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Background: In 2009, Portugal ratified the UN CRPD and a turn to a rights-based approach in disability law and policy has intensified since. It thus becomes important to understand whether these legal changes are furthering the social inclusion of adults with intellectual and complex disabilities. Method: Questionnaires were applied to a stratified sample of 127 adults with intellectual and complex disabilities attending social care and vocational training programmes across the country. Results: Participants reported low rates of social participation, and many (49%) were found to live below the poverty line. High rates of discrimination and violence and feelings of loneliness and sadness were also reported, which can be strong indicators of the oppression that many of them daily endure. Conclusion: Adults with intellectual and complex disabilities in Portugal face exclusion, discrimination, and violence. The poverty and isolation in which many of them live compounds their (de)citizenship status in Portuguese society.

Abstract Background The 22q11.2 deletion syndrome (22q11.2DS) is a microdeletion syndrome with highly variable phenotypic manifestations, even though most patients present the typical 3 Mb microdeletion, usually affecting the same ~ 106 genes. One of the genes affected by this deletion is DGCR8, which plays a crucial role in miRNA biogenesis. Therefore, the haploinsufficiency of DGCR8 due to this microdeletion can alter the modulation of the expression of several miRNAs involved in a range of biological processes. Results In this study, we used next-generation sequencing to evaluate the miRNAs profiles in the peripheral blood of 12 individuals with typical 22q11DS compared to 12 healthy matched controls. We used the DESeq2 package for differential gene expression analysis and the DIANA-miTED dataset to verify the expression of differentially expressed miRNAs in other tissues. We used miRWalk to predict the target genes of differentially expressed miRNAs. Here, we described two differentially expressed miRNAs in patients compared to controls: hsa-miR-1304-3p, located outside the 22q11.2 region, upregulated in patients, and hsa-miR-185-5p, located in the 22q11.2 region, which showed downregulation. Expression of miR-185-5p is observed in tissues frequently affected in patients with 22q11DS, and previous studies have reported its downregulation in individuals with 22q11DS. hsa-miR-1304-3p has low expression in blood and, thus, needs more validation, though using a sensitive technology allowed us to identify differences in expression between patients and controls. Conclusions Thus, lower expression of miR-185-5p can be related to the 22q11.2 deletion and DGCR8 haploinsufficiency, leading to phenotypic consequences in 22q11.2DS patients, while higher expression of hsa-miR-1304-3p might be related to individual genomic variances due to the heterogeneous background of the Brazilian population.

Abstract Background Mounting evidence links glucose intolerance and diabetes as aspects of metabolic dysregulation that are associated with an increased risk of developing dementia. Inflammation and inflammasome activation have emerged as a potential link between these disparate pathologies. As diet is a key factor in both the development of metabolic disorders and inflammation, we hypothesize that long term changes in dietary factors can influence nervous system function by regulating inflammasome activity and that this phenotype would be sex-dependent, as sex hormones are known to regulate metabolism and immune processes. Methods 5-week-old male and female transgenic mice expressing a caspase-1 bioluminescent reporter underwent cranial window surgeries and were fed control (65% complex carbohydrates, 15% fat), high glycemic index (65% carbohydrates from sucrose, 15% fat), or ketogenic (1% complex carbohydrates, 79% fat) diet from 6 to 26 weeks of age. Glucose regulation was assessed with a glucose tolerance test following a 4-h morning fast. Bioluminescence in the brain was quantified using IVIS in vivo imaging. Blood cytokine levels were measured using cytokine bead array. 16S ribosomal RNA gene amplicon sequencing of mouse feces was performed to assess alterations in the gut microbiome. Behavior associated with these dietary changes was also evaluated. Results The ketogenic diet caused weight gain and glucose intolerance in both male and female mice. In male mice, the high glycemic diet led to increased caspase-1 biosensor activation over the course of the study, while in females the ketogenic diet drove an increase in biosensor activation compared to their respective controls. These changes correlated with an increase in inflammatory cytokines present in the serum of test mice and the emergence of anxiety-like behavior. The microbiome composition differed significantly between diets; however no significant link between diet, glucose tolerance, or caspase-1 signal was established. Conclusions Our findings suggest that diet composition, specifically the source and quantity of carbohydrates, has sex-specific effects on inflammasome activation in the central nervous system and behavior. This phenotype manifested as increased anxiety in male mice, and future studies are needed to determine if this phenotype is linked to alterations in microbiome composition.

Abstract Cancer patients often undergo rounds of trial-and-error to find the most effective treatment because there is no test in the clinical practice for predicting therapy response. Here, we conduct a clinical study to validate the zebrafish patient-derived xenograft model (zAvatar) as a fast predictive platform for personalized treatment in colorectal cancer. zAvatars are generated with patient tumor cells, treated exactly with the same therapy as their corresponding patient and analyzed at single-cell resolution. By individually comparing the clinical responses of 55 patients with their zAvatar-test, we develop a decision tree model integrating tumor stage, zAvatar-apoptosis, and zAvatar-metastatic potential. This model accurately forecasts patient progression with 91% accuracy. Importantly, patients with a sensitive zAvatar-test exhibit longer progression-free survival compared to those with a resistant test. We propose the zAvatar-test as a rapid approach to guide clinical decisions, optimizing treatment options and improving the survival of cancer patients.

The alkali-activated materials have properties like commonly used cementitious materials, however, it does not have burning steps at high temperatures that emit large amounts of CO2 into the atmosphere. The main precursor used in the production of activated alkali materials is metakaolin, which in general has a heterogeneous chemical and mineralogical composition and high shrinkage. Therefore, the objective of this research is to evaluate the production potential of an alternative precursor based on calcined clay, aiming to standardize the material's shrinkage parameters. The properties of mechanical strength to bending and linear shrinkage, in the face of exposure to degradation cycles such as wetting/drying in saline environment and ice and thaw cycles, were analyzed to simulate and predict real application situations. The results indicate that the calcined clay has a lower mechanical strength than the composition containing metakaolin, due to its lower reactivity. However, in degradation simulations, it is observed that the calcined clay has greater durability than the composition with metakaolin, since it has less shrinkage. The compositions with calcined clay reached a maximum content of 1.2%, while compositions with metakaolin reached shrinkage of around 6%. In function, it is concluded that it is possible to use the alternative precursor based on calcined clay in alkali activated materials.

Jaime Guedes,1,2 Sacha Fernandes Pereira,3 Dillan Cunha Amaral,4 Larissa C Hespanhol,5 Adriano Cypriano Faneli,6 Ricardo Danilo Chagas Oliveira,2,7 Denisse J Mora-Paez,1 Bruno M Fontes2 1Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA; 2Ophthalmology, Opty Group, Rio de Janeiro, RJ, Brazil; 3Faculty of Medical Sciences of Paraiba, AFYA, João Pessoa, PB, Brazil; 4Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; 5Faculty of Medicine, Federal University of Campina Grande, Campina Grande, PB, Brazil; 6Faculty of Medicine, Bahiana School of Public Health and Medicine, Salvador, BA, Brazil; 7Ophthalmology, Federal University of Bahia, Salvador, BA, BrazilCorrespondence: Jaime Guedes, Email jguedes@willseye.orgBackground: Cataract surgery is one of the most frequently performed eye surgeries worldwide, and among several techniques, phacoemulsification has become the standard of care due to its safety and efficiency. We evaluated the advantages and disadvantages of two phacoemulsification techniques: phaco-chop and divide-and-conquer.Methods: PubMed, Cochrane, Embase, and Web of Science databases were queried for randomized controlled trial (RCT), prospective and retrospective studies that compared the phaco-chop technique over the divide-and-conquer technique and reported the outcomes of (1) Endothelial cell count change (ECC); (2) Ultrasound time (UST); (3) Cumulated dissipated energy (CDE); (4) Surgery time; and (5) Phacoemulsification time (PT). Heterogeneity was examined with I2 statistics. A random-effects model was used for outcomes with high heterogeneity.Results: Nine final studies, (6 prospective RCTs and 3 observational), comprising 837 patients undergoing phacoemulsification. 435 (51.9%) underwent the phaco-chop technique, and 405 (48.1%) underwent divide-and-conquer. Overall, the phaco-chop technique was associated with several advantages: a significant difference in ECC change postoperatively (Mean Difference [MD] − 221.67 Cell/mm2; 95% Confidence Interval [CI] − 401.68 to − 41.66; p < 0.02; I2=73%); a shorter UST (MD − 51.16 sec; 95% CI − 99.4 to − 2.79; p = 0.04; I2=98%); reduced CDE (MD − 8.68 units; 95% CI − 12.76 to − 4.60; p < 0.01; I2=84%); a lower PT (MD − 55.09 sec; 95% CI − 99.29 to − 12.90; p = 0.01; I2=100). There were no significant differences in surgery time (MD − 3.86 min; 95% CI − 9.55 to 1.83; p = 0.18; I2=99%).Conclusion: The phaco-chop technique proved to cause fewer hazards to the corneal endothelium, with less delivered intraocular ultrasound energy when compared to the divide-and-conquer technique.Keywords: meta-analysis, systematic review, cataract, cataract extraction, phaco-chop, divide-and-conquer, phacoemulsification

Ana Margarida Ferreira,1 Rodrigo Vilares-Morgado,1,2 Mário Lima-Fontes,1,3 Manuel Falcão,1,2 Fernando Falcão-Reis,1,2 Ângela Carneiro1,2 1Department of Ophthalmology, Local Health Unit of São João, Porto, Portugal; 2Department of Surgery and Physiology, Faculty of Medicine of University of Porto, Porto, Portugal; 3Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, PortugalCorrespondence: Ana Margarida Ferreira, Department of Ophthalmology of Local Health Unit of São João, Avenida Prof. Hernâni Monteiro, Porto, 4202 – 451, Portugal, Tel +351 912 605 085, Fax +351 225 512 100, Email amargaridapferreira@gmail.comPurpose: To evaluate the progression of chorioretinal atrophic areas associated with myopic choroidal neovascularization (CNV) in high myopic patients followed by a minimum period of 10 years.Patients and Methods: Patients with myopic CNV lesions that achieved clinical and structural remissions over 10 years of follow-up were included. Medical records were reviewed for CNV characterization and treatment, best-corrected visual acuity at baseline (BCVA0), immediately after the last treatment (BCVA1) and at the latest visit (BCVA2). Fundus autofluorescence (FAF) was used to quantify the amount of atrophic area increase per year associated with the treated myopic CNV lesion. The first FAF performed after treatment suspension (FAF1) was compared with the most recent exam (FAF2).Results: Thirty-six eyes from 36 patients were included. Mean total follow-up was 12.38 ± 2.68 years. Mean number of intravitreal injections (IVI) was 12.50 ± 12.40 and 25% of the eyes had previous treatment with photodynamic therapy (PDT). Mean improvement between BCVA0 and BCVA1 was 5.58 ± 15.98 letters (p < 0.001). However, a drop of 8.03 ± 12.25 letters was noticed between BCVA1 and BCVA2. FAF1 was 6.34 ± 4.92mm2 and increased to 9.88 ± 7.56mm2 (3.54 ± 3.79mm2 variation p < 0.001). The mean growth rate of the atrophic area was 0.89 ± 0.84mm2 per year. BCVA2 negatively correlated with FAF2 (k = − 0.498, p = 0.002) being worse in patients with higher atrophic area growth rate (k = − 0.341, p = 0.042). Eyes treated with PDT needed less IVI (5.89 ± 5.21 vs 14.70 ± 13.36, p = 0.008) but had larger FAF1 (9.80 ± 5.33 vs 5.19 ± 4.27, p = 0.013) and FAF2 (16.05 ± 7.10 vs 7.83 ± 6.63, p = 0.003). Hypothyroidism was associated with higher atrophy growth rate (1.55 ± 1.15 vs 0.73 ± 0.67, p = 0.016).Conclusion: This research demonstrates the importance of chorioretinal atrophy progression after myopic CNV lesions regression and its impact on visual prognosis, reporting a mean yearly growth of 0.89 mm2 in atrophic areas. Previous treatment with PDT and hypothyroidism were identified as risk factors associated with larger atrophic areas and worse visual outcomes.Keywords: chorioretinal atrophic lesions, myopic choroidal neovascularization

Abstract The complex two-Higgs doublet model (C2HDM) is one of the simplest extensions of the Standard Model with a source of CP-violation in the scalar sector. It has a $${\mathbb{Z}}_{2}$$ symmetry, softly broken by a complex coefficient. There are four ways to implement this symmetry in the fermion sector, leading to models known as Type-I, Type-II, Lepton-Specific and Flipped. In the latter three models, there is a priori the surprising possibility that the 125 GeV Higgs boson couples mostly as a scalar to top quarks, while it couples mostly as a pseudoscalar to bottom quarks. This “maximal” scenario was still possible with the data available in 2017. Since then, there have been more data on the 125 GeV Higgs boson, direct searches for CP-violation in angular correlations of τ-leptons produced in Higgs boson decays, new results on the electron electric dipole moment, new constraints from LHC searches for additional Higgs bosons and new results on b → sγ transitions. Highlighting the crucial importance of the physics results of LHC’s Run 2, we combine all these experiments and show that the “maximal” scenario is now excluded in all models. Still, one can have a pseudoscalar component in $$h\tau \overline{\tau }$$ couplings in the Lepton-Specific case as large as 87% of the scalar component for all mass orderings of the neutral scalar bosons.

Objective: To determine the reference intervals (RI) for serum levels of IgG, IgM, and IgE in healthy children aged 1–10 years living in central Brazil. Method: A sample of 1743 healthy children was randomly selected from kindergartens and public schools. Reference intervals were defined by non-parametric rank (Clinical Laboratory Standards Institute, USA), bootstrapping, and Horn's robust methods. Results: By the rank method, the IgG RI was 792–1771 mg/dL for children of both sexes aged 1–10 years. IgM RI were different for gender and age groups, being 45–196 mg/dL and 34–190 mg/dL for boys aged 1–2 years and 3–10 years, respectively. For girls, the IgM RI were 50–212 mg/dL and 39–212 mg/dL, for ages 1–4 and 5–10 years, respectively. The IgE RI for both sexes and ages 1–10 years was 6–1005 mg/dL. The bootstrap method showed RI similar to the rank method but with slightly different confidence intervals. Horn's robust method determined RI different from those obtained by previous methods. Conclusion: RI for serum concentrations of IgG, IgM, and IgE were established for Brazilian children aged 1–10 years. This definition will be useful for Brazilian physicians, who will have more adequate parameters for their clinical decision-making.

Pathological manifestations in building systems is a complex problem from economical, cultural and environmental points of view, associated with the need of a durability analysis appears as a relevant aspect to be considered regarding the construction materials. Indeed, these materials present different degradation mechanisms, mainly with joint participation of cement. An example of these materials cementitious is the coating mortar, which has the function of protecting the structure and the sealing of the building, recognized to play a fundamental role in the constructions durability. In recent years, studies on the durability of coating mortar have intensified. In this context, this work aimed to carry out a bibliographical review of the main methods of durability analysis for coating mortar, covering the most common techniques. It was identified that the most used durability tests in coating mortars are: water absorption by capillarity and immersion, wetting and drying cycles, porosity, carbonation, freeze-thaw cycles, drying shrinkage, chloride penetration, and sulfate attack. Among them, it was verified that the most used tests are those of water absorption and accelerated aging with wetting and drying cycles. In addition, it was observed that there are significant variations between the methodologies adopted for all tests, with large discrepancies in those using aging cycles. In addition to carrying out accelerated degradation tests, it is was emphasized the need to evaluate the performance of the mortars by means of: flexural and compressive strengths, as well as mass loss, visual evaluation, dynamic modulus of elasticity, adherence, SEM and X-ray diffraction.

Este artigo insere-se no quadro teórico-metodológico da abordagem diacrônica de processos de construção textual formulada no interior do Projeto para a História do Português Brasileiro, uma abordagem que aplica princípios da Perspectiva Textual-Interativa ao estudo diacrônico do texto. O trabalho tem os seguintes objetivos: descrever como os processos de organização tópica, parentetização e repetição se desenvolvem diacronicamente em cartas de leitor paulistas e formular a hipótese de que a diacronia desses processos estaria ligada a uma alteração na finalidade sociocomunicativa e a uma alteração no estilo das cartas. O material de análise é composto por cartas de jornais paulistas publicadas nos séculos XIX e XX. Os resultados destacam as seguintes mudanças no uso desses processos: expressiva queda do percentual de emprego da unidade tópica de interpelação, pela qual o escrevente dirige um pedido a um destinatário; drástica diminuição da incidência de parênteses com foco no interlocutor; forte redução de repetições com foco na interatividade. Conforme se argumenta no artigo, os dados sugerem que, historicamente, as missivas passariam da finalidade de discutir um tema como sustentação de uma solicitação para a finalidade de discutir um tema como expressão de opinião e migrariam de um estilo textualmente mais interativo para um estilo menos interativo. Essas duas alterações estariam entre as motivações das mudanças nos processos textuais analisados. Ao correlacionar a diacronia desses processos com alterações na finalidade sociocomunicativa e no grau de interatividade das cartas, o artigo procura, em última instância, evidenciar a relação intrínseca que existe entre linguagem e intersubjetividade.

Nasal swab tests have been extensively utilized for the diagnosis and prevention of the spread of pandemic coronavirus infection (COVID-19). Although deemed a safe and well-tolerated procedure, serious complications have been reported in its administration. This paper presents the case of a 36-year-old patient who experienced continuous watery rhinorrhea from the right nostril five days following a COVID-19 nasal swab. A diagnostic suspicion of cerebrospinal fluid (CSF) fistula was established six weeks after the onset of rhinorrhea, which was initially misinterpreted as allergic rhinitis. Rhinoendoscopic and radiological findings failed to conclusively identify a fistulous defect at the skull base, but the detection of β-2 transferrin in the nasal fluid confirmed the presence of CSF. Following medical treatment, the CSF rhinorrhea progressively decreased until resolution, with no recurrence over a one-year follow-up period. Nasal swab tests for COVID-19, while considered safe, are not without risks. The reported case demonstrated a severe intracranial injury that, despite late diagnosis, was manageable with the implemented medical treatment.

Genetically improved forest reproductive materials are now widely accessible in many European countries due to decades of continuous breeding efforts. Tree breeding does not only contribute to higher-value end products but allows an increase in the rate of carbon capture and sequestration, helping to mitigate the effects of climate change. The usefulness of breeding programmes depends on (i) the relevance of the set of selected traits and their relative weights (growth, drought tolerance, phenology, etc.); (ii) the explicit management of targeted and “neutral” diversity; (iii) the genetic gain achieved; and (iv) the efficiency of transferring diversity and gain to the plantation. Several biological factors limit both operational breeding and mass reproduction. To fully realise the potential of tree breeding, the introduction of new technologies and concepts is pivotal for overcoming these constraints. We reviewed several European breeding programmes, examining their current status and factors that are likely to influence tree breeding in the coming decades. The synthesis was based on case studies developed for the European Union-funded B4EST project, which focused on eight economically important tree species with breeding histories and intensities ranging from low-input breeding (stone pine, Douglas-fir and ash) to more complex programmes (eucalyptus, maritime pine, Norway spruce, poplar, and Scots pine). Tree breeding for these species is managed in a variety of ways due to differences in species’ biology, breeding objectives, and economic value. Most programmes are managed by governmental institutes with full or partial public support because of the relatively late return on investment. Eucalyptus is the only tree species whose breeding is entirely sponsored and managed by a private company. Several new technologies have emerged for both phenotyping and genotyping. They have the potential to speed up breeding processes and make genetic evaluations more accurate, thereby reducing costs and increasing genetic gains per unit of time. In addition, genotyping has allowed the explicit control of genetic diversity in selected populations with great precision. The continuing advances in tree genomics are expected to revolutionise tree breeding by moving it towards genomic-based selection, a perspective that requires new types of skills that are not always available in the institutions hosting the programmes. We therefore recognise the importance of promoting coordination and collaboration between the many groups involved in breeding. Climate change is expected to bring in new pests and diseases and increase the frequency of extreme weather events such as late frosts and prolonged droughts. Such stresses will cause slow growth and mortality, reducing forest productivity and resilience. Most of these threats are difficult to predict, and the time-consuming nature of conventional breeding does not allow for an adequate and timely reaction. We anticipate that most breeding programmes will need to revise their selection criteria and objectives to place greater emphasis on adaptive performance, tolerance to multiple environmental stresses, stability in different environments, and conservation of genetic diversity. Testing breeding materials in a variety of environments, including potentially contrasting climates, will become increasingly important. Climate change may also force the incorporation of new genetic resources that provide new useful adaptations, which may involve the use of new, previously unexplored gene pools or hybridisation, with the enormous challenge of incorporating useful alleles without adding along an unfavourable genetic background. Decision-support tools to help landowners and foresters select the best-performing forest reproductive material in each specific environment could also help reduce the impact of climate change.

Children with autism spectrum disorder (ASD) generally have a delay in the development of motor skills when compared to typical children, however, to date, no study has investigated whether motor limitations can interfere in the participation of these children. The objectives of this study were: verify if the motor skills can explain the frequency, the percentage of number of activities, the involvement and the desire to change in participation at home, school and community of children with autism spectrum disorder (ASD) and; identify if contextual factors would modify the association between motor skills and participation outcomes. The participation and the motor skills were evaluated in 30 children with ASD between 5 and 10 years old. Participation outcomes were measured by the Participation and Environment Measure--Children and Youth (PEM-CY) and the motor skills were assessed by the Timed Up and Go, Timed Up and Down Stairs, Test of Gross Motor Development--2nd edition and Pediatric Balance Scale. The results of the study demonstrated that the motor skills of the locomotion, objects control, change position and balance explained participation outcomes of children with ASD classified from mild to moderate, between 5 and 10 years old. Moreover, the sex variable modified the association between the motor skills and the school participation, with girls performing less activities at this setting.

In grape and wine production, one of the main relevant and recurrent diseases is downy mildew, caused by the fungus Plamospara viticola. It is frequently present in wine production worldwide, with a significant high annual incidence in some regions. Since the discovery of Bordeaux mixture (copper sulphate and lime) in the 1880’s, many formulations based on copper (Cu) have been developed and used in viticulture production. https://coppereplace.com/.

O objetivo deste artigo foi analisar a percepção da família fundadora, sobre a existência e a preservação das dimensões da riqueza socioemocional (SEW). Esta pesquisa é do tipo exploratória, descritiva e de natureza aplicada. Utilizou-se o método qualitativo, com a técnica de análise de conteúdo nas entrevistas realizadas com os membros da família fundadora que atuam na empresa usando as dimensões FIBER para identificar a riqueza socioemocional. De acordo com a percepção dos familiares, os Laços Sociais são representados por um Instituto mantido pela família, o qual contribui para uma educação de qualidade para crianças e jovens em todo o país. As dimensões ligadas à marca, sendo a dimensão I, relacionada ao nome da família, e a dimensão E, ao apego emocional, também se mostraram fortes na análise. Assim, a família fundadora percebe a existência e se ela preserva as dimensões da riqueza socioemocional para tornar a empresa diferenciada e estrategicamente valiosa diante das demais empresas. O estudo aplica a teoria de riqueza socioemocional utilizando o método FIBER para a análise das respostas dos entrevistados. O estudo contribui com elementos importantes para a gestão, relacionando os laços familiares e a diferenciação estratégica das empresas familiares.

Abstract The settlement is a critical factor in foundation selection. To ensure the safety and stability of a structure, engineers must accurately predict settlement and design the foundation accordingly. However, in cases where the soil stratigraphy is complex, a more detailed analysis is necessary to determine safe and cost-effective solutions for a building's foundation. This paper presents a case study in which settlement monitoring was performed on a 23-story building with spread footings laid on a stiff rock layer of limited thickness overlying more compressible layers of clay and sand. The building was monitored through four construction stages, during which data on vertical displacements and stress distribution on the soil were obtained. To improve the accuracy of the results, a methodology for calibrating the thicknesses of the soil strata was applied, based on the measured settlements, soil-structure interaction, and estimates from semi-empirical methods. Furthermore, a numerical analysis was performed using the finite element method, where more conservative displacements were observed. Finally, the safety of the building was evaluated by verifying angular distortions.

ABSTRACT: Background: Spinal deformity as a sequela of nontuberculous spondylodiscitis is a rarely discussed clinical entity. Sagittal plane deformity, segmental instability, and persistently active infection overlap in these patients resulting in severe restriction in activity and quality of life. The presence of multiple medical co-morbidities restricts surgical options but nonoperative care may be ineffective and result in persistent, refractory discitis for years. We describe our experience with vertebrectomy and long-segment fixation for patients with postinfectious thoracic or lumbar deformity. Methods: A retrospective chart review of 23 consecutive patients who underwent vertebrectomy and long-segment fixation for thoracic or lumbar deformity secondary to nontuberculous bacterial spondylodiscitis was performed. Pre, peri- and postoperative data is compiled and analyzed with a focus on the perioperative management algorithm to safely perform an extensive reconstruction in this very sick patient population. Results: Extremely low preoperative quality of life was evident with 87% (20/23) of patients bedridden primarily due to pain despite 70% (16/23) of patients being strong enough to ambulate (Frankel D or E). Most patients (87%) already had an identified infection under adequate treatment either through blood cultures, prior biopsy or decompressive surgery. A single-stage posterior-only was the primary surgical approach utilized in the majority (83%) of cases. Complications were present in 100% of patients, most commonly perioperative anemia and hypotension requiring vasopressor support and aggressive blood product replacement. One in-hospital mortality occurred secondarily to pulmonary embolism. Mean preoperative segmental angle was 18±10 degrees of kyphosis which was corrected to 1±9 degrees of lordosis (p=.001). The mean correction of the segmental angle was 19 degrees (standard deviation 23 degrees). Visual analogue scale scores improved from a preoperative value of 8.8±0.9 to a postoperative value of 2.5±1.4 (p

A atividade mineradora acarreta alterações significativas em várias esferas da vida humana, especialmente na comunidade local em que está inserida. Essas alterações são denominadas impactos sociais, e são os objetos de análise das Avaliações de Impacto Social (AIS), as quais são importantes instrumentos de identificação, mensuração e planejamento para construção de planos de proteção e recuperação das comunidades onde essas atividades acontecem. AIS podem ser conduzidas de inúmeras formas, sendo necessário assim formulação de linhas gerais e diretrizes para sua construção. Dessa forma, o presente artigo visa apresentar linhas gerais para definição de indicadores de impacto social da atividade mineradora, mapear as dimensões e indicadores utilizados e descritos na literatura e levantar as melhores práticas de AIS presentes na literatura. Para isso, foi realizada revisão sistemática da literatura conforme protocolo de Pagani, Kovaleski e Resende (2015). A análise dos resultados permitiu identificar as sete principais dimensões presentes nos artigos, bem como outras 33 dimensões e mais de 200 indicadores. Ademais, foram detectadas lacunas nas principais dimensões e indicadores das AIS, como questões de gênero, percepção errônea de homogeneidade da comunidade e a falta de políticas governamentais que exijam mitigação dos impactos negativos advindos dessas atividades.

ABSTRACT Wheel slipping and fuel consumption are variables influenced by tire pressure, speed, ballasting, and soil surface. Once the tractor is present in all agricultural operations, knowledge of these variables is essential to achieving the most operational efficiency. This study aimed to develop an embedded system to collect data and show tractor slipping and fuel consumption in real-time via smartphone. The system was developed using prototyping platforms and validated through randomized field tests under four speeds and two terrain conditions. Three methods for determining slippage under different conditions were compared. The developed embedded system determined an agricultural tractor's slipping and fuel consumption conditions. The slip and fuel consumption rates varied depending on the type of rolling surface (ground preparations) and the tractor's operating speeds. Conventional tillage surface increased fuel demand by 6% and slippage by 17% compared to no-till rates. The proposed embedded system found similar results and could present the slipping values in the developed Android to real-time operation compared to a conventional method. This application shows both slipping and fuel consumption values over time on graphs, which can be very useful during machine operation, helping to define better configuration and reduce environmental impacts.

Objective To evaluate the admission brain computed tomography (CT) scan findings in patients with traumatic brain injury (TBI) in a low- and middle-income country (LMIC) to predict long-term neurological outcomes.

Abstract Introduction: Chronic kidney disease (CKD) and metabolic syndrome (MS) are recognized as public health problems which are related to overweight and cardiometabolic factors. The aim of this study was to develop a model to predict MS in people with CKD. Methods: This was a prospective cross-sectional study of patients from a reference center in São Luís, MA, Brazil. The sample included adult volunteers classified according to the presence of mild or severe CKD. For MS tracking, the k-nearest neighbors (KNN) classifier algorithm was used with the following inputs: gender, smoking, neck circumference, and waist-to-hip ratio. Results were considered significant at p < 0.05. Results: A total of 196 adult patients were evaluated with a mean age of 44.73 years, 71.9% female, 69.4% overweight, and 12.24% with CKD. Of the latter, 45.8% had MS, the majority had up to 3 altered metabolic components, and the group with CKD showed statistical significance in: waist circumference, systolic blood pressure, diastolic blood pressure, and fasting blood glucose. The KNN algorithm proved to be a good predictor for MS screening with 79% accuracy and sensitivity and 80% specificity (area under the ROC curve – AUC = 0.79). Conclusion: The KNN algorithm can be used as a low-cost screening method to evaluate the presence of MS in people with CKD.

ABSTRACT Purpose: This study aimed to evaluate a new therapeutic option for the spasticity using ultrasound neuromodulation in an animal model of spastic cerebral palsy. Methods: Thirty-two adult male Wistar rats were randomly distributed in: negative control (NC); positive control (PC); untreated model (UTM); and treated model (TM). Rats in the control groups received sham surgery, and rats in the model groups received the spastic cerebral palsy model surgery. The rats’ motor functions were evaluated by the Rotarod and CatWalk tests before and after surgery. PC and TM groups underwent ultrasonic neuromodulation by a physiotherapeutic ultrasound (intensity 0.1 W/cm2, at 1 MHz) continuous mode for 5 seconds, for seven days. Results: Twelve rats showed a spastic pattern (UTM = 6 and TM = 6), motor limitations (UTM = 6 and TM = 6), and ten had difficulty feeding (UTM = 5 and TM = 5). One UTM group rat could not recover its preoperative latency time, while the other rats in the model groups did. The speed at which the limbs swung reduced after surgery and increased in subsequent assessments, demonstrating greater instability and a deficit in locomotion balance. Conclusions: Results were not yet sufficient to assert ultrasound neuromodulation as a possible therapy for spasticity in spastic cerebral palsy in the parameters used, and more studies are necessary.

Objective: This article reviews clinical implications and costs associated with orthopedic surgeries performed in inpatient versus outpatient settings. Methods: Studies spanning the publication period between 2000 and 2023 were included, exploring a variety of study designs. Results: Results indicate that outpatient surgeries are associated with lower rates of postoperative complications, shorter recovery times, and greater patient satisfaction, as well as with significantly lower direct and indirect costs. Analysis of postoperative complications suggests that factors such as the home recovery environment and early mobilization may contribute to improved clinical outcomes, corroborating existing literature on the safety and efficacy of outpatient surgeries. Faster recovery after outpatient surgeries was consistently observed, with patients returning to normal activities an average of two weeks earlier compared with those undergoing inpatient surgeries. The greater patient satisfaction with outpatient surgeries reflects the convenience of avoiding hospitalization, with less disruption to daily life and reduced anxiety associated with the hospital environment. In economic terms, outpatient surgeries have been shown to be a financially advantageous alternative, with reduced direct costs due to the lower hospital fees and nursing services required, as well as lower indirect costs due to reduced productivity loss and transportation expenses. Conclusion: Findings are particularly relevant in a context of increasing pressure to contain spending in the health system. Level of Evidence I; Systematic review of level I studies.

A deficiência intelectual pode ser entendida como um conjunto de limitações no funcionamento comportamental adaptativo e intelectual, apresentado por mudanças comportamentais, práticas, sociais e conceituais. Todas as pessoas passam pelo desenvolvimento sexual, e as com deficiência intelectual não são exceção, já que, assim como a maioria, também enfrentam dificuldades emocionais, sentimentos, necessidades e experiências sexuais. A relação inclusiva e sexualidade tem sido objeto de muito debate nos campos da psicologia e da educação. Os vastos mitos que cercam a sexualidade das pessoas com deficiência intelectual reforçam as desigualdades relacionadas com a sexualidade dos outros. Desta forma, aspiramos refletir e reconhecer a relevância da educação sexual para pessoas com deficiência intelectual. Portanto, este estudo utiliza uma revisão de literatura para organizar o pensamento de diferentes autores e estudiosos sobre temas relacionados, divididos em três temas. No primeiro tópico, faremos uma breve revisão da epidemiologia, etiologia e fatores de risco para pessoas com deficiência intelectual. No segundo, discutiremos aspectos relacionados à sexualidade em pessoas com deficiência intelectual. No terceiro, apresentaremos as possibilidades e estratégias de educação sexual para pessoas com deficiência intelectual.

ABSTRACT The genus Psidium is recognized for its economic value and the species that produce essential oils with notable biological activities. This study investigated the characteristics of the essential oil from the leaves of Psidium myrtoides and Psidium cattleyanum under different drying temperatures. We aimed to understand how drying temperatures affect the yield and composition of the essential oil, as well as its biological activity. The oils obtained from the leaves of P. myrtoides and P. cattleyanum dried in an oven at 40°C showed the highest yields (0.86% and 1.07%, respectively). β-caryophyllene was the major compound in all essential oils of P. myrtoides and P. cattleyanum, except in the oil extracted from P. myrtoides leaves dried at room temperature, where the major compound was α-bisabolol (14.46%). Different phytotoxic effects were observed using the emulsion of these oils in bioassays with Lactuca sativa and Sorghum bicolor, which were associated with the chemical composition and synergy of the identified compounds. The essential oil emulsion from leaves dried at room temperature of both species showed greater phytotoxic activity in the bioassays. Thus, optimizing drying conditions to maximize yield and synergy of compounds from the essential oils of P. myrtoides and P. cattleyanum is an important step in developing environmentally friendly natural agrochemicals.

IntroductionThe fungus Fusarium verticillioides significantly threatens maize crops in tropical soils. In light of this, biological control has emerged as a promising strategy to reduce fungicide costs and environmental risks. In this study, we aimed to test the antifungal activity of cell-free supernatant (CFS) from three Bacillus velezensis (CT02, IM14, and LIS05) and one Paenibacillus ottowii (LIS04) against F. verticillioides, thereby contributing to the development of effective biocontrol measures.MethodsThe research employed a comprehensive approach. The antifungal activity of the bacterial strains was tested using cell-free supernatant (CFS) from three Bacillus velezensis (CT02, IM14, and LIS05) and one Paenibacillus ottowii (LIS04). The UPLC-MS evaluated the CFS to identify the main bioactive molecules involved in the inhibitory effect on F. verticillioides. Scanning electron microscopy (SEM) was used to assess the impact of CFS on spores and hyphae, and genome sequencing was conducted to identify the genes involved in biological control. These robust methodologies ensure the reliability and validate our findings.ResultsThe CFS of the four strains demonstrated significant inhibition of fungal growth. The UPLC-MS analysis revealed the presence of lipopeptides with antifungal activity, including surfactin and fengycins A and B expressed by the three strains of Bacillus velezensis and iturin A expressed by strains LIS05 and IM14. For Paenibacillus ottowii, fusaricidins, ABCDE, and five previously unreported lipopeptides were detected. Scanning electron microscopy (SEM) showed that treatments with CFS led to significant distortion and breakage of the F. verticillioides hyphae, in addition to the formation of cavities in the membrane. Genome mining confirmed the presence of genes coding for the lipopeptides identified by UPLC-MS, including the gene for iturin in CTO2. Genomic sequencing revealed that CT02, IM14, and LIS05 belong to different strains of Bacillus velezensis, and LIS04 belongs to Paenibacillus ottowii, a species recently described.DiscussionThe four bacterial strains, including three novel strains identified as Bacillus velezensis and one as the recently described species Paenibacillus ottowii, demonstrate significant potential as biocontrol agents for managing fungal disease. This finding underscores the novelty and potential impact of our research.

O relato de experiência refere-se ao Segundo Dia de Campo do Umbu Gigante, realizado pela Universidade Estadual do Sudoeste da Bahia (UESB), o qual contou com a participação de acadêmicos, pesquisadores, professores; instituições de ensino, instituição governamental estadual, municipal, prefeituras, secretarias de desenvolvimento regionais, associações comunitárias, entre outras empresas parceiras comprometidas com o desenvolvimento rural. O dia de campo é uma importante ação de extensão, especialmente para capacitar agricultores familiares e outros interessados no cultivo do umbu gigante por meio de troca de informações práticas e teóricas sobre os métodos adequados de implantação, manejo e comercialização desse fruto. Ao capacitar os agricultores, esta metodologia visa incentivar uma forma sustentável de gerar trabalho e encorajar os agricultores a permanecerem no campo. Por sua vez, ao incluir a comunidade acadêmica no processo de extensão, a universidade não só beneficia o desenvolvimento profissional dos graduandos, mas também contribui para a melhoria das habilidades e conhecimentos dos agricultores, possibilitando que o umbu gigante se torne uma fonte de renda viável. Por conseguinte, isso estimula o crescimento econômico das áreas rurais e reforça a reprodução social da agricultura familiar.

The initial stages of early embryonic development were analyzed as a function of the incubation period and age of Japanese quail breeders. A total of 203 Japanese quails housed in 29 conventional laying cages with 5 females and 2 males at 31, 39, 48, and 59 weeks of age were used, and the fertile eggs from these breeders were selected and incubated. The eggs were opened, and the embryos were isolated, fixed in a glutaraldehyde solution, analyzed and classified according to the stage of development. For after laying and the incubation periods of 24, 48, and 72 hours, the embryos presented, on average, Hamburger-Hamilton stages XI, HH 6.1, HH 12.7, and HH 18.5, respectively, with no effect of breeder age. It was also observed that, between 31 and 59 weeks of age in Japanese quail breeders, the eggs become longer and wider, with greater weight, volume, and area. Therefore, it is concluded that the age of the Japanese quail mother influences the weight, length, width, volume, and area of the eggs but does not influence the embryonic development up to 72 hours.

Four strains of Staphylococcus aureus isolated from cows with mastitis were assessed as to in vitro sensitivity to four commercial disinfectants (chlorine, polvidone-iodine, chlorhexidine, and lactic acid) used in teat pre- and post-dipping, in the presence and absence of organic matter. The concentration of the disinfectants was determined in accordance with the Brazilian Pharmacopoeia. Four isolates identified as S. aureus from cows diagnosed with subclinical mastitis were subjected to susceptibility testing against disinfectants through an absorbance evaluation at 600 nm on a spectrophotometer. Exposure times (15”, 30”, 60” and 90”) were clocked, and streaking was performed in Brain Heart Infusion (BHI) medium. The iodine sample presented a lower concentration (1.9%) than that given by the manufacturer (2.5%). There was greater (p < 0.05) in vitro disinfectant activity for chlorhexidine and chlorine, with and without organic matter. However, inhibition by organic matter occurred more intensely in the iodine disinfectant (99.0%). The inhibition percentage of S. aureus against iodine and lactic acid at 15, 30, 60 and 90 s was numerically lower than against chlorhexidine and chlorine, regardless of organic matter. Therefore, chlorhexidine and chlorine have greater inhibitory activity against S. aureus, both with and without organic matter.