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BackgroundThe Thr92Ala-DIO2 polymorphism has been associated with clinical outcomes in hospitalized patients with COVID-19 and neuropsychiatric diseases. This study examines the impact of the Thr92Ala-DIO2 polymorphism on neuropsychological symptoms, particularly depressive symptoms, in patients who have had moderate to severe SARS-CoV-2 infection and were later discharged.MethodsOur prospective cohort study, conducted from June to August 2020, collected data from 273 patients hospitalized with COVID-19. This included thyroid function tests, inflammatory markers, hematologic indices, and genotyping of the Thr92Ala-DIO2 polymorphism. Post-discharge, we followed up with 68 patients over 30 to 45 days, dividing them into depressive (29 patients) and non-depressive (39 patients) groups based on their Beck Depression Inventory scores.ResultsWe categorized 68 patients into three groups based on their genotypes: Thr/Thr (22 patients), Thr/Ala (41 patients), and Ala/Ala (5 patients). Depressive symptoms were less frequent in the Thr/Ala group (29.3%) compared to the Thr/Thr (59.1%) and Ala/Ala (60%) groups (p = 0.048). The Thr/Ala heterozygous genotype correlated with a lower risk of post-COVID-19 depression, as shown by univariate and multivariate logistic regression analyses. These analyses, adjusted for various factors, indicated a 70% to 81% reduction in risk.ConclusionOur findings appear to be the first to show that heterozygosity for Thr92Ala-DIO2 in patients with COVID-19 may protect against post-COVID-19 depression symptoms up to 2 months after the illness.

To understand how certain types of agroecosystem management provide resources for biodiversity and conservation opportunities beyond protected areas, it is necessary to consider the cumulative effects on a local scale. Our study focuses on a rice-Pantanal wetland agricultural system within Brazil, where our goals were: i) to quantify the impact of rice paddies on taxonomic, functional, and phylogenetic diversity metrics of small mammals as biodiversity indicators, ii) to compare diversity indices based on incidence and abundance data. We carried out a thorough assessment to sample small mammal species in both the rice paddy and the adjacent legal reserve by employing a multiple diversity metrics approach. We captured the small mammals until reaching saturation on the species accumulation curve over 12,774 trap nights, resulting in 447 individuals, 10 species, including seven rodents and three marsupial species. Abundance-based beta-diversity between rice-paddy and forest reserve were higher (0.95) than incidence-based estimate (0.33). The species composition differed between the legal reserve (8 spp.) and the rice paddy (7 spp.), with the reserve exhibiting higher taxonomic diversity values compared to the rice paddy. In terms of functional and phylogenetic diversity, overall, the rice paddy exhibited higher values for the incidence-based metrics and the abundance-based metrics indicated that the reserve was more diverse. We conclude that Neotropical Pantanal rice fields retain substantial functional and phylogenetic diversities, providing suitable habitats for species thriving in open and semi-aquatic environments. Simultaneously, the legal reserve retains an essential aspect of functional diversity, when considering abundance, needed to maintain ecosystem resilience and stability. Proper abundance estimation is thus a key parameter for accurately evaluating the role of agricultural landscapes as biodiversity conservation opportunities beyond protected areas. Abundance-based indices should be used to correctly evaluate the contribution of each habitat to agroecosystem sustainability, especially in seasonal or extreme event-prone environments.

Introduction: Pan-TRK immunohistochemistry staining can assess the protein expression from NTRK gene fusions. A little is known about its utility in differentiated thyroid cancer samples from children, adolescents, and young adults patients. Objective: Investigate pan-TRK immunohistochemistry sensitivity and specificity in differentiated thyroid cancer samples from children, adolescents, and young adults patients. Methods: Tumor samples obtained from 79 children, adolescents, and young adults patients (age

The Central Campus of the Federal University of Paraíba, located in João Pessoa, has 12 forest fragments with approximately 84 ha of Atlantic Forest where a population of Bradypus variegatus Schinz, 1825 inhabites and has been exposed to anthropogenic disturbances. The present study aims to identify, describe and analyze anthropogenic disturbances on the population of B. variegatus that inhabits the atlantic forest fragments on the Central Campus of the Federal University of Paraíba, located in João Pessoa, Paraíba, Northeastern Brazil. Observations were carried out from September 2021 to January 2022 using the ad libitum method through daily 4-hour walks around the fragments. Locomotion behavior was recorded in 16% (n=45) of the 269 observations. An average of 24.5 (n=3 to 61) sloth sightings were recorded per fragment. The correlation between disturbances and the number of recorded sightings was positive and significant, which demonstrates the resilience of B. variegatus in an urbanized environment. Situations classified as low risks prevailed, probably due to the social isolation imposed by the period of COVID-19 pandemic. High risks were 17.5% (n=47) for vehicles, 14.9% (n=40) for domestic animals and 1% (n=3) for people. Results showed that the human activities surrounding the forest fragments cause disturbances in the population of B. variegatus and efforts to mitigate the disturbances caused to these animals must be done, such as forest densification, the accumulation of litter in areas between fragments to avoid falls into the impervious surface and forest connection through rope bridge arboreal overpasses in hotspot areas with a higher density of sloths.

Background: Variations in temperature and precipitation can cause an increase in vector-borne and water-borne diseases. Situated in a vulnerable geographic area, Mozambique is particularly susceptible to such climate-related incidents, leading to floods and the spread of diseases. In this study, we investigated the changes in temperature and precipitation patterns and their impact on the occurrence of vector-borne and water-borne diseases in Nampula, Mozambique. Methods: We used both intra-annual and inter-annual analysis techniques to identify monthly and yearly trends. Linear regression and ANOVA models were applied to assess the relationship between temperature, precipitation, and the selected vector and water-borne diseases (malaria, diarrhea, and dysentery). Results: The analysis of temperature and precipitation data from 2000 to 2019 revealed an overall positive trend and delayed onset and earlier end of the rainy season, implying changes in the timing and duration of rainfall. The analysis of temperature data over the last 10 years revealed an increase in mean minimum temperature. These findings suggest a changing climate pattern characterized by consistent warming trends. Statistically significant results were obtained for the mean minimum temperature from 2010 to 2019 and the mean precipitation from 2000 to 2009 in relation to diarrhea and dysentery, respectively (P

Rodrigo Vilares-Morgado,1,2 Vera Correia,3 Ana Margarida Ferreira,1 Flávio Alves,1 António Benevides Melo,1,3 Sérgio Estrela-Silva,1,3 Joana Araújo,1,3 João Tavares-Ferreira,1,3 Marta Silva,1 Amândio Rocha-Sousa,1,2 Angela Carneiro,1,2 João Barbosa-Breda1,2,4 1Department of Ophthalmology, Centro Hospitalar e Universitário de São João, Porto, Portugal; 2UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; 3Faculty of Medicine, University of Porto, Porto, Portugal; 4KULeuven, Research Group Ophthalmology, Department of Neurosciences, Leuven, BelgiumCorrespondence: Rodrigo Vilares-Morgado, Department of Ophthalmology, Centro Hospitalar e Universitário de São João, Alameda Professor Hernâni Monteiro, 4202 – 451, Porto, Portugal, Tel +351 914 471 067, Fax +351 225 512 100, Email vilaresmorgador@gmail.comPurpose: To evaluate whether repeated intravitreal injections (IVI) with an anti-vascular endothelial growth factor (anti-VEGF) agent are associated with glaucomatous progression in eyes with glaucoma spectrum diseases (GSD).Methods: Single-center, retrospective, longitudinal study of patients with bilateral and similar GSD who: (1) received ≥ 8 IVI in only one eye during the study period; (2) had ≥ 2 retinal nerve fiber layer thickness (RNFL) measurements obtained by spectral-domain optical coherence tomography (SD-OCT) at least 12 months apart. The primary outcome was the absolute RNFL thickness change, comparing injected and fellow uninjected eyes. Linear mixed effects models were constructed, including a multivariable model.Results: Sixty-eight eyes from 34 patients were included, 34 injected and 34 fellow uninjected eyes. Average baseline age was 67.68± 21.77 years with a follow-up of 3.66± 1.89 years and 25.12± 14.49 IVI. RNFL thickness decreased significantly from 80.92± 15.78 to 77.20± 17.35 μm (p< 0.001; − 1.18± 1.93 μm/year) in injected eyes and from 79.95± 17.91 to 76.61± 17.97 μm (p< 0.001; − 1.07± 0.98 μm/year) in uninjected eyes. In a multivariable linear mixed model of injected eyes, only higher baseline RNFL thickness (p < 0.001) significantly predicted higher absolute RNFL thickness loss. Neither absolute RNFL thickness variation (p=0.716) nor RNFL rate (p=0.779) was significantly different between paired injected and uninjected eyes. Absolute IOP variation was not significantly different between groups (16.62± 4.77 to 15.09± 4.34 mmHg in injected eyes and 17.68± 5.01 to 14.50± 3.39 mmHg in fellow uninjected eyes; p=0.248). The proportion of eyes receiving glaucoma medical treatment increased significantly in both groups (55.9% to 76.5% in injected eyes; p=0.039; 58.8% to 76.5% in uninjected eyes; p = 0.031). The number of glaucoma medications also increased significantly in both groups (1.03± 1.11 to 1.59± 1.18 glaucoma medications in injected eyes; p=0.003; 1.09± 1.11 to 1.56± 1.19 glaucoma medications in uninjected eyes; p=0.003).Conclusion: Repeated IVI do not seem to accelerate glaucomatous progression. Future studies with a longer follow-up are needed.Keywords: glaucoma, intravitreal injections, progression, optical coherence tomography, retinal nerve fiber layer thickness

Historic centres bring together the numerous values of architectural history, forming a specific context that can be considered an “educational city” in which situated learning can be enhanced. They offer the possibility of providing visitors with tours and points of interest related to heritage. Among the various approaches to the study of historic architecture, one focuses on its forms and dimensions, analyzing proportions and geometric layouts, which can help us to understand the criteria that guided the project phases and construction process. Additionally, the analysis of forms is applicable to observing existing architecture and its graphic representation. With the aim of promoting this type of research, this investigation explores the possibilities of Augmented Reality (AR) as a technology for visualization and graphic interaction that introduces innovative developments in the field of Cultural Heritage, with the common thread of geometric layouts.DOI: https://doi.org/10.20365/disegnarecon.30.2023.23

During the civil war, a large number of anti-aircraft shelters were built in Castellón de la Plana. At present, the outer part of most of them has disappeared due to the abandonment suffered after the end of the war and the inexorable urban growth, so its underground galleries have remained hidden below the city.The objective of our research work has been to recover these constructions from oblivion as well as make easier the conservation and enhancement of this architectural heritage of the city. To achieve this, to collect the existing information about the shelters has been essential, which was obtained mostly from the Municipal Historical Archive of Castellón. This documentation has been digitized and processed to be used for the development of a new editable graphic documentation of each of the shelters which, together with the surveys of those that are still preserved and accessible, is part of the information to be added to the cadastral cartography of the city by the use of Geographic Information Systems. In this way, together with the geolocation of the site of the different shelters, you can consult all the information of each of them, from the original project to its current state, in those which are accessible.Therefore, the results achieved, that are by themselves an unpublished documentation of this part of the heritage of Castellón, are presented in an easy-to-consult format that allows improving access to them for future research, as well as to be used as an useful tool in city planning.DOI: https://doi.org/10.20365/disegnarecon.30.2023.21

Globalisation is driving the internationalisation of higher education, promoting open access to universities, enhancing educational programs with an international focus, and stronger presence in the international higher education market. Thus, globalisation stimulates the internationalisation of universities. For universities to attract international students successfully, it is necessary to understand general issues regarding the decision-making process. The study aims to analyse the benefits of studying abroad at a Hungarian university among international students. To fulfil the aim of this study, a questionnaire was administered to 100 international students, aged 18 to 38. The study results showed that international students had been looking for benefits while studying abroad, such as personal development, cultural experience, career prospects, and the possibility of travelling. Some benefits were also related to social and economic factors such as access to unique courses and knowledge, positive country image, safety situation, and affordable living costs in Hungary. The decision to study at a Hungarian university was made according to such benefits, including a desired program of study, comfortable facilities, flexible schedule, admission criteria, opportunity to improve English language skills, good reputation of the university, European degree, supportive environment, related costs, and future career prospects. At the same time, different age groups of international students considered the importance of benefits differently. Also, different groups of international students based on perceived social family status paid attention to different benefits. The findings of this study can be used for the promotion of Hungarian universities internationally to attract more international students with benefits that they look for when studying abroad.

The purpose of this clinical report was to describe a case of Cohen syndrome with its classical ophthalmological manifestations and novel VPS13B genetic variants. A 39-year-old Caucasian male patient with severe rod-cone retinal dystrophy and no history of parental consanguinity was referred to our ophthalmology department. Ophthalmologic history included high bilateral myopia and a 3-year prior bilateral cataract surgery. Systemic history included facial dysmorphism, intellectual disability, transient neutropenia, microcephaly, truncal obesity, and joint hyperextensibility. The patient presented classic fundoscopic features of pigmentary retinopathy in both eyes (OU). Optical coherence tomography (OCT) revealed bilateral central and diffuse retinal pigment epithelium (RPE) and outer retinal atrophy without concomitant macular edema, while fluorescein angiography (FA) demonstrated diffuse RPE atrophy with prominent choroidal vessels. The full-field ERG (ffERG) showed no dark-adapted or light-adapted responses and the P50 wave was not identified in the pattern ERG (pERG). The genetic study revealed two novel heterozygous variants in the VPS13B gene: (1) c.5138T>C p.(Leu1713Pro) and (2) c.10179del p.(Asn3393Lysfs*37), thus confirming the diagnosis of Cohen syndrome. This case report introduces these two novel genetic variants to the literature, in a patient with classic phenotypic characteristics of Cohen syndrome, a rare genetic disease which has been increasingly reported since its first description in 1973.

For microbiome biology to become a more predictive science, we must identify which descriptive features of microbial communities are reproducible and predictable, which are not, and why. We address this question by experimentally studying parallelism and convergence in microbial community assembly in replicate glucose-limited habitats. Here, we show that the previously observed family-level convergence in these habitats reflects a reproducible metabolic organization, where the ratio of the dominant metabolic groups can be explained from a simple resource-partitioning model. In turn, taxonomic divergence among replicate communities arises from multistability in population dynamics. Multistability can also lead to alternative functional states in closed ecosystems but not in metacommunities. Our findings empirically illustrate how the evolutionary conservation of quantitative metabolic traits, multistability, and the inherent stochasticity of population dynamics, may all conspire to generate the patterns of reproducibility and variability at different levels of organization that are commonplace in microbial community assembly.

Knowledge about how the COVID-19 pandemic can affect aquatic wildlife is still extremely limited, and no effect of SARS-CoV-2 or its structural constituents on invertebrate models has been reported so far. Thus, we investigated the presence of the 2019-new coronavirus in different urban wastewater samples and, later, evaluated the behavioral and biochemical effects of the exposure of Culex quinquefasciatus larvae to two SARS-CoV-2 spike protein peptides (PSPD-2002 and PSPD-2003) synthesized in our laboratory. Initially, our results show the contamination of wastewater by the new coronavirus, via RT-qPCR on the viral N1 gene. On the other hand, our study shows that short-term exposure (48 h) to a low concentration (40 μg/L) of the synthesized peptides induced changes in the locomotor and the olfactory-driven behavior of the C. quinquefascitus larvae, which were associated with increased production of ROS and AChE activity (cholinesterase effect). To our knowledge, this is the first study that reports the indirect effects of the COVID-19 pandemic on the larval phase of a freshwater invertebrate species. The results raise concerns at the ecological level where the observed biological effects may lead to drastic consequences.

Objetiva-se traçar o perfil dos ingressantes nos cursos de Biblioteconomia no Brasil, priorizando-se as seguintes variáveis: região geográfica, raça, sexo, faixa etária, moda-lidade de ensino, interrupção do curso, tipo de instituição de procedência do ensino médio (escola pública ou privada) e de vinculação na graduação. O perfil foi traçado a partir dos Microdados do Censo do Ensino Superior, publicado em 2020 pelo Insti-tuto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira. Foram conside-rados os alunos ingressantes nos cursos de biblioteconomia ofertados por instituições públicas e privadas de ensino superior no período de 2015 a 2019 – último ano cober-to pelo censo. Os principais resultados apontaram que o quadro de ingressantes nos cursos de Biblioteconomia do Brasil é composto em sua maioria por brancos, do sexo feminino, com idade entre 20 e 29 anos. Esses ingressantes concluíram o ensino médio em escolas públicas. Em relação à cor-raça, há variações entre as regiões geográficas. A taxa de interrupção do curso é maior entre discentes das cores-raças brancas e in-dígenas e na modalidade EaD. As mulheres ingressantes no EaD apresentam maior percentual de interrupção do curso. Na modalidade presencial, os homens são mais propensos a interromperem seus estudos. As instituições públicas de ensino superior congregam boa parte desses ingressantes, com preponderância do ensino na modali-dade presencial.

Abstract Purpose Inconsistencies in the medical management of hypothyroidism have been reported between endocrinologists in different countries. This study aimed to identify the attitudes of Latin America thyroid specialists towards the use of thyroid hormones. Methods Online survey of members of the Latin America Thyroid Society. Results 81/446 (18.2%) completed the questionnaire. Levothyroxine (LT4) was the initial treatment of choice for all respondents. 56.8% would consider LT4 use in biochemically euthyroid patients: infertile women with elevated anti-thyroid antibodies (46.9%), resistant depression (17.3%) and growing goiter (12%). Most respondents preferred tablets (39.5%) over liquid formulations (21.0%) or soft gel capsules (22.2%) and would not consider switching formulations in patients with persistent symptoms. 39.5% would never use LT4 + liothyronine (LT3) combination therapy in symptomatic euthyroid patients, due to low quality evidence for benefit. 60.5% reported that persistence of symptoms despite normal TSH is rare (below 5% of patients) and its prevalence has been stable over the last five years. Psychosocial factors (84.0%), comorbidities (86.4%) and the patient unrealistic expectation (72.8%) were considered the top three explanations for this phenomenon. Conclusion LT4 tablets is the treatment of choice for hypothyroidism. A significant proportion of respondents would use LT4 in some groups of euthyroid individuals, contrasting the recommendations of the major clinical practice guideline indications. LT4 + LT3 combination treatment in euthyroid symptomatic patients was considered by nearly 50%. Practices based on weak or absent evidence included use of thyroid hormones for euthyroid subjects by 56.8% of respondents and use of LT4 + LT3 treatment by 60.5% of respondents for patients with persistent symptoms. In contrast to many European countries, LATS respondents report a low and unchanged proportion of dissatisfied patients over the last five years.

Abstract Background Mental disorders represent a major public health challenge worldwide, affecting 80% of people living in low- and middle-income countries. Depression, a mental disorder, is a chronic disease of long duration that causes changes in the brain, resulting from a combination of genetic, physiologic, environmental, and behavioral factors. The aim of this study was to investigate possible factors associated with depression in Brazilian adults. Methods A population-based, cross-sectional study was carried out using the public domain database of the 2019 National Health Survey, conducted in Brazil. Depression was considered the dependent variable, and through hierarchical analysis, predictor variables were investigated such as, at the distal level—socioeconomic variables, at the intermediate level—variables related to lifestyle behavior, health condition, and history, and at the proximal level—demographic variables. Logistic regression analysis was used to obtain the adjusted Odds Ratio and the respective 95% confidence interval to identify possible factors associated with depression. Results The study included 88,531 participant records with 10.27% diagnosed with depression. The adjusted association measurements, after selecting the independent variables in the hierarchical analysis, showed the following factors associated with depression with differing magnitudes: age, brown and white race/skin color, female sex, poor, very poor, or regular self-reported health condition, diagnosis of cardiovascular disease, work-related musculoskeletal disorder, history of smoking habit, and macroeconomic region. Conclusions An effective strategy for preventing and managing depression in Brazilian adults must include the control of health status and lifestyle behavior factors, with actions and programs to reduce people's exposure to these factors, understanding that socioeconomic-demographic differences of each population can potentially reduce the disease burden.

The New World porcupines of the genus Coendou comprise 16 species of arboreal nocturnal rodents. Some of these species are poorly known and have not been included in phylogenetic analyses. Based on recently collected specimens with associated tissue from the Brazilian Amazonia, we investigate the distribution and phylogenetic relationships of Roosmalens’ dwarf porcupine, Coendou roosmalenorum, using an integrative approach using mitochondrial gene sequences and morphological data from new specimens and localities. Our results recovered C. roosmalenorum in the subgenus Caaporamys. However, analyses of our molecular and combined datasets produced different topologies. The new record shows the presence of C. roosmalenorum 480 km to the southeast of the Rio Madeira and 95 km away from Rio Juruena in Mato Grosso state, indicating a wider distribution in southern Amazonia than suspected. All known records of C. roosmalenorum are in the Madeira biogeographical province, to which it might be endemic.

Abstract Background The increased survival provided by the access, development, and evolution of antiretroviral drugs (ARV) greatly increased the life expectancy of people living with HIV (PWH). This has also led to an increased occurrence of diseases or morbidities related to aging. In individuals with multiple comorbidities, the simultaneous use of multiple medications, also known as polypharmacy, is common, and rational use of medications is essential. This study aims to describe the pharmacotherapeutic profile, estimate the prevalence of polypharmacy and identify factors associated with polypharmacy in a cohort of adult PWH from a referral unit in Rio de Janeiro, Brazil. Methods Cross-sectional study including PWH on ARV who received at least one medical prescription (outpatient/hospitalized) in 2019. We described the proportion of prescribed medications according to ARV and Anatomical Therapeutic Chemical (ATC) classes stratified by age (

In the last two decades, the Brazilian music scenario has been marked by an increasingly academic-oriented interest in studying and applying musical knowledge stemming from African-heritage. Institutions and researchers from Salvador city hold an important role in the development and dissemination of this type of knowledge. Accordingly, this article’s general aim is to discuss possible implications of the application of African-based musical knowledge in the study of non-African-based instruments, focusing on the Soteropolitan context. This paper has four specific aims to support the general purpose: 1) To present the Salvador city and the main historical and social elements related to musical contexts; 2) To present some publications which employed African-based musical knowledge for the development of musical competences related to non-African-based musical instruments; 3) To analyze these materials from a music education perspective; and 4) To integrate the examinations with broader social discussions. Pursuing these aims, the current study applies a qualitative document analysis as its methodological approach to acquire the data, examine the materials and develop the knowledge which will support the proposed reflections. Despite the municipal orientation, it is expected that the promotion of a deep understanding of a local phenomenon can influence broader sectors of music education.

In the farming, increasing demands for higher yields has put pressure on land resources which eventually increased demand for phosphate fertilizers (non-renewable resource), given that low availability of phosphorus in many soils is often compensated by the application high doses phosphate fertilizers. Complementary, studies have been made with a view to select phosphate-solubilizing bacteria. The purpose of his study was to: (i) isolate and characterization potential phosphate-solubilizing bacteria from sludge from the wastewater treatment plant of a poultry slaughterhouse; (ii) evaluate the ability of bacteria to solubilize phosphate rock and promoting plant growth. The bacteria were isolated in culture medium containing calcium phosphate. Morphological characterization consisted in cell shape, Gram staining and the characteristics of the colonies. To assess natural phosphate (NPh) solubilization, maize seeds were inoculated together with Araxá phosphate. The experiment consisted of 10 treatments: eight bacterial isolates + NPh, NPh and a control. The experiment was carried out in a greenhouse for 45 days, in a randomized block design, with six replications. The variables measured were the growth characteristics of the maize. Eight strains were isolated, all stained gram-positive, and 90% were rod-shaped and 10% coccoid-shaped. Inoculation with isolate LSOF-7 (Sphinghomonas sp.) combined with NPh induced increased maize dry matter by 20% compared to the treatment containing only NPh and by 67% compared to the control. It was concluded that sludge from wastewater treatment plants of poultry slaughterhouses contains bacterial strains with potential to phosphate-solubilizing and them also probably present promoting plant growth and promote maize plant growth.

The diversity of criteria used in the diagnosis of periodontitis in pregnant women makes it difficult to define and compare the disease. Using a systematic review, this study evaluated the accuracy of criteria for diagnosing periodontitis in pregnant women. Searches were carried out in the databases: Medline/PubMed, Embase, Scopus, Web of Science, SciELO, Lilacs, ProQuest, and CINAHL. Validation studies of the criteria used for diagnosing periodontitis met the inclusion criteria. The study steps were performed by three independent reviewers. A qualitative synthesis of the included articles was carried out and the quality methodological analysis using the QUADAS-2 instrument. The assessment of the quality of the evidence was obtained through the GRADE tool. A total of 592 records were identified, of which only 6 made up this systematic review. The included studies analyzed different criteria for diagnosing periodontitis, evaluating 3,005 pregnant women. The criteria selected as a test presented results equivalent to the performance of those recognized as the gold standard. The self-reported criteria were of lower diagnostic accuracy. A major limitation of this review was the small number of primary studies that evaluated clinical diagnosis of periodontitis in pregnant women, which was highly heterogeneous, making it impossible to carry out accuracy meta-analysis and additional analyzes. There is a lack of consensus on the criteria for the diagnosis of periodontitis, with great variability in the accuracy and prevalence of the disease in pregnant women.

Introduction: Antiretroviral therapy increased the survival and life expectancy of People living With HIV (PWH). Frailty-related syndromes among older PWH (aged 50+ years) may affect their Health-related Quality of Life (HQoL). Additionally, the COVID-19 pandemic has impacted health-related outcomes. This study aimed to estimate the prevalence of frailty and pre-frailty among older PWH, and to explore associations of HQoL with the study assessment period and frailty status. Methods: Cross-sectional study conducted pre- (23-Mar-2019 to 5-Mar-2020) and post-COVID-19 pandemic onset (23-Jun-2021 to 5-May-2022), among older PWH at INI-Fiocruz, the largest cohort of PWH in Rio de Janeiro, Brazil. We measured frailty using Fried assessment, consisting of five domains: unintentional weight loss; self-reported exhaustion, weakness, slow walking speed, low physical activity. HQoL was assessed using the ACTG SF-21, which contains 21 questions divided into 8 domains. We used Chi-Square test, Fisher's exact test, Kruskal-Wallis and ranksum test for comparisons. Results: We included 250 older PWH: 109 (43.6 %) pre- and 141 (56.4 %) post-COVID-19 pandemic onset. Median age was 60-years (IQR: 55‒64). Most self-identified as cisgender men 152 (60.8 %), Pardo/Black 146 (58.4 %), with completed secondary education or less 181 (72.7 %) and low income 132 (52.8 %). Overall, prevalence of frailty and pre-frailty were 9.2 % (95 % CI: 8.1‒10.3) and 61.6 % (95 % CI: 54.0‒69.2). Prevalence of frailty in the pre- and pos-COVID-19 pandemic periods were 7.3 % and 10.6 % (p = 0.66). HQoL scores were lower among participants with frailty compared to those with non-frailty and pre-frailty in all eight domains, and among those included in the post-COVID-19 compared to pre-COVID-19 period for four domains. Conclusions: We observed low prevalence of frailty, but high prevalence of pre-frailty among older PWH. Frailty status did not differ according to the COVID-19 assessment period. Assessment of frailty and HQoL should be incorporated in clinical practice for older PWH. Programs to reverse or prevent frailty should be implemented within the public health system.

Craniosynostosis (CS) or the premature fusion of one or more cranial sutures in utero, or during the first years of life, can present in isolation or as a multisystem clinical disorder with a particular impact on visual function. Among ophthalmic complications, optic neuropathy is a significant cause of irreversible vision loss in these patients. Children with CS are at higher risk of developing elevated intracranial pressure which can lead to papilledema and, ultimately, optic atrophy. In addition, sometimes associated obstructive sleep apnea, abnormalities in central nervous system venous development, and Chiari malformation may contribute to optic neuropathy. Ophthalmologists have an important role in managing a number of coexistent ophthalmologic complications such as strabismus, anisometropia, amblyopia, ptosis, and exposure keratopathy in addition to maintaining surveillance for early signs of optic neuropathy; they play a critical consultative role contributing to the decision for primary or repeat decompressive surgery. In this article, we aim to review the etiology, diagnostic approach, and management of optic neuropathies in patients with craniosynostosis.

In cycling, drag is the force that opposes the cyclist's motion and is caused by the cyclist's and their equipment's interaction with the air. The surface area of the cyclist and their equipment, such as the bike, helmet and body postures, have a substantial impact on how much drag they encounter. This study compared the energy cost an able-bodied and shoulder amputee cyclist through numerical simulations using computer fluid dynamics. According to the hypothesis, an able-bodied cyclist may use more energy at a given speed than an able-bodied cyclist. For this study, a professional male cyclist who weighs 65 kg and is 1.72 m tall took part. The estimated energy cost was lower in an shoulder amputee in comparison to the able-bodied cyclist. Significant statistical differences and relationships were found between the cyclists for the 11 selected speeds. Altogether, this study allows to conclude that, for the same conditions, an able-bodied cyclist deliver less energy cost in comparison to a shoulder amputee.

Directed evolution has been used for decades to engineer biological systems at or below the organismal level. Above the organismal level, a small number of studies have attempted to artificially select microbial ecosystems, with uneven and generally modest success. Our theoretical understanding of artificial ecosystem selection is limited, particularly for large assemblages of asexual organisms, and we know little about designing efficient methods to direct their evolution. Here, we have developed a flexible modelling framework that allows us to systematically probe any arbitrary selection strategy on any arbitrary set of communities and selected functions. By artificially selecting hundreds of in silico microbial metacommunities under identical conditions, we first show that the main breeding methods used to date, which do not necessarily let communities reach their ecological equilibrium, are outperformed by a simple screen of sufficiently mature communities. We then identify a range of alternative directed evolution strategies that, particularly when applied in combination, are well suited for the top-down engineering of large, diverse and stable microbial consortia. Our results emphasize that directed evolution allows an ecological structure-function landscape to be navigated in search of dynamically stable and ecologically resilient communities with desired quantitative attributes.

Directed evolution is a form of artificial selection that has been used for decades to find biomolecules and organisms with new or enhanced functional traits. Directed evolution can be conceptualized as a guided exploration of the genotype-phenotype map, where genetic variants with desirable phenotypes are first selected and then mutagenized to search the genotype space for an even better mutant. In recent years, the idea of applying artificial selection to microbial communities has gained momentum. In this article, we review the main limitations of artificial selection when applied to large and diverse collectives of asexually dividing microbes and discuss how the tools of directed evolution may be deployed to engineer communities from the top down. We conceptualize directed evolution of microbial communities as a guided exploration of an ecological structure-function landscape and propose practical guidelines for navigating these ecological landscapes.

Cranioplasty for the treatment of cranial bone defects has as its main objective the three-dimensional and functional reconstruction of the skull. Computer-assisted surgeries (CAS) have been used since the 1990s efficiently and bring improvements and optimization in reconstructive craniofacial surgical approaches, especially in large bone defects. This clinical case report addresses virtual planning and CAD/CAM technology in secondary craniofacial reconstruction using polymethylmethacrylate (PMMA). A 48-year-old male patient had two bone defects in the frontal region with skin dehiscence into the frontal sinus. A computed tomography was performed with 1mm slices and converted into a 3D model of the frontal bone and in the mold of the bone defect in real size. To address the bone defects, a neurosurgeon was involved in the treatment of dura mater, cranialization of the frontal sinus, and obliteration of the nasofrontal duct, and was completed by the oral and maxillofacial surgery team. After the surgery, a tomographic exam was performed, and a perfect adaptation between the prosthesis and the bone contours and a great anatomical contour of the frontal bone were observed, making it satisfactory to the initial surgical planning. The use of virtual planning and the CAD/CAM system resulted in greater predictability and greater safety for the craniofacial reconstruction procedure, as well as a reduction in the perioperative time. The material used, PMMA, presented itself as a material of easy manipulation, low cost, and with perfect adaptation to bone contours.

La arquitectura valenciana vivió un momento de esplendor durante los siglos XIV, XV y XVI en un tiempo de desarrollo económico, en correspondencia con la expansión por el Mediterráneo de la Corona de Aragón. Personajes nobles construyen casas señoriales y palacios que destacan por su riqueza arquitectónica, y acabados decorativos. Entre ellos cabe señalar los dibujos geométricos de la carpintería de sus puertas y ventanas, que resultan característicos de este tipo de edificio en la época y entorno geográfico mencionado. En algunos casos pueden suponerse originales, pero dadas sus características, es un elemento que ha podido sufrir renovaciones y sustituciones, en algunos casos datadas en el siglo XX. Se presenta una aportación a su conocimiento, aplicando una metodología de análisis de los trazados decorativos, que puede ser complementaria a estudios de tipo histórico, dentro de un enfoque multidisciplinar. A partir de un número representativo de casos se analiza la generación de formas en base a las teselaciones regulares y semirregulares, descubriéndose un variado repertorio. Ello permite establecer una clasificación y descripción de los distintos tipos, que se definen gráficamente y se ilustran con ejemplos de aplicación concreta y de adaptación a las formas de las portadas y ventanales.

Recent advances in robotics and affordable genomic sequencing technologies have made it possible to establish and quantitatively track the assembly of enrichment communities in high-throughput. By conducting community assembly experiments in up to thousands of synthetic habitats, where the extrinsic sources of variation among replicates can be controlled, we can now study the reproducibility and predictability of microbial community assembly at different levels of organization, and its relationship with nutrient composition and other ecological drivers. Through a dialog with mathematical models, high-throughput enrichment communities are bringing us closer to the goal of developing a quantitative predictive theory of microbial community assembly. In this short review, we present an overview of recent research on this growing field, highlighting the connection between theory and experiments and suggesting directions for future work.

(1) Background/Objectives: Accurate determination of chronological age is crucial in legal dental identification. This study aimed to compare the effectiveness of different formulas in estimating the age of a Brazilian subpopulation by analyzing the pulp/tooth ratio of the maxillary canine and mandibular second premolar in panoramic and periapical radiographs. (2) Methods: The sample consisted of panoramic and periapical radiographs of 247 individuals. The file of each radiograph was opened in the Adobe Photoshop CS4® program to outline and obtain values in pixels for calculating the pulp/tooth ratio. Statistical analysis was conducted using the SPSS program, with a significance level set at 5%. (3) Results: The interclass correlation coefficient demonstrated excellent intra-observer agreement (0.990–0.999). The determination coefficients (R2) suggested that only 30–35% of the actual age results could be explained by the pulp/tooth ratio. The smallest differences were observed with Cameriere’s formula for the mandibular second premolar on panoramic radiographs (+4.1 years). The greatest differences were found with the formulas for the mandibular second premolar in panoramic radiographs of the Korean (+12.5 years) and Portuguese (−12.1 years) populations. (4) Conclusions: The equations employed showed little agreement between the actual age and the estimated age.

(1) Background: This study assessed the spatial position and anatomical features associated with impacted third molars through a map-reading strategy employing cone-beam computed tomography (CBCT). (2) Methods: The positioning of impacted third molars on CBCT was assessed using Winter’s and Pell and Gregory’s classifications. External root resorption in mandibular second molars was categorized according to Herman’s classification. Additionally, the relationship between the mandibular third molar root apex and the mandibular canal was examined. Comparative statistical analysis was conducted using Fisher’s exact test, with a significance level considered as 5%. (3) Results: The results indicated that, based on Winter’s classification, 48.06 % of impacted teeth were positioned mesioangularly. Employing Pell and Gregory’s classification, 43.22% of the impacted molars fell into positions B and C, with 54.2% classified as Class II. A notable 69.7% of teeth exhibited no contact between the root apex and the mandibular canal, and external root resorption in the distal aspect of the second molar was absent in 88.7% of cases. (4) Conclusions: Utilizing the map-reading strategy with CBCT scans to assess the anatomical positions and characteristics of impacted third molars enhances professional confidence and sets a standard for quality and safety in the surgical procedure for patients.

Considering the high frequency of malignant breast tumors, there is a growing search for new therapeutic strategies that control neoplastic growth and dissemination, combined with fewer adverse reactions. Therefore, this study evaluated the effects of ozone therapy in female dogs with mammary cancer undergoing chemotherapy treatment. Twenty-five canines diagnosed with malignant mammary neoplasia were divided into two groups: one treated with carboplatin alone (n = 11) and the other with carboplatin associated with ozone therapy (n = 14). Clinical and laboratory evaluations, mastectomy, analysis of the oxidative profile based on total antioxidant capacity (TAC) and serum concentrations of malondialdehyde (MDA), survival rate, and quality of life were performed. Animals in the ozone therapy group had higher concentrations of red blood cells and platelets, significantly improving the survival rate and quality of life. Furthermore, adverse reactions were less intense and frequent in this group, which was associated with an increase in TAC and a reduction in MDA. These results indicate that the combination of carboplatin and ozone therapy represents a promising complementary treatment for female dogs with mammary cancer, as it was associated with fewer adverse reactions and a better oxidative profile.

Water scarcity will increase in the world in the coming decades due to climate change, especially in areas that currently already have water scarcity, such as the Mediterranean area. In these areas, to guarantee water resources, systems’ sustainability is necessary to improve demand management and the development of non-conventional resources, such as treated wastewater reuse or seawater desalination. These non-conventional resources are highly energy-consuming; so, reducing energy costs is a key element in developing their use in different sectors, including agriculture. Combining photovoltaic solar energy with seawater desalination by reverse osmosis will reduce the cost of producing water to below 0.36 EUR/m3; so, this resource can be attractive for agriculture, as demonstrated in this work. The arrangement of bifacial solar modules in horizontal single-axis tracking systems increases the energy amount generated from the sun in one hour or more, improving the facility’s efficiency and reducing the desalinated water cost. The greater distance between the solar module lines, with a ground coverage ratio (GCR) = 0.3, makes for a better environmental integration of the facility and allows the development of agrovoltaic strategies, such as native flora planting and pollinator colonization.

Fresh food is difficult to preserve, especially because its characteristics can change, and its nutritional value may decrease. Therefore, from the consumer’s point of view, it would be very useful if, when buying fresh fruit or vegetables, they could know where it has been cultivated, when it was harvested and everything that has happened from its harvest until it reached the supermarket shelf. In other words, the consumer would like to have information about the traceability of the fruit or vegetables they intend to buy. This article presents a blockchain-based platform that allows institutions, consumers and business partners to track, back and forward, quality and sustainability information about all types of fresh fruits and vegetables.

Objetivou-se descrever ações das Vigilâncias Epidemiológica e Ambiental da Prefeitura do Recife, mediante caso de raiva humana. A metodologia empregada foi a descrição das intervenções baseadas em roteiro do Ministério da Saúde. Em 26/06/2017, foi notificado caso suspeito de raiva em mulher de 35 anos, ativista da causa animal, agredida por gato de rua, não vacinado em 26/04/2017. A pesquisa em saliva e folículo piloso confirmou a infecção pelo vírus rábico em 30/06/2017 e a paciente evoluiu para óbito. Foi identificada a variante antigênica AgV3, espécie-específica para morcegos hematófagos (Desmodus rotundus). Quatro pessoas contactantes foram identificadas e encaminhadas para avaliação médica. Três delas necessitaram da profilaxia antirrábica. A Vigilância Ambiental visitou 81% dos imóveis na área focal, vacinou 1.182 animais cães/gatos. Outros postos fixos de vacinação foram abertos e 3.283 cães/gatos foram vacinados. Ações de mobilização comunitária e educação em saúde foram iniciadas com o curso de sensibilização para ativistas da causa animal e as capacitações sobre a raiva urbana e silvestre para os Agentes de Saúde Ambiental e Controle às Endemias (ASACE). Uma equipe especial foi formada para captura, identificação de espécies, manejo ambiental e envio de amostras de morcegos para exame. No município do Recife-PE foram diagnosticados morcegos positivos para o vírus da raiva, mas não foram notificados outros casos de raiva em cães, gatos ou humanos. Conclui-se que a raiva silvestre em ambiente urbano necessita das articulações de setores e saberes no contexto de Saúde Única, bem como, a implementação de políticas públicas para garantir um ambiente saudável.

The way each person dresses has been considered a cultural manifestation and a portrait of societies, where each one expresses their habits, customs and values. The improvement in living standards, especially in developed countries, accompanied by the emergence of Fast fashion, has led to an exaggerated increase in the consumption of clothing products. This increase has a growing impact on the environment, not only in soil erosion and water consumption, due to the production of fibers such as cotton, linen, and others, but also due to the use of chemical products in the manufacturing processes of these products. The increase in consumption and the reduction in the useful lifetime of garments has led to a large increase in textile waste, which often ends up in undifferentiated garbage. One of the ways to mitigate the problem is to embark on the circular economy. This requires the involvement of all actors in the value chain, including especially the end-consumer, as this is the main responsible for closing the cycle of the economy, by sending end-of-life textile products for recycling. In this article, a systematic review on digital solutions for involving the end-consumer in the circular economy of the Textile and Clothing value chain is made, not only in closing the cycle, sending end-of-life textile products for recycling, but also in extending the useful lifetime of their garments, and in the implementation of good practices in use, maintenance and disposal of their garments.

O adenocarcinoma renal é uma neoplasia maligna que afeta as células do epitélio tubular e é relativamente raro em gatos, geralmente ocorrendo nas regiões dos rins e da bexiga. Os sintomas clínicos frequentemente são inespecíficos, o que torna o diagnóstico desafiador. A ultrassonografia e a laparotomia exploratória são ferramentas diagnósticas essenciais, mas somente o exame histopatológico confirma a presença da doença. O tratamento indicado para neoplasias renais geralmente envolve cirurgia e/ou quimioterapia, visando a melhoria da qualidade de vida e da sobrevida do paciente. Este relato de caso descreve um gato de 12 anos que apresentava vômitos incontroláveis. A ultrassonografia abdominal revelou uma neoformação no rim direito, levando à realização de uma laparotomia exploratória e uma biópsia transcirúrgica subsequente. A análise histopatológica confirmou o diagnóstico de adenocarcinoma renal, levando à realização de uma nefrectomia como tratamento. A ausência de metástases em tecidos circundantes não indicou a necessidade de quimioterapia naquele momento. Esse relato destaca a importância da utilização de exames de imagem e biópsia transcirúrgica no diagnóstico e tratamento de neoplasias renais assintomáticas.

Introdução: O CDT tem bom prognóstico, com sobrevida em longo prazo superior a 90%. Entretanto, quando o CDT é refratário à radioiodoterapia (CDT RAIR) a taxa de sobrevida, em dez anos, é 10%. A despeito da constante evolução nas opções terapêuticas, na perspectiva da Saúde Suplementar, o tratamento disponível baseia-se na quimioterapia citotóxica, que apresenta baixa eficácia e importante toxicidade aos pacientes com CDT RAIR. Objetivos: Avaliar a eficácia, segurança, custo- utilidade e impacto orçamentário do mesilato de Lenvatinibe na perspectiva da Saúde Suplementar no tratamento de pacientes com CDT RAIR. Material e Método: A eficácia e segurança do mesilato de Lenvatinibe foi avaliada a partir de uma revisão sistemática conduzida até setembro de 2022 nas bases de dados The Cochrane Library, MEDLINE via Pubmed, LILACS, CRD e EMBASE. Para análise de custo-utilidade, foi utilizado modelo de sobrevida particionado de três estados de saúde com um horizonte de tempo lifetime. O comparador selecionado foi o padrão de tratamento com doxorrubicina. Foram considerados somente custos médicos diretos, sendo anos de vida ajustados pela qualidade (AVAQ), o desfecho clínico utilizado. Na análise de impacto orçamentário,a população elegível foi determinada a partir do método epidemiológico, considerando um cenário de incorporação gradual do mesilato de Lenvatinibe no mercado ao longo de cinco anos. Resultados: A revisão sistemática incluiu dois ensaios clínicos randomizados (ECRs) de fase III e dez outros estudos adicionais. O estudo SELECT, responsável pela aprovação do Lenvatinibe para CDT RAIR no FDA e ANVISA, proporcionou significativa redução no risco progressão ou morte na população global do estudo (redução de 79%; hazard ratio: 0,21 [intervalo de confiança 95%: 0,14 a 0,31]) quando comparado ao placebo, proporcionando um aumento significativo na sobrevida livre de progressão (18,3 meses vs. 3,6 meses do grupo placebo). Lenvatinibe foi considerado seguro, visto que os eventos adversos relatados nos ECRs foram toleráveis. A avaliação econômica sugere que a incorporação de Lenvatinibe na Saúde Suplementar resultaria em um incremento de custo por paciente acompanhada de benefícios clínicos significativos como incremento de 2,40 AVAQs, resultando em razão de custo- utilidade incremental de aproximadamente R$ 215 mil por AVAQ ganho. Estimou-se impacto orçamentário incremental de aproximadamente R$ 3,3 milhões no primeiro ano após a incorporação, com um total acumulado de aproximadamente R$78 milhões em cinco anos. Após a apresentação dos dados à ANS, a agência conduziu análise e reunião técnica para avaliação destes dados seguida por consulta pública com recomendação inicial favorável à incorporação e confirmada por 98,7% dos participantes da consulta pública, os quais foram favoráveis à incorporação. Discussão e Conclusões: Os dados apresentados são robustos e favoráveis a disponibilização desta tecnologia em saúde (mesilato de Lenvatinibe) para os beneficiários da ANS.

Abstract The relationship between chromosomal and morphological variation in mammals is poorly understood. We analyzed the cranial size and shape variation in Ctenomys lami concerning to the geographic variation in their chromosome numbers. This subterranean rodent occurs in a narrow range of sand-dunes in the Coastal Plain of southern Brazil. This species presents a high karyotypic variation with diploid numbers varying from 2n = 54 to 2n = 58, involving the fission and fusion of chromosome pairs 1 and 2. Due to different chromosome rearrangement frequencies along their geographic distribution, four karyotypic blocks were proposed. This study, explored cranium shape and size variation in geographical, chromosomal polymorphism, and chromosome rearrangements contexts to test whether the four karyotypic blocks reflect morphologically distinct units. For this, we measured 89 craniums using geometric morphometrics and used uni and multivariate statistics to discriminate the predicted groups and test for an association among chromosomal and morphological variation. Our results show the size and shape of sexual dimorphism, with males larger than females, and support the existence of four karyotypic blocks for Ctenomys lami based on morphological variation. However, our results do not support a direct relationship between chromosomal and cranial morphological variation in C. lami.