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Abstract Mitochondrial diseases are highly heterogeneous metabolic disorders caused by genetic alterations in the mitochondrial DNA (mtDNA) or in the nuclear genome. In this study, we investigated a panel of blood biomarkers in a cohort of 123 mitochondrial patients, with prominent neurological and muscular manifestations. These biomarkers included creatine, fibroblast growth factor 21 (FGF21) and growth/differentiation factor 15 (GDF-15), and the novel cell free circulating-mtDNA (ccf-mtDNA). All biomarkers were significantly increased in the patient group. After stratification by the specific phenotypes, ccf-mtDNA was significantly increased in the Mitochondrial Encephalomyopathy Lactic Acidosis Stroke-like episodes syndrome (MELAS) group, and FGF21 and GDF-15 were significantly elevated in patients with MELAS and Myoclonic Epilepsy Ragged Red Fibers syndrome. On the contrary, in our cohort, creatine was not associated to a specific clinical phenotype. Longitudinal assessment in four MELAS patients showed increased levels of ccf-mtDNA in relation to acute events (stroke-like episodes/status epilepticus) or progression of neurodegeneration. Our results confirm the association of FGF21 and GDF-15 with mitochondrial translation defects due to tRNA mutations. Most notably, the novel ccf-mtDNA was strongly associated with MELAS and may be used for monitoring the disease course or to evaluate the efficacy of therapies, especially in the acute phase. Key messages • FGF21/GDF15 efficiently identifies mitochondrial diseases due to mutations in tRNA genes. • The novel ccf-mtDNA is associated with MELAS and increases during acute events. • Creatine only discriminates severe mitochondrial patients. • FGF21, GDF-15, and ccf-mtDNA are possibly useful for monitoring therapy efficacy.

There has been an increase in surgical interventions in frailer elderly with concomitant chronic diseases. The purpose of this paper was to evaluate the impact of aging and comorbidities on outcomes in patients who underwent surgery for the treatment of colorectal cancer (CRC) in Veneto Region (Northeastern Italy). This is a retrospective cohort study in patients ≥ 40 years who underwent elective or urgent CRC surgical resection between January 2013 and December 2015. Independent variables included: age, sex, and comorbidities. We analyzed variables associated with the surgical procedure, such as stoma creation, hospitalization during the year before the index surgery, the surgical approach used, the American Society of Anesthesiologists (ASA) score, and the Charlson Comorbidity Index score. Eight thousand four hundred and forty-seven patients with CRC underwent surgical resection. Patient age affected both pre- and post-resection LOS as well as the overall survival (OS); however, it did not affect the 30-day readmission and reoperation rates. Multivariate analysis showed that age represented a risk factor for longer preoperative and postoperative LOS as well as for 30-day and 365-day mortality, but it was not associated with an increased risk of 30-day reoperation and 30-day readmission. Chronic Heart Failure increased the 30-day mortality risk by four times, the preoperative LOS by 51%, and the postoperative LOS by 33%. Chronic renal failure was associated with a 74% higher 30-day readmission rate. Advanced age and comorbidities require a careful preoperative evaluation and appropriate perioperative management to improve surgical outcomes in older patients undergoing elective or urgent CRC resection.

Produced water, a mixture of inorganic and organic components, comprises the largest effluent stream from oil and gas activities. The removal of contaminants from this wastewater is receiving special attention of the researchers since most of them are persistent and difficult to remove with simple techniques. Several technologies from conventional to advanced oxidation processes have been employed to treat produced water. However, the achievement of greater efficiency may be conditioned to a combination of different wastewater treatment techniques. Hereupon, the present paper discusses three important aspects regarding produced water treatment: analytical methods used for characterization, relevant aspects regarding photochemical systems used for advanced oxidation processes, and combined techniques for treating oil field wastewaters. Analytical methods employed for the quantification of the main species contained in produced water are presented for a proper characterization. Photochemical aspects of the reaction systems such as operating conditions, types of irradiation sources, and technical details of reactors are also addressed. Finally, research papers concerning combined treatment techniques are discussed focusing on the essential contributions. Thus, this manuscript aims to assist in the development of novel techniques and the improvement of produced water treatment to obtain a high-quality treated effluent and reduce environmental impacts.

Resumo A espécie Sus scrofa (javali) foi introduzida no Brasil, nos anos de 1904 e 1906, tornando-se uma ameaça à biodiversidade, à economia do setor agrícola e à sociedade. Neste trabalho, foi proposto identificar os impactos ambientais causados na região de Bagé, as ocorrências e danos na agricultura local, assim como o que vem sendo feito para o efetivo controle da espécie. Para obtenção dos resultados, foi realizado um levantamento de dados através de artigos, documentos on-line e instituições locais. Verificou-se que esta situação é originária do manejo realizado no passado, que ocasionou no aumento da população de javalis gerando este desequilíbrio. A proliferação desta espécie tem causado danos ambientais e danos econômicos ao ecossistema local e aos produtores. Nas lavouras de soja, milho, trigo e arroz já se estimaram prejuízos de diferentes montas, chegando a registrar perdas totais em pequenos cultivos. Com estes impactos crescentes, foram necessárias medidas ambientalmente seguras para reorganizar este ecossistema, pois com a ausência de predadores naturais, esta população tende a crescer, sendo necessária a implantação de uma política de controle. Como método de controle populacional, foi identificada a liberação da caça do javali a partir de um Cadastro Técnico Federal e certificação. Palavras-chave: Manejo; crescimento; javali; biodiversidade. Abstract An analysis of the environmental impacts of exotic species in the Pampa Biome: from proliferation to the necessary control of Sus scrofa populations The species Sus scrofa (wild boar) was introduced in Brazil, during 1904 and 1906, becoming a threat to biodiversity, to agricultural sector economy and to society. In this research, it was proposed to identify environmental impacts caused in the Bagé region, occurrences and damages in local agriculture, as well as what has been done for the species effective control. In order to obtain the results, a data survey was carried out through articles, online documents and local institutions. It was found that this situation originates from management carried out in the past, which caused an increase in the wild boar population, generating this imbalance. The proliferation of this species has caused environmental damage and economic damage to local ecosystem and to producers. In soybean, corn, wheat and rice crops, losses of different amounts have already been estimated, reaching total losses in small crops. With these growing impacts, environmentally safe measures were necessary to reorganize this ecosystem, as with the absence of natural predators this population tends to grow, requiring the implementation of a control policy. As a method of population control, the release of wild boar hunting from a Federal Technical Register and certification was identified. Keywords: Management; growth; boar; biodiversity. Resumen Un análisis sobre los impactos ambientales de las especies exóticas en el Bioma Pampa: de la proliferación al control necesario de las poblaciones de Sus scrofa La especie Sus scrofa (jabalí) fue introducida en Brasil en los años de 1904 y 1906, convirtiéndose en una amenaza para la biodiversidad, a la economía del sector agrícola y de la sociedad. En este trabajo se propuso identificar los impactos ambientales provocados en la región de Bagé, las ocurrencias y daños en la agricultura local, así como lo que se está haciendo para el efectivo control de la especie. Para la obtención de los resultados, se realizó una encuesta de datos a través de artículos, documentos en línea e instituciones locales. Se verificó que esta situación se origina en el manejo realizado en el pasado, que provocó en el aumento de la población de jabalíes, generando este desequilibrio. La proliferación de esta especie ha causado daños ambientales y económicos al ecosistema local y a los productores. En los cultivos de soya, maíz, trigo y arroz ya se han estimado pérdidas de diferentes cantidades, alcanzando registrar pérdidas totales en cultivos pequeños. Con estos impactos crecientes, fueron necesarias medidas ambientalmente seguras para reorganizar este ecosistema, ya que, con la ausencia de depredadores naturales, esta población tiende a crecer, requiriendo la implementación de una política de control. Como método de control de la población, fue identificada la liberación de la caza de jabalíes a partir de un Registro Técnico Federal y una certificación. Palabras clave: Gestión; crecimiento; jabali; biodiversidad.

A utilização de urina de vaca pode ser considerada uma prática de baixo custo para os produtores rurais do Sudoeste do Paraná. Assim objetivou-se com este trabalho avaliar o efeito da urina de vaca sobre o crescimento e produção de mudas de alface. O delineamento experimental utilizado foi em inteiramente casualizado, com quatro repetições. Foram analisados os efeitos de sete concentrações de urina de vaca (1,0; 2,0; 3,0; 4,0; 5,0; 6,0 e 7,0%) (v v-1). Nas condições do sudoeste paranaense, o melhor desenvolvimento da alface foi obtido com a aplicação da concentração de 5,0%. Os índices de clorofila (a e b), também foram superiores com a utilização da concentração de 5,0%.

Immunotherapy, so promising in many neoplasms, still does not have a precise role in the treatment of neuroendocrine neoplasms (NENs). In this article, we provide an overview on the current knowledge about immunotherapy with immune checkpoint inhibitors (ICIs) applied to NENs, evaluating future perspectives in this setting of tumors.Evidence so far available for ICIs in gastroenteropancreatic (GEP)-NENs is definitively not as robust as for other tumors such as Small Cell Lung Cancer or Merkel Cell Carcinoma. In fact, with regard to the well-differentiated forms of NENs (NETs), the results obtained nowadays have been disappointing. However, the near future, might reserve interesting results for ICIs in GEP-NEN from a total of nine different ICI drugs, used throughout 19 randomised controlled trials. Such numbers highlight the growing attention gathering around NENs and ICIs, in response to the need of stronger evidences supporting such therapy.For the future, the most important aspect will be to study strategies that can make NETs more susceptible to response to ICI and, thus, enhance the effectiveness of these treatments. Therefore, the combination of conventional therapy, target therapy and immunotherapy deserve attention and warrant to be explored. A sequential chemotherapy, possibly inducing an increase in tumor mutational burden and tested before immunotherapy, could be a hypothesis deserving more consideration. A radiation treatment that increases tumor-infiltrating lymphocytes, could be another approach to explore before ICIs in NENs. Equally essential will be the identification of biomarkers useful for selecting patients potentially responsive to this type of treatment.

Nanoscience and technology have enabled better insights into the environmental and health impacts arising from the mining, production and use of fossil and mineral fuels. Here we provide an overview of the nanoscience-based applications and discoveries concerning coal and mineral fuel (i.e., uranium-containing minerals) mining, refining/production, use, and disposal of wastes. These processes result in massive nanoparticle release and secondary nanoparticle generation which have highly significant environmental implications and human health consequences on local, regional, and even global levels. Until recently, very little was known about nanoparticle fractions. Recent advancements and sophistications enable us to detect, collect and study these materials which are roughly 1 nm (0.001 μm) up to several tens of nanometers in size. These materials are known to behave differently (chemically, electrically, and mechanically), relative to their macroscopic equivalents. This is what makes nanoscience fascinating and difficult to predict, underscoring the importance of this emerging new field. For example, nanoparticles associated with coal and mineral fuel influence the release, uptake, and transportation of hazardous elements associated with mining, processing, and waste storage in the surrounding areas. This includes long distance transport down streams, rivers, and eventually to oceans such as from coal and uranium mine drainages. In terms of human health, in all phases of mining, production/refining, use, and waste disposal, the associated nanoparticles can be acquired through oral ingestion, inhalation, and dermal absorption. Inhalation has been shown to be particularly damaging, where lung, heart, kidney, and brain diseases are prevalent. Relative to all other fields of science and engineering associated with coal and mineral fuel mining, production, use, and clean-up efforts, nanoscience, although a much newer field then the rest by comparison, is still greatly under-represented and under-utilized. There is also a continuing gap between what we so far know about the behavior of nanoparticles, and what remains to be discovered.

Background: Patients with sporadic neuroendocrine neoplasms may exhibit a higher risk of a second primary tumor than the general population. Aim: This study aimed to analyze the occurrence of second primary malignancies.Methods: A retrospective cohort of 2757 patients with sporadic lung and gastro-entero-pancreatic neuroendocrine neoplasms, managed at eight Italian tertiary referral Centers, was included.Results: Between 20 0 0 and 2019, a second primary malignancy was observed in 271 (9.8%) neuroendocrine neoplasms patients with 32 developing a third tumor. There were 135 (49.8%) females and the median age was 64 years. The most frequent locations of the second tumors were breast (18.8%), prostate (12.5%), colon (9.6%), blood tumors (8.5%), and lung (7.7%). The second primary tumor was synchronous in 19.2% of cases, metachronous in 43.2%, and previous in 37.6%. As concerned the neuroendocrine neoplasms, the 5and 10-year survival rates were 87.8% and 74.4%, respectively. PFS for patients with a second primary malignancy was shorter than for patients without a second primary malignancy. Death was mainly related to neuroendocrine neoplasms.Conclusion: In NEN patients the prevalence of second primary malignancies was not negligible, suggest ing a possible neoplastic susceptibility. Overall survival was not affected by the occurrence of a second primary malignancy. (C) 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

In this work, coal bottom ash was modified by alkaline fusion route in order to improve its pore properties and make it a potential adsorbent to remove crystal violet dye from aqueous medium. The solids were characterized and posteriorly subjected to kinetic, isotherm, and thermodynamic studies, as well as regenerated and reused for five adsorption tests. The alkaline fusion step resulted in the amorphization of material and generation of high surface area (102 m 2 g −1) and pore volume (0.180 cm 3 g−1), resulting in superior performance compared to the raw material. Kinetic and equilibrium studies showed that the adsorption process was better adjusted by the pseudo-second order and Langmuir models, respectively. The maximum adsorption capacity at equilibrium was 177. 37 mg g−1, with the adsorptive step occurring spontaneously and endothermically. The adsorbent maintained notable levels of dye removal after five consecutive cycles of thermal regeneration and reuse. Besides, the adsorbent was able to remove 64% of the colour of simulated industrial wastewater. Therefore, the alkaline fusion step proved to be a route capable of transforming the coal bottom ash into an adsorbent with improved textural and adsorptive properties.

Objective This study aimed to assess the characteristics of different designs of systematic reviews (SRs) registered in the International Prospective Register of Systematic Reviews (PROSPERO) about COVID‐19. Methods The search was performed in the PROSPERO database using the strategy proposed by the database and considered only human studies. The last date of the search was April 27, 2020. Full text of all records was accessed, and data were extracted by a single researcher, which was further double‐checked by another researcher. A descriptive analysis was performed considering record characteristics using tables. Results We included 564 records from which the vast majority were registered as SRs (n = 513, 91%). In general, we found poor reporting and missing or confusing information, since 84% of the records (n = 474) did not report the full search that would be adopted, 16% (n = 90) did not report clearly the databases that would be used, and 49.1% (n = 277) did not report the number of primary outcomes. The main focus of most of the records involved clinical, epidemiological, complication, and laboratory characteristics (n = 173, 30.7%) or the treatment of COVID‐19 (n = 138, 24.5%). Conclusion A large number of SRs about COVID‐19 have been conducted, and many of the assessed records were poorly reported and would be difficult to replicate. Besides, collected data points to an epidemic of redundant reviews on COVID‐19.

This study aimed to assess root canal irrigants' effect on the bond strength between endodontic sealers and root canal dentin, through a systematic review. The study protocol is available online (h...

School choice policy is ubiquitous in urban school districts. Evidence suggests that it has not fully delivered on its proponents’ promises of equitable educational opportunity. While scholars and policymakers scrutinize data to determine school choice’s equity outcomes, little attention has been paid to how school choice policy directly influences youth understanding of educational equity and opportunity. This study therefore explores how youth who engage with school choice policy come to understand and act upon the distribution of educational opportunities, and the extent to which their understandings and actions vary by social identity, family resources, school resources and admissions outcomes. 36 youth, engaged in the high school choice process, participated in this study, which is guided by policy enactment theory. Across subgroups, participants overwhelmingly valued merit as the best principle by which to distribute educational opportunity. Alongside this near-universal embrace of merit and widespread participation in choice policy-required actions, those who accessed the highest-performing schools often did so by activating non-academic resources that required financial capital. These findings highlight a shared ritual that serves to instantiate and reinforce ideals of meritocracy. Findings inform our discussion of school choice policy’s educational equity and civic implications.

Fatigue cracking is the main type of distress in flexible pavements in Brazil. Numerical models that are based on viscoelastic continuum damage (VECD) theory can help to explain the damage evolutio...

Splenic abscess is a rare but extremely dangerous condition generally spreading from a local, or systemic, focus of infection. We present the case of a young immunocompetent female admitted with sepsis and multiple splenic abscesses. The patient had a recent left ear piercing on the tragus complicated by an ear infection. The presence of a solitary parotid abscess, the absence of other infectious foci on computed tomography scan, the negativity of blood cultures and the absence of endocarditis vegetations led us to think that the most likely culprit was a hematogenous dissemination from the left tragus. The patient was successfully treated with intravenous antibiotics. There had been no need of splenectomy or any other procedure. This rather unique case underscores that splenic abscess should be suspected when a long-lasting fever and pain in the left hypochondrium are present, even when an apparently innocuous invasive procedure, such as a body piercing, is performed.

Peripheral nerve blocks (PNBs) provide excellent perioperative analgesia but can increase the risk of severe postoperative pain once the block wears off. Poor adherence to discharge instructions may increase this risk. Panda-Nerve Block (Panda) is an app that alerts the patient to assess their PNB, score their pain, and take scheduled pain medication. We assessed the usability and feasibility of Panda for assisting patients after receiving a PNB. Twenty-nine patients tested Panda in three rounds, for two to seven days, postoperatively to assess and manage their pain and PNB. Feedback was provided via phone interview and the Computer System Usability Questionnaire (CSUQ). Additionally, each user’s usage log was analyzed for parameters such as alert response times. Feasibility was determined by alert responses that occurred before the next alert, with a goal of greater than 50%. User adherence was measured as percentage compliance with alerts within one hour; usability and user satisfaction were determined from the CSUQ and interviews. A median [interquartile range (IQR)] of 68 [34–93]% responded before the next alert during the first 48 hr of app use, and 83 [54–92]% responded before the next alert with 87 [75–96]% of these within one hour. There were no significant differences in usage between rounds. Ninety-three percent of patients reported Panda to be easy to use and helpful, and 79% of patients would use Panda again. Critical themes included changes to the layout and appearance, clarification of the language of the PNB check, and requests for dynamic adjustments to the medication schedule based on user responses. Panda-Nerve Block is a feasible method for PNB patients to manage postoperative pain with a high response rate. Future work should include providing two-way communication for patients and clinicians and assessing its effect on pain outcomes. www.clinicaltrials.gov (NCT03369392); registered 5 December 2017.

Purpose: The purpose of this study was to assess visual function by visually evoked potentials in adults with orbital and other primary brain tumors affecting the optic pathway. Methods: In this retrospective case–control series, patients with orbital (intraconal and extraconal) or midline/chiasmatic tumors were included. Visually evoked potentials using pattern-reversal visually evoked potential and flash visually evoked potential stimuli were performed according to the international standards. Outcome measures were visually evoked potential parameters of amplitude (µV) and peak times (ms) measured both for the P100 component (pattern-reversal visually evoked potentials) and the N2P2 complex (flash visually evoked potential). Individual results were also compared with gender-based normative values. Results: A group of 21 adult patients (17 females) and age- and sex-matched controls were evaluated. Tumor location was intraconal (6 meningiomas, 3 hemangiomas, 1 glioma), extraconal (6 meningiomas), and midline (3 pituitary adenomas, 2 hypothalamic/chiasmatic low-grade gliomas). Abnormal fundus (76%), abnormal pupillary reflexes (71%), reduced visual acuity (62%), strabismus (48%), and proptosis (38%) were present. Visually evoked potential abnormalities were found in at least one eye of all cases. Affected eyes had significantly reduced amplitudes and prolonged peak times for pattern-reversal visually evoked potentials ( p Conclusion: Visually evoked potential abnormalities were found in all adult patients with orbital and other intracranial primary tumors, even in eyes with normal exam and good visual acuity. Visually evoked potential can be used as a non-invasive ancillary test to characterize and monitor visual function in subjects with these neoplastic lesions.

OBJECTIVE This study aimed to evaluate whether a master and PhD thesis in Brazilian graduate programs in dentistry can be based on a systematic review (SR). METHODS In this cross-sectional study, we surveyed the coordinators of Brazilian graduate programs in dentistry using a self-administered questionnaire including questions about whether an SR meets requirements for approval of a master or PhD thesis, instructions regarding how to use an SR as the method for a master or PhD thesis, and reasons and barriers that SRs were not recognized as acceptable for a master or PhD thesis. The responses were analyzed descriptively, and tables and graphs were created to summarize the data. RESULTS Among 101 graduate programs invited to participate in the study, 38 (37.6%) returned the questionnaire. Over three-quarters of surveyed programs (n = 30, 78.1%) answered that SRs, in whole or in part, meet the criteria for a master or PhD thesis. Likewise, most programs answered that a master or PhD thesis could be exclusively based on an SR (n = 28, 73.7%). The same number of programs pointed out that one possible reason for not recognizing SRs as a master or PhD thesis is either the lack of SR expertise among committee members (n = 28, 73.7%) or the lack of adequate training of candidates in SR methodology (n = 26, 68.4%). CONCLUSIONS SRs are well accepted as a master or PhD thesis by Brazilian graduate programs in dentistry. Educational initiatives should be encouraged to promote understanding of SR methodology and increase acceptance among graduate programs worldwide.

The morphology and composition of roots with different degrees of oxidation as a function of time were evaluated aiming to identify possible hazardous elements and nanoparticles. The roots were obtained from an abandoned coal mine located in the city of Criciuma, Santa Catarina, Brazil. From the roots, analyses were performed to identify nanoparticles (NPs) and ultrafine particles (UFPs), containing possible hazardous elements (PHEs) that cause potential environmental risks and impacts on human health. The identification of nanoscale materials requires greater robustness, so advanced integrated techniques have been used. The characterization of different types of roots was done by using focused ion beam (FIB), to evaluate nano-compound assemblies with high-resolution transmission electron microscopy/energy dispersive spectroscopy (HR-TEM/EDS). The results showed the presence of NPs containing Hg, Co, Cr, Ni, and V. The presence of these elements has increased consistently with the increase of C concentration in the roots, suggesting that the PHEs were gradually released from organic matter and inorganic minerals of coal. However, even with their decrease in roots, it was found that these elements still remained in the soil in significant quantities, even after 15 years of inactivation of the coal mine.

The fast pace of the technological evolution forces workers to update their competencies in order to remain attractive in the labor market. Those changes suggest that in order to remain employable, workers need to add new skills (either soft or digital) to their “traditional” competencies, demonstrating the ability to work in an interdisciplinary agile fashion. We argue that this professional evolution resembles the characteristics of the T-shaped professionals, and that it is possible to interpret the changes of jobs that are caused by the technological revolution drawing on job design literature. Hence, analyzing the data of a survey administered to a sample of 238 workers employed in Veneto Region, we explore the skill shapes of jobs that are present in the labor market and we assess their relationship with the workers’ and organizational characteristics.

Purpose: Pancreatic neuroendocrine neoplasms (PNENs) are a group of clinically rare and heterogeneous tumors of the pancreas. Currently there are no studies investigating the gender difference in PNEN susceptibility. Thus, the purpose of this study was aimed at examining how gender shapes risk factors, clinicopathological features, and comorbidities in PNENs. Methods: The study design consisted of an Italian multicenter, retrospective study. The study included all consecutive patients with PNENs followed at the participating centers. Two hundred and twenty-nine patients (105 males,124 females, age 54 ± 0.98 years) with PNENs were enrolled at the participating centers. The clinicopathological features (age, gender, BMI, histology, tumor size, tumor grade, distant metastasis, hormonal function, and diagnostic circumstances), comorbidities (cardiovascular diseases (CVD), pancreatitis, type 2 diabetes (T2DM), and potential risk factors (smoking and drinking) were included in the analysis. Results: Females were slightly prevalent (54.15%). PNENs were diagnosed at younger age in females compared to males (p = 0.04). The prevalence of CVD was significantly higher in males than in females (p = 0.006). In the female group, the presence of T2DM was significantly associated with higher tumor grade (p = 0.04) and metastatic disease (p = 0.02). The proportion of smokers and alcohol drinkers was significantly higher in the male group (p < 0.001). No significant gender differences were detected regarding the other parameters included in the analysis. Conclusions: This study has identified gender differences of PNENs in terms of age at diagnosis, associated comorbidities, and potential risk factors. A gender-tailored approach could become a potential strategy to better understand the natural history of PNENs and improve the effectiveness of PNENs clinical management.

Objectives To explore the impact of sex and age on relationship between prodromal constipation and disease phenotype in Parkinson’s disease at early stages. Methods A total of 385 Parkinson’s disease patients from the PRIAMO study were classified according to the presence of prodromal constipation and followed for 24 months. Multivariable mixed-effect models were applied. All analyses were performed separately for sex (64.1% men) and median age (different by sex: 67 years-old in men and 68 years-old in women). Results As for sex, prodromal constipation was associated with greater odds of attention/memory complaints and apathy symptoms in women only. As for age, prodromal constipation was associated with lower cognitive and higher apathy scores in older patients only. Conclusions Prodromal constipation anticipates lower cognitive performances and more severe apathy since the earliest stages in women and older patients. Sex- and age-related heterogeneity of prodromal markers of Parkinson’s disease may impact disease phenotype.

In 2021, the DART spacecraft will be launched by NASA to intercept the binary system Didymos and impact the moonlet (Dimorphos), to test the effectiveness of kinetic impactors for the deviation of hazardous asteroids’ trajectories. The impact is expected to generate a cloud of particles, whose study could provide valuable data about asteroid’s properties and impact models. Observations from ground to characterize ejecta and plume evolution after impact would be possible, but the resulting quality would be significantly lower than a short-range imaging. In this framework, ASI (Italian Space Agency) and NASA started a collaboration to embark on the US DART vehicle the LICIA (Light Italian CubeSat for Imaging Asteroid) 6U CubeSat as a piggyback payload. LICIA is devoted to grasp science data by imaging the ejecta plume after the impact, and observe Dimorphos surface while flying by the binary system. The Italian consortium involved in the mission sees ARGOTEC for the platform development, and INAF, Politecnico di Milano and Universita di Bologna to cover the mission science, trajectory design and orbit de-termination tasks, respectively. The paper focuses on the mission analysis and maneuvers design, strongly driven by the science return, under the tight constraints enforced by the platform. In particular, it describes the preliminary procedure followed to derive trajectory constraints and to select the best option for the flyby. Despite the mission is still under development, and subjected to frequent updates of several parameters, the final performances derived in this paper maintain their validity as they represent the desired target values for the mission.

Context Colonic polyps occur in 30–40% of acromegalic patients, increasing the risk of colon carcinoma. Although debated, there is emerging evidence that metformin may play a protective role in diabetic and non-diabetic patients with colonic polyps and its use in chemoprevention is currently explored. Objective Evaluate the prevalence of colonic polyps in acromegalic patients treated or not with metformin and explore its possible protective role. Design Exploratory cross-sectional study in two tertiary Italian referral centres. Met hods: Out of 153 acromegalic patients, we selected 58 patients (36–82 years; f: 33) who had at least one colonoscopy performed within the first 2 years of diagnosis. Presence of colonic polyps/cancer and related risk factors, current metformin and acetylsalicylic acid intake, disease duration, therapies for acromegaly, hormonal and metabolic parameters were assessed. Results An overall prevalence of 36% polyps was found. Based on the presence of polyps, we identified two groups, comparable for age, BMI, disease duration, glucose, insulin, HOMA-IR, HbA1c, GH and IGF-I levels. Of the patients with polyps (including three adenocarcinomas) only 24% were treated with metformin vs 57% of patients without polyps. Multivariate analysis confirmed a significant negative association between colonic polyps and metformin intake (OR: 0.22, 95% CI: 0.06-0.77, P = 0.01), whereas no significant association was found between polyps and age (P = 0.10), overweight/obesity (P = 0.54), smoking (P = 0.15), acetylsalicylic acid intake (P = 0.99), disease duration (P = 0.96), somatostatin analogues treatment (P = 0.70). Conclusions These findings, though deriving from an exploratory study, could suggest a protective role of metformin on the development of colonic polyps in acromegaly, and need to be confirmed in an extended study population.

Made available in DSpace on 2019-10-06T17:18:08Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-12-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) The annotation of large datasets is an issue whose challenge increases as the number of labeled samples available to train the classifier reduces in comparison to the amount of unlabeled data. In this context, semi-supervised learning methods aim at discovering and propagating labels to unlabeled samples, such that their correct labeling can improve the classification performance. In this work, we propose a semi-supervised methodology that explores the optimum connectivity among unlabeled samples through the Optimum-Path Forest (OPF) classifier to improve the learning process of Convolution Neural Networks (CNNs). Our proposal makes use of the OPF to classify an unlabeled training set that is used to pre-train a CNN for further fine-tuning using the limited labeled data only. The proposed approach is experimentally validated on traditional datasets and provides competitive results in comparison to state-of-the-art semi-supervised learning methods. Federal University of Grande Dourados São Paulo State University - UNESP Corumbá Concessões S.A São Paulo State University - UNESP FAPESP: 2013/07375-0 FAPESP: 2014/12236-1 FAPESP: 2015/25739-4 FAPESP: 2016/19403-6 CNPq: 307066/2017-7 CNPq: 427968/2018-6

The impact of sex hormones on anticancer immunity deserves attention due to the importance of the immune system in cancer therapy and the recognition of sex differences in immunity. Cancer is ultimately the result of failed immune surveillance, and the diverging effects of male and female sex hormones on anticancer immunity could contribute to the higher cancer incidence and poorer outcome in men. Estrogens and androgens affect the number and function of immune cells, an effect that depends on cell type, tumor microenvironment, and the age and reproductive status of the individual. Despite the recent progress in immuno-oncology, our current understanding of the interplay between sex hormones and anticancer immune responses is in its infancy. In this review, we will focus on the impact of sex hormones on anticancer immunity and immunotherapy. We will discuss the potential role of the changing hormone levels in anticancer immunity during aging and in the context of menopausal hormone therapies and oral contraception. We will review emerging data on sex differences in PD-L1 expression and potential biomarkers predictive for the efficacy of immune checkpoint inhibitors such as the microbiome and consider ongoing clinical trials evaluating the potential impact of hormone deprivation therapies to increase response to immune checkpoint inhibitors in breast and prostate cancer. Finally, we will point to areas of future research.

Background: Failure of the native aortic valve and degenerative anatomy of ascending aorta in patients with previous Tirone-David operation may represent a clinical challenge, because sometimes the risk of reoperation is prohibitive.Case: We described the case of a patient suffering from severe aortic valve regurgitation and pseudoaneurysm of the aortic arch, 6 years after cardiac surgery operation. The aim of this clinical case was to assess if the complex anatomy of aortic pseudoaneurysm and aortic root geometry can be accurately reproduced from contrast-enhanced computed tomography scan into a three-dimensional (3D) printed model. Based on this procedural method, with the aid of transesophageal 3D ultrasound, we efficaciously treated the patient percutaneously with a combination of transcatheter occluder device plus microcoil embolization and transfemoral aortic valve implantation. The patient was free from complications and the need to redo cardiac surgery.Conclusion: To the best of our knowledge, this is the first description of two simultaneous complications and their staged treatment in a patient with previous aortic valve-sparing operation. This is a useful report in a single 3D model applying such specific technology to these two simultaneous clinical settings.

Photoemission is one of the fundamental processes that describes the generation of charged particles from materials irradiated by photons. The continuous progress in the development of ultrashort lasers allows investigation into the dynamics of the process at the femtosecond timescale. Here we report about experimental measurements using two ultrashort ultraviolet laser pulses to temporally probe the electrons release from a copper cathode in a radio-frequency photoinjector. By changing their relative delay, we studied how the release mechanism is affected by two-photon photoemission when tens of G W / c m 2 intensities are employed. We evaluated the limits it poses on the achievable beam brightness and analyzed the resulting emission yield in terms of the electronic temperature by modeling the cathode as a two-temperature system.

Next-generation plasma-based accelerators can push electron beams to GeV energies within centimeter distances. The plasma, excited by a driver pulse, is indeed able to sustain huge electric fields that can efficiently accelerate a trailing witness bunch, which was experimentally demonstrated on multiple occasions. Thus, the main focus of the current research is being shifted towards achieving a high quality of the beam after the plasma acceleration. In this paper we present a beam-driven plasma wakefield acceleration experiment, where initially preformed high-quality witness beam was accelerated inside the plasma and characterized. In this experiment the witness beam quality after the acceleration was maintained on high level, with 0.2% final energy spread and 3.8 μm resulting normalized transverse emittance after the acceleration. In this article, for the first time to our knowledge, the emittance of the plasma wakefield accelerated beam was directly measured

Medullary thyroid carcinoma is a rare neuroendocrine neoplasm that originates from thyroid C cells. Surgery, with complete resection of the tumor, is the only curative approach. However, in most cases, the tumor recurs at locoregional or metastatic level. In this setting, the management remains challenging. In recent years, the immune checkpoint inhibitors have provided promise for changing the cancer treatment paradigm through the application of new approaches that enhance the body’s natural antitumor defenses. The aim of this review is to summarize and discuss available data on efficacy and safety of the Food and Drug Administration-approved immune checkpoint inhibitors in patients with medullary thyroid carcinoma. After an extensive search, we found 7 useful data sources (one single-case report, one short article with very preliminary data, five ongoing registered clinical trials). Despite the lack of published evidence regarding the use of immune check point inhibitors, it must be considered that all the ongoing registered clinical trials saw first light in the last three years, thus indicating a growing interest of researchers in this field. Results coming from these trials, and hopefully, in the next future, from additional trials, will help to clarify whether this class of drugs may represent a new weapon in favor of patients with medullary thyroid carcinoma.

Purpose: To determine visual impairment due to optic pathway tumors in children unable to perform recognition acuity tests. Methods: Grating visual acuity scores, in logMAR, were obtained by sweep visually evoked potentials (SVEP) in children with optic pathway tumors. The binocular grating visual acuity deficit was calculated by comparison with age-based norms and then assigned to categories of visual impairment as mild (from 0.10 to 0.39 logMAR), moderate (from 0.40 to 0.79 logMAR), or severe (≥0.80 logMAR). Interocular differences were calculated by subtraction and considered increased if >0.10 logMAR. Results: The participants were 25 children (13 boys; mean ± SD age, 35.1 ± 25.9 months; median age, 32.0 months) with optic pathway tumors (24 gliomas and 1 embryonal tumor), mostly located at the hypothalamic-chiasmatic transition (n=21; 84.0%) with visual abnormalities reported by parents (n=17; 68.0%). The mean grating acuity deficit was 0.60 ± 0.36 logMAR (median, 0.56 logMAR). Visual impairment was detected in all cases and was classified as mild in 10 (40.0%), moderate in 8 (32.0%), and severe in 7 (28.0%) children, along with increased interocular differences (>0.1 logMAR) (n=16; 64.0%). The remarkable ophthalmological abnormalities were nystagmus (n=17; 68.0%), optic disc cupping and/or pallor (n=13; 52.0%), strabismus (n=12; 48.0%), and poor visual behavior (n=9; 36.0%). Conclusion: In children with optic pathway tumors who were unable to perform recognition acuity tests, it was possible to quantify visual impairment by sweep-visually evoked potentials and to evaluate interocular differences in acuity. The severity of age-based grating visual acuity deficit and interocular differences was in accordance with ophthalmological abnormalities and neuroimaging results. Grating visual acuity deficit is useful for characterizing visual status in children with optic pathway tumors and for supporting neuro-oncologic management. RESUMO Objetivo: Determinar o grau de deficiência visual em crianças com tumores da via óptica incapazes de informar a acuidade visual de reconhecimento. Método: A acuidade visual de grades, em logMAR, foi estimada por potenciais visuais evocados de varredura em crianças com tumores das vias ópticas. O déficit da acuidade visual de grades binocular foi calculado em relação ao valor mediano normativo esperado para a idade e a deficiência visual, classificada como leve (0,10 a 0,39 logMAR), moderada (0,40 a 0,79 logMAR) ou grave (≥0,80 logMAR). Diferenças inter-oculares foram calculadas por subtração e consideradas aumentadas se >0,10 logMAR. Resultados: Foram avaliadas 25 crianças (13 meninos; média de idade ± DP=35,1± 25,9 meses; mediana=32,0 meses) com tumores da via óptica (24 gliomas e 1 tumor embrionário) localizados particularmente na transição hipotalâmico-quiasmática (n=21; 84,0%) e com anormalidades visuais detectadas pelos pais (n=17; 68,0%). A média do déficit da acuidade de grades foi 0,60 ± 0,36 logMAR (mediana=0,56 logMAR). Observou-se deficiência visual leve em 10 (40,0%), moderada em 8 (32,0%) e grave em 7 (28,0%), além de aumento da diferença interocular da acuidade visual (n=16; 64,0%). As principais alterações oftalmológicas encontradas foram: nistagmo (n=17; 68,0%), aumento da escavação do disco óptico e/ou palidez (n=13; 52,0%), estrabismo (n=12; 48,0%) e comportamento visual pobre (n=9; 36,0%). Conclusão: Em crianças com tumor da via óptica e incapazes de responder aos testes de acuidade visual de reconhecimento, foi possível quantificar deficiência visual por meio dos potenciais visuais evocados de varredura e avaliar a diferença interocular da acuidade visual de grades. A gravidade do déficit da acuidade visual de grades relacionado à idade e a diferença interocular da acuidade visual de grades foram congruentes com alterações oftalmológicas e neuroimagem. O déficit da acuidade visual de grades foi útil à caracterização do estado visual em crianças com tumores da via óptica e ao embasamento da assistência neuro-oncológica.

Pheochromocytoma and paraganglioma are neuroendocrine neoplasms, originating in the adrenal medulla and in parasympathetic and sympathetic autonomic nervous system ganglia, respectively. They usually present as localized tumours curable with surgery. However, these tumours may exhibit heterogeneous clinical course, ranging from no/minimal progression to aggressive (progressive/metastatic) behavior. For this setting of patients, current therapies are unsatisfactory. Immune checkpoint inhibitors have shown outstanding results for several types of solid cancers. We therefore aimed to summarize and discuss available data on efficacy and safety of current FDA-approved immune checkpoint inhibitors in patients with pheochromocytoma and paraganglioma. After an extensive search, we found 15 useful data sources (four full-published articles, four supplements of scientific journals, seven ongoing registered clinical trials). The data we detected, even with the limit of the small number of patients treated, make a great expectation on the therapeutic use of immune checkpoint inhibitors. Besides, the newly detected predictors of response will (hopefully) be of great helps in selecting the subset of patients that might benefit the most from this class of drugs. Finally, new trials are in the starting blocks, and they are expected to shed in the next future new light on a therapy, which is considered a milestone in oncology.

Here we present an Italian criminal case that shows how statistical methods can be used to extract information from a series of mixed DNA profiles. The case involves several different individuals and a set of different DNA traces. The case possibly involves persons of interest of a small population of Romani origin. First, a brief description of the case is provided. Secondly, we introduce some heuristic tools that can be used to evaluate the data and we also briefly outline the statistical model used for analysing DNA mixtures. Finally, we illustrate some of the findings on the case and discuss further directions of research. The results show how the use of different population database allele frequencies for analysing the DNA mixtures can lead to very different results, some seemingly inculpatory and some seemingly exculpatory. We also illustrate the results obtained from combining the evidence from different samples.

The ability of microalgae to sequester carbon and at the same time synthesise valuable compounds with potential applications in nutraceutical, pharmaceutical and cosmetic industries makes them attractive for commercial deployment, especially in view of a blue bioeconomy. Among microalgae, the diatom Phaeodactylum tricornutum is considered as an important potential source of omega-3 polyunsaturated fatty acids, such as eicosapentanoic acid, an essential polyunsaturated fatty acid with anti-inflammatory and antimicrobial properties. The aim of this study was to perform the Life Cycle Assessment of the cultivation of P. tricornutum - at semi-industrial scale in photobioreactor - for the production of high-quality bioactive compounds comparing synthetic carbon dioxide supply to a supply with waste carbon dioxide from a biogas upgrading process hypothesizing industrial symbiosis network. The effect of renewable energy use instead of the European electricity mix was also examined. Primary data on the production process, including the stages of cleaning and sterilisation, cultivation, harvesting and freeze-drying, were used. The midpoint impact categories recommended in the ILCD Handbook were used for performing the impact assessment. A sensitivity analysis was also performed on algal productivity, culture medium recirculation factor and amount of solvents per cleaning cycle. Firstly, results indicate in general cultivation and freeze-drying as the most contributing stages to the impacts. Secondly, they demonstrate in the comparative assessment that the use of carbon dioxide from the biogas upgrading is a feasible and attractive alternative to the synthetic one, as it allows for the improvement of the environmental performance of the production process in all the analysed impact categories. Finally, sensitivity analysis suggests that the environmental performance could be further improved by acting on other key factors, such as electricity source, nutrients culture medium and cleaning solutions.

Wolfram syndrome (WS) is a recessive multisystem disorder defined by the association of diabetes mellitus and optic atrophy, reminiscent of mitochondrial diseases. The role played by mitochondria remains elusive, with contradictory results on the occurrence of mitochondrial dysfunction. We evaluated 13 recessive WS patients by deep clinical phenotyping, including optical coherence tomography (OCT), serum lactic acid at rest and after standardized exercise, brain Magnetic Resonance Imaging, and brain and muscle Magnetic Resonance Spectroscopy (MRS). Finally, we investigated mitochondrial bioenergetics, network morphology, and calcium handling in patient-derived fibroblasts. Our results do not support a primary mitochondrial dysfunction in WS patients, as suggested by MRS studies, OCT pattern of retinal nerve fiber layer loss, and, in fibroblasts, by mitochondrial bioenergetics and network morphology results. However, we clearly found calcium mishandling between endoplasmic reticulum (ER) and mitochondria, which, under specific metabolic conditions of increased energy requirements and in selected tissue or cell types, may turn into a secondary mitochondrial dysfunction. Critically, we showed that Wolframin (WFS1) protein is enriched at mitochondrial-associated ER membranes and that in patient-derived fibroblasts WFS1 protein is completely absent. These findings support a loss-of-function pathogenic mechanism for missense mutations in WFS1, ultimately leading to defective calcium influx within mitochondria.

Peptide receptor radionuclide therapy (PRRT) has been strengthened since the publication of NETTER-1. Nevertheless, the correct positioning in the therapeutic algorithm is debated, and no optimal sequence has yet been standardized. Possible criteria to predict the response to PRRT in neuroendocrine tumors (NET) have been proposed. The aim of this review is to define the perfect identity of the eligible patient who can mostly benefit from this therapy. Possible predictive criteria which have been analysed were: primary tumor site, grading, tumor burden, FDG PET and 68Ga-PET uptake. Primary tumor site and 68Ga-PET uptake do not play a pivotal role in predicting the response, while tumor burden, FDG PET uptake and grading seem to represent predictive/prognostic factors for response to PRRT. The heterogeneity in trial designs, patient populations, type of radionuclides, previous therapies and measurement of outcomes, inevitably limits the strength of our conclusions, therefore care must be taken in applying these results to clinical practice. In conclusion, the perfect patient, selected by 68Ga-PET uptake, will likely have a relatively limited liver tumor burden, a ki67 index

Purpose. Recent advances show that ultrasonic implant site osteotomy is related to a decreased trauma and a better postoperative healing of the surgical site when compared to traditional drilling techniques. The micrometric bone cutting control and the operative advantages related to the piezoelectric approach are also characterized by a learning curve for the clinician in surgical practice and an increased operative duration of the procedure. The aim of this investigation is to compare the operative time, the postoperative pain, and the amount of painkillers taken by the patient during the healing period. Methods. A total of 65 patients were treated at the Unit of Oral Surgery (Department of Medical Sciences, Surgery and Health, University of Trieste, Italy) using a split mouth model: 75 drill-inserted implants (G1) and 75 piezoelectric device-inserted implants (G2) were placed. The Visual Analogue Scale (VAS) was performed to evaluate the postoperative pain at 15 days from surgery. The operative time and frequency of intake of painkillers were measured. Results. The G1 and G2 groups showed a significant difference with a higher use of painkillers observed for G1. The G2 patients showed a lower level of pain (VAS) at all experimental times between 8 hours to 7 days (p<0.01) postsurgery. At 15 days, the pain levels were similar for both groups. No differences were found in site preparation duration between the study groups. Conclusions. The evidence supports the application of the piezoelectric approach compared to the drill’s osteotomy as a useful technique for implant site preparation. This trial is registered with NCT03978923.

To validate the use of a three-dimensional printing system for metric and volumetric analysis of the segments of an abdominal aortic aneurysm (AAA).In patients scheduled to undergo endovascular AAA repair, the computed tomography angiography (CTA) measurements obtained during the preoperative assessment of the patients were compared with those obtained by computed tomography of individualized three-dimensional biomodels.The volumetric assessment showed a discrepancy of 3-12%, and the difference between the areas was 10-16%.Computed tomography measurements of 3D-printed biomodels of AAAs appear to be comparable to those of threedimensional CTA measurements of the same AAAs, in terms of the metric and volumetric dimensions.Validar a aplicação do método de impressão tridimensional de biomodelos para aferição métrica e volumétrica de segmentos de aneurisma de aorta abdominal.Compararam-se as medidas obtidas por tomografia computadorizada dos biomodelos tridimensionais com as realizadas no planejamento pré-operatório de pacientes submetidos a correção endovascular de aneurisma de aorta abdominal.A avaliação da volumetria demonstrou discrepância de 3% a 12% e a diferença entre as áreas foi de 10% a 16%.A tomografia computadorizada dos biomodelos impressos é compatível nas aferições métricas e volumétricas com as imagens tridimensionais da angiotomografia do paciente.

(1) Background: Multiple myeloma is a rare cancer that primarily affects the bone marrow. Osteoclasts are responsible for increased bone resorption and, therefore, bone destruction. Bisphosphonates are a class of drugs that can slow down bone resorption by reducing the number and action of osteoclasts. Intravenous injections of bisphosphonates (generally Zoledronic Acid) are administered to patients affected by Multiple Myeloma, but BRONJ is described as a serious side effect. This 5-year retrospective study aims to evaluate the efficacy of appropriate dental treatment protocols prior to initiating bisphosphonate therapy to prevent the development of BRONJ. (2) Methods: A total of 99 patients with symptomatic multiple myeloma were involved in this study (41&ndash, 90 years, mean age 65 years, standard deviation 5 years). The data relating to the visits were tracked using a specific server and consulting the clinical reports. The AAOMS (American Association of Oral and Maxillofacial Surgeons) position was applied for both diagnosis and treatment. A total of 79 patients were examined before the administration of bisphosphonates (group A) and 20 after (group B). (3) Results: The entire sample required dental treatment: 23.2% underwent restorative therapy, 8% endodontic treatments, 44.4% tooth extractions. Periodontal disease was present in 41.4% of the patients. No osteonecrosis was observed in the first group, whereas BRONJ was found in five patients of the second one (25%) and two patients (10%) showed osteosclerotic areas under investigation [OR 0.026 (CI 0.0027 to 0.2454)]. (4) Conclusions: In the literature, there are no precise data about the prevalence of BRONJ. Despite the limitation of the present study, we point out that dental treatment before the treatment with intravenous bisphosphonates can help in reducing the incidence of BRONJ and good dental status is necessary for BRONJ prevention.

Funding Information: Acknowledgments. The authors would like to thank the Hausdorff Research Institute for Mathematics in Bonn for their hospitality during the Junior Trimester Program in Topology in 2016. Much of the work on this paper was carried out during that program. The authors also acknowledge the support of the Danish National Research Foundation through the Centre for Symmetry and Deformation (DNRF92). The second author was supported by the Max Planck institute for Mathematics and thanks the Mittag-Leffler Institute for their hospitality. The third author was supported by the German Research Foundation Schwerpunktprogramm 1786. The fourth author was supported by Independent Research Fund Denmark’s Sapere Aude program (DFF–4002-00224) and by the Max Planck Institute for Mathematics. Publisher Copyright: © European Mathematical Society 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

Intrauterine adhesions cause total or partial obliteration of the endocervix and/or uterine cavity, resulting in hypomenorrhea or amenorrhea, infertility, and pregnancy loss. The majority of patients with IUAs present with menstrual abnormalities, usually hypomenorrhea or secondary amenorrhea. Others may have relatively normal menses and in which case a high index of suspicion is needed to make diagnosis.

Objective: To evaluate the left ventricular mass (LVM) reduction induced by dietary sodium restriction. Patients and Methods: A simple sodium-restricted diet was advised in 138 treated hypertensives. They had to avoid common salt loads, such as cheese and salt-preserved meat, and were switched from regular to salt-free bread. Blood pressure (BP), 24-h urinary sodium (UNaV) and LVM were recorded at baseline, after 2 months. and after 2years. Results: In 76 patients UNaV decreased in the recommended range after 2 months and remained low at 2 years. In 62 patients UNaV levels decreased after 2 months and then increased back to baseline at 2 years. Initially the two groups did not differ in terms of BP (134.3 &plusmn, 16.10 / 80.84 &plusmn, 12.23 vs.134.2 &plusmn, 16.67 / 81.55 &plusmn, 11.18 mmHg, mean &plusmn, SD), body weight (72.64 &plusmn, 15.17 vs.73.79 &plusmn, 12.69 kg), UNaV (161.0 &plusmn, 42.22 vs.158.2 &plusmn, 48.66 mEq/24 h), and LVM index (LVMI, 97.09 &plusmn, 20.42 vs.97.31 &plusmn, 18.91 g/m2). After 2years. they did not differ in terms of BP (125.3 &plusmn, 10.69 / 74.97 &plusmn, 7.67 vs.124.5 &plusmn, 9.95 / 75.21 &plusmn, 7.64 mmHg) and body weight (71.14 &plusmn, 14.29 vs.71.50 &plusmn, 11.87 kg). Significant differences were seen for UNaV (97.3 &plusmn, 23.01 vs.152.6 &plusmn, 49.96 mEq/24 h) and LVMI (86.38 &plusmn, 18.17 vs.103.1 &plusmn, 21.06 g/m2). Multiple regression analysis: UNaV directly and independently predicted LVMI variations, either as absolute values (R2 = 0.369, &beta, = 0.611, p &lt, 0.001), or changes from baseline to +2years. (R2 = 0.454, = 0.677, 0.001). Systolic BP was a weaker predictor of LVMI (R2 = 0.369, = 0.168, p = 0.027, R2 = 0.454, = 0.012, p = 0.890), whereas diastolic BP was not correlated with LVMI. The prevalence of left ventricular hypertrophy decreased (29/76 to 15/76) in the first group while it increased in the less compliant patients (25/62 to 36/62, Chi2p = 0.002). Conclusion: LVM seems linked to sodium consumption in patients already under proper BP control by medications.

Introduction The purpose of this study was to evaluate the accuracy of low-dose multidetector computed tomographic (LD-MDCT) imaging for the volumetric measurement of simulated periapical lesions. Methods Eighteen monoradicular teeth were introduced in bone blocks, and periapical lesions were simulated at the periapical region of each tooth. All teeth were imaged using 4 acquisition protocols: large (dentoalveolar) field of view (FOV) cone-beam computed tomographic (CBCT) imaging (120 kV, 5 mA, and 0.2-mm voxel), small (dental) FOV CBCT imaging (90 kV, 10 mA, and 0.2-mm voxel), standard multidetector computed tomographic imaging (120 kV, 50 mA, and 0.62-mm voxel), and LD-MDCT imaging (120 kV, 10 mA, and 0.62-mm voxel). Tomographic images were evaluated by a single trained and calibrated examiner (intraclass correlation coefficient = 0.991) using ITK-SNAP segmentation software (University of Pennsylvania, Philadelphia, PA). The gold standard was obtained by the impressions of the lesions with regular fluid addition silicone and individual weighing using a precision analytical scale. Data were evaluated by the repeated measures analysis of variance test; the significance level was defined as P Results No statistical differences (P > .05) were found among the groups regardless of the device, milliamperage, FOV, or voxel size. Conclusions LD-MDCT shows performance comparable with other standard reference methods for measuring the volume of periapical lesions and can be a useful and safe protocol in clinical situations in which CBCT imaging is not available, such as in cases of patients admitted to hospitals.

This scoping review study aimed to map the evidence about solvents' use for gutta-percha dissolution and removal during endodontic retreatments. The study protocol followed the Joanna Briggs Institute guidelines, available online (https://osf.io/5vy8n/). Reporting was based on PRISMA Extension for Scoping Reviews. We selected dentistry studies that considered the effectiveness of solvents in gutta-percha dissolution in endodontic retreatments and compared their performance to the use of instrumentation techniques without solvents. The search and study screening were performed in PubMed and Scopus databases by two independent researchers. A descriptive analysis considered the study design, method/technique used for obturation, method/technique used for instrumentation during retreatment, solvent solutions tested, exposure time, and main findings. A total of 41 studies were included. Despite that, most studies suggested that solvents' use may complicate root canal cleanliness, regardless of the type of instrumentation used, and facilitate the presence of gutta-percha remnants in the root surface. Thus, the use of solvents should be avoided and its use should only be considered if the previous working length was not possible to access without it. Despite that, high heterogeneity was observed, further studies are still encouraged comparing the performance and effects of different solvents in different clinical scenarios.

Objectives This scoping review aimed to map and compile the available evidence regarding the effectiveness of decontaminating N95 respirators against the novel coronavirus (SARS-CoV-2). Data We selected studies written in English assessing or discussing the decontamination strategies of N95 respirators against SARS-CoV-2. Two independent researchers performed the search and study screening. A descriptive analysis was carried out considering the study design of the included studies. Sources PubMed, SCOPUS, and Preprint platforms (bioRxiv and medRxiv). Study selection We included 55 reports from PubMed and SCOPUS. Nine articles were letters to the editors, 21 were in vitro studies, 16 were literature reviews, and 9 were classified as other study designs. We included 37 preprints. Two articles were letters to the editors, 24 were in vitro studies, 3 were literature reviews, and 8 were classified as other study designs. In general, vaporized hydrogen peroxide and ultraviolet irradiation were the strategies most cited and most promising. However, there is a lack of evidence and consensus related to the best method of N95 respirator decontamination. Conclusion The evidence regarding decontamination strategies of N95 respirators against SARS-CoV-2 remains scarce. Vaporized hydrogen peroxide and ultraviolet irradiation seem to be the current standard for N95 respirator decontamination. Clinical significance Vaporized hydrogen peroxide and ultraviolet irradiation appear to be the most promising methods for N95 respirator decontamination.

To identify the prevalence of alcohol and tobacco drug use among pregnant women and investigate their perceptions regarding advice from health professionals during prenatal care. We used a sequential explanatory mixed-methods design for this cross-sectional study; the study period was January 2017 to December 2018. Multistage random sampling resulted in the selection of 255 pregnant women assisted in primary care units and through the Family Health Strategy in a city in southern Brazil. Trained interviewers collected data on the use of alcohol and tobacco drugs and socioeconomic characteristics via a questionnaire. Qualitative interviews were performed with pregnant women identified as alcohol and tobacco drug users in the quantitative phase. Interviews proceeded consecutively until saturation was reached, followed by a thematic analysis of interview content based on Braun and Clarke. The prevalence of smoking and alcohol use was 12.55% and 14.12%, respectively. From the 14 interviews conducted, five categories emerged from the discourses: prenatal care from the perspective of pregnant women, habits and knowledge regarding smoking during pregnancy, habits and knowledge regarding alcohol use during pregnancy, previous experiences and empirical knowledge, and pregnant women’s preferences for talking about their habits. Study findings identified smoking and alcohol use as habits among some women during pregnancy and, consequently, the need for improving care because of their superficial knowledge regarding tobacco and alcohol use. The findings underscore the importance of strengthening measures and establishing new strategies that ensure women’s understanding, empowerment, and choices—from the beginning of childbearing age—regarding habits during pregnancy.