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Animal reproduction biotechniques are important tools for the technological advancement of livestock, as they allow the selection of the reproductive potential of superior quality females and males; however, infectious diseases that have a predilection for the reproductive system can be a hindrance for the use of these technologies. Therefore, the present study aimed to detect Brucella spp. in the ovarian follicular fluid of brucellosis-positive bovine cows. A total of 47 bovine ovarian follicular fluid aspirates from cows, positive in tests for brucellosis and from Brucella-positive herd, were submitted to PCR. The primers used in the PCR were specific to the genus Brucella (bcsp31 gene). All 47 bovine aspirates were negative for Brucella spp. 0.00% (95% CI: 0.00-4.00%). Our results demonstrated that Brucella spp. was absent in the ovarian follicular fluid from seropositive cows, which indicates that Brucella spp.-infected cows could be used for reproductive biotechnologies carried out with follicular aspirates. Future studies are needed to more precisely evaluate the feasibility and safety of using these oocytes from brucellosis-seropositive cows to transfer embryos to heifers/cows not infected by Brucella, aiming to produce calves free of the infection., (© 2024 Wiley‐VCH GmbH. Published by John Wiley & Sons Ltd.)

Cancer is a leading cause of mortality globally and is projected to be the primary cause of death in Brazil by 2030. Yet, for high school students, information and understanding about cancer are primarily offered through standard biology lessons. This study aimed to assess the feasibility of a brief educational intervention related to cancer among high school students in a Brazilian private school. Participants attended a 1-h online session regarding different aspects of cancer. A self-reported questionnaire about the main topics addressed in the session was filled out before [pre] and after [post] the educational intervention and the results were compared by McNemar's chi-square test. From 900 parents invited, 44 (4.9%) responded to the invitation and agreed with their children's participation, and 24 students attended the activity. The questionnaire was easy to fill out for the students and allowed us to measure differences after the educational intervention. The high school students considered the most interesting topics cancer myths and protective/risk factors. The project was feasible and showed easy application and better knowledge after the educational intervention. The main challenge is related to the access to parents to authorize their children's participation. Designing interventions that focus on cancer education might be a viable way to increase prevention and early diagnosis with implications for students, their families, and the community., (© 2024. The Author(s) under exclusive licence to American Association for Cancer Education.)

The aim of this scoping review was to describe the zoonotic bacterial pathogens already reported and their frequency in different bat species. Six databases were searched, without restriction on the year or location where the studies were carried out. Based on the inclusion and exclusion criteria, 146 studies that were published between 1964 and 2020 (most after 2005) were selected. In these studies, 102 zoonotic bacterial genera were described in different samples of fourteen bat families in 55 countries, suggesting the possible role of bats as hosts for these pathogens. The pathogens mainly identified in bats were Bartonella spp., Leptospira spp. and Staphylococcus spp. In conclusion, the information provided by this scoping review expands the knowledge about zoonotic bacterial pathogens already identified in bats, which can guide epidemiological surveillance policies for these pathogens in different countries., Competing Interests: Declaration of Competing Interest The authors declare that there is no conflict of interest regarding the publication of this article., (Copyright © 2024 Elsevier B.V. All rights reserved.)

We aimed to determine the antimicrobial susceptibility profile of pathogenic Escherichia coli strains isolated from fecal samples of calves and buffalo calves (2008-2013), in Minas Gerais, Brazil, as well as the frequency of O157 gene and strains carrying extended-spectrum beta-lactamases (ESBL) and mobile colistin resistance (mcr) genes. E. coli strains (n=518) were tested for susceptibility against ten antimicrobials. Tetracycline was the antimicrobial with the highest resistance rate (382/518), followed by ampicillin (321/518), sulfamethoxazole/trimethoprim (312/518), chloramphenicol (192/518), gentamicin (126/518), ciprofloxacin (148/518), cefazolin (89/518), colistin (54/518) and cefoxitin (34/518). Multidrug resistance (MDR) was observed in 381/518 isolates. No strain harbored mcr or O157 genes, whereas 19/99 were ESBL positive. The most prevalent pathotype and phylogroup were STEC and B1, respectively. Age, EHEC pathotype and resistance to aminoglycoside and cephem were significantly associated with MDR in the multivariate model. Overall, E. coli strains showed high rates of resistance to penicillin, tetracyclines and folate inhibitors, in addition to an alarming rate of MDR and ESBL-producing strains., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Our study explored the patterns of bovine brucellosis dissemination in Minas Gerais state, Brazil, by examining data on passive surveillance of bovine brucellosis cases from the Instituto Mineiro de Agropecuaria (IMA) (Animal Health Authority), as well as cattle population and bovine brucellosis testing, from 2011 to 2018 by means of a spatiotemporal analysis. We plotted cases, populations and testing distributions and performed spatial autocorrelation (Moran's I test) and local indicators of spatial autocorrelation (LISA) analyses. Moreover, we assessed the correlation of the spatial distribution and the compiled data (brucellosis cases, cattle populations, and brucellosis testing) by Lee's test. Our results showed that bovine brucellosis cases occurred mainly in the Triângulo Mineiro, Alto Paranaíba and Northwest regions, which reported cases in all analyzed years (2011 to 2018). The cattle population of Minas Gerais was concentrated in the same regions as bovine brucellosis cases, and the performed tests through the analyzed years (2011 to 2018). Moran's I test results of the case data showed significant spatial autocorrelation in 2011, 2015 and 2018 (p value < 0.05), and from 2011 to 2018, the population and testing data were also significant in Moran's I test (p value < 0.01). The results of cluster analysis (LISA) of cases showed clusters mainly in the Triângulo Mineiro, Alto Paranaíba, Northwest and South regions in 2011, 2015 and 2018. The local clusters for cattle populations and brucellosis testing were also observed in the same regions as bovine brucellosis cases in all years (2011 to 2018). The correlation results between clusters (Lee's test) were 0.22 (p value < 0.01) in 2011, 0.15 (p value < 0.01) in 2015 and 0.43 (p value <0.01) in 2018 between cases and populations, and 0.25 (p value <0.01) in 2011, 0.14 (p value <0.01) in 2015 and 0.38 (p value < 0.01) in 2018 for testing and cases. Therefore, our results showed that brucellosis cases were distributed together with cattle populations and brucellosis testing data, indicating that brucellosis in cattle in Minas Gerais state is being identified where there are more animals and where more tests are performed., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: Typically, oncology is not a structured part of the curriculum in Brazilian medical schools. Furthermore, sarcomas, which are uncommon tumors, are seldom covered in depth. A lack of comprehensive education on sarcomas might result in medical professionals being ill-equipped to care for patients with this condition., Objectives: To assess medical students' understanding and awareness of sarcomas and the specific principles related to these tumors., Materials and Methods: A quantitative, cross-sectional study was conducted using a questionnaire, applied to medical students, focusing on the epidemiology, pathophysiology, and treatments of bone and soft tissue sarcomas. In all tests, the significance level adopted was 5%. The SPSS version 25.0 software was used., Results: Of the 825 questionnaires distributed, 325 were returned. Educational sessions on sarcomas did not appear to significantly improve the student's knowledge. Only 29.5% of students identified the lack of pain as an indicator of potential malignancy in soft tissue sarcomas, while 73.8% correctly recognized pain as a symptom of bone sarcomas. Limb amputation as the optimal surgical method for patient recovery was incorrectly reported by 39.1% of the sample., Conclusion: A great part of the surveyed population does not have adequate knowledge about the basic concepts associated with limb sarcomas. The minority of them are satisfied with the knowledge gained during their medical education about these tumors. Inadequate medical academic training may initially lead to the wrong clinical management of patients with bone and soft tissue tumor lesions. An educational effort is needed to enhance oncology education for medical students, especially concerning sarcomas., (© 2024. The Author(s).)

The objective of this study was to validate an indirect enzyme-linked immunoassay (iELISA) using the recombinant proteins, malate dehydrogenase (MDH) and superoxide dismutase (SOD) [CuZn], as antigens and to evaluate its ability to discriminate antibodies produced by vaccination from those induced by infection in the diagnosis of bovine brucellosis. Sera from six groups were evaluated: G1 - culture-positive animals (52 serum samples) (naturally infected); G2 - non-vaccinated animals (28 serum samples) positive in RBT (Rose Bengal test) and 2ME (2-mercaptoethanol test) selected from brucellosis-positive herds; G3 - animals from a brucellosis-free area (32 serum samples); G4 - S19 vaccinated heifers (114 serum samples); G5 - RB51 vaccinated heifers (60 serum samples); G6 - animals inoculated with inactivated Yersinia enterocolitica O:9 (42 serum samples). Diagnostic sensitivity (DSe) and diagnostic specificity (DSp) were estimated using the frequentist approach and the confidence interval (CI) (95%) calculated by the Clopper-Pearson (exact) method. The DSe for iELISA&#95;MDH in the G1 group was 71.7% (CI 95%: 57.6-83.2%) and for the G2 100.0% (CI 95%: 87.7-100.0%), whereas the DSp was 84.4% in the G3 (CI 95%: 67.2-94.7%). For the iELISA&#95;SOD the DSe was estimated 67.3% for the G1 (CI 95%: 52.9-79.7%) and 71.4% for G2 (CI 95%: 51.3-86.8%), while the DSp for G3 was 87.5% (CI 95%: 71.0-96.5%). iELISA&#95;MDH and iELISA&#95;SOD showed potential to be used in the diagnosis of infected animals, increasing the range of serological tests available for the diagnosis of bovine brucellosis, with the advantage of being S-LPS-free. However, none of the tests could differentiate between infection and vaccination., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Andrey Pereira Lage reports financial support was provided by Minas Gerais State Foundation of Support to the Research (RED 00132-22). Elaine Maria Seles Dorneles also reports financial support was provided by Minas Gerais State Foundation of Support to the Research (APQ 02920-18). 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 © 2023 Elsevier B.V. All rights reserved.)

Despite enormous recent advances in stage IV melanoma treatment, it continues to have a significant mortality. Five-years survival is below 50% even when granted full access to effective therapeutic regimens. Considering the real world, mostly with low or medium-income countries like Brazil, where 75% of population depends on public health system receiving ineffective Dacarbazine chemotherapy, more than 95% of stage IV patients are dead before 5 years. Knowing the survival process of melanoma end-of-life time is imperative to help physicians to establish better symptoms control and improve the quality of death of these patients., Methods: Relative caregiver of melanoma end of life patients were invited to participate in a specific interview answering questions for the purpose of gathering information regarding symptoms and patients' complaints at the last 30 days, 7 days and at the day of death., Results: Although melanoma has a highest propensity for brain dissemination, seizure and focal neurological deficits were not a major complaint. Most of dying melanoma symptoms are shared among other solid terminality tumor process and get worse from 30 days to 7 days, but the majority of symptoms kept unchanged from 7 days till time to death. Wound bleeding and bad odor were the only complaints that got worse during the whole terminality process and could be improved with better commitment of assistant team., Conclusions: although a strong effort is made to control brain metastasis, local and regional open wound metastasis represents a major remediable complaint that should receive more attention at end-of-life melanoma patients., Competing Interests: CONFLICT OF INTEREST All the authors declare that they have no conflict of interest.

Purpose: Assess the local recurrence rate and global survival rate among women diagnosed with breast cancer who underwent intraoperative electron radiotherapy (IOERT) between 2007 and 2017, in a single private healthcare setting in Belo Horizonte, Brazil., Material and Methods: This is a retrospective study based on medical records about the outcomes of patients submitted to breast-conserving surgery followed by IOERT. The collected variables included the patient's profile and tumor features, IOERT isodose, and outcomes. The quantitative data were presented in tables of frequency. The survival curves were created with the Kaplan-Meier method. In all tests, the adopted relevance level was 5%. The analyses were carried out with SPSS version 25.0., Results and Conclusions: The samples consisted of 78 patients, among which a total of 14 (17.9%) recurrences were observed. The median time of recurrence was 49 months after the IOERT was performed. Of the 78 patients analyzed, 13 (16.7%) died, 5 (6.4%) of which were due to breast cancer. The global survival rate in 5 years was 94.9% and 90.4% in 10 years. The local recurrence rate in 5 years was 89.7% and 86.4% in 10 years. Our findings revealed a higher local recurrence rate than the literature data. However, our results also showed that patients classified as low-risk had an overall survival of 5 and 10 years similar to other studies in the literature, reaffirming that low-risk women can benefit from IOERT. Given this finding, it is reaffirmed that rigorous eligibility criteria for IOERT are critical to reducing local recurrence.

The direct methods for diagnosis of bovine brucellosis have several limitations, therefore serological tests are the basis for the diagnosis of the disease. However, a meta-analysis estimating the diagnostic sensitivity (DSe) and diagnostic specificity (DSp) on the main tests used in bovine brucellosis control programs worldwide has not been performed. This systematic review and meta-analysis aimed to estimate the DSe, DSp and thereby accuracy of serological tests individually used in the diagnosis of bovine brucellosis. The databases CABI, Cochrane Library, PubMed/MEDLINE, SciELO, Scopus and Web of Science were used to select articles. The search resulted in 5308 studies, of which 71 were selected for systematic review using quality assessment tools and 65 studies were included in the meta-analysis. For the meta-analysis, 178 assays and 11 different serological tests were considered. To estimate DSe and DSp of the tests, studies were divided according to animal selection for the studies: (1) studies that carried out a random or consecutive selection of participants (noncasecontrol studies) and (2) all studies, including casecontrol studies. Considering only the non-case-control studies to estimate the DSe, the tests that exhibited the best and worst performance were the iELISA test (indirect enzyme immunoassay - bacterial suspension as antigen - BS) (96.5%, 95% CI: 94.1-97.9%) and 2ME (2- mercaptoethanol test) (85.0%, 95% CI: 79.6-89.1%), respectively; while for DSp, the FPA (fluorescence polarization assay) (99, 7%, 95% CI: 99.5-99.8%) and PCFIA tests (protein concentration fluorescence immunoassay) (78.5%, 95% CI: 70.0-85.1%) showed better and worse performance, respectively. Overall, our results showed an overestimation in the DSe and DSp of the eleven serological tests assessed when casecontrol studies were included in the meta-analysis, which is a concern considering its impacts on the time and costs associated with populational diagnosis of the diseases, since several of these tests are routinely used in the control and eradication programs of bovine brucellosis worldwide. Furthermore, the tests that exhibited the best DSe and DSp, iELISA (BS) and FPA, respectively, are relatively easy to perform and interpret and the test which showed the best overall accuracy was FPA., 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.)

Introduction: The recurrence of cutaneous melanoma is one of the main reasons for surveillance after primary tumor treatment, and there is still little data on melanoma recurrence related to the Brazilian population., Objective: We sought to evaluate the profile of patients with cutaneous melanoma recurrence within five years of (early) and five years after (late) initial diagnosis., Methods: Patients diagnosed between 2006 and 2014 in a private reference service in Belo Horizonte, Brazil, were included. Demographic, clinical, histopathological, and disease evolution variables were collected and analyzed using the R version 4.0.0 program. A p -value less than 0.05 was considered significant., Results: The sample was composed of 331 patients with melanoma, and the 43 patients with recurrence presented with higher mean age ( p =0.049), male predominance ( p =0.030), a lower proportion of Breslow thickness under 0.8mm ( p <0.001), and a more significant presence of mitosis ( p =0.007). The 29 patients (8.8%) with early recurrence presented with tumors with ulceration ( p <0.018). Late recurrence occurred in 14 patients (4.2%). Five patients relapsed after 10 years; most of them had tumors up to 1mm thick, without ulceration, regression, or satellitosis, but with the presence of mitosis., Conclusion: The possibility of cutaneous melanoma recurrence after five, and even 10, years, although rare, might indicate the need for longer medical follow-up. Multicenter studies may better characterize Brazilian patient profiles of those with early and late recurrence of melanoma., Competing Interests: DISCLOSURES: The authors have no conflicts of interest relevant to the contents of this article., (Copyright © 2023. Matrix Medical Communications. All rights reserved.)

Background: Recent therapeutic advances such as immune checkpoint inhibitors (ICIs) have impact on the care of non-small cell lung cancer (NSCLC) patients, however, they bring new setbacks for regulatory agencies., Objective: To evaluate the regulatory journey of ICIs registered for NSCLC treatment in Brazil and to establish comparisons of Brazilian regulatory agency with the US regulatory agency., Methods and Data Source: Information for each ICI prescribing as well as the date of regulatory approval of the therapeutic indications of interest were collected from the Anvisa and the FDA websites. The search took place on October 2022., Key Findings: There are only 20 % disagreements on regulatory approvals between Anvisa and FDA. The prioritization review at Anvisa in 2008 has made the regulatory assessment faster., Conclusions: The results of this study identified a potential improvement in Anvisa's time performance to connect the target established by the legal framework of the sector., Competing Interests: Declaration of Competing Interest Cássia Rita Pereira da Veiga, Claudimar Pereira da Veiga and Ana Paula Drummond-Lage have no conflicts of interest. Erika Machado is an employer of Merck Sharp and Dohme., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Diabetic foot ulcers (DFUs) are considered one of the most severe chronic complications of diabetes and can lead to amputation in severe cases. In addition, bacterial infections in diabetic chronic wounds aggravate this scenario by threatening human health. Wound dressings made of polymer matrices with embedded metal nanoparticles can inhibit microorganism growth and promote wound healing, although the current clinical treatments for diabetic chronic wounds remain unsatisfactory. In this view, this research reports the synthesis and characterization of innovative hybrid hydrogels made of carboxymethyl cellulose (CMC) and poly(vinyl alcohol) (PVA) chemically crosslinked by citric acid (CA) functionalized with silver nanoparticles (AgNPs) generated in situ using an eco-friendly aqueous process. The results assessed through comprehensive in vitro and in vivo assays demonstrated that these hybrid polymer hydrogels functionalized with AgNPs possess physicochemical properties, cytocompatibility, hemocompatibility, bioadhesion, antibacterial activity, and biocompatibility suitable for wound dressings to support chronic wound healing process as well as preventing and treating bacterial infections. Hence, it can be envisioned that, with further research and development, these polymer-based hybrid nanoplatforms hold great potential as an important tool for creating a new generation of smart dressings for treating chronic diabetic wounds and opportunistic bacterial infections.

Among almost 200 types of cancers, glioma is considered one of the most common forms of malignant tumors located in the central nervous system (CNS). Glioblastoma (GBM), one of the deadliest types of brain cancer, remains one of the challenges faced by oncologists. Thus, smartly designed nanomaterials biofunctionalized with polypeptides can offer disruptive strategies relying on the earliest possible diagnosis (" seeing is believing ") combined with more efficient therapies for fighting cancer cells. To worsen this scenario, bacteria infections very often pose a serious challenge to cancer-immunodeficient patients under chemotherapy. Thus, in this research, we report for the first time the design and synthesis of novel nanoconjugates composed of photoluminescent ZnS quantum dots (ZnS QDs), which were directly surface biofunctionalized with epsilon-poly-l-lysine (εPL), acting as an amine-rich cell-penetrating peptide (CPP) and antimicrobial peptide agent (AMP). These nanoconjugates (named ZnS@CPP-AMP) were produced through a one-step facile, eco-friendly, and biocompatible colloidal aqueous process to be applied as a proof of concept as nanoprobes for bioimaging GBM cancer cells (U87-MG) associated with synergic antibacterial activity. They were characterized regarding their physicochemical and optical properties associated with the biological activity. The results demonstrated that chemically stable aqueous colloidal nanoconjugates were effectively formed, resembling core-shell (inorganic, ZnS, organic, εPL) nanostructures with positively surface-charged features due to the cationic nature of the amine-rich polypeptide. More importantly, they demonstrated photoluminescent activity, cytocompatibility in vitro , and no significant intracellular reactive oxygen species (ROS) generation. These ZnS@CPP-AMP nanocolloids behaved as fluorescent nanoprobes for bioimaging GBM cancer cells, where the polycationic nature of the εPL biomolecule may have enhanced the cellular uptake. Additionally, they displayed mild antibacterial growth inhibition due to electrostatic interactions with bacterial membranes. Thus, it can be envisioned that these novel photoluminescent colloidal nanoconjugates offer novel nanoplatforms that can be specifically targeted with biomolecules for bioimaging to diagnose highly lethal cancers, such as GBM, and as an adjuvant in antibacterial therapy., Competing Interests: All authors have read the manuscript, understood the content, and agreed to the published version. The authors confirm no competing interests to declare regarding the publication of this article., (This journal is © The Royal Society of Chemistry.)

Objective  To compare the spatial-temporal parameters and walking kinematics of toddlers wearing biomimetic shoes, regular shoes (daily use owned shoes), and barefoot. Methods  Spatial-temporal parameters (speed, step length, and stride width), the mean vertical displacement of the center of mass (COM), knee flexion peak, and maximal foot height were analyzed. Results  Children were not different in biomimetic shoes and barefoot conditions on speed, step length, and COM vertical displacement. There was no difference among conditions on stride width and foot height. The knee flexion peak was greater in shod conditions than barefoot. The regular shoes showed greater COM vertical displacement than biomimetic shoes and barefoot. Conclusion  The findings showed that shoes affected the walking pattern in young children, but a shoe with a biomimetic design had a lesser effect on the walking pattern., Competing Interests: Conflito de Interesses Liria Akie Okai-Nóbrega and Ana Paula Lage work at Anamê Science and Technology in Child Health Products. The others authors do not have conflicts of interest. Dr. Lage reports grants from Inovation award SESI/SENAI, during the conduct of the study; In addition, Dr. Lage has a patent Dynamic Insole (Brazil) pending, and a patent Biomimetic Shoe (Brazil, USA, India, Japan, UE) pending., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit ( https://creativecommons.org/licenses/by/4.0/ ).)

Background: Colon cancer is an important cause of mortality related to cancer. During the COVID-19 pandemic, an important reallotment of assistance resources was necessary to tackle the crisis, directly impacting medical practice all over the globe., Objective: To assess the impact of the Sars-Cov-2 pandemic on the time between diagnosis and the beginning of systemic treatment in patients diagnosed with high-risk colon neoplasia., Methods: This is a retrospective study based on the analysis of medical records of patients diagnosed with colon neoplasia who required systemic treatment and were treated between March 2019 and March 2022, in a reference Oncology unit of the Brazilian Unified Health System. The study's population was divided into two groups: (I) Pre-COVID-19: diagnoses made between March 2019 and February 2020, (II) COVID-19: diagnoses made between March 2020 and March 2022., Results: The sample consisted of 228 patients, 108 (47.97%) of whom were diagnosed during pre-COVID-19 and 118 (52.21%) diagnosed during the two years-period of COVID-19. Regarding the time between colonoscopy and surgery, the time between surgery and first consultation in clinical oncology, and the time between requesting and beginning of systemic treatment, a statistically significant reduction was observed during the COVID-19 period., Conclusion: A decrease in time between diagnosis and systemic treatment of patients with colorectal cancer during the COVID-19 pandemic was observed. Yet, even with this improvement, the time to begin treatment remains greater than the recommended by the current guidelines, regardless of the time of diagnosis (before or after the pandemic), which negatively impacts the disease outcome., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Cancer is a leading cause of death in Brazil and worldwide. However, Brazilian medical education fails to include oncology as an essential topic. This creates a gap between the health status of the population and medical education. Bone sarcomas fall into both the group of malignant neoplasms and rare diseases and are thus doubly influenced by misinformation. To assess medical students' knowledge of imaging diagnostic methods for bone sarcomas. A cross-sectional, quantitative study was undertaken by obtaining the responses of medical students to a questionnaire containing radiographic images and questions about the radiological aspects of bone sarcomas. The categorical variables were compared using the chi-square test. The level of significance was 5% for all the tests. SPSS software version 25.0 was used for the analysis. A total of 325 responses were collected, with 72% of the participants having no interest in oncology and 55.6-63.9% not knowing how to diagnose a periosteal reaction on bone radiography. Only 11.1-17.1% of the students correctly interpreted the radiographic image of osteosarcoma. Medical students fail to correctly interpret images of bone sarcomas. It is important to promote oncology undergraduate education in general and to include the approach to bone sarcomas in this context., (© 2023. The Author(s) under exclusive licence to American Association for Cancer Education.)

Numerous genotyping techniques based on different principles and with different costs and levels of resolution are currently available for understanding the transmission dynamics of brucellosis worldwide. We aimed to compare the population structure of the genomes of 53 Brazilian Brucella abortus isolates using eight different genotyping methods: multiple-locus variable-number tandem-repeat analysis (MLVA8, MLVA11, MLVA16), multilocus sequence typing (MLST9, MLST21), core genome MLST (cgMLST) and two techniques based on single nucleotide polymorphism (SNP) detection (parSNP and NASP) from whole genomes. The strains were isolated from six different Brazilian states between 1977 and 2008 and had previously been analyzed using MLVA8, MLVA11, and MLVA16. Their whole genomes were sequenced, assembled, and subjected to MLST9 MLST21, cgMLST, and SNP analyses. All the genotypes were compared by hierarchical grouping method based on the average distances between the correlation matrices of each technique. MLST9 and MLST21 had the lowest level of resolution, both revealing only four genotypes. MLVA8, MLVA11, and MLVA16 had progressively increasing levels of resolution as more loci were analyzed, identifying 6, 16, and 44 genotypes, respectively. cgMLST showed the highest level of resolution, identifying 45 genotypes, followed by the SNP-based methods, both of which had 44 genotypes. In the assessed population, MLVA was more discriminatory than MLST and was easier and cheaper to perform. SNP techniques and cgMLST provided the highest levels of resolution and the results from the two methods were in close agreement. In conclusion, the choice of genotyping technique can strongly affect one's ability to make meaningful epidemiological conclusions but is dependent on available resources: while the VNTR based techniques are more indicated to high prevalence scenarios, the WGS methods are the ones with the best discriminative power and therefore recommended for outbreaks investigation., 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. Published by Elsevier B.V.)

Brucellosis in equines, including horses, donkeys, and mules, is characterized by abscesses in tendons, bursae, and joints. Reproductive disorders, which are common in other animals, are rare in both males and females. Joint breeding of horses, cattle, and pigs was found as the main risk factor for equine brucellosis, with the transmission from equines to cattle or among equines possible, although unlikely. Hence, evaluation of the disease in equines can be considered an indirect indicator of the effectiveness of brucellosis control measures employed for other domestic species. Generally, the disease in equines reflects disease status in the sympatric domestic species, mainly cattle. It is important to note that in equines, the disease has no validated diagnostic test, which limits the interpretation of available data. Finally, it is important to mention that equines also represent significant Brucella spp. infection sources for humans. Considering the zoonotic aspect of brucellosis, the significant losses due to infection, and the representativeness of horses, mules, and donkeys in the society, as well as the continuous efforts to control and eradicate the disease in livestock, in this review, we covered the various aspects of brucellosis in equines and compile the sparse and diffuse information on the subject., (Copyright © 2023. Published by Elsevier Inc.)

Background: A full understanding of the economic burden associated with treatment-related adverse events (AEs) can aid estimates of the incremental costs associated with incorporating new technologies and support cost-effective economic modeling in Brazil. In this context, the main objective of this work was to evaluate in a real-life database: (i) the direct medical cost of monitoring the occurrence of AEs (CMO); (ii) the direct medical cost of managing an identified AE (CMN); and (iii) the total direct medical cost of monitoring and managing AEs (TMC), in quarterly periods from 0 to 24 months of the monitoring of cancer patients who used a PD-1 inhibitor from the perspective of the supplementary health system in Brazil., Methods: This study was conducted from the supplementary health system (SSS) perspective and followed the methodological guidelines related to cost-of-illness studies. A bottom-up (person-based) approach was used to assess the use of health resources to monitor and manage AEs during the use of PD-1 inhibitors, which made it possible to capture differences in the mean frequency of the use of health services with stratification results for different subgroups. As the Brazilian SSS is complex, asymmetric, and fragmented, this study used information from different sources. The methodology was divided into three parts: (i) Data Source: clinical management of AEs; (ii) Microcosting: management of the economic burden of AEs; (iii) Statistical analysis: stratification of results for different subgroups., Results: Analysis of the economic burden of toxicity showed higher CMO costs than CMN in all the periods analyzed. In general, for every BRL 100 on average invested in the TMC of AEs, BRL 95 are used to monitor the occurrence of the AE and only BRL 5 to manage an identified AE. This work also showed that the sociodemographic characteristics of patients, the journey of oncological treatment, and the toxicity profile affect the economic burden related to AE., Conclusion: This study provided real-world evidence of the economic burden of AEs associated with the use of PD-1 inhibitors in Brazil. This work also made methodological contributions by evaluating the economic burden of AE of PD-1 inhibitors considering the kinetics of toxicity occurrence and categorizing the costs in terms of CMO, CMN and TMC., (© 2023. The Author(s).)

The contamination and pollution of wastewater with a wide diversity of chemical, microbiological, and hazardous substances is a field of raising environmental concern. In this study, we developed, for the first time, new hybrid multifunctional nanoplexes composed of ZnS semiconductor quantum dots (ZnS QDs) chemically biofunctionalized with epsilon-poly-l-lysine (ɛPL) and coupled with magnetic iron oxide nanoparticles (MION, Fe 3 O 4 ) stabilized by carboxymethylcellulose (CMC) for the photodegradation (ZnS) of organic molecules and antibacterial activity (ɛPL) with a potential of recovery by an external magnetic field (Fe 3 O 4 ). These nanosystems, which were synthesized entirely through a green aqueous process, were comprehensively characterized regarding their physicochemical properties combined with spectroscopic and morphological features. The results demonstrated that supramolecular colloidal nanoplexes were formed owing to the strong cationic/anionic electrostatic interactions between the biomacromolecule capping ligands of the two nanoconjugates (i.e., polypeptide in ZnS@ɛPL and polysaccharide in Fe 3 O 4 @CMC). Moreover, these nanosystems showed photocatalytic degradation of methylene blue (MB) used as a model dye pollutant in water. Besides MB, methyl orange, congo red, and rhodamine dyes were also tested for selectivity investigation of the photodegradation by the nanoplexes. The antibacterial activity ascribed to the ɛPL biomolecule was confirmed against Gram-positive and Gram-negative bacteria, including drug-resistance field strains. Hence, it is envisioned that these novel green nanoplexes offer a new avenue of alternatives to be employed for reducing organic pollutants and inactivating pathogenic bacteria in water and wastewater treatment, benefiting from easy magnetic recovery., 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.)

Background: Due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, recently, Radiotherapy (RT) protocols requiring fewer sessions (hypofractionated) have been used to shorten RT treatment and minimize patient exposure to medical centers, and decrease the risk of SARS-CoV-2 infection., Methods: This longitudinal, prospective, observational study aimed to compare the quality of life (QoL) and the incidence of oral mucositis and candidiasis in 66 patients with head and neck cancer (HNC) who undergo a hypofractionated RT protocol (GHipo), total of 55 Gy for 4 weeks, or a conventional RT protocol (GConv), total of 66 - 70 Gy for 6 - 7 weeks., Purpose: To assess the incidence and severity of oral mucositis, the incidence of candidiasis, and QoL were evaluated using the World Health Organization scale, clinical evaluation, and the QLC-30 and H&N-35 questionnaires, respectively, at the beginning and the end of RT., Results: The incidence of candidiasis did not show differences between the two groups. However, at the end of RT, mucositis had a higher incidence (p < 0.01) and severity (p < 0.05) in GHipo. QoL was not markedly different between the two groups. Although mucositis worsened in patients treated with hypofractionated RT, QoL did not worsen for patients on this regimen., Conclusions: Our results open perspectives for the potential use of RT protocols for HNC with fewer sessions in conditions that require faster, cheaper, and more practical treatments., (© 2023. The Author(s).)

The use of opioid analgesics remains the primary therapy for pain control in cancer patients. However, ample evidence persists showing that treatment is still inadequate. This cross-sectional study was carried out during one year in a Brazilian Cancer Hospital to evaluate the impact of opioid use on analgesia and patients' quality of life. The Pain Management Index (PMI), EORTC QLQ.C30 (Quality of Life of Cancer Patients), Karnofsky Performance Status (KPS), Douleur Neuropathique 4 (DN4), and Brief Pain Inventory-Short Form (BPI-SF) were used. A hundred patients with advanced solid tumors and using opioids were included, with 82% of them reporting daily pain with 58% having intense pain. Morphine with a mean dose of 49 Morphine Milligram Equivalent were used by 57% of them, and PMI was negative in 34% of the sample. Neuropathic pain was found in 72% of patients. The pain was related to all BPI variables. Despite the substantial negative impact of pain on QOL, no association was found between the clinical factors assessed and QOL itself. This gap can be related to the persistence of high levels of sub-treatment, depression, and neuropathic pain associated with the use of low doses of opiates and adjuvant medications in the sample.

The collapse of the B1 Dam of VALE SA mining company in Brumadinho, Minas Gerais, Brazil was the largest humanitarian disaster and occupational accident in the country's history, and it posed challenges regarding the management and identification of multiple victims. We evaluated the impact of the iron ore tailings on the victims' bodies. We examined the scientific identification of the victims and the dynamics of the disaster over the 1st year after it occurred. We also determined the socio-demographic profiles of the victims. In this retrospective, cross-sectional study, we investigated the expert reports of the victims' biological remains from 25 January 2019 to 25 January 2020. We analysed the socio-demographic data, identification methods, identification status, identification time, and necroscopic information. During the study period, 259 of 270 victims were identified, and 603 biological materials were analysed; among them, 86.2% were body parts and 13.8% were whole bodies. Of the total cases registered that year, 476 (78.9%) were submitted during the first 10 weeks after the disaster. Friction ridge analysis accounted for 67.9% of primary identifications and DNA analysis did so for 91.6% of re-identification cases. Body dismemberment was 3.4 times greater among mine workers than among community victims. Adult males accounted for the greatest number of victims ( P < 0.001). Polytraumatic injury was the prevalent single cause of death. Necropsy examination revealed the occurrence of asphyxia in 7% of cases. The higher number of fatalities and greater dismemberment among employees than with community residents underlines the occupational dangers in the mining industry and clarifies the dynamics of the disaster. In the initial weeks after the dam collapsed, friction ridge analysis was the most appropriate method for identification. Subsequently, DNA analysis became the most-used technique for identification and re-identification owing to the great volume of body parts and decomposed biological tissue. Autopsy allowed diagnosis of the causes of death to be clarified according to the Brazilian criminal legal system., Competing Interests: The authors report there are no competing interests to declare., (© 2023 The Author(s). Published by Taylor & Francis Group on behalf of the Academy of Forensic Science.)

The suicide phenomenon involves complex interactions between psychological, biological, cultural and socio-environmental factors. This study aimed to assess the epidemiological and toxicological profiles of officially confirmed suicide victims. A retrospective study was performed using autopsy reports, forensic anthropology examinations and police summaries of all suicide cases that underwent toxicological analysis at an Official Forensic Laboratory (Minas Gerais, Brazil) in 1 year. The sample set was composed of 351 suicide victims, predominantly men (70.32%), most of them were adults between 31 and 64 years old (62.11%), with mixed skin colour (48.89%) and low educational level (66.44%). The most common suicide method was hanging (57.79%), followed by intoxication (30.45%). Most victims presented positive toxicological results (56.41%), especially for the presence of medicines (37.6%), illicit drugs (36.3%) and pesticides (26.1%). Our study corroborated previous data that most suicide victims have low educational levels. The most common toxicological findings were medicines, especially prescription drugs, followed by illicit drugs and pesticides. We hope this study contributes to reflections and planning of preventive suicide programmes, considering the described profiles of victims., Competing Interests: The authors report there are no competing interests to declare., (© 2023 The Author(s). Published by Taylor & Francis Group on behalf of the Academy of Forensic Science.)

Background: After the biopsy of a suspicious melanocytic lesion, patients depend on the pathologist's precision of specimen evaluation., Methods: We assessed the agreement between histopathological reports made by general pathologists and reviewed by a dermatopathologist to evaluate the impact on the patient's management., Results: In 79 cases analyzed, underdiagnosis was observed in 21.6% and overdiagnosis in 17.7%, resulting in changes in the patients' conduct. The assessment of the Clark level, ulceration and histological type showed mild agreement (P<0.001); the Breslow thickness, surgical margin, and staging showed moderate agreement (P<0.001)., Conclusions: A dermatopathologist's review should be incorporated into the routine of reference services for pigmented lesions.

The Brucellaceae family comprises microorganisms similar both phenotypically and genotypically, making it difficult to identify the etiological agent of these infections. This study reports the first isolation, identification, and characterization of Pseudochrobactrum saccharolyticum (strain 115) from Latin America. Strain 115 was isolated in 2007 from a bovine in Brazil and was initially classified as Brucella spp. by classical microbiological tests and bcsp31 PCR. The antimicrobial susceptibility of strain 115 was tested against drugs used to treat human brucellosis by minimal inhibitory concentration test. Subsequently, the whole genome of the strain was sequenced, assembled, and characterized. Phylogenetic trees built from 16S rRNA and recA gene sequences enabled the classification of strain 115 as Pseudochrobactrum spp. Phylogenomic analysis using Single Nucleotide Polymorphisms and Average Nucleotide Identity allowed the classification of the strain as P. saccharolyticum. Additionally, a Tetra Correlation Search identified one related genome from the same species, which was compared with strain 115 by analyzing genomic islands. This is the first identification and whole-genome sequence of P. saccharolyticum in Latin America and highlights a challenge in the diagnosis of bovine brucellosis, which could be solved by including the sequencing of 16S rRNA and recA genes in routine diagnostics., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.)

Biochemical, serological, and molecular methods have been developed for the laboratory diagnosis of diseases caused by C. pseudotuberculosis (CP), but the identification of the pathogen and biovars differentiation may be time-consuming, expensive, and confusing compared with other bacteria. This study aimed to evaluate MALDI Biotyper and Overall Genome Relatedness Index (OGRI) analysis to optimize the identification and differentiation of biovars of C. pseudotuberculosis . Out of 230 strains isolated from several hosts and countries, 202 (87.8%) were precisely classified using MALDI Biotyper and the BioNumerics platform. The classification accuracies for the Ovis and Equi biovars were 80 (88.75%) and 82 (92.68%), respectively. When analyzing a sampling of these strains by Average Nucleotide Identity based on BLAST and TETRA analyses using genomic sequence data, it was possible to differentiate 100% of the strains in Equi and Ovis. Our data show that MALDI Biotyper and OGRI analysis help identify C. pseudotuberculosis at the species and biovar levels.

Objective: This study aims to analyse patients' clinical profiles seen at an emergency unit of a public oncology reference hospital in Belo Horizonte, Brazil., Methods: This is a cross-sectional, observational, retrospective study, with data collection through patients' medical records seen between 2016 and 2018. The identification of patients was carried out through research on hospital admission authorization guides., Results: A total of 2932 medical records were evaluated, of which only 21.5% were cancer patients. A cancer diagnosis was made for 21.5% of patients during hospitalisation. In this group, pain and weight loss are frequent symptoms, and haematological diseases (15.2%) were the most frequent tumour type. Patients with a previous cancer diagnosis presented the most prevalent tumour breast (18.3%) and altered consciousness level as a leading symptom. Analgesics were the most prescribed drugs in both groups., Conclusion: This study showed two distinct groups of cancer patients: with or without a previous cancer diagnosis. However, these two groups are comparable in almost all the variables analysed. Therefore, we believe that the factors that could guide the care in an emergency are related to education on cancer symptoms for the population to contribute to an early diagnosis and cancer training for emergency department (ED) professionals' to better monitor advanced-stage patients for symptom management., (© 2022 John Wiley & Sons Ltd.)

Background: The knowledge of risk factors and complications related to extended pelvic lymph node dissection (ePLND) during radical prostatectomy can help selecting patients who will benefit the most with lymph node dissection concomitant to radical prostatectomy., Materials and Methods: Retrospective cohort evaluating 135 patients with PC, with a high risk for lymph node metastasis, submitted to ePLND by a single surgeon between 2013 and 2019, performed either by the laparoscopic or laparoscopic robot-assisted approach. Data related to complications were properly recorded using the Martin's criteria and were classified by the Satava and Clavien-Dindo-Strasberg methods. Logistic regression was used to determine predictors of complications related to ePLND., Results: The mean number of lymph nodes removed was 10.2 ± 4.9, and in 28.2%, they were positive for metastasis. There were five intraoperative complications (4%), all in patients operated by laparoscopic approach. There were nine severe postoperative complications (7.3%), four of which occurred after postoperative day 30. Three patients (2.4%) had thromboembolic complications and five patients (4.0%) had lymphocele that required treatment. There was a correlation between the American Society of Anesthesiologists (ASA) physical status classification and postoperative complications ( p =0.06), but it was not possible to identify statistically significant predictors., Conclusion: ePLND during radical prostatectomy has a low rate of intraoperative complications and may change prostate cancer staging. Postoperative complications, especially venous thromboembolism and lymphocele, need to be monitored even in the late postoperative period., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Pedro Castro et al.)

In Brazil, 75% of the population uses the Sistema Único de Saúde (SUS), public health system, where the general practitioner (GP) is responsible for melanoma diagnosis. Identify the factors related to the delay in diagnosing melanoma patients assisted by SUS. A prospective observational study based on a questionnaire and medical records review assessed the sociodemographic features, melanoma signs and symptoms, previous knowledge of the disease, and factors related to delays in seeking medical care. One hundred sixty-six patients were included. Healthcare professionals suspected a lesion in only 23.5% of cases. The average time between lesion suspicion by patient/relative and first medical appointment with GP was over 6 months (31%). The time between the first GP exam and biopsy conducted by a specialist ranged from less than 1 month (34.9%) to more than 1 year (18.7%). Half of the patients (49.4%) experienced delays in histopathological diagnosis due to SUS bureaucracy/slowness. Most (80%) patients did not know what melanoma was before diagnosis. Delay in melanoma diagnosis was related to a lack of knowledge about the disease's signs and symptoms for both the study population and the primary physicians, indicating that both players must receive proper education about melanoma. Also, the infrastructure and work processed at SUS impeded the patient flow, contributing to the diagnosis of the lesions at more advanced stages., (© 2022. The Author(s) under exclusive licence to American Association for Cancer Education.)

Walking experience is crucial for inter-joint coordination during gait acquisition. Toddlers show asymmetrical lower limb function during early locomotion for transferring body weight (regulatory limb) and steering the direction of walking (impulse limb). This study aimed to investigate the association between coordination patterns and walking experience, and between coordination variability and walking experience according to healthy toddlers' lower limb function and stance periods. Typically developing toddlers (n = 22; 17.27 ± 3.13 months) were distributed into two groups: up to (LWE) and greater than (GWE) three months of walking experience. The lower limbs were classified as regulatory or impulse limb and analyzed during the onset (SO), mid (MS), and late (LS) stance intervals. Hip-ankle, knee-ankle, and hip-knee coupling angle (CA) and its variability (CAV) were assessed. A relationship was found between inter-joint coordination pattern and groups, which was distinct according to stance period and lower limb function: (a) hip-ankle CA: at SO for both limbs, MS for the regulatory limb, and LS for the impulse limb; (b) knee-ankle CA: at SO for both limbs and MS for the regulatory limb; (c) hip-knee CA: at SO for both limbs, at MS for the regulatory limb, and LS for the impulse limb. These findings were linked to differences observed in distal joints between groups, mainly at the ankle during stance onset. The CAV was negatively associated with walking experience only in the regulatory limb in the following variables: hip-ankle at MS, knee-ankle at SO, and hip-knee at LS. Findings showed different functional roles of the lower limbs in dealing with the demands of balance and propulsion during early walking., (Copyright © 2022 Elsevier Inc. All rights reserved.)

According to Brazilian Law 12.732/12 ("60-day law"), cancer patients have 60 days after diagnosis for beginning treatment at the Unified Health System (SUS). The study aimed to evaluate the achievement and effectiveness of the '60-day law' for melanoma patients in a SUS cancer reference unit. A retrospective study analysed 58 medical charts from patients with the initial diagnosis performed before and after the "60-day law". The Law does not change the time interval between diagnosis and the beginning of treatment, and after the Law, patients presented a worse overall survival (p < 0.001). In conclusion, the '60-day law' was not effective., (© 2022 John Wiley & Sons Ltd.)

Introduction: Immunotherapy revolutionized cancer care in the last decade and, notably among its tools, the programmed cell death protein-1 (PD-1) inhibitors. These drugs are related to increased life expectancy rates. However, they can cause several adverse events that have not been fully characterized, thus challenging clinical practice., Objective: To evaluate the toxicity profile, determining its frequency, causality, and severity associated with treatment with PD-1 inhibitors in patients treated at an oncology service in the private health sector in Belo Horizonte., Methods: Observational, retrospective, and cross-sectional study, based on the review of electronic medical records. The eligibility criteria included patients over 18 years old with a diagnosis of any cancer and staging, receiving a PD-1 inhibitor from January 2017 to January 2020., Results: The sample consisted of 134 patients with lung cancer (46,3%), melanoma (34,3%), and kidney cancer (19,4%). The most common adverse event (AE) related to treatment were fatigue (51.5%), anorexia (23.1%), hypothyroidism (15.7%), and skin rash (14.9%), being grades 1 and 2 more prevalent. Between 3 and 12 months, there were more cutaneous, nutritional, and metabolic toxicities, and fatigue was present throughout the entire treatment period. Gastrointestinal and pulmonary toxicities were more frequent up to the 9th month., Conclusion: Based on real-world evidence, it was possible to reveal important findings to support the safe practice of PD-1 inhibitors treatment. Fatigue was the most prevalent AE among patients. In addition, the kinetics of AE allowed the identification of major occurrences according to the period o treatment, allowing more precise monitoring and surveillance., (Copyright © 2022 Elsevier B.V. All rights reserved.)

This systematic review and meta-analysis aimed to recalculate the efficacy of Brucella abortus S19 and RB51 vaccine strains and discuss the main variables associated with controlled trials to evaluate bovine brucellosis vaccine efficacy (VE). The most commonly used vaccine strain was S19, at a dose of 10 10 colony forming units (CFU), followed by RB51 at 10 10 CFU. The most commonly used challenge strain was B. abortus 2308, at a dose of 10 7 CFU, by the intraconjunctival route. Regarding the meta-analysis, trials were grouped according to the vaccine strain and dose to recalculate protection against abortion (four groups) or infection (five groups) using pooled risk ratio (RR) and VE. Regarding protection against abortion (n = 15 trials), the S19 vaccine at 10 9 CFU exhibited the highest protection rate (RR = 0.25, 95% confidence interval (CI) : 0.12-0.52; VE = 75.09%, 95% CI: 48.08-88.05), followed by RB51 at 10 10 CFU (RR = 0.31, 95% CI: 0.16-0.61; VE = 69.25%, 95% CI: 39.48-84.38). Regarding protection against infection (n = 23 trials), only two subgroups exhibited significant protection: S19 at 10 9 CFU (RR = 0.28, 95% CI: 0.14-0.55; VE = 72.03%, 95% CI: 57.70- 81.50) and RB51 at 10 10 CFU (RR = 0.43, 95% CI: 0.22-0.84; VE = 57.05%, 95% CI: 30.90-73.30). In conclusion, our results suggest that a dose of 10 9 CFU for S19 and 10 10 CFU for RB51 are the most suitable for the prevention of abortion and infection caused by B. abortus., (© 2021 Wiley-VCH GmbH.)

The aim of this systematic review was to investigate the prevalence of leptospirosis among stray and sheltered dogs worldwide. Six databases were searched, which resulted in the retrieval of 476 articles. Sixty articles were selected for analysis according to 10 quality criteria. Among the selected papers, 26 papers [43.4% (26/60)] met five of the 10 quality criteria established, 10 papers [16.7% (10/60)] met three criteria, nine papers [15.0% (9/60)] met four criteria, six papers [10.0% (6/60)] met six criteria, four papers [6.7% (4/60)] met eight criteria, and three papers [5.0% (3/60)] met nine of the 10 criteria, whereas two papers [1.7% (1/60)] met two and seven [1.7% (1/60)] criteria. Publications originated mainly from the Americas [45.0% (27/60)] and in the last 16 years (2003-2019) [81.7% (49/60)], and most of the sampled dogs were stray dogs [65.0% (39/60)]. The most commonly used diagnostic test for leptospirosis was the microscopic agglutination test [78.4% (47/60)] followed by polymerase chain reaction [21.7% (13/60)], and the most common serovars were Canicola [71.4% (35/49)], Icterohaemorrhagiae [65.3% (32/49)], Grippotyphosa [40.8% (20/49)], and Pomona [40.8% (20/49)]. In conclusion, our results showed that Leptospira spp. are present in unowned dogs worldwide; however, the low-methodological quality of the recovered cross-sectional studies precluded a meta-analysis.

Purpose: This study aimed to determine the feasibility of preoperative lymphoscintigraphy and intraoperative radio-guided sentinel lymph node biopsy (SLNB) in patients previously submitted to complete lymphadenectomy (CL) in the same region. There is no current proposal to stage patients diagnosed with a new melanoma after SLNB if the regional lymph node (LN) was removed, preventing this specific population from adjuvant treatments due to understaging. Methods: We assessed six cases of patients with a previous cancer diagnosis (melanoma, breast, or thyroid cancer) who had undergone CL and later developed a new cutaneous melanoma in the same extremity submitted to CL. They underwent preoperative lymphoscintigraphy to locate the sentinel lymph node (SLN), followed by a radio-guided SLNB with the assistance of patent blue dye. A pathologist then evaluated the excised SLN. Results: We had 100% feasibility, all six patients had their SLN located, and three (50%) patients tested positive for metastasis in the excised LNs. Conclusions: All these patients met the criteria to undergo SLNB, but no previous reports demonstrated and corroborated the performance of this procedure in this situation. SLNB with expected drainage for regions previously submitted to a radical lymphadenectomy is a safe and effective procedure. A lymphoscintigraphy allows locating the SLN that is likely to be resected in surgery. In this scenario, we had a 50% positivity, providing how relevant and essential this information is for the prognosis and practical therapeutical approaches for this rare but relevant melanoma population.

Objective  To evaluate the biomechanical behavior of the medial longitudinal arch (MLA) of the foot and the kinematic parameters of the lower limbs with biomimetic footwear (BF) and non-biomimetic (NB1, NB2, NB3 and NB4) footwear in children at the beginning of the gait acquisition phase. Methods  Four toddlers were evaluated at the beginning of the gait acquisition phase under the following conditions: walking barefoot, ambulation with BF and NB1, NB2, NB3 and NB4 footwear in hard floor. BF is described as biomimetic because of its property of emulating natural and irregular floors through a dynamic internal insole. The MLA and kinematics of the hip, knee, and ankle during gait were evaluated by three-dimensional motion analysis system. The similarity between the kinematic curves of barefoot and footwear conditions was analyzed by root mean square error (RMSE). Results  The use of BF presented the highest magnitude of MLA and the greatest difference in relation to barefoot condition (higher RMSE). The BF showed less difference in the kinematics of the knee and ankle joints during gait when compared to barefoot condition (lower RMSE). NB2 footwear presented hip kinematics more similar to barefoot condition (lower RMSE). Conclusion Biomimetics footwear and NB2 shoes (both with wider forefoot region) generated smaller differences in lower limbs compared to barefoot. In addition, the MLA was higher in the BF, probably because different design from other shoes., Competing Interests: Conflito de interesses A Dra Liria Akie Okai-Nóbrega e a Dra Ana Paula Lage trabalham com pesquisa na Anamê Ciência e Tecnologia em Saúde Infantil Ltda., (Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Background: Due to the longer life expectancy and consequently an increase in the elderly population, a higher incidence of gastric cancer is expected in this population in the coming decades., Aim: To compare the results of laparoscopic GC surgical treatment between individuals aged<65 years (group I) and ≥ 65 years (group II), according to clinical, surgical, and histopathological characteristics., Methods: A observational retrospective study was performed by analyzing medical charts of patients with gastric cancer undergoing total or subtotal laparoscopic gastrectomy for curative purposes by a single oncologic surgery team., Results: Thirty-six patients were included in each group. Regarding the ASA classification, 31% of the patients in group I was ASA 1, compared to 3.1% in group II. The mean number of concomitant medications in group II was statistically superior to group I (5±4.21 x 1.42±3.08, p<0.001). Subtotal gastrectomy was the most performed procedure in both groups (69.4% and 63.9% in groups I and II, respectively) due to the high prevalence of distal tumors in both groups, 54.4% group I and 52.9% group II. According to Lauren's classification, group I presented a predominance of diffuse tumors (50%) and group II the intestinal type (61.8%). There was no difference between the two groups regarding the number of resected lymph nodes and lymph node metastases and the days of hospitalization and mortality., Conclusion: Laparoscopic gastrectomy showed to be a safe procedure, without a statistical difference in morbidity, mortality, and hospitalization time between both groups.

Background: This study aimed to evaluate the main drivers of robot assisted radical prostatectomy (RARP) hospitalization costs, in addition to assess perioperative predictors that impact costs., Methods: Overall, 474 RARP were analyzed between February 2018 and December 2019. The association between perioperative variables and total direct costs was analyzed by simple and multiple linear regression., Discussion: The main drivers of RARP hospitalization costs were robotic surgical supplies. Costs increased with American Society of Anesthesiologists score 3, a one-hour increase in OR time, increased utilization of polymeric clip packs and longer length of hospital stay. There was a 11.5% reduction in costs with the use of four robotic instruments instead of five., Conclusion: Costs of hospitalization were mainly influenced by the OR time, use of surgical supplies and length of hospital stay. Reducing the number of robotic instruments used in RARP represented the potentially modifiable factor with the greatest impact on cost reduction., (© 2021 John Wiley & Sons Ltd.)

The understanding on the role of bats in the ecology of zoonotic diseases, especially its relevance as a carrier of pathogens, is important for the determination of preventive measures considering the One Health context. The present study aimed to investigate the presence of Brucella spp., Leptospira spp. and Salmonella spp. in blood (n = 163), liver (n = 35) and spleen (n = 62) samples from bats captured in Montes Claros, Minas Gerais, Brazil. Only Salmonella spp. was found in a blood sample of an insectivorous female bat of the species Lasiurus blossevilli, evidencing the capacity of this animal species to host this pathogen. In conclusion, our results in bats from Montes Claros indicate that they do not act as hosts for Brucella spp. and Leptospira spp., although being potential carriers of Salmonella spp. in a low prevalence., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Staphylococcus aureus mastitis remains a major challenge for dairy farming. Here, 24 mice were immunized and divided into four groups: G1: control; G2: Granulocyte Macrophage Colony-Stimulating Factor (GM-CSF) DNA vaccine; G3: F0F1 ATP synthase subunit α (SAS), succinyl-diaminopimelate (SDD), and cysteinyl-tRNA synthetase (CTS) recombinant proteins; and G4: SAS+SDD+CTS plus GM-CSF DNA vaccine. The lymphocyte subpopulations, and the intracellular interleukin-17A (IL-17A) and interferon-γ production in the draining lymph node cells were immunophenotyped by flow cytometry. The immunophenotyping and lymphocyte proliferation was determined in spleen cells cultured with and without S. aureus stimulus. Immunization with S. aureus recombinant proteins generated memory cells in draining lymph nodes. Immunization with the three recombinant proteins plus GM-CSF DNA led to an increase in the percentage of IL-17A + cells among overall CD44 + (memory), T CD4 + , CD4 + T CD44 + CD27 - , γδ TCR, γδ TCR + CD44 + CD27 + , and TCRVγ4 + cells. Vaccination with S. aureus recombinant proteins associated with GM-CSF DNA vaccine downregulated T H 2 immunity. Immunization with the three recombinant proteins plus the GM-CSF DNA led to a proliferation of overall memory T, CD4 + , and CD4 + TEM cells upon S. aureus stimulus. This approach fostered type 3 immunity, suggesting the development of a protective immune response against S. aureus .

The chemotaxis of C. fetus subsp. venerealis and C. fetus subsp. fetus was determined in the presence of bovine cervical mucus and bovine placental extract. Some reported substances and ion in those materials, such amino acids, ferrous iron, hormones, sugars and organic acids were also investigated. Bovine cervical mucus, bovine placenta extracts and some substances and ion of these materials namely L-fucose, L- aspartate, L-glutamate, L-serine, ferrous iron, fumarate, pyruvate and succinate were chemoattractants. The chemottraction was significantly larger in higher concentrations of the tested substances and ion and significant differences among tested strains were also observed. Meso-erythritol and hormones bovine placental lactogen, 17β-estradiol, and progesterone did not elicit chemotactical response. In conclusion, this chemotactic behavior may guide the C. fetus navigation in the bovine host's genital tract and be an important cofactor of tissue tropism for this bacterium., Competing Interests: Conflicts of interest: The authors have no conflict of interest to declare., (Copyright © The Author(s).)

Melanoma is the most aggressive skin cancer. Since diagnosis is visual, it is critical to evaluate if students acquire enough knowledge for early detection during medical school. To assess the melanoma knowledge of first-year (freshman) and sixth-year (senior) medical students, in a Brazilian Institution. It was a transversal and quantitative study. A questionnaire with sociodemographic data, knowledge about melanoma, and the habit of skin self-exam was filled out by medical students. A total of 128 first-year and 122 seniors students were included. All the sixth-year students knew melanoma as a skin cancer compared with 46.09% of the first-year students. Melanoma clinical characteristics were known by 30.51% of the freshman and 97.54% of seniors. However, they did not know the most usual site of melanoma occurrence (79.66% of first-year students and 24.59% of senior). About the skin self-exam, only 50% of first-year students and 53.28% of senior had the habit of doing it sometimes. Medical school was effective in providing knowledge about melanoma and its features. However, this was not reflected in an increase in the number of students that did the skin self-exam, which indicates the need for new approaches in teaching., (© 2020. American Association for Cancer Education.)

The aim of this study was to identify possible effects of different vaccination strategies (concomitantly or not) against brucellosis and clostridia on intake, performance, feeding behavior, blood parameters, and immune responses of dairy heifers calves. Fifty heifers calves were enrolled [38 Gyr (Zebu, Bos taurus indicus) and 12 5/8 Holstein × Gyr]. At 120 d of age, animals were randomly distributed among 3 groups: B (n = 18), vaccinated against brucellosis; C (n = 14), vaccinated against clostridia and CB (n = 18), vaccinated concomitantly for both. Rectal and thermographic temperatures were evaluated on days -1, 0, 1, 2, 3, 5, 7,10, 14, and 28 relatives to the vaccination day. Feed and water intake, body weight (BW), and feeding behavior were monitored daily by an electronic feeding system. Blood was sampled on days 0, 3, 7, 14, and 28, relative to the vaccination day for determination of glucose and β -hydroxybutyrate (BHBA) concentrations. Blood sampled on day 0 (prevaccination) and on days 28 and 42 were used to evaluate the immune response against Brucella abortus and clostridia. There was an increase in rectal temperature between the first and the third day postvaccination in the 3 groups. The thermography revealed an increase of local temperature for 7 d on groups B and CB. Group C had increased local temperature for a longer period, lasting for up to 14 d. Dry mater intake was reduced for groups B and CB, but no alteration was observed for group C. No alterations regarding initial BW, final BW, average daily weight gain, and feed efficiency were observed. No differences were observed for the 3 vaccination groups for blood parameters throughout the evaluation period. The concomitant vaccination against brucellosis and clostridia led to lower neutralizing antibody titers against epsilon toxin of Clostridium perfringens and botulinum toxin type C of C. botulinum (C > CB > B). When cellular proliferation assay and serological tests to B. abortus were evaluated, no differences were observed between groups B and CB. The present results indicate that the concomitant vaccination against brucellosis and clostridia has no relevant impact on the intake, performance, and feeding behavior of dairy calves. However, the concomitant vaccination of vaccines against these 2 pathogens impacts animal immunity against clostridial infections., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society of Animal Science. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Brucellosis is an important occupational disease, mainly among veterinarians, because of their frequent contact with sick animals, contaminated secretions and live attenuated anti-Brucella vaccines. This study aimed to determine the prevalence of accidental exposure to S19 and RB51 vaccine strains and occupational brucellosis among veterinarians registered to administer vaccinations in Minas Gerais, Brazil, as well as to identify the risk factors associated with accidental exposure to anti-Brucella abortus vaccines. Data were collected through an online questionnaire. Three hundred and twenty-nine veterinarians were included in the analyses using stratified random sampling. A multivariate logistic regression analysis was used to evaluate the predictors of accidental exposure to S19 and RB51 strains. Nearly one third of the veterinarians registered to administer bovine brucellosis vaccination in Minas Gerais, 32.83% (108/329) (95% confidence interval [CI]: 27.78-38.19%), reported having been accidentally exposed to S19 or RB51 vaccine strains. The exposure factors associated with this outcome included a score of personnel protective equipment (PPE) use during work (odds ratio [OR], 0.94; 95% CI: 0.89-0.98) and a score of knowledge about brucellosis symptoms, classified as poor (base category), intermediate (OR, 0.26; 95% CI: 0.07-0.87) or good (OR, 0.22; 95% CI: 0.07-0.62). In addition, 4.56% (15/329) (95% CI: 2.57-7.41%) of veterinarians reported that they had brucellosis, of which 46.67% (7/15) considered that the disease was due to accidental exposure to anti-B. abortus live attenuated vaccine. The prevalence of accidental exposure to B. abortus vaccine strains among veterinarians from Minas Gerais enrolled in the control of bovine brucellosis was high. The reduced knowledge about human brucellosis symptoms and lack of appropriate PPE use were risk factors from unintentional contact with S19 and RB51 vaccine strains., (© 2020 Wiley-VCH GmbH.)

In this work, it was developed three-dimensional (3D) porous hydrogel sponges produced by the freeze-dried process using chitosan polymer functionalized by 11-mercaptoundecanoic acid (MUA). These chitosan-based sponges were used as cationic adsorbents for the removal of anionic methyl orange (MO) dye, simulating a model organic pollutant in aqueous medium. Moreover, these porous 3D constructs were also evaluated as 'antibiotic-free' antibacterial materials against gram-negative and gram-positive bacteria, Pseudomonas aeruginosa and Staphylococcus aureus, respectively, which were used as model pathogens possibly found in contaminated hospital discharges. These 3D hydrogels were comprehensively characterized through morphological methods such as scanning electron microscopy and X-ray micro-computed tomography techniques, combined with FTIR, Raman, and UV-visible spectroscopy analyses. Additionally, the surface area, the degree of swelling, and the adsorption profiles and kinetics of these scaffolds were systematically investigated. The chemically thiolated chitosan (CHI-MUA) hydrogels were successfully produced with a supramolecular polymeric network based on hydrogen bonds, disulfide bonds, and hydrophobic interactions that resulted in higher stability in aqueous medium than hydrogels of pristine chitosan. CHI-MUA exhibited sponge-like three-dimensional structures, with highly interconnected and hierarchical pore size distribution with high porosity and surface area. These architectural aspects of the 3D sponges favoured the high adsorption capacity for MO dye (∼388 mg.g -1 ) in water with removal efficiency greater than 90% for MO solutions (from 20 mg.L -1 -1200 mg.L -1 ). The adsorption data followed a pseudo-second-order kinetic model and adsorption isotherm analysis and spectroscopy studies suggested a multilayer behaviour with coexistence of adsorbent-adsorbate and adsorbate-adsorbate interactions. Additionally, the in vitro evaluation of toxicity (MTT and LIVE-DEAD® assays) of 3D-sponges revealed a non-toxic response and preliminary suitability for bio-related applications. Importantly, the 3D-sponges composed of chitosan-thiolated derivative proved high antibacterial activity, specificity against P. aeruginosa (model hazardous pathogen), equivalent to conventional antibiotic drugs, while no lethality against S. aureus (reference commensal bacteria) was observed.

The molecular typing of Mycobacterium bovis , which causes bovine tuberculosis, can be accomplished by combining different polymorphic markers, contributing to its epidemiological investigation. Multispacer sequence typing (MST) is a sequencing-based method that employs intergenic regions susceptible to higher mutation rates given the low selection pressure. It has been applied to M. tuberculosis , but not to M. bovis . The aim of this study was to evaluate a MST for M. bovis . A total of 58 strains isolated from tissues with lesions suggestive of bovine tuberculosis, coming from cattle herds in six Brazilian states and four standard samples of M. bovis were typified employing the MST technique. Fourteen intergenic regions were used, and four types of genetic events were reported: single nucleotide mutation (SNP), insertion, deletion, and tandem repeat (TR). Seven loci were chosen for typing. Twenty-eight type sequences (ST) were identified, indicating type sequences (ST) were identified, indicating a 92.9% HGDI (Hunter Gaston Discriminatory Index). The data were used to analyze the evolutionary patterns of these isolates and correlate them to phylogeographic lineages based on the formation of clonal complexes generated from eBURST software. Later, we associated the MST with spoligotyping technique, currently considered the gold standard for classification of M. bovis . The results support the MST as an alternative method for genotyping of M. bovis . The method has the advantage of sequencing and the availability of sequences analyzed in public databases, which can be used by professionals around the world as a tool for further analysis. This was the first study to identify the variability of isolates of M. bovis by the MST method., 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 © 2021 Sales, Fonseca, Gonçalves, Lage, Andrade, Suffys, Gomes, Dias, Ferreira Neto, Guimarães and Heinemann.)