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Competing Interests: Conflicts of interest This study was conducted as an investigator-initiated study. AbbVie Inc only provided Botox vials under the terms of the IIS Agreement with no other commitments to this research.

Objective: To verify the likelihood of dysphonia in firefighters and its relationship with individual and occupational factors and mental health., Method: This cross-sectional observational study with 442 firefighters collected data on sociodemographic, occupational, and lifestyle aspects and screening for common mental disorders (CMD). Individuals were divided into two groups: those slightly likely and those moderately/highly likely to have dysphonia, according to the Brazilian Dysphonia Screening Tool. The questionnaire's items addressed their sex, age, race, marital status, education, work schedule, administrative or field activity, alcohol consumption, smoking, and CMD. Those who answered "yes" to the question about having a hoarse voice were considered to have dysphonia with an indication for clinical voice assessment. The suspicion of a CMD was measured with the SRQ-20 Self Report Questionnaire. Data were subjected to descriptive and association analysis. Statistical tests were performed assuming a significance level of 5%., Results: The moderate/high likelihood of dysphonia was 6.12%. Most firefighters were males (90.31%), aged over 30 (52.47%), multiracial (44.39%), living with a partner (61.39%), and with a bachelor's or higher degree (42.35%). Individuals self-declared as Black or multiracial had a higher percentage of dysphonia (8.10%). Black and multiracial individuals were approximately 2.5 times more likely to pass the dysphonia screening than Whites and other races. Individuals with symptoms of CMD were also 2.7 times as likely to have dysphonia., Conclusion: The results of the study show that Black and multiracial firefighters and those with symptoms of CMD were moderately/highly likely to have dysphonia. Firefighters with the highest likelihood of having dysphonia are indicated for clinical voice assessment to confirm the diagnosis., Competing Interests: Declaration of Competing Interest We state that there is no conflict of interest., (Copyright © 2024 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Aims: To develop a model capable of distinguishing carcinoma ex-pleomorphic adenoma from pleomorphic adenoma using a convolutional neural network architecture., Methods and Results: A cohort of 83 Brazilian patients, divided into carcinoma ex-pleomorphic adenoma (n = 42) and pleomorphic adenoma (n = 41), was used for training a convolutional neural network. The whole-slide images were annotated and fragmented into 743 869 (carcinoma ex-pleomorphic adenomas) and 211 714 (pleomorphic adenomas) patches, measuring 224 × 224 pixels. Training (80%), validation (10%), and test (10%) subsets were established. The Residual Neural Network (ResNet)-50 was chosen for its recognition and classification capabilities. The training and validation graphs, and parameters derived from the confusion matrix, were evaluated. The loss curve recorded 0.63, and the accuracy reached 0.93. Evaluated parameters included specificity (0.88), sensitivity (0.94), precision (0.96), F1 score (0.95), and area under the curve (0.97)., Conclusions: The study underscores the potential of ResNet-50 in the microscopic diagnosis of carcinoma ex-pleomorphic adenoma. The developed model demonstrated strong learning potential, but exhibited partial limitations in generalization, as indicated by the validation curve. In summary, the study established a promising baseline despite limitations in model generalization. This indicates the need to refine methodologies, investigate new models, incorporate larger datasets, and encourage inter-institutional collaboration for comprehensive studies in salivary gland tumors., (© 2024 Wiley Periodicals LLC.)

Objective: This scoping review (SR) aimed to investigate the impact of quercetin on mineralized dental tissues intended to be used in preventive and restorative dentistry., Methods: This SR was conducted following the PRISMA-ScR statement. A comprehensive search was performed across databases for articles published up to March 2024. Eligible studies included in vitro and in situ studies and evaluating the potential therapeutic effects of quercetin on dental enamel and dentin. Data were extracted, and synthesis of study findings was conducted., Results: Out of the 2322 records screened, 22 studies were included in the review. Quercetin, in solution or into dental materials increased the bond strength to enamel and dentin. Additionally, quercetin also enhanced the bond strength of enamel after bleaching. Co-administration of quercetin with fluoride prevented erosive wear and inhibited the proteolytic activity in dentin more effectively than either agent alone. Hardness and modulus of elasticity was higher in dentin treated with quercetin compared to placebo. Reduction of nanoleakage at the composite-dentin interface was reduced in the presence of quercetin as a solution or incorporated into dental adhesives., Conclusions: Quercetin exhibits promising therapeutic effects on mineralized dental tissues, including remineralization and enhancement of bond strength. It shows potential as a multifunctional agent for improving the longevity and effectiveness of dental biomaterials, as well as in preventing erosion and dental caries. However, as these conclusions are largely drawn from lab-based (in vitro) studies, further research, including clinical trials, is needed to fully explore its therapeutic potential and applications in dentistry., 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 Ltd. All rights reserved.)

Purpose: To compare the temperature of thermoanatomic points and areas of the upper and lower lips between mouth-breathing and nasal-breathing children., Methods: This cross-sectional observational study had a sample of 30 nasal-breathing and 30 mouth-breathing children aged 4 to 11 years. One front-view, one left-view, and one right-view infrared thermogram of the face were acquired from each participant. A total of 14 thermoanatomic points plus the upper lip and lower lip areas were marked on the front-view thermograms, while on the side-view thermograms, six thermoanatomic points were marked. The research also calculated the difference between the temperature of the upper and lower lip areas (∆T area) and between the temperature of the points on the upper and lower lips (∆T points). The normalized mean temperatures of points and areas and temperature differences were compared between groups with the t-test and Mann-Whitney test., Results: The temperature of the thermoanatomic points closest to the lip (nasolabial, Labial Commissure, and lower labial), areas of the lips, and external acoustic meatus was lower in mouth breathers than in nasal breathers, which did not happen for most other points. ∆T area and ∆T points were not different between the groups., Conclusion: Thermography is a promising complementary diagnostic tool, since showed mouth-breathing children had lower temperatures in the region of the lips than nasal breathers., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Despite numerous studies on Salmonella enterica subsp. enterica serovar Typhimurium, the underlying mechanisms of several aspects of its virulence are still under investigation, including the role of the pdu and ttrA genes, associated with the metabolism of 1,2-propanediol using tetrathionate as an electron acceptor respectively. Our objective was to contribute to an understanding of the role of these genes inbacterial virulence for mice (Mus musculus) using an S. Typhumirum ΔttrApduA mutant. The experiment was conducted with a group infected by the S. Typhimurium mutant and a control group infected with a wild-type strain. The mutant was not attenuated compared with the parent strain. There were no differences in the bacterial numbers recovered from the mesenteric lymph nodes and Peyer's patches but at 8-day after oral infection higher numbers were recovered from the spleen, liver, and cecum. Unlike the single pduA and ttrA mutants, the double ΔttrApduA mutation did not affect invasion and survival in mice, which highlights the need for further studies to clarify the role of these important metabolism genes under reduced redox conditions linked to Salmonella virulence., (© 2024. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.)

Purpose: Accidental ureteric injury during colorectal surgery is a rare but dreadful event. It is associated with a higher risk of urinary tract infection (UTI) and acute kidney injury (AKI). Prophylactic placement of double J stents could improve ureteral identification and decrease the chance of accidental ureteral injury., Methods: We searched MEDLINE, Cochrane, Central Register of Clinical Trials, and Web of Science for studies published until March 2024. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled with a random-effects model. Statistical significance was defined as p < 0.05. Heterogeneity was assessed using the Cochran Q test and I 2 statistics, with p-values inferior to 0.10 and I 2  > 25% considered significant. Statistical analysis was conducted in RStudio version 4.4.1., Results: Eleven observational studies were included, comprising 71,784 patients. Among them, 11,723 (16.4%) were submitted to a prophylactic ureteral stent while 59,961 (83.6%) were not. There was no significant difference in ureteral injury between the groups (0.66% vs 0.8%; OR 1.45; 95% CI 0.43-4.87; p = 0.552; I 2  = 56%). Prophylactic stent placement was associated with an increase in AKI (1.7% vs. 0.56%; OR 1.54; 95% CI 1.24-1.91; p < 0.001; I 2  = 44%), operative time (MD 24.8 min; 95% CI 4.9-44.8; p = 0.01; I 2  = 91%), and a decrease in mortality (OR 0.11; 95% CI 0.05-0.23; p < 0.001; I 2  = 42%). No differences were observed in UTI, hematuria, length of hospital stays, and reoperation., Conclusion: In colorectal surgery, prophylactic ureteral stents were associated with increased AKI and operative time. No significant difference was observed in ureteral injury, UTI, hematuria, length of hospital stays, and reoperation., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Matrix Support (MS) is a strategy that can be used to improve integration between Primary Health Care (PHC) and other levels of care., Objective: The aim of this study was to investigate the association between MS carried out in Brazilian Dental Specialty Centers (CEOs) (secondary level of oral health care) and aspects of the integrated work process with PHC, as well as contextual variables., Methods: A quantitative cross-sectional study was conducted using data from the Program for Quality Improvement and Access to CEOs (PMAQ-CEO). Secondary data from the External Evaluation of the second cycle of PMAQ-CEO were analyzed, including contextual variables obtained from sources such as the Unified Health System (SUS) and official research institutions. Descriptive analyses were performed, and four multiple models were adjusted to investigate the association between the variables., Results: The results showed that about half of the CEOs did not carry out therapeutic projects developed with the oral health teams of PHC. It was found that the lack of therapeutic projects developed with the teams was associated with the lack of discussion of complex cases by the team, lack of discussion of individual therapeutic project, absence of joint continuing education activities, lack of construction and discussion of clinical protocols, and lack of belief in the importance of planning and periodic evaluation. The results suggest that the articulation between PHC and secondary oral health care still presents weaknesses within the scope of SUS. Comprehensive care needs to be strengthened, requiring greater intervention from management., Conclusion: It was concluded that the individual factors of CEOs, related to the work process, have a greater influence on the lack of integration with oral health teams of PHC, compared to the contextual variables of municipalities., (© 2024. The Author(s).)

The present cross-sectional study aimed to compare climacteric symptoms and arterial stiffness indices between perimenopausal and postmenopausal women. The study sample comprised 70 healthy female participants, including 27 perimenopausal (49.8 ± 3.8 years) and 43 postmenopausal (55.7 ± 4 years) individuals. Validated methods were used to assess physical activity level, quality of life, climacteric symptoms, and anthropometric data. Arterial stiffness parameters were measured using Mobil-O-Graph. Pulse wave velocity (PWV) had a higher mean in the postmenopausal group than in the perimenopause group [8.04 m/s (SD 0.79) vs 7.01 m/s (SD 0.78), p  < .001). PWV was strongly correlated with peripheral ( r  = 0.619) and central ( r  = 0.632) Systolic Blood Pressure (SBP) in postmenopausal group and an even stronger correlation was observed in perimenopausal group ( r  = 0.779 pSBP and 0.782 cSBP). BMI was a risk predictor in the perimenopausal group contributing positively to increase Pulse Pressure Amplification (PPA) (0.458, p  < .05). In postmenopausal women, heart rate (HR) was a stronger predictor for central SBP, cardiac output, and total vascular resistance, whereas perimenopausal women HR influenced central diastolic blood pressure and PPA. Vascular changes initiating during perimenopause may contribute to the development of cardiovascular pathologies in the postmenopausal period. Further research with larger, representative samples is warranted to corroborate these findings.

Aim : (I) to verify if there are sex differences in respiratory function, respiratory muscle strength, and effort limitation in individuals recovered from severe acute COVID-19 30 months after the initial infection, and (II) to evaluate the influence of length of stay on cardiorespiratory capacity among men and women. Methods : Cross-sectional observational multicentric study with participants from five Brazilian states (São Paulo, Amazonas, Minas Gerais, Bahia, and Brasília). We assessed lung function and respiratory muscle strength by maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and cardiorespiratory fitness by cardiopulmonary exercise test (CPET). Results : 86 individuals were stratified by sex (48 women and 38 men). Females had significantly longer hospitalization for acute COVID-19 ( p < 0.05) and showed a marked reduction in MIP (cmH 2 O and % predicted). Regarding the CPET, women presented lower V˙O 2 % predicted, O 2 pulse, and oxygen uptake efficiency slope (OUES, % predicted) ( p < 0.05). In addition, women also had greater abnormal combinations between RER < 1.10, OUES < 80% predicted, VE/VVM < 15% [3 (6.2%)] and V˙O 2 % predicted < 80%, V˙E/V˙CO 2 slope and V˙O 2 /workload < 8.4 mL/min/W [8 (17%)]. The regression analysis showed a significant influence of age, length of hospitalization (< and >10 days), and FEV 1 /FVC (%) on the V˙O 2 peak (mL·kg -1 ·min -1 ). Secondarily, we found that women hospitalized for more than 10 days had worse O 2 pulse ( p = 0.03), OUES % predicted ( p < 0.001), and worse V˙O 2 % predicted ( p < 0.009). Conclusion : Women exhibited more pronounced impairments in several key indicators of cardiopulmonary function 30 months post-infection.

Purpose: The aim of this pilot study was to analyze the potential financial loss and a range of potential risk factors for hamstring muscle injuries in elite Brazilian soccer., Methods: Thirty-four male players (age: 25 ± 6 years; stature: 180 ± 8 cm; body mass: 78 ± 9 kg; minutes played in matches: 2243 ± 1423 min) from an elite professional soccer club were monitored during a 12-month season. Muscle injury was identified by magnetic resonance imaging and the severity was defined according to the number of days away: minimal (1-3 days), mild (4-7 days), moderate (8-28 days), severe (>28 days). Potential financial loss due to the team's under achievements was determined. Dorsiflexion range of motion, eccentric knee flexor strength and isokinetic tests were performed during the pre-season. Association between dependent variables and the occurrence of injury was evaluated., Results: Nine hamstring muscle injuries with moderate severity were found in 8 athletes. Recovery time was 22 days off the field on average. Potential financial loss was $-43.2 million USD and earnings on merit money was 21%. Previous injury, increased flexor deficit 60° /sec and increased flexor fatigue index 300°/sec were all associated with a greater chance of hamstring muscle injury. Ankle dorsiflexion range of motion was significantly lower in the injured group (35.6 ± 3° vs. 39.1 ± 4.9°; p  = 0.017, effect size = -0.74)., Conclusion: High financial burden was found in elite Brazilian soccer during one full season. Injured athletes had high hamstring fatigue index, knee flexor strength deficit, ankle range of motion restriction and previous hamstring muscle injury when compared to non-injured athletes. Therefore, preventive approaches in professional soccer players with previous hamstring injuries should be a priority., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Oliveira-Júnior, Gabbett, Bittencourt, Quintão, Reis, Claudino, Lasmar and Leopoldino.)

Purpose: Evidence from animal and human studies demonstrates that cortical regions play a key role in autonomic modulation with a differential role for some brain regions located in the left and right brain hemispheres. Known as autonomic asymmetry, this phenomenon has been demonstrated by clinical observations, by experimental models, and currently by combined neuroimaging and direct recordings of sympathetic nerve activity. Previous studies report peculiar autonomic-mediated cardiovascular alterations following unilateral damage to the left or right insula, a multifunctional key cortical region involved in emotional processing linked to autonomic cardiovascular control and featuring asymmetric characteristics., Methods: Based on clinical studies reporting specific damage to the insular cortex, this review aims to provide an overview of the prognostic significance of unilateral (left or right hemisphere) post-insular stroke cardiac alterations. In addition, we review experimental data aiming to unravel the central mechanisms involved in post-insular stroke cardiovascular complications., Results and Conclusion: Current clinical and experimental data suggest that stroke of the right insula  can present a worse cardiovascular prognosis., (© 2024. Springer-Verlag GmbH Germany.)

Soil conservation adheres to various United Nations Sustainable Development Goals while in Brazil is a constitutional obligation. To attain the goals and fulfil the obligation, laws, policies, governance and science must be imbricated to deliver suitable conservation solutions for the long term, namely appropriate to positively influence other downstream chains such as the food chain. However, in Brazil, a major world producer and exporter of food, weaknesses were recently diagnosed by judicial authorities concerning soil governance and coordinated land use policies. Integrated scientific assessments on soil conservation and mitigation of degraded soil are also lacking in this country. This was enough motivation and the purpose to present here a holistic view over the soil conservation agenda and promoting policies in Brazil, based on a literature review that followed the guidelines and criteria of PRISMA approach. We termed this analysis a review hinged on "edge-to-edge" science contributions for two reasons. Firstly, the intent of retrieving from the recently published literature solely papers centered on a relevant soil conservation topic (e.g., soil characterization, here called an "edge") but with complementary analyses over boundary topics (frontier "edges", such as soil degradation). Secondly, the intent of underlining the urgency to assist decision-makers with scientific evidence in all dimensions of the soil conservation agenda ("edge-to-edge" science), namely soil characterization (e.g., quality reference values), soil degradation assessment (e.g., anthropogenic-related soil erosion or contamination), soil degradation consequences focused on the carbon cycle (e.g., net CO 2 emissions and climate warming), sustainable management practices and production systems (e.g., no-tillage agriculture and integrated crop-livestock-forestry systems), and scientific evaluation of existing laws as well as of governance and policy programs with potential implications on soil quality (e.g., the Forest Code). Thus, this literature review addressed all these topics following a multidisciplinary discourse, which produced an extensive but comprehensive document about soil conservation in Brazil., Competing Interests: Declaration of competing interest The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The production of controlled doping in two-dimensional semiconductor materials is a challenging issue when introducing these systems into current and future technology. In some compounds, the coexistence of distinct crystallographic phases for a fixed composition introduces an additional degree of complexity for synthesis, chemical stability, and potential applications. In this work, we demonstrate that a multiphase In 2 Se 3 layered semiconductor system, synthesized with three distinct structures─rhombohedral α and β-In 2 Se 3 and trigonal δ-In 2 Se 3 ─exhibits chemical stability and well-behaved n-type doping. Scanning tunneling spectroscopy measurements reveal variations in the local electronic density of states among the In 2 Se 3 structures, resulting in a compound system with electronic bandgaps that range from infrared to visible light. These characteristics make the layered In 2 Se 3 system a promising candidate for multigap or broad spectral optical devices, such as detectors and solar cells. The ability to tune the electronic properties of In 2 Se 3 through structural phase manipulation makes it ideal for integration into flexible electronics and the development of heterostructures with other materials.

Staphylococcus pseudintermedius is frequently associated with several bacterial infections in dogs, highlighting a One Health concern due to the zoonotic potential. Given the clinical significance of this pathogen, we performed comprehensive genomic analyses of 28 S. pseudintermedius strains isolated from canine infections throughout whole-genome sequencing using Illumina HiSeq, and compared the genetic features between S. pseudintermedius methicillin-resistant (MRSP) and methicillin-susceptible (MSSP) strains. Our analyses determined that MRSP genomes are larger than MSSP strains, with significant changes in antimicrobial resistance genes and virulent markers, suggesting differences in the pathogenicity of MRSP and MSSP strains. In addition, the pangenome analysis of S. pseudintermedius from canine and human origins identified core and accessory genomes with 1847 and 3037 genes, respectively, which indicates that most of the S. pseudintermedius genome is highly variable. Furthermore, phylogenomic analysis clearly separated MRSP from MSSP strains, despite their infection sites, showing phylogenetic differences according to methicillin susceptibility. Altogether our findings underscore the importance of studying the evolutionary dynamics of S. pseudintermedius , which is crucial for the development of effective prevention and control strategies of resistant S. pseudintermedius infections.

Bitter melon (Momordica charantia) has several biological properties including anthelmintic activity. Presented in vivo study evaluated the anthelmintic activity of the hydroalcoholic extract of M. charantia Presented in vivo study (HEMC) and its effect on animal performance, carcass characteristics and lamb meat quality in animals infected by Haemonchus contortus. The HEMC demonstrated effectiveness against the parasite. Lambs treated with HEMC showed a significant reduction in egg count per gram of faeces and in the number of parasites in the abomasum. However, nutrient intake decreased with increasing doses of HEMC, leading to reductions in final live weight and carcass weight. No significant effects were observed on meat quality. Therefore, it is concluded that HEMC presents anthelmintic action, but it also impairs animal performance, highlighting the need to assess the benefits and impacts of HEMC use for H. contortus control., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Laura reports administrative support and equipment, drugs, or supplies were provided by National Council for Scientific and Technological Development., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: To provide a comprehensive overview of the epidemiologic characteristics, outcomes, and risk factors of COVID-19-related deaths in children and adolescents in Brazil., Study Design: We conducted a population-based, retrospective cohort study that included all patients aged <18 years with laboratory-confirmed, symptomatic SARS-CoV-2 infection as registered in official Brazilian national surveillance systems for COVID-19 between February 2020 and February 2023. The primary outcome was COVID-19-related deaths. Odds ratios (ORs) of risk factors associated with death were estimated using multivariable logistic regression., Results: Over a 3-year period, 2 855 704 pediatric patients with symptomatic SARS-CoV-2 infection were registered in Brazil. Of these, 59 179 (2.1%) were hospitalized, 13 844 (0.48%) were admitted to the intensive care unit, and 4943 (0.17%) received mechanical ventilation. A total of 4740 (0.17%) patients had fatal outcomes. The case fatality rate increased to 7.9% among patients who required hospitalization; 2102 (44.3%) patients who died did not receive advanced critical support. Notably, 2 (65%, 95% CI 58-71) or 3 doses (86%, 95% CI 81-89) of the vaccine provided strong protection against death. The following adjusted covariates were significantly associated with increased odds of death: age (0-4 and 11-17 years), ethnicity (Brown and Indigenous), region (Northeast or North), dyspnea, nosocomial infection, and comorbidities. Conversely, living in the South or Central-West regions, admission in the later period of the pandemic, and receiving a vaccine were all associated with protection against death., Conclusions: Our findings suggest that a complex interplay between individual factors and social inequities has shaped the impact of COVID-19 on Brazilian children and adolescents., Competing Interests: Declaration of Competing Interest This study was supported by the CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico) and FAPEMIG (Fundação de Amparo a Pesquisa do Estado de Minas Gerais). 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 Inc. All rights reserved.)

Objective: This study aimed to analyze the risk factors associated with diabetes mellitus (DM) among Brazilian adults., Study Design: Cross-sectional study., Methods: Data of 75,860 Brazilian adults (≥18 years) were collected using the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel) (2020-2023). Variables assessed included self-reported medical diagnosis of DM, sociodemographic factors (sex, age, schooling, marital status) and DM risk factors (regular consumption of sweetened beverages (≥5 times/week), infrequent consumption of fruits and vegetables, and beans (<5 times/week), insufficient physical activity, prolonged screen time on cell phones, computers, tablets (CCT), and television (TV), smoking, heavy episodic drinking, excess weight, and obesity). Logistic regression models estimated crude and adjusted odds ratio (aOR) (adjusted for sociodemographic characteristics) for the association between the risk factors and the presence of DM., Results: The overall prevalence of self-reported DM in the population was 9.2%. There was a lower chance of regular consumption of sweetened beverages (aOR 0.79; 95% CI: 0.65-0.97) and heavy episodic drinking (aOR 0.77; 95% CI: 0.65-0.93) and a greater chance of insufficient physical activity (aOR 1.40; 95% CI: 1.25-1.55), prolonged TV screen time (aOR 1.22; 95% CI: 1.09-1.36), excess weight (aOR 1.62; 95% CI: 1.44-1.82) and obesity (aOR 1.87; 95% CI: 1.67-2.10) among individuals with DM., Conclusion: There was a lower chance of regular consumption of sweetened beverages and heavy episodic drinking among individuals with DM and a greater chance of insufficient physical activity, prolonged TV screen time, excess weight, and obesity, among that., (Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

With the growing concerns about the protection of ecosystem functions and services, governments have developed public policies and organizations have produced an awesome volume of digital data freely available through their websites. On the other hand, advances in data acquisition through remote sensed sources and processing through geographic information systems (GIS) and statistical tools, allowed an unprecedent capacity to manage ecosystems efficiently. However, the real-world scenario in that regard remains paradoxically challenging. The reasons can be many and diverse, but a strong candidate relates with the limited engagement among the interest parties that hampers bringing all these assets into action. The aim of the study is to demonstrate that management of ecosystem services can be significantly improved by integrating existing environmental policies with environmental big data and low-cost GIS and data processing tools. Using the Upper Rio das Velhas hydrographic basin located in the state of Minas Gerais (Brazil) as example, the study demonstrated how Principal Components Analysis based on a diversity of environmental variables assembled sub-basins into urban, agriculture, mining and heterogeneous profiles, directing management of ecosystem services to the most appropriate officially established conservation plans. The use of GIS tools, on the other hand, allowed narrowing the implementation of each plan to specific sub-basins. This optimized allocation of preferential management plans to priority areas was discussed for a number of conservation plans. A paradigmatic example was the so-called Conservation Use Potential (CUP) devoted to the protection of aquifer recharge (provision service) and control of water erosion (regulation service), as well as to the allocation of uses as function of soil capability (support service). In all cases, the efficiency gains in readiness for plans' implementation and economy of resources were prognosed as noteworthy., 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 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: This study aimed to analyze the clinicoradiologic features and Ki-67 proliferation indices between the histopathologic variants of ameloblastomas (ABs) for possible associations., Study Design: The diagnosis and histopathologic variant were confirmed for all cases by experienced Oral and Maxillofacial Pathologists. Immunohistochemistry for Ki-67 was performed on the most representative formalin-fixed paraffin-embedded tissue block. Demographic, clinical data and radiologic features were analyzed from patient records and available radiographic examinations. The investigators were blinded to the histopathologic variant and proliferation index when the clinicoradiologic features were assessed., Results: The current study included 116 cases of AB in the final sample. The indolent behavior of the unicystic variant was supported by their low proliferation index and slow growth paired with low frequencies of cortical destruction, loss of teeth, root resorption, and encroachment on anatomical structures. In contrast, the comparatively high proliferation index of the plexiform variant correlated with their fast growth and pain. Furthermore, high radiologic frequencies of cortical destruction, loss of teeth, and encroachment of surrounding anatomical structures supported their more aggressive clinical course., Conclusion: Statistically significant differences were noted between certain variants and Ki-67, location, borders, locularity, and cortical destruction, providing better insight into their biological behavior., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Chagas Disease (CD) can cause Chagas cardiomyopathy. The new coronavirus disease (COVID-19) also affects the cardiovascular system and may worsen Chagas cardiomyopathy. However, the cardiac evolution of patients with CD infected by COVID-19 is not known. Thus, the objective of this study is to assess, within one year, whether there was cardiac progression after COVID-19 in CD., Methods: Longitudinal study with CD patients. The outcome was cardiac progression, defined as the appearance of new major changes in the current ECG compared to the previous ECG considered from the comparison of electrocardiograms (ECGs) performed with an interval of one year. Positive Anti-SARS-CoV2 Serology was the independent variable of interest. For each analysis, a final multiple model was constructed, adjusted for sociodemographic, clinical, and pandemic-related characteristics., Results: Of the 404 individuals included, 22.8 % had positive serology for COVID-19 and 10.9 % had cardiac progression. In the final model, positive serology for COVID-19 was the only factor associated with cardiac progression in the group as a whole (OR = 2.65; 95 % CI = 1.27-5.53) and for new-onset cardiomyopathy in the group with normal previous ECG (OR = 3.50; 95 % CI = 1.21-10.13)., Conclusion: Our study shows an association between COVID-19 and progression of Chagas cardiomyopathy, evaluated by repeated ECGs, suggesting that COVID-19 accelerated the natural history of CD., 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 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Access to diagnostic tools like chest radiography (CXR) is challenging in resource-limited areas. Despite reduced reliance on CXR due to the need for quick clinical decisions, its usage remains prevalent in the approach to neonatal respiratory distress syndrome (NRDS)., Objectives: To assess CXR's role in diagnosing and grading NRDS severity compared to current clinical features and laboratory standards., Methods: A review of studies with NRDS diagnostic criteria was conducted across six databases (MEDLINE, EMBASE, BVS, Scopus-Elsevier, Web of Science, Cochrane) up to 3 March 2023. Independent reviewers selected studies, with discrepancies resolved by a senior reviewer. Data were organised into descriptive tables to highlight the use of CXR and clinical indicators of NRDS., Results: Out of 1,686 studies screened, 23 were selected, involving a total of 2,245 newborns. All selected studies used CXR to diagnose NRDS, and 21 (91%) applied it to assess disease severity. While seven reports (30%) indicated that CXR is irreplaceable by other diagnostic tools for NRDS diagnosis, 10 studies (43%) found that alternative methods surpassed CXR in several respects, such as severity assessment, monitoring progress, predicting the need for surfactant therapy, foreseeing Continuous Positive Airway Pressure failure, anticipating intubation requirements, and aiding in differential diagnosis., Conclusion: CXR remains an important diagnostic tool for NRDS. Despite its continued use in scientific reports, the findings suggest that the study's outcomes may not fully reflect the current global clinical practices, especially in low-resource settings where the early NRDS approach remains a challenge for neonatal survival. Trial registration: PROSPERO number CRD42022336480.

Lesser metatarsophalangeal joint plantar plate degeneration and tear typically presents as an attritional pattern of capsuloligamentous deficiency in middle-aged patients or sports-related chronic injuries. Knowledge of the anatomy, pathophysiological basis, common patterns, grading and classification of these injuries, and indications for surgery will aid imaging interpretation in the preoperative setting. The acuity and extent of injury, tissue quality, and functional requirements of the patient influence clinical decision-making with respect to surgical management. This article provides an overview of the open surgical treatment alternatives and the most used techniques to solve instability of the metatarsophalangeal joints., Competing Interests: Disclosure D. Baumfeld and C. Nery are speakers for Arthrex and Stryker., (Copyright © 2024 Elsevier Inc. All rights reserved.)

External beam radiotherapy is a treatment modality that employs high doses for curative or palliative purposes. Safety in such treatments, particularly with high-precision equipment, necessitates strict adherence to quality control protocols to ensure the efficacy of oncological treatments. In this context, chemical dosimeters, particularly the Fricke gel, have emerged as valuable tools for quantitatively analysing absorbed radiation doses. These dosimeters can be applied both as tissue-equivalent phantoms and as radiation detectors in radiotherapy centers. The objective of this study was to evaluate the feasibility of new gelling matrices, comprising common materials such as CMC, GGU, and PVA, for producing ferrous sulphate dosimeters aimed at the relative quantification of radiation dose. A rheological study was conducted for different Fricke gel dosimetric formulations. Initially, the performance of these dosimeters, produced at various gel concentrations, was evaluated in terms of their consistency at room temperature. This was achieved through the straightforward process of humidification the gels with glycerine. These matrices consist of both natural and synthetic polymers that are readily accessible, easy to handle, and can be easily incorporated into the acidic ferrous sulphate solution. Parameters such as the influence of gelling matrix concentration, linearity, and stability were assessed and correlated with those previously investigated for Fricke gel produced with bloom 300 pig skin gelatine (GEL). Ferrous sulphate dosimeters fabricated with sodium carboxymethylcellulose (CMC), guar gum (GGU), and polyvinyl alcohol (PVA) exhibited a coefficient of variation of less than 1% relative to the dose response evaluated in this study. By using readily available and easily manageable materials, it is possible to replicate dosimeters with a favourable dosimetric response for high-dose measurements., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Telma Fonseca reports financial support was provided by Minas Gerais State Foundation of Support to the Research. TELMA FONSECA reports a relationship with Minas Gerais State Foundation of Support to the Research that includes: funding grants. TELMA FONSECA has patent NO PATENT pending to NOT LICENSEE. THERE IS NO CONFLITS OF INTEREST If there are other authors, they 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 Ltd. All rights reserved.)

Purpose: To evaluate the intramucosal retention system in patients' masticatory efficiency and quality of life in this case series., Material and Methods: A total of 3 individuals with maxillectomy were included for rehabilitation with a complete obturator prostheses with an intramucosal retention system (OPI). The complete obturator prostheses was made for 60 days, and electromyography assessments and bite force were applied before, after 30, 60, and 90 days of surgery and prostheses installation. The University of Washington Quality of Life Questionnaire (UW-QoL) and the Obturator Functional Scale (OFS) were also administered at baseline and in the same follow-up periods. The electromyography was evaluated on both sides of the masseter, temporalis, and buccinator muscles while chewing hard and soft food. The maximum bite force was recorded in the central incisors and both sides of the first molar region., Results: Bite force values increased in the first molar region, and muscular electrical activity remained constant. Items related to the taste and swallowing of the UW-QOL impacted. Most OFS questionnaire data responses indicated that patients improved in swallowing liquid foods and appearance., Conclusions: The rehabilitative capacity improves masticatory efficiency and QoL in adults maxilectomized and rehabilitated with OPI analysis in the study. Further clinical studies should be encouraged to determine the effectiveness of this retentive system., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

CO 2 exposure has been used to investigate the panicogenic response in patients with panic disorder. These patients are more sensitive to CO 2 , and more likely to experience the "false suffocation alarm" which triggers panic attacks. Imbalances in locus coeruleus noradrenergic (LC-NA) neurotransmission are responsible for psychiatric disorders, including panic disorder. These neurons are sensitive to changes in CO 2 /pH. Therefore, we investigated if LC-NA neurons are differentially activated after severe hypercapnia in mice. Further, we evaluated the participation of LC-NA neurons in ventilatory and panic-like escape responses induced by 20% CO 2 in male and female wild type mice and two mouse models of altered LC-NA synthesis. Hypercapnia activates the LC-NA neurons, with males presenting a heightened level of activation. Mutant males lacking or with reduced LC-NA synthesis showed hypoventilation, while animals lacking LC noradrenaline present an increased metabolic rate compared to wild type in normocapnia. When exposed to CO 2 , males lacking LC noradrenaline showed a lower respiratory frequency compared to control animals. On the other hand, females lacking LC noradrenaline presented a higher tidal volume. Nevertheless, no change in ventilation was observed in either sex. CO 2 evoked an active escape response. Mice lacking LC noradrenaline had a blunted jumping response and an increased freezing duration compared to the other groups. They also presented fewer racing episodes compared to wild type animals, but not different from mice with reduced LC noradrenaline. These findings suggest that LC-NA has an important role in ventilatory and panic-like escape responses elicited by CO 2 exposure in mice., Competing Interests: Declaration of competing interest The authors have no competing interests to declare and have no relevant financial or non- financial interests to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: The CTNS gene mutation causes infantile nephropathic cystinosis (INC). Patients with INC develop Fanconi syndrome and chronic kidney disease (CKD) with significant bone deformations. C57BL/6 Ctns -/- mice are an animal model for studying INC. Hyperleptinaemia results from the kidney's inability to eliminate the hormone leptin in CKD. Ctns -/- mice have elevated serum leptin concentrations. Leptin regulates bone metabolism through its receptor that signals further via the hypothalamic melanocortin 4 receptor (MC4R). Leptin signalling may affect bone health in Ctns -/- mice., Methods: We first defined the time course of bone abnormalities in Ctns -/- mice between 1 and 12 months of age. We used both genetic and pharmacological approaches to investigate leptin signalling in Ctns -/- mice. We generated Ctns -/- Mc4r -/- double knockout mice. Bone phenotype of Ctns -/- Mc4r -/- mice, Ctns -/- mice and wild type (WT) mice at 1, 4, and 9 months of age were compared. We then treated 12-month-old Ctns -/- mice and WT mice with a pegylated leptin receptor antagonist (PLA) (7 mg/kg/day, IP), a MC4R antagonist agouti-related peptide (AgRP) (2 nmol, intracranial infusion on days 0, 3, 6, 9, 12, 15, 18, 21, 24, and 27), or vehicle (normal saline), respectively, for 28 days. Whole-body (BMC/BMD, bone area) and femoral bone phenotype (BMC/BMD, bone area, length and failure load) of mice were measured by DXA and femoral shaft biochemical test. We also measured lean mass content by EchoMRI and muscle function (grip strength and rotarod activity) in mice. Femur protein content of JAK2 and STAT3 was measured by ELISA kits, respectively., Results: Bone defects are present in Ctns -/- mice throughout its first year of life. The deletion of the Mc4r gene attenuated bone disorder in Ctns -/- mice. Femoral BMD, bone area, length, and strength (failure load) were significantly increased in 9-month-old Ctns -/- Mc4r -/- mice than in age-matched Ctns -/- mice. PLA and AgRP treatment significantly increased femoral bone density (BMC/BMD) and mechanical strength in 12-month-old Ctns -/- mice. We adopted the pair-feeding approach for this study to show that the protective effects of PLA or AgRP on bone phenotype are independent of their potent orexigenic effect. Furthermore, an increase in lean mass and in vivo muscle function (grip strength and rotarod activity) are associated with improvements in bone phenotype (femoral BMC/BMD and mechanical strength) in Ctns -/- mice, suggesting a muscle-bone interplay. Decreased femur protein content of JAK2 and STAT3 was evident in Ctns -/- mice. PLA or AgRP treatment attenuated femur STAT3 content in Ctns -/- mice., Conclusions: Our findings suggest a significant role for dysregulated leptin signalling in INC-related bone disorder, either directly or potentially involving a muscle-bone interplay. Leptin signalling blockade may represent a novel approach to treating bone disease as well as muscle wasting in INC., (© 2024 The Author(s). Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.)

In mammals, enteric salmonellas can use tetrathionate (ttr), formed as a by-product from the inflammatory process in the intestine, as electron acceptor in anaerobic respiration, and it can fuel its energy metabolism by degrading the microbial fermentation product 1,2-propanediol. However, recent studies have shown that this mechanism is not important for Salmonella infection in the intestine of poultry, while it prolongs the persistence of Salmonella at systemic sites in this species. In the current study, we show that ΔttrApduA strains of Salmonella enterica have lower net survival within chicken-derived HD-11 macrophages, as CFU was only 2.3% (S. Enteritidis ΔttrApduA), 2.3% (S. Heidelberg ΔttrApduA), and 3.0% (S. Typhimurium ΔttrApduA) compared to wild-type strains after 24 h inside HD-11 macrophage cells. The difference was not related to increased lysis of macrophages, and deletion of ttrA and pduA did not impair the ability of the strains to grow anaerobically. Further studies are indicated to determine the reason why Salmonella ΔttrApduA strains survive less well inside macrophage cell lines., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Methane conversion to valuable chemicals is a highly challenging and desirable reaction. Photocatalysis is a clean pathway to drive this chemical reaction, avoiding the high temperature and pressure of the syngas process. Titanium dioxide, being the most used photocatalyst, presents challenges in controlling the oxidation process, which is believed to depend on the metal sites on its surface that function as heterojunctions. Herein, we supported different metals on TiO 2 and evaluated their activity in methane photooxidation reactions. We showed that Ni-TiO 2 is the best photocatalyst for selective methane conversion, producing impressively high amounts of methanol (1.600 μmol·g -1 ) using H 2 O 2 as an oxidant, with minimal CO 2 evolution. This performance is attributed to the high efficiency of nickel species to produce hydroxyl radicals and enhance H 2 O 2 utilization as well as to induce carrier traps (Ti 3+ and SETOVs sites) on TiO 2 , which are crucial for C-H activation. This study sheds light on the role of catalyst structure in the proper control of CH 4 photoconversion.

Objective: The goal of this review was to investigate factors associated with physical activity and sedentary behavior in people with Parkinson disease (PD). The magnitude of these associations were investigated in line with the International Classification of Functioning, Disability and Health components., Methods: A systematic literature review was conducted until February 2023, searching 4 databases (PubMed, EMBASE, Web of Science, and Scopus) for original articles investigating associations with physical activity or sedentary behavior in people with PD. Two independent researchers performed data extraction, and the risk of bias in the included studies was assessed using the Quality in Prognosis Studies tool. Meta-analyses were conducted to determine the magnitude of the associations, and significant regression models from the included studies were described., Results: Forty-two studies were included. Twenty-one factors associated with overall physical activity were identified. Higher levels of physical activity had small association with cognition and body mass index, and fair association with 17 factors related to self-efficacy, physical function, mobility, quality of life, age, PD symptoms, and more. Better manual dexterity and functional gait had moderate to good association with higher levels of physical activity. The regression model with the higher magnitude was composed mostly of contextual factors, except for the body max index. The magnitude of factors associated with physical activity intensity or sedentary behavior could not be identified., Conclusion: Functional gait and manual dexterity were the strongest factors related to physical activity in people with PD. Further investigation is needed to understand the factors associated with physical activity intensity and sedentary behavior., Impact: This study emphasizes the significance of considering contextual factors alongside body function and structure, activity and participation, and the health condition to enhance physical activity improvement during the rehabilitation process. By adopting such holistic approach, rehabilitation professionals can optimize the overall health and wellbeing of individuals with Parkinson disease., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Malnutrition is a complicated illness that affects people worldwide and is linked to higher death rates, a heightened vulnerability to infections, and delayed cognitive development. Experimental models have been constructed to comprehend the mechanisms associated with hunger. In this regard, the current study used two different types of food aiming to validate a murine model of malnutrition based on dietary restriction. The study was conducted with fifty-six Swiss male mice (eight-week-old) divided into eight groups (n=7 each) and fed the following experimental diets (10 weeks): Standard Diet (ST) ad libitum; ST 20% dietary restriction; ST 40% dietary restriction; ST 60% dietary restriction; AIN93-M diet ad libitum; AIN93-M 20% dietary restriction; AIN93-M 40% dietary restriction; AIN93-M 60% dietary restriction. Body, biochemical, and histological parameters were measured, and the restriction effects on genes related to oxidative stress (GPX1 and GPX4) in epididymal adipose tissue were evaluated. The results obtained showed that 20%, 40%, and 60% of dietary restrictions were able to reduce body weight when compared to controls, highlighting the accentuated weight loss in animals with 60% restrictions, especially those fed with AIN-93 M, which showed physical changes such as whitish skin and dull coat, voracious eating, and hunched posture. The present animal model also showed biochemical changes with hypoalbuminemia, as well as histological epididymal adipose tissue modulation. The presence of increased oxidative stress was observed when evaluating the GPX4 gene. Given the results, 60% food restriction using the AIN93-M diet was the best protocol for inducing malnutrition., 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 Inc. All rights reserved.)

The combination of clinical characteristics and diagnostic exams including imaging, laboratory, and molecular tests help in the differential diagnosis of retroperitoneal lesions. We report a 41-year-old male with a metastatic retroperitoneal lesion with atypical characteristics, displaying pathological findings consistent with both nonsecretory pheochromocytomas/paragangliomas and adrenal cortex carcinoma. The patient was examined for abdominal pain, weight loss, and hypertension. Abdominal computed tomography showed a 21 × 8 × 10-cm right retroperitoneal mass. He was initially diagnosed as pheochromocytoma/paraganglioma (PHEO/PGL). However, the diagnosis was later changed to adrenocortical carcinoma based on histopathological features of the metastatic lesions and the findings of normal urinary levels of catecholamines/metanephrines. Systemic chemotherapy and abdominal radiotherapy were performed, in addition to multiple surgical resections, with no satisfactory response. The indolent course of the disease and minimal impact on the patient's performance status led to a genetic evaluation which resulted in the identification of a germline mutation in the succinate dehydrogenase complex subunit B ( SDHB ). An immunohistology review of previous slides was consistent with the hypothesis of a neuroendocrine tumor. Forty percent of the patients with PHEO/PGL have an underlying germline mutation. SDHB mutation is frequently associated with metastatic disease and dominant secretion of noradrenaline and/or dopamine. In addition to the metastatic disease, few cases with the mutations can be a biochemically silent PHEO/PGL. We concluded that the patient presented a metastatic abdominal paraganglioma associated with an SDHB mutation and we reinforced the need to perform genetic screening for all adrenal/extra-adrenal lesions characteristic of PHEO/PGL., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Izabella Freitas et al.)

Background: The use of fluorescent technologies in vascular neurosurgery emerged after indocyanine green video angiography (ICG-VA) was first described in 2003. As data supporting the efficiency of ICG in preventing postoperative complications has grown substantially, it has now established itself as the standard of care. However, the predominant literature centers on ICG techniques, leaving the evaluation of cost-effective fluorescein tools pending. We report the results of a prospective study in which we demonstrated the impact of intraoperative fluorescein videoangiography (FL-VA) in aneurysm surgery., Methods: Between December 2021 and September 2022, a total of 57 patients underwent craniotomy for intracranial aneurysm surgery. After aneurysm clipping, we administered a 0.5 mg/Kg of sodium fluorescein, and the intracranial area of interest was inspected through the microscope integrated module. The following data were collected: patient age and sex; number of clipped aneurysms; aneurysm location, size, and rupture status; Hunt Hess grade; intraoperative rupture; aneurysm calcification and thrombosed aneurysm; visualization of blood flow in perforating arteries; need for a clip adjustment after FL-VA analysis by neurosurgeon., Results: For the surgical clipping of 64 aneurysms in 57 patients, 80 FL-VA studies were performed. Clip adjustments were performed following FL-VA in 13 aneurysms. FL-VA had an impact on 20 % of the clipping. In seven aneurysms, clip adjustment was due to the "presence of residual aneurysm", in three cases due to the "presence of neck", and in three cases due to "adjacent vessel stenosis". Regarding the evaluation of flow in the perforating vessels, it was possible, with a good and detailed image in all cases., Conclusion: The use of FL-VA has a significant impact in aneurysm surgery, enhancing effectiveness and safety. The dosage of 0.5 mg/kg administered is sufficient for assessing both aneurysm occlusion and the presence of flow in adjacent vessels., 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. Published by Elsevier Ltd.)

Objective: To evaluate the influence of the personal experience of female obstetricians and gynaecologists (Obst/Gyns) who utilise contraceptive methods on the provision of these methods., Methods: An anonymous online web-based survey was carried out with female Obst/Gyns. The instrument contained questions about their current and previous contraceptive methods use, factors that influenced the choice and satisfaction with the ongoing method, as well as the occurrence of adverse events. They were also asked whether the experience of any adverse events influenced their decision in prescribing any particular contraceptive method., Results: 476/9000 (5.3%) female Obst/Gyns answered the survey. The most common contraceptive in use was the 52-mg levonorgestrel-intrauterine device (52-mg LNG-IUD) (34%), followed by non-Long-Acting Reversible Contraception hormonal methods (21.2%). More than half of the respondents (57.6%) reported having some adverse effects and 18.7% reported that the personal experience of an adverse effect with the use of a contraceptive method influenced the prescription of that method., Conclusion: Half of female Obst/Gyns encountered adverse events linked to contraceptive usage. Additionally, almost one-fifth believe that their own encounter with adverse effects from a contraceptive method impacts their decision to prescribe the same method.

Objectives: This study aimed to determine the median age at natural menopause and analyze lifestyle, anthropometric, and dietary characteristics associated with the age at natural menopause among Brazilian women., Methods: This cross-sectional study involved 2,731 women 50 years and over, drawn from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2015/16). Nonparametric Kaplan-Meier cumulative survivorship estimates were used to assess the median timing of natural menopause. Cox proportional hazards regression models were employed to estimate the associations between age at natural menopause and exposure variables., Results: The overall median age at natural menopause was 50 years. In the adjusted Cox model, current smoking (hazard ratio [HR], 1.11; 95% CI, 1.01-1.23) and underweight (HR, 1.34; 95% CI, 1.12-1.61) were associated with earlier natural menopause. Conversely, performing recommended levels of physical activity in the last week (HR, 0.88; 95% CI, 0.80-0.97), being overweight (HR 0.86; 95% CI, 0.74-0.99), and adhering to two or three healthy eating markers (HR, 0.80; 95% CI, 0.66-0.97; HR, 0.76; 95% CI, 0.61-0.94, respectively) were associated with later age at natural menopause. Binge drinking and waist circumference were not associated with age at natural menopause., Conclusions: Lifestyle, anthropometric, and dietary characteristics are significant factors that affect the age at natural menopause. Our findings can contribute to public policies targeted at Brazilian women's health., Competing Interests: Financial disclosure/conflicts of interest: None reported., (Copyright © 2024 by The Menopause Society.)

Aim: To evaluate the effects of systematic rehabilitation on both the neuropsychomotor development, and on the peripheral response from immunological and neuroplastic mediators in children with cerebral palsy., Methods: This is a prospective cohort study with 90 children with cerebral palsy at 18 months of age. Sixty children received rehabilitation for 6 months, and they were compared to 30 children that were placed in the waiting list. Peripheral biomarkers and neuropsychomotor parameters were compared between the Rehab vs the Nonrehab groups at baseline and at 6 months., Results: Results showed higher Bayley III scores in the Rehab group, with significant differences in inflammatory and neurotrophic biomarkers between groups. Rehabilitation was associated to decreased levels of IL-12p70, IL-6, IL-1β, CXCL8 IL-8, and CXCL9/MIG and increased levels of BDNF and GDNF. Nonrehab children had stable immune molecule levels but decreased BDNF levels over time., Conclusion: Rehabilitation improved neurodevelopment parameters and modulated levels of inflammatory (↓) and neurotrophic (↑) biomarkers., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study evaluated the effect on adhesive layer thickness, bond strength, and adhesive failure pattern of the application of universal adhesive (Scotchbond Universal) using either manual or rotary brush in dentin previously impregnated with bioceramic sealer (Sealer Plus BC) using a manual brush, at 24 h and 1 year. Eighty-eight bovine crowns were divided into four groups (n = 22) according to the intervention: (i) use of bioceramic sealer and adhesive application using manual brush, (ii) use of bioceramic sealer and adhesive application using rotary brush, (iii) use of resin sealer and adhesive application using manual brush, and (iv) use of resin sealer and adhesive application using rotary brush. Subsequently, specimens were restored with a composite resin (Filtek Z-250). Adhesive layer thickness was evaluated using confocal microscopy. Bond strength was assessed using the microtensile bond strength test, and adhesive failure pattern was evaluated under a stereomicroscope. Data were analyzed using two-way ANOVA/Tukey tests. Specimens where a rotary brush had been used exhibited lower adhesive layer thickness. Specimens treated with resin sealer and using a manual brush showed lower bond strength values and a higher occurrence of adhesive failures at 24 h and 1 year than specimens treated with bioceramic sealer and using rotary brush for adhesive application., (© 2024 Scandinavian Division of the International Association for Dental Research. Published by John Wiley & Sons Ltd.)

Objective: This study aimed to evaluate the fecal shedding of C. difficile in calves on farms in Sao Paulo State, Brazil., Materials and Methods: Fecal samples (n = 300) were collected from diarrheic (n = 78) and nondiarrheic (n = 222) calves less than 60 days of age from 20 farms. Fecal samples were inoculated into enrichment broth supplemented with taurocholate and cultured under anaerobic conditions. Colonies suspected to be C. difficile were harvested for DNA extraction and then multiplex PCR for the detection of genes encoding toxins A and B and binary toxins. All toxigenic isolates were ribotyped and tested for antimicrobial susceptibility, and five selected strains were subjected to whole-genome sequencing to determine their sequence type., Results and Discussion: C. difficile was isolated from 29.3 % (88/300) of the samples. All toxigenic isolates (17/88, 19.3 %) were classified as ribotypes RT046 (13/17-79.47 %, A + B + CDT - ) and RT126 (4/17 = 20.53 %, A + B + CDT + ). The sequenced strains from RT046 were classified as ST35 (Clade 1), while those from RT126 were classified as ST11 (Clade 5). No associations between the epidemiological factors in any of the groups and C. difficile isolation were observed. Most of the toxigenic isolates (16/17 = 94.41 %) were classified as multidrug-resistant. Calves can be an important source of toxigenic C. difficile strains, including multidrug-resistant isolates from ribotypes commonly observed in humans., 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 Ltd. All rights reserved.)

The aim of this study was to evaluate the effects of the application of universal adhesive in the etch-and-rinse (ER) strategy with a manual brush (MB) or rotary brush (RB) in adhesion to dentin impregnated (WB) or not (NB) with bioceramic sealer, at 24 h and 1 year. Eighty-eight crowns of bovine incisors were divided into four groups (n=22): WB-MB, WB-RB, NB-MB, NB-RB. After the restorative protocol, dentin penetrability was evaluated by confocal microscopy. Bond strength was evaluated by microtensile test. Data were analyzed using one-way ANOVA/Tukey tests (α=0.05). NB-RB and WB-RB exhibited greater extensions of resin tags in dentin. At 24 h, WB-RB and NB-MB showed the highest and lowest values of bond strength, respectively. At 1 year, WB-MB and WB-RB demonstrated the highest bond strength values. The RB increases the formation of resin tags and residues of bioceramic sealer provides higher bond strength in the ER strategy.

Background: Breast and cervical cancer are major public health issues globally. The reduction in incidence and mortality rates of these cancers is linked to effective prevention, early detection, and appropriate treatment measures. This study aims to analyze the temporal trends in the prevalence of mammography and Papanicolaou test coverage among women living in Brazilian state capitals between 2007 and 2023, and to compare the coverage of these tests before and during the Covid-19 pandemic., Methods: A time series study was conducted using data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey from 2007 to 2023. The variables analyzed included mammography and Papanicolaou test coverage according to education level, age group, race/skin color, regions, and Brazilian capitals. The Prais-Winsten regression model was used to analyze the time series, and Student's t-test was employed to compare the prevalence rates between 2019 and 2023., Results: Between 2007 and 2023, mammography coverage showed a stationary trend (71.1% in 2007 and 73.1% in 2023; p-value = 0.75) with a declining trend observed among women with 12 years or more of education (APC= -0.52% 95%CI -1.01%; -0.02%). Papanicolaou test coverage for all women aged between 25 and 64 exhibited a downward trend from 82% in 2007 to 76.8% in 2023 (APC= -0.45% 95%CI -0.76%; -0.13%). This decline was also noticed among those with 9 years or more of education; in the 25 to 44 age group; among women with white and mixed race; and in the Northeast, Central-West, Southeast, and South regions. When comparing coverage before and during Covid-19 pandemic, a reduction was noted for both tests., Conclusions: Over the years, there has been stability in mammography coverage and a decline in Papanicolaou test. The COVID-19 pandemic negatively impacted the number of these tests carried out among women, highlighting the importance of actions aimed at increasing coverage, especially among the most vulnerable groups., (© 2024. The Author(s).)

Honey, traditionally known as a pure and natural substance, has become an unexpected reservoir for microplastic contamination. This study consisted of an experimental investigation to assess the occurrence of microplastics in honey produced by Melipona quadrifasciata , a native bee species in Brazil. Our investigation covers eight areas (one sample per area), including built and vegetated areas located in São Paulo city, Brazil, to understand the distribution of microplastics in these environments. Honey samples (10 mL) were collected using a syringe and sent to the laboratory for further analysis. Microplastics extracted from honey samples were characterized under a stereomicroscope to determine their size, color, and morphology. Also, the polymer type was determined by FTIR analysis. All honey samples (100%) showed microplastics. The predominant particles displayed a fiber shape with a size below 299 μm and a transparent color and were primarily composed of polypropylene. Their concentrations ranged from 0.1 to 2.6 particles per mL of honey, raising concerns about their potential impact on bee populations and human consumers. This study underscores the need for further research on the sources and implications of microplastic contamination in Melipona quadrifasciata honey, shedding light on the broader issue of environmental plastic pollution and its impact on pollinators.

This study evaluated the photoactivation of hydrogen peroxide gels at different concentrations using blue or violet LED in terms of whitening efficacy and tooth sensitivity. Forty patients were randomly divided into 4 groups: HP6V (violet LED and 6% hydrogen peroxide), HP6B (blue LED and 6% hydrogen peroxide), HP35V (violet LED and 35% hydrogen peroxide), and HP35B (blue LED and 35% hydrogen peroxide). The L*, a* and b* values were measured before, 1 week and 3 months after treatment, and the ΔE and ΔW ID values were calculated. Tooth sensitivity was measured using a visual analogue scale (VAS) before, immediately after, and 24 h after bleaching. The ΔE, ΔW ID and bleaching sensitivity values were subjected to the ANOVA test and Bonferroni post-test. HP35V and HP35B showed higher whitening efficacy than HP6VL, while HP6V did not show statistical differences compared to the other groups. Regarding bleaching-related sensitivity, the HP6V and HP6B groups presented the lowest values when compared to HP35V and HP35B. HP6V showed whitening efficacy comparable to HP35V and HP35B but with reduced tooth sensitivity. TRIAL REGISTRATION NUMBER: NCT06165458; registration date: 12/09/2023., (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Stray dogs and cats pose significant challenges for public health and animal welfare due to their potential involvement in zoonotic disease transmission, accidents, and aggressions. Large urban centers exacerbated challenges due to the presence of these animals in public areas with high human density. Ethical Population Management Programs (EPMP), rooted in the One Health approach, are crucial for addressing this issue comprehensively. This study aimed to demonstrate the approach on cats and dogs EPMP and evaluate the perceptions of academic community regarding EPMP implementation on a campus situated in urban territory. The study was conducted at the Pampulha campus of UFMG in Belo Horizonte, Brazil. In response to issues of animal abandonment and conflicts, the Permanent Commission for Animal Policies (CPPA-UFMG) was established in 2019 to manage the campus's dog, cat, and wildlife populations. The commission implemented the Trap-Neuter-Return (TNR) method, along with health assessments and vaccinations for animals. Interviews were conducted with campus staff to gauge their perception of animal management strategies. Retrospective and prospective analyses of the commission's actions were carried out to assess implementation processes and challenges. The animal population survey conducted on campus between July 2018 and September 2021 revealed a total of 266 animals recorded. Among these animals, 195 were cats (73.3%) and 71 were dogs (26.7%), with the majority being adults. Subsequent surveys in 2019 and 2021 showed a slight increase in the animal population, with measures such as sterilization contributing to population control. Perception analysis among campus users indicated strategies such as TNR were widely endorsed for population control. The employees perception questionnaire was applied to 115 individuals, representing 42 units/departments and five gates. Associations were found between these beliefs and support for institutional actions. The majority favored sterilization (92.17%) and agreed that TNR is an appropriate approach to population control. Overall, the study reflects a community concerned about animal welfare and supportive of measures to address population management and cruelty prevention. The continuous efforts of the university's CPPA have led to stability in the resident animal population, indicating success in achieving population control objectives., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Bicalho, Oliveira, de Oliveira, Costa Val Bicalho, Bastos, Torres, Malm, de Souza, Lima, Maia, Villalta, de Carvalho, de Freitas, Goveia, Barrado, Oliveira and Soares.)

Deep brain stimulation (DBS) stands as the preferred treatment for Parkinson's disease (PD) patients manifesting refractory motor symptoms or when medication side effects outweigh the benefits. Though traditionally administered under local anesthesia coupled with sedation (LA + S), recent evidence hints at comparable outcomes under general anesthesia (GA). This systematic review and meta-analysis aimed to scrutinize post-surgical outcomes in randomized PD patients undergoing DBS surgery while GA versus LA + S. We searched PubMed, Cochrane, and Embase databases following PRISMA guidelines. We included randomized studies directly comparing DBS surgery under GA versus LA + S, delineating clinical outcomes. Safety outcomes assessed disparities in infection and hemorrhage risk. Mean differences (MD) and Risk Differences (RD) with 95% Confidence Intervals (CI) were utilized to evaluate outcomes, under a random-effects model. Heterogeneity was evaluated through I² statistics, and in studies exhibiting high heterogeneity, exclusion analysis was performed. Evaluated outcomes encompassed motor improvement, complications, behavioral and mood effects gauged by the Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire 39 (PDQ39), and daily levodopa equivalent dose (LEDD). A total of 3 studies, encompassing 203 patients, were reviewed. At a 6-month follow-up, in patients undergoing GA during surgery, there was no statistically significant difference compared to the LA + S group in terms of UPDRS III ON (MD 0.19; 95% CI -2.21 to 2.59; p = 0.88; I²=0%), UPDRS III OFF (MD 0.58; 95% CI -4.30 to 5.45; p = 0.21; I²=0%), UPDRS IV ON ( (MD 0.98; 95% CI -0.95 to 2.92; p = 0.32; I²=23%), PDQ39 (MD -1.27; 95% CI -6.31 to 3.77; p = 0.62; I²=0%), and LEDD (MD -1.99; 95% CI -77.88 to 73.90; p = 0.96; I²=32%). There was no statistically significant difference between groups in terms of infection (RD 0.02; 95% CI -0.02 to 0.05; p = 0.377; I²=0%) or hemorrhage (RD 0.04; 95% CI -0.03 to 0.11; p = 0.215; I²=0%). Our findings suggest, based on short-term follow-up, that GA is not inferior to LA + S in terms of benefits for the selected outcomes. However, further studies are needed to determine whether there are significant long-term clinical differences between these groups., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study aims to develop and validate the content and response processes of a questionnaire intended for caregivers to screen for dysphagia in Brazilian older adults with dementia due to Alzheimer's disease and/or vascular dementia. The instrument items were developed in Brazilian Portuguese language based on the theoretical framework. A committee of speech-language-hearing therapists analyzed the relevance, objectivity, clarity, and understandability of the items with the Delphi method. The content validity index cutoff agreement score for experts' answers to validate each item in the questionnaire was 0.78; in the intraclass correlation coefficient, it was 0.75 for all items. For response process validity evidence, the questionnaire was applied to 30 caregivers of older adults with dementia, who judged the clarity and understandability of the items. Each item was validated when understood by at least 95% of participants. The first version of the instrument had 29 items. After two expert assessments, the last version had 24 items. The intraclass correlation coefficient was 0.85. Only one item needed semantic adjustments in the pre-test. The dysphagia screening instrument applied to caregivers of older adults with dementia was developed with adequate content and response process validity evidence, enabling adjustments in its construct. Future studies will analyze the remaining evidence of validity and reliability., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Loxoscelism refers to a set of clinical manifestations caused by the bite of spiders from the Loxosceles genus. The classic clinical symptoms are characterized by an intense inflammatory reaction at the bite site followed by local necrosis and can be classified as cutaneous loxoscelism. This cutaneous form presents difficult healing, and the proposed treatments are not specific or effective. This study aimed to evaluate the protective effect of mesenchymal stromal cells-derived secretome on dermonecrosis induced by Loxosceles intermedia spider venom in rabbits., Methods: Sixteen rabbits were distributed into four groups (n = 4). Except for group 1 (G1), which received only PBS, the other three groups (G2, G3, and G4) were initially challenged with 10 μg of L. intermedia venom, diluted in 100 μL of NaCl 0.9%, by intradermic injection in the interscapular region. Thirty minutes after the challenge all groups were treated with secretome, except for group 2. Group 1 (G1-control group) received intradermal injection (ID) of 60 μg of secretome in 0.15 M PBS; Group 2 (G2) received 0.9% NaCl via ID; Group 3 (G3) received 60 μg of secretome, via ID and Group 4 (G4), received 60 μg of secretome by intravenous route. Rabbits were evaluated daily and after 15 days were euthanized, necropsied and skin samples around the necrotic lesions were collected for histological analysis., Results: Rabbits of G1 did not present edema, erythema, hemorrhagic halo, or necrosis. In animals from G2, G3, and G4, edema appeared after 6h. However, minor edema was observed in the animals of G2 and G3. Hemorrhagic halo was observed in animals, six hours and three days after, on G2, G3, and G4. Macroscopically, in G4, only one animal out of four had a lesion that evolved into a dermonecrotic wound. No changes were observed in the skin of the animals of G1, by microscopic evaluation. All animals challenged with L. intermedia venom showed similar alterations, such as necrosis and heterophilic infiltration. However, animals from G4 showed fibroblast activation, early development of connective tissue, neovascularization, and tissue re-epithelialization, indicating a more prominent healing process., Conclusion: These results suggest that secretome from mesenchymal stromal cells cultured in a xeno-free and human component-free culture media can be promising to treat dermonecrosis caused after Loxosceles spiders bite envenoming., Competing Interests: Competing interest : The authors declare that they have no conflict of interest.

This study aimed to evaluate the bond strength between relined fiberglass posts with different composite resin opacities in different thirds of the intraradicular dentin. Thirty single-rooted premolars were endodontically treated and divided into three groups (n=10): fiberglass posts relined with translucent composite resin, fiberglass posts relined with opaque composite resin, and fiberglass posts without relining. After cementation of the posts, the specimens were cut perpendicular to the long axis of the tooth in slices of approximately 1.3 mm of each third to be analyzed (cervical, middle, and apical) and then subjected to the push-out test. The bond strength (MPa) data were subjected to Shapiro-Wilk normality tests and two-way repeated measures analysis of variance, considering the experimental groups and different regions as study factors. Tukey's post-hoc test (p<.05) was applied for comparisons between the groups. In the cervical third, higher values of bond strength were found for the group relined with translucent resin, with a statistically significant difference for the other groups. In the other regions, both opaque and translucent resins showed similar results, but both showed higher values of bond strength compared to fiberglass posts without relining. The bond strength of fiberglass posts to different thirds of intraradicular dentin is influenced by composite resin relining as well as the opacity of the resin. The use of translucent composite resin is a more effective alternative for fiberglass posts relining.