk factor for neurodegenerative conditions such as Alzheimer's disease. This study aimed to explore the impact of mild HHcy and the neuroprotective effects of ibuprofen and rivastigmine via immunohistochemical analysis of glial markers (Iba-1 and GFAP). Additionally, we assessed levels of vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), chemokine ligand 5 (CCL5/RANTES), CX3C chemokine ligand 1 (CX3CL1), and the NGF/p75NTR/tropomyosin kinase B (TrkB) pathway in the hippocampus of adult rats. Mild chronic HHcy was induced chemically in Wistar rats by subcutaneous administration of Hcy (4 mg/kg body weight) twice daily for 30 days. Rivastigmine (0.5 mg/kg) and ibuprofen (40 mg/kg) were administered intraperitoneally once daily. Results revealed elevated levels of CCL5/RANTES and reduced levels of VEGF, EGF, and TrkB in the hippocampus of HHcy-exposed rats. Rivastigmine mitigated the neurotoxic effects of HHcy by increasing TrkB and VEGF levels. Conversely, ibuprofen attenuated CCL5/RANTES levels against the neurotoxicity of HHcy, significantly reducing this chemokine's levels. HHcy-induced neurochemical impairment in the hippocampus may jeopardize neurogenesis, synapse formation, axonal transport, and inflammatory balance, leading to neurodegeneration. Treatments with rivastigmine and ibuprofen alleviated some of these detrimental effects. Reversing HHcy-induced damage through these compounds could serve as a potential neuroprotective strategy against brain damage., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: The aim of this study was to analyze the association between participation in fitness-related exercises (FRE) and body image dissatisfaction (BID) in adolescents and evaluate the interaction between physical exercise and nutritional status in this association., Methods: A cross-sectional study was conducted in 2015 involving 799 adolescents (10-16 years old) from 14 public schools in Curitiba (PR), Brazil. BID was assessed using the Body Shape Questionnaire and the Silhouette Scale. The FRE was classified as "does not practice," "practices ≤300 min/week," and "practices >300 min/week" by the Physical Activity Questionnaire for Adolescents. Poisson and multinomial logistic regressions, adjusted for sex, sexual maturation, and nutritional status analyzed the association of FRE and BID., Results: The BID prevalence was 28.3%; 52.4% of the adolescents wanted to reduce their silhouettes; and 48.7% did not practice FRE. Adolescents who practiced FRE >300 min/week had a 28% higher prevalence for some level of BID (PR 1.28; 95%CI 1.08-1.52) and a 46% lower chance of wanting to reduce silhouettes (OR 0.54; 95%CI 0.35-0.82), compared to nonpractitioners. There was no interaction between FRE and nutritional status in association with BID., Conclusions: The adolescents who practice FRE >300 min/week are likely to have some level of BID and are less likely to report the desire to increase their silhouettes, regardless of their nutritional status.

Objective: The aim of this study was to examine the association between bullying victimization and health risk behaviors in adolescents., Methods: A representative sample of 1020 adolescents participated in the study. The variables such as bullying, health risk behaviors (tobacco, drugs, alcohol, sedentary behavior, smartphone use, level of physical activity, and sleep), and economic status were assessed using self-reported questionnaires. Odds ratios with 95% confidence intervals (95%CI) were obtained using binary logistic regression and ordinal, gross, and adjusted logistic regression (p<0.05)., Results: Victims of bullying were more likely to smoke (OR 1.75; 95%CI 1.28-2.40), consume alcohol (OR1.43; 95%CI 1.05-1.94), have worse sleep quality (OR 1.94; 95%CI 1.28-2.91), and more sedentary behavior (OR 1.43; 95%CI 1.08-1.89) than those who were not bullied. However, victims were more likely to have high levels of physical activity than their non-bullied peers (OR 1.66; 95%CI 1.22-2.27)., Conclusions: Bullying victimization was associated with an increased predisposition for the adoption of health risk behaviors. Interestingly, victims were also more prone to participate in physical activity.

To ensure the accuracy of radiation delivery to patients in a 1.5 T MRI-linac, the implementation of quality assurance (QA) devices compatible with MR technology is essential. The OCTAVIUS 4D MR, made by PTW (Freiburg, Germany) is designed to ensure consistent and ideal alignment of its detectors with the direction of each beam segment. This study focuses on investigating the fundamental characteristics of the detector response for the OCTAVIUS Detector (OD) 1500 MR and OCTAVIUS 1600 MR when used in the MR-compatible OCTAVIUS 4D. Characteristics examined included short-term reproducibility, dose linearity, field size dependency, monitor unit (MU) rate dependency, dose-per-pulse dependency, and angular dependency. The evaluation of OD 1500 MR also involved measuring 25 clinical treatment plans across diverse target sizes and anatomical sites, including the liver/pancreas, rectum, prostate, lungs, and lymph nodes. One plan was measured with the standard setup and with a 5 cm left offset. The OD 1600 MR was not available for these measurements. The capability of the OD 1500 MR to identify potential errors was assessed by introducing a MU and positional shift within the software. The results demonstrated no significant differences in short-term reproducibility (<0.2%), dose linearity (<1%), field size dependency (<0.7%for field sizes larger than 5 cm × 5 cm), MU rate dependency (<0.8%), dose-per-pulse dependency (<0.4%) and angular dependency (standard deviation<0.5%). All tests of clinical plans were successfully completed. The OD 1500 MR demonstrated compatibility with the standard 95% pass rate when employing a global 3%/3 mm gamma criterion, and a 90% pass rate using a global 2%/2 mm gamma criterion. The detector demonstrated the capacity to measure treatment plans with a 5 cm left offset. With the standard parameters, the gamma test was sensitive to position errors but required an addition tests of mean/median dose or point dose in order to detect small dose difference., (Creative Commons Attribution license.)

Background: Pityriasis versicolor (PV), a cutaneous fungal infection, most commonly affects adolescents and young adults and is associated with hyperhidrosis and humid weather. Understanding other factors associated with PV might help improve diagnostic and treatment practices., Objectives: PV's associations with patient demographics, comorbidities and medication exposures were assessed using the All of Us Database, a large, diverse, national database from the United States., Methods: A case-control study with multivariable analysis was performed., Results: We identified 456 PV case-patients and 1368 control-patients. PV case-patients (vs. control-patients) were younger (median age [years] (standard deviation): 48.7 (15.4) vs. 61.9 (15.5); OR: 0.95, CI: 0.94-0.96) and more likely to be men versus women (42.8% vs. 33.9%, OR: 1.45, CI: 1.16-1.79) and Black (19.5% vs. 15.8%, OR: 1.35, 95% CI: 1.02-1.80) or Asian (4.6% vs. 2.7%, OR: 1.86, CI: 1.07-3.24) versus White. PV case-patients more frequently had acne (5.3% vs. ≤1.5%, OR: 5.37, CI: 2.76-10.48) and less frequently had type 2 diabetes mellitus (T2DM) (14.7% vs. 24.7%, OR: 0.52, CI: 0.39-0.70) and hypothyroidism (OR: 10.3% vs. 16.4%, OR: 0.59, CI: 0.42-0.82). In multivariable analysis, PV odds were significantly higher in those with acne and lower in those with T2DM, older age and female sex., Conclusions: Our results may be used as a basis for future studies evaluating whether acne treatment may decrease PV risk. Physicians could educate patients with acne about PV, including strategies to control modifiable PV risk factors, such as avoidance of hot and humid environments and avoidance of use of topical skin oils., (© 2024 Wiley‐VCH GmbH. Published by John Wiley & Sons Ltd.)

The incorporation of different molecules by eukaryotic cells occurs through endocytosis, which is critical to the cell's survival and ability to reproduce. Although this process has been studied in greater detail in mammalian and yeast cells, several groups working with pathogenic protists have made relevant contributions. This review analysed the most relevant data on the endocytic process in anaerobic protists (Entamoeba histolytica, Giardia intestinalis, Trichomonas vaginalis, and Tritrichomonas foetus). Many protozoa can exert endocytic activity across their entire surface and do so with great intensity, as with E. histolytica. The available data on the endocytic pathway and the participation of PI-3 kinase, Rab, and Rho molecular complexes is reviewed from a historical perspective.

Understanding how biological visual systems process information is challenging because of the nonlinear relationship between visual input and neuronal responses. Artificial neural networks allow computational neuroscientists to create predictive models that connect biological and machine vision. Machine learning has benefited tremendously from benchmarks that compare different model on the same task under standardized conditions. However, there was no standardized benchmark to identify state-of-the-art dynamic models of the mouse visual system. To address this gap, we established the SENSORIUM 2023 Benchmark Competition with dynamic input, featuring a new large-scale dataset from the primary visual cortex of ten mice. This dataset includes responses from 78,853 neurons to 2 hours of dynamic stimuli per neuron, together with the behavioral measurements such as running speed, pupil dilation, and eye movements. The competition ranked models in two tracks based on predictive performance for neuronal responses on a held-out test set: one focusing on predicting in-domain natural stimuli and another on out-of-distribution (OOD) stimuli to assess model generalization. As part of the NeurIPS 2023 competition track, we received more than 160 model submissions from 22 teams. Several new architectures for predictive models were proposed, and the winning teams improved the previous state-of-the-art model by 50%. Access to the dataset as well as the benchmarking infrastructure will remain online at www.sensorium-competition.net.

This observational, cross-sectional study with retrospective collection was aimed to evaluate the prevalence of morphological changes in mandibular condyles in individuals with class II malocclusion, classified according to different vertical growth patterns (brachyfacial, mesofacial, and dolichofacial), through cone beam computed tomography (CBCT). Seventy CBCT images (140 mandibular condyles) were selected from individuals without orthodontic treatment, of both sexes, aged between 25 and 50 years. No statistically significant differences were found between facial patterns; however, there was a higher relative prevalence of bone changes in dolichofacial individuals with flattening (62%), sclerosis (44%), and subchondral bone cyst (20%). Erosion and osteophytes prevailed in mesofacial (39%), and brachyfacial individuals (32%), respectively. Thus, there was no statistically significant difference in the prevalence of degenerative changes between the vertical skeletal patterns. Flattening was the most prevalent change, whereas subchondral bone cyst was the least prevalent among the three groups studied. The observational design of this study makes it possible to analyze image banks to verify the correlation of morphological changes in the temporomandibular joint in different facial patterns in patients with class II malocclusion. A limitation of the study is that clinical characteristics were not evaluated.

A combined heart+liver transplant is the only option for survival in some patients with end-stage combined cardiac and hepatic disease. These patients may suffer from congenital or acquired cardiac disease. The potential aetiologies of the associated hepatic disease are heterogeneous and include systemic disease that impacts the liver as well as venous congestion in patients with functionally univentricular circulation. In the latter scenario, patients with functionally univentricular circulation often require complex cardiac reconstruction in the setting of a cardiac transplant after staged palliation. During cardiac procurement, our approach is to dissect the entire ascending aorta and aortic arch in continuity; the entire superior caval vein and innominate vein in continuity; and the pulmonary arteries from hilum to hilum if the donor is not a candidate for recovery of the lungs. The cardiac and abdominal organ procurement teams work in parallel during dissection and combined en bloc cardio-hepatectomy. This technique minimizes exposure of both organs to cold ischaemia. This video tutorial demonstrates the key steps for combined en bloc heart+liver organ procurement., (© The Author 2024. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Introduction: Background: the COVID-19 pandemic has impacted people's behaviors and mental health around the world. Aim: to verify the mediating role of physical activity (PA) level in the relationship between body mass index (BMI) and anxiety and depression symptoms in adults during the COVID-19 pandemic. Methods: this is a cross-sectional study with Brazilian adults aged ≥ 18 years (N = 2000, 59.6 % women) selected by the nonprobabilistic snowball method through digital means of communication (WhatsApp®, Telegram®, Facebook®, Twitter®, e-mails). Linear regression models were fitted for PA level mediation analyses in the relationship between BMI and anxiety/depression symptoms. Results: significant differences were found between the active/not overweight group and the other three groups (active/overweight, insufficiently active/not overweight and insufficiently active/overweight [p < 0.001]) for anxiety/depression after adjusting for age, sex, chronic diseases, alcohol consumption, and smoking. When testing the mediating role of daily PA in the association between BMI and anxiety/depression symptoms, BMI was negatively associated with daily PA in the first regression equation (p < 0.001); in the second, BMI was positively related to anxiety/depression symptoms (p < 0.001); and in the third, daily PA showed an inverse relationship with anxiety/depression symptoms (p < 0.001), and although BMI remained negatively associated with anxiety/depression symptoms, these associations maintained their statistical significance. Conclusions: the results suggest that the effect of BMI on anxiety and depression was partially mediated by daily PA.

Background: Immunotherapy with checkpoint inhibitors, especially those targeting programmed death receptor 1 (PD-1)/PD-1 ligand (PD-L1), is increasingly recognized as a highly promising therapeutic modality for malignancies. Nevertheless, the efficiency of immune checkpoint blockade therapy in treating glioblastoma (GBM) is constrained. Hence, it is imperative to expand our comprehension of the molecular mechanisms behind GBM immune escape (IE)., Methods: Protein chip analysis was performed to screen aberrantly expressed OMA1 protein in PD-1 inhibitor sensitive or resistant GBM. Herein, public databases and bioinformatics analysis were employed to investigate the OMA1 and PD-L1 relation. Then, this predicted relation was verified in primary GBM cell lines through distinct experimental methods. To investigate the molecular mechanism behind OMA1 in immunosuppression, a series of experimental methods were employed, including Western blotting, co-immunoprecipitation (Co-IP), mass spectrometry (MS), immunofluorescence, immunohistochemistry, and qRT-PCR., Results: Our findings revealed that OMA1 competitively binds to HSPA9 to induce mitophagy and mediates the IE of GBM. Data from TCGA indicated a significant correlation between OMA1 and immunosuppression. OMA1 promoted PD-L1 levels in primary cells from patients with GBM. Next, the results of Co-IP and MS conducted on GBM primary cells revealed that OMA1 interacts with HSPA9 and induces mitophagy. OMA1 promoted not only cGAS-STING activity by increasing mitochondrial DNA release but also PD-L1 transcription by activating cGAS-STING. Eventually, OMA1 has been found to induce immune evasion in GBM through its regulation of PD-1 binding and PD-L1 mediated T cell cytotoxicity., Conclusions: The OMA1/HSPA9/cGAS/PD-L1 axis is elucidated in our study as a newly identified immune therapeutic target in GBM., Competing Interests: Competing interests: No, there are no competing interests., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Mg 0.472 Zn 0.528 O/Mg 0.447 Zn 0.553 O double layer structure UV detectors are made on single structure MgO substrate by PLD method, and the effect of different thickness top MgZnO layer on the UV response characteristics of the detector are studied. Compared with the single layer MgZnO detector that made by Mg 0.3 Zn 0.7 O target, the Mg 0.472 Zn 0.528 O/Mg 0.447 Zn 0.553 O double layer detector with 30 nm top layer, shows much higher deep UV response (21.3 A W -1 at 265 nm), much smaller dark current(66.9 pA) and much higher signal-to-noise ratio (2.8 × 10 5 ) at 25 V bias voltage. And the device also shows relative high response (23.1 A W -1 ) at 235 nm deep UV light at 25 V bias voltage, which is mainly attributed by the bottom MgZnO layer with higher Mg composition. When the top layer is 66.7 nm thick, the response of the Mg 0.472 Zn 0.528 O/Mg 0.447 Zn 0.553 O detector reached 228.8 A W -1 at 255 nm under 25 V bias voltage, the signal-to-noise ratio of which is 10573 under 20 V bias voltage, and the near UV response of the device is also big because of more h-MgZnO in top MgZnO layer. When the top layer reached 90.2 nm, there are much more h-MgZnO in the top MgZnO layer, the peak response of the Mg 0.472 Zn 0.528 O/Mg 0.447 Zn 0.553 O detector is just 6.65 A W -1 at 320 nm under 25 V bias voltage, the signal-to-noise ratio of which is 1248. The high Mg composition bottom MgZnO decrease the dark current of the Mg 0.472 Zn 0.528 O/Mg 0.447 Zn 0.553 O detector, both the 2DEG effect of the double layer structure and the amplify effect of the mix-phase MgZnO top layer, increased the I uv and deep UV response of the Mg 0.472 Zn 0.528 O/Mg 0.447 Zn 0.553 O detector. Therefore, the double layer Mg 0.472 Zn 0.528 O/Mg 0.447 Zn 0.553 O detector is more sensitive at faint deep UV light compared with previous reported MgZnO detectors, and the Mg x Zn 1- x O/Mg y Zn 1- y O detector shows similar I uv and signal-noise-ratio at faint deep UV light as high-temperature fabricated Al x Ga 1- x N/Al y Ga 1- y N detectors., (© 2024 IOP Publishing Ltd.)

Objective: to evaluate the quality of life (QOL) and the presence of symptoms related to depression, anxiety, and stress among students in the healthcare field, in comparison to the period before the COVID-19 pandemic., Methods: A comparative cross-sectional research was conducted at a Brazilian public university. QOL was assessed using the WHOQOL-bref scale, while symptoms of depression, anxiety, and stress were evaluated using the DASS-21 scale. Descriptive and inferential analyses were employed to compare the two time periods., Results: A total of 355 students participated in this study. During the pandemic, there were significant increases in severe depression symptoms (15.1% versus 24.8%), moderate anxiety (18.3% versus 29.4%), and moderate stress (40.9% versus 53.8%) observed among the participants. Additionally, a significant reduction in QOL was noted, particularly in the domain of social relationships (65.2 versus 59.6, p-value 0.029)., Conclusion: The study highlights a deterioration in both the quality of life and the mental health of healthcare students during the COVID-19 pandemic.

Background: Identifying asymptomatic individuals at risk of developing cardiovascular disease is one of the main goals of preventive cardiology. The coronary calcium score (CCS) makes it possible to estimate vascular age, which has shown to be more reliable than chronological age for determining cardiovascular risk., Objectives: To reclassify cardiovascular risk based on arterial age and evaluate CCS progression during follow-up., Methods: We included 150 asymptomatic men who underwent clinical and CCS evaluation in 2 evaluations with an interval of 7.6 years. We classified patients by traditional risk scores and arterial age. We evaluated which variables were associated with greater CCS progression during the period, considering a statistical significance level of 5% (p < 0.05)., Results: The use of arterial age in the stratification of cardiovascular risk in comparison with the Framingham risk score (FRS) reclassified 29% of individuals to a higher risk category and 37% to a lower risk category. Regarding the American Heart Association and American College of Cardiology score (ASCVD), 31% were reclassified as higher risk and 36% as lower risk. The initial classification by arterial age was directly related to the progression of CCS throughout follow-up (p < 0.001). This was not observed for the FRS (p = 0.862) or ASCVD (p = 0.153). The individual variables most associated with CCS progression were high systolic blood pressure and low HDL., Conclusion: Cardiovascular risk stratification using arterial age showed a better association than the FRS and ASCVD in identifying individuals with higher risk of atherosclerosis progression.

Endothelial dysfunction is a key phenomenon in COVID-19, induced by direct viral endothelial infection and secondary inflammation, mainly affecting the microvascular circulation. However, few studies described the subcellular aspects of the lung microvasculature and the associated thrombotic phenomena, which are widely present in severe COVID-19 cases. To that end, in this transversal observational study we performed transmission and scanning electron microscopy in nine lung samples of patients who died due to COVID-19, obtained via minimally invasive autopsies in Sao Paulo, Brazil, in 2020. All patients died due to acute respiratory failure and had microvascular thrombosis at histology. Electron microscopy revealed areas of endothelial damage with basal lamina disruption and virus infection in endothelial cells. In the capillary lumens, the ultrastructure of the thrombi is depicted, with red blood cells stacking, dysmorphism and hemolysis, fibrin meshworks, and extracellular traps. Our description illustrates the complex pathophysiology of microvascular thrombosis at the cellular level, which leads to some of the peculiar characteristics of severe COVID-19. NEW & NOTEWORTHY In this study, electron microscopy was used to explain the pathophysiology of respiratory failure in severe COVID-19. Before the advent of vaccination, as the virus entered the respiratory system, it rapidly progressed to the alveolar capillary network and, before causing exudative alveolar edema, it caused mainly thrombosis of the pulmonary microcirculation with preserved lung compliance explaining "happy hypoxia." Timing of anticoagulation is of pivotal importance in this disease.

The genus Lecithocera Herrich-Schffer, 1853 in the Democratic Republic of theCongo (DR Congo) is reviewed, with descriptions of four new species: Lecithocera katangaica Park, sp. nov., L. seydeliella Park, sp. nov., L. cornutispina Park, sp. nov., and L. lusingensis Park, sp. nov. Five species are already recorded from this country: 1) L. chloroscia Meyrick described from DR Congo; 2) L. lucernata Meyrick previously reported from DR Congo by Ghesquire in 1940; 3) L. trifera Meyrick and 4) L. xanthochalca Meyrick, their generic assignments still remain doubtable; and 5) L. ideologa Meyrick. Lecithocera dicentropa Meyrick, 1938 is synonymized as a junior synonym of L. ideologa Meyrick. Adults and the genitalia of the new species and L. ideologa Meyrick are illustrated, and a lectotype for L. trifera Meyrick is designated herein.

Being one of the oldest en most frequently performed invasive procedures; the lack of scientific progress of tooth removal procedures is impressive. This has most likely to do with technical limitations in measuring different aspects of these keyhole procedures. The goal of this study is to accurately capture the full range of motions during tooth removal as well as angular velocities in clinically relevant directions. An ex vivo measuring setup was designed consisting of, amongst others, a compliant robot arm. To match clinical conditions as closely as possible, fresh-frozen cadavers were used as well as regular dental forceps mounted on the robot's end-effector. Data on 110 successful tooth removal experiments are presented in a descriptive manner. Rotation around the longitudinal axis of the tooth seems to be most dominant both in range of motion as in angular velocity. Buccopalatal and buccolingual movements are more pronounced in the dorsal region of both upper and lower jaw. This study quantifies an order of magnitude regarding ranges of motion and angular velocities in tooth removal procedures. Improved understanding of these complex procedures could aid in the development of evidence-based educational material., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Riet et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: To verify whether parental physical activity and social support are associated with adolescents meeting physical activity recommendations., Methods: This is a cross-sectional study that selected 1,390 adolescents (59.6% girls) from Curitiba, Paraná, Brazil. The IPAQ (International Physical Activity Questionnaire), QAFA (Physical Activity Questionnaire for Adolescents), and ASAFA (Social Support for Physical Activity Practice in Adolescents) questionnaires were applied. Binary logistic regression was used to test the relationship among the study variables., Results: For boys, having parents who "always attend" (OR = 1.96; 95%CI: 1.16-3.32) and having parents or legal guardians who meet the PA recommendations (OR = 2.78; 95%CI: 1.76-4.38) were associated with meeting the PA recommendations. Odds were greater after adjusting for socioeconomic status (OR = 3.47; 95%CI: 1.73-6.96) and schooling level (OR = 4.20; 95%CI: 1.96-9.02). For girls, those with parents or legal guardians who "sometimes encourage them" (OR = 0.61; 95%CI: 0.37-0.98) had lower odds of meeting PA recommendations. These odds were higher after adjusting for socioeconomic status (OR = 2.11; 95%CI: 1.36-3.29) and schooling level (OR = 4.30; 95%CI: 2.41-7.69)., Conclusions: Boys and girls were more likely to meet PA recommendations daily by having parents who meet PA recommendations than by receiving parental social support. These results could help establish future interventions aimed at modifying behaviors related to PA in adolescents.

Targeted radionuclide therapy (TRT) using targeting moieties labeled with α-particle-emitting radionuclides (α-TRT) is an intensely investigated treatment approach as the short range of α-particles allows effective treatment of local lesions and micrometastases. However, profound assessment of the immunomodulatory effect of α-TRT is lacking in literature. Methods: Using flow cytometry of tumors, splenocyte restimulation, and multiplex analysis of blood serum, we studied immunologic responses ensuing from TRT with an antihuman CD20 single-domain antibody radiolabeled with 225 Ac in a human CD20 and ovalbumin expressing B16-melanoma model. Results: Tumor growth was delayed with α-TRT and increased blood levels of various cytokines such as interferon-γ, C-C motif chemokine ligand 5, granulocyte-macrophage colony-stimulating factor, and monocyte chemoattractant protein-1. Peripheral antitumoral T-cell responses were detected on α-TRT. At the tumor site, α-TRT modulated the cold tumor microenvironment (TME) to a more hospitable and hot habitat for antitumoral immune cells, characterized by a decrease in protumoral alternatively activated macrophages and an increase in antitumoral macrophages and dendritic cells. We also showed that α-TRT increased the percentage of programmed death-ligand 1 (PD-L1)-positive (PD-L1 pos ) immune cells in the TME. To circumvent this immunosuppressive countermeasure we applied immune checkpoint blockade of the programmed cell death protein 1-PD-L1 axis. Combination of α-TRT with PD-L1 blockade potentiated the therapeutic effect, however, the combination aggravated adverse events. A long-term toxicity study revealed severe kidney damage ensuing from α-TRT. Conclusion: These data suggest that α-TRT alters the TME and induces systemic antitumoral immune responses, which explains why immune checkpoint blockade enhances the therapeutic effect of α-TRT. However, further optimization is warranted to avoid adverse events., (© 2023 by the Society of Nuclear Medicine and Molecular Imaging.)

This study aimed to analyze the spatial pattern of natural infection index (NII) for triatomines and the risk of Chagas disease transmission in an endemic area of Northeastern Brazil. An ecological study was conducted, based on 184 municipalities in five mesoregions. The NII for triatomines was evaluated in the Pernambuco State, Brazil, from 2016 to 2018. Spatial autocorrelations were evaluated using Global Moran Index (I) and Local Moran Index (II) and were considered positive when I > 0 and p < 0.05, respectively. In total, 7,302 triatomines belonging to seven different species were detected. Triatoma brasiliensis had the highest frequency (53%; n = 3,844), followed by Triatoma pseudomaculata (25%; n = 1,828) and Panstrongylus lutzi (18.5%; n=1,366). The overall NII was 12%, and the higher NII values were P. lutzi (21%) and Panstrongylus megistus (18%). In the mesoregions of Zona da Mata, Agreste, Sertao, and Sertao do Sao Francisco, 93% of triatomines were detected indoors. The global spatial autocorrelation of I to NII was positive (0.2; p = 0.01), and II values calculated using BoxMap, MoranMap, Lisa Cluster Map were statistically significant for natural infections. With regard to the risk areas for the presence of triatomines, Zone 2 (the Agreste and Sertao regions) presented a relative risk of 3.65 compared to other areas in the state. Our study shows the potential areas of vector transmission of Chagas disease. In this study, the application of different methods of spatial analysis made it possible to locate these areas, which would not have been identified by only applying epidemiological indicators.

Objective: to evaluate the association between quality of life and presence of symptoms of depression, anxiety, and stress in college students in the health area., Method: cross-sectional study that included 321 students from undergraduate courses in the health area. Quality of life was measured using the World Health Organization scale, abbreviated version, in the physical, psychological, social relations and environment domains, and symptoms were assessed by the depression, anxiety and stress scale. Multivariate analysis was performed using robust linear regression to evaluate the association between quality of life and symptoms., Results: a negative association was observed between the quality of life and depression symptoms in all domains, while anxiety symptoms showed a negative association in the environment domain, and stress symptoms had a negative association in the psychological domain. Symptom severity was unfavorably associated with quality of life, that is, the greater the symptom severity, the lower the mean scores in all domains., Conclusion: symptoms of depression, anxiety, and stress were prevalent and had a negative impact on students' quality of life, especially in the presence of depressive symptoms. The decrease in scores was significantly associated with the severity of symptoms.

Brunner's gland adenoma is extremely uncommon small bowel tumors with an incidence of <0.01% and account for less than 1% of all gastrointestinal tumors. They are branched acinotubular glands found within the submucosal layer and located between the pyloric ring and the major duodenal papilla. Brunner's glands produce an alkaline secretion containing viscous mucin to protect the duodenum from acidic gastric chyme. Although these lesions are usually asymptomatic and are incidentally discovered on upper gastrointestinal endoscopy, they may occasionally present with symptoms of upper gastrointestinal hemorrhage, duodenal obstruction, and more rarely with biliary fistulation or intussusception. We present an atypical case of a large 9-cm Brunner's gland adenoma causing duodenojejunal intussusception in a 44-year-old Chinese man, who presented with long-standing epigastric pain, nausea, and vomiting., (© 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)

Dental plaque (DP) is found on the surface of teeth and comprises a community of microorganisms that form a structured biofilm. Bacteria present in DP are potential periodontal pathogens when there is an imbalance in the healthy oral environment, and are precursors of periodontal disease (PD). In dogs, the treatments, such as mechanical removal, are difficult and expensive to apply. Therefore, in order to seek new therapeutic alternatives to control dental plaque in dogs, Brazilian red propolis ethanol extract (RPEE) was tested to evaluate its antibacterial effect on bacteria isolated from DP of dogs without PD. DP was collected from the supragingival dental surfaces of 10 dogs. Bacterial isolates of DP were identified by PCR and sequencing of 16S rDNA gene. The RPEE was obtained using the ultrasound ethanol extraction technique, and the chemical composition was obtained by HPLC-DAD and UV-spectrophotometry. In total, 29 different bacteria belonging to five genera were identified. Formononetin, biochanin A, liquiritigenin and daidzein were the major constituents of the RPEE. The cytotoxic effect showed cell viability after 24 h above 50 % at all concentrations evaluated. The minimum inhibitory concentration was between 37.5 and 150.0 µg/mL for all bacterial isolates. The minimal bactericidal concentration was between 150 and 1200 µg/mL for Gram-positive and 300-1200 µg/mL for Gram-negative bacteria. The results are promising and suggest that RPEE has significant antibacterial potential against the bacteria present in the DP of healthy dogs. Although further studies are still needed, the results suggest RPEE might be safely used in the prevention of periodontal disease., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Integration of the Insured Person's Perspective in the Quality Assessment of Medical Evaluations Abstract. In the current practice of medical work disability evaluations and other pension assessments, insured persons in Switzerland lack the possibility to routinely provide feedback on the extent to which they felt treated with dignity and respect by medical experts, which, according to occasional complaints, does not always seem to be the case. In order to be able to systematically capture such aspects of interactive fairness, we developed a questionnaire, the Basel Fairness Questionnaire (BFQ). The BFQ contains 30 statements such as «The reviewer listened to me.», which the insured person can agree to on four levels (from «I do not agree at all.» to «I fully agree.»). For validating the questionnaire, 305 claimants for disability pensions completed the BFQ after their medical work disability evaluation. A factor analysis conducted on the answered questions confirmed our assumption that the BFQ questions covered the areas of 1) respect and trust , 2) participation , 3) case familiarity of the expert , and 4) transparency of the evaluation process . Furthermore, our study demonstrated divergent and convergent validity of the BFQ with other questionnaire instruments. The BFF opens up the possibility to capture the abstract concept of fairness by means of assessments of concrete expert behavior. We expect that the questionnaire can thus contribute to quality assurance in this sensitive area.

As a semi-essential amino acid, l-arginine (l-Arg) plays an important role in food, health care, and medical treatment. At present, the main method of producing l-Arg is the use of microbial fermentation. Therefore, the selection and breeding of high-efficiency microbial strains is the top priority. To continuously improve the l-Arg production performance of the strains, a series of metabolic engineering strategies have been tried to transform the strains. The production of l-Arg by metabolically engineered Corynebacterium glutamicum (C. glutamicum) reached a relatively high level. Escherichia coli (E. coli), as a strain with great potential for l-Arg production, also has a large number of research strategies aimed at screening effective E. coli for producing l-Arg. E. coli also has a number of advantages over C. glutamicum in producing l-Arg. Therefore, it is of great significance to screen out excellent and stable E. coli to produce l-Arg. Here, based on recent research results, we review the metabolic pathways of l-Arg production in E. coli, the research progress of l-Arg production in E. coli, and various regulatory strategies implemented in E. coli., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: The university context plays an important role in the health-disease process since students are potentially vulnerable to obesogenic behaviors that can influence long-term health., Objective: To estimate the prevalence of and factors associated with the co-occurrence of obesogenic behaviors among university students., Design and Setting: This was a cross-sectional study at a Brazilian public university., Methods: This study was conducted with all university students in the first and second semesters of 2019 at Universidade Federal de Ouro Preto, Minas Gerais, Brazil. Data were collected between April and September 2019, using a self-administered questionnaire. The outcome was the co-occurrence of obesogenic behaviors, measured as the sum of three risk behaviors: inadequate eating practices, leisure-time physical inactivity, and sedentary behavior. A Venn diagram was used to evaluate the simultaneous occurrence of risk behaviors. Pearson's chi-square test and multivariate logistic regression were used for statistical analyses., Results: A total of 351 students participated in the study. Inadequate eating practices constituted the most prevalent isolated risk behavior (80.6%), which was also the most prevalent when combined with sedentary behavior (23.6%). University students aged 20 years or younger, with non-white skin color, poor self-rated health, and symptoms of depression had increased chances of simultaneous occurrence of obesogenic behaviors., Conclusion: These findings highlight the importance of developing and implementing actions to reduce combined obesogenic behaviors in the university environment. Institutions should focus on creating an environment that promotes health-protective behaviors such as physical activity and healthy eating.

Objective: To compare the lung mechanics and outcomes between COVID-19-associated acute respiratory distress syndrome and non-COVID-19-associated acute respiratory distress syndrome., Methods: We combined data from two randomized trials in acute respiratory distress syndrome, one including only COVID-19 patients and the other including only patients without COVID-19, to determine whether COVID-19-associated acute respiratory distress syndrome is associated with higher 28-day mortality than non-COVID-19 acute respiratory distress syndrome and to examine the differences in lung mechanics between these two types of acute respiratory distress syndrome., Results: A total of 299 patients with COVID-19-associated acute respiratory distress syndrome and 1,010 patients with non-COVID-19-associated acute respiratory distress syndrome were included in the main analysis. The results showed that non-COVID-19 patients used higher positive end-expiratory pressure (12.5cmH2O; SD 3.2 versus 11.7cmH2O SD 2.8; p < 0.001), were ventilated with lower tidal volumes (5.8mL/kg; SD 1.0 versus 6.5mL/kg; SD 1.2; p < 0.001) and had lower static respiratory compliance adjusted for ideal body weight (0.5mL/cmH2O/kg; SD 0.3 versus 0.6mL/cmH2O/kg; SD 0.3; p = 0.01). There was no difference between groups in 28-day mortality (52.3% versus 58.9%; p = 0.52) or mechanical ventilation duration in the first 28 days among survivors (13 [IQR 5 - 22] versus 12 [IQR 6 - 26], p = 0.46)., Conclusion: This analysis showed that patients with non-COVID-19-associated acute respiratory distress syndrome have different lung mechanics but similar outcomes to COVID-19-associated acute respiratory distress syndrome patients. After propensity score matching, there was no difference in lung mechanics or outcomes between groups.

Objectives: Suppression of viral replication in patients on antiretroviral therapy (ART) is determined by plasma viral load (pVL) measurement. Whenever pVL reaches values below the limit of quantification, the qualitative parameter 'target detected' or 'target not detected' is available but often not reported to the clinician. We investigated whether qualitative pVL measurements can be used to estimate the viral reservoir size., Design: The study recruited 114 people with HIV (PWH) who are stable on ART between 2016 and 2018. The percentage of pVL measurements qualitatively reported as 'target detected' (PTD) within a 2-year period was calculated., Methods: t-DNA and US-RNA were used to estimate viral reservoir size and were quantified on peripheral blood mononuclear cells (PBMCs) using droplet digital PCR., Results: A median of 6.5 pVL measurements over a 2-year period was evaluated for each participant to calculate PTD. A positive correlation was found between t-DNA and PTD (r = 0.24; P = 0.011) but not between US-RNA and PTD (r = 0.1; P = 0.3). A significantly lower PTD was observed in PWH with a small viral reservoir, as estimated by t-DNA less than 66 copies/106 PBMCs and US-RNA less than 10 copies/106 PBMCs, compared with PWH with a larger viral reservoir (P = 0.001). We also show that t-DNA is detectable whenever PTD is higher than 56% and that ART regimen does not affect PTD., Conclusion: Our study shows that PTD provides an efficient parameter to preselect participants with a small viral reservoir based on already available pVL data for future HIV cure trials., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Mycoprotein is a fungal-based meat alternative sold in food retail in various countries around the world. The present study builds on a multi-national sample and uses partial least square structural equation modeling. The proposed conceptual model identified key factors that are driving and inhibiting consumer willingness to try, buy, and pay a price premium for mycoprotein. The results relate to the overall sample of 4088 respondents and to two subsample comparisons based on gender and meat consumption behavior. The results show that the biggest drivers of willingness to consume mycoprotein were healthiness, followed by nutritional benefits, safe to eat, and sustainability. Affordability and taste had mixed results. Willingness to consume mycoprotein was inhibited if nutritional importance was placed on meat and, to a lesser extent, if the taste, texture, and smell of meat were deemed important. Best practice recommendations address issues facing marketing managers in the food industry.

Background and Aims: We investigated whether the use of postmanual cleaning adenosine triphosphate (ATP) tests lowers the number of duodenoscopes and linear echoendoscopes (DLEs) contaminated with gut flora., Methods: In this single-center before-and-after study, DLEs were ATP tested after cleaning. During the control period, participants were blinded to ATP results: ATP-positive DLEs were not recleaned. During the intervention period, ATP-positive DLEs were recleaned. DLEs underwent microbiologic sampling after high-level disinfection (HLD) with participants blinded to culture results., Results: Using 15 endoscopes of 5 different DLE types, we included 909 procedures (52% duodenoscopes, 48% linear echoendoscopes). During the intervention period, the absolute rate of contamination with gut flora was higher (16% vs 21%). The main analysis showed that contamination was less likely to occur in the intervention period (odds ratio, .32; 95% credible interval [CI], .12-.85). A secondary analysis showed that this effect was based on 1 particular duodenoscope type (estimated probability, 39% [95% CI, 18%-64%] vs 9% [95% CI, 2%-21%]), whereas no effect was seen in the other 4 DLE types. In detail, of the 4 duodenoscopes of this type, 2 had lower contamination rates (69% vs 39% and 36% vs 10%). During the control period, both these duodenoscopes had multiple episodes with ongoing contamination with the same microorganism that ended weeks before the start of the intervention period (ie, they were not terminated by ATP testing)., Conclusions: Postmanual cleaning ATP tests do not reduce post-HLD gut flora contamination rates of DLEs. Hence, postcleaning ATP tests are not suited as a means for quality control of endoscope reprocessing., (Copyright © 2022 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)

Nephrotoxicity is a common and dose-limiting side effect of platinum compounds, which often manifests as acute kidney injury or hypomagnesemia. This study aimed to investigate the genetic risk loci for platinum-induced nephrotoxicity. Platinum-treated brain tumor and head-neck tumor patients were genotyped with genome-wide coverage. The data regarding the patient and treatment characteristics and the laboratory results reflecting the nephrotoxicity during and after the platinum treatment were collected from the medical records. Linear and logistic regression analyses were performed to investigate the associations between the genetic variants and the acute kidney injury and hypomagnesemia phenotypes. A cohort of 195 platinum-treated patients was included, and 9,799,032 DNA variants passed the quality control. An association was identified between RBMS3 rs10663797 and acute kidney injury (coefficient -0.10 (95% confidence interval -0.13--0.06), p -value 2.72 × 10 -8 ). The patients who carried an AC deletion at this locus had statistically significantly lower glomerular filtration rates after platinum treatment. Previously reported associations, such as BACH2 rs4388268, could not be replicated in this study's cohort. No statistically significant associations were identified for platinum-induced hypomagnesemia. The genetic variant in RBMS3 was not previously linked to nephrotoxicity or related traits. The validation of this study's results in independent cohorts is needed to confirm this novel association.

Background: During the COVID-19 pandemic, universities have had to adopt remote education, a strategy that caused sudden changes of routine for everyone involved in academia., Objective: To assess the profile of medicine use by the employees of a Brazilian public university during the COVID-19 pandemic., Design and Setting: Cross-sectional study at a Brazilian public university., Methods: Employees were invited to answer an online self-administered questionnaire, containing questions on sociodemographic features, medicine use, mental health and lifestyle habits during the COVID-19 pandemic. The outcome variable was the use of medicines stratified according to occupation. Descriptive, bivariate and multivariate (Poisson regression) statistical analyses were performed., Results: A total of 372 employees participated in the study and use of medicine was reported by 53.2%. Among professors, suicide attempts (prevalence ratio [PR], 1.81; 95% confidence interval [CI], 1.20-2.74), physical activity (PR, 1.53; 95% CI, 1.11-2.11) and poor self-rated health (PR, 1.29; 95% CI, 1.01-1.66); and among technicians, decreased workload during the COVID-19 pandemic (PR, 1.41; 95% CI, 1.00-1.99), excess body weight (PR, 1.39; 95% CI, 1.02-1.88) and poor self-rated health (PR, 1.48; 95% CI, 1.14-1.92) were positively associated with use of medicines. In addition, among technicians, engaging in physical activity (PR, 0.60; 95% CI, 0.46-0.78) was a protective factor against medicine use., Conclusion: The profile of medicine use among these employees was similar to that of the Brazilian population. However, some associated factors may have been influenced by the COVID-19 pandemic, thus highlighting the need to examine this topic in a longitudinal study.

Background: A substantial portion of people with COVID-19 subsequently experience lasting symptoms including fatigue, shortness of breath, and neurological complaints such as cognitive dysfunction many months after acute infection. Emerging evidence suggests that this condition, commonly referred to as long COVID but also known as post-acute sequelae of SARS-CoV-2 infection (PASC) or post-COVID-19 condition, could become a significant global health burden., Main Text: While the number of studies investigating the post-COVID-19 condition is increasing, there is no agreement on how this new disease should be defined and diagnosed in clinical practice and what relevant outcomes to measure. There is an urgent need to optimise and standardise outcome measures for this important patient group both for clinical services and for research and to allow comparing and pooling of data., Conclusions: A Core Outcome Set for post-COVID-19 condition should be developed in the shortest time frame possible, for improvement in data quality, harmonisation, and comparability between different geographical locations. We call for a global initiative, involving all relevant partners, including, but not limited to, healthcare professionals, researchers, methodologists, patients, and caregivers. We urge coordinated actions aiming to develop a Core Outcome Set (COS) for post-COVID-19 condition in both the adult and paediatric populations., (© 2022. The Author(s).)

Objective: This longitudinal study aimed to verify possible changes in the time spent in sedentary activities occurring as screen-time, educational, cultural, social, and transportation domains in a sample of Brazilian adolescents between 2015 and 2017., Methods: It is a longitudinal prospective study with 586 adolescents from 12 to 15 years old at the Baseline (2015) enrolled in 14 public schools from Curitiba, Brazil. The Adolescent Sedentary Activity Questionnaire assessed the time spent in sedentary activities in five domains (recreational screen-time, educational, cultural, social, and transportation). A series of linear random effects regressions analyzed changes in the sedentary time between 2015 and 2017, with p < .05., Results: Overall, 323 adolescents dropped out of the study resulting in a retention rate of 44.9%. The overall sedentary time remained stable from 2015 to 2017 (-3.98 min/day, 95%CI: -15.39; 7.42). The screen-time decreased (-22.22 min/day, 95%CI: -30.30; -14.15), and educational (8.29 min/day, 95% CI: 3.52; 13.06), cultural (3.41 min/day, 95% CI: 0.66; 6.15) and social sedentary activities (8.20 min/day, 95% CI: 2.06; 14.34) increased from 2015 to 2017., Conclusion: Significant reductions in screen-time were evidenced along with increases in time spent on other sedentary activities of educational, cultural, and social nature. KeywordsSedentary behavior, Adolescent health, Longitudinal studies., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2021 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)

Acute and chronic diarrheal illness secondary to gastrointestinal infection is a significant cause of morbidity and mortality around the world. A cornerstone of management includes prompt diagnosis and appropriate treatment of culprit pathogens. Timely diagnosis can improve patient care, assist in infection control, and prevent disease outbreaks. Historical methods of diagnosis include traditional culture methods and stool analysis. These are limited by long turnaround time and inability to simultaneously assess multiple pathogens. The advent of multiplexed nucleic acid amplification tests first began with the Food and Drug Administration-approved respiratory virus multiplex polymerase chain reaction (PCR) panel in 2009, followed by gastrointestinal infections in 2013, and neurological infections in 2014. We conducted a review of current literature pertaining to the clinical utility of a gastrointestinal multiplex PCR in management of acute and chronic diarrhea in patients. To date, seven platforms approved by the US Food and Drug Administration are used in detection of various bacterial, viral, and parasitic causative organisms for diagnosis of gastrointestinal infections. The sensitivity and specificity of each assay vary depending on the tested organism. Interpretation of a positive result has to be tailored to the clinical context. Further studies are required to establish the utility of gastrointestinal multiplex PCR from a cost-based perspective, whether specific enteropathogens such as Clostridioides difficile are better assessed with toxin gene detection and whether new parameters such as cycle threshold values can improve clinical application of test results., (© 2021 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

One of the major associative fiber pathways in the brain is the superior longitudinal system. This review discusses the current knowledge gained from studies on the third branch of the superior longitudinal system (SLS) regarding its anatomy, functional role in healthy individuals, results from lesion-symptom mapping studies and intraoperative electrostimulation studies. The results of these studies clearly indicate that the third branch of the SLS is a distinct pathway, as seen both from a functional and anatomical perspective. The third branch of the SLS should be distinguished from the long segment of the arcuate fasciculus, that courses along its trajectory but seems implicated in different functions. Moreover, these studies also provide substantial evidence that the right and left third branch of the SLS have different functional roles. Finally, a hypothesis for an integrated anatomo-functional model is proposed, that describes three subcomponents of the third branch of the superior longitudinal system.

Neurodegenerative diseases affect millions of people worldwide. Regardless of the underlying cause, neuroinflammation is the greatest risk factor for developing any of these disorders. Pectolinarigenin (PNG) is an active flavonoid with several biological properties, anti-metastatic and anti-inflammatory activity. This study investigate the biological effects of PNG in macrophage and astrocyte cultures, with focus on elucidating the molecular mechanisms involved in the PNG activity. J774A.1 murine macrophage or cerebral cortex primary astrocytes primary cultures were treated with different concentration of PNG (1-160 μM) and the inflammatory process was stimulated by LPS (1 μg/ml) and the effect of PNG in different inflammatory markers were determined. PNG did not affect astrocyte or macrophage viability. Moreover, this flavonoid reduced NO• release in macrophages, attenuated astrocyte activation by preventing the overexpression of glial fibrillary acidic protein, and decreased the release of inflammatory mediators, IL-1β and IL-6 induced by LPS by the glial cell, as well as enhanced basal levels of IL-10. In addition, PNG suppressed NFκB, p38MAPK and ERK1/2 phosphorylation in astrocytes culture induced by LPS. The results show clear evidence that this novel flavonoid protects astrocytes against LPS-induced inflammatory toxicity. In conclusion, PNG presents neuroprotective and anti-inflammatory property through the inhibition of inflammatory signaling pathways., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

It was recently demonstrated that long noncoding RNAs (lncRNAs) have key regulation functions in the biology of human cancer. The current study aimed to determine the expression, clinicopathological characteristics and functional roles of lncRNA PCAT18 in gastric cancer (GC). By analysis of (Gene Expression Omnibus) GEO and TCGA data, following experimental verification, we identified the function role and molecular mechanism of PCAT18 in tumorigenesis of GC. We discovered that PCAT18 is significantly decreased in paired GC tissues and correlates with a poor outcome. Mechanistic studies found that suppression of the expression of EZH2 could prevent its binding to the PCAT18's promoter region and decrease H3K27's trimethylation modification. In addition, PCAT18 could adjust cell proliferation of GC in vitro as well as in vivo . Further mechanism research revealed that PCAT18 could regulate the expression of p16 by interacting with miR-570a-3p, thus inhibiting cell proliferation of GC. Our results have shown that the histone modification-mediated epigenetic suppression of PCAT18 and its essential role of PCAT18 in GC oncogenesis, which could provide a theoretical basis for GC therapy., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Dietary factors may influence the process of atherosclerosis and coronary artery calcification (CAC). This study assessed CAC and its association with dietary intake in asymptomatic men. We evaluated 150 asymptomatic men with mean age of 58.2±5.3 years. The dietary intake was assessed by the Food Consumption Register method. CAC was measured through multidetector computed tomography (MDCT) and assessed in accordance with the Agatston score. Modified Poisson regression model was used to estimate the effects of intake of different nutrients that are prevalent in moderate/severe CAC, adjusted for calorie intake and CAC risk factors by means of prevalence ratios and 95% confidence intervals [95%CI]. An association was found between the intake of some nutrients and moderate/severe CAC. Lower carbohydrate intake (P=0.021) and higher lipid intake (P=0.006) were associated with moderate/severe CAC. After adjustment, the nutrients associated with the prevalence of moderate/severe CAC were carbohydrates (P=0.040), lipids (P=0.005), and saturated fatty acids (SFA) (P=0.013). A 1% increase in lipids and SFA intake caused an increase of 4% [95%CI: 1-7%] and 8% [95%CI: 2-14%] in the prevalence of moderate/severe CAC, respectively. A 1% increase of carbohydrate intake led to a 2% decrease in the likelihood of moderate/severe CAC [95%CI: 1-4%]. These conclusions showed that the higher intake of total lipids and SFA was associated with higher CAC scores, whereas higher carbohydrate intake was associated with lower CAC scores in asymptomatic men.

The present study focused on the scenario of confirmed cases of SARS-CoV-2 infection in the state of Minas Gerais (MG), Brazil, from March 2020 to March 2021. We evaluated the evolution of COVID-19 prevalence and death in one municipality from each of the 14 health macro-regions of MG state. Socio-demographic characteristics and variables related to the municipalities were analyzed. The raw dataset used in this study was freely sourced from the website Brasil.io. From the raw dataset, two time series were extracted: the cumulative confirmed cases of COVID-19 and cumulative death counts, and they were compared to the state data using a nowcasting approach. In order to make time series comparisons possible, all data was normalized per 100,000 inhabitants. When analyzing in light of colored wave code interventions initiated in August 2020 in MG, for the majority of the municipalities, there was an absence of clear influence on prevalence and deaths. The national holidays in the first semester of 2020 had a small impact on the COVID-19 prevalence of the municipalities, but the holidays in the second semester of 2020 and beginning of 2021 caused important impacts on COVID-19 prevalence. The low number of ICU beds in some municipalities contributed to the higher number of deaths. The analysis showed here is expected to contribute to the improvement of decision making of the MG government, as it opened a huge possibility to have the total macro-regions and state data analyzed.