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Introduction This study aimed to systematically analyze and describe the main challenges of congenital heart diseases (CHDs) in the countries in the Amazon region. Methods The methodology followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist utilizing the Medline, Embase, Lilacs, and Google Scholar databases. The inclusion criteria were articles addressing any topic involving CHD in the Amazon region. Incomplete articles, book chapters, lectures, conference abstracts, and editorials were excluded. Results Nine studies were identified, 7 of which were published in the last decade and were of Colombian and Brazilian origin. The methodology of the studies was cross-sectional and ecological, evaluating the regional and epidemiological factors, challenges to diagnosis and treatment, multidisciplinary team challenges, and the impact of the COVID-19 pandemic. Studies carried out by surgeons demonstrate more existing data regarding the challenges of the health-care system. Conclusions There is growing interest in analyzing the situation of CHD in the region. However, only a few studies are available, mostly on ecological and cross-sectional analysis. These records show the lack of hospital infrastructure and multidisciplinary teams for the diagnosis and treatment of CHD in the Amazon region; we see an initiative by specialists from two countries (Colombia and Brazil) to demonstrate the difficulties by seeking international training programs and government aid to improve the health system situation.

Abstract Background The Brazilian Policy for Comprehensive Care for People with Rare Diseases was implemented in 2014; however, national epidemiological data on rare diseases (RDs) are scarce and mainly focused on specific disorders. To address this gap, University Hospitals, Reference Services for Neonatal Screening, and Reference Services for Rare Diseases, all of which are public health institutions, established the Brazilian Rare Diseases Network (RARAS) in 2020. The objective of this study was to perform a comprehensive nationwide epidemiological investigation of individuals with RDs in Brazil. This retrospective survey collected data from patients receiving care in 34 healthcare facilities affiliated with RARAS in 2018 and 2019. Results The survey included 12,530 participants with a median age of 15.0 years, with women representing 50.5% of the cohort. Classification according to skin color demonstrated that 5044 (47.4%) participants were admixed. Most had a confirmed diagnosis (63.2%), with a predominance of phenylketonuria (PKU), cystic fibrosis (CF), and acromegaly. Common clinical manifestations included global developmental delay and seizures. The average duration of the diagnostic odyssey was 5.4 years (± 7.9 years). Among the confirmed diagnoses, 52.2% were etiological (biochemical: 42.5%; molecular: 30.9%), while 47.8% were clinical. Prenatal diagnoses accounted for 1.2%. Familial recurrence and consanguinity rates were 21.6% and 6.4%, respectively. Mainstay treatments included drug therapy (55.0%) and rehabilitation (15.6%). The Public Health System funded most diagnoses (84.2%) and treatments (86.7%). Hospitalizations were reported in 44.5% of cases, and the mortality rate was 1.5%, primarily due to motor neuron disease and CF. Conclusion This study marks a pioneering national-level data collection effort for rare diseases in Brazil, offering novel insights to advance the understanding, management, and resource allocation for RDs. It unveils an average diagnostic odyssey of 5.4 years and a higher prevalence of PKU and CF, possibly associated with the specialized services network, which included newborn screening services.

Abstract Visceral leishmaniasis (VL) is an urgent public health concern in Brazil. We evaluated the spatiotemporal distribution of VL to better understand the effects of economic activities related to agriculture, livestock, and deforestation on its incidence in the Brazilian Legal Amazon (BLA). The data on newly confirmed cases of VL in Brazilian municipalities from 2007 to 2020 were extracted from the Brazilian Notifiable Diseases Information System (SINAN) and analyzed. The data on agricultural production (planted area in hectares) and livestock (total number of cattle) were obtained from the Brazilian Institute of Geography and Statistics (IBGE), whereas deforestation data (in hectares) were obtained from the Amazon Deforestation Estimation Project (PRODES). SatScan and the local indicators of spatial association (LISA) were used to identify the spatial and temporal patterns of VL and its relationships with economic and environmental variables. The cumulative incidence rate was found to be 4.5 cases per 100,000 inhabitants. Based on the LISA results, areas with a high incidence of VL and deforestation were identified in the states of Roraima, Pará, and Maranhão. Strengthening deforestation monitoring programs and environmental enforcement actions can help implement public policies to control illegal deforestation and mitigate the socio-environmental vulnerability in the BLA. Therefore, areas identified in this study should be prioritized for controlling VL.

Abstract Inherited retinal dystrophies/degenerations (IRDs) are the leading cause of visual impairment and incurable familial blindness in the Western world. Given the clinical and genetic heterogeneity, establishing a molecular diagnosis is especially relevant. The aim of this study was to perform the first nationwide survey to understand the prevalence and current management of IRDs in Portugal. A response was obtained from 26 healthcare providers (HCP) (76.5% response rate). Only 4 respondents reported not managing IRD patients. Most HCPs (68.1%) reported managing up to 100 patients, while three currently manage between 501 and 1000 patients. Based on the Portuguese population, an estimated IRD prevalence of 0.031%, i.e., about 1 in 3000 individuals, was calculated. In most HCPs (86.3%), most patients are adults, and non-syndromic retinitis pigmentosa is the most frequent diagnosis. Only 4 HCPs currently use the national, web-based IRD registry (IRD-PT). However, all but one respondent expressed interest in participating in such a registry. Genetic testing is available in 54.5%, with 58.3% HCPs reporting solved rates between 61–80%, but 4 to 9 months to get a genetic test result in 83.4% of cases. Based on this survey, the prevalence of biallelic RPE65-associated disease in Portugal is 0.00031%, i.e., approximately 1:300,000 individuals. Data from this study provide vital background information on national differences in the diagnosis and management of IRD patients. Nationwide implementation of the IRD-PT registry should be encouraged and supported to provide population-based reference data and to identify patients eligible for current and future therapies.

Abstract We evaluated the prevalence of pathogenic/likely pathogenic germline variants (PGV) in Brazilian pancreatic adenocarcinoma (PC) patients, that represent a multiethnic population, in a cross-sectional study. We included 192 PC patients unselected for family history of cancer. We evaluated a panel of 113 cancer genes, through genomic DNA sequencing and 46 ancestry-informative markers, through multiplex PCR. The median age was 61 years; 63.5% of the patients presented disease clinical stages III or IV; 8.3% reported personal history of cancer; 4.7% and 16.1% reported first-degree relatives with PC or breast and/or prostate cancer, respectively. Although the main ancestry was European, there was considerable genetic composition admixture. Twelve patients (6.25%) were PGV carriers in PC predisposition genes (ATM, BRCA1, BRCA2, CDKN2A, MSH2, PALB2) and another 25 (13.0%) were PGV carriers in genes with a limited association or not previously associated with PC (ACD, BLM, BRIP1, CHEK2, ERCC4, FANCA, FANCE, FANCM, GALNT12, MITF, MRE11, MUTYH, POLE, RAD51B, RAD51C, RECQL4, SDHA, TERF2IP). The most frequently affected genes were CHEK2, ATM and FANC. In tumor samples from PGV carriers in ACD, BRIP1, MRE11, POLE, SDHA, TERF2IP, which were examined through exome sequencing, the main single base substitutions (SBS) mutational signature was SBS1+5+18, probably associated with age, tobacco smoking and reactive oxygen species. SBS3 associated with homologous repair deficiency was also represented, but on a lower scale. There was no difference in the frequency of PGV carriers between: (a) patients with or without first-degree relatives with cancer; and (b) patients with admixed ancestry versus those with predominantly European ancestry. Furthermore, there was no difference in overall survival between PGV carriers and non-carriers. Therefore, genetic testing should be offered to all Brazilian pancreatic cancer patients, regardless of their ancestry. Genes with limited or previously unrecognized associations with pancreatic cancer should be further investigated to clarify their role in cancer risk.

Abstract Background Empathy is an essential core competency for future doctors. Unfortunately, the medical curriculum is infamously known to burn out aspiring doctors, which may potentially lead to a decline in empathy among medical students. This research was planned to understand the evolution of empathic approaches among students across the curriculum using the Interpersonal reactivity index (IRI) as a benchmark at the Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB) and University of Sharjah (UoS). Methods We adopted a cross-sectional design and administered an online survey to the medical students of RCSI-MUB and UoS using a modified version of the IRI along with its three subscales of empathic concern (EC), perspective taking (PT), and personal distress (PD). To identify intra- and inter-institutional variations in empathy scores, the Analysis of Variance (ANOVA) was performed separately for each institution and with both institutions combined. A two-way ANOVA was conducted for the comparison between years and institutions. For the subscale analysis of EC, PT, and PD, we used one-way ANOVA for significant differences between years at both institutions. For the gender-effect analysis, t-test was performed to examine the differences in total IRI scores at both institutions combined and at each institution separately. Additionally, an Analysis of Covariance (ANCOVA) was done to identify the influence of gender on empathy scores. Results A total of 140 students from both institutions participated in this study. We found a fluctuating pattern of empathy scores without a clear trend across the years. The sub-scales of EC, PD, and PT across academic years at both institutions showed significant differences within the EC at RCSI-MUB (p = 0.003). No significant differences were identified across other years from both institutions. There were significant differences between empathy scores from RCSI-MUB and UoS for EC (p = 0.011). Additionally, a pronounced interaction effect between year and institution was observed for PT (p = 0.032). The gender-wise analysis showed that female students had higher empathy scores than males (p = 0.004). The ANCOVA for IRI score results revealed a p-value of 0.023, indicating that gender plays a crucial role in empathy levels among medical students. The ANCOVA results revealed a p-value of 0.022 in the EC subscale. Conclusion Our study unveiled intricate patterns in empathy development among medical students across years and genders at RCSI-MUB and UoS. These congruences and dissimilarities in empathy scores signal a subjective understanding of empathy by medical students. The disparities in understanding may encourage medical educators to embed empathy in standard medical curricula for better healthcare outcomes.

Abstract Projected to impact 310 million children by the next decade, childhood obesity is linked to serious health issues like metabolic disturbance and cardiovascular diseases. This study introduces a novel approach for the integrated assessment of inflammatory, glycemic and lipid disorders in obese children in resources-limited settings and also identifies key factors contributing to these changes. Conducting a cross-sectional analysis of 231 children aged 5–12 years from public schools in Brazil's semi-arid region, the research involved collecting medical history, anthropometric measurements, and blood samples to analyze glycemic and lipid profiles, along with C-reactive protein levels. We used an adapted the Molecular Degree of Perturbation model to analyze deviations in metabolic markers from a healthy control group. Statistical analyses included Mann–Whitney and Fisher exact tests, backward logistic regression, and hierarchical cluster analysis. The study identified a direct and independent association between elevated Metabolic Disturbance Degree and both overweight and obesity in children, with significant differences in CRP, Triglycerides, and HDL levels noted between obese and healthy-weight groups. The findings highlight the critical need for early detection and comprehensive understanding of obesity-related changes to mitigate the severe health risks associated with childhood obesity.

The correct diagnosis is fundamental for the appropriate treatment to be employed in a particular pathology. The best treatment is not the one that solves only local problems, fragmenting the patient, and therefore, it is necessary to integrate the entire systemic condition of the individual before initiating any local treatment. This context inevitably requires dentistry to participate in a multidisciplinary approach, where the role of the dentist is expanded in concepts that encompass ethics, human dignity, and professional valorization. This article describes a clinical case of a patient with mucopolysaccharidosis type I, whose treatment of cystic lesions present in the mandible was exclusively performed through marsupialisation. The objective of this study is to demonstrate, within the complexity of this rare syndrome, the difficulties of diagnosis and the need for evaluation of the patient beyond the limits of the oral cavity, as well as to report two cases of large dentigerous cysts, surgically treated conservatively through marsupialisation, without the need for re-approach for enucleation and without recurrences over a 20-year period.

Abstract Introduction Professionalism is fundamental to the existence of professions. In pharmacy, interest in this theme improved with events that examined the resocialization of pharmacists in care. With this, evaluating professionalism can help the operationalization of the theme and, consequently, the development of strategies for pharmacy consolidation before its challenges. Therefore, this study aimed to evaluate the professionalism of Brazilian pharmacists. Methods To meet the objective, a cross-sectional study was conducted between March 2022 and August 2023. Data were collected using the Brazilian version of the “Modification of Hall’s Professionalism Scale for Use with Pharmacists”. The scale has 39 items grouped into the domains: autonomy, vocation, professional council, self-regulation, continuing education, and altruism. Data were analyzed using descriptive statistics and an ANOVA analysis of variance with post-hoc Hochberg or Games-Howell tests with Bootstrapping was conducted to verify differences between groups. Results 600 pharmacists participated in this study. The majority (69%) was female and carried out their professional activities in community pharmacies (50%). Professionalism scores ranged between 14 and 29 points, with an average of 22.8 points. Pharmacists working in outpatient clinics had higher scores in most factors, namely, altruism, continuing education, professional council, vocation, and autonomy. This indicates that the inclination of pharmacists to occupy areas focused on care can be significant to assess professionalism. Conclusions The data obtained indicate that pharmacists working in outpatient clinics had higher professionalism scores compared to others. This corroborates the worldwide trend experienced by pharmacy in recent decades, which is the execution of increasingly patient-centered practice models.

Abstract The carbon capture and storage (CCS) process has become one of the main technologies used for mitigating greenhouse gas emissions. The success of CCS projects relies on accurate subsurface reservoir petrophysical characterization, enabling efficient storage and captured $$\textrm{CO}_2$$ CO 2 containment. In digital rock physics, X-ray microtomography ( $$\upmu $$ μ -CT) is applied to characterize reservoir rocks, allowing a more assertive analysis of physical properties such as porosity and permeability, enabling better simulations of porous media flow. Estimating petrophysical properties through numeric simulations usually requires high-resolution images, which are expensive and time-inefficient to obtain with $$\upmu $$ μ -CT. To address this, we propose using two deep learning models: a super-resolution model to enhance the quality of low-resolution images and a surrogate model that acts as a substitute for numerical simulations to estimate the petrophysical property of interest. A correction process inspired by generative adversarial network (GAN) adversarial training is applied. In this approach, the super-resolution model acts as a generator, creating high-resolution images, and the surrogate network acts as a discriminator. By adjusting the generator, images that correct the errors in the surrogate’s estimations are produced. The proposed method was applied to the DeePore dataset. The results shows the proposed approach improved permeability estimation overall.

Abstract AI-powered segmentation of hip and knee bony anatomy has revolutionized orthopedics, transforming pre-operative planning and post-operative assessment. Despite the remarkable advancements in AI algorithms for medical imaging, the potential for biases inherent within these models remains largely unexplored. This study tackles these concerns by thoroughly re-examining AI-driven segmentation for hip and knee bony anatomy. While advanced imaging modalities like CT and MRI offer comprehensive views, plain radiographs (X-rays) predominate the standard initial clinical assessment due to their widespread availability, low cost, and rapid acquisition. Hence, we focused on plain radiographs to ensure the utilization of our contribution in diverse healthcare settings, including those with limited access to advanced imaging technologies. This work provides insights into the underlying causes of biases in AI-based knee and hip image segmentation through an extensive evaluation, presenting targeted mitigation strategies to alleviate biases related to sex, race, and age, using an automatic segmentation that is fair, impartial, and safe in the context of AI. Our contribution can enhance inclusivity, ethical practices, equity, and an unbiased healthcare environment with advanced clinical outcomes, aiding decision-making and osteoarthritis research. Furthermore, we have made all the codes and datasets publicly and freely accessible to promote open scientific research.

Abstract To evaluate association of vitamin D with sleep quality in adults and the influence of VDR-gene polymorphism FokI (rs2228570;A > G). Cross-sectional population-based study in adults, conducted in Brazil. The outcome was sleep-quality, evaluated by the Pittsburgh Sleep Quality Index. Vitamin D was determined by indirect electrochemiluminescence and classified as deficiency (VDD), 25(OH)D

Abstract Mental disorders are intricate and multifaceted and encompass social, economic, environmental, and biological factors. This study aimed to explore the potential association between vitamin D deficiency and anxiety and depression symptoms in adults, considering the role of the vitamin D receptor gene polymorphism FokI (rs2228570). This was a population-based cross-sectional study with stratified and cluster sampling, evaluating anxiety symptoms (AS) and depression symptoms (DS) in 1637 adults. Vitamin D levels were measured using electrochemiluminescence and were considered deficient when

Abstract Background and Aims Healthcare students are expected to lead healthy lives yet they may engage in health risk behaviors (HRBs) like physical inactivity, poor diet, and substance use. These behaviors can have negative consequences for both the individual's health and well‐being, as well as their ability to perform their future roles as healthcare providers. This study aimed to assess the prevalence of HRBs and associated factors among medical and nursing students at Lumbini Medical College, Nepal. Methods A cross‐sectional study was conducted among 412 undergraduate healthcare students using a self‐administered questionnaire. HRBs across various domains were assessed. Validated scales screened for anxiety and depression. Regression analyses determined associations between mental health and HRBs. Results Low physical activity was prevalent, with only 10.7% exercising ≥5 times/week. Inadequate fruit/vegetable intake (1–2 servings/day) was reported by 79.9% students. Short sleep duration (5–6 h) on weeknights (51.2%) was common. More than three quarter (76.5%) of students met the screening cutoff score for HRBs. The study highlighted that students with addiction, depression and anxiety are more likely to exhibit HRBs (p

ABSTRACT Objective: To describe the 3-year long experience of addressing disruptive events by medical staff in a private hospital. Methods: The cross-sectional study that was conducted between 2020 and 2022, involved collection, analysis, and management of suspected cases of disruptive behavior by medical staff. Results: Relevant information was collected from reports issued by health care leaders (69%), anonymous reports accessed from the health institution's intranet tool "SINAPSE" (19%), the compliance center (5%), customer attendance service (3.7%), the hospital board (2.3%), and the medical practice department (1%). Surgical specialties were responsible for 70.3% of the disruptive incidents, and the average time to outcome was 24.5 days, with most solutions involving guided education of physicians (92.7%). Conclusion: Management of disruptive behavior by medical staff is essential for the prevention of unsafe work environments and strengthening a culture of safety.

Introduction The study of electrophysiological auditory measures with different types of masking makes it possible to understand temporal processing skills and the processes involved in speech recognition in noise situations. The use of modulated masking in cortical measures of hearing enables the obtainment of analysis parameters of the masking release and its impact on neural auditory processing.

Introdução: A COVID-19 impactou negativamente a vida dos idosos, considerados como grupo de risco para o vírus. Objetivo: Este estudo longitudinal prospectivo teve como objetivo verificar as alterações na aptidão física de idosos durante o período da pandemia COVID-19, levando em consideração o sexo e a faixa etária. Métodos: Participaram do estudo 76 idosos (72,6 ± 6,47 anos), que faziam parte de um programa de extensão universitário. A aptidão física foi avaliada por meio da bateria de testes Senior Fitness Test (SFT). Os pesquisadores, devidamente treinados, aplicaram a SFT antes da pandemia (novembro de 2019) e durante a pandemia (abril de 2022). Resultados: Os resultados indicaram uma piora significativa na aptidão física dos idosos em todos os testes, exceto no teste de flexão de cotovelo. A maior redução na aptidão física foi observada no teste de caminhada de 6 minutos. Em relação ao sexo, tanto homens quanto mulheres apresentaram maiores reduções na resistência aeróbia e na força dos membros inferiores. Quanto à faixa etária, os idosos com 80 anos ou mais foram os mais afetados, apresentando as maiores reduções, especialmente na resistência aeróbia e na força dos membros inferiores. Conclusão: O estudo conclui que o período da pandemia de COVID-19 teve um impacto negativo significativo na aptidão física dos idosos, especialmente nas mulheres e nos idosos com 80 anos ou mais. Portanto, recomenda-se a implementação de atividades físicas para essas populações, com o objetivo de minimizar ou até reverter os impactos negativos causados pela COVID-19 na aptidão física dos idosos.

Enquadramento: O acolhimento é uma estratégia de cuidado às crianças em situação de maus-tratos, pois compreende a organização de um espaço físico, equipa qualificada, fluxo de notificação e atendimento sensível pelos profissionais de saúde. Objetivo: Descrever o conhecimento e a prática dos profissionais de saúde no atendimento de crianças em situação de maus-tratos sob a ótica do acolhimento. Metodologia: Pesquisa qualitativa, descritiva, de caráter exploratório. A colheita foi realizada por entrevista não diretiva individual no ambiente hospitalar. Utilizou-se análise temática. Resultados: Participaram 23 profissionais de saúde. O sexo feminino foi o predominante e 17 participantes não possuíam curso de capacitação. O acolhimento foi apontado no modo de falar, agir e na rotina de cuidado. Conclusão: O conhecimento dos profissionais de saúde foi desenvolvido na prática profissional pelo tempo de formação e pelo cuidado sensível. A capacitação deficiente interfere na identificação de crianças e adolescentes em situação maus-tratos. Crianças menores são mais vulneráveis e podem sofrer negligência. O acolhimento precisa ser articulado com outras esferas com fluxo de atendimento conhecido

Introduction Pituitary tumors account for 25% of all primary brain tumors and for 15% of overall intracranial expansive masses. Pituitary metastases, in contrast, are a rare condition, estimated as 1.8% of all resected sellar lesions. We present here a rare case of clear cell renal carcinoma metastasis to the pituitary gland.

We generated 238 Zika virus (ZIKV) genomes from 135 persons in Brazil who had samples collected over 1 year to evaluate virus persistence. Phylogenetic inference clustered the genomes together with previously reported ZIKV strains from northern Brazil, showing that ZIKV has been remained relatively stable over time. Temporal phylogenetic analysis revealed limited within-host diversity among most ZIKV-persistent infected associated samples. However, we detected unusual virus temporal diversity from >5 persons, uncovering the existence of divergent genomes within the same patient. All those patients showed an increase in neutralizing antibody levels, followed by a decline at the convalescent phase of ZIKV infection. Of interest, in 3 of those patients, titers of neutralizing antibodies increased again after 6 months of ZIKV infection, concomitantly with real-time reverse transcription PCR re-positivity, supporting ZIKV reinfection events. Altogether, our findings provide evidence for the existence of ZIKV reinfection events.

Abstract The aim of this study was to evaluate the mediation role of muscle quantity in the relationship between physical fitness and cardiometabolic risk factors (CMRF) in adolescents. This cross-sectional study conducted with 120 adolescents of both sexes, aged between 10 and 17 years. Body mass, height, fat mass (FM), lean mass, blood pressure, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, insulin, cardiorespiratory fitness (CRF) and 1 repetition maximum strength (1-RM) with evaluation of the leg press 45° (RM-leg), bench press (RM-bench) and arm curl (RM-arm). Body mass index z-score, appendicular skeletal muscle mass, appendicular skeletal muscle mass index, lean mass index (LMI), muscle-to-fat ratio (MFR), age at peak height velocity, and CMRF z-score were calculated. The direct relation between FM and CMRF was mediated by the LMI (26%) and inverse relation between CRF and CMRF was mediated by the LMI (26%). For girls, the direct relation between FM and CMRF was mediated by the LMI (32%); the inverse relation between CRF, RM-leg, RM-arm and CMRF was mediated by the LMI (32%, 33%, and 32%, respective). For boys, the indirect effect was not significant, indicating that LMI is not a mediator in the relation between FM, CRF, 1-RM with CMRF. The direct relation between RM-leg and CMRF was mediated by the MRF (16%). This finding evidenced the importance of promoting a healthy lifestyle to improve physical fitness levels and the quantity of muscle mass in adolescents.

Abstract Melatonin receptors MT1 and MT2 are G protein-coupled receptors that mediate the effects of melatonin, a hormone involved in circadian rhythms and other physiological functions. Understanding the molecular interactions between these receptors and their ligands is crucial for developing novel therapeutic agents. In this study, we used molecular docking, molecular dynamics simulations, and quantum mechanics calculation to investigate the binding modes and affinities of three ligands: melatonin (MLT), ramelteon (RMT), and 2-phenylmelatonin (2-PMT) with both receptors. Based on the results, we identified key amino acids that contributed to the receptor-ligand interactions, such as Gln181/194, Phe179/192, and Asn162/175, which are conserved in both receptors. Additionally, we described new meaningful interactions with Gly108/Gly121, Val111/Val124, and Val191/Val204. Our results provide insights into receptor-ligand recognition’s structural and energetic determinants and suggest potential strategies for designing more optimized molecules. This study enhances our understanding of receptor-ligand interactions and offers implications for future drug development.

Abstract Candida species have been responsible for a high number of invasive infections worldwide. In this sense, Rottlerin has demonstrated a wide range of pharmacological activities. Therefore, this study aimed to evaluate the antifungal, antibiofilm and antivirulence activity of Rottlerin in vitro against Candida spp. and its toxicity and antifungal activity in vivo. Rottlerin showed antifungal activity against all yeasts evaluated, presenting Minimum Inhibitory and Fungicidal Concentration (MIC and MFC) values of 7.81 to > 1000 µg/mL. Futhermore, it was able to significantly inhibit biofilm production, presenting Biofilm Inhibitory Concentration (MICB50) values that ranged from 15.62 to 250 µg/mL and inhibition of the cell viability of the biofilm by 50% (IC50) from 2.24 to 12.76 µg/mL. There was a considerable reduction in all hydrolytic enzymes evaluated, with emphasis on hemolysin where Rottlerin showed a reduction of up to 20%. In the scanning electron microscopy (SEM) analysis, Rottlerin was able to completely inhibit filamentation by C. albicans. Regarding in vivo tests, Rottlerin did not demonstrate toxicity at the therapeutic concentrations demonstrated here and was able to increase the survival of C. elegans larvae infected. The results herein presented are innovative and pioneering in terms of Rottlerin’s multipotentiality against these fungal infections.

Abstract Current approaches to diagnosing male infertility inadequately assess the complexity of the male gamete. Beyond the paternal haploid genome, spermatozoa also deliver coding and non-coding RNAs to the oocyte. While sperm-borne RNAs have demonstrated potential involvement in embryo development, the underlying mechanisms remain unclear. In this study, 47 sperm samples from normozoospermic males undergoing fertility treatment using donor oocytes were sequenced and analyzed to evaluate associations between sperm RNA elements (exon-sized sequences) and blastocyst progression. A total of 366 RNA elements (REs) were significantly associated with blastocyst rate (padj

Abstract In critically ill patients, overweight and obesity are associated with acute respiratory distress syndrome and acute kidney injury (AKI). However, the effect of obesity on ischemia–reperfusion injury (IRI)-induced AKI is unknown. We hypothesized that obesity would aggravate renal IRI in mice. We fed mice a standard or high-fat diet for eight weeks. The mice were divided into four groups and submitted to sham surgery or IRI: obese, normal, normal + IRI, obese, and obese + IRI. All studies were performed 48 h after the procedures. Serum glucose, cholesterol, and creatinine clearance did not differ among the groups. Survival and urinary osmolality were lower in the obese + IRI group than in the normal + IRI group, whereas urinary neutrophil gelatinase-associated lipocalin levels, tubular injury scores, and caspase 3 expression were higher. Proliferating cell nuclear antigen expression was highest in the obese + IRI group, as were the levels of oxidative stress (urinary levels of thiobarbituric acid-reactive substances and renal heme oxygenase-1 protein expression), whereas renal Klotho protein expression was lowest in that group. Expression of glutathione peroxidase 4 and peroxiredoxin 6, proteins that induce lipid peroxidation, a hallmark of ferroptosis, was lower in the obese + IRI group. Notably, among the mice not induced to AKI, macrophage infiltration was greater in the obese group. In conclusion, greater oxidative stress and ferroptosis might aggravate IRI in obese individuals, and Klotho could be a therapeutic target in those with AKI.

Abstract Geotextiles made from plant fibers creates a suitable environment for plant growth as part of soil bioengineering techniques. The faster decomposition of plant fiber geotextiles compared to synthetic ones demands the use of composites that enhance their waterproofing and extend their durability in the environment. The objective of this work was to evaluate the resistance of a geotextile made with Thypha domingensis to degradation caused by climatic variables. Tensile strength tests were conducted in the laboratory in order to evaluate the degradation of geotextiles treated with single and double layers of waterproofing resin. Based on Scanning Electron Microscopy (SEM) images, it was verified that applying double layer of waterproofing resin delays the fibers degradation up to 120 days of exposure to the effects of climatic variables other than temperature. The maximum resistance losses due to the geotextile's exposure to degradation were statistically significant for all three treatments: control-without waterproofing resin, with one layer resin, and with two layers resin. Therefore, waterproofing resin, provides a long-term protective solution for geotextiles made from cattail fibers.

Abstract Monitoring the intergranular variables of corn grain mass during the transportation, drying, and storage stages it possible to predict and avoid potential grain quality losses. For monitoring the grain mass along the transport, a probe system with temperature, relative humidity, and carbon dioxide sensors was developed to determine the equilibrium moisture content and the respiration of the grain mass. These same variables were monitored during storage. At drying process, the drying air and grain mass temperatures, as well as the relative humidity, were monitored. For the prediction of the physical and physical–chemical quality of the grains, the results obtained from the monitoring were used as input data for the multiple linear regression, artificial neural networks, decision tree, and random forest models. A Pearson correlation was applied to verify the relationship between the monitored and predicted variables. From the results obtained, we verified that the intergranular relative humidity altered the equilibrium moisture content of the grains, contributing to the increased respiration and hence dry matter losses along the transport. At this stage, the artificial neural network model was the most indicated to predict the electrical conductivity, apparent specific mass, and germination. The random forest model satisfactorily estimated the dry matter loss. During drying, the air temperature caused volumetric contraction and thermal damage to the grains, increasing the electric conductivity index. Artificial neural network and random forest models were the most suitable for predicting the quality of dry grains. During storage, the environmental conditions altered the moisture contents causing a reduction in the apparent specific mass, germination, and crude protein, crude fiber, and fat contents. Artificial neural network and random forest were the best predictors of moisture content and germination. However, the random forest model was the best predictor of apparent specific mass, electrical conductivity, and starch content of stored grains.

Abstract Inspiratory muscles pre-activation (IMPA) has been studied to improve subsequent performance in swimming. However, the effects of IMPA on various parameters in swimmers are still unknown. Therefore, this study aimed to investigate the effects of IMPA on the mechanical parameters, physiological responses, and their possible correlations with swimming performance. A total of 14 young swimmers (aged 16 ± 0 years) underwent a 30-s all-out tethered swimming test, preceded or not by IMPA, a load of 40% of the maximal inspiratory pressure (MIP), and with a volume of 2 sets of 15 repetitions. The mechanical (strength, impulse, and fatigue index) and physiological parameters (skin temperature and lactatemia) and the assessment of perceived exertion and dyspnea were monitored in both protocols. The IMPA used did not increase the swimming force, and skin temperature, decrease blood lactate concentration, or subjective perception of exertion and dyspnea after the high-intensity tethered swimming exercises. Positive correlations were found between mean force and blood lactate (without IMPA: r = 0.62, P = 0.02; with IMPA: r = 0.65, P = 0.01). The impulse was positively correlated with blood lactate (without IMPA: r = 0.71, P

Mesenchymal-epithelial plasticity driving cancer progression in cancer-associated fibroblasts (CAFs) is undetermined. This work identifies a subgroup of CAFs in human breast cancer exhibiting mesenchymal-to-epithelial transition (MET) or epithelial-like profile with high miR-200c expression. MiR-200c overexpression in fibroblasts is sufficient to drive breast cancer aggressiveness. Oxidative stress in the tumor microenvironment induces miR-200c by DNA demethylation. Proteomics, RNA-seq and functional analyses reveal that miR-200c is a novel positive regulator of NFκB-HIF signaling via COMMD1 downregulation and stimulates pro-tumorigenic inflammation and glycolysis. Reprogramming fibroblasts toward MET via miR-200c reduces stemness and induces a senescent phenotype. This pro-tumorigenic profile in CAFs fosters carcinoma cell resistance to apoptosis, proliferation and immunosuppression, leading to primary tumor growth, metastases, and resistance to immuno-chemotherapy. Conversely, miR-200c inhibition in fibroblasts restrains tumor growth with abated oxidative stress and an anti-tumorigenic immune environment. This work determines the mechanisms by which MET in CAFs via miR-200c transcriptional enrichment with DNA demethylation triggered by oxidative stress promotes cancer progression. CAFs undergoing MET trans-differentiation and senescence coordinate heterotypic signaling that may be targeted as an anti-cancer strategy.

Abstract This study aimed to analyze the detection and duration of the Zika virus (ZIKV) in plasma, urine, saliva, sweat, rectal swabs, vaginal secretions, breast milk, and semen and to explore risk factors associated with prolonged viral persistence. A prospective cohort study of symptomatic patients and their household contacts was conducted in Brazil from July 2017 to June 2019. A total of 260 individuals (184 women and 76 men) with confirmed ZIKV infection were enrolled and followed up for 12 months. ZIKV RNA was present in all body fluid specimens and detectable for extended periods in urine, sweat, rectal swabs, and semen. The longest detection duration was found in semen, with high viral loads in the specimens. ZIKV RNA clearance was associated with several factors, including age, sex, education level, body mass index, non-purulent conjunctivitis, joint pain, and whether the participant had a history of yellow fever vaccination. The influence of each of these factors on the low or fast viral clearance varied according to the specific body fluid under investigation. Recurrent ZIKV detection events after total viral clearance were observed in the cohort. Our findings provide valuable insights into the persistence and potential recurrence of ZIKV infection, highlighting the need for continued monitoring and follow-up of individuals infected with ZIKV and for effective prevention measures to reduce the risk of transmission.

ABSTRACT Objective To identify dietary patterns and analyze factors associated with the consumption profile of socially vulnerable children, Maceió, state of Alagoas, Brazil, August 2019 to December 2021. Methods This was a cross-sectional study; sociodemographic, anthropometric and food consumption variables were collected, factor analysis was used to identify dietary patterns; associations were analyzed using Poisson regression. Results Among the 567 children studied, two dietary patterns were identified, healthy and unhealthy; age ≥ 24 months (PR = 2.75; 95%CI 1.83;4.14), male gender (PR = 0.66; 95%CI 0.49;0.87) and maternal schooling ≤ 9 years (PR = 0.61; 95%CI 0.46;0.81) was higher in the healthy pattern; the unhealthy pattern was associated with age ≥ 24 months (PR = 1.02; 95%CI 1.01;1.03) and male gender (PR = 1.46; 95%CI 1.08;1.98). Conclusion The healthy pattern was more frequent in children aged ≥ 24 months, less frequent in male children and mothers with low level of schooling; children aged ≥ 24 months and males showed a higher prevalence of the unhealthy pattern.

Abstract: This study aimed to investigate the association between child maltreatment and human capital, measured by intelligence quotient (IQ) at age 18 years and schooling at age 22 years in 3,736 members from a population-based birth cohort in Southern Brazil. A multiple linear regression was used to assess the association between child maltreatment and human capital measurements. Physical and emotional abuse and physical neglect occurring up to 15 years of age were considered child maltreatment. Physical neglect was associated with lower IQ scores in women (β = -4.40; 95%CI: -6.82; -1.99) and men (β = -2.58; 95%CI: -5.17; -0.01) and lower schooling for all sexes: women (β = -1.19; 95%CI: -1.64; -0.74) and men (β = -0.82; 95%CI: -1.34; -0.30). Moreover, men who had experienced one type of child maltreatment and women who had experienced two or more types had lower years of schooling at 22 years (β = -0.41; 95%CI: -0.73; -0.89 and β = -0.57; 95%CI: -0.91; -0.22, respectively) than those who suffered no kind of maltreatment. Efforts to improve future educational and cognitive outcomes must include early prevention and intervention strategies for child maltreatment.

Os eventos científicos desempenham um papel crucial na formação de professores e também na divulgação científica e popularização da ciência, tornando-se parte essencial da rotina de qualquer curso de graduação ou programa de pós-graduação. No estado do Ceará, o Instituto Federal tem se destacado, desde 2017, ao unir diversas instituições em prol da realização de um Evento Científico Unificado, conhecido como Jornada de Física. Essa iniciativa pioneira começou com a participação de sete instituições e, ao longo dos últimos anos, tem atraído mais de uma centena de instituições de ensino representadas por professores, estudantes, funcionários administrativos, intérpretes de Libras e jornalistas. Neste trabalho, buscamos resgatar a memória das edições anteriores do Evento Científico Unificado: Jornada de Física. Esperamos que os relatos aqui descritos possam inspirar ações semelhantes, incentivando outras instituições educacionais a buscar o trabalho coletivo e colaborativo, unindo esforços na divulgação da atividade científica e na valorização da ciência e da docência.

Abstract: This study aimed to analyze the incidence of work-related musculoskeletal disorders (WMSD) in Brazil from 2007 to 2019, examining the spatial, temporal, and spatiotemporal patterns of their occurrence. An ecological time series study was conducted using spatial analysis techniques. WMSD morbidity data from 2007 to 2019 were collected from the Brazilian Information System for Notificable Diseases of the Brazilian Health Informatics Department. Incidence rates were standardized and smoothed using the local empirical Bayes’ theorem. Time trends were analyzed by segmented linear regression. Spatial analysis was performed using Moran’s univariate global (I) and local (LISA) indexes. The spatiotemporal scan statistic was used to identify high-risk spatiotemporal clusters for WMSD. A total of 93,387 cases of WMSD were recorded in Brazil. Temporal trends showed an increase in all regions except the Northeast, which remained stable. The incidence of WMSD showed a spatial dependence, with spatial and space-time clusters identified, especially in the Southeast region, overlapping the largest economic-industrial center of the country. The spatiotemporal clustering observed in one region suggests the highest level of industrial and economic development. Our findings highlight the need to implement intersectoral surveillance policies, inspect working conditions, and invest in the prevention and promotion of workers’ health.

Esta resenha crítica discute o papel relevante da extensão universitária como dimensão fundamental e comprometida com uma educação superior pública, inclusiva e democrática. Realizou-se uma análise reflexiva dos debates construídos no 52º Encontro Nacional do Fórum de Pró-Reitores de Extensão das Instituições Públicas de Educação Superior Brasileiras (FORPROEX) que constituíram a Carta de Goiânia. Os principais temas abordados na carta supracitada foram: mediação tecnológica nas atividades de extensão, relação da extensão com a cultura, relação da extensão na pós-graduação e políticas públicas para a orçamentação da extensão. Através de discussão apoiada em literatura especializada, os temas que formaram o escopo da Carta de Goiânia foram problematizados. Destaca-se a necessidade do fortalecimento e da ampliação do potencial formador da extensão universitária para a construção de uma sociedade mais justa, igualitária e sustentável.

It has been indicated that extreme sport activities result in a highly rewarding experience, despite also providing fear, stress and anxiety. Studies have related this experience to the concept of flow, a positive feeling that individuals undergo when they are completely immersed in an activity. However, little is known about the exact nature of these experiences, and, there are still no empirical results to characterize the brain dynamics during extreme sport practice. This work aimed at investigating changes in psychological responses while recording physiological (heart rate–HR, and breathing rate–BR) and neural (electroencephalographic–EEG) data of eight volunteers, during outdoors slackline walking in a mountainous environment at two different altitude conditions (1 m–low-walk– and 45 m–high-walk–from the ground). Low-walk showed a higher score on flow scale, while high-walk displayed a higher score in the negative affect aspects, which together point to some level of flow restriction during high-walk. The order of task performance was shown to be relevant for the physiological and neural variables. The brain behavior during flow, mainly considering attention networks, displayed the stimulus-driven ventral attention network–VAN, regionally prevailing (mainly at the frontal lobe), over the goal-directed dorsal attention network–DAN. Therefore, we suggest an interpretation of flow experiences as an opened attention to more changing details in the surroundings, i.e., configured as a ‘task-constantly-opened-to-subtle-information experience’, rather than a ‘task-focused experience’.

Objetivo: Verificar a correlação entre o estado inflamatório e nutricional de pacientes com insuficiência cardíaca. Método: Estudo transversal e quantitativo com pacientes portadores de insuficiência cardíaca, adultos e idosos, de ambos os sexos, no período de agosto a dezembro de 2020. Inflamação foi avaliadas pela relação proteína C-reativa/albumina e o estado nutricional pelos seguintes parâmetros: índice de massa corporal, circunferência do braço, dobra cutânea triciptal, circunferência muscular do braço. A correlação foi testada utilizado o coeficiente de Spearman. Resultados: Participaram do estudo 33 pacientes, com idade média de 53,6 ± 18,7 anos. Não houve correlação estatisticamente significante entre o estado inflamatório (proteína C-reativa/albumina) e os parâmetros antropométricos (índice de massa corporal, circunferência do braço, dobra cutânea triciptal e circunferência muscular do braço) (p>0,05), sendo o diagnóstico de desnutrição mais evidente pela dobra cutânea triciptal (54,5%). Conclusão: Não foi observado correlação estatisticamente significante entre o estado inflamatório e nutricional e nem consenso quanto ao diagnóstico nutricional pelos parâmetros utilizados, mas foi mais evidente desnutrição pela perda de gordura corporal através da dobra cutânea triciptal.

ABSTRACT There is increasing interest in ultrasound-guided ablation treatments for thyroid diseases, including benign and malignant ones. Surgeons, radiologists, and endocrinologists carry out these treatments, and various organizations within these specialties have recently released multiple international consensus statements and clinical practice standards. The aim of the present consensus statement is to provide guidance, cohesion, and standardization of best practices for thermal ablation procedures of thyroid nodules. The statement includes the indications for these procedures, preprocedural evaluations, technical aspects of the procedures, posttreatment care, follow-up, complications, and training recommendations. This document was written by a panel of specialists from the Brazilian Society of Interventional Radiology and Endovascular Surgery (SOBRICE), the Brazilian Society of Head and Neck Surgery (SBCCP), and the Brazilian Society of Endocrinology and Metabolism (SBEM). The statement does not aim to provide criteria for assessing the capability of specialists to perform the procedure. Instead, it aims to promote the standardization of best practices to reduce potential adverse outcomes. Additionally, it strives to enhance the delivery of high-quality care and the widespread adoption of these technologies on a national level. The recommendations collectively serve as a guidebook for applying best practices in thyroid ablation.

BACKGROUND AND OBJECTIVES: The mechanisms underlying nociplastic pain, such as fibromyalgia (FM), are not fully understood, however, it is believed that altered sensory processing and pain modulation play prominent roles in the maintenance of nociplastic pain. The hypothesis is that changes in the primary somesthetic cortex (S1) contribute to the generalized pain character of FM. The objective of this study was to evaluate the involvement of the primary somesthetic cortex in humans with fibromyalgia, as well as to investigate possible associations between S1 changes and clinical signs and symptoms of FM. CONTENTS: For this integrative review, the following databases were used: Pubmed and Web of Science, including observational studies carried out in humans with FM. In total, 541 studies were identified and four were included. The majority of studies are case-control studies, published between 2016 and 2022. In total, data from 161 individuals were included in this review. It was identified that there are morphological changes, hyperactivation and increased functional connectivity between S1 and periaqueductal gray matter and between S1 and anterior cingulate cortex. CONCLUSION: Patients with FM present morphological changes and hyperactivation in S1, as well as increased functional connectivity between S1 and periaqueductal gray matter and S1 and limbic system. Furthermore, different bilateral somatotropic subregions (legs, chest, fingers, hands, face and back) showed reduced functional connectivity in patients with FM. These regions are often presented as “tender points” in FM.

Background Desserts with vegetable ingredients are a constantly expanding global market due to the search for alternatives to cow’s milk. Fermentation of these matrices by lactic acid bacteria can add greater functionality to the product, improving its nutritional, sensory, and food safety characteristics, as well as creating bioactive components with beneficial effects on health. Concern for health and well-being has aroused interest in byproducts of the industry that have functional properties for the body, such as mature coconut water, a normally discarded residue that is rich in nutrients. This study aimed to develop a probiotic gelatin based on pulp and water from mature coconuts and evaluate the physicochemical characteristics, viability of the Lacticaseibacillus rhamnosus LR32 strain in the medium, as well as the texture properties of the product. Methods After collection and cleaning, the physicochemical characterization, mineral analysis, analysis of the total phenolic content and antioxidant activity of mature coconut water were carried out, as well as the centesimal composition of its pulp. Afterwards, the gelling was developed with the addition of modified corn starch, gelatin, sucrose, and probiotic culture, being subjected to acidity analysis, texture profile and cell count, on the first day and every 7 days during 21 days of storage, under refrigeration at 5 °C. An analysis of the centesimal composition was also carried out. Results The main minerals in coconut water were potassium (1,932.57 mg L−1), sodium (19.57 mg L−1), magnesium (85.13 mg L−1) calcium (279.93 mg L−1) and phosphorus (11.17 mg L−1), while the pulp had potassium (35.96 g kg−1), sodium (0.97 g kg−1), magnesium (2.18 g kg−1), 37 calcium (1.64 g kg−1), and phosphorus (3.32 g kg−1). The phenolic content of the water and pulp was 5.72 and 9.77 mg gallic acid equivalent (GAE) 100 g−1, respectively, and the antioxidant capacity was 1.67 and 0.98 39 g of 2, 2-diphenyl-1-picrylhydrazyl (DPPH) mg−1, respectively. The coconut pulp had 2.81 g 100 g−1of protein, 1.11 g 100 g−1 of 40 ash, 53% moisture, and 5.81 g 100 g−1 of carbohydrates. The gelatin produced during the storage period presented firmness parameters ranging from 145.82 to 206.81 grams-force (gf), adhesiveness from 692.85 to 1,028.63 gf sec, cohesiveness from 0.604 to 0.473, elasticity from 0.901 to 0.881, gumminess from 86.27 to 97.87 gf, and chewiness from 77.72 to 91.98 gf. Regarding the viability of the probiotic microorganism, the dessert had 7.49 log CFU g−1 that remained viable during the 21-day storage, reaching 8.51 CFU g−1. Acidity ranged from 0.15 to 0.64 g of lactic acid 100 g−1. The centesimal composition of the product showed 4.88 g 100 g−1 of protein, 0.54 g 100 g−1 of ash, 85.21% moisture, and 5.37g 100 g−1 of carbohydrates. The development of the gelatin made it possible to obtain a differentiated product, contributing to diversification in the food sector, providing a viable alternative for maintaining consumer health and reducing costs compared to desserts already available on the market.

Background and objectives: During the SARS-CoV-2 pandemic, reduction in detection of other Respiratory Viruses (RV) was observed. Epidemiological studies are needed to understand the impact of the pandemic on the circulation of RV. The aim of this study is to analyze the epidemiological profile of cases of severe acute respiratory infection (SARI) associated with the main RV in hospitalized patients from RS, between 2010 and 2019 (period A) and between 2020 and 2021 (period B). Methods: Data related to SARI cases in RS were retrieved from SIVEP-Gripe. Results: In period A there were more infections with Influenza, Parainfluenza, Adenovirus and Respiratory Syncytial Virus, while in period B most cases were of SARS-CoV-2 infection. The most affected age groups were individuals 60 years old (50%) in period B. The main symptoms were fever and cough in period A, and dyspnea and O2saturation

SUMMARY Lipodystrophies are characterized by complete or selective loss of adipose tissue and can be acquired or inherited. Familial partial lipodystrophy (FPLD) is a hereditary lipodystrophy commonly caused by mutations in the LMNA gene. Herein, we report two cases of FPLD associated with podocytopathies. Patient 1 was diagnosed with FPLD associated with the heterozygous p.Arg482Trp variant in LMNA and had normal glucose tolerance and hyperinsulinemia. During follow-up, she developed nephrotic-range proteinuria. Renal biopsy was consistent with minimal change disease. Patient 2 was diagnosed with FPLD associated with a de novo heterozygous p.Arg349Trp variant in LMNA. Microalbuminuria progressed to macroalbuminuria within 6 years and to nephrotic range proteinuria in the last year. He remained without diabetes and with hyperinsulinemia. Renal biopsy revealed focal segmental glomerulosclerosis not otherwise specified. This report provides further evidence of variable features of lipodystrophy associated with LMNA variants and the importance of long-term follow-up with evaluation of kidney dysfunction.

ABSTRACT Objective To verify the rate of COVID-19 infection among healthcare personnel at high and low risk of COVID-19 infection and identify the underlying risk factors. Methods This cross-sectional study was conducted between December 1, 2020 and February 28, 2021. Associations were verified between the levels of risk (high or low) of occupational COVID-19 infection and participant characteristics using the World Health Organization risk assessment questionnaire and adjusted using logistic regression models in single and multiple approaches. Results Of the 486 participants, 57.4% were classified as having a high occupational risk for SARS-CoV-2 infection, with a diagnosis rate of 12.1%. The factors identified in the multivariate analysis for high occupational risk were age up to 29 years (odds ratio [OR] = 2.7, 95% confidence interval [95%CI] = 1.63-4.47), monthly family income greater than eight times the basic salary (OR= 1.8, 95%CI= 1.07-3.16), and healthcare personnel who did not participate in initial training to work in the area of patients with COVID-19 infection (OR= 2.39, 95%CI= 1.53-3.75). Conclusion Encouraging training for occupational infection prevention is very important to reduce the impact of infectious diseases on healthcare personnel, especially young health professionals.

Introduction Traumatic brain injury (TBI) is among the main causes of death and neurological sequelae worldwide. Injuries are classified as diffuse (diffuse axonal injury and brain swelling) or focal (cerebral contusion [CCo], epidural hematoma, and acute subdural hematoma). Among all TBIs, CCos are the most frequent focal lesion, and treatment modalities are many. Hematoma evacuation using large craniotomies has been well described in the literature. The main goal of the present study is to discuss the advantages of minimally invasive approaches for the treatment of CCos, regarding operative time, blood loss, and postoperative tomographic results.

Abstract The aim of this study was to verify whether the expression of cell proliferation and apoptosis markers in different types of unicystic ameloblastoma (UA) is associated with the location of neoplastic cells. Immunohistochemical study with a sample of 32 cases of UA, 11 cases of conventional ameloblastoma (CAM) and ten dental follicles (DF) cases was performed. Cell proliferation was assessed using Ki-67 status, and apoptosis by caspase-3 expression. Mural UA (MUA) showed a higher immunostaining of Ki-67 (p

Abstract Background Diabetes is a spectrum of metabolic diseases affecting millions of people worldwide. The loss of pancreatic β-cell mass by either autoimmune destruction or apoptosis, in type 1-diabetes (T1D) and type 2-diabetes (T2D), respectively, represents a pathophysiological process leading to insulin deficiency. Therefore, therapeutic strategies focusing on restoring β-cell mass and β-cell insulin secretory capacity may impact disease management. This study took advantage of powerful integrative bioinformatic tools to scrutinize publicly available diabetes-associated gene expression data to unveil novel potential molecular targets associated with β-cell dysfunction. Methods A comprehensive literature search for human studies on gene expression alterations in the pancreas associated with T1D and T2D was performed. A total of 6 studies were selected for data extraction and for bioinformatic analysis. Pathway enrichment analyses of differentially expressed genes (DEGs) were conducted, together with protein–protein interaction networks and the identification of potential transcription factors (TFs). For noncoding differentially expressed RNAs, microRNAs (miRNAs) and long noncoding RNAs (lncRNAs), which exert regulatory activities associated with diabetes, identifying target genes and pathways regulated by these RNAs is fundamental for establishing a robust regulatory network. Results Comparisons of DEGs among the 6 studies showed 59 genes in common among 4 or more studies. Besides alterations in mRNA, it was possible to identify differentially expressed miRNA and lncRNA. Among the top transcription factors (TFs), HIPK2, KLF5, STAT1 and STAT3 emerged as potential regulators of the altered gene expression. Integrated analysis of protein-coding genes, miRNAs, and lncRNAs pointed out several pathways involved in metabolism, cell signaling, the immune system, cell adhesion, and interactions. Interestingly, the GABAergic synapse pathway emerged as the only common pathway to all datasets. Conclusions This study demonstrated the power of bioinformatics tools in scrutinizing publicly available gene expression data, thereby revealing potential therapeutic targets like the GABAergic synapse pathway, which holds promise in modulating α-cells transdifferentiation into β-cells.

Abstract The timely and accurate diagnosis of candidemia, a severe bloodstream infection caused by Candida spp., remains challenging in clinical practice. Blood culture, the current gold standard technique, suffers from lengthy turnaround times and limited sensitivity. To address these limitations, we propose a novel approach utilizing an Electronic Nose (E-nose) combined with Time Series-based classification techniques to analyze and identify Candida spp. rapidly, using culture species of C. albicans, C.kodamaea ohmeri, C. glabrara, C. haemulonii, C. parapsilosis and C. krusei as control samples. This innovative method not only enhances diagnostic accuracy and reduces decision time for healthcare professionals in selecting appropriate treatments but also offers the potential for expanded usage and cost reduction due to the E-nose’s low production costs. Our proof-of-concept experimental results, carried out with culture samples, demonstrate promising outcomes, with the Inception Time classifier achieving an impressive average accuracy of 97.46% during the test phase. This paper presents a groundbreaking advancement in the field, empowering medical practitioners with an efficient and reliable tool for early and precise identification of candidemia, ultimately leading to improved patient outcomes.

A hipodermóclise é uma técnica antiga, simples e segura para infusão de grandes volumes por via subcutânea, podendo apresentar benefícios importantes em pacientes críticos, em que é comum o acesso venoso difícil ou este pode não ser tolerado ou desejável. Este estudo tem por objetivo realizar uma revisão da literatura acerca do uso de medicamentos por hipodermóclise, permitindo sua prática segura e eficaz. Para isso, evidenciou-se o perfil farmacoterapêutico dos pacientes de uma unidade de terapia intensiva em um hospital universitário do Ceará, com levantamento em banco de dados realizado de março a maio de 2018, sendo selecionados os 20 medicamentos injetáveis mais utilizados. Para a revisão, buscaram-se artigos, manuais e diretrizes até setembro de 2023 nas ferramentas Medical Literature Analysis and Retrieval System Online (Medline), Biblioteca Virtual em Saúde (BVS), Scientific Electronic Library Online (SciELO) e Google Scholar. Foram selecionadas 70 publicações com informações sobre a técnica, em que 45,71% (32/70) se referiam a relato e série de casos. Dos 20 medicamentos selecionados, 3 (15%) são contraindicados para administração por hipodermóclise, 2 (10%) não foram encontrados relatos acerca desta técnica e 2 medicamentos (10%) continham informações insuficientes com relação ao modo de preparo. Muitos dos medicamentos abordados neste estudo têm apresentado, na literatura, eficácia e segurança semelhantes à via endovenosa, e alguns mostraram segurança superior, como o midazolam. Embora a hipodermóclise seja consagrada na literatura, ainda são escassos os estudos na área, principalmente com relação à eficácia e segurança dos medicamentos de uso habitual na prática clínica.

Abstract Although it is well established that platelet-activated receptor (PAF) and protease-activated receptor 2 (PAR2) play a pivotal role in the pathophysiology of lung and airway inflammatory diseases, a role for a PAR2-PAFR cooperation in lung inflammation has not been investigated. Here, we investigated the role of PAR2 in PAF-induced lung inflammation and neutrophil recruitment in lungs of BALB/c mice. Mice were pretreated with the PAR2 antagonist ENMD1068, PAF receptor (PAFR) antagonist WEB2086, or aprotinin prior to intranasal instillation of carbamyl-PAF (C-PAF) or the PAR2 agonist peptide SLIGRL-NH2 (PAR2-AP). Leukocyte infiltration in bronchoalveolar lavage fluid (BALF), C-X-C motif ligand 1 (CXCL)1 and CXCL2 chemokines, myeloperoxidase (MPO), and N-acetyl-glycosaminidase (NAG) levels in BALF, or lung inflammation were evaluated. Intracellular calcium signaling, PAFR/PAR2 physical interaction, and the expression of PAR2 and nuclear factor-kappa B (NF-КB, p65) transcription factor were investigated in RAW 264.7 cells stimulated with C-PAF in the presence or absence of ENMD1068. C-PAF- or PAR2-AP-induced neutrophil recruitment into lungs was inhibited in mice pretreated with ENMD1068 and aprotinin or WEB2086, respectively. PAR2 blockade impaired C-PAF-induced neutrophil rolling and adhesion, lung inflammation, and production of MPO, NAG, CXCL1, and CXCL2 production in lungs of mice. PAFR activation reduced PAR2 expression and physical interaction of PAR2 and PAFR; co-activation is required for PAFR/PAR2 physical interaction. PAR2 blockade impaired C-PAF-induced calcium signal and NF-κB p65 translocation in RAW 264.7 murine macrophages. This study provides the first evidence for a cooperation between PAFR and PAR2 mediating neutrophil recruitment, lung inflammation, and macrophage activation.

Resumo: Este estudo analisa a insegurança alimentar e os fatores a ela associados na área urbana de um município na bacia hidrográfica do Rio Amazonas, Amazônia Ocidental. Trata-se de pesquisa transversal, de base populacional, realizada de agosto a novembro de 2021, com 983 domicílios selecionados por amostragem probabilística estratificada. Empregou-se o modelo de regressão logística multinomial, adotando-se os seguintes critérios: valor de p < 20% na análise bivariada e valor de p < 5% para o ajuste multivariado. Os resultados das análises foram descritos como odds ratios (OR) e intervalo de 95% de confiança (IC95%). Foram significantemente associadas à insegurança alimentar leve ou moderada as seguintes variáveis: insegurança hídrica domiciliar, número de moradores ≥ 5 no domicílio, pertencer à classe socioeconômica D ou E, ter pai, mãe ou outro, como chefe da família e ter algum morador beneficiário do Programa Bolsa Família. No modelo de análise para a insegurança alimentar grave constatou-se que viver em insegurança hídrica domiciliar, pertencer à classe socioeconômica D ou E, ter pai, mãe ou outro chefe da família, e tendo este menos que 55 anos, e renda familiar menor que dois salários mínimos aumentaram as chances de insegurança alimentar grave, comparativamente àqueles em segurança alimentar. Em conclusão, verificou-se alta prevalência de insegurança alimentar no Município de Itapiranga, Amazonas, Região Norte do Brasil, associada à situação de vulnerabilidade social e econômica, à falta de serviços públicos e à insegurança hídrica domiciliar.