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Background: Cirrhosis is a prevalent disease and ranks among the leading causes of death worldwide. Sarcopenia is believed to be associated with a poorer prognosis in patients with cirrhosis., Objective: To evaluate the impact of sarcopenia on the prognosis of patients hospitalized for acute decompensation of cirrhosis, with or without acute-on-chronic liver failure., Methods: This prospective cohort study evaluated patients hospitalized for acute decompensation of cirrhosis, with or without acute-on-chronic liver failure. Sarcopenia was assessed according to the European Working Group on Sarcopenia in Older People, using skeletal muscle mass analysis by bioelectrical impedance and handgrip strength testing. The data was collected between March-2019 and April-2020. Qualitative variables were presented as frequencies and percentages, and quantitative variables as means and standard deviations when symmetrical, or medians and 25th and 75th percentiles when asymmetrical. The association of sarcopenia and mortality with quantitative variables was tested using Student's t-test or the Mann-Whitney test, while associations with qualitative variables were tested using the Chi-square test or Fisher's Exact test. For significant associations, crude and adjusted (multivariate analysis) relative risk estimates with a 95% confidence interval were calculated using Poisson regression analysis. Results with P<0.05 were considered significant., Results: Fifty patients were included, with a mean age of 60.5 years (±10.4) and a slight predominance of men (56%). The main causes of cirrhosis were alcohol use disorder (28%) and hepatitis C (24%). The median Child-Pugh score was 8 points (7-10), and the median Model for End-stage Liver Disease score was 15 points (12.5-21). Ten patients were diagnosed with acute-on-chronic liver failure. Sarcopenia was present in 50% of the sample. Sarcopenia was present in 70.0% of patients with acute-on-chronic liver failure and in 43.2% of those without acute-on-chronic liver failure (P=0.168). Overall mortality was 48% in patients with sarcopenia and 44% in those without sarcopenia (P=1.000). In multivariate analysis, overall mortality was associated only with leukocyte count (relative risk=1.01, 95% confidence interval=1.01-1.01) and Model for End-stage Liver Disease score (relative risk=1.07, 95% confidence interval =1.03-1.10)., Conclusion: In this study, sarcopenia was not associated with mortality in patients hospitalized for acute decompensation of cirrhosis, with or without acute-on-chronic liver failure. There was a non-significant trend towards a higher prevalence of sarcopenia among individuals with acute-on-chronic liver failure.

Objectives: To assess the prevalence of urinary incontinence and the clinical and demographic factors associated with patients with Post-COVID-19 Syndrome., Method: A cross-sectional study was conducted with 59 participants from Porto Alegre/RS. Data were collected via telephone interviews using a structured instrument, the Functional Status Scale, and the International Consultation on Incontinence Questionnaire - Short Form, between September 2021 and October 2022. Numerical data were analyzed for normality using the Shapiro-Wilk test. Student's t-test with Mann-Whitney's post-hoc was applied for comparison of continuous variables. Fisher's exact test was used for correlation of categorical data., Results: The sample included 32 women (56.4 ± 11.3 years) and 27 men (49.5 ± 10.7 years). Only women reported post-COVID-19 urinary incontinence (28%), as well as emotional alterations (p=0.006). Urinary incontinence was associated with insomnia (p=0.005)., Conclusion: Urinary incontinence was prevalent only in women and was not affected by COVID-19. Women also exhibited greater emotional alterations. Insomnia was the variable associated with the outcome. Thus far, there is incipient evidence regarding the association of the SARS-CoV-2 infection with the prevalence of urinary incontinence in individuals with Post-COVID-19 Syndrome.

The mid-face has been rendered as the cornerstone of facial aesthetic improvement, since treating the mid-face has also beneficial effects on neighboring esthetic units and therefore should be one of the first areas to be assessed. Retaining ligaments (RL) bind soft tissue layers of the face to the underlying facial skeleton. It remains controversial whether RL suffers laxity with aging or if changes in 42 bone and other structures where ligaments are inserted lead to altered mechanical function of the latter. Enhancement of the supportive effect of the ligaments could help restore the soft tissues to their original anatomical positions and achieve a lifting effect. While injectable hyaluronic acid implants have been used to improve ligament support, calcium hydroxylapatite has one of the highest viscoelasticities when compared with other dermal fillers and can induce collagen synthesis, which could provide long-term laxity correction. In this preliminary report of a case series, our goal was to describe the use of calcium hydroxylapatite in different dilutions and combinations for different aging profiles to treat the midface as an alternative for hyaluronic acid injections and to describe the ultrasonographic behavior in the long run., Competing Interests: Dr Sato and Dr Muniz have been speakers for Merz Pharmaceuticals. The authors report no other conflicts of interest in this work., (© 2024 Sato et al.)

Resistance training, as a modality of physical exercise, has been recognized as a fundamental pillar in the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD). Current reviews, however, have not given due priority to the specific effects of this type of training on hepatic and clinical markers in individuals with MASLD. This study aimed to compile the available evidence on the impact of resistance training on hepatic and clinical parameters in individuals diagnosed with MASLD. To this end, a systematic search was conducted in the PubMed, Lilacs, Embase, Cochrane, SciELO, and Pedro databases, as well as a manual search, covering the period from January 2011 to December 2023. Randomized clinical trials that evaluated liver fat, insulin resistance, and liver enzymes in individuals with MASLD who were exclusively subjected to resistance training interventions were selected. This study is registered with International Prospective Register of Systematic Reviews (PROSPERO) (CRD4202236638) and the risk of bias in the eligible studies was assessed using ROB 2. Six studies were included, totaling 232 adult participants. Resistance training resulted in a significant reduction in liver fat ( P  < 0.001), liver enzymes ( P  < 0.05), and insulin resistance ( P  < 0.05) in individuals in the strength training group. Furthermore, greater adherence to resistance training (>90%) was observed compared to aerobic training. It is concluded that resistance training can be an easily accepted and consistent option for adults with MASLD, playing an important role in improving the clinical and hepatic markers of these individuals., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Hypotension is one of the main characteristics of the systemic inflammation, basically caused by endothelial dysfunction. Studies have shown that the amino acid L-kynurenine (KYN) causes vasodilation in mammals, leading to hypotensive shock. In hypotensive shock, when activated by the KYN, the voltage-gated potassium channel encoded by the family KCNQ (Kv7) gene can cause vasodilation. Fructose-1,6-bisphosphate (FBP) it is being considered in studies an anti-inflammatory, antioxidant, immunomodulator, and a modulator of some ion channels (Ca2+, Na+, and K+). We analyzed the effects of KYN and FBP on mean blood pressure (MBP), systolic and diastolic (DBP) blood pressure, and heart rate variability (HRV) in Wistar rats. Results demonstrated that the administration of KYN significant decreased MBP, DBP, and increased HRV. Importantly, the FBP treatment reversed the KYN effects on MBP, DBP, and HRV. Molecular Docking Simulations suggested that KYN and FBP present a very close estimated free energy of binding and the same position into structure of KCNQ4. Our results did demonstrate that FBP blunted the decrease in BP, provoked by KYN. Results raise new hypotheses for future and studies in the treatment of hypotension resulting from inflammation., (© 2024 The Author(s). Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

Background: Tai Chi Chuan (TCC) is considered a mind and body practice of Chinese origin, considered as an intangible cultural heritage of humanity by UNESCO, and recommended by the World Health Organization as a therapeutic approach to prevent falls., Objective: To assess the effects of TCC on older adult's balance., Methods: A systematic review of randomized clinical trials was conducted by two independent reviewers using the ROB2 tool to assess the risk of bias under the following databases: PubMed, SCOPUS, Web of Science, PEDro, Embase, Cochrane, CINAHL, and LILACS. A meta-analysis of the selected articles for the dynamic and static balance criteria was conducted in a population of older adults (over 65 years) with publications from 2010 to 2024., Results: Eighteen randomized clinical trials fulfilled the criteria. TCC improves dynamic balance in the timed up and go and gait speeds tests, and static balance in the single-leg test and functional reach test when compared with the control group in the meta-analysis. Adverse events were found in only one study, and the training parameters were heterogeneous., Conclusion: TCC improves older adults with both dynamic and static balance. The results of the parameters indicate a direction in which TCC is prescribed for clinical practice with minimal or no risk of adverse effects.

Background: The study aims to describe midterm outcomes following treatment of infrarenal abdominal aortic aneurysms (AAAs) with short necks by endosutured aneurysm repair using the Heli-FX EndoAnchor system., Methods: This is a retrospective study of prospectively collected data from 9 vascular surgery departments between June 2010 and December 2019, including treated AAAs with neck lengths ≤10 mm. The decision for the use of EndoAnchors was made by the treating surgeon or multidisciplinary aortic committee according to each center's practice. There were 2 Groups further assessed according to neck length, A (≥4 and <7 mm) and B (≥7 and ≤10 mm). The main outcomes analyzed were technical success, freedom from type Ia endoleaks (TIaELs), sac size increase, all-cause and aneurysm-related mortality., Results: Seventy-six patients were included in the study, 17 fell into Group A and 59 into Group B. Median follow-up for the cohort was 40.5 (interquartile range 12-61) months. A median of 6 (interquartile range 3) EndoAnchors were deployed in each subject. Technical success was 86.8% for the total group, 82.4% and 88.1% (P = 0.534) for Groups A and B respectively. Six out of 10 (60%) of TIaELs at the completion angiographies showed spontaneous resolution. Cumulative freedom from TIaEL at 3 and 5 years for the total group was 89% and 84% respectively; this was 93% and 74% for Group A and 88% at both intervals in Group B (P = 0.545). In total, there were 7 (9.2%) patients presenting with TIaELs over the entire study period. Two (11.8%) in Group A and 5 (8.5%) in Group B (P = 0.679). There were more patients with sac regression in Group B (Group A = 6-35.3% vs. Group B = 34-57.6%, P = 0.230) with no statistical significance. All-cause mortality was 19 (25%) patients, with no difference (4-23.5% vs. 15-25.4%, P = 0.874) between groups; whereas aneurysm-related mortality occurred in 1 patient from Group A and 3 from Group B., Conclusions: This study demonstrates reasonable outcomes for patients with short-necked AAAs treated by endosutured aneurysm repair in terms of TIaELs up to 5-year follow-up. EndoAnchor use should be judiciously evaluated in short necks and may be a reasonable option when anatomical constraints are encountered, mainly for those with 7-10 mm neck lengths. Shorter neck length aspects, as indicated by the results from Group A, may be an alternative when no other options are available or feasible., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Sarcopenia, a subject of extensive research, has led to numerous clinical trials and systematic reviews (SR). These reviews aid healthcare professionals by summarizing results and conducting meta-analyses, enhancing reliability. However, the abundance of reviews complicates decision-making on sarcopenia management. To address this, SR of SR have emerged, consolidating data from various sources into comprehensive documents., Objective: To assess the isolated impact of dietary interventions on sarcopenia's diagnostic criteria for older individuals., Methods: A study protocol for a SR of SR, following Cochrane and PRISMA recommendations. The search strategy includes the MeSH 'sarcopenia' and its subheadings; 'aged' and its subheadings; 'nutrition' and its subheadings; and filter 'systematic review', performed at main databases. Selected studies must include older adults, submitted to nutritional interventions compared to control groups. Quantitative analyses will use inverse variance statistic method (random effects); the effect measures mean difference. Heterogeneity measured with Q-Test., Results: The results of this SR of SR may provide valuable information about the sarcopenia treatment, deepening the knowledge about., Conclusion: This protocol is reproducible, requires low cost and personnel, and may allow a higher understanding on sarcopenia treatment and management on older people., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ferreira 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.)

This study investigated the effects of biset, drop-set and traditional resistance training (RT) techniques on metabolic responses in resistance-trained males. Fifteen trained males (age 29.7 ± 6.1 years; body mass 83.4 ± 7.6 kg; RT experience 11.4 ± 6.7 years; one-repetition maximum (1RM) barbell bench press: body mass ratio 1.4 ± 0.1 a.u.) were assigned to three experimental conditions, in a randomized crossover design. The experimental conditions were bi-set (3×10 repetitions at 70%1RM in barbell bench press followed by 10 repetitions at 60%1RM in incline bench press), drop-set (3×10 repetitions at 70%1RM followed by 10 repetitions at 50%1RM in barbell bench press) and traditional RT (3×20 at 60%1RM in barbell bench press). A portable gas analyzer was used to assess energy expenditure and maximal oxygen uptake during the experimental protocols. Blood lactate levels were assessed at baseline and 1, 3, and 5 minutes after the training session. There were no differences for total training volume ( p = 0.999). Post hoc comparisons revealed that bi-set elicited higher aerobic energy expenditure ( p = 0.003 vs. drop-set; p < 0.001 vs. traditional RT) and aerobic oxygen consumption ( p = 0.034 vs. drop-set; p < 0.001 vs. traditional RT) than other RT schemes. There were no differences regarding anaerobic EE between-conditions ( p > 0.05). There was a main effect of time and condition for blood lactate levels ( p < 0.001). Post hoc comparisons revealed that drop-set training elicited higher blood lactate levels than traditional RT ( p = 0.009). The results suggest that RT techniques may have a potential role in optimizing metabolic responses in resistance-trained males.

Cognitive impairments are a prevalent consequence of acquired brain injury, dementia, and age-related cognitive decline, hampering individuals' daily functioning and independence, with significant societal and economic implications. While neurorehabilitation represents a promising avenue for addressing these deficits, traditional rehabilitation approaches face notable limitations. First, they lack adaptability, offering one-size-fits-all solutions that may not effectively meet each patient's unique needs. Furthermore, the resource-intensive nature of these interventions, often confined to clinical settings, poses barriers to widespread, cost-effective, and sustained implementation, resulting in suboptimal outcomes in terms of intervention adaptability, intensity, and duration. In response to these challenges, this paper introduces NeuroAIreh@b, an innovative cognitive profiling and training methodology that uses an AI-driven framework to optimize neurorehabilitation prescription. NeuroAIreh@b effectively bridges the gap between neuropsychological assessment and computational modeling, thereby affording highly personalized and adaptive neurorehabilitation sessions. This approach also leverages virtual reality-based simulations of daily living activities to enhance ecological validity and efficacy. The feasibility of NeuroAIreh@b has already been demonstrated through a clinical study with stroke patients employing a tablet-based intervention. The NeuroAIreh@b methodology holds the potential for efficacy studies in large randomized controlled trials in the future., 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. The handling editor, TP is currently organizing a Research Topic with the author AF. The authors declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Faria, Almeida, Branco, Câmara, Cameirão, Ferreira, Moreira, Paulino, Rodrigues, Spinola, Vilar, Bermúdez i Badia, Simões and Fermé.)

In order to select for further development novel photosensitizers for photodynamic therapy in cutaneous disorders, three unsymmetrical porphyrins, namely 5-(4-hydroxy-3-methoxyphenyl)-10,15,20-tris-(4-acetoxy-3-methoxyphenyl) porphyrin (P2.2), 5-(2-hydroxy-5-methoxyphenyl)-10,15,20-tris-(4-carboxymethylphenyl) porphyrin (P3.2), and 5-(2,4-dihydroxyphenyl)-10,15,20-tris-(4-acetoxy-3-methoxyphenyl) porphyrin (P4.2), along with their fully symmetrical counterparts 5,10,15,20-tetrakis-(4-acetoxy-3-methoxyphenyl) porphyrin (P2.1) and 5,10,15,20-tetrakis-(4-carboxymethylphenyl) porphyrin (P3.1) were comparatively evaluated. The absorption and fluorescence properties, as well as atomic force microscopy measurements were performed to evaluate the photophysical characteristics as well as morphological and textural properties of the mentioned porphyrins. The cellular uptake of compounds and the effect of photodynamic therapy on the viability, proliferation, and necrosis of human HaCaT keratinocytes, human Hs27 skin fibroblasts, human skin SCL II squamous cell carcinoma, and B16F10 melanoma cells were assessed in vitro, in correlation with the structural and photophysical properties of the investigated porphyrins, and with the predictions regarding diffusion through cell membranes and ADMET properties. All samples were found to be isotropic and self-similar, with slightly different degrees of aggregability, had a relatively low predicted toxicity (class V), and a predicted long half-life after systemic administration. The in vitro study performed on non-malignant and malignant skin-relevant cells highlighted that the asymmetric P2.2 porphyrin qualified among the five investigated porphyrins to be a promising photosensitizer candidate for PDT in skin disorders. P2.2 was shown to accumulate well within cells, and induced by PDT a massive decrease in the number of metabolically active skin cells, partly due to cell death by necrosis. P2.2 had in this respect a better behavior than the symmetric P.2.1 compound and the related asymmetric compound P4.2. The strong action of P2.2-mediated PDT on normal skin cells might be an important drawback for further development of this compound. Meanwhile, the P3.1 and P3.2 compounds were not able to accumulate well in skin cells, and did not elicit significant PDT in vitro. Taken together, our experiments suggest that P2.2 can be a promising candidate for the development of novel photosensitizers for PDT in skin disorders.

The shortage of deceased donor organs has prompted the development of alternative liver grafts for transplantation. Living-donor liver transplantation (LDLT) has emerged as a viable option, expanding the donor pool and enabling timely transplantation with favorable graft function and improved long-term outcomes. An accurate evaluation of the donor liver's volumetry (LV) and anatomical study is crucial to ensure adequate future liver remnant, graft volume and precise liver resection. Thus, ensuring donor safety and an appropriate graft-to-recipient weight ratio. Manual LV (MLV) using computed tomography has traditionally been considered the gold standard for assessing liver volume. However, the method has been limited by cost, subjectivity, and variability. Automated LV techniques employing advanced segmentation algorithms offer improved reproducibility, reduced variability, and enhanced efficiency compared to manual measurements. However, the accuracy of automated LV requires further investigation. The study provides a comprehensive review of traditional and emerging LV methods, including semi-automated image processing, automated LV techniques, and machine learning-based approaches. Additionally, the study discusses the respective strengths and weaknesses of each of the aforementioned techniques. The use of artificial intelligence (AI) technologies, including machine learning and deep learning, is expected to become a routine part of surgical planning in the near future. The implementation of AI is expected to enable faster and more accurate image study interpretations, improve workflow efficiency, and enhance the safety, speed, and cost-effectiveness of the procedures. Accurate preoperative assessment of the liver plays a crucial role in ensuring safe donor selection and improved outcomes in LDLT. MLV has inherent limitations that have led to the adoption of semi-automated and automated software solutions. Moreover, AI has tremendous potential for LV and segmentation; however, its widespread use is hindered by cost and availability. Therefore, the integration of multiple specialties is necessary to embrace technology and explore its possibilities, ranging from patient counseling to intraoperative decision-making through automation and AI., Competing Interests: Conflict-of-interest statement: Authors declare no conflict of interests for this article., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Lentinula edodes , commonly known as shiitake mushroom, is renowned for its potential health advantages. This research delves into the often-overlooked by-product of shiitake cultivation, namely spent mushroom substrate (SMS), to explore its nutraceutical properties. The SMS samples were collected and subjected to different extraction methods, namely short or long agitation, and ultrasound-assisted extractions using different temperatures and distilled water or a 50% ( v / v ) ethanol as solvents. The extracts were tested for phenolic content (total phenols, ortho -diphenols, and flavonoids), antioxidant capacity (DPPH, 2,2-diphenyl-1 picrylhydrazyl; ABTS, 2,2'-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid; and FRAP, ferric reducing antioxidant power), and antibacterial activity. The different extraction methods revealed substantial variations ( p < 0.05) in phenolic composition and antioxidant capacity. The highest phenolic content and antioxidant capacity were achieved using 24 h extraction, agitation, 50 °C, and ethanol as the solvent. Furthermore, the extracted compounds displayed antibacterial activity in specific tested bacterial strains. This study highlights the nutraceutical potential of L. edodes ' SMS, positioning it as a valuable dietary supplement for animal nutrition, with emphasis on its prebiotic properties. Hence, this research unveils the promising health benefits of SMS in both human and animal nutrition.

This report presents the case of a 47-year-old male patient who worked as a mathematics teacher and experienced the sudden onset of disorientation, aphasia, and acalculia during an online class. The current study reveals the first documented case of HIV and progressive multifocal leukoencephalopathy with the detection of SARS-CoV-2 and human polyomavirus 2 (previously known as John Cunningham virus) in the cerebrospinal fluid. Furthermore, serum analysis revealed elevated concentrations of interleukin (IL)-6, IL-17, and IL-8, which are potential factors known to reduce the expression of tight junctions and adhesion molecules in the extracellular matrix, thereby affecting the permeability of the blood-brain barrier. Finally, the study discusses whether SARS-CoV-2 triggers or exacerbates progressive multifocal leukoencephalopathy., Competing Interests: Declarations of competing interest The authors have no competing interests to declare., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The purpose of this study was to determine the effect of exercise intensity on the proportion and rate of carbohydrate oxidation and glucoregulatory hormone responses during recovery from exercise. Six physically active participants completed 1 hr of low-intensity (LI; 50% lactate threshold) or moderate-intensity (MI; 100% lactate threshold) exercise on separate days following a randomized counterbalanced design. During exercise and for 6 hr of recovery, samples of expired air were collected to determine oxygen consumption, respiratory exchange ratio, energy expenditure, and substrate oxidation rates. Blood samples were also collected to measure glucoregulatory hormones (catecholamines, GH) and metabolites (glucose, free fatty acids, lactate, pH, and bicarbonate). During exercise, respiratory exchange ratio, energy expenditure, and the proportion and rate of carbohydrate (CHO) oxidation were higher during MI compared with LI. However, during recovery from MI, respiratory exchange ratio and the proportion and rate of CHO oxidation were lower than preexercise levels and corresponding LI. During exercise and early recovery, catecholamines and growth hormone were higher in MI than LI, and there was a trend for higher levels of free fatty acids in the early recovery from MI compared with LI. In summary, CHO oxidation during exercise increases with exercise intensity but there is a preference for CHO sparing (and fat oxidation) during recovery from MI exercise compared with LI exercise. This exercise intensity-dependent shift in substrate oxidation during recovery is explained, in part, by the pattern of change of key glucoregulatory hormones including catecholamines and growth hormone and plasma fatty acid concentrations.

Zika virus (ZIKV) is a flavivirus transmitted by infected Aedes genus mosquitoes. An infected person may be asymptomatic or present symptoms such as fever, arthralgia, and in pregnancy it may lead to neurological disorders in the fetus, such as microcephaly. Based on the high dissemination potential of ZIVK and its similar antigen composition to other arboviruses, new approaches for selective virus detection are urgently needed. This work reports the development of an electrochemical immunoassay for detection of anti-ZIKV antibodies, using magnetic beads functionalized with recombinant protein derived from the non-structural protein 1 (ΔNS1-ZIKV) and anti-IgG antibodies labeled with horseradish peroxidase (HRP) enzyme. The magneto-immunoassay uses disposable microfluidic devices for detection of anti-ZIKV in serum samples. A linear response was obtained for a wide concentration range from 0.01 to 9.80 × 10 5  pg mL -1 (r 2  = 0.982), with a limit of detection of 0.48 pg mL -1 . The proposed immunoassay proved to be highly efficient for the detection of anti-ZIKV antibodies in serum, offering promising perspectives for the development of fast, simple, and affordable point-of-care diagnosis devices for ZIKV., 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 © 2023 Elsevier B.V. All rights reserved.)

n-Alkane and long-chain alcohol (LCOH) profiles of needle cuticular waxes of nine provenances of three Pinus species (P. taeda. P. pinaster and P. pinea) were determined and their chemotaxonomic importance was studied. n-Alkanes concentrations were very low in all Pinus spp. A lack of ability of these compounds to differentiate Pinus spp. and their provenances was observed. LCOH concentrations were much higher, being nonacosan-10-ol (10-C 29 -OH) the most abundant one in all Pinus spp. Total LCOH concentrations varied (P<0.001) between Pinus spp. with P. taeda presenting the highest (P<0.05) value and P. pinea the lowest one. Differences in LCOH profiles were large (P<0.001) and allowed separation of Pinus spp. in the Principal Component Analysis (PCA). Although a noticeable separation of individuals was not observed. cluster analysis on LCOH concentrations allowed a clear distinction between species, indicating their potential to be used as chemotaxonomic markers to differentiate provenances of different Pinus spp., (© 2023 The Authors. Chemistry & Biodiversity published by Wiley-VHCA AG, Zurich, Switzerland.)

This paper presents an efficient and reliable approach to study the low-velocity impact response of woven composite shells using 3D finite element models that account for the physical intralaminar and interlaminar progressive damage. The authors' previous work on the experimental assessment of the effect of thickness on the impact response of semicylindrical composite laminated shells served as the basis for this paper. Therefore, the finite element models were put to the test in comparison to the experimental findings. A good agreement was obtained between the numerical predictions and experimental data for the load and energy histories as well as for the maximum impact load, maximum displacement, and contact time. The use of the mass-scaling technique was successfully implemented, reducing considerably the computing cost of the solutions. The maximum load, maximum displacement, and contact time are negligibly affected by the choice of finite element mesh discretization. However, it has an impact on the initiation and progression of interlaminar damage. Therefore, to accurately compute delamination, its correct definition is of upmost importance. The validation of these finite element models opens the possibility for further numerical studies on of woven composite shells and enables shortening the time and expenses associated with the experimental testing.

The ability to predict the maintenance needs of machines is generating increasing interest in a wide range of industries as it contributes to diminishing machine downtime and costs while increasing efficiency when compared to traditional maintenance approaches. Predictive maintenance (PdM) methods, based on state-of-the-art Internet of Things (IoT) systems and Artificial Intelligence (AI) techniques, are heavily dependent on data to create analytical models capable of identifying certain patterns which can represent a malfunction or deterioration in the monitored machines. Therefore, a realistic and representative dataset is paramount for creating, training, and validating PdM techniques. This paper introduces a new dataset, which integrates real-world data from home appliances, such as refrigerators and washing machines, suitable for the development and testing of PdM algorithms. The data was collected on various home appliances at a repair center and included readings of electrical current and vibration at low (1 Hz) and high (2048 Hz) sampling frequencies. The dataset samples are filtered and tagged with both normal and malfunction types. An extracted features dataset, corresponding to the collected working cycles is also made available. This dataset could benefit research and development of AI systems for home appliances' predictive maintenance tasks and outlier detection analysis. The dataset can also be repurposed for smart-grid or smart-home applications, predicting the consumption patterns of such home appliances., Competing Interests: 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. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:, (© 2023 The Author(s).)

Introduction: In the present study we evaluated the features of different recombinant forms of Zika virus (ZIKV) proteins produced in either bacterial ( Eschericha coli ) or insect cells ( Drosophila melanogaster ). The ZIKV-envelope glycoprotein (E ZIKV ) is responsible for virus entry into host cells, is the main target of neutralizing antibodies and has been used as a target antigen either for serological tests or for the development of subunit vaccines. The E ZIKV is composed of three structural and functional domains (EDI, EDII, and EDIII), which share extensive sequence conservation with the corresponding counterparts expressed by other flaviviruses, particularly the different dengue virus (DENV) subtypes., Methods: In this study, we carried out a systematic comparison of the antigenicity and immunogenicity of recombinant EZIKV, EDI/IIZIKV and EDIIIZIKV produced in E. coli BL21 and Drosophila S2 cells. For the antigenicity analysis we collected 88 serum samples from ZIKV-infected participants and 57 serum samples from DENV-infected. For immunogenicity, C57BL/6 mice were immunized with two doses of EZIKV, EDI/IIZIKV and EDIIIZIKV produced in E. coli BL21 and Drosophila S2 cells to evaluate humoral and cellular immune response. In addition, AG129 mice were immunized with EZIKV and then challenge with ZIKV., Results: Testing of samples collected from ZIKV-infected and DENV-infected participants demonstrated that the EZIKV and EDIIIZIKV produced in BL21 cells presented better sensitivity and specificity compared to proteins produced in S2 cells. In vivo analyses were carried out with C57BL/6 mice and the results indicated that, despite similar immunogenicity, antigens produced in S2 cells, particularly EZIKV and EDIIIZIKV, induced higher ZIKV-neutralizing antibody levels in vaccinated mice. In addition, immunization with EZIKV expressed in S2 cells delayed the onset of symptoms and increased survival rates in immunocompromised mice. All recombinant antigens, either produced in bacteria or insect cells, induced antigen-specific CD4+ and CD8+ T cell responses., Conclusion: In conclusion, the present study highlights the differences in antigenicity and immunogenicity of recombinant ZIKV antigens produced in two heterologous protein expression systems., 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 © 2023 Lunardelli, Almeida, Apostolico, Rezende, Yamamoto, Pereira, Bueno, Pereira, Carvalho, Slhessarenko, de Souza Ferreira, Boscardin and Rosa.)

Objective: To compare the results of different modalities of physical exercises on the sarcopenia diagnostic criteria in older people., Methods: Systematic review of systematic reviews. Search strategy included older people and sarcopenia MeSh, performed at mainly databases. Selected studies include older adults, submitted to physical training (Intervention Group: IG) compared to control groups (CG). Quantitative analyses with the inverse variance statistic method (random effects). The effect measures mean difference. Heterogeneity measured with Q-Test., Results: 494 systematic reviews found. After screening, 5 were included (48 papers. n=3,877). Mean age: 74.02±6.1. 73.44% female. Mean interventions duration: 17.38 weeks (average: 2.56 weekly sessions). AMSTAR and PRISMA showed high methodological quality. Meta-analyses compared results of resistance training interventions (RTA) with other than resistance (Non-resistance Training interventions: NRTA). Handgrip strength, skeletal muscle mass (SMM) and gait speed showed statistically significant differences (SSD) favorable to IG. In chair stand test, RTA showed SSD favorable to the IG, and NRTA to CG. The timed-up-and-go do not showed SSD., Discussion: The SMM and strength showed better results in RTA, although the confidence intervals (CI) overlap. Both valences can be trained with similar volume and training intensity, which can modify muscle volume and strength. Physical performance obtained better results in NRTA, even with CI overlap. For severely sarcopenic, training including more than one valence may be best. In sarcopenia diagnosis most studies do not take into account the consensuses of standardization, making hard the larger groups analysis., Conclusion: Being part of any training program can be beneficial for sarcopenia in older people, with resistance training better for strength and SMM, and mixed modalities for physical performance., Competing Interests: Declaration of Competing Interest The authors of this article declare that there is no conflict of interest or any kind of founding for their realization., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Despite specialists' efforts to find the best solutions for cancer diagnosis and therapy, this pathology remains the biggest health threat in the world. Global statistics concerning deaths associated with cancer are alarming; therefore, it is necessary to intensify interdisciplinary research in order to identify efficient strategies for cancer diagnosis and therapy, by using new molecules with optimal therapeutic potential and minimal adverse effects. This review focuses on studies of porphyrin macrocycles with regard to their structural and spectral profiles relevant to their applicability in efficient cancer diagnosis and therapy. Furthermore, we present a critical overview of the main commercial formulations, followed by short descriptions of some strategies approached in the development of third-generation photosensitizers.

Objective: Individual unsupervised home-based exercise programs can enhance muscle strength, physical function, gait, and balance in older adults. However, the effectiveness of such programs may be limited by the lack of supervision. This study aims to verify the effectiveness of individual unsupervised home-based programs, compare the effects of individual unsupervised home-based to supervised programs, and verify the influence of supervision over individual unsupervised home-based programs on the physical function of older adults., Methods: A systematic literature search was performed in four electronic databases, and the trials involved randomized controlled comparing the home-based programs to supervised, control groups, or home-based + supervised evaluating the muscle strength, physical function, gait, and balance in older adults., Results: Eleven studies met the inclusion criteria. The meta-analysis revealed no differences between home-based program versus supervised program in gait, mobility, and balance, revealing a trend of significance to supervised program on strength (standardized mean difference [SMD] = 0.27, p = .05). The analysis revealed effects in mobility (SMD = 0.40, p = .003), balance (SMD = 0.58, p = .0002), and muscle strength (SMD = 0.36, p = .02) favoring home-based program versus control group. Significant effects between home-based program versus home-based + supervised program were observed in balance (SMD = 0.74, p = .002) and muscle strength (SMD = 0.58, p = .01) in favor of home-based + supervised program., Conclusion: Home-based programs effectively improve older adults' physical function compared with control groups. However, supervised programs were more effective for muscle strength.

Seed hydropriming or nutripriming has been used for wheat biofortification. Previously, the untreated S1 offspring of bread wheat S0 seeds hydro- and nutriprimed with FeSO 4 .7H 2 O and/or ZnSO 4 .7H 2 O showed improved yield relative to the offspring of untreated S0 seeds. We hypothesize that such improvement would have its origin in the higher quality of S1 seeds resulting from plants whose seeds were primed. In this work, we characterised biochemically the whole-wheat flour of unprimed S1 offspring whose S0 seeds were hydro- and nutriprimed with Fe and/or Zn and compared it to the offspring of untreated S0 seeds (control). We identified and quantified 16 free amino acids and five soluble sugars per offspring using high-performance liquid chromatography and the Association of Official Analytical Chemists (AOAC) methods. The most abundant amino acids were glutamic acid and glutamine, proline, and glycine, presenting their highest contents in the offspring of seeds nutriprimed with 8 ppm Zn (0.351 mmol∙g -1 ), 8 ppm Fe + 8 ppm Zn (0.199 mmol∙g -1 ), and (0.135 mmol∙g -1 ), respectively. The highest contents of glucose (1.91 mg∙g -1 sample), ash (24.90 g∙kg -1 dry matter, DM), and crude protein (209.70 g∙kg -1 DM) were presented by the offspring resulting from 4 ppm Fe + 4 ppm Zn, 8 ppm Zn, and 8 ppm Fe + 8 ppm Zn, respectively. The highest total starch content (630.10 g∙kg -1 DM) was detected in the offspring of seeds soaked in 8 ppm Fe. The nutritional value of the flour of the S1 offspring resulting from nutripriming was significantly higher than the control. Overall, the novelty of our research is that seed priming can improve the quality of the wheat grain and flour, at least till the first offspring, without the need to repeat the presowing treatment. Beyond the study of subsequent generations, the unravelling of transgenerational mechanisms underlying the biochemical improvement of the offspring is approached.

The effects of acute caffeine supplementation on muscular strength remain unclear. We examined the effects of two different doses of caffeine on muscle strength and calcium in plasma compared to placebo using a crossover, randomized, double-blind, placebo-controlled design. Twenty-one (n = 21) recreationally resistance-trained participants were randomly assigned into three experimental conditions: 6 mg·kg bw−1 of caffeine (CF6); 8 mg·kg bw−1 of caffeine (CF8); or placebo (PLA), with a 7-day washout period between conditions. Muscular strength assessments were made for both upper (bench press) and lower body muscles (squat and deadlift). Calcium release in plasma was measured on five different occasions. Bench press (CF8: 100.1 ± 1.9 kg; PLA: 94.2 ± 2.5 kg), deadlift (CF8: 132.8 ± 3.5 kg; PLA: 120.7 ± 5.7 kg), and squat (CF8: 130.1 ± 4.9 kg; PLA 119.4 ± 5.4 kg) strength were all significantly (p < 0.001) improved in CF8 compared to PLA. Calcium release in plasma was significantly increased in CF8, whereas no changes were observed in CF6 or PLA. Overall, 8 mg·kg bw−1 of caffeine appears to be an effective dose to optimize upper and lower body muscular strength and calcium release in recreationally trained participants.

n-Alkanes and long-chain alcohols (LCOH) have been used as faecal markers to assess the feeding behaviour of both wild and domestic herbivore species. However, their chemical analysis is time-consuming and expensive, making it necessary to develop more expeditious methodologies to evaluate concentrations of these markers. This work aimed to evaluate the use of Fourier Transform Infrared Spectroscopy (FTIR) technology in the near infrared (NIR) and mid infrared (MIR) intervals, for the determination of n-alkane and LCOH concentrations of different plant species and faecal samples of domestic herbivores. Spectra of 33 feed samples, namely L. perenne, T. repens, U. gallii, short heathers (mixture of Erica spp. and Calluna vulgaris), improved pasture grasses (mixture of L. perenne and A. capillaris), heath grasses (mixture of P. longifolium and A. curtissii), improved pasture species (mixture of L. perenne, T. repens and A. capillaris) and herbaceous species (mixture of all herbaceous species found in the plot)) and 181 faecal samples (cattle and horses) were recorded. In order to develop calibrations for the prediction of n-alkanes and LCOH concentrations, partial least squares (PLS) regression was used. Regarding the models developed for plant species, the best results were observed for the calibrations using NIR. The best external validation coefficients of determination (R 2 v) obtained were 0.90 and 0.79 for LCOH and n-alkanes, respectively. For faecal samples, in the NIR interval, results indicate similar external validation predictions (R 2 v) for both animal species (0.64). On the contrary, in the MIR interval, differences between cattle (0.70) and horses (0.57) faecal samples in R 2 v were observed. Regarding the models created for both animal species faeces, LCOH (C 26 -OH and C 30 -OH concentrations ranging from 713.3 to 4451.9 mg/kg DM, respectively; R 2 v values ranging from 0.72 to 0.95) and n-alkanes (C31 and C33 concentrations ranging from 112.8 to 643.2 mg/kg DM, respectively; R 2 v values ranging from 0.19 to 0.90) present in higher concentrations tended to be those with better estimates. Results obtained suggest that the selection of the technique to be used may depend on the type of matrix, being the homogeneity of the matrices one of the most important factors for its success. In order to improve the accuracy and robustness of the models created for the estimation of the concentrations of these markers using these methodologies, the database (greater variability) used for the calibrations of these models must be increased., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Arouquesa is an autochthonous bovine breed known for its Arouquesa PDO beef labeling. There are several production systems under the definition of PDO labeling. This study aimed to compare the effect of different production systems on carcass and meat traits for the Arouquesa breed. Two trials differing in diet and weaning age were conducted. The first trial included a TF group fed the traditional way and weaned at 9 months; a TF + S1 group, equal to TF, but with a starter supplement; and finally, a S1 + S2 group that was fed with a starter and a growth supplement and weaned at 5 months. The second trial was composed of a TF + S3 group fed like the TF + S1 group but reared until 12 months with a finishing supplement, and finally, the S3 group fed like the S1 + S2 group but reared until 12 months. In the first trial, the TF + S1 and S1 + S2 groups showed higher final live weight and average daily gain. In the second trial, we observed differences in the subcutaneous fat that was higher in the S3 group. Regarding meat traits, we observed differences in exudative and cooking losses in the first trial. In general, supplementation improved meat production without affecting meat quality parameters.

Sexual transmission of Zika virus (ZIKV), an important arbovirus, and the virus persistence in semen raise several questions about how and where it circulates in the male reproductive system (MRS). Several studies reported detection of the virus in testes, epididymis, and prostate at 5 days post-infection (dpi) or more in animal models. In the present study, we investigated the interactions of ZIKV with mouse MRS using the AG129 strain, a ZIKV permissive immunodeficient mouse strain, at two dpi. Viral RNA was detected in blood, testes, epididymis, and prostatic complexes (prostate and seminal vesicles). Immunohistochemical (IHC) analyses, based on the envelope protein, showed an early infection in organs of MRS since ZIKV positive antigens were detected in cells within or surrounding blood vessels, Sertoli, and germ cells in testes and epithelial cells in epididymis and prostate. Positive antigens for NS5 protein, the virus RNA-dependent RNA polymerase, were also detected by IHC in these organs and circulating leukocytes, suggesting that the virus replicates in these sites as early as 2 days post-infection. Analysis of the early stages of ZIKV infection in MRS may improve the current knowledge about this issue and contribute to the development of therapies directed to the infection at this site., (© 2022. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.)

Objective: Endovascular aortic aneurysm repair (EVAR) has become the standard of care for abdominal aortic aneurysms (AAAs) in the modern era. Although numerous devices exist for standard infrarenal AAA repair, fenestrated EVAR (fEVAR) offers a minimally invasive alternative to traditional open repair for patients with a short infrarenal neck. Over time, aortic neck dilation can occur, leading to loss of the proximal seal, endoleaks, and AAA sac growth. In the present study, we analyzed aortic remodeling after EVAR vs fEVAR and further evaluated whether fEVAR confers a benefit in terms of sac shrinkage., Methods: A retrospective review of prospectively collected data from 120 patients who had undergone EVAR was performed. Of these 120 patients, 30 had been treated with fEVAR (Zenith fenestrated; Cook Medical Inc, Bloomington, IN) and 90 patients were treated with EVAR devices (30 each with Endurant [Medtronic, Dublin, Ireland], Excluder [W.L. Gore & Associates, Flagstaff, AZ], and Zenith [Cook Medical Inc]). The demographic data were recorded. Also, anatomic measurements were performed for each patient preoperatively, at 30 days postoperatively, and at the longest follow-up point using three-dimensional reconstruction software., Results: No significant differences were found in demographic data between the four groups. fEVAR had been used more often in aortas with large necks and irregular morphology (P = .004). At the longest follow-up, the suprarenal aorta encompassing 5, 10, and 15 mm above the lowest renal artery had dilated the most for the fEVAR group vs all EVAR groups. However, the infrarenal segment had tended to increase the least, or to even have regressed, for fEVAR compared with all three EVAR groups and was associated with the overall greatest proportion of sac shrinkage for the fEVAR group compared with the Medtronic, Gore, and Cook devices (-13.90% vs -5.75% vs -2.31% vs -4.68%, respectively; P = .025)., Conclusions: Compared with EVAR, the patients treated with fEVAR had experienced greater suprarenal dilation over time, consistent with an overall greater burden of disease in the proximal native aorta. However, the infrarenal segment had dilated significantly less over time in the fEVAR group compared with all three EVAR groups, suggesting that fEVAR might stabilize the infrarenal neck, promoting positive sac remodeling, which was evidenced by the greatest degree of decrease in the largest AAA diameter in the fEVAR group., (Copyright © 2022 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

Ultrasound (US) imaging despite being safe, cost-effective, and radiation-free, presents poor quality and artifacts, requiring specific medical training in US probe handling and image evaluation. The use of simulators to train physicians has proven its effectiveness, but most of them require specific facilities and hardware. In the last few years, augmented reality has gained relevance to simulate real scenarios which can avoid large setups and broaden medical training to more physicians. This work proposes a new framework for the training of US images acquisition. It consists of a custom-made application that runs on AR glasses (Microsoft HoloLens 2) and interacts with a US simulator application. The AR glasses track the orientation of a QR code mounted on a US probe, communicating its orientation with the US simulator application. This allows the physician to interact with a US probe seeing in real-time the US image in the physician's field of view. The QR code tracking assessment of the AR glasses was conducted by measuring the orientation accuracy and precision when compared with the measures of an electromagnetic tracking device (i.e., NDI Aurora). The proposed solution presented a good performance, rendering the US image in AR glasses with real-time feedback. Moreover, it can track the QR code on the US probe with an accuracy of 0.755°, and a precision of 0.018°. Overall, the proposed framework presents promising results and the use of AR glasses as a tracking device reached a good performance. Clinical Relevance- Simulation is a relevant tool to train physicians, especially in US imaging. AR glasses can broaden the training to less trained physicians by reducing the need for complex setups. This technology allows the implementation of a more natural user interface, which can be relevant in scenarios where good coordination between the eyes and hands of the physician is necessary (i.e., Biopsies).

Abstract: Zandona, BA, Ramos, RA, de Oliveira, CdS, McAnulty, SR, Ferreira, LHB, Smolarek, AC, Enes, AAN, Urbinati, KMdSS, Aragon, AA, Schoenfeld, BJ, and de Souza Junior, TP. Reduced Dose of Beta-Alanine Is Sufficient to Maintain Performance in Repeated Sprints. J Strength Cond Res 36(6): 1636-1642, 2022-Beta-alanine (BA) supplementation has been shown to be effective in improving physical performance by increasing carnosine concentration. However, it is still necessary to know the effect of a maintenance dose on performance. Thus, this study aimed to investigate the effects of a maintenance dose of BA supplementation on performance. Forty-four anaerobically trained men with 23.9 ± 3.8 years of age, 176.0 ± 0.05 cm height, 81.2 ± 7.5 kg body mass, and 15.5 ± 2.9% of body fat performed a cycle ergometer test consisting of 4 sprints of 30 s with 4 minutes of active recovery. The study comprised 3 phases: (a) presupplementation, (b) supplementation with 6.4 g·d-1 BA or placebo, and (c) postsupplementation with a maintenance dose of 1.2 g·d-1 of BA or interruption of supplementation. Data were analyzed using generalized estimated equations with a priori 0.05 level of significance. The placebo group and interruption group presented a lower power (7.28 ± 0.66 and 7.71 ± 0.42 W·kg-1 vs. 8.04 ± 0.84 and 9.25 ± 1.18 W·kg-1, respectively; p < 0.05) during the third sprint in postsupplementation, whereas the maintenance group maintained the required power (7.47 ± 1.03 vs. 8.74 ± 1.07 W·kg-1; p > 0.05). The placebo group also presented higher percentage of fatigue (44.5% ± 12.3 and 44.8% ± 7.7 vs. 37.6 ± 7.2%; p = 0.021) and higher subjective perception of exertion (8.92 ± 0.90 vs. 8.00 ± 1.60; p = 0.028). Therefore, the maintenance dose of 1.2 g·d-1 BA was effective in maintaining performance, whereas a reduction in performance was observed after supplementation interruption., (Copyright © 2020 National Strength and Conditioning Association.)

Objective: To translate and perform the cross-cultural adaptation of the Young Spine Questionnaire (YSQ) into Portuguese, and to assess its reliability., Method: Translation and cross-cultural adaptations were conducted according to accepted international standards. A preliminary version underwent pilot-testing with 32 children (11-14 years), equally divided by gender and age. Children were asked to rate each question in terms of clarity and comprehensibility, and to provide general feedback regarding the questionnaire. The final version of the questionnaire was approved by a committee consisting of experts from various fields. Test-retest reliability was assessed on 58 children using Cohen's and Fleiss' Kappa., Results: Translation and cross-cultural adaptation of the YSQ only resulted in minor changes and the children rated all questions as "clear and understandable" in the pilot test, without gender or age differences being detected. Test-retest data was collected with a mean interval of 13 days. Reliability scores ranged from 0.56-0.97, equivalent to "moderate" to "almost perfect" agreement. Most questions (84%) had "substantial" or "almost perfect" agreement., Conclusion: The translation and cross-cultural adaptation of YSQ into Portuguese was successfully performed. This questionnaire was also shown to be reliable, supporting its future use in research projects.

Introduction: Driver behavior related to overtaking maneuvers, which are considered a major safety risk determinant on two-lane two-way highway in low- and middle-income countries (LMIC), are an important subject of further analysis. This study evaluates safety risk in terms of nature and severity of probable conflicts during overtaking maneuvers on a bi-directional undivided two-lane highway in a heterogeneous traffic environment of a low-income country. Nature and severity of probable conflicts were defined with the application of surrogate safety proximity indicators in real-world naturalistic driving environment., Method: A risk severity model for overtaking maneuver was developed to better understand the significant factors associated with the probability of conflict and its severity during overtaking maneuver using discrete choice modeling approaches. The relevance of three alternate discrete outcome frameworks, namely multinomial logit (ML), ordered probit (OP), and mixed logit (MXL) models are addressed. The best fitted model is identified and estimated. The impact of the significant attributes was also evaluated. The study collected data from a section of two-lane highway in Bangladesh using naturalistic driving from both observational and computer vision techniques. A total of 46 explanatory variables related to overtaking maneuver are assessed., Results: Speed differential between overtaking and overtaken vehicles have a significant impact on the probability of severe conflicts. Moreover, the presence of a bus as an overtaking vehicle was found to contribute significantly to the severity of conflicts., Conclusions: The study makes substantial research contributions related to overtaking behavior and safety risk evaluation during overtaking in mixed traffic environment in low-income countries. The results can be used as a proactive tool for the evaluation of overtaking maneuvers and associated safety risk, and making policy decisions reducing safety risk during overtaking maneuver as well as overall safety, while acknowledging the limited resources and facilities in low-income countries., (Copyright © 2021 National Safety Council and Elsevier Ltd. All rights reserved.)

Aging is associated with reductions in muscle and bone mass and brain function, which may be counteracted by several lifestyle factors, of which exercise appears to be most beneficial. However, less than 20% of older adults (> 55 years of age) adhere to performing the recommended amount of resistance training (≥ 2 days/week) and less than 12% regularly meet the aerobic exercise guidelines (≥ 150 min/week of moderate to vigorous intensity aerobic exercise) required to achieve significant health benefits. Therefore, from a healthy aging and clinical perspective, it is important to determine whether other lifestyle interventions (independent of exercise) can have beneficial effects on aging muscle quality and quantity, bone strength, and brain function. Creatine, a nitrogen containing organic compound found in all cells of the body, has the potential to have favorable effects on muscle, bone, and brain health (independent of exercise) in older adults. The purpose of this narrative review is to examine and summarize the small body of research investigating the effects of creatine supplementation alone on measures of muscle mass and performance, bone mineral and strength, and indices of brain health in older adults.

Sarcopenia is one of the main issues associated with the process of aging. Characterized by muscle mass loss, it is triggered by several conditions, including sedentary habits and negative net protein balance. According to World Health Organization, it is expected a 38% increase in older individuals by 2025. Therefore, it is noteworthy to establish recommendations to prevent sarcopenia and several events and comorbidities associated with this health issue condition. In this review, we discuss the role of these factors, prevention strategies, and recommendations, with a focus on protein intake and exercise.

Background: The gold-standard treatment for acute exacerbation of chronic obstructive pulmonary disease (ae-COPD) is non-invasive ventilation (NIV). However, NIV failures may be observed, and invasive mechanical ventilation (IMV) is required. Extracorporeal CO₂ removal (ECCO₂R) devices can be an alternative to intubation. The aim of the study was to assess ECCO₂R effectiveness and safety., Methods: Patients with consecutive ae-COPD who experienced NIV failure were retrospectively assessed over two periods of time: before and after ECCO₂R device implementation in our ICU in 2015 (Xenios AG)., Results: Both groups (ECCO₂R: n=26, control group: n=25) were comparable at baseline, except for BMI, which was significantly higher in the ECCO₂R group (30 kg/m² vs 25 kg/m²). pH and PaCO₂ significantly improved in both groups. The mean time on ECCO₂R was 5.4 days versus 27 days for IMV in the control group. Four patients required IMV in the ECCO₂R group, of whom three received IMV after ECCO₂R weaning. Seven major bleeding events were observed with ECCO₂R, but only three led to premature discontinuation of ECCO₂R. Eight cases of ventilator-associated pneumonia were observed in the control group. Mean time spent in the ICU and mean hospital stay in the ECCO₂R and control groups were, respectively, 18 vs 30 days, 29 vs 49 days, and the 90-day mortality rates were 15% vs 28%., Conclusions: ECCO₂R was associated with significant improvement of pH and PaCO₂ in patients with ae-COPD failing NIV therapy. It also led to avoiding intubation in 85% of cases, with low complication rates., Trial Registration Number: ClinicalTrials.gov, NCT04882410. Date of registration 12 May 2021, retrospectively registered.https://www.clinicaltrials.gov/ct2/show/NCT04882410., Competing Interests: Competing interests: Rita Serbouti, from Fresenius Medical Care France, Medical affairs, helped train staff in Extracorporeal CO2 Removal Device and contributed to proofreading this paper. No financial support from the industry was received., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Multicomponent physical exercise programs are a viable strategy for treating physical decline resulting from the aging process in older populations and can be applied in supervised and home-based modalities. However, the magnitude of the intervention effects in terms of physical function development may vary according to the modalities application due to different supervision degrees., Objective: This study aims to compare the effects of supervision in a multicomponent exercise program in different application modalities (supervised vs. home vs. supervised+home) in neuromuscular adaptations, muscle strength, gait, physical function, and quality of life, analyzing the differences between intensity, volume, and density of home and supervised sessions in community older adults., Methods: This protocol is a randomized controlled clinical trial with a sample of 66 older adults divided into three groups: supervised exercise (SUP = 22), home-based exercise (HB = 22), and supervised plus home-based exercise (SUP+HB = 22). The multicomponent exercise program will last 12 weeks, three times per week, for 60 min per session and include warm-up, balance, muscle-strengthening, gait, and flexibility exercises. The study's primary outcomes will be neuromuscular function, composed of the assessment of muscle isokinetic strength, muscle architecture, and neuromuscular electrical activation. The secondary outcome will be physical function, usual and maximum gait speed with and without dual-task, and quality of life. All outcomes will be assessed at baseline and post-intervention (week 12)., Conclusion: This study will be the first clinical trial to examine the effects of different supervision levels on home-based exercises compared to supervised protocols. The results of this study will be essentials for planning coherent and viable home-based programs for older adults., Trial Registration: Brazilian Registry of Clinical Trials. Number RBR- 7MZ2KR. https://apps.who.int/trialsearch/Trial2.aspx?TrialID=RBR-7mz2kr., Competing Interests: The authors have declared that no competing interests exist.

Objective: To describe the neurological and neurodevelopmental outcomes of children with Congenital Zika Syndrome (CZS) associated microcephaly beyond 2 years of age., Method: We followed children with CZS-associated microcephaly in an outpatient clinic in Salvador, Brazil. Neurological and neurodevelopmental assessments were performed using the Hammersmith Infant Neurological Examination (HINE) and Bayley Scales of Infant and Toddler Neurodevelopment (Bayley-III) respectively., Results: Of the 42 children included, 19 were male (45.2%); median (interquartile range) age at neurological evaluation was 28 (25-32) months, and 36 (85.7%) had severe microcephaly. HINE and Bayley-III results were completed for 35/42 (83.3%) and 33/42 (78.5%) children respectively. Bayley-III identified a severe developmental delay in 32/33 (97.0%) children while 1/33 (3.0%) had only a mild delay. In the multivariable analysis, we found that Bayley-III and HINE scores were correlated. Better HINE scores were associated with higher Bayley-III cognitive raw scores (β = 0.29; CI 95% = 0.02-0.57) and motor raw scores (β = 0.43; CI 95% = 0.04-0.82) after adjusting for head circumference, prematurity, and age at neurodevelopmental evaluation. Furthermore, we found that greater head circumference at follow up was associated with higher cognitive (β = 1.27; CI 95% = 0.01-2.53) and motor raw scores (β = 2.03; CI 95% = 0.25-3.81)., Conclusion: Children with CZS-associated microcephaly demonstrate severe neurodevelopmental delays and slower growth rates than their peers over time. Still, they have remarkably heterogeneous neurodevelopmental profiles according to neurological exam scores which correlate with their long-term outcomes. We found that HINE scores effectively captured the heterogeneity of neurological capabilities among these children and could be predictive of cognitive and motor development progress., Competing Interests: The authors have declared that no competing interests exist.

An unprecedented global health crisis has been caused by a new virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We performed experiments to test if a hypertonic saline solution was capable of inhibiting virus replication. Our data show that 1.2% NaCl inhibited virus replication by 90%, achieving 100% of inhibition at 1.5% in the nonhuman primate kidney cell line Vero, and 1.1% of NaCl was sufficient to inhibit the virus replication by 88% in human epithelial lung cell line Calu-3. Furthermore, our results indicate that the inhibition is due to an intracellular mechanism and not to the dissociation of the spike SARS-CoV-2 protein and its human receptor. NaCl depolarizes the plasma membrane causing a low energy state (high ADP/ATP concentration ratio) without impairing mitochondrial function, supposedly associated with the inhibition of the SARS-CoV-2 life cycle. Membrane depolarization and intracellular energy deprivation are possible mechanisms by which the hypertonic saline solution efficiently prevents virus replication in vitro assays., Competing Interests: The authors declare no competing financial interest., (© 2021 American Chemical Society.)

With the current increased incidence of cirrhosis, the demand for liver transplant continues to grow. Here, we performed a systematic review to assess the feasibility, safety, and long-term outcomes of reused liver grafts for expansion of the donor pool. Our search identified 19 studies, including 36 patients plus 1 patient from our own institution. Ten studies were single case reports, 4 were case series, 4 were letters to the editor, and 1 was a literature review and also included a case report. Our patient presented with intentional acetaminophen overdose, received a transplant from a brain dead donor, and was confirmed brain dead 12 days posttransplant. The second recipient, who had alcoholrelated liver disease cirrhosis, underwent orthotopic liver transplant with the reused liver and was discharged from the hospital after an uneventful postoperative course. Among the 19 studies, all donors had confirmed brain death and all transplants included the whole liver, except for 2 cases of auxiliary liver grafts (reduced liver transplant) and 1 case of extended right living-donor liver graft (donor and recipient being related sisters). Overall, among first recipients, the most frequent cause of liver disease was acetaminophen overdose followed by alcohol-related liver disease cirrhosis. There were 2 cases of retransplant. Among second recipients, hepatocellular carcinoma was the most frequent cause of liver disease followed by alcohol-related liver disease cirrhosis. We found that functional outcomes with these grafts were comparable to outcomes with grafts from conventional donors; in the absence of other contraindications, we suggest that, not only for liver transplant but for other organs, these reused grafts can be used for those awaiting transplantation. Because the ability to reuse grafts is an infrequent condition, it would be difficult to generally recommend this technique; however, on a case-by-case basis, this source could expand the donor pool.

Background: The objective of this study was to explore the usefulness of virtual models and three-dimensional (3D) printing technologies for planning complex non-congenital cardiovascular surgery., Methods: Between July 2018 and December 2019, adult patients with different cardiovascular structural diseases were included in a clinical protocol to explore the usefulness of Standard Tessellation Language (STL)-based virtual models and 3D printing for prospectively planning surgery. A qualitative descriptive analysis from the surgeon's viewpoint was done based on the characteristics, advantages and usefulness of 3D models for guiding, planning and simulating the surgical procedures., Results: A total of 14 custom 3D-printed heart and great vessel replicas with their corresponding 3D virtual models were created for preoperative surgical planning. Six of 14 models helped to redefine the surgical approach, 3 were useful to verify device delivery, while the rest did not change the surgical decision. In all open surgery cases, cardiac and vascular anatomy accuracy of virtual and physical 3D replicas was validated by direct visualisation of the organs during surgery. Printing was achieved through an external provider associated with the Hospital, who printed the final prototype in 5-7 days. Printed production cost was between 100 and 500 USD per model., Conclusions: In the current study, the selected 3D printed models presented different advantages (visual, tactile, and instrumental) over the traditional flat anatomical images when simulating and planning some complex types of surgery. Notwithstanding 3D printing advantages, STL-based virtual models were pre-printing useful tools when instrumentation on a physical replica was not required.

Resistance training (RT) is considered a viable strategy to enhance the autonomy and functionality of older populations. We randomized 49 older women (64.2 ± 3.8) into one of two groups: an intervention group (IG) ( n  = 29) that performed regimented RT or a nontraining control group (CG) ( n  = 20). The RT protocol was carried out three times a week for both the upper and lower limbs over a 12-week study period. A 30-second arm flexion test was used to test upper limb endurance and a 30-second chair stand test was used to analyze lower limb endurance. Dynamic balance was tested by a Y balance test normalized by leg length. A Soda Pop test was employed to analyze coordination. Results showed significant improvements in IG versus CG in both upper limb (19.50 ± 1.52 vs. 11.40 ± 2.87, p  = 0.001) and lower limb muscular endurance (14.90 ± 3.10 vs. 26.56 ± 3.17, p  = 0.001). Moreover, the training group showed superior improvements in anterior and posterolateral balance compared to CG (63.9% ± 3.1% to 70.2 ± 2.1 and 88.1 ± 3.9 to 94.2 ± 2.7 with p  = 0.001, respectively). There were no significant differences in coordination outcomes between groups. In conclusion, we demonstrate that RT is effective in developing muscular endurance and dynamic balance in postmenopausal women, but does not influence muscular coordination in the measures studied. Study registered in the Brazilian Registry Clinical Trials Registry (No. RBR-7MZ2KR).

The fact that the COVID-19 fatality rate varies by sex and age is poorly understood. Notably, the outcome of SARS-CoV-2 infections mostly depends on the control of cytokine storm and the increasingly recognized pathological role of uncontrolled neutrophil activation. Here, we used an integrative approach with publicly available RNA-Seq data sets of nasopharyngeal swabs and peripheral blood leukocytes from patients with SARS-CoV-2, according to sex and age. Female and young patients infected by SARS-CoV-2 exhibited a larger number of differentially expressed genes (DEGs) compared with male and elderly patients, indicating a stronger immune modulation. Among them, we found an association between upregulated cytokine/chemokine- and downregulated neutrophil-related DEGs. This was correlated with a closer relationship between female and young subjects, while the relationship between male and elderly patients was closer still. The association between these cytokine/chemokines and neutrophil DEGs is marked by a strongly correlated interferome network. Here, female patients exhibited reduced transcriptional levels of key proinflammatory/neutrophil-related genes, such as CXCL8 receptors (CXCR1 and CXCR2), IL-1β, S100A9, ITGAM, and DBNL, compared with male patients. These genes are well known to be protective against inflammatory damage. Therefore, our work suggests specific immune-regulatory pathways associated with sex and age of patients infected with SARS-CoV-2 and provides a possible association between inverse modulation of cytokine/chemokine and neutrophil transcriptional signatures.

Conversion efficiency as high as 80-100% and 50% selectivity for camphene and limonene was achieved with low production of polymeric byproducts (18-28%), easy recovery with a magnet and reuse for up to five cycles maintaining similar activity and distribution of products, using a new magnetically recyclable catalyst based on niobium oxide coated on superparamagnetic iron oxide nanoparticles (SPION) impregnated with phosphotungstic acid (HPW). The catalyst was demonstrated to be effective in the selective conversion of alpha and beta-pinenes into valuable terpenes, under ultrasonic probe activation and with toluene as solvent. A unique synergic effect between the components generating more active and selective catalytic sites was demonstrated, indicating that the SPION covered with 30 wt% of Nb 2 O 5 gives the best performance when impregnated with HPW as co-catalyst. The materials were fully characterized by XRD, EDX, XPS, TEM, BET, VSM and FTIR., Competing Interests: The authors declare no conflict of interest., (This journal is © The Royal Society of Chemistry.)

Caffeine is one of the most studied supplements in the world. Studies correlate its use to increased exercise performance in endurance activities, as well as its possible ergogenic effects for both intermittent and strength activities. Recent findings show that caffeine may increase or decrease exercise performance. These antagonist responses may occur even when using the same dosage and for individuals with the same characteristics, making it challenging to explain caffeine's impact and applicability. This review article provides an analytic look at studies involving the use of caffeine for human physical performance, and addresses factors that could influence the ergogenic effects of caffeine on different proposed activities. These factors subdivide into caffeine effects, daily habits, physiological factors, and genetic factors. Each variable has been focused on by discussions to research related to caffeine. A better understanding and control of these variables should be considered in future research into personalized nutritional strategies., 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 © 2020 Martins, Guilherme, Ferreira, de Souza-Junior and Lancha.)

Vascular Doppler ultrasound is a noninvasive method that can help in diagnostic and therapeutic planning in case of pedal arterial obstructive disease. The dorsalis pedis artery is the direct continuation of the anterior tibial artery and follows a straight course along the dorsum of the foot, leading medially to the first intermetatarsal space, where it gives off its terminal branches. The posterior tibial artery forks distal to the medial malleolus and gives rise to the lateral plantar and medial plantar arteries. The medial plantar artery has a smaller caliber and runs medially in the sole of the foot, while the lateral plantar artery is of larger caliber, following a lateral course in the plantar region and forming the deep plantar arch, which anastomoses with the dorsalis pedis artery via the deep plantar artery. The arteries of the foot can be assessed noninvasively with Doppler, providing an adequate level of anatomical detail., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed in Brazil in February 2020, the first cases were followed by an increase in the number of cases throughout the country, resulting in an important public health crisis that requires fast and coordinated responses., Objectives: The objective of this work is to describe the isolation and propagation properties of SARS-CoV-2 isolates from the first confirmed cases of coronavirus disease 2019 (COVID-19) in Brazil., Methods: After diagnosis in patients that returned from Italy to the São Paulo city in late February by RT-PCR, SARS-CoV-2 isolates were obtained in cell cultures and characterised by full genome sequencing, electron microscopy and in vitro replication properties., Findings: The virus isolate was recovered from nasopharyngeal specimen, propagated in Vero cells (E6, CCL-81 and hSLAM), with clear cytopathic effects, and characterised by full genome sequencing, electron microscopy and in vitro replication properties. Virus stocks - viable (titre 2.11 × 106 TCID50/mL, titre 1.5 × 106 PFUs/mL) and inactivated from isolate SARS.CoV2/SP02.2020.HIAE.Br were prepared and set available to the public health authorities and the scientific community in Brazil and abroad., Main Conclusion: We believe that the protocols for virus growth and studies here described and the distribution initiative may constitute a viable model for other developing countries, not only to help a rapid effective pandemic response, but also to facilitate and support basic scientific research.

Biodiesel is an alternative biodegradable and non-toxic fuel, with a low emission profile and capable of reducing significantly the level of carcinogenic pollutants released into the atmosphere. A newly designed nano-biocatalyst prepared by conjugation of lipase A on superparamagnetic iron oxide nanoparticles (SPIONs) demonstrated high efficiency for production of biodiesel by the reaction of soybean oil with anhydrous methanol. The nanomaterial was characterized by FTIR, TGA and XRD, and its enzymatic activity compared with Lipozyme 435, a commercial gold standard from Novozyme™, which presented average enzymatic activity of 4559 ± 75 only twice as large as that of the SPION-CAL-A catalyst (2283 ± 249 PLU g -1 ), whereas Lipozyme TLIM showed a much lower activity of 588 ± 16 PLU g -1 . These results were confirmed in the transesterification reaction for production of biodiesel where a yield of 11.4% was achieved with Lipozyme 435 and 4.6 ± 0.5% with the nano-biocatalyst. Such an improved performance associated with easy magnetic recovery and reuse make the material potentially interesting for production of biodiesel from used cooking oil, adding value to this abundant resource., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)