Search

Hospital-acquired infections (HAIs) increase morbidity, mortality, and health care costs. Effective hand hygiene (HH) is crucial for prevention, but achieving high compliance remains challenge. This study explores using machine learning to integrate an electronic HH auditing system with electronic health records to predict HAIs. A retrospective cohort study was conducted at a Brazilian hospital during 2017-2020. HH compliance was recorded electronically, and patient data were collected from electronic health records. The primary outcomes were HAIs per CDC/National Healthcare Safety Network surveillance definitions. Machine learning algorithms, balanced with Random Over Sampling Examples (ROSE), were utilized for predictive modeling, including generalized linear models (GLM); generalized additive models for location, scale, and shape (GAMLSS); random forest; support vector machine; and extreme gradient boosting (XGboost). 125 of 6,253 patients (2%) developed HAIs and 920,489 HH opportunities (49.3% compliance) were analyzed. A direct correlation between HH compliance and HAIs was observed. The GLM algorithm with ROSE demonstrated superior performance, with 84.2% sensitivity, 82.9% specificity, and a 93% AUC. Integrating electronic HH auditing systems with electronic health records and using machine learning models can enhance infection control surveillance and predict patient outcomes. Further research is needed to validate these findings and integrate them into clinical practice. [Display omitted] • Electronic hand hygiene and health records enhance infection prediction. • Machine learning predicts hospital-acquired infections with high accuracy. • Study finds correlation between hand hygiene compliance and infection rates. • Further validation needed to apply findings in clinical practice. [ABSTRACT FROM AUTHOR]

• Individuals with PAD need assessment instruments that are less dependent on walking and can infer the aerobic capacity. • The SPPB was able to discriminate individuals with PAD stratified into different aerobic levels. • The SPPB is a viable alternative to indirectly assess aerobic capacity in individuals with PAD. Peripheral artery disease (PAD) negatively affects functional ability. Persons with PAD experience gait limitation, and changes in mobility, muscle strength, and balance. Assessing individuals with PAD with tests of lower limb performance during activities other than walking may provide information about aerobic capacity. To evaluate whether the Short Physical Performance Battery (SPPB) can discriminate aerobic capacity and level of physical activity in individuals with PAD. The SPPB, Incremental Shuttle Walking Test (ISWT), and the Human Activity Profile (HAP) were completed by 42 volunteers with PAD. The sample was stratified into tertiles by the distance walked in the ISWT and the Adjusted Activity Score (AAS) of HAP. One-way analysis of variance with a post-hoc least significant difference was used to compare the SPPB values between tertiles of ISWT and AAS of HAP. P-value < 0.05 was considered significant. The mean age was 65 ± 7.7 years, the walking distance was 259.29 ± 115.28 m, and AAS of HAP was 68.36 ± 9.04. There was a significant difference in the total SPPB score and scores for gait speed and sit-to-stand for groups stratified by ISWT and AAS of HAP(p = 0.01). The balance domain was different only for groups stratified into tertiles by AAS of HAP(p = 0.04). The results of this study have clinical relevance for the evaluation of individuals with PAD at different aerobic and physical activity levels. The SPPB is a viable alternative in the practice of the specialty of vascular nursing and other areas of health to assess patients whose ability to perform walking tests is often limited. [ABSTRACT FROM AUTHOR]

The Baveno VII guidelines were proposed to identify which patients could safely avoid screening esophagogastroduodenoscopy (EGD) for gastroesophageal varices. We aimed to evaluate the frequency of gastric neoplasia in compensated advanced chronic liver disease (cACLD) patients who underwent EGD for screening of gastroesophageal varices (GOEV) compared to a healthy population. Retrospective study that enrolled all cACLD patients who underwent EGD for GOEV screening (January 2008-June 2018) in a tertiary reference center. cACLD patients were compared with asymptomatic healthy individuals who underwent EGD in a private hospital setting (April 2017-March 2018). We evaluated 1845 patients (481 cACLD patients, 1364 healthy individuals). A significantly higher frequency of gastric neoplasia was observed in patients with cACLD compared to healthy individuals (4.0% vs. 1.0 %; p < 0.001). Rare histopathological subtypes (WHO Classification) accounted for 28.7 % of gastric carcinoma cases in the cACLD cohort. Seven cases of gastric neoplasia (36.8 % of gastric neoplasia cases in the cACLD patients) were diagnosed in patients who, according to the Baveno VII criteria, would have not been submitted to EGD. We found an increased frequency of gastric neoplasia in patients with cACLD in comparison with healthy individuals. In countries with intermediate-high risk for GC, continuing to perform EGD could be beneficial. [ABSTRACT FROM AUTHOR]

A lower risk of type 2 diabetes mellitus (T2DM) is associated with the intake of insoluble fiber. This contradicts the postulate that insoluble fibers do not decrease postprandial glycemic response and that only viscous gel-forming soluble fibers would do this. This study aimed to investigate the effect of a dose of insoluble fibers that meets dietary recommendations on postprandial hyperglycemia in T2DM patients. This is a randomized crossover clinical trial. Nineteen T2DM men randomly ate a balanced breakfast either without (Control) or with prior consumption of insoluble fibers (5.8 g) in the form of 15 g of raw wheat bran (RWB). Glycemia was measured at fasting and 15, 30, 45, 60, 90, and 120 min postprandially. Markers of taste intensity and palatability were assessed after breakfast intake. The glucose peak rise of 87 mg/dL and the incremental area under the curve (AUC) elicited by the breakfast were decreased by RWB (15.80 % and 23.14 %, respectively). Time-to-glucose-peak did not differ between groups. The addition of the RWB to the meal decreased its level of creaminess and tasty and increased the sourness and bitterness. The postprandial hyperglycemia in T2DM patients in response to complex carbohydrates was decreased by prior intake of a recommended dose of raw insoluble fibers. This antihyperglycemic effect is in accordance with the acarbose-like property of raw insoluble fibres, but not of heated ones (e.g., bread and pasta), to inhibit the activities of the carbohydrate-digesting enzymes alpha-glucosidase/alpha-amylase. RBR-98tx28b (https://ensaiosclinicos.gov.br/rg/RBR-98tx28b). • Postprandial hyperglycemia in diabetic patients was decreased by raw insoluble fibers. • Hyperglycemia elicited by complex carbohydrates was decreased by raw insoluble fibers. • Wheat raw insoluble fiber lowers the glycemic peak rise in diabetics. • Raw wheat bran showed an acarbose-like effect–an α-glucosidase activity inhibition. • Raw insoluble fiber lowers glycemia like acarbose, but heated fiber does not. [ABSTRACT FROM AUTHOR]

The trueness and precision of intraoral scanners (IOSs) and the effect of intracoronal restorations have been reported. However, studies addressing the accuracy of IOSs in reproducing different complete coverage onlay preparation designs are lacking. The purpose of this in vitro study was to evaluate the influence of complete coverage onlay preparation design and intraoral scanning devices on the accuracy of digital scans in terms of trueness and precision. Three preparation designs on the mandibular first molar were considered: a traditional preparation design with isthmus reduction (IST), a traditional preparation design without isthmus reduction (wIST), and simplified nonretentive preparation (nRET). Digital scans of epoxy resin mandibular arch reference models of the preparations (containing second premolar, first molar, and second molar) were obtained by using 3 IOSs (iTero Element 2 [ELE], TRIOS 3 [TRI], and Primescan [PRI]) (n=10). Trueness (μm) and precision (μm) were analyzed by superimposing the digital scan on the digital reference models obtained with a high-accuracy industrial scanner (ATOS Core 80) in a tridimensional metrology software program. Accuracy was quantified by the absolute deviation (μm). Local and overall mean positive and negative deviations for trueness were also obtained. Data were analyzed by using the Kruskal-Wallis and Dunn tests with a statistical software program (α=.05). The nonretentive preparation groups obtained higher trueness (3.8 μm) and precision (2.7 μm) than the IST and wIST groups (trueness=7.5 to 6.3 μm, precision=5.5 to 4.6 μm). Trueness values were lower with ELE×IST (16 μm), followed by ELE×wIST (13 μm), and PRI×IST (7.8 μm). In general, no difference was found between PRI and TRI scanners (6.3 to 5.9 μm), with lower performance for ELE (13 μm). Positive deviations were higher on the proximal box of the IST and wIST preparation and on the occlusal box of the IST group. Negative deviation was higher on the ELE×IST occlusal box. Different intraoral scanners and preparation designs influenced the accuracy of digital scans. A more complex preparation such as IST and wIST showed higher deviation. The iTero Element 2 scanner exhibited higher deviation for both trueness and precision. [ABSTRACT FROM AUTHOR]

Given that people with patellofemoral pain (PFP) exhibit deficits in postural control, certain postural reactions may be associated with movement alterations in this population. Therefore, the objective of the present study was to investigate whether manipulation of the support base for balance maintenance could lead to different patterns of lower limb kinematics in people with PFP during single-legged squats. Fourteen participants with PFP and 14 asymptomatic controls were first assessed performing single-legged squats freely, and then while holding a stick to provide stabilization during the task. Center of pressure (CoP) behavior and movements of the hip, knee, ankle in the sagittal, frontal, and transverse planes were evaluated. For the participants with PFP, the use of support led to a reduction in the magnitude of CoP oscillation compared to free squatting, with effect sizes ranging from small to large, but no significant differences were found for the kinematic variables. No significant differences were observed for CoP or kinematic variables in the comparisons between squat conditions in asymptomatic controls. In summary, performing single-legged squats in a more stabilized condition did not influence lower limb movements in people with PFP. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess functional performance and perceived fatigue post-COVID-19 in asymptomatic or mildly symptomatic patients. A cross-sectional prospective study was conducted of 1448 individuals who were evaluated for perceived fatigue, functional capacity, handgrip strength, physical activity level, pain and dyspnea. IgG anti-SARS-CoV-2 nucleocapsid serology results and self-declared symptoms were used to classify patients into three study groups: SARS-CoV-2 seronegative, asymptomatic SARS-CoV-2 seropositive and mild infection SARS-CoV-2 seropositive. Participants with a history of moderate or severe COVID-19 were excluded from the analysis. Chi-square test and Kruskal Wallis were used to test for associations between variables. Poisson regression with robust variance was performed for perceived fatigue outcome. Statistical significance was defined as p < 0.05. Measurements for physical performance, body pain or dyspnea between the three study groups were similar. However, a significant difference was observed in reported fatigue between the study groups. Poisson crude and adjusted models confirmed an association between SARS-CoV-2 exposure and presence of perceived fatigue among the asymptomatic and symptomatic mild COVID-19 groups (PR = 1.33 [95%CI:1.09,1.61], P = 0.004 and PR = 1.26 [95%CI:1.03,1.53], P = 0.026), respectively. Upon review, although seropositive SARS-CoV-2 individuals presented a higher prevalence of perceived fatigue, their physical performance was equal to that of the seronegative group. [ABSTRACT FROM AUTHOR]

Pregnancy's physiological changes and weight gain can decrease balance control, increasing the risk of falls and impacting quality of life. The effect of obesity on balance control in pregnant women needs further investigation. Investigate the effect of obesity during pregnancy on center of pressure (COP) control under sensory disturbances at different gestational age. The COP (95% ellipse area, mean velocity and total length) of 23 pregnant women classified as normal weight (CG: n = 12) and obese (OG: n = 11) was evaluated at three gestational-age week times (T1 = 16th, T2 = 24th, T3 = 32nd week) on a force platform on standing position (SP) and under three disturbances: 1) visual disturbance (eyes closed), 2) proprioceptive disturbance (over an unstable surface) and, 3) vestibular disturbance (head movement). A mixed ANOVA (3 repeated measures vs. 2 groups) and LSD post-hoc was applied to examine main effects and interactions. Effect sizes were assessed using generalized eta squared (η2). As main effect, in SP, COP area increased from T2 to T3 for both groups (P = 0.021, η2 = 0.193). One interaction was observed, under visual disturbance, the area increased from T2 to T3 only in the CG group (P = 0.020, η2 = 0.195). The progression of pregnancy negatively impacts postural stability throughout its course. Visual disturbance only affected the balance of the CG. Hence, obesity combined with pregnancy does not appear to alter COP variables. [ABSTRACT FROM AUTHOR]

To evaluate the presence of host bone marrow edema (BME) surrounding osteochondral allograft (OCA) plugs on routine 6-month postoperative magnetic resonance imaging (MRI) and to determine whether such BME is correlated with subsequent failure. The present study was approved under our institutional review board–approved database (#2020-2123). We included patients who underwent cartilage repair with OCA for focal chondral and osteochondral defects of the distal femur by 2 senior surgeons between January 2016 and May 2021 with minimum 2-year follow-up. OCA is frequently performed with concomitant procedures, and therefore ligament reconstruction, meniscal surgery, and osteotomy were not exclusion criteria. Failure was defined as (1) poor clinical outcome with graft collapse on follow-up MRI or second-look arthroscopy, (2) primary OCA removal or revision, or (3) conversion to unicompartmental or total knee arthroplasty. Routine MRI scans were performed at 6 ± 2 months postoperatively. All postoperative MRI scans were reviewed from our imaging record by 2 blinded fellowship-trained orthopaedic surgeons. Patients were divided for analyses into 2 groups: BME ≥10 cm3 versus BME <10 cm3. Of the 85 patients eligible for the study, 56 patients (30 female, mean age 31.69 ± 11.34 years) had a minimum 2-year follow-up. Nonfailure cases had a mean clinical follow-up of 3.13 ± 0.93 years. The mean time from surgery to failure in our cohort was 1.67 ± 0.91 years. There were 12 (21.4%) patients with BME ≥10 cm³ and 44 (78.6%) patients with BME <10 cm³. No statistically significant differences were found between groups when compared for sex, age, body mass index, OCA size, time to MRI, mean follow-up, number of plugs, graft location, diagnosis, previous surgeries, or concomitant procedures. All OCA failures of the study cohort were in the BME ≥10 cm³ group, representing 50% of this group (P <.001). Kaplan-Meier survival analysis with the log-rank test demonstrated significant difference in survival distributions between groups (P <.001). Patients who ultimately failed had a mean BME volume of 18.49 ± 5.82 cm3, while the nonfailure group had a mean volume of 4.66 ± 4.97 cm3 (P <.001). Cutoff values around 10 cm³ in receiver operating characteristic curve analysis demonstrated 100% sensitivity and close to 90% specificity for OCA failure diagnosis. Host BME with a volume greater than 10 cm³ on 6-month postoperative MRI is predictive of an increased subsequent failure rate after OCA transplantation with a failure rate of 50%. Level III, cohort study. [ABSTRACT FROM AUTHOR]

This study evaluated the probability of developing malocclusions in mixed dentition. A longitudinal study was conducted with 598 children (aged 5 years) in deciduous dentition. The children were followed for 3 years until mixed dentition (aged 8 years). Overjet, overbite, and transversal relations were evaluated. Bayesian models were used to analyze the data and estimate the parameters. The parameter θ was used for the distributions, indicating the probability of presenting a given condition with a credibility index (ICr) of 95%. After 3 years of follow-up, 121 children were reevaluated. The results showed that children have a high probability of malocclusion in mixed dentition. There was a higher probability of developing an increased overjet in the mixed dentition of 20.5% (ICr 95%, 13.6-28.4) to 48.3% (ICr 95%, 39.1-57.7) and a higher probability of having a normal overbite in the deciduous dentition and a lower probability in the mixed dentition (ICr 95%, 9.2-21.3). Considering the probabilistic model of Bayesian analysis, children with normal overjet in the deciduous dentition may show an increased overjet in the mixed dentition. Concerning overbite, children may present an anterior open bite during the transition between deciduous and mixed dentition, as well as self-correction of deep overbite in mixed dentition. Furthermore, they may present a posterior crossbite during the mixed dentition when there is a normal transverse relationship in the deciduous dentition. • We assessed the probability of developing malocclusion in the primary dentition for mixed dentition. • The probability analysis used Bayesian statistical methods, a pioneering study in the field. • Our findings indicate a higher likelihood of developing increased overjet in the mixed dentition compared to the primary dentition. • Children are more inclined to exhibit a reduced overbite in mixed dentition than in the primary dentition. • Bayesian analysis can be employed to assess the likelihood of malocclusion. [ABSTRACT FROM AUTHOR]

Complete denture wearers present with less sensory function than dentate individuals because of the loss of periodontal receptors. However, the role of the palatal receptors on such function is still unclear. The purpose of this systematic review and meta-analysis was to evaluate the influence of palatal coverage associated with complete dentures or palatal devices on oral stereognosis in edentulous or dentate adults. Eight major literature databases and the nonpeer-reviewed literature were searched up to December of 2021. Randomized clinical trials and nonrandomized clinical trials comparing oral stereognosis in edentulous or dentate participants using conventional complete dentures or implant-supported prostheses or those using palatal devices were included. Bias was assessed with Cochrane tools (ROBINS-I and RoB 2.0). Meta-analyses were conducted to compare oral stereognosis before and after palatal coverage (α=.05). Certainty of the evidence was verified using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Of 14 included studies, the risk of bias was considered low for 9 studies and moderate for 5 studies. Despite the very low certainty of evidence, meta-analyses showed no differences in oral stereognosis immediately after complete denture insertion (standardized mean difference [SMD]=0.302; 95% confidence interval [CI]: −0.124, 0.728; P =.165; I2=92.4%). Oral stereognosis scores improved after ≥1 month of complete denture use compared with initial evaluations without them. Qualitative analysis indicated that oral stereognosis was not influenced by palatal coverage shortly after complete denture installation and that oral stereognosis scores improved over time after prosthesis use. Oral stereognosis improved with the use of palate-covering prostheses over time. However, because of the very low certainty of evidence, the statement must be interpreted with caution. [ABSTRACT FROM AUTHOR]

To explore the relationship between knee crepitus, quadriceps muscle thickness and isometric strength in individuals with patellofemoral pain (PFP). Cross-sectional. Individuals with PFP. Participants with PFP underwent assessments for presence, frequency and severity of knee crepitus. Real-time ultrasound images of the quadriceps muscles (rectus femoris, vastus medialis and lateralis) at rest and during contraction were obtained, muscle thickness was measured in both conditions. Maximal voluntary isometric contraction tests were performed to measure knee extensor strength. The relationship between knee crepitus and quadriceps muscle thickness and knee extensor strength was explored using logistic and linear regressions. Sixty individuals with PFP were included (age: 24; 60% women; 38% with crepitus). Knee crepitus severity was related to rectus femoris and vastus medialis thickness during rest (R2 = 0.19 and 0.09, respectively) and contraction (R2 = 0.16 and 0.07, respectively) and with vastus lateralis during contraction (R2 = 0.08). Isometric knee extensor strength was not related to knee crepitus presence, frequency, or severity. Higher severity of knee crepitus is related to lower quadriceps muscle thickness in individuals with PFP. There is no relationship between the presence and frequency of knee crepitus with quadriceps muscle thickness or knee extensor strength. • Knee crepitus severity is related to quadriceps muscle thickness in individuals with patellofemoral pain. • Knee crepitus presence and frequency are not related to quadriceps muscle thickness in individuals with patellofemoral pain. • Knee crepitus is not related to knee extensor muscle torque in individuals with patellofemoral pain. [ABSTRACT FROM AUTHOR]

• Volume increased along with the difficulty level of walking trails, while intensity remained unchanged. • All CENTR(AR) walking trails seem to be of moderate intensity for COPD. • Walking trails were safe and can be used to promote physical activity in COPD. Validating walking trails is essential to promote physical activity (PA) safely and confidently in people with COPD. We aimed to validate predetermined light, moderate, and vigorous intensities of walking trails in people with COPD. This cross-sectional study included individuals with COPD walking in predetermined light, moderate and vigorous intensity trails. Activity intensity and volume outcomes were collected. Dyspnoea and fatigue (modified Borg scale), energy expenditure (EE, Sensewear), heart rate (HR, HR monitor), time spent in different PA intensities, and cadence (ActiGraph) were recorded and used to classify PA intensity. Twenty people with COPD [71(7) years, 80 % male, FEV 1 %predicted 65.6(11.6)] were included. Fatigue differed significantly between light and moderate [3.0(2.0;4.0) vs 3.4(2.5;4.5), p = 0.01], but not vigorous (3.5[2.5–4.0]) tracks. Dyspnoea [2.3(1.5) vs 2.7(1.6) vs 2.6(1.4)], EE [5.1(0.8) vs 4.9(0.5) vs 4.6(0.8) METs], HR [92.5(11.1) vs 93.7(18.6) vs 95.4(15.0) beats/min] and cadence [115.1(104.0;120.3) vs 104.7(99.6;117.6) vs 111.2(99.9;118.5) steps/min] were similar across trails (p > 0.05). Time spent in light and moderate PA, EE volume, walking time, and step count increased along with the proposed intensity levels (p < 0.01). Walking trails were categorised as moderate intensity in most participants. Walking trails were safe and valid for practising moderate-intensity PA in people with COPD. Participants adjusted their physiological responses and perceived symptoms to match a moderate intensity. [ABSTRACT FROM AUTHOR]

The Northeast region of Brazil boasts a rich tradition of utilizing natural resources, particularly medicinal plants, for therapeutic purposes, especially wound healing. However, many of these plants lack comprehensive investigation into their phytochemical, pharmacological, and toxicological properties. This article presents a literature review focused on the phytochemical and pharmacological studies of medicinal plant extracts from Northeastern Brazil, renowned for their healing properties. Employing the PRISMA methodology, a thorough search of electronic databases such as PUBMED, ScienceDirect, SCOPUS, and Web of Science was conducted, yielding 16 pertinent articles. These studies revealed promising outcomes regarding the curative activity of plants from eleven different families in preclinical trials. Notably, these plants are abundant sources of biologically active compounds including flavonoids, tannins, chalcones, alkaloids, saponins, triterpenes, and steroids, crucial for wound healing. Animal models, most often the "excision wound" model, demonstrated that 88% of the evaluated plants expedited the healing process. Furthermore, these extracts were assessed for their antibacterial, anti-inflammatory, toxic, and antioxidant properties alongside their healing effect. Despite showcasing significant healing potential, the precise mechanisms underlying their action remain elusive, underscoring the necessity for further preclinical trials to comprehensively evaluate the healing activity of plant extracts from the northeast. [Display omitted] • Plant extracts tested in animal models showed promising results in accelerating the healing process. • Phenolic compounds are frequently correlated to the wound healing activities observed. • The Fabaceae family recorded the highest number of species with healing properties. • Further tests to evaluate the healing activity of these plant extracts are necessary in order to investigate the mecanism of action. [ABSTRACT FROM AUTHOR]

Respiratory symptoms are a frequent manifestation of patients with post-acute sequela of SARS-CoV-2 (PASC), also known as long-COVID. Many cohorts of predominantly hospitalized patients have shown that a significant subset may have persistent chest computed tomography findings for more than 12 months after the acute infection. Proper understanding of the evolving long-term imaging findings and terminology is crucial for accurate imaging interpretation and patient care. The goal of this article is to review the chronic chest computed tomography findings of patients with PASC and common pitfalls. [ABSTRACT FROM AUTHOR]

In one of the world's worst mining disasters, after flowing 670 km down the Doce River, about 20 million m3 of tailings reached the coast of Brazil in November 2015. The occurrence of persistent northerly winds favored the detachment of the river plume from the coastline and its displacement southward. However, observations of the sediment plume along the coast during the year following the breach, using aerial photographs, indicated that the plume is more extensive and persistent in a northerly direction. Previous studies have shown that although the most persistent winds are from the northern sector (70%), there is a greater incidence of waves from the southern sector (62%), especially with greater heights and periods. In this research, the effect of gravity waves on the transport of sediments is investigated, and, therefore, tailings from the Doce River and deposited on the adjacent inner continental shelf, mixed with the fluvial mud deposit also are investigated. Two mechanisms were investigated: 1) the effect of waves on sediment resuspension and their combination with tidal and wind forcings, using a two-dimensions in the horizontal directions (2DH) numerical model within the DELFT3D software, and 2) the capture of the fluvial plume by littoral drift, calculated by means of analytical models using data from wave propagation modeling. Both mechanisms were studied for 2019, also considering two major meteorological events in the region. Both effects were relevant for the northward dispersion of fine sediment, highlighting the effect of waves on the potential for northward transport of tailings towards the Abrolhos Bank. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effects of photobiomodulation therapy (PBMT) on the gastrocnemius muscle of X-linked muscular dystrophy (mdx) mice. The study used an experimental model of Duchenne muscular dystrophy, at 3 stages of degeneration/regeneration of muscle fibers: an acute stage (14-28 days old), acute and stabilized stages (14-42 days old), and a stabilized stage (28-42 days old). Photobiomodulation therapy (also known as low-level light therapy) at 0.6 J was applied 3 times per week to the dystrophic gastrocnemius muscle of mdx mice at ages 14 to 28, 14 to 42, and 28 to 42 days. After the treatment period, the gastrocnemius muscle was collected, and cryosections were prepared for histopathologic analysis. In all 3 stages evaluated, a significant reduction was observed in immunoglobulin G uptake by muscle fibers, the inflammatory area, macrophage infiltration, the reactive dihydroethidium area, and the number of autofluorescent lipofuscin granules in the gastrocnemius muscle of mdx mice after PBMT. The results demonstrated that low-level light therapy, when applied during or after the acute phase of the degeneration/regeneration muscle process, improves the pathological histomorphologic features in dystrophic muscle. Based on these results, PBMT appears to be a promising therapy for dystrophinopathies, warranting further research in humans to verify its efficacy. [ABSTRACT FROM AUTHOR]

Additive Manufacturing (AM) is vital for industrial innovation, offering high potential for groundbreaking solutions. However, its successful implementation still depends on overcoming several challenges. Particularly, the assessment of surface integrity in AM-generated components, and its degradation when subjected to contact stresses presents an ongoing endeavor. Within this context, the current work delves into the study of the surface integrity of 20MnCr5 case-hardened samples manufactured through laser powder bed fusion (L-PBF), as well as delves into the investigation of surface failure progression when the samples are subjected to cyclic contact stresses. This study encompasses the analysis of residual stresses, hardness, and roughness of specimens manufactured through both additive and conventional production routes. The study's findings show that it is feasible to attain analogous surface quality when proper finishing is applied to L-PBF samples. Although, despite the comparable surface quality, the contact fatigue performance was significative lower on the AM sample when compared to the conventionally manufactured. Additionally, additive manufacturing brings up new challenges to performance by presenting a heterogeneous stress distribution and sub-superficial porosity. In conclusion, to attain a desirable surface integrity for additive manufactured parts, further research should not only focus on improving the process parametrization but should also developing finishing routes especially oriented to additive manufacturing, considering therefore how the interaction between the manufacturing processes will evolve into a desirable surface integrity state. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, health service practices underwent significant changes, impacting the occurrence of health care–associated infections (HAIs). This study presents the epidemiology of bacterial infections and compares clinical data on nosocomial infections in hospitalized patients before and during the pandemic. A unicentric, observational, retrospective cohort study was conducted with descriptive analyses on the microorganism identification and resistance profile. Patient's clinical data who had hospital-acquired infection (HAI), during their hospitalization in a tertiary hospital before and during the COVID-19 pandemic was compared by descriptive and inferential analyses. A total of 1,581 bacteria were isolated from 1,183 hospitalized patients. Among patients coinfected with COVID-19, there was a statistically significant increase in HAI-related deaths (P <.001) and HAI caused by multidrug-resistant organisms (P <.001), mainly by Acinetobacter baumannii and Staphylococcus aureus. A higher odds ratio of HAI-related deaths compared to the prepandemic period was observed (odds ratio 6.98 [95% confidence interval 3.97-12.64]). The higher incidence of multidrug-resistant bacteria and increased deaths due to HAI, especially in patients with COVID-19 coinfection, might be related to various factors such as increased workload, broad-spectrum antibiotic use, and limited resources. The pandemic has changed the profile of circulating bacteria and antimicrobial resistance. Prevention strategies should be considered to reduce the impact of these infections. • COVID-19 pandemic increased the incidence of Healthcare-Associated Infections. • Non-fermenting BGN and MRSA were more prevalent microorganisms of HAIs. • Patients with HAIs during the pandemic presented elevated risks of mortality. • Patients with at least one MDR infection exhibited a heightened risk of death. [ABSTRACT FROM AUTHOR]

• RS excels in small-medium VS hearing. • MF for intracanalicular, RS for larger. • Meta-analysis favors RS for VS. Vestibular schwannomas (VS) are benign tumors arising from vestibular nerve's Schwann cells. Surgical resection via retrosigmoid (RS) or middle fossa (MF) is standard, but the optimal approach remains debated. This meta -analysis evaluated RS and MF approaches for VS management, emphasizing hearing preservation and Cranial nerve seven (CN VII) outcomes stratified by tumor size. Systematic searches across PubMed, Cochrane, Web of Science, and Embase identified relevant studies. Hearing and CN VII outcomes were gauged using the American Academy of Otolaryngology-Head and Neck Surgery, Gardner Robertson, and House-Brackmann scores. Among 7228 patients, 56 % underwent RS and 44 % MF. For intracanalicular tumors, MF recorded 38 % hearing loss, compared to RS's 54 %. In small tumors (<1.5 cm), MF showed 41 % hearing loss, contrasting RS's lower 15 %. Medium-sized tumors (1.5 cm–2.9 cm) revealed 68 % hearing loss in MF and 55 % in RS. Large tumors (>3 cm) were only reported in RS with a hearing loss rate of 62 %. Conclusively, while MF may be preferable for intracanalicular tumors, RS demonstrated superior hearing preservation for small to medium-sized tumors. This research underlines the significance of stratified outcomes by tumor size, guiding surgical decisions and enhancing patient outcomes. [ABSTRACT FROM AUTHOR]

Conduction system pacing (CSP) has emerged as a promising alternative to biventricular pacing (BVP) in patients with heart failure with reduced ejection fraction (HFrEF) and ventricular dyssynchrony, but its benefits are uncertain. In this study, we aimed to evaluate clinical outcomes of CSP vs BVP for cardiac resynchronization in patients with HFrEF. PubMed, Scopus, and Cochrane databases were searched for randomized controlled trials comparing CSP to BVP for resynchronization therapy in patients with HFrEF. Heterogeneity was examined with I2 statistics. A random-effects model was used for all outcomes. We included 7 randomized controlled trials with 408 patients, of whom 200 (49%) underwent CSP. Compared to BVP, CSP resulted in a significantly greater reduction in QRS duration (MD –13.34 ms; 95% confidence interval [CI] –24.32 to –2.36, P =.02; I2 = 91%) and New York Heart Association functional class (standardized mean difference [SMD] –0.37; 95% CI –0.69 to –0.05; P =.02; I2 = 41%), and a significant increase in left ventricular ejection fraction (mean difference [MD] 2.06%; 95% CI 0.16 to 3.97; P =.03; I2 = 0%). No statistical difference was noted for left ventricular end-systolic volume (SMD –0.51 mL; 95% CI –1.26 to 0.24; P =.18; I2 = 83%), lead capture threshold (MD –0.08 V; 95% CI –0.42 to 0.27; P =.66; I2 = 66%), and procedure time (MD 5.99 minutes; 95% CI –15.91 to 27.89; P =.59; I2 = 79%). These findings suggest that CSP may have electrocardiographic, echocardiographic, and symptomatic benefits over BVP for patients with HFrEF requiring cardiac resynchronization. [Display omitted] [ABSTRACT FROM AUTHOR]

Obtaining an aircraft carrier represents a vital resource for bolstering a nation's defense and security capabilities, ensuring the projection of power and influence on a global scale while fostering security and stability at both the regional and international levels. In this sense, this article aims to select a suitable aircraft carrier for Brazil, based on the Multicriteria Decision Making Methods, Analytic Hierarchy Process (AHP), and Simple Weighted Sum-Product Method (WISP), to enhance the capacity to project naval power and contribute to national security and sovereignty. To this end, experts were consulted who identified six aircraft carrier models as alternatives, along with eight evaluation criteria. The AHP Method was used to determine the weights of the criteria considered in this study, while the WISP was used to order the previously selected aircraft carrier alternatives. The results obtained after modeling the problem indicated the choice of the Nimitz-class aircraft carrier. However, it is crucial to consider whether Brazil has the financial resources available for the acquisition of this vessel. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of radiotherapy and taper of root canal preparation on the biomechanical behavior of mesial roots of mandibular molars. Eighty mandibular molars with 2 canals in the mesial root were randomly allocated into 2 groups (n = 40): one group underwent irradiation (60 Gy), while the other did not. Subsequently, the mesial roots were sectioned and each group was subdivided into 5 subgroups (n = 8), according to the preparation taper: no preparation (control); 25.03; 25.04; 25.06; and 25.08. All groups were considered homogeneous regarding their dimensions, weight, and morphology. The prepared specimens were embedded in cylindrical plastic molds and subjected to a cyclic fatigue test. A failure analysis was performed according to the extension and course of the fractures. Two-way ANOVA, Tukey's post-hoc, Fisher's exact, and Kaplan–Meier tests were conducted to evaluate the obtained data (α = 5%). Fatigue resistance decreased as the taper of the preparation increased (P <.05). Preparation 25.03 presented significantly higher values only than 25.08 (P <.05), while 25.04, 25.06, and 25.08 were considered similar (P >.05). Irradiation significantly reduced the biomechanical performance (P <.05). Survival analysis corroborated these findings. There were no differences in the distribution of fracture types among the groups (P >.05). The biomechanical behavior of the mesial roots of the mandibular molars decreased significantly in the face of irradiation and as the taper of the preparation increased. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The SAFE EUROPE project, a European-funded project, addressed educational gaps of Therapeutic Radiographers/Radiation Therapists (TR/RTTs) by offering a series of free webinars. This study aimed to assess the quality of these webinars and their impact on professional practice. Data collection involved two methods: an automated feedback form administered after each webinar, supplemented by a survey disseminated through social media. The collected data encompassed attendance statistics, participants' professions and geographic locations, webinar quality assessment, the acquisition of new knowledge and skills, the application of this newfound knowledge in practice, and the likelihood of recommending these webinars. Descriptive statistics and thematic analysis were used to analyse the quantitative and qualitative data, respectively. Ethical approval for the study was obtained. 11,286 individuals from 107 countries participated in 18 webinars. Despite 72.7% being radiographers, a diverse array of professionals attended the webinars, including medical physicists, oncologists, radiologists, and academics. Remarkably, 98.7% of respondents rated the webinar quality as either good or excellent. The average rating for the likelihood of recommending these webinars to colleagues was 8.96/10. A substantial proportion of respondents expressed agreement or strong agreement that the webinars enhanced their knowledge (85%) and skills (73%). Furthermore, 79% of participants indicated that the webinars motivated them to change practice, with 65% having already implemented these changes. The insights from open-ended questions corroborated these findings. The webinars effectively achieved the aim of the SAFE EUROPE project to enhance practice by increasing knowledge and skills. Participants overwhelmingly endorsed the quality of these webinars. Webinars represent a cost-efficient training tool that reaches a global audience and various radiography/radiotherapy professions. The development of additional webinars is strongly recommended. [ABSTRACT FROM AUTHOR]

To assess the incidence of fever at diagnosis in children with leukemia and determine if fever at diagnosis is a predictor of bloodstream infection (BSI) or central venous access device (CVAD) removal for infection either within the first 30 days or between 30 and 90 days after CVAD insertion. One hundred fifty-one patients with acute leukemia (July 1, 2018, to December 31, 2020) who underwent a CVAD insertion within 2 weeks of diagnosis were included. Patient data included demographic characteristics, fever at diagnosis, CVAD type, antibiotics before and/or on the day of CVAD insertion, BSI incidence, BSI rates per 1,000 catheter days, and need for catheter removal after CVAD insertion within 30 days and between 30 and 90 days. Patients with fever at diagnosis had a significantly higher incidence of BSI within the first 30 days after CVAD insertion (17/23) than that among patients without fever (6/23) (P =.046) at diagnosis. No statistically significant difference was observed in the incidence of BSI between 30 and 90 days after CVAD insertion between patients with fever (5/11) and those without fever at diagnosis (6/11) (P =.519). Fever at diagnosis was not a predictor of CVAD removal within 30 days (9 patients required CVAD removal; 7/9 had fever and 2/9 had no fever) (P =.181) or between 30 and 90 days (4 patients required CVAD removal; 1/4 had fever and 3/4 had no fever at diagnosis) (P =.343) after insertion. Fever at diagnosis in patients with leukemia is not a predictor of CVAD removal for infection. [Display omitted] [ABSTRACT FROM AUTHOR]

Ichthyophthirius multifiliis , the causative agent of white spot disease, is a ciliated protozoan parasite that infects freshwater fish and induces high mortality. Outbreaks occur both in natural and production sites. The aim of the present study was to describe the lesions caused by chronic infection by I. multifiliis in goldfish (Carassius auratus) from an ornamental fish farm, highlighting important ultrastructural aspects of this protozoan. Damaged skin and gills, collected from fish with white or ulcerative skin lesions, were routinely processed for histological analysis and transmission electron microscopy. The parasitic forms present in the skin were associated with an inflammatory infiltrate consisting of macrophages, lymphocytes and other polymorphonuclear cells. The lesions associated with the presence of the parasite were organized in the form of granulomas, with macrophages in the layers closest to the parasites. A trophont-thickened membrane and induction of granulomatous inflammation were identified in this study as mechanisms for evasion of the immune response. We concluded that the presence of I. multifiliis trophonts resulted in the formation of granulomatous inflammation, whether associated or not with pathogen lysis, suggesting that the parasite can use an inflammatory response to evade the immune response. [ABSTRACT FROM AUTHOR]