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Background and context of the study: Neck pain is a prevalent and globally burdensome problem. Clinical practice guidelines have recommended conservative treatments such as education, exercise therapy (ET), manual therapy (MT), and pharmacological therapy (i.e., medication) to manage all types of neck pain based on the chronicity of the disease (acute, subacute, and chronic pain). However, there is scarce evidence to determine which interventions constitute the most effective strategy for this condition. Research question: What are the best conservative treatment options (i.e., ET, MT, education, and/or medication) to relieve pain and disability-related outcomes in patients with neck pain? The overall purpose of the study: (1) To identify which type of conservative treatment (education, ET, MT, and/or medication) and their combinations have the greatest probability of being most effective for neck pain using a network meta-analysis (NMA) approach. (2) To rank these conservative treatments in terms of safety (when possible) and effectiveness for managing neck pain. Methodology: Systematic review (SR) with NMA of randomized controlled trials (RCTs). Studies should include adults (aged > 18) with neck pain who received any of the interventions of interest (education, ET, MT, and medication). The main outcome will be pain intensity. Searches will be conducted in Ovid Medline All®, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus, and Cochrane Library Trials database. No language or publication date restrictions will be applied. The revised Cochrane Risk-of-Bias (RoB) tool for RCTs (RoB-2) will be used to evaluate RoB, and the certainty of evidence will be evaluated by Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). NMAs will be conducted to rank interventions according to their effectiveness and safety (when possible), allowing a comprehensive analysis of all available evidence, with different nodes specified for all conservative interventions of interest, placebo, sham therapy, and non-intervention control. Major findings/summary of interpretations/conclusions: This NMA will help clinicians and the scientific community choose the most effective strategy or combinations of strategies for treating neck pain. The information gathered in this project will inform decision-making and guide personalized care of individual patients in the future. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic had a widespread global impact and presented numerous challenges. The emergence of SARS-CoV-2 variants has changed transmission rates and immune evasion, possibly impacting the severity. This study aims to investigate the impact of variants on clinical outcomes in southern Brazil. Methods: In total, samples from 277 patients, hospitalized and non-hospitalized, were collected between March 2020 and March 2021, before the vaccine was made widely available to the general population in Brazil. Whole genome sequencing of SARS-CoV-2 was performed and bioinformatics and biostatistics analyses were implemented on molecular and clinical data, respectively. Results: The study identified significant demographic and clinical differences. The hospitalized group exhibited a higher proportion of males (51.9%) and an increased prevalence of comorbidities, including hypertension (66.0%), obesity (42.6%), and chronic kidney disease (23.6%). Patients were identified with twelve SARS-CoV-2 strains, predominantly B.1.1.28 and B.1.1.33 in the early 2020 first wave, and P.1 overlapping in the late 2020 and early 2021 second wave of COVID-19. Significant differences in hospitalization rates were found among patients infected with the different SARS-CoV-2 lineages: B.1.1.33 (46.0%), B.1.1.28 (65.9%), and P.1 (97.9%). Severity markers, such as pneumonia (62.5%, p=0.002), acute respiratory distress syndrome (ARDS, 72.9%, p<0.001), and oxygen support >6 L/min O2 (64.6%, p<0.001), were more frequent in patients from the second wave. These findings highlight the impact of different variants on the clinical evolution and prognosis of COVID-19, especially when comparing the first and second waves of the pandemic. Conclusions: The study underscores the association between SARS-CoV-2 strains and COVID-19 severity by integrating clinical and viral data for public health responses during different pandemic phases, highlighting the importance of adapting pandemic strategies as the pandemic evolves. [ABSTRACT FROM AUTHOR]

Biomechanical studies in sauropod dinosaurs are mainly focused on neck posture and feeding strategy. Few works investigate other aspects such as tail movement and function, especially in the clade Titanosauria, the most diverse within Neosauropoda. This study applied biomechanical concepts of neutral pose (cartilaginous neutral pose) and range of motion to verify the shape and direction of the caudal region of the advanced titanosaurs Adamantisaurus mezzalirai and Baurutitan britoi, in addition to comparing it with other titanosaurs (e.g., Arrudatitan maximus, Lirainosaurus astibiae, and Trigonosaurus pricei). As a result, the tails analyzed have a sigmoidal‐convex shape, probably close to the ground (but not touching it). The sigmoidal‐convex shape could increase the moment arm for the M. caudofemoralis longus, making it possible to use the tail as a fifth stabilizing member. This work expands our knowledge about sauropod dinosaurs by exposing a diversity of shapes for the tails of titanosaur sauropods and brings new possibilities for how these dinosaurs could use their tails. [ABSTRACT FROM AUTHOR]

Background: In this study, we investigated the role of extracellular vesicles (EVs) in the pathogenesis of Congenital Zika Syndrome (CZS). Previous studies have highlighted the role of EVs in intercellular communication and the modulation of biological processes during viral infections, motivating our in-depth analysis. Our objective was to identify specific molecular signatures in the EVs of patients with CZS, focusing on their potential as biomarkers and on cellular pathways affected by the infection. Methods: We conducted advanced proteomic and metabolomic analyses using mass spectrometry for protein and metabolite identification. EVs were isolated from CZS patient samples and control groups using Izon qEV size-exclusion chromatography columns. Results: The analyzed EVs presented distinct molecular profiles in patients with CZS. Proteomic analysis revealed significant alterations in specific proteins, suggesting involvement in the PI3K-AKT-mTOR pathway, while metabolomics highlighted metabolites related to critical processes in Zika virus pathogenesis. These findings suggest a key role for the PI3K-AKT-mTOR pathway in regulating cellular processes during infection and indicate the involvement of EVs in intercellular communication. Additionally, the results identified potential biomarkers capable of aiding early diagnosis and assessing disease progression. Conclusions: This study demonstrates that EVs play a crucial role in intercellular communication during Zika virus infection. The identification of specific alterations in the PI3K-AKT-mTOR pathway highlights a possible therapeutic target, providing new opportunities for the development of more effective treatment strategies for CZS. Our findings significantly advance the understanding of CZS and underscore the need for further investigations using advanced techniques to validate and explore these potential molecular targets. [ABSTRACT FROM AUTHOR]

Titanosaurs were the most diverse sauropod group during the Cretaceous period, with most of its diversity being found during the Late Cretaceous. In this work, Tiamat valdecii , gen. et sp. nov. is described, a new species of basal titanosaur prospected from the Açu Formation (Albian–Cenomanian), Potiguar Basin, Ceará state, north-east Brazil. The new taxon is composed by an associated sequence of anterior to middle caudal vertebrae, being diagnosed by four diagnostic features: a marked accessory tuberosity dorsoventrally developed, located on the prezygapophyses; deeply medioventral excavated articulation facets of prezygapophysis and post-zygapophyses articular facets; presence of developed hypantrum–hyposphene articulations; and short middle centra with a well-marked articular facet for the haemal arch. The phylogenetic analysis reveals that Tiamat valdecii was a basal member of Titanosauria. Tiamat is the first species of Early Cretaceous titanosaur known for the Açu Formation. Biomechanical analysis shows that the tuberosity and excavation of the zygapophyses of the middle caudal vertebrae of Tiamat provide greater stability against shear loads in the amphicoelous vertebrae presented; in addition, they allow greater range of lateral movements without affecting the integrity of the joints. These features may have been an evolutionary alternative for the stability of the middle of the caudal vertebral column. The discovery of T. valdecii in the Açu Formation not only increases the known dinosaur diversity for this unit, but also helps us elucidate part of the first titanosaur radiation. [ABSTRACT FROM AUTHOR]

Several theoretical frameworks have been used to understand exercise adherence. Basic psychological needs (BPN), grounded on self‐determination theory, have received large attention for this purpose. More recently, the hedonic theory and the assumptions related to the exercise characteristics (e.g., intensity) that can bolster positive affective responses have been revitalized. This study aimed to explore the associations between the agreement of current exercise intensity and the one individually preferred, BPN satisfaction/frustration, enjoyment, the intention to continue exercise, and exercise frequency. Additionally, an exploration of the direct and indirect effects while testing sex as a moderator was performed. A sample of 369 exercisers (Mage = 43.6, standard deviation = 12.96; 214 females) enrolled in 26 health clubs participated in this study voluntarily. Data were received in a first‐approach descriptive and correlational analyses. Next, a moderated mediation was performed using model 15 (PROCESS v.4.2). As a result, agreement in preference for exercise intensity was positively associated with enjoyment (r = 0.35), intention (r = 0.43), and all needs satisfaction (ranging from r = 0.12 to r = 0.45) and negatively associated with all needs frustration (ranging from r = −0.15 to r = −0.31). In the moderated mediation analysis, the same pattern of results emerged in direct effects. Indirect effects were significant for autonomy in the enjoyment and frequency models. Findings suggest that promoting an individually adjusted training intensity may foster BPN satisfaction. It appears to be present an independent (of needs) and positive association with exercise enjoyment and intention to continue exercising. Highlights: An agreement between exercise intensity and the one individually preferred can be seen as a need‐supportive toolExercise intensity agreement presents an independent effect on exercise enjoyment and intentionThe way autonomy promotes enjoyment may be different between sexes, a relation that seems to favor menFemales appear to be more dependent on preference agreement to support enjoyment and intention, while in men, this relation appears to be valid only for intention [ABSTRACT FROM AUTHOR]

This article examines the expression and activity of plasmacytoid dendritic cells (pDCs) in patients with recurrent erythema multiforme (REM), a condition characterized by repeated outbreaks of erythema multiforme (EM). The study found that REM patients had increased expression of CD123, a marker for pDCs, in the epidermis and dermis. However, they also had reduced expression of Toll-like receptor 9 (TLR9), which suggests impaired activation of pDCs. The authors hypothesize that this impaired activation may contribute to the persistence of herpes simplex virus (HSV) and REM episodes. Further research on the role of reduced TLR9 expression in REM patients could lead to new targeted therapies. [Extracted from the article]