Search

Objectives: To investigate the effect of vestibular rehabilitation exercises supported with virtual reality containing real-life environments on dizziness, static and dynamic balance, functional mobility, fear of falling, anxiety, and depression in elderly patients with dizziness. Methods: In this prospective randomized controlled study, 32-patients aged 65-years and older who applied to the otorhinolaryngology clinic with dizziness complaint randomly assigned to 2 groups. In Group 1 (n = 16), vestibular rehabilitation program, supported with virtual reality, and in Group 2 (n = 16), conventional vestibular rehabilitation program was applied 30-min a day, 5 sessions per week, 15 sessions in total for 3 weeks. Subjects were evaluated with The Vertigo Symptom Scale (VSS), Dizziness Handicap Inventory (DHI), Berg Balance Test (BBT) and Timed Up & Go Test (TUG), Falls Efficacy Scale-International (FES-I), Postural Stability Test (PST), Geriatric Depression Scale (GDS), Hamilton Anxiety Scale (HAS) at baseline, at the end of the treatment and 6-months after the treatment. Results: Statistically significant improvements were seen in the DHI emotional subscale and TUG in Group 1 compared to Group 2 at the end of the treatment in elderly with dizziness (p < 0.05). Also, there were significant improvements in the VSS, all DHI subgroups, and total scores, BBT, HAS in Group 1 compared to Group 2 at the 6-months after the treatment (p < 0.05). Conclusion: The application of vestibular rehabilitation in a virtual reality environment can lead to additional improvements especially in dizziness symptoms, disability, balance, and mobility in the elderly with chronic dizziness. © 2021 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial

RESUMO Introdução: O ambiente da web 3.0 tem como característica marcante a apresentação de dados personalizados aos seus usuários, por meio de seus algoritmos que atuam como artefatos mediadores das relações dos usuários com a rede. Neste cenário de cooperação entre pessoas e computadores inerentes à web 3.0, a Ciência da Informação contribui ao refletir sobre o sujeito informacional e seu contexto, especialmente por meio da abordagem das práticas informacionais. Objetivo: Construir aporte teórico entre os propósitos do design thinking que se aliam aos objetivos de estudo de práticas situadas de apropriação de tecnologias pelos usuários. Metodologia: Através da revisão bibliográfica exploratória narrativa, desenvolve-se o aporte teórico para a construção dos artefatos mediadores na web 3.0 com base na perspectiva de estudo das práticas informacionais associada à abordagem metodológica do design thinking como alternativa para o desenvolvimento participativo e humano de novos contextos de organização e relação sociais na web. Resultados: São tecidas relações conceituais entre a web 3.0, desmediação e artefatos mediadores. A metodologia do design thinking é apresentada e relacionada à abordagem de estudos de usuários das práticas informacionais. Conclusão: A construção de artefatos mediadores para a web 3.0 requer a abordagem de estudos centrada no contexto de interação dos seus usuários, por meio de uma metodologia sensível à modelagem de contexto, como é a proposta do design thinking. A aposta teórica é que o design thinking é congruente com a abordagem de práticas informacionais dos usuários da informação, podendo ser uma abordagem inovadora para a área de CI. ABSTRACT Introduction: The web 3.0 environment has, as a remarkable characteristic, the presentation of personalized data to its users, through its algorithms that act as mediating artifacts of the users' relationships with the network. In this scenario of cooperation between people and computers, inherent to web 3.0, Information Science contributes by reflecting on the informational subject and their context, especially through the informational practice approach. Objective: Build theoretical contributions across the purposes of design thinking that are combined with the study objectives of situated practices of technology appropriation by users. Methodology: Through an exploratory narrative literature review, the theoretical underpinning for the construction of mediating artifacts on the web 3.0 is developed based on the perspective of studying information practices associated with the methodological approach of design thinking as an alternative for the participatory and human development of new contexts of social organization and relationship on the web. Results: Conceptual relationships are woven among web 3.0, dismediation and mediating artifacts. The design thinking methodology is presented and related to the approach of user studies of information practices. Conclusion: The construction of mediating artifacts for the web 3.0 requires a study approach centered on the interaction context of its users, through a context-sensitive methodology, as proposed by design thinking. The theoretical proposal is that design thinking is convergent with the informational practice approach of information users, and it can be an innovative approach for the field of Information Science.

This paper investigates the effect of the Internet on tax revenue instability, notably through the international trade channel. It has used a sample of 142 countries over the period 1995-2017, and relied primarily on the two-step system Generalized Methods of Moments (GMM) estimators (but also incidentally on the Error Component Two-Stage Least Squares estimator). Tax revenue instability is primarily measured by the instability of non-resource tax revenue, but also by the instability of total tax revenue (for robustness check). The findings indicate that the Internet exerts a negative effect on tax revenue instability. Interestingly, this effect genuinely translates through the international trade channel, regardless of the measure of tax revenue instability considered. Countries enjoy a higher negative effect of the Internet on tax revenue instability as they enjoy a greater participation in international trade. These findings, therefore, add to the potential benefits of the Internet adoption (e.g., strengthening countries' participation in international trade, enhance their tax revenue performance and promote tax reform, including in developing countries) by showing that it could also help to stabilize tax revenue, particularly through the degree of countries' participation in international trade.

Purpose: To compare the success rates of balloon dacryocystoplasty (BDP) and probing as a primary procedure in congenital nasolacrimal duct obstruction (CNLDO) and investigate the effect of age on both procedures.Methods: A total of 135 patients (171 eyes) with simple or incomplete complex CNLDO were included in this retrospective study; complete complex CNLDO cases were excluded. The success rates for primary BDP (118 eyes) and for probing (53 eyes) were compared as overall and among the age groups; Group 1 (12–24 months old), Group 2 (25–36 months old), and Group 3 (> 36 months old).Results: Mean age of the patients was 41.5±27.2 months for primary BDP, and 21.8±10.8 months for probing (pConclusion: Probing success decreased to a point where different treatment options such as primary BDP can be discussed with the patient’s parents after 18 months of age. The success of BDP decreased after 36 months, while it maintained a high success rate between 24-36 months as primary treatment.

Introduction Functional gastrointestinal disorders (FGIDs) are a very common pediatric disease, with strong implications for children and their families. We aimed to determine their frequency in our environment (per Rome IV criteria) and to establish if there is seasonal variability in diagnosis. Material and methods Descriptive, prospective study. For 12 months, children under 16 years of age with suspected FGIDs who had a first pediatric gastroenterology consultation were included and classified according to Rome IV criteria. Statistical analysis was done with SPSS v22. Results 574 children received consultations, 67% were >4 years of age. FGIDs were suspected in 44.6% of the patients, 32.4% were diagnosed according to Rome IV criteria (16.4%, 4 years). 51.1% were female, average age of 8.4±4.2 years and mean of 7 months of symptoms until diagnosis (range 3-150). In patients 4 years of age, functional abdominal pain (29%), functional dyspepsia (28.4%) and functional constipation (16.8%) were most frequent. We did not discern seasonal variations in diagnosis in the global study population (p=.96) or by age group ( 4, P=.57). Conclusions FGIDs account for one third of our patients' consultations. While the Rome IV criteria are more inclusive than before, almost 30% of patients with suspected FGIDs do not meet said criteria. Although a seasonal difference regarding diagnosis was observed, it was not statistically significant either in the sample group as a whole or by age group.

Bipolar androgen therapy (BAT) is a novel treatment strategy for patients with metastatic castration-resistant prostate cancer (mCRPC). We retrospectively identified patients with mCRPC that achieved deep PSA responses to BAT. All patients with available next-generation molecular sequencing harbored pathogenic mutations in TP53 and/or a homologous recombination DNA repair gene. BACKGROUND: Bipolar androgen therapy (BAT) is an emerging treatment strategy for men with metastatic castration resistant prostate cancer (mCRPC) whereby serum testosterone is cycled from supraphysiologic to near-castrate levels each month. BAT has been shown to induce clinical responses in a significant proportion of patients, some of which are extreme. We explored the clinical and molecular characteristics of patients with mCRPC who achieved deep responses to BAT. METHODS: We conducted a retrospective analysis of patients with mCRPC treated with BAT at Johns Hopkins. We identified 22 of 114 (19%) patients with mCRPC who achieved ≥70% PSA reductions upon treatment with BAT. All patients were treated using 400 mg testosterone cypionate intramuscularly every 28 days, together with continuous LHRH agonist therapy. Clinical-grade DNA sequencing was obtained using commercially available assays. RESULTS: Somatic next-generation sequencing was obtained for 15 of 22 (68%) patients. Of these 15 extreme PSA responders with sequencing data available, All 15 of 15 (100%) harbored a pathogenic mutation in TP53 and/or a homologous recombination DNA repair (HRD) gene. Among the subset of patients with measureable disease (N = 15), 10 patients (67%) achieved an objective response including one patient with a complete response. The median radiographic progression-free survival of these deep PSA responders was 11.3 months (95% CI, 7.9–25.0 months). CONCLUSIONS: We observed an enrichment of TP53 and HRD mutations in mCRPC patients with extreme PSA responses to BAT, with durability lasting about a year. These data support the hypothesis that BAT may most benefit patients with DNA repair-deficient mCRPC. Further studies of BAT in biomarker-selected mCRPC populations (ie, TP53/HRD-mutated) are warranted.

This study aimed to systematically review and summarize gene therapy treatment for monogenic retinal and optic nerve diseases.This review was prospectively registered (CRD42021229812). A comprehensive literature search was performed in Ovid MEDLINE, Ovid Embase, Cochrane Central, and clinical trial registries (February 2021). Clinical studies describing DNA-based gene therapy treatments for monogenic posterior ocular diseases were eligible for inclusion. Risk of bias evaluation was performed. Data synthesis was undertaken applying Synthesis Without Meta-analysis guidelines.This study identified 47 full-text publications, 50 conference abstracts, and 54 clinical trial registry entries describing DNA-based ocular gene therapy treatments for 16 different genetic variants. Study summaries and visual representations of safety and efficacy outcomes are presented for 20 unique full-text publications in RPE65-mediated retinal dystrophies, choroideremia, Leber hereditary optic neuropathy, rod-cone dystrophy, achromatopsia, and X-linked retinoschisis. The most common adverse events were related to lid/ocular surface/cornea abnormalities in subretinal gene therapy trials and anterior uveitis in intravitreal gene therapy trials.There is a high degree of variability in ocular monogenic gene therapy trials with respect to study design, statistical methodology, and reporting of safety and efficacy outcomes. This review improves the accessibility and transparency in interpreting gene therapy trials to date.

Objective To analyze the results of prospective studies on the presence of sarcopenia and its association with cardiovascular events and mortality in patients with non-dialysis-dependent chronic renal disease. Methods This study used the PRISMA protocol for systematic review. The systematic review and meta-analysis protocol was recorded in the prospective record of systematic reviews by PROSPERO International: CRD42019120391. Data sources: MEDLINE via PubMed, Embase, Cochrane Library, CINAHL, Scopus, Web of Science and LILACS from December 2018 to April 20, 2019, with the survey results updated in January 2021. Data analysis: Random effect models were calculated to compare the results due to high heterogeneity identified. Results The survey identified 951 studies. Of these, 392 were removed by duplicates and 559 references were selected for analysis. In the stage of evaluating titles and abstracts, 555 articles were excluded because they did not include inclusion criteria related to the population and study design, leaving 4 articles that were included in the systematic review and meta-analysis. A meta-analysis identified that the presence of sarcopenia increased the risk of mortality by 143%. Conclusion(s) The meta-analysis identified the influence of sarcopenia on mortality in non-dialysis-dependent chronic renal disease.

PURPOSE: Oncofertility counseling regarding the reproductive risks associated with cancer therapy is essential for quality cancer care. We aimed to increase the rate of oncofertility counseling for patients of reproductive age (18-40 years) with cancer who were initiating systemic therapy at the Johns Hopkins Cancer Center from a baseline rate of 37% (25 of 68, June 2019-January 2020) to 70% by February 2021. METHODS: We formed an interprofessional, multidisciplinary team as part of the ASCO Quality Training Program. We obtained data from the electronic medical record and verified data with patients by phone. We surveyed patients, oncologists, and fertility specialists to identify barriers. After considering a prioritization matrix, we implemented Plan-Do-Study-Act (PDSA) cycles. RESULTS: We identified the following improvement opportunities: (1) oncologist self-reported lack of knowledge about counseling and local fertility preservation options and (2) lack of a standardized referral mechanism to fertility services. During the first PDSA cycle (February 2020-August 2020, disrupted by COVID-19), we introduced the initiative to increase oncofertility counseling at faculty meetings. From September 2020 to November 2020, we implemented a second PDSA cycle: (1) educating and presenting the initiative at Oncology Grand Rounds, (2) distributing informative pamphlets to oncologists and patients, and (3) implementing an electronic medical record order set. In the third PDSA cycle (December 2020-February 2021), we redesigned the order set to add information (eg, contact information for fertility coordinator) to the patient after-visit summary. Postimplementation (September 2020-February 2021), counseling rates increased from 37% to 81% (38 of 47). CONCLUSION: We demonstrate how a trainee-led, patient-centered initiative improved oncofertility care. Ongoing work focuses on ensuring sustainability and assessing the quality of counseling.

Objective To assess the recent trends, acceptability, and effectiveness of digital maternal patient education through summarizing the literature. Methods Articles published in 2010–2020 on patient education, digital tools, and maternal health were searched on PubMed. Abstract and full texts were reviewed to identify eligible studies and extract key information. Results Digital patient education studies covered various topics throughout pregnancy, with the greatest number of studies targeting the prenatal period. Among the 55 studies, 38 (69%) reported significant patient outcomes, with the main benefits of increased knowledge (83.3%), emotional benefits (73.7%), and behavioral changes (60.6%). The number of studies per year increased steadily over the past decade, with frequently utilized formats of texts with images (40%), SMS (30.9%), and videos (25.5%). Video produced the highest rate of positive patient outcomes; however, no statistical significance was found. Conclusion Our study presented evidence supporting the high effectiveness and prevalence of digital tools in maternal patient education, and analyzed the content, platforms, and formats utilized by digital tools of the past decade. Practice implications Digital tools are effective and feasible in conducting maternal patient education. No specific patient education format is found to be superior in improving patient’s health outcomes.

Gilles de la Tourette Syndrome (GTS) is a multifactorial neurodevelopmental disorder characterized by tics and multiple comorbidities. The pathophysiology is not yet fully understood, but both environmental and genetic risk factors seem to be involved. Twin studies provide important knowledge on genetic factors. We assessed the concordance of GTS and chronic tic disorders (CTD) in monozygotic (MZ) twins, and examined tic severity, symptoms of obsessive-compulsive disorder (OCD), attention deficit/hyperactivity disorder and autism spectrum disorder. Twin pairs, where at least one twin was diagnosed with any tic disorder, were identified through Danish Twin Registry, Psychiatric Central Registry, Danish National Patient Registry and National Tourette Clinic, Copenhagen University Hospital, Herlev. Zygosity was tested with single-nucleotide polymorphism (SNP) genotyping and clinical assessment was done with validated tools. 14 MZ twin pairs were included: five were discordant. Seven twin pairs were concordant for GTS, and for two pairs one twin had GTS and the other CTD. Among the twins with CTD or GTS, 50% had at least one comorbidity, which is higher than in background populations. The GTS + OCD-phenotype was significantly more frequent among GTS-concordant than among discordant twins. No statistically significant differences were found between the GTS-concordant and discordant twin pairs regarding tic severity or comorbidities. Thorough clinical assessment and SNP-based genotyping are important when conducting clinical twin studies. We found high concordance of GTS and CTD, which supports the notion that both disorders have common genetic risk factors. Further studies with larger cohorts including dizygotic twins are warranted for more conclusive results.

Graphene is novel & invigorating nanocarbon material that has drawn in both scholastic and industrial interest in last 10–15 years. It is by and large widely investigated as a result of its extraordinary properties including, superior mechanical and non-corrosive property, amazingly high surface area, great optical translucency, outstanding electrical and heat carrying properties and so forth. More importantly, these properties can be tailored to some extent by developing different grades of derivatives of Graphene. In this report, a various routes used to produce Graphene & Graphene-based materials are reviewed, detailed review of recent progress in application of these materials for desalination of water and purification of air is presented. Various attributes of Graphene & its derivatives which can revolutionise the air filtration & water desalination processes are underlined. Graphene Aerogels and doped sheets prove to be efficient alternates for air filtration & pollutant removal applications with relatively high specific surface area of around 1300 m2/g [24]. These doped derivatives show improved adsorption efficiency around 55–65% [25], which is studied to be rising with energy inputs like potential difference. Graphene and its derivatives-based water filtration is proving to be extremely efficient than the conventional water filtration & desalination mechanisms. Reverse Osmosis (RO), one of the widely used conventional methods of desalination comes with a large expense of money and energy but yields low volumes of filtered water. About 85–95% of input water gets wasted in the RO mechanism, yielding only 5–15% of usable water. The conventional Solar desalination is more efficient as compared to RO, but even that can be improved by 70–90% [45-47] by incorporating Graphene and its derivatives as part of a volumetric system, light absorbing layer and filtration layer in Solar Desalination process. The graphene-based membranes because of their high permeability and excellent ion repellency can be used for desalination applications with a removal efficiency of 33–100% [61] depending on the pore size and the applied pressure. Capacitive Deionization method of desalination can also be a very efficient alternative to the RO due to its minimal energy requirement of only 0.1–2.03 kWh/m3 [52].

Summary Background & aims Studies using the Global Leadership Initiative on Malnutrition (GLIM) criteria for patients with liver cirrhosis are limited. This study aimed to assess the impact of malnutrition according to the GLIM criteria on the outcomes of patients awaiting a liver transplant (LTx) and compare these criteria with Subjective Global Assessment (SGA). Methods This retrospective observational study included adult patients awaiting LTx. Patient clinical data, nutritional status according to various tools including SGA, and resting energy expenditure were assessed. The distinct phenotypic and etiologic criteria provided 36 different GLIM combinations. The GLIM criteria and SGA were compared using the kappa coefficient. The variables associated with mortality before and after the LTx and with a longer length of stay (LOS) after LTx (≥18 days) were assessed by Cox regression and logistic regression analyses, respectively. Results A total of 152 patients were included [median age 52.0 (interquartile range: 46.5–59.5) years; 66.4% men; 63.2% malnourished according to SGA]. The prevalence of malnutrition according to the GLIM criteria ranged from 0.7% to 30.9%. The majority of the GLIM combinations exhibited poor agreement with SGA. Independent predictors of mortality before and after LTx were presence of ascites or edema (p = 0.011; HR:2.58; CI95%:1.24–5.36), GLIM 32 (PA + MELD) (p = 0.026; HR:2.08; CI95%:1.09–3.97), GLIM 33 (PA + MELD-Na ≥ 12) (p = 0.018; HR:2.17; CI95%:1.14–4.13), and GLIM 34 (PA + Child–Pugh) (p = 0.043; HR:1.96; CI95%:1.02–3.77). Malnutrition according to GLIM 28 (handgrip strength + Child-Pugh) was independently associated with a longer LOS (p = 0.029; OR:7.21; CI95%:1.22–42.50). Conclusion The majority of GLIM combinations had poor agreement with SGA, and 4 of the 36 GLIM combinations were independently associated with adverse outcomes.

Introduction Anastomotic leakage is the most important postoperative complication following colorectal anastomoses. Endoscopic techniques are newly implemented and are somewhat in between options that can be considered for the treatment of AL in selected cases. Aim Aim of this literature review is to present, analyze, and synthesize material from diverse sources to provide a comprehensive summary of the endoscopic procedures available for the treatment of fistula following LAR for rectal cancer. Materials and Methods A bibliographic search was carried out on Pubmed for articles published until 31th January 2021. Two hundred thirteen articles were screened and after a proper assessment thirty-four articles were left for the scopes of this narrative review. Results The most commonly applied endoscopic solutions are the transrectal vacuum-assisted closure (VAC), the Over-The-Scope clipping system (OTSC) and the OverStitch suturing system. They all seems to offer integrate solutions in the management of colorectal anastomotic leaks. Conclusion Early detection of anastomotic leak might increase the success rate of endoscopic techniques, reducing overall healing time and length of hospital stay. Endoscopic evaluation could be added as an adjunctive screening test to all those patients who are suspected of an early postoperative colorectal leak, in order to confirm the suspicion and to promptly start the endoscopic treatment.

Heat stress has well-known influences on dairy calf physiology, but less is understood about calf behavioral responses to heat stress. Herein, we evaluated milk replacer intake, standing activity, and lying behaviors of calves exposed to prenatal or postnatal heat stress or both. Holstein calves were born to dams experiencing heat stress (HT; shade of a freestall barn) or cooling (CL; shade, fans, and soakers) during late gestation [∼44 d before calving, prenatal; mean daily temperature-humidity index (THI) = 78]. They were then subsequently exposed to postnatal heat stress (shade and natural ventilation of an open-sided barn) or cooling (shade of the barn and forced ventilation by fans) from birth to weaning (56 d; mean daily THI = 77; n = 12 per prenatal × postnatal treatment). Heat stress was confirmed by elevated respiration rate and rectal temperature of the prenatal dam and the postnatal calf. Calves were group-housed with automatic milk feeders, from which milk replacer (MR) intake was assessed. Calf behavior was monitored using loggers and video. Postnatal-HT calves tended to consume less MR per hour in the late morning and drank less MR per visit relative to postnatal-CL calves. Postnatal-HT calves spent more time lying laterally and less time lying sternally in a tucked position during overnight hours. Prenatal-HT calves stood longer across the day, particularly overnight, compared with prenatal-CL calves. This study characterized behavioral responses of preweaning dairy calves exposed to chronic heat stress or active cooling during early-life developmental windows.

Contains fulltext : 237219.pdf (Publisher’s version ) (Open Access) Objective: To describe characteristics of randomised controlled trials (RCTs) conducted using electronic health records (EHRs), including completeness and transparency of reporting assessed against the 2021 CONSORT Extension for RCTs Conducted Using Cohorts and Routinely Collected Data (CONSORT-ROUTINE) criteria. Study design: MEDLINE and Cochrane Methodology Register were searched for a sample of RCTs published from 2011–2018. Completeness of reporting was assessed in a random sample using a pre-defined coding form. Results 183 RCT publications were identified; 122 (67%) used EHRs to identify eligible participants, 139 (76%) used the EHR as part of the intervention and 137 (75%) to ascertain outcomes. When 60 publications were evaluated against the CONSORT 2010 item and the corresponding extension for the 8 modified items, four items were 'adequately reported' for the majority of trials. Five new reporting items were identified for the CONSORT-ROUTINE extension; when evaluated, one was 'adequately reported', three were reported 'inadequately or not at all', the other 'partially'. There were, however, some encouraging signs with adequate and partial reporting of many important items, including descriptions of trial design, the consent process, outcome ascertainment and interpretation. Conclusion: Aspects of RCTs using EHRs are sub-optimally reported. Uptake of the CONSORT-ROUTINE Extension may improve reporting. 12 p.

BACKGROUND Phlebitis is one of the most frequent complications in peripheral venous catheters. The aim was to compare the frequency of phlebitis before and after the implementation of the Flebitis Zero project, in order to ascertain its effectiveness and what factors were associated with this complication. METHODS Randomized pre-post intervention (Flebitis Zero project) study performed in the Complejo Hopsitalario de Navarra (Pamplona, Spain) between 2015 and 2019. The intervention consisted of training of professionals along with the implementation of measures in order to lower the incidence of complications associated with the peripheral venous catheters. The control group (CG) was selected prior the intervention and the Intervention Group (IG) in the subsequent five years. RESULTS The study included 656 patients, 96 (14.6%) in the CG and 569 in the IG. Lower frequency of complications (49.0 vs 37.1%; p

Transformative results of adeno-associated virus (AAV) gene therapy in patients with spinal muscular atrophy and Leber’s congenital amaurosis led to approval of the first two AAV products in the United States to treat these diseases. These extraordinary results led to a dramatic increase in the number and type of AAV gene-therapy programs. However, the field lacks non-invasive means to assess levels and duration of therapeutic protein function in patients. Here, we describe a new magnetic resonance imaging (MRI) technology for real-time reporting of gene-therapy products in the living animal in the form of an MRI probe that is activated in the presence of therapeutic protein expression. For the first time, we show reliable tracking of enzyme expression after a now in-human clinical trial AAV gene therapy (ClinicalTrials.gov: NTC03952637) encoding lysosomal acid beta-galactosidase (βgal) using a self-immolative βgal-responsive MRI probe. MRI enhancement in AAV-treated enzyme-deficient mice (GLB-1−/−) correlates with βgal activity in central nervous system and peripheral organs after intracranial or intravenous AAV gene therapy, respectively. With >1,800 gene therapies in phase I/II clinical trials (ClinicalTrials.gov), development of a non-invasive method to track gene expression over time in patients is crucial to the future of the gene-therapy field., Graphical abstract, We describe a bio-responsive contrast agent that informs on the biodistribution and durability of gene expression in the lysosomal storage disease, GM1 gangliosidosis. We illustrate the sensitivity of this contrast agent to detect β-galactosidase enzyme in the central nervous system and periphery of an AAV-GLB-1-treated mouse model of GM1.

Objective Coronavirus disease 2019 (COVID-19) caused a universal psychosocial impact and individuals exposed to threats prefer to try self-care interventions and adhere to non-conventional approaches such as traditional and complementary medicine (T&CM) for preventive purposes. This study was conducted to determine the use and belief about T&CM among the general population during the COVID-19 outbreak. Method A cross-sectional online survey was carried out among the general population (aged ≥ 18 years) of Adana, Turkey during the strict lockdown period (April 11 to April 30, 2020). The survey instrument included details about sociodemographic characteristics, general information, T&CM use and beliefs was distributed among eligible participants via social media channels (Instagram, WhatsApp and Facebook accounts). Results Out of the total 389 participants, almost 39.3% (n=153) of the participants were the T&CM user and 60.7% were non-T&CM user during COVID-19 in this study. Additionally, 61 (39.8%) participants reported the usage of more than one form of T&CM modalities. Most of them used herbal medicine (30.8%), followed by nutritional supplements/vitamins (23.8%). Around 33.9% (n=52 out of 153 T&CM user) of participants did not report T&CM use to their family physicians. A statistically significant difference was observed between T&CM users and non-T&CM users in gender, age, marital status, level of education, income, and prior use of T&CM (p

A qualidade do solo refere-se à avaliação das propriedades químicas, físicas e biológicas do solo e tem sido um assunto explorado dentro das linhas de pesquisas agronômicas em decorrência de ações antrópicas que, muitas vezes, causam degradação. Objetivou-se pesquisar, entre os atributos físicos e biológicos estudados, aqueles que melhor expliquem, linear e espacialmente, a variabilidade do solo cultivado com soja na estação chuvosa e em pousio na estação seca no sistema agrossilvipastoril. O trabalho foi conduzido no ano agrícola 2015/2016, em Ipameri, Goiás. Analisaram-se as distribuições espaciais e as correlações entre alguns atributos indicadores da qualidade do solo: carbono da biomassa microbiana (CBM), respiração microbiana do solo (C-CO2), quociente metabólico (qCO2) e umidade do solo (UG), na profundidade de 0,00-0,10 m, nos períodos de chuva e seca. Instalou-se no local, uma malha geoestatística, onde foram coletados 52 pontos. Foi realizada a análise descritiva dos dados, a fim de obter correlações lineares, simples e múltiplas, entre os atributos. Os semivariogramas foram modelados a fim de obter as respectivas krigagens e validações cruzadas. Estabeleceram-se as co-krigagens de interesse. Os atributos microbiológicos do solo foram bons indicadores de zonas de manejo específico, apresentando maior dependência espacial no período chuvoso. O qCO2 apresentou relação direta com C-CO2 no período chuvoso, enquanto CBM apresentou relação inversamente proporcional tanto no período chuvoso, como no seco. O qCO2 foi o atributo que melhor representou, linear e espacialmente, a variabilidade do solo sob o sistema ILPF, refletindo as zonas de maior eficiência do uso do substrato pelos organismos do solo.

Soft-tissue sarcomas (STS) represent a heterogeneous group of tumours with similar histological characteristics and biological behaviour. This study aimed to describe the correlation between clinical, histopathological and histomorphometric features of STS in dogs. Medical records were reviewed to identify all dogs in which an STS was diagnosed between 2006-2017. Thirty cases were included, and tumour samples and medical records were recovered. Most of the dogs were mixed breed (40%) and 80% of the STS were located in the subcutaneous connective tissue. Histopathological classification showed that undifferentiated sarcoma (17%) and peripheral nerve sheath tumour (30%) were the most common STS. Grade I STS were obtained in 50% of cases (15/30), and grade II or III tumours compromised 43% (13/30) and 7% (2/30) respectively. The mitotic index ranged from zero to 26 (5.8 ± 7.5). Increased nucleus:cytoplasm ratio was moderately associated with higher tumour grade (p = 0.05; rS = 0.361) and mitotic index (p = 0.05; rS = 0.355), while the number of microvessels was positively correlated with degree of differentiation (p = 0.05; rS = 0.362) and nuclear pleomorphism (p = 0.036; rS = 0.384). Histomorphometry proved to be useful in the evaluation of STS, representing an additional tool correlated with well-established prognostic factors (histopathological grade, degree of differentiation, nuclear pleomorphism).

Background: The city of Manaus, Brazil, has seen two collapses of the health system due to the COVID-19 pandemic. We report anti-SARS-CoV-2 nucleocapsid IgG antibody seroconversion rates and associated risk factors in Manaus residents before the second wave of the epidemic in Brazil. Methods: A convenience sample of adult (aged ≥18 years) residents of Manaus was recruited through online and university website advertising into the DETECTCoV-19 study cohort. The current analysis of seroconversion included a subgroup of DETECTCoV-19 participants who had at least two serum sample collections separated by at least 4 weeks between Aug 19 and Oct 2, 2020 (visit 1), and Oct 19 and Nov 27, 2020 (visit 2). Those who reported (or had no data on) having a COVID-19 diagnosis before visit 1, and who were positive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at visit 1 were excluded. Using an in-house ELISA, the reactivity index (RI; calculated as the optical density ratio of the sample to the negative control) for serum anti-SARS-CoV-2 nucleocapsid IgG antibodies was measured at both visits. We calculated the incidence of seroconversion (defined as RI values ≤1·5 at visit 1 and ≥1·5 at visit 2, and a ratio >2 between the visit 2 and visit 1 RI values) during the study period, as well as incidence rate ratios (IRRs) through cluster-corrected and adjusted Poisson regression models to analyse associations between seroconversion and variables related to sociodemographic characteristics, health access, comorbidities, COVID-19 exposure, protective behaviours, and symptoms. Findings: 2496 DETECTCoV-19 cohort participants returned for a follow-up visit between Oct 19 and Nov 27, 2020, of whom 204 reported having COVID-19 before the first visit and 24 had no data regarding previous disease status. 559 participants were seropositive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at baseline. Of the remaining 1709 participants who were seronegative at baseline, 71 did not meet the criteria for seroconversion and were excluded from the analyses. Among the remaining 1638 participants who were seronegative at baseline, 214 showed seroconversion at visit 2. The seroconversion incidence was 13·06% (95% CI 11·52–14·79) overall and 6·78% (5·61–8·10) for symptomatic seroconversion, over a median follow-up period of 57 days (IQR 54–61). 48·1% of seroconversion events were estimated to be asymptomatic. The sample had higher proportions of affluent and higher-educated people than those reported for the Manaus city population. In the fully adjusted and corrected model, risk factors for seroconversion before visit 2 were having a COVID-19 case in the household (IRR 1·49 [95% CI 1·21–1·83]), not wearing a mask during contact with a person with COVID-19 (1·25 [1·09–1·45]), relaxation of physical distancing (1·31 [1·05–1·64]), and having flu-like symptoms (1·79 [1·23–2·59]) or a COVID-19 diagnosis (3·57 [2·27–5·63]) between the first and second visits, whereas working remotely was associated with lower incidence (0·74 [0·56–0·97]). Interpretation: An intense infection transmission period preceded the second wave of COVID-19 in Manaus. Several modifiable behaviours increased the risk of seroconversion, including non-compliance with non-pharmaceutical interventions measures such as not wearing a mask during contact, relaxation of protective measures, and non-remote working. Increased testing in high-transmission areas is needed to provide timely information about ongoing transmission and aid appropriate implementation of transmission mitigation measures. Funding: Ministry of Education, Brazil; Fundação de Amparo à Pesquisa do Estado do Amazonas; Pan American Health Organization (PAHO)/WHO. World Health Organization Revisión por pares

We analyzed the European countries participation in clinical trials addressing to new drug development focused on rare diseases in women comparing to more prevalent diseases as breast cancer. Participation was not associated with type of healthcare system neither socio-economic features, but it was associated with population size. Protocol ratios focused on breast cancer vs. orphan drugs and rare diseases was 15:1 and 9:1, respectively, mainly focused on ovarian cancer. Protocol number was insufficient to evaluate the success of Regulation (EC) 141/2000, it is necessary to increase the scientific quality and the number of really new molecules.

This paper investigates whether language and associated message framing (low-cost signal) can provide a solution to the risks generated by asymmetric information in P2P lending, drawing on the signalling and message-framing theories. First, it examines the extent to which message framing is associated with funding outcomes in the context of P2P lending; second, it investigates whether positive message framing reinforces the positive impact of credit ratings (high-cost signal) on funding outcomes. Our analysis is conducted on a dataset of 33028 listings of potential borrowers from a Chinese P2P lending platform using the Heckman selection models. We find that the use of positively framed messages is positively associated with positive funding outcomes and enhances the positive impact of the credit ratings on funding outcomes. Our results contribute to the literature on the effectiveness of low-cost signals in of Internet-based interactions while highlighting complementarities between different types of signals in P2P lending.

Economy-wide investment in Big Data Analytics (BDA) offers retailers a number of opportunities and while there is some evidence that new technologies have been widely adopted by retailers, it also transpires that many retailers have yet to fully exploit the benefits of BDA. Most research on Big Data and productivity (or performance) tends to focus on internal factors that prevent retailers from fully exploiting their investment in BDA. Research has paid scarce attention to the benefits that can accrue to the focal firm from the upstream investment in BDA and the features of the B2B marketing environment that may hamper (or enhance) these benefits. Unlike the previous literature, the paper tests the extent to which retailers, by having access to larger share of graduate workforce at regionally, can benefit more from inter-industry upstream investment in BDA than retailers located in areas where such workforce is scarce. Using data from ORBIS, KLEMS and QLFS, we show that retailers located in regions with a larger proportion of graduate workforce benefit more from inter-industry upstream investment in BDA as they tend to be more efficient on average. Equally, upstream investment in BDA is positively associated to frontier shifts over time (i.e. technical progress).

Introduction Low mean arterial pressure (MAP) periods occur frequently during cardiopulmonary bypass (CPB), and their management remains controversial. Our aim was to correlate MAP during CPB with the occurrence of post-operative acute kidney injury (AKI), considering two different parameters: consecutive and cumulative low MAP periods. Methods Single-centre observational retrospective study including 250 patients submitted to non-emergent aortic valve replacement, with tepid to mild hypothermia (not below 32°C). The primary outcome was the occurrence of AKI. A propensity scored matching of 43 patients was used to adjust both populations (AKI and No AKI). MAP measures were automatically and continuously recorded during CPB. Low MAP periods were analysed employing two parameters: consecutive and the cumulative sum of time. Results Patients who experienced at least 5 min with MAP Conclusion Low MAP periods during CPB are associated with an increased occurrence of post-operative AKI, leading to 1) higher creatinine levels; 2) decreased GFR and 3) longer ICU and ward lengths of stay. Both consecutive and cumulative periods of low MAP are associated with an increased risk of AKI. MAP appears to be an important contributor to post-operative AKI and should be carefully managed during CPB. Further studies must address if MAP variations lead to definitive and long-term consequences.

Hydrogels have emerged as leading candidates to reproduce native extracellular matrix. To provide structures and functions similar to tissues in vivo, controlled porosity and vascular networks are required. However, fabrication techniques to introduce these are still limited. In this study we propose stereolithography as a fabrication technique to achieve 3D vascular networks using water-based solvents only. A 3D printable hydrogel is formulated based on available commercial chemicals such as acrylamide (AAm) and polyethylene glycol diacrylate 700 (PEGDA700), with nanocellulose crystals (CNC) as a nanofiller. An optimisation procedure to increase resolution, tune porosity as well as mechanical properties is developed. The results highlight the importance of photoabsorber addition to improve channel resolution. We demonstrate that with the adequate choice of chemicals and fillers for photocurable formulations, structural and functional properties of the fabricated scaffold can be tailored, opening the path for advanced applications. Graphic abstract

Ghrelin has previously been proven to have anti-inflammatory and antioxidant properties in preventing cisplatin-induced ovarian damage. The aim of this study was to evaluate the potential effects of this hormone in preventing this damage in rats using histopathological and biochemical methods. Twenty-eight Wistar-albino rats were randomly divided into four groups. While no drug was given to Group 1 (sham group), acylated ghrelin was intraperitoneally administered to Group 2 at 0.5 nmol/kg and Group 3 at 2 nmol/kg for 21 days. Group 4 received only saline solution. On the 15th day, a single dose of 5 mg/kg cisplatin was intraperitoneally administered to each rat in Groups 2, 3 and 4. Serum anti-Mullerian hormone (AMH) values were measured on days 0, 15 and 21. Then, laparotomy and bilateral oophorectomy were performed, and the ovaries were histopathologically examined. The number of primordial and primary follicles was significantly higher in Group 3 than in the saline solution + cisplatin group. In Group 4, cisplatin caused significantly higher follicle damage in the primordial, primary and secondary phases compared to the sham group. The AMH level of the SF + cisplatin group was significantly lower than that of the sham group and the high-dose ghrelin + cisplatin group, and the AMH level of the sham group was significantly higher than that of the low-dose ghrelin + cisplatin group. High-dose ghrelin was effective in preventing cisplatin-induced ovarian damage by preserving the number of primordial and primary follicles. Larger randomized studies are needed to determine the optimal dosage and duration of ghrelin.

INTRODUCTION Tubal reanastamosis offers hope to conceive again. However, there are many factors that affect the success of this procedure. In our study we aimed to compare the pregnancy rates of the surgical methods used for tubal reanastamosis in pregnancy requested after tubal sterilization. METHODS In our study we compared the rates of pregnancies after reanastamosis retrospectively in female patients under the age of 40 who underwent reanastamosis between 2010 and 2019 with laparotomic, laparoscopic and robotic methods. A single layer of 4 quadrant 6/0 number polydioxanone absorbable sutures were used in all surgical methods. A similar surgical technique was used. RESULTS In surgical methods (laparotomy, laparoscopy, and robotics), there was a statistical difference between the three groups in terms of operation times of surgical methods used for tubal reanastamosis (p

Introdução: A ninfoplastia é uma cirurgia que envolve a redução dos lábios genitais e correção de assimetrias. A hipertrofia de pequenos lábios corrobora com o desconforto na função sexual. Logo, esse procedimento visa melhorar a qualidade de vida em relação a parte álgica, psíquica e sexual. Metodologia: Trata-se de uma revisão literária, com utilização das bases de dados: Google Acadêmico, Scielo e Portal Capes, descritores “labioplastia” OR “ninfoplastia” AND “satisfação sexual”, entre os anos 2011-2020, que configuram revisão sistemática e ensaio clínico controlado, nos idiomas inglês, espanhol e português. Foram selecionados 7 artigos com base em relevância clínica e terapêutica.Discussão: A hipertrofia dos pequenos lábios está associada ao desconforto funcional e estético, o que interfere diretamente na vida sexual em relação à satisfação, higiene, dores relacionadas ao uso de roupas justas. Isso afeta a autopercepção feminina e compromete o prazer íntimo da mulher. O padrão estético anatômico para a genitália feminina advém da ideia de que os lábios menores devem ser recobertos pelos lábios maiores, principalmente sobre influência midiática e da indústria pornográfica que preconiza uma genitália pré-puberal. Sendo assim, aquelas que se distanciam desse estereótipo buscam melhorar sua autoimagem e decidem se adequar ao que é socialmente idealizado. Entretanto, uma parcela substancial das mulheres procura a cirurgia com intenção de amenizar sofrimentos álgicos diários, visto que os neurônios somatossensoriais presentes nos lábios menores, em contato prolongado com roupas justas podem desencadear dor. Sendo assim, com a correção cirúrgica da hipertrofia, os lábios menores ficarão protegidos pela vulva, reduzindo a estimulação dolorosa pelo toque por longos períodos com tecidos. Com isso, após a ninfoplastia as pacientes apresentam melhora da função sexual, que deve ser multidimensional e centrada em si, uma vez que a autoconfiança juntamente com a diminuição da dor está diretamente relacionada ao aumento da satisfação sexual.Conclusão: A hipertrofia de pequenos lábios pode interferir no conforto psicológico e no bem estar pessoal e sexual, o que causa conflitos no relacionamento íntimo. Logo, a ninfoplastia de pequenos lábios possibilita eliminar o desconforto social, funcional e estético, sendo evidente a relevância deste procedimento cirúrgico.

Em decorrencia do subito surgimento da pandemia decorrente da doenca causada pelo novo coronavirus, iniciou-se uma incessante busca por uma alternativa terapeutica que minimizasse os danos causados pelo virus. Estudos acerca de medicamentos ja existentes foram redirecionados para a COVID-19. Entretanto, o emprego destes tratamentos empiricos propiciou uma nova problematica: o aumento do risco de interacoes medicamentosas, principalmente no que tange o grupo de risco com comorbidades pre-existentes, devido possuirem uma terapia farmacologica ativa para controle da doenca pregressa. Diante disso, foi realizado um estudo avaliativo atraves de revisao de literatura com abordagem qualitativa, retrospectiva e analitico-discursiva das potenciais interacoes dos medicamentos empregados para tratamento da COVID-19, segundo o manuseio medicamentoso precoce do Ministerio da Saude do Brasil, com o objetivo de elencar os principais farmacos descritos na nota informativa e classificar as interacoes medicamentosas em graves ou moderadas, de acordo com o grau de severidade. Dessa forma, verificou-se que os principais medicamentos referidos para esse tratamento precoce foram a hidroxicloroquina, lopinavir/ritonavir, azitromicina, heparina, metilprednisolona tanto como alternativa para neutralizacao viral quanto para controle de sintomatica. A ivermectina e a nitazoxanida foram empregados devido aos estudos acerca dos seus possiveis potenciais antivirais. Quanto ao perfil de interacao medicamentosa, avaliou-se que a hidroxicloroquina e o medicamento que mais possui interacoes de graus grave e moderada, destacando as de classe medicamentosa com os outros farmacos presentes no “kit COVID-19” e as interacoes com as principais comorbidades, tais como doencas cardiovasculares, doencas hepaticas, diabetes mellitus e disturbios renais cronicos. A combinacao de antivirais lopinavir/ritonavir e o antimicrobiano azitromicina tambem apresentaram interacoes e reacoes adversas relevantes, bem como o corticosteroide metilprednisolona. Destaca-se que o uso destes medicamentos fora da sua terapeutica habitual nao garante um tratamento medicamentoso eficaz contra a COVID-19 e pode prejudicar o quadro clinico do paciente. Portanto, deve-se monitorar a farmacoterapia e conscientizar o paciente quanto a importância do uso racional de medicamentos, mesmo em um cenario pandemico.

Coronavirus disease 2019 (COVID-19) has been accepted as a global pandemic, and poses a greater risk to the elderly and those with comorbidities. Comorbid diseases (particularly end-stage kidney disease with hemodialysis) and impaired immunity place patients in the high-risk group for COVID-19. In recent studies, it was also mentioned that exaggerated inflammation and a cytokine storm were the underlying causes related to the high mortality in COVID-19 patients. Currently, treatment modalities to balance the immune system of such vulnerable patient groups are essential, to protect them from the disease. Several vitamins (like vitamins C, D, and E), trace elements like zinc, and probiotics have been proposed as immune boosters to protect and combat infectious conditions. It is well known that these vitamins and elements are insufficient in hemodialysis patients. In this review, we aimed to evaluate the immune-boosting mechanisms of vitamins C, D, E, zinc, and probiotics, the studies related to their beneficial effects against infections, and their possible benefits for hemodialysis patients during the COVID-19 pandemic.

La fisura labiopalatina bilateral es una anomalía craneofacial común y multifactorial, pudiendo estar asociada a factores genéticos y ambientales. El reparo de una fisura palatina requiere de varias intervenciones quirúrgicas y no quirúrgicas por parte de un equipo multidisciplinar. El perfeccionamiento de las técnicas quirúrgicas reduce la prevalencia de complicaciones intra y posoperatorias. Como en cualquier cirugía, la palatoplastia presenta algunos riesgos inherentes. Evaluar el resultado quirúrgico es un desafío debido a los diversos factores que lo afectan; incluyendo el tipo de fisura y su extensión, peculiaridades del paciente, experiencia del cirujano, técnica adoptada y manejo posoperatorio. El presente relato de caso describe, e ilustra mediante fotografías, los datos clínicos encontrados posterior a palatoplastia de una paciente con fisura labiopalatina bilateral, así como sus complicaciones bucales y el plan de tratamiento odontológico propuesto para otorgar función y estética en el área afectada.

Building Information Modelling (BIM) is a process used for new buildings but has been used in existing and heritage buildings since 2008. Historic BIM (HBIM) offers historians, architects, engineer...

Introdução: O treinamento de força (TF) é efetivo para aumentar a aptidão funcional (AF) em idosos. Entretanto, a literatura é escassa em relação a alguns métodos de TF. Objetivo: Verificar o efeito de um modelo de treinamento agonista-antagonista realizado em circuito (AAC) na AF em mulheres idosas. Métodos: Foram recrutadas 13 mulheres idosas (68,6 ± 6,1 anos, 66,4 ± kg, 1,57 ± 0,007 metros) para participar desta pesquisa. Todas foram submetidas ao Sênior Fitness Test para avaliar a AF e medidas de peso, estatura e circunferência de panturrilha para medir a composição corporal. O protocolo de treinamento foi em um modelo AAC com exercícios realizados na sequência: extensão de joelhos, flexão de joelhos, cadeira abdutora, cadeira adutora, supino reto, remada articulada, rosca tríceps e rosca bíceps durante oito semanas. Todas realizaram entre 8 e 10 repetições, intervalo de 30 segundos e três séries no circuito. Resultados: Após oito semanas de treinamento AAC, a AF melhorou significativamente (p ≤ 0,05). Porém, não foram observadas diferenças para a composição corporal (p ≥ 0,05). Conclusão: O treinamento organizado em um modelo AAC promove melhora da AF e pode ser utilizado para manutenção de uma vida ativa e melhora da qualidade de vida nessa população.

The aims of this review were to form a more precise description for Master Knot of Henry (MKH), and to modify classifications related to interconnections between flexor hallucis longus (FHL) and flexor digitorum longus (FDL) for showing all configurations in the literature. A literature search was performed in main databases to obtain information related to anatomical definitions and variations of MKH. The search was carried out using the following keywords: “Master Knot of Henry”, “Chiasma plantare”, “Flexor hallucis longus” and “Flexor digitorum longus”. Information extracted from the studies was: sample size, numerical values, classifications, variation types, incidence of types, anatomical definitions of MKH, year of publication, and type of study. This study proposes that MKH should be defined as the intersection territory where FDL crosses over FHL in the plantar foot. The postchiasmatic plantar area located at distal to MKH (the narrow space between MKH and the division of FDL) should be termed as the triangle of Henry. Moreover, the classification systems showing different configurations related to interconnections situated at Henry’s triangle were updated as eight types to present all forms in the literature. Our definitions may assist in determining the precise anatomical boundaries of MKH, and thus facilitate the use of MKH as a surgical landmark. In addition, our modified classification systems covering all variations in the current literature may be helpful for surgeons and anatomists to understand formations of the triangle of Henry, and the long flexor tendons of the lesser toes.

The knowledge of the spinal cord irrigation is important for the therapeutic planning of aortic pathologies; however, its vasculature is complex due to the caliber of its arteries that pass through a three-dimensional network with great anatomical variability. Its clinical importance is evidenced during the preoperative procedure of thoracic and thoracoabdominal aortic surgeries, because its identification is essential for the prevention of spinal cord injuries. This study consists of a literature review, in which searches were conducted in the databases - Bireme, Science Direct, Pubmed and Lilacs. Articles published between 1999 and 2020, written in English, Portuguese or Spanish, were selected. The search was conducted using the descriptors Anatomy, Spinal Cord Irrigation and Spinal Cord Ischemia. The Adamkiewicz artery is the main artery responsible for the arterial supply to the lower part of the spinal cord. Thus, paraplegia is a complication of this type of surgical approach resulting from ischemic suffering of the spinal cord during the process. Therefore, further study on these factors should be encouraged, because the preservation of this vessel is relevant given the search for protection of the spinal cord and the maintenance of its functions in this type of procedure.

Resumo Objetivou-se analisar a prevalência e os fatores associados à ideação suicida em travestis e transexuais. Estudo transversal, realizado entre 2015 e 2016 com travestis (n = 22) e transexuais (n = 36) associadas a quatro organizações civis do Rio Grande do Norte. Avaliou-se a diferença entre as categorias por meio dos testes qui-quadrado, exato de Fisher e de razão de verossimilhança. Realizou-se a análise múltipla por meio da regressão de Poisson com variância robusta. A prevalência de ideação suicida foi de 41,4% (IC 95%: 41,3-54,51%), sendo de 13,79% entre travestis (IC 95%: 4,91-22,66%) e 27,61% entre transexuais (IC 95%: 16,08-39,08%). Observou-se que apresentaram maior prevalência de ideação suicida os participantes com histórico de violência na escola (RP = 2,05; IC 95%: 1,08-3,87) e classificados com níveis depressivos moderado/grave (RP = 3,86; IC 95%: 1,51-9,83). Contexto escolar desfavorável e presença de sintomatologia depressiva parecem prejudicar a saúde mental e colaborar com a ideação suicida de pessoas transexuais e travestis. Abstract The aim of this study was to determine the prevalence of suicidal ideation and explore associated factors among travestis and transsexuals. A cross-sectional study was conducted between 2015 and 2016 with 22 travestis and 36 transsexuals who were members of the four transgender organizations operating in the state of Rio Grande do Norte, Brazil. Associations between suicidal ideation and the categorical variables were measured using the chi-squared test, Fisher’s exact test, and likelihood ratios. Multivariate analysis was performed using robust Poisson regression. The suicidal ideation prevalence rate was 41.4% (95%CI 41.3-54.51%): 13.79% among travestis (95%CI 4.91-22.66%) and 27.61% in transsexuals (95%CI 16.08-39.08%). The prevalence of suicidal ideation was higher among respondents who reported suffering violence at school (PR = 2.05; 95%CI 1.08-3.87) and those experiencing moderate/severe depression (PR = 3.86; 95%CI 1.51-9.83). The findings suggest that unfavorable school contexts and the presence of depression compromise mental health and contribute to suicidal ideation among travestis and transsexuals.

Purpose The aim of this study was to show that bariatric surgery (BS) is more effective than medical therapy (MT) in Asian obese patients. Methods In this prospective, multicenter, nonrandomized, controlled trial, obese patients with body mass index of ≥35 kg/m2 or 30.0–34.9 kg/m2 with obesity-related comorbidities were assigned to undergo BS, such as laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass, or MT. Patients who underwent BS were evaluated 4, 12, 24, and 48 weeks after surgery, whereas patients who received MT were monitored at a hospital every 6 weeks for 1 year. At each visit, weight, waist and hip circumference, and blood pressure were measured, and patients underwent physical examination and laboratory testing. Health-related quality of life (HQOL) was investigated using Euro QOL-5 Dimension, Impact of Weight on Quality of Life questionnaire-Lite and Obesity-related Problems scale. Results The study included 264 patients from 13 institutions; of these, 64 underwent BS and 200 received MT. Of the patients who underwent BS, 6.3% experienced early complications. Relative weight changes from baseline to 48 weeks were significantly greater in the BS than in the MT group (26.9% vs. 2.1%, P < 0.001), as were the rates of remission of diabetes (47.8% vs. 16.7%, P = 0.014), hypertension (60.0% vs. 26.1%, P < 0.001), and dyslipidemia (63.2% vs. 22.0%, P < 0.001). HQOL was better in the BS than in the MT group at 48 weeks. Conclusion BS was safe and effective in Korean obese patients, with greater weight reduction, remission of comorbidities, and quality of life improvement than MT.

Background: We described the demographics, cancer subtypes, comorbidities, and outcomes of patients with a history of cancer and coronavirus disease 2019 (COVID-19). Second, we compared patients hospitalized with COVID-19 to patients diagnosed with COVID-19 and patients hospitalized with influenza. Methods: We conducted a cohort study using eight routinely collected health care databases from Spain and the United States, standardized to the Observational Medical Outcome Partnership common data model. Three cohorts of patients with a history of cancer were included: (i) diagnosed with COVID-19, (ii) hospitalized with COVID-19, and (iii) hospitalized with influenza in 2017 to 2018. Patients were followed from index date to 30 days or death. We reported demographics, cancer subtypes, comorbidities, and 30-day outcomes. Results: We included 366,050 and 119,597 patients diagnosed and hospitalized with COVID-19, respectively. Prostate and breast cancers were the most frequent cancers (range: 5%–18% and 1%–14% in the diagnosed cohort, respectively). Hematologic malignancies were also frequent, with non-Hodgkin's lymphoma being among the five most common cancer subtypes in the diagnosed cohort. Overall, patients were aged above 65 years and had multiple comorbidities. Occurrence of death ranged from 2% to 14% and from 6% to 26% in the diagnosed and hospitalized COVID-19 cohorts, respectively. Patients hospitalized with influenza (n = 67,743) had a similar distribution of cancer subtypes, sex, age, and comorbidities but lower occurrence of adverse events. Conclusions: Patients with a history of cancer and COVID-19 had multiple comorbidities and a high occurrence of COVID-19-related events. Hematologic malignancies were frequent. Impact: This study provides epidemiologic characteristics that can inform clinical care and etiologic studies.

Context Terminal dyspnea in dying cancer patients is frequent and distressing, and the impact extends to their families. Families are often involved in providing care for terminal dyspnea. Objectives This study aimed to describe various care strategies for terminal dyspnea in cancer patients hospitalized in palliative care units (PCUs), evaluate families’ satisfaction with care for terminal dyspnea, and explore determinants contributing to families’ satisfaction. Methods A nationwide, cross-sectional survey was conducted using a self-reported questionnaire among bereaved families of cancer patients who died in PCUs. The questionnaire consisted of questions on the perceptions of care offered to patients with terminal dyspnea and their families, satisfaction with care for terminal dyspnea, family-perceived intensity of terminal dyspnea, use of oxygen, and background data of patients and families. Results In total, 533 participants (response rate = 54%) returned the completed questionnaires, and 231 reported that their loved one had experienced terminal dyspnea. Dedicated and compassionate care was perceived by 60%–89% of the participants as the strategy provided for patients. Care for family members was perceived by 58%–69% of the participants. Perception of dedicated and compassionate care for patients and that of care for family members were significantly associated with high satisfaction (odds ratio, 95% confidence interval: 8.64, 3.85–19.36 and 15.37, 5.00–47.25, respectively). Conclusion Dedicated and compassionate care may be the essential part of the care for terminal dyspnea. Dedicated and compassionate care for patients and care for family members have a potential of improving the care satisfaction among family caregivers.

A pesquisa de tendências que, mostra-se mais relevante na atualidade, diz respeito a observações e ponderações acerca da sociedade consumidora, principalmente, nos novos núcleos e nichos de consumo. Diferentes autores afirmam que profissionais da pesquisa prospectiva mapeiam diversas áreas de predomínio atualmente em cena e avaliam suas principais implicações para o futuro. As pesquisas de tendências observam o comportamento das pessoas e o contexto em que ele acontece. Embora já estivessem ganhando cada vez mais espaço e interesse das pessoas, a busca por conteúdos ligados ao lifekacking e ao biohacking se ampliou de forma significativa durante a pandemia de Covid-19.Neste sentido a pesquisa busca analisar como este momento e contexto específico puderam impulsionar estas tendências de comportamento e refletir sobre possíveis impactos sobre a moda.

Radiation myelopathy (RM) is a rare but serious complication of radiotherapy. Small vessel ischemia and demyelination are some of the more remarkable indications of RM's pathophysiology. The RM is a diagnosis of exclusion. In the differential diagnosis, infectious causes, tumors, rheumatic diseases, and paraneoplastic syndromes are the main diseases that should be excluded. Contrast-enhanced magnetic resonance imaging (MRI) is a useful method for diagnosis. We present a report on 3 patients diagnosed with radiation myelitis. All the patients presented with late paraparasia and paresthesia. Despite high-dose steroids, hyperbaric oxygen, and physical therapy, there was no clinical improvement at the follow-up one year later.

This study aimed to investigate the structural behavior of castellated beam-column steel elements. The benefit of castellation laid in increasing the section’s depth to induce an increase in the moment of inertia Ix and the section modulus Sx without the slightest increase in the element weight. Most of the previous researches focused on castellated beams but only few concentrated on beam-column elements. An experimental investigation was performed on twelve short and long castellated beams, columns and beam-column elements. The results of the performed experimental work were compared to the finite element analysis (FEA) to validate the applicability of FEA as a numerical tool. FEA was found to be in favorable agreement with their experimental counterparts. In this research, the behavior and strength of the castellated beam, columns, and beam-column elements were investigated by means of the verified finite element modeling. The various parameters taken into consideration in this research were respectively; load eccentricity, element length and castellation ratio.

Background: Obesity is a serious health problem that dysregulate Renin-Angiotensin System (RAS) and intestinal microbiota. Objective: The present study aimed to evaluate the Angiotensin-(1-7) [ANG-(1-7)] oral formulation effects on obese mice intestinal microbiota. Methods: Mice were divided into four groups: obese and non-obese treated with ANG-(1-7) and obese and non-obese without ANG-(1-7) during four weeks. Results: We observed a significant decrease in the fasting plasma glucose, total cholesterol, triglycerides, and Low-density lipoprotein levels and increased High-density lipoprotein in animals treated with ANG-(1-7). The histological analysis showed intestinal villi height reduction in mice treated with ANG-(1-7). Additionally, increased Bacteroidetes and decreased Firmicutes (increased Bacteroidetes/ Firmicutes ratio) and Enterobacter cloacae populations were observed in the High-Fat Diet + ANG-(1-7) group. Receptor toll-like 4 (TLR4) intestinal mRNA expression was reduced in the HFD+ANG-(1-7) group. Finally, the intestinal expression of the neutral amino acid transporter (B0AT1) was increased in animals treated with ANG-(1-7), indicating a possible mechanism associated with tryptophan uptake. Conclusion: The results of the present study suggest for the first time an interaction between oral ANG-(1-7) and intestinal microbiota modulation.

Thirteen female Wistar rats were divided into two groups: one treated with ethanol and the other of untreated. Four newborns from each mother were selected and weighed, measured, and evaluated for physical characteristics. From these neonates, chondrocytes were extracted from the articular cartilages of the femur and tibia, and cultivated in a chondrogenic medium at 37oC and 5% CO2. At 7, 14, and 21 days of cultivation, alkaline phosphatase activity tests, MTT conversion to formazan, and percentage area covered by cells per field were performed. At 21 days, the percentage of PAS+ areas in 3D cultures was performed, as well as the evaluation of gene transcript expression for aggrecan, SOX-9, collagen type II, collagen X, Runx-2, and VEGF by real-time RT-PCR. The means were compared by Student’s t-test. The weight of the ethanol group neonates was significantly lower than that of the controls. Chondrocyte cultures from the ethanol group showed significantly higher AP activity, MTT conversion, and cell percentage. There was higher expression of collagen type II and lower expression of SOX-9 in the ethanol group. There was no difference in the percentage of PAS+ areas in pellets and in expression of aggrecan, collagen X, Runx-2, or VEGF between groups. In conclusion, prenatal exposure to ethanol alters the phenotype and activity of offspring chondrocytes, which may be mechanisms by which endochondral bone formation is compromised by maternal ethanol consumption.

Introduction/Purpose Obesity increases significantly every year worldwide. Since 1980, the prevalence of individuals with obesity has practically doubled. Obesity plays an important role in the pathophysiology of diseases that arise from a complex interaction of nutritional, genetic, and metabolic factors, characterizing a chronic inflammatory state. This study aimed to verify the systemic inflammatory response through the analysis of IGF-1, IL-23, and resistin levels and the lipid profile in severely obese women undergoing surgery for obesity and weight-related diseases. Materials and Methods This randomized controlled clinical trial includes female patients clinically diagnosed with severe obesity with an indication for bariatric surgery. Results In the initial evaluation, no significant difference was observed between the control (CG) and bariatric surgery (BSG) groups. The weight, BMI, systolic and diastolic blood pressures, total cholesterol, LDL, HDL, total non-HDL cholesterol, and glucose in BSG patients showed a significant change after surgery. Pre- and post-surgery levels of resistin, IGF-1, and IL-23 showed a significant difference in the BSG group, but only IL-23 was changed after 6 months in the CG. Conclusion The results of this study confirmed that weight loss induced by surgery for obesity and weight-related diseases improved the lipid profile and reduced the chronic inflammatory status in women with severe obesity.

Helicobacter pylori é uma bactéria Gram negativa, microaerófila, móvel, não esporulada capaz de colonizar a mucosa gástrica de humanos. A infecção por esse microrganismo provoca alterações gástricas e extra gástricas devido ao processo inflamatório crônico que pode promover um efeito sistêmico e provocar rompimento da homeostase de diversos órgãos e tecidos, desencadeando diversas patologias. O objetivo desse trabalho foi realizar o levantamento bibliográfico de patologias não gástricas que são desencadeadas pela infecção crônica por H. pylori, considerando a fisiopatologia e os efeitos sistêmicos no hospedeiro. Para isso foi realizada uma revisão da literatura integrativa, de característica qualitativa, nas bases de dados Scientific Eletronic Library Online (SCIELO), Google Acadêmico, LilACS e NCBI PubMed. Foram incluídos artigos publicados em português, espanhol e inglês, no período de 2010 a 2020 que abordavam a temática e os critérios de exclusão foram teses, monografias e dissertações, e artigos que não abordavam o tema. Foram identificados alguns grupos de doenças não gástricas associadas à infecção por H. pylori, incluindo doenças hematológicas, neurológicas, hepatobiliares, respiratórias, vasculares, alérgicas, neoplásicas, metabólicas, oculares, bucais e autoimunes. O efeito sistêmico à infecção por H. pylori, onde são liberadas diversas citocinas e mediares químicos, provoca alterações e desequilíbrios homeostático em diferentes tecidos e órgãos extra gástricos do organismo, e muitas vezes ocorre uma resposta imunológica exacerbada. Apesar de não ser um consenso entre os trabalhos pesquisados, verificou-se que a infecção por H. pylori pode estar associada ao surgimento e progressão dessas diferentes patologias.

Objective: Inflammation markers increase during Familial Mediterranean Fever (FMF) attacks and often return to normal within a few days. It is known that a subclinical inflammation continues in FMF patients in the inter-episode period, which increases the risk of developing amyloidosis. In recent years, several works have been conducted showing the relationship between platelet indices and inflammation, such as platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), plateletrite (PCT). In this study, we aimed to investigate the relationship between platelet indices and disease severity in FMF patients without attacks. Method: The records of all FMF patients followed by us were reviewed retrospectively. Patients with a hematological or oncological disease, patients with data deficiency for the study, and patients under 18 years of age were excluded. While the laboratory data were recorded, the condition of patients to be at least 3 months without attack was required. As the control group, the automation records of all healthcare professionals working in the internal medicine clinic of our hospital were examined. Our clinical staff, who did not have chronic diseases and regular drug use, were taken as a healthy control group. 173 patients and 20 control groups who met the conditions mentioned above were included in the study. Platelet indices were compared between patient and control groups. Results: It was determined that the value of MPV, one of the platelet indices, in the patient group was statistically significantly higher than the value in the healthy control group (p = 0.029). MPV was also found to correlate with disease severity (p