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Abstract Background This study aimed to develop prognostic models for predicting the need for invasive mechanical ventilation (IMV) in intensive care unit (ICU) patients with COVID-19 and compare their performance with the Respiratory rate-OXygenation (ROX) index. Methods A retrospective cohort study was conducted using data collected between March 2020 and August 2021 at three hospitals in Rio de Janeiro, Brazil. ICU patients aged 18 years and older with a diagnosis of COVID-19 were screened. The exclusion criteria were patients who received IMV within the first 24 h of ICU admission, pregnancy, clinical decision for minimal end-of-life care and missing primary outcome data. Clinical and laboratory variables were collected. Multiple logistic regression analysis was performed to select predictor variables. Models were based on the lowest Akaike Information Criteria (AIC) and lowest AIC with significant p values. Assessment of predictive performance was done for discrimination and calibration. Areas under the curves (AUC)s were compared using DeLong’s algorithm. Models were validated externally using an international database. Results Of 656 patients screened, 346 patients were included; 155 required IMV (44.8%), 191 did not (55.2%), and 207 patients were male (59.8%). According to the lowest AIC, arterial hypertension, diabetes mellitus, obesity, Sequential Organ Failure Assessment (SOFA) score, heart rate, respiratory rate, peripheral oxygen saturation (SpO2), temperature, respiratory effort signals, and leukocytes were identified as predictors of IMV at hospital admission. According to AIC with significant p values, SOFA score, SpO2, and respiratory effort signals were the best predictors of IMV; odds ratios (95% confidence interval): 1.46 (1.07–2.05), 0.81 (0.72–0.90), 9.13 (3.29–28.67), respectively. The ROX index at admission was lower in the IMV group than in the non-IMV group (7.3 [5.2–9.8] versus 9.6 [6.8–12.9], p

LiDAR devices are capable of acquiring clouds of 3D points reflecting any object around them, and adding additional attributes to each point such as color, position, time, etc. LiDAR datasets are usually large, and compressed data formats (e.g. LAZ) have been proposed over the years. These formats are capable of transparently decompressing portions of the data, but they are not focused on solving general queries over the data. In contrast to that traditional approach, a new recent research line focuses on designing data structures that combine compression and indexation, allowing directly querying the compressed data. Compression is used to fit the data structure in main memory all the time, thus getting rid of disk accesses, and indexation is used to query the compressed data as fast as querying the uncompressed data. In this paper, we present the first data structure capable of losslessly compressing point clouds that have attributes and jointly indexing all three dimensions of space and attribute values. Our method is able to run range queries and attribute queries up to 100 times faster than previous methods.

Objetivo: el coronavirus del síndrome respiratorio agudo grave de tipo 2 (SARS-CoV-2) causa un gran espectro de síntomas, dentro de los que se incluyen manifestaciones gastrointestinales como náuseas, vómito, diarrea y dolor abdominal. El objetivo del presente estudio fue evaluar si la presencia o no de dichos síntomas gastrointestinales podía estar relacionada con una progresión más grave de la enfermedad, entendida como muerte, necesidad de manejo en unidad de cuidados intensivos, ventilación mecánica o coinfección bacteriana. Pacientes y métodos: se realizó un estudio observacional analítico de tipo cohorte con pacientes con covid-19 confirmado con síntomas gastrointestinales y un grupo comparador sin síntomas gastrointestinales. Los pacientes incluidos debían ser mayores de 18 años, que acudieran por sintomatología sugestiva de covid-19 y que se les confirmara el diagnóstico mediante una prueba de reacción en cadena de la polimerasa. Resultados: se analizó a un total de 414 pacientes que cumplieron con los criterios de selección y se encontró que la mortalidad solo está influenciada por la edad, mientras que la ventilación mecánica y la necesidad de manejo en la unidad de cuidados intensivos están relacionadas con el perfil de función hepática. Sin embargo, no se encontró ninguna diferencia en cuanto a la gravedad con respecto a los pacientes que sí presentaron síntomas gastrointestinales frente a los que no tenían síntomas. Conclusiones: los síntomas gastrointestinales de manera individual no representan un riesgo de progresión de la enfermedad por SARS-CoV-2; sin embargo, sí se debería incluir dentro de la valoración inicial de estos pacientes los niveles de alanina-aminotransferasa (ALT), aspartato-aminotransferasa (AST) y bilirrubina directa (BD), pues aportan un valor en cuanto al pronóstico según los resultados de nuestro estudio.

The aim of this study is to assess the impact of various row spacings on the morphology, components of grain yield, and overall grain yield of soybean. The experiments were conducted over two planting seasons (2014/2015 and 2015/2016) using two planting dates (November and December) and two cultivars, FPS Urano RR and BMX Tornado RR. The row spacings tested were: 45 cm (wide row), 45 × 45 cm (cross row), 22.5 × 45 cm (twin row), and 22.5 cm (narrow row). Measurements included leaf area index and sunlight interception at R2 stage, as well as grain yield components and overall grain yield. Narrow rows, in addition to achieving canopy closure, also demonstrated enhanced sunlight interception at the R2 stage. However, the positive effect of increased sunlight interception on grain yield was only significant for the December planting date, with no notable difference observed for the November planting date. These findings imply that while narrow rows may offer advantages, particularly in later planting dates, their implementation should be carefully considered and may not consistently lead to increased grain yield, reinforcing the continued preference for conventional row spacing.

ABSTRACT Influence of Quaternary climate change on the potencial distribution of Atlantic Forest dung beetles (Coleoptera: Scarabaeidae: Scarabaeinae). The role of Cenozoic paleoclimatic changes in the distribution of dung beetles species from the Atlantic Forest (AF) remains poorly understood. We used ecological niche modeling under different scenarios (present, 6 ka, 21 ka, and 120 ka) to investigate how climatic oscillations during the Quaternary might have influenced the distribution of species endemic to this region. Models were built for five of the nine dung beetle species of the Dichotomius sericeus group: D. iannuzziae, D. irinus, D. laevicollis, D. schiffleri, and D. sericeus. The models of climatic suitability for D. irinus and D. laevicollis show a similar historical pattern in response to climate change but were divergent from D. iannuzziae, D. schiffleri, and D. sericeus. Dichotomius schiffleri is the species with the smallest area of potencial occurrence. Over time, the species probably remained limited to lowland AF areas on the Brazilian coast and, it is currently found preferentially in Restinga ecosystems along the coast. Regarding the potential distribution models at the present, D. iannuzziae, D. schiffleri, and D. sericeus have potential distributions similar to their realized distribution. This study shows that the historical distribution of the D. sericeus species group has been influenced by paleoclimatic changes that occurred in the AF over the last 120 ka.

Sugarcane is a crucial crop for sugar and bioenergy production. Saccharose content and total weight are the two main key commercial traits that compose sugarcane’s yield. These traits are under complex genetic control and their response patterns are influenced by the genotype-by-environment (G×E) interaction. An efficient breeding of sugarcane demands an accurate assessment of the genotype stability through multi-environment trials (METs), where genotypes are tested/evaluated across different environments. However, phenotyping all genotype-in-environment combinations is often impractical due to cost and limited availability of propagation-materials. This study introduces the sparse testing designs as a viable alternative, leveraging genomic information to predict unobserved combinations through genomic prediction models. This approach was applied to a dataset comprising 186 genotypes across six environments (6×186=1,116 phenotypes). Our study employed three predictive models, including environment, genotype, and genomic markers as main effects, as well as the G×E to predict saccharose accumulation (SA) and tons of cane per hectare (TCH). Calibration sets sizes varying between 72 (6.5%) to 186 (16.7%) of the total number of phenotypes were composed to predict the remaining 930 (83.3%). Additionally, we explored the optimal number of common genotypes across environments for G×E pattern prediction. Results demonstrate that maximum accuracy for SA (ρ=0.611) and for TCH (ρ=0.341) was achieved using in training sets few (3) to no common (0) genotype across environments maximizing the number of different genotypes that were tested only once. Significantly, we show that reducing phenotypic records for model calibration has minimal impact on predictive ability, with sets of 12 non-overlapped genotypes per environment (72=12×6) being the most convenient cost-benefit combination.

O vírus citomegálico (CMV) é um tipo de vírus de ácido desoxirribonucleico de dupla cadeia que pertence à família herpesviridae. Após uma infeção primária, o vírus torna-se latente em vários tipos de glóbulos brancos. A infeção por CMV pode permanecer latente ou tornar-se ativa, especialmente em indivíduos imunodeprimidos, como aqueles submetidos a transplantes de células progenitoras hematopoiéticas (TPH), onde a reativação do CMV pode ocorrer. Neste contexto, a infeção por CMV é comum e associada a elevadas taxas de morbilidade e mortalidade. A pneumonite é uma das complicações mais graves, com taxas de mortalidade superiores a 50%. Além disso, mesmo na ausência de doença específica do órgão, a infeção por CMV está relacionada com um aumento da mortalidade não relacionada com a recidiva da neoplasia hematológica. Dada a frequência e gravidade desta infeção em doentes submetidos a TPH, é crucial implementar estratégias eficazes de monitorização, prevenção e tratamento. Este protocolo foi desenvolvido para identificar os grupos de doentes que se beneficiam de uma abordagem sistematizada para a infeção por CMV e definir a estratégia mais adequada para cada grupo. A monitorização da carga viral de CMV no sangue periférico é fundamental, especialmente em doentes com risco moderado a elevado de infeção ativa. A profilaxia primária com letermovir (fármaco antiviral) é recomendada para reduzir a incidência de infeção ativa, especialmente em doentes com alto risco. A profilaxia secundária com valganciclovir (fármaco antiviral) é recomendada após um episódio de infeção ativa, enquanto o tratamento de antecipação e de doença é baseado na monitorização da carga viral e na resposta clínica. Este protocolo visa melhorar a abordagem da infeção por CMV em doentes submetidos a TPH, garantindo uma abordagem preventiva e terapêutica eficaz e segura.

RESUMO: O presente trabalho consiste em analisar o embate entre representação, imaginário e modernidade, identificado no romance A selva (1930), do escritor português Ferreira de Castro (1898-1974). Por esses meandros, propõe-se, igualmente, tecer uma apreciação a fim de verificar a maneira pela qual a produção literária em tela reconstrói, de forma crítica e inventiva, uma poética vinculada ao imaginário e outra correlacionada à decadência do universo amazônico, também detectadas, à sua maneira, em diferentes produções literárias publicadas na literatura brasileira, inclusive em obras ficcionais compostas na região norte do país.

High electrical conductivity, along with high piezoresistive sensitivity and stretchability, are crucial for designing and developing nanocomposite strain sensors for damage sensing and on-line structural health monitoring of smart carbon fiber-reinforced polymer (CFRP) composites. In this study, the influence of the geometric features and loadings of carbon-based nanomaterials, including reduced graphene oxide (rGO) or carbon nanofibers (CNFs), on the tunable strain-sensing capabilities of epoxy-based nanocomposites was investigated. This work revealed distinct strain-sensing behavior and sensitivities (gauge factor, GF) depending on both factors. The highest GF values were attained with 0.13 wt.% of rGO at various strains. The stability and reproducibility of the most promising self-sensing nanocomposites were also evaluated through ten stretching/relaxing cycles, and a distinct behavior was observed. While the deformation of the conductive network formed by rGO proved to be predominantly elastic and reversible, nanocomposite sensors containing 0.714 wt.% of CNFs showed that new conductive pathways were established between neighboring CNFs. Based on the best results, formulations were selected for the manufacturing of pre-impregnated materials and related smart CFRP composites. Digital image correlation was synchronized with electrical resistance variation to study the strain-sensing capabilities of modified CFRP composites (at 90° orientation). Promising results were achieved through the incorporation of CNFs since they are able to form new conductive pathways and penetrate between micrometer-sized fibers.

La principal herramienta para la obstrucción biliar maligna es la descompresión de la vía biliar, mediante la colangiopancreatografía retrógrada endoscópica (CPRE) con colocación de stent, la cual en un gran porcentaje de los casos es satisfactoria; sin embargo, el verdadero reto se presenta cuando es imposible canular la papila de váter por compromiso neoplásico a ese nivel. Aunque el drenaje biliar transhepático percutáneo (PTBD) es una opción, representa una gran morbilidad, que repercute directamente en la calidad de vida del paciente al tener un dispositivo externo sumado a una patología maligna. Con la llegada de la ultrasonografía endoscópica (USE), existen nuevos métodos reportados como la hepaticogastrostomía guiada por EUS (EUS-HGS), la cual se realiza por un orificio natural (NOTES) e impacta positivamente en el desenlace de estos pacientes. A continuación, se ejemplifica nuestra experiencia con los primeros 3 casos en Colombia.

Introduction: Stroke is considered one of the greatest public health challenges worldwide, with the ischemic subtype being the most prevalent. Various acute stroke clinical guidelines recommend early rehabilitation interventions, including very early mobilization. However, despite the studies conducted in recent years regarding when to initiate mobilization after an acute stroke, there are few systematic and personalized protocols based on the factors for which patient mobilization should ideally be performed. We aim to conduct an umbrella review of systematic reviews and meta-analyses to study the early mobilization decision after an acute ischemic stroke in comparison with conventional care and correlate the different approaches with patient clinical outcomes. Methods and Analysis: We will perform a systematic search on PubMed/MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Epistemonikos and Web of Science Core Collection databases. Retrieved studies will be independently reviewed by two authors and any discrepancies will be resolved by consensus or with a third reviewer. Reviewers will extract the data and assess the risk of bias in the selected studies. We will use the 16-item Assessment of Multiple Systematic Reviews 2 (AMSTAR2) checklist as the critical appraisal tool to assess cumulative evidence and risk of bias of the different studies. This will be the first umbrella review that compares early mobilization approaches in post-acute ischemic stroke. This study may help to define the optimal early mobilization strategy in stroke patients. PROSPERO registration number: CRD42023430494

The global healthcare industry plays a crucial role in preserving human health and well-being [...]

Background: During lifespan of reverse osmosis systems applied in seawater desalination plants, a common phenomenon of undesirable growth and accumulation of biological material known as biofouling occurs. Microbial cells are first settlers, attaching and enclosing themselves in extracellular polymeric substances –biomass accumulation usually referred to as microfouling or biofilms, which becomes a serious issue when having a detrimental effect on materials or hampering industrial processes. Thus, control of microfouling on reverse osmosis membranes is crucial since chemical and physical treatments are usually costly and ineffective. In this context, even though microorganisms are the source of the problem, they can also provide possible solutions due to their capacity to produce secondary metabolites, being several of these competition mediators secreted compounds (i.e., bioactive molecules) produced during the stationary phase (e.g., lipases, proteases, DNases and other enzymes with alginate lyase and xanthine oxidases). Such bioactive substances can be utilized against the development of biofilms. Considering biofouled surfaces a niche for complex microbial interactions, here we have used reverse osmosis membranes and cartridge filters applied in a seawater desalination plant as a source for the isolation of bacteria with anti-fouling potential, among other biotechnological applications. Results: We obtained 27 bacterial isolates able to secrete exoenzymes displaying a wide array of bioactivity such as lipases, alginases, and glucosidases, among others. Additionally, we showed two main candidates able to inhibit the growth of common microbial colonizers of ROM and cartridge filter. Conclusions: These results highlight the potential biotechnological application of bioactive molecules against biofouling formation.How to cite: Vera-Villalobos H, Cortes-Martinez A, Gonzalez-Gutierrez Á, et al. Reverse osmosis membranes applied in seawater desalination plants as a source of bacteria with antifouling activity: Isolation, biochemical and molecular characterization. Electron J Biotechnol 2023;66. https://doi.org/10.1016/j.ejbt.2023.09.003.

Increasing the effectiveness of vaccines against respiratory viruses is particularly relevant for the elderly, since they are prone to develop serious infections due to comorbidities and the senescence of the immune system. The addition of saponin-based adjuvants is an interesting strategy to increase the effectiveness of vaccines. We have previously shown that ISCOM matrices from Q. brasiliensis (IMXQB) are a safe and potent adjuvant. In this study, we evaluated the use of IMXQB as an adjuvant for the seasonal trivalent influenza vaccine (TIV) in an aged mice model. Herein, we show that subcutaneous injection of the adjuvanted vaccine promoted higher titers of IgM, IgG (and isotypes), and serum hemagglutination inhibition titers (HAI). Notably, aged mice immunized by intranasal route also produced higher IgG (and isotypes) and IgA titers up to 120 days after priming, as well as demonstrating an improvement in the HAI antibodies against the TIV. Further, experimental infected aged mice treated once with sera from adult naïve mice previously immunized with TIV-IMXQB subcutaneously successfully controlled the infection. Overall, TIV-IMXQB improved the immunogenicity compared to TIV by enhancing systemic and mucosal immunity in old mice conferring a faster recovery after the H1N1pdm09-like virus challenge. Thus, IMXQB nanoparticles may be a promising platform for next-generation viral vaccines.

In this article, we conduced an investigation into how the Conceptual Field of Geometry is inbricated with other Conceptual Fields in the statements of the Mathematics questions of the New ENEM exams. Thus, we operated a documentary research on the statements of all 1.305 Mathematics questions of the New ENEM, from the year 2009 to 2021, using the methodological steps of Content Analysis and ? as theoretical foundations of the analysis ? the Theory of Conceptual Fields and the Theory of Imbrications between Conceptual Fields. Through this study, we realized that the number of concepts and conceptual inbrications in the statements of the New ENEM questions can be directly associated with the level of complexity of the situations proposed in the exams, which could confirmed from a future investigation that includes the resolutions of the issues analyzed here.

Abstract BackgroundIn aesthetic practice, delayed-onset (late) inflammatory reactions (DIRs) to dermal fillers are encountered. The treatment of DIRs can be challenging, with a response to established therapies, including oral antibiotics, intralesional and oral steroids, and hyaluronidase injection, occasionally reported as unsatisfactory. ObjectivesEvaluate the efficacy of low-dose oral methotrexate (MTX) therapy in treating recalcitrant DIRs. MethodsWe retrospectively reviewed cases of recalcitrant DIRs treated with oral MTX. Data collected included individuals' gender and age, medical history, filler type, facial area(s) injected, previous treatments attempted to dissolve the DIR, MTX treatment dosage and duration, and outcome. Adverse events were monitored throughout the treatment. ResultsThirteen females with a mean age of 52.6 years (range, 31-67 years) who developed recalcitrant DIRs to dermal filler injection are included. Eight reactions were triggered by the injection of hyaluronic acid (HA) fillers, 4 by liquid injectable silicone (LIS), and 1 by polymethylmethacrylate (PMMA). The average starting dosage of MTX was 12.1 mg/week (range, 7.5-12.5 mg/week). Patients were treated for 2 to 3 months in most cases. The average follow-up post-MTX therapy was 11.8 months (range, 2-36 months). A complete response to MTX treatment was observed in 10 patients (6 HA and 4 LIS cases), partial response in 1 (HA case), and an unsatisfactory response in 2 (HA and PMMA cases). Treatment was well tolerated. ConclusionsA short course of low-dose oral MTX is a possible treatment for DIRs that have not responded to established therapies. The promising results of this report require validation by powered studies. Level of Evidence: 4

Este artigo tem como principal objetivo analisar a viabilidade e competitividade sistêmica do biodiesel na região do MATOPIBA, tendo como base a aplicação da metodologia Viable System Model (VSM) no contexto da área de estudo selecionada. É relevante analisar como a competitividade do biodiesel MATOPIBA pode tornar mais viável em um contexto cada vez mais dinâmico e complexo, onde há atualmente uma grande dependência excessiva da soja como principal matéria-prima. A metodologia utilizada neste estudo se baseou na aplicação do Viable System Model (VSM) por meio do uso do software VSMod®. Com base nos resultados encontrados, foi possível identificar opções de matérias-primas pouco exploradas, como o sebo bovino e o algodão, que podem ser consideradas alternativas viáveis para a produção de biodiesel. O estudo identificou que a produção de biodiesel na região do MATOPIBA é fortemente dependente da soja, impactando negativamente a cadeia alimentar e a competitividade do setor. Assim, considera-se que é necessário diversificar as matérias-primas para reduzir essa dependência. Abstract: This article's main objective is to analyze the systemic viability and competitiveness of biodiesel in the MATOPIBA region, based on the application of the Viable System Model (VSM) methodology in the context of the selected study area. It is relevant to analyze how the competitiveness of MATOPIBA biodiesel can become more viable in an increasingly dynamic and complex context, where there is currently a great excessive dependence on soy as the main raw material. The methodology used in this study was based on the application of the Viable System Model (VSM) through the use of the VSMod® software. Based on the results found, it was possible to identify little explored raw material options, such as beef tallow and cotton, which can be considered viable alternatives for the production of biodiesel. The study considered that biodiesel production in the MATOPIBA region is heavily dependent on soybeans, which negatively impacts the food chain and the competitiveness of the sector. Therefore, it is considered necessary to diversify raw materials to reduce this dependence.

Familial hypercholesterolemia (FH) is a common genetic disorder of lipid metabolism caused by pathogenic/likely pathogenic variants in LDLR, APOB, and PCSK9 genes. Variants in FH-phenocopy genes (LDLRAP1, APOE, LIPA, ABCG5, and ABCG8), polygenic hypercholesterolemia, and hyperlipoprotein (a) [Lp(a)] can also mimic a clinical FH phenotype. We aim to present a new diagnostic tool to unravel the genetic background of clinical FH phenotype. Biochemical and genetic study was performed in 1,005 individuals with clinical diagnosis of FH, referred to the Portuguese FH Study. A next-generation sequencing panel, covering eight genes and eight SNPs to determine LDL-C polygenic risk score and LPA genetic score, was validated, and used in this study. FH was genetically confirmed in 417 index cases: 408 heterozygotes and 9 homozygotes. Cascade screening increased the identification to 1,000 FH individuals, including 11 homozygotes. FH-negative individuals (phenotype positive and genotype negative) have Lp(a) >50 mg/dl (30%), high polygenic risk score (16%), other monogenic lipid metabolism disorders (1%), and heterozygous pathogenic variants in FH-phenocopy genes (2%). Heterozygous variants of uncertain significance were identified in primary genes (12%) and phenocopy genes (7%). Overall, 42% of our cohort was genetically confirmed with FH. In the remaining individuals, other causes for high LDL-C were identified in 68%. Hyper-Lp(a) or polygenic hypercholesterolemia may be the cause of the clinical FH phenotype in almost half of FH-negative individuals. A small part has pathogenic variants in ABCG5/ABCG8 in heterozygosity that can cause hypercholesterolemia and should be further investigated. This extended next-generation sequencing panel identifies individuals with FH and FH-phenocopies, allowing to personalize each person’s treatment according to the affected pathway.

ObjectivesIn this study, we aimed to systematically review the literature of the prevalence of systemic antibacterial use during pregnancy and to perform a descriptive analysis focused on methodological characteristics.Materials and methodsThis study was registered in PROSPERO under protocol number CRD42022376634. Medline, Embase, Scientific Electronic Library Online, Biblioteca Virtual em Saúde, Cumulative Index to Nursing and Allied Health Literature, and Web of Science databases were searched (published studies until November 3rd, 2022). Selected studies were population-based cross-sectional or cohort, carried out with pregnant women, and providing information about the prevalence of systemic antibacterial use at least in one trimester of pregnancy. Reviewers conducted in pairs the title and abstract screening, eligibility criteria check, and data extraction of selected studies. Quality appraisal was performed with an adapted version of the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. Data of included studies were pooled into a graphical and tabular summary.ResultsA total of 16,251,280 pregnant women and 5,169,959 pregnancy registers were identified. The prevalence estimates of systemic antibacterial use during pregnancy ranged from 2.0% (95%CI 2.0-2.0) to 64.3% (95%CI not reported) in the 79 included studies. The majority were performed in high-income countries (91.5%). Overall, the studies revealed considerable prevalence heterogeneity in terms of study type and dataset used. The 95% confidence intervals were not reported in 41% of studies.ConclusionThe disparities in the prevalence of systemic antibacterial use during pregnancy can be related to methodological issues and different health policies. Lack of uniform databases and changes in data collection methods over time should be taken into account in public health strategy planning. The scarce evidence in low- and middle-income settings hampers the comprehensiveness of the global prevalence of antibacterial use during pregnancy.

Purpose Soybean is critical in the global food scenario, and increased grain productivity and sustainability are always sought. This study evaluates the agronomic performance of soybeans with biofertilizer (BF) applications in different soybean phenological stages.Method Experiments were performed in two regions and designed in randomized blocks using a 2×4 factorial scheme (two cultivars and four BF managements). Representative plants from each parcel were used. Plant biometric variables were assessed on plants at the full bloom stage. At the beginning of grain filling, the leaf and seed biochemical components were measured. Quantitative yield components were measured at harvest.Results In both areas, the BF did not affect the soybean leaf area index, leaf dry biomass, and branch dry biomass. The BF application improved the total sugars, starch, and reducing sugars in area 1. In area 2, the chlorophyll was similar among the BF managements. Soybean cultivars and BF did not affect seed protein content in area 1. In area 2, the BF application presented a similar or greater soybean yield compared to control (no BF). The divergences observed between areas may be related to interactions between the soil-climatic conditions and the soybean cultivars.Conclusion Choosing a more appropriate soybean cultivar is fundamental to obtaining higher yields. Nutritional management with leaf-applied BF is an alternative to increase soybean field performance. However, it is still necessary to consider the interactions of the BF with the crop genetics chosen for the region of cultivation and the best dose and time of application.

Patient blood samples are invaluable in clinical omics databases, yet current methodologies often fail to fully uncover the molecular mechanisms driving patient pathology. While genome-scale metabolic models (GEMs) show promise in systems medicine by integrating various omics data, having only exometabolomic data remains a limiting factor. To address this gap, we introduce a comprehensive pipeline integrating GEMs with patient plasma metabolome. This pipeline constructs case-specific GEMs using literature-based and patient-specific metabolomic data. Novel computational methods, including adaptive sampling and an in-house developed algorithm for the rational exploration of the sampled space of solutions, enhance integration accuracy while improving computational performance. Model characterization involves task analysis in combination with clustering methods to identify critical cellular functions. The new pipeline was applied to a cohort of trauma patients to investigate shock-induced endotheliopathy using patient plasma metabolome data. By analyzing endothelial cell metabolism comprehensively, the pipeline identified critical therapeutic targets and biomarkers that can potentially contribute to the development of therapeutic strategies. Our study demonstrates the efficacy of integrating patient plasma metabolome data into computational models to analyze endothelial cell metabolism in disease contexts. This approach offers a deeper understanding of metabolic dysregulations and provides insights into diseases with metabolic components and potential treatments.

Sediment deposition at the bottom of artificial reservoirs has become a worldwide problem. This comprises a dual issue that is, in the first place, associated with the reduction in storage capacity and lifetime of large reservoirs. The second aspect comprises the threat that the sediment represents for the dam structure. This research is mainly aimed at identifying and inferring the main sediments’ triggering processes through a rigorous analysis of deposition shapes in a large reservoir. For identifying the main deposition shapes, a sequential methodology was designed and developed comprising the following stages. First, an analysis of XYZ cartography from bathymetric development was conducted. Then, a shapes categorization was developed that comprises the identification of six types of shapes based on four parameters: slope continuity, slope break, absolute and relative slope, and arc configuration. The third stage comprised a visualization and spatial calculation of shapes through GIS-based cartography. The fourth stage comprised an interpretation of deposition shapes processes: for that, a dual analysis was developed. First, an analysis based on fluvial sediments transport processes was realized. The second stage implied an analysis of the dam influence on fluvial hydrodynamics and sediments transport. Results comprised a quantitative assessment of each shape as well as physical processes identification and interpretation, generating a robust equivalence between shapes and triggering processes. This research proved successful for the identification and characterization of the main deposition and transport processes that may help to prevent, palliate, and/or correct phenomenon of silting in large reservoirs. This detailed knowledge of deposition forms opens new strategies to release sediments from storage water more effectively.

Introduction Nearly 30 000 Mexican women develop breast cancer annually, frequently presenting unmet supportive care needs. In high-income countries, incorporating electronic patient-reported outcomes (ePROs) into cancer care has demonstrated potential for increasing patient-centred care and reducing unmet needs. No such ePRO interventions have been implemented in Mexico. This paper presents the study protocol for designing and evaluating an ePRO digital health application combined with proactive follow-up by nurses.Methods and analysis We designed a two-component intervention for women receiving breast cancer treatment: a responsive web application for monitoring ePROs and clinical algorithms guiding proactive follow-up by nurses. We will conduct a pilot test of the intervention with 50 patients with breast cancer for 6 weeks to assess feasibility and adjust the application. We will conduct a parallel arm randomised controlled trial assigning 205 patients each to intervention and control in one of Mexico’s largest public oncology hospitals. The intervention will be provided for 6 months, with additional 3 months of post-intervention observation. The control group will receive usual healthcare and a list of breast cancer information sources. Women diagnosed with stages I, II or III breast cancer who initiate chemotherapy and/or radiotherapy will be invited to participate. The primary study outcome will be supportive care needs; secondary outcomes include global quality of life and breast symptoms. Information on the outcomes will be obtained through web-based self-administered questionnaires collected at baseline, 1, 3, 6 and 9 months.Ethics and dissemination The National Research and Ethics Committees of the Mexican Institute of Social Security approved the study (R-2021-785-059). Participants will sign an informed consent form prior to their inclusion. Findings will be disseminated through a policy brief to the local authorities, a webinar for patients, publications in peer-reviewed journals and presentations at national and international conferences.Trial registration number NCT05925257.

Introdução: A mucormicose é uma infecção fúngica oportunista, altamente invasiva, causada por fungos da ordem murcorales, mais incidentes em pacientes com diabetes. A forma rinocerebral é a mais frequente e manifesta-se por edema periorbital, cefaleia e necrose tecidual com evolução rapidamente progressiva para sistema nervoso central. Relato de Caso: Paciente de 19 anos, sexo feminino, com antecedente de diabetes mellitus tipo I, sem adesão ao tratamento e com histórico de internações frequentes por Cetoacidose Diabética (CAD). Apresentava otalgia à direita, cefaleia e parestesia em face iniciada anteriormente à exodontia e à drenagem de abscesso dentário realizadas há 1 ano. Iniciou quadro de taquicardia e sudorese há 2 dias da internação em hospital secundário do Distrito Federal associado a episódio de CAD, evoluindo com edema de hemiface direita. A tomografia de face mostrou celulite periorbitária, pansinusite e ausência de coleções. Após 12 dias da internação, foi visto tumefação em palato duro à direita, pontos de necrose e exposição óssea. Realizada exodontia e drenagem de palato com tratamento empírico para infecção de etiologia bacteriana, sem resposta terapêutica. Evoluiu com piora clínica sendo submetida à intubação orotraqueal e iniciada anfotericina B por suspeita de mucormicose. Foi encaminhada para o Hospital de Base do Distrito Federal onde foi internada em unidade de unidade intensiva com posterior extubação e ressecção de lesão irregular em região de arco zigomático e maxilectomia à direita. O histopatológico evidenciou fungos em forma de hifas largas, onduladas, pauciseptadas sugestivos de mucormicose e presença de angioinvasão. Na cultura de fragmento de tecido, cresceu Aspergillus spp. e na de fragmento ósseo, A. baumannii. Diante disso, a paciente manteve estabilidade clínica com uso de anfotericina B lipossomal, voriconazol e antibioticoterapia guiada para A. baumanni. Segue internada em enfermaria de Infectologia. Comentários: A mucormicose associada à aspergilose revela um caráter atípico, visto que o diagnóstico histológico se baseia no achado de hifas não septadas ou poucos septadas ao contrário do Aspergillus. Ademais, o quadro agudo e deformante característico da murcomicose foi associado à manifestação indolente da aspergilose descrita nos antecedentes, corroborado pelo seu crescimento em cultura. Dessa forma, deve-se considerar infecções fúngicas concomitantes com miscelânia clínica em pacientes diabéticos.

Introdução: O panarício herpético (PH) é uma infecção cutânea de acometimento periungueal causada pelo vírus herpes simples (HSV) tipo 1 e 2. As apresentações clínicas das infecções por HSV se correlacionam com o status imunológico do paciente. Assim, em imunossuprimidos, como naqueles com AIDS, a clínica pode assumir aspecto atípico e crônico em vez da forma clássica marcada por vesículas. Relato de caso: Paciente do sexo feminino, 40 anos, com o diagnóstico de infecção pelo HIV há 16 anos, sem adesão à terapia antirretroviral, foi internada na enfermaria de Infectologia do Hospital de Base para manejo de síndrome demencial e lesões cutâneas difusas. Na ocasião, apresentava carga viral de HIV de 9.717 cópias/ml e contagem de linfócitos T-CD4 de 26 células/mm³. Ao exame físico, apresentava lesão ulcerada em 2° quirodáctilo esquerdo, não dolorosa. A lesão foi submetida à biópsia e encaminhada para análise histopatológica e para cultura de bactérias, fungos e micobactérias tuberculosas e não-tuberculosas. A paciente evoluiu com lesão vegetante no local, tendo sido realizado tratamento empírico para infecção de etiologia bacteriana e fúngica, sem resposta terapêutica. Ao longo da internação, a paciente evoluiu com coleção organizada e com progressão da úlcera de forma rapidamente erosiva e deformante, inicialmente no 2° quirodáctilo esquerdo e, em seguida, apresentou acometimento idêntico do 3° quirodáctilo ipsilateral. As culturas de fragmento de pele foram todas negativas. Após várias tentativas terapêuticas sem sucesso, obteve-se o resultado do histopatológico, que apontou para infecção por Herpes simplex, com a seguinte descrição: dermatite ulcerada com atipias citológicas compatíveis com HSV. Somado às lesões digitais, a paciente também apresentava extensa úlcera em região interglútea, cuja análise histopatológica identificou o mesmo aspecto morfológico da lesão dos dígitos. Diante dos resultados, a paciente realizou tratamento com aciclovir por 14 dias e obteve resolução completa das lesões e regeneração do tecido adjacente em cerca de 3 meses após o término do antiviral. Comentários: Esse caso é permeado de várias características não usuais do PH. A apresentação em mais de um quirodáctilo, indolor, vegetante e rapidamente ulcerativa das lesões, levando à importante perda tecidual, denota o caráter atípico do PH em pacientes imunossuprimidos. Dessa forma, urge sempre considerar apresentações inabituais das infecções de pele nos pacientes com AIDS.

Introdução: A infecção pela bactéria B. henselae, conhecida como Doença da Arranhadura do Gato, pode levar a sintomas com amplo espectro de gravidade e manifestações clínicas, tipicamente se apresentando com um quadro autolimitado e benigno, iniciado por lesão cutânea no local da inoculação, que se desenvolve em média de 3 a 10 dias após a infecção. Cerca de 2 semanas após o inóculo, costuma surgir quadro de linfonodomegalia próxima à lesão cutânea. No entanto, cerca de 5 a 10% dos casos podem manifestar-se por envolvimento ocular, tornando o olho o segundo local mais comum de afecção pela doença. Quando envolve o sistema nervoso central, a doença pode afetar os pares cranianos, acarretando uma neurorretinite unilateral. Descrição do caso: Paciente do sexo feminino, 17 anos, internada no Hospital de Base do Distrito Federal devido à febre com duração de dois dias, cefaleia intensa em região frontotemporal esquerda, dor à mobilização ocular e redução da acuidade visual. Somado a isso, apresentou hematomas espontâneos pelo corpo, esquecimentos frequentes, parestesia e edema em membro superior esquerdo. Quanto à epidemiologia, residia em área rural, tendo contato com cavalos, cães e gatos não vacinados. Um dos gatos faleceu um mês antes do início do quadro por causa indeterminada. Ao exame físico, apresentava força muscular normal em dimídio direito e grau 4 em dimídio esquerdo, sinal de Hoffman e Tromner positivos bilateralmente. A fundoscopia demonstrou papiledema bilateral, mais severo e com estrela macular no olho esquerdo. No exame abdominal, possuía dor à palpação e baço palpável. Durante a internação, a tomografia de abdome confirmou a esplenomegalia. Na investigação diagnóstica, foi submetida à punção lombar, com líquor sem alterações. Também foi realizada sorologia para Bartonella henselae com IgG +1:400 e IgM negativo. Diante desse resultado, foi iniciado tratamento para bartonelose ocular com rifampicina, doxiciclina e prednisona e a paciente apresentou melhora expressiva da acuidade visual e dos sintomas neurológicos. Comentários: A apresentação ocular bilateral e o acometimento do sistema nervoso central em uma paciente previamente imunocompetente sustentam a característica incomum do caso, tipicamente marcado apenas por linfadenopatia e sintomas leves, autolimitados, em pacientes dessa natureza. Portanto, é fundamental manter a suspeição clínica e as medidas de prevenção adequadas, mesmo dentro da população geral.

O artigo propõe uma leitura dos romances Deuses Econômicos (1966), Sol Subterrâneo (1981) e Prodígios (1980), de Dyonelio Machado (1895-1985), a fim de sistematizar certa alegorização da violência política e de destacar o papel do intelectual representado em meio às contradições do poder. Sob tal enfoque, entre outras características, ao mesmo tempo em que esta trilogia focaliza as divergências do Principado de Nero (54-68 d.C), é possível detectar uma crítica à Era Vargas (1930-45/1950-54), ao Golpe de 64 e à Ditadura Militar. Além disso, o texto também procura mapear traços do projeto estético do autor, considerando-o como mensagem que reitera a necessidade de uma práxis de vida, baseada no exercício e na conscientização política.

Mountain glaciers are considered great reservoirs of water, and their importance lies in the fact that many of our ecosystems and numerous communities depend on them; Peru has one of the largest extensions of Andean snow-capped mountains, which have been affected by the decline in their glacier coverage and that is warned, will disappear due to environmental conditions and alterations in the current global temperature. This problem has increased due to ignorance, misinformation, indifference, and lack of solidarity on the part of the population who favors this discouraging situation. Taking advantage of the current technological immersion, in which we live, the development of a mobile application was proposed as a pedagogical resource to raise awareness among educational institutions about the glacial retreat of the Peruvian Andean snow-capped mountains, showing the current situation of some of the snow-capped mountains of the Andes that have suffered a greater impact, implementing augmented reality technology to obtain an interactive link. To provide greater detail of the situation, previous studies were carried out on glacial retreats in two Peruvian snow-capped mountains over the last 40 years, where it was found that, of the snow-capped mountains considered, Chicon had a decrease of 32.5% of its glacier cover, and Pumahuanca had a decrease of 56.9%. Such results are exposed within the application to provide realistic data on the glacial conditions of both Peruvian snow-capped mountains, as well as the consequences and conservation techniques to mitigate and cope with deglaciation. Taking into consideration that environmental education from an early age turns out to be key to forming an informed and participatory society about climate change.

Abstract Background The Five Times Sit-to-Stand Test (FTSST) has been found reliable, safe and valid for measuring healthy adults’ lower limb muscle strength and for determining balance control, fall risk, and exercise capacity among older examinees. We believe that the FTSST has the potential to be a straightforward, low cost and valuable tool for identifying muscle disability and functional status following critical illness. The aim of our study was to establish the applicability, safety, and psychometric qualities of FTSST in patients at Intensive Care Unit (ICU) discharge. Methods In our study applicability was determined by assessing the percentage of patients who could perform the test at ICU discharge. Safety was assessed by examining data regarding any exacerbated haemodynamic and respiratory responses or adverse events associated with the test. For assessing FTSST reliability, intraclass correlation coefficients (ICCs), standard error of measurement (SEM) and Bland-Altman plot were used. For assessing concurrent validity handgrip strength, ICU length of stay, duration of invasive ventilation, Simplified Acute Physiology Score 3 (SAPS3) and age variables were used. For investigating predictive validity, correlations between the FTSST and measures of hospital length of stay and functional independence were evaluated. Results Only 30% of ICU survivors (n = 261 out of 817) were eligible to perform the FTSST and 7% of patients who performed the test (n = 10 out of 142) presented adverse events. Both inter (ICC 0.92 CI95% 0.89–0.94) and intra-rater (ICC 0.95 CI95% 0.93–0.96) reliability were excellent and higher scores were associated with lower muscle strength, longer hospital stay and greater functional impairment at hospital discharge in adult survivors of critical diseases. Conclusion Our results suggest that the FTSST may be applicable only to high-functioning critical care survivors. In this specifical population, FTSST is a safe, easy to perform, valid and reliable measure that can be applied to fall risk and functional recovery management.

Brazil stands out at the global level for having implemented several policies intending to promote agroecology as a productive paradigm for small-holder farmers. However, the impacts of this process of institutionalization of agroecology still lack research and debates that evaluate the effectiveness of these policies. In this paper, we assess and discuss the impacts of a policy specifically focused on education in agroecology, the support to the establishment of Centers for the Study of Agroecology and Organic Production (NEAs) in higher education institutions throughout Brazil. NEAs bring together teachers, researchers, and students who engage in teaching, research, and extension activities in partnerships with peasant farmers, their organizations, and rural extension workers. The hypothesis that guides our analysis is that this support to establish NEAs allowed redistribution of symbolic power in the universities where they were established, supporting agroecology to gain greater legitimacy inside and outside the university field. Based on an in-depth study of four NEAs, the NEAs are evaluated from the perspective of social fields in dispute. Our findings suggest that the State support to university groups dedicated to the promotion of agroecology has allowed the construction of what we have named agroecological spaces, which symbolically dispute the dominant paradigms in educational institutions, supporting the constitution of agroecological territories.

Este artigo tem como objetivo refletir sobre a influência dos booktubers na assimilação dos livros que comentam por meio de resenhas literárias e, para tal, se propõe a jogar luz sobre o processo de patemização dos discursos que constituem estes vídeos. Para isto, utilizam-se os conceitos de patemização e de contrato comunicativo, de Charaudeau, tendo como objetivo descrever como as visadas patêmicas utilizadas nos vídeos podem influenciar o mercado editorial e, consequentemente, o livro que está sendo analisado pela booktuber. O corpus de análise é composto por um vídeo de resenha com spoilers do livro “O morro dos ventos uivantes”, da autora Emily Brontë, publicado pela booktuber Ju Cirqueira no dia 10 de outubro de 2021, em seu canal do YouTube. A pesquisa é descritiva, bibliográfica, e com abordagem qualitativa por meio da Análise do Discurso. Como resultado, identificou-se que há diversos momentos em que são empregadas visadas patêmicas na vídeo-resenha e que essas emoções contribuem para a visibilidade, credibilidade e notoriedade da booktuber na sua comunidade e no mercado editorial.

During June 2022, Spain was one of the countries most affected worldwide by a multicountry monkeypox outbreak with chains of transmission without identified links to disease-endemic countries. We provide epidemiologic features of cases reported in Spain and the coordinated measures taken to respond to this outbreak.

The importance of fungal infections, particularly those caused by yeasts, is increasing among the medical community. Candida albicans and Cryptococcus neoformans are amongst the high-priority fungal species identified by the World Health Organization (WHO) and are considered in the critical group, while Candida krusei is included in the medium-priority group. The cyclam salt H4[H2(4-CF3PhCH2)2Cyclam]Cl4 proved to be active against the growth of these three yeasts, and the aim of this work was to verify its interference with their virulence mechanisms, whether shared or unique. H4[H2(4-CF3PhCH2)2Cyclam]Cl4 significantly inhibited biofilm production and catalase activity, being able to interfere with C. albicans dimorphic transition and C. neoformans melanin production. At the minimal inhibitory concentration (MIC) values, H4[H2(4-CF3PhCH2)2Cyclam]Cl4 had no antioxidant effect, as determined by the DPPH method. When using the RAW264.7 macrophage cell line, H4[H2(4-CF3PhCH2)2Cyclam]Cl4 reduced nitric oxide (NO) detection (the Griess reaction), but this effect was associated with a significant toxic effect on the cells.

The threat of viral influenza infections has sparked research efforts to develop vaccines that can induce broadly protective immunity with safe adjuvants that trigger robust immune responses. Here, we demonstrate that subcutaneous or intranasal delivery of a seasonal trivalent influenza vaccine (TIV) adjuvanted with the Quillaja brasiliensis saponin-based nanoparticle (IMXQB) increases the potency of TIV. The adjuvanted vaccine (TIV-IMXQB) elicited high levels of IgG2a and IgG1 antibodies with virus-neutralizing capacity and improved serum hemagglutination inhibition titers. The cellular immune response induced by TIV-IMXQB suggests the presence of a mixed Th1/Th2 cytokine profile, antibody-secreting cells (ASCs) skewed toward an IgG2a phenotype, a positive delayed-type hypersensitivity (DTH) response, and effector CD4+ and CD8+ T cells. After challenge, viral titers in the lungs were significantly lower in animals receiving TIV-IMXQB than in those inoculated with TIV alone. Most notably, mice vaccinated intranasally with TIV-IMXQB and challenged with a lethal dose of influenza virus were fully protected against weight loss and lung virus replication, with no mortality, whereas, among animals vaccinated with TIV alone, the mortality rate was 75%. These findings demonstrate that TIV-IMXQB improved the immune responses to TIV, and, unlike the commercial vaccine, conferred full protection against influenza challenge.

Antecedentes: El cáncer de células pequeñas (CPCP) representa el 13-15% del total de neoplasias primarias de pulmón. Se caracteriza por su rapidez en la tasa de crecimiento y en el desarrollo de metástasis a distancia. Objetivos: Orientar y estandarizar el tratamiento del CPCP enfermedad extensa en México basado en evidencia clínica nacional e internacional. Material y métodos: Este documento se desarrolló como una colaboración del Instituto Nacional de Cancerología y la Sociedad Mexicana de Oncología en cumplimiento con estándares internacionales. Se integró un grupo conformado por oncólogos médicos, cirujanos oncólogos, cirujanos de tórax, radio-oncólogos y metodólogos con experiencia en revisiones sistemáticas de la literatura y guías de práctica clínica. Resultados: Se consensaron, por el método Delphi y en reuniones a distancia, las recomendaciones en CPCP enfermedad extensa, producto de preguntas de trabajo. Se identificó y evaluó la evidencia científica que responde a cada una de dichas preguntas clínicas antes de incorporarla al cuerpo de la guía. Conclusión: Esta guía proporciona recomendaciones clínicas para el manejo de la enfermedad extensa del CPCP y durante el proceso de toma de decisiones de los clínicos involucrados con su manejo en nuestro país para mejorar la calidad de la atención clínica para estos pacientes.

BackgroundThe trematode Fasciola hepatica is the most widespread causative agent of fasciolosis, a parasitic disease that mainly affects humans and ruminants worldwide. During F. hepatica infection, newly excysted juveniles (FhNEJ) emerge in the duodenum of the mammalian host and migrate towards their definitive location, the intra-hepatic biliary ducts. Understanding how F. hepatica traverses the intestinal wall and migrates towards the liver is pivotal for the development of more successful strategies against fasciolosis. The central enzyme of the mammalian fibrinolytic system is plasmin, a serine protease whose functions are exploited by a number of parasite species owing to its broad spectrum of substrates, including components of tissue extracellular matrices. The aim of the present work is to understand whether FhNEJ co-opt the functions of their host fibrinolytic system as a mechanism to facilitate trans-intestinal migration.Methodology/principal findingsA tegument-enriched antigenic extract of FhNEJ (FhNEJ-Teg) was obtained in vitro, and its capability to bind the zymogen plasminogen (PLG) and enhance its conversion to the active protease, plasmin, were analyzed by a combination of enzyme-linked immunosorbent, chromogenic and immunofluorescence assays. Additionally, PLG-binding proteins in FhNEJ-Teg were identified by bidimensional electrophoresis coupled to mass spectrometry analysis, and the interactions were validated using FhNEJ recombinant proteins.Conclusions/significanceOur results show that FhNEJ-Teg contains proteins that bind PLG and stimulate its activation to plasmin, which could facilitate the traversal of the intestinal wall by FhNEJ and contribute to the successful establishment of the parasite within its mammalian host. Altogether, our findings contribute to a better understanding of host-parasite relationships during early fasciolosis and may be exploited from a pharmacological and/or immunological perspective for the development of treatment and control strategies against this global disease.

Introduction.Melanoma is a public health problem; it represents 4% of malignant skin tumors and is responsible for 80% of deaths from this type of neoplasm. Objective: Show the response to Temozolomide in patients with metastatic melanoma. Methods: Descriptive, cross-sectional study. The clinical response of patients with metastatic melanoma, managed with Temozolomide 200 mg/m2 once a day was analyzed for 5 days every 28 days. The risk factors analyzed were: histological variety, topographic region of the primary lesion, metastasis, ulceration, and Breslow. Descriptive statistics were used for normality Kolmogorov-Smirnoff, Student's t-test, and binary logistic regression. Results: There were 51 les, 47 met the criteria; 25 men, 22 women, mean age 54.45, minimum 22, maximum 85 years, Complete response was obtained in 3 (6.3%), partial response in 7 (14.8%), stable disease in 10 (21%) and disease progression in 27 (57.44%) patients. The presence of ulceration is associated with a higher Breslow index and, as a result, a higher risk of disease progression. Conclusions: Temozolomide as monotherapy is a treatment that presents low rates of complete response and partial response, showing better results in patients with lymph node metastases.

Mycotoxins present a significant health concern within the animal-feed industry, with profound implications for the pig-farming sector. The objective of this study was to evaluate the efficacy of two commercial adsorbents, an organically modified clinoptilolite (OMC) and a multicomponent mycotoxin detoxifying agent (MMDA), to ameliorate the combined adverse effects of dietary aflatoxins (AFs: sum of AFB1, AFB2, AFG1, and AFG2), fumonisins (FBs), and zearalenone (ZEN) at levels of nearly 0.5, 1.0, and 1.0 mg/kg, on a cohort of cross-bred female pigs (N = 24). Pigs were randomly allocated into six experimental groups (control, mycotoxins (MTX) alone, MTX + OMC 1.5 kg/ton, MTX + OMC 3.0 kg/ton, MTX + MMDA 1.5 kg/ton, and MTX + MMDA 3.0 kg/ton), each consisting of four individuals, and subjected to a dietary regimen spanning 42 days. The administration of combined AFs, FBs, and ZEN reduced the body-weight gain and increased the relative weight of the liver, while there was no negative influence observed on the serum biochemistry of animals. The supplementation of OMC and MMDA ameliorated the toxic effects, as observed in organ histology, and provided a notable reduction in residual AFs, FBs, and ZEN levels in the liver and kidneys. Moreover, the OMC supplementation was able to reduce the initiation of liver carcinogenesis without any hepatotoxic side effects. These findings demonstrate that the use of OMC and MMDA effectively mitigated the adverse effects of dietary AFs, FBs, and ZEN in piglets. Further studies should explore the long-term protective effects of the studied adsorbent supplementation to optimize mycotoxin management strategies in pig-farming operations.

Although wastewater-based surveillance (WBS) is an efficient community-wide surveillance tool, its implementation for pathogen surveillance remains limited by ineffective sample treatment procedures, as the complex composition of wastewater often interferes with biomarker recovery. Moreover, current sampling protocols based on grab samples are susceptible to fluctuant biomarker concentrations and may increase operative costs, often rendering such systems inaccessible to communities in low-to-middle-income countries (LMICs). As a response, passive samplers have emerged as a way to make wastewater sampling more efficient and obtain more reliable, consistent data. Therefore, this study aims to review recent developments in passive sampling technologies to provide researchers with the tools to develop novel passive sampling strategies. Although promising advances in the development of nanostructured passive samplers have been reported, optimization remains a significant area of opportunity for researchers in the area, as methods for flexible, robust adsorption and recovery of viral genetic materials would greatly improve the efficacy of WBS systems while making them more accessible for communities worldwide.

ABSTRACT Knowledge Management is a field of research that seeks to articulate the intricate relationship between the various organizational dimensions that influence in favor of knowledge. Measurement, as a dimension of this management, proposes to measure the level or capacity of knowledge management in organizational locus. However, the instruments for this purpose are expressed without an apparent psychometric assessment, as well as they do not articulate the holistic perspective, embodied by the totality of the critical dimensions for the success of this management. In the meantime, this research aims to build and validate an instrument for assessing holistic Knowledge Management. So, this is descriptive research with a quantitative approach, which makes use of the perception of four expert judges concerning the aspects of clarity, coherence, and pertinence of the statements of the constructed instrument. These aspects were analyzed using the Content Validation Coefficient method and must be equal to or greater than 0.70 to certify the quality of the questionnaire. The results express that the total coefficients, composed of all instrument items, are 0.87, 0.94, and 0.95 for each aspect, respectively, attesting to the quality of that instrument. Thus, this questionnaire can be applied for purposes of organizational diagnosis, which is an opportunity for future research.

The impact of lag effects produced by disturbances on primary production has been a major concern among ecologists during the last decade. Sudden and extreme climatic events are imposing drastic reductions in radial growth of trees as evidenced in tree-rings series Dendrochronological samples are obtained at tree level but analyzed at an aggregated scale (i.e., mean chronologies), although aggregating tree-ring chronology on a regional scale may reduce the possibility of studying the variability of individual tree response to drought, by amplifying the average population response. Here, we conducted experimental research in which 370 trees of 5 species were analyzed to assess the potential statistical and scaling issues that may occur when using regression-based methods to analyze ecosystem responses to disturbances. Drought legacy effects were quantified using individual and aggregated scales. Then, lag effects were validated using confidence and prediction intervals to identify values falling outside the certainty of the climate-growth model Individual scale legacy effects contrasted with confidence intervals were commonly distributed across species but were scarce when compared with prediction intervals. The analysis of aggregated scale legacies detected significant growth reductions when validated using prediction intervals; however, individual scale legacy lag effects were not detected. This finding directly contrasts the results obtained when using an aggregated scale. Our results provide empirical evidence on how aggregating ecological data to infer processes that emerge from an individual scale can lead to distorted conclusions. We therefore encourage the use of individual based statistical and ecological procedures to analyze tree rings as a means of further understanding the ecosystem responses to disturbances.

Antecedentes: El cáncer de células pequeñas (CPCP) representa el 13-15% del total de neoplasias primarias de pulmón. Se caracteriza por su rapidez en la tasa de crecimiento y en el desarrollo de metástasis a distancia. Objetivos: Orientar y estandarizar el tratamiento del CPCP, enfermedad limitada, en México, basado en evidencia clínica nacional e internacional. Material y métodos: Este documento se desarrolló como una colaboración entre el Instituto Nacional de Cancerología y la Sociedad Mexicana de Oncología en cumplimiento con estándares internacionales. Se integró un grupo conformado por oncólogos médicos, cirujanos oncólogos, cirujanos de tórax, radio-oncólogos y metodólogos con experiencia en revisiones sistemáticas de la literatura y guías de práctica clínica. Resultados: Se consensuaron, por el método Delphi y en reuniones a distancia, las recomendaciones en CPCP enfermedad limitada, producto de las preguntas de trabajo. Se identificó y evaluó críticamente la evidencia científica que responde a cada una de dichas preguntas clínicas, antes de incorporarla a la guía. Conclusión: Esta guía proporciona recomendaciones clínicas para el manejo de la enfermedad limitada del CPCP y durante el proceso de toma de decisiones de los clínicos involucrados con su manejo en nuestro país para mejorar la calidad de la atención clínica en estos pacientes.

La colangiopancreatografía retrógrada endoscópica (CPRE) es un procedimiento útil en el manejo de enfermedades biliopancreáticas. Los pacientes con alteración anatómica del tracto gastrointestinal representan un desafío técnico por múltiples razones. Con técnicas como la enteroscopia de doble balón (EDB) es posible realizar una CPRE en estos pacientes. El caso que se presenta es el primero de este tipo publicado en Colombia sobre una paciente con gastrectomía total con reconstrucción en Y-de-Roux y coledocolitiasis.

Abstract COVID-19 pandemic led to a worldwide increase of hospitalizations for interstitial pneumonia with thrombosis complications, endothelial injury and multiorgan disease. Common CT findings include lung bilateral infiltrates, bilateral ground-glass opacities and/or consolidation whilst no current laboratory parameter consents rapidly evaluation of COVID-19 risk and disease severity. In the present work we investigated the association of sFLT-1 and CA 15.3 with endothelial damage and pulmonary fibrosis. Serum sFlt-1 has been associated with endothelial injury and sepsis severity, CA 15.3 seems an alternative marker for KL-6 for fibrotic lung diseases and pulmonary interstitial damage. We analysed 262 SARS-CoV-2 patients with differing levels of clinical severity; we found an association of serum sFlt-1 (ROC AUC 0.902, decision threshold > 90.3 pg/mL, p 24.8 U/mL, p

RESUMO Objetivo: Avaliar a utilidade do pico de fluxo da tosse para predizer o desfecho da extubação em pacientes que obtiveram sucesso no teste de respiração espontânea. Métodos: A busca cobriu as bases de dados científicos MEDLINE, Lilacs, Ibecs, Cinahl, SciELO, Cochrane, Scopus, Web of Science e literatura cinzenta. Utilizaram-se os critérios Quality Assessment of Diagnostic Accuracy Studies para avaliar a qualidade da metodologia e o risco de viés dos estudos. A heterogeneidade estatística da razão de verossimilhança (LR) e razão de chance diagnóstica (RCD) do diagnóstico foram avaliadas com utilização de gráficos em floresta, teste Q de Cochran e um gráfico crosshair summary Receiver Operating Characteristic, utilizando um modelo com múltiplos pontos de corte. Resultados: Inicialmente obteve-se, nas bases de dados, um total de 3.522 referências; dentre estas, selecionaram-se para análise qualitativa 12 estudos que incluíram 1.757 participantes. Muitos estudos apresentavam um risco de viés incerto em termos da seleção de pacientes e do fluxo e tempo. Dentre os 12 estudos incluídos, sete tinham alto risco e cinco risco incerto para o item padrão de referência. O desempenho diagnóstico do pico de fluxo da tosse para o resultado da extubação foi baixo a moderado quando se consideram os resultados de todos os estudos incluídos, com +LR de 1,360 (IC95% 1,240 - 1,530), -LR de 0,218 (IC95% 0,159 - 0,293) e razão de chance diagnóstica de 6,450 (IC95% 4,490 - 9,090). Uma análise de subgrupos que incluiu somente estudos com valores de corte entre 55 e 65 L/minuto demonstrou desempenho ligeiramente melhor, porém ainda moderado. Conclusão: A avaliação do pico de fluxo da tosse, considerando valor de corte entre 55 e 65 L/minuto, pode ser útil como medida complementar antes da extubação. São necessários estudos com melhor delineamento para elucidar o melhor método e equipamento para registrar o pico de fluxo da tosse, assim como o melhor ponto de corte.

Fasciolosis caused by the trematode Fasciola hepatica is a zoonotic neglected disease affecting animals and humans worldwide. Infection occurs upon ingestion of aquatic plants or water contaminated with metacercariae. These release the newly excysted juveniles (FhNEJ) in the host duodenum, where they establish contact with the epithelium and cross the intestinal barrier to reach the peritoneum within 2–3 h after infection. Juveniles crawl up the peritoneum towards the liver, and migrate through the hepatic tissue before reaching their definitive location inside the major biliary ducts, where they mature into adult worms. Fasciolosis is treated with triclabendazole, although resistant isolates of the parasite are increasingly being reported. This, together with the limited efficacy of the assayed vaccines against this infection, poses fasciolosis as a veterinary and human health problem of growing concern. In this context, the study of early host-parasite interactions is of paramount importance for the definition of new targets for the treatment and prevention of fasciolosis. Here, we develop a new in vitro model that replicates the first interaction between FhNEJ and mouse primary small intestinal epithelial cells (MPSIEC). FhNEJ and MPSIEC were co-incubated for 3 h and protein extracts (tegument and soma of FhNEJ and membrane and cytosol of MPSIEC) were subjected to quantitative SWATH-MS proteomics and compared to respective controls (MPSIEC and FhNEJ left alone for 3h in culture medium) to evaluate protein expression changes in both the parasite and the host. Results show that the interaction between FhNEJ and MPSIEC triggers a rapid protein expression change of FhNEJ in response to the host epithelial barrier, including cathepsins L3 and L4 and several immunoregulatory proteins. Regarding MPSIEC, stimulation with FhNEJ results in alterations in the protein profile related to immunomodulation and cell-cell interactions, together with a drastic reduction in the expression of proteins linked with ribosome function. The molecules identified in this model of early host-parasite interactions could help define new tools against fasciolosis. Author summary Fasciolosis caused by Fasciola hepatica poses a serious concern for animal and human health worldwide. Treatment and prevention of this disease is challenging due to the appearance of parasites that are resistant to the current treatment and the suboptimal efficacy of assayed vaccines. In this context, the importance of early interactions with the host for parasite migration and infection progression prompted us to develop and study new models of interaction between F. hepatica juveniles and their host. Here, an in vitro model coupled with a quantitative proteomics approach was developed to evaluate the changes in F. hepatica newly excysted juveniles right after their contact with intestinal epithelial cells, which represent the first line of host cells that the parasite encounters upon host infection. Additionally, this model has been used to decipher potential changes elicited by the parasite in the host intestine. A proteomic study of parasites and host cells upon co-incubation revealed specific changes in the repertoire of proteins from both host and parasite following their interaction. These proteins could be of importance for parasite migration and survival inside the host, and give new important insights to understand the host-parasite molecular crosstalk in early fasciolosis.

The OMICAS alliance is part of the Colombian government’s Scientific Ecosystem, established between 2017-2018 to promote world-class research, technological advancement and improved competency of higher education across the nation. Since the program’s kick-off, OMICAS has focused on consolidating and validating a multi-scale, multi-institutional, multi-disciplinary strategy and infrastructure to advance discoveries in plant science and the development of new technological solutions for improving agricultural productivity and sustainability. The strategy and methods described in this article, involve the characterization of different crop models, using high-throughput, real-time phenotyping technologies as well as experimental tissue characterization at different levels of the omics hierarchy and under contrasting conditions, to elucidate epigenome-, genome-, proteome- and metabolome-phenome relationships. The massive data sets are used to derive in-silico models, methods and tools to discover complex underlying structure-function associations, which are then carried over to the production of new germplasm with improved agricultural traits. Here, we describe OMICAS’ R&D trans-disciplinary multi-project architecture, explain the overall strategy and methods for crop-breeding, recent progress and results, and the overarching challenges that lay ahead in the field.