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Throughout history, natural biomaterials have benefited society. Nevertheless, in recent years, tailoring natural materials for diverse biomedical applications accompanied with sustainability has become the focus. With the progress in the field of materials science, novel approaches for the production, processing, and functionalization of biomaterials to obtain specific architectures have become achievable. This review highlights an immensely adaptable natural biomaterial, bacterial cellulose (BC). BC is an emerging sustainable biopolymer with immense potential in the biomedical field due to its unique physical properties such as flexibility, high porosity, good water holding capacity, and small size; chemical properties such as high crystallinity, foldability, high purity, high polymerization degree, and easy modification; and biological characteristics such as biodegradability, biocompatibility, excellent biological affinity, and non-biotoxicity. The structure of BC consists of glucose monomer units polymerized via cellulose synthase in β-1-4 glucan chains, creating BC nano fibrillar bundles with a uniaxial orientation. BC-based composites have been extensively investigated for diverse biomedical applications due to their similarity to the extracellular matrix structure. The recent progress in nanotechnology allows the further modification of BC, producing novel BC-based biomaterials for various applications. In this review, we strengthen the existing knowledge on the production of BC and BC composites and their unique properties, and highlight the most recent advances, focusing mainly on the delivery of active pharmaceutical compounds, tissue engineering, and wound healing. Further, we endeavor to present the challenges and prospects for BC-associated composites for their application in the biomedical field.

Algal organic matter (AOM) in water reservoirs is a worldwide concern for drinking water treatment; once it is one of the main precursors for disinfection by-products formation (DBPs). In this context, this study investigated the ecotoxicity of DBPs from chlorination of AOM to Ceriodaphnia silvestrii and Daphnia similis (Crustacea, Cladocera). The bioassays evaluated three scenarios, including the AOM extracted from Chlorella sorokiniana, the quenching condition used in the tests, and the DBPs formed after the chlorination of the two test waters with AOM (with and without bromide presence). The results showed that AOM has no toxic effects for the tested species under typical environmental concentration (5 mg∙L -1 ). However, since AOM is a potential precursor of DBPs, the toxicity of two test waters (TW-1 and TW-2) after the chlorination process (25 mg Cl 2 ·L -1 , for 7 days, at 20 °C) was tested. The sample with higher toxicity to the tested species was TW-1, in which chloroform and chloral hydrate were quantified (615 and 267 µg∙L -1 , respectively). However, TW-2 showed lower concentration of chloroform and chloral hydrate (260 and 157 µg∙L -1 , respectively), although bromodichloromethane, dibromochloromethane, and bromoform were also detected (464, 366, and 141 µg∙L -1 , respectively). Although free chlorine is highly toxic to the tested species, the quenching conditions also affected the organisms' survival due to the use of ascorbic acid and the presence of reaction intermediates. Nonetheless, both species were more affected by TW-1 and TW-2 than the quenching condition. These results endorse the importance of removing the AOM before the disinfection process to avoid the formation of DBPs. In addition, ecotoxicological analyses could provide a more comprehensive assessment of water quality, especially considering the challenges of quantifying DBPs and other emerging contaminants., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The discharge of raw wastewater into the environment can be a contamination source of Giardia spp. cysts and Cryptosporidium spp. oocysts. The UASB (Upflow Anaerobic Sludge Blanket) reactor is the most popular technology applied for wastewater treatment in Brazil, nevertheless there is little information concerning its capacity for (oo)cyst removal. In this context, this study investigated the occurrence and removal of Giardia spp. cysts and Cryptosporidium spp. oocysts by three different UASB reactors ( i.e. Reactor A, B, and C) treating different wastewater types. In the wastewater influent, the concentration varied from 493.3 to 14,000 cysts·L -1 for Giardia spp. and from 'not detected' to 53.3 oocysts·L -1 for Cryptosporidium spp . . The (oo)cyst concentration increased after the anaerobic treatment in Reactors A and B, while Giardia spp. log-removal of 0.5 ± 0.2 was found in Reactor C. The increment in (oo)cyst concentration may happened due to the inefficacy for (oo)cyst removal by the specific UASB reactor and/or due to the reduction of matrix interference for reactor effluent samples in the detection method. The results suggest that hydraulic retention time (HRT) may be the key parameter for Giardia spp. removal by the UASB reactor. Furthermore, no parameter analysed (physical-chemical and indicator microorganisms) showed a common correlation with the (oo)cyst concentration in the three UASB reactors. Considering that official data of cryptosporidiosis and giardiasis cases are rarely reported in Brazil, monitoring Giardia spp. cysts and Cryptosporidium spp. oocysts in wastewater could be an alternative to estimate the occurrence of diseases in the served population.

Cadmium (Cd) is a heavy metal used as raw material for several fertilizers and pesticides. The increase of Cd concentration in soils has been observed in cultivated areas, affecting animals, plants, and microorganisms. Gluconacetobacter diazotrophicus is a plant growth-promoting bacterium able to survive under adverse environmental conditions. Here, we investigated key mechanisms involved with the resistance of G. diazotrophicus to Cd. Proteomic analyses revealed that the main pathways regulated in response to Cd are nutrient uptake, multidrug efflux pumps, response to oxidative stress, and protein quality control system. Extracytoplasmic proteins related to multidrug efflux pumps were up-accumulated, while several proteins related to nutrients uptake were down-accumulated. The relevance of these pathways for bacterial resistance to Cd was investigated by reverse genetic analysis using mutants defective for nutrient uptake (tdbr, ompW, and oprB), multidrug efflux (czcC), response to oxidative stress (ggt), and protein quality control system (clpX). Our data demonstrated the essential role of the tdbr and czcC genes for resistance to Cd in G. diazotrophicus. These results contribute to a better understanding of the resistance mechanisms to Cd in G. diazotrophicus, shedding light on responses associated with extracytoplasmic compartments., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2022 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.)

Objectives: This study aimed at estimating the pre-pandemic and pandemic prevalence of loneliness and investigating the association of loneliness with social disconnectedness during social distancing strategies in the time of the COVID-19 pandemic period. Methods: We used data from the ELSI COVID-19 initiative with participants from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which comprised 4,431 participants aged 50 years and over. Loneliness (hardly ever/some of the time/often) was assessed by the question "In the past 30 days, how often did you feel alone/lonely?". Social disconnectedness included information on social contacts through virtual talking (i.e. telephone, Skype, WhatsApp, or social media) and outside-home meetings with people living in another household. Covariates included sociodemographic and health related characteristics. Multinomial logistic regression models were used to estimate odds ratios (OR) with their 95% confidence interval (CI). Results: The overall prevalence of loneliness during the pandemic was 23.9% (95% CI 20.7-27.5); lower than in the pre-pandemic period (32.8%; 95% CI 28.6-37.4). In the pandemic period, 20.1% (95% CI 16.9-23.6) reported some of the time feeling lonely and 3.9% (95% CI 3.1-4.8) reported often feeling lonely. In the fully adjusted model, virtual talking disconnectedness (OR=1.67; 95% CI 1.09-2.56) was positively associated with some of the time feeling lonely and outside-home disconnectedness (OR=0.33; 95% CI 0.18-0.60) was negatively associated with often feeling lonely. Conclusion: Individuals with virtual talking disconnectedness and without outside-home disconnectedness are at higher risk of loneliness during the time of COVID-19 pandemic. Stimulating virtual talking connectedness might have the potential to diminish loneliness despite steep outside-home disconnectedness.

Background: Brazil is facing increasing cycles of numbers of infected people and deaths resulting from coronavirus disease 2019 (COVID-19). This situation involves a series of factors, including the behavior of the population, that can be decisive for controlling the disease., Objective: To determine the knowledge, attitudes and practices of the Brazilian population regarding COVID-19., Design and Setting: Cross-sectional survey-type study, conducted using a population sample from different Brazilian states., Methods: A quantitative, descriptive and analytical approach was used. Sampling was done according to convenience and via snowballing. The data collection instrument was a knowledge, attitudes and practices system., Results: 1,655 people from all over Brazil participated in the survey; 80% were living in the southern region and 70.15% were female. More than 90% had knowledge and good attitudes relating to the means of transmission, preventive care and symptoms associated with COVID-19, although their knowledge and attitudes were not fully reflected in daily practices, for which there was lower adherence (80%). Greater knowledge was correlated with older participants, larger number of children, female sex and marital status; better attitude, with female sex and complete higher education; and better practices, with greater age, larger number of children and female sex., Conclusion: A large part of the population has general knowledge about COVID-19, but not all knowledge was applied in practice. Older people, females and university graduates stood out as the best informed and most committed to controlling the disease.

Central Core Disease (CCD) is a genetic neuromuscular disorder characterized by the presence of cores in muscle biopsy. The inheritance has been described as predominantly autosomal dominant (AD), and the disease may present as severe neonatal or mild adult forms. Here we report clinical and molecular data on a large cohort of Brazilian CCD patients, including a retrospective clinical analysis and molecular screening for RYR1 variants using Next-Generation Sequencing (NGS). We analyzed 27 patients from 19 unrelated families: four families (11 patients) with autosomal dominant inheritance (AD), two families (3 patients) with autosomal recessive (AR), and 13 sporadic cases. Biallelic RYR1 variants were found in six families (two AR and four sporadic cases) of the 14 molecularly analyzed families (~43%), suggesting a higher frequency of AR inheritance than expected. None of these cases presented a severe phenotype. Facial weakness was more common in biallelic than in monoallelic patients ( p = 0.0043) and might be a marker for AR forms. NGS is highly effective for the identification of RYR1 variants in CCD patients, allowing the discovery of a higher proportion of AR cases with biallelic mutations. These data have important implications for the genetic counseling of the families.

Schistosoma mansoni is a heteroxenous parasite, meaning that during its life cycle needs the participation of obligatory intermediate and definitive hosts. The larval development occurs in aquatic molluscs belonging to the Biomphalaria genus, leading to the formation of cercariae, which emerge to infect the final vertebrate host. For this reason, studies for control of the diseases caused by digenetic trematodes often focus on combating the snail hosts. Thus, the objective of this study was to evaluate the susceptibility of Biomphalaria tenagophila embryos to the fungus Pochonia chlamydosporia (isolate Pc-10). The entire experiment was conducted in duplicate, with five replicates for each repetition (five egg masses/replicate), utilizing a total of 100 egg masses, with 20-30 eggs/egg mass. At the end of 15 days, the egg masses were evaluated under a stereomicroscope to analyze the hatching of B. tenagophila embryos in both experimental groups. After days of interaction, the exposure to the fungal hyphae bodies significantly impaired the viability of the B. tenagophila eggs, inhibiting the embryogenesis process by 83.7% in relation to the control group. Transmission and scanning electron microscopic images revealed relevant structural alterations in the egg masses exposed to the hyphae action of the fungus, interfering in the development and hatching of the young snails under analysis. These results indicate the susceptibility of B. tenagophila embryos to the fungus P. chlamydosporia (isolate Pc-10) and suggest the potential of Pc-10 to be used in the control of intermediate host, for its ovicidal capacity and for being an ecologically viable option, but in vivo experiments become necessary., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background and study aims  In patients with inflammatory bowel disease (IBD), endoscopically visible lesions with distinct borders can be considered for endoscopic resection. The role of endoscopic submucosal dissection (ESD) for these lesions is not well defined because of a paucity of data. We aimed to evaluate the outcomes of colorectal ESD of dysplastic lesions in patients with IBD across centers in the United States. Patients and methods  This was a retrospective analysis of consecutive patients with IBD who were referred for ESD of dysplastic colorectal lesions at nine centers. The primary endpoints were the rates of en bloc resection and complete (R0) resection. The secondary endpoints were the rates of adverse events and lesion recurrence. Results  A total of 45 dysplastic lesions (median size 30mm, interquartile range [IQR] 23 to 42 mm) in 41 patients were included. Submucosal fibrosis was observed in 73 %. En bloc resection was achieved in 43 of 45 lesions (96 %) and R0 resection in 34 of 45 lesions (76 %). Intraprocedural perforation occurred in one patient (2.4 %) and was treated successfully with clip placement. Delayed bleeding occurred in four patients (9.8 %). No severe intraprocedural bleeding or delayed perforation occurred. During a median follow-up of 18 months (IQR 13 to 37 months), local recurrence occurred in one case (2.6 %). Metachronous lesions were identified in 11 patients (31 %). Conclusions  ESD, when performed by experts, is safe and effective for large, dysplastic colorectal lesions in patients with IBD. Despite the high prevalence of submucosal fibrosis, en bloc resection was achieved in nearly all patients with IBD undergoing ESD. Careful endoscopic surveillance is necessary to monitor for local recurrence and metachronous lesions after ESD., Competing Interests: Competing interests Dr. Kumta is a consultant for Apollo Endosurgery, Boston Scientific, and Olympus. Dr. Yang is a consultant for Boston Scientific, Lumendi and Steris. Dr. Draganov is a consultant for Boston Scientific, Lumendi, Cook, Olympus and Microtech. Dr. Ngamruengphong is a consultant for Boston Scientific. Dr. Aihara is a consultant for Olympus America, Boston Scientific, Fujifilm Medical Systems, Auris Health, Lumendi, Medtronic, ConMed, and 3 D Matrix. Dr. Nishimura is a consultant for Boston Scientific, Lumendi, and Olympus America. Dr. Marion is on the Advisory Board for Janssen. Dr. Song is a consultant for Olympus America and US Endoscopy. Dr. Friedland is a consultant for Capsovision Inc., Dr. Charabaty is on the advisory board of and/or a consultant for and/or receives educational grants from Abbvie, Janssen, Pfizer, and Takeda., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Lipid-based drug-delivery nanoparticles, including non-lamellar-type, mesophasic nanostructured materials of lyotropic liquid crystals (LLCs), have been a topic of interest for researchers for their applications in the encapsulation of biopharmaceutical drugs as well as their controlled and targeted release. Cubosomes, derived from LLCs, are self-assembled cubic-phase bicontinuous crystalline nanoparticulate colloidal dispersions. Their lipid bilayers are arranged in 3D space such that they have an uninterrupted, regular cubic symmetrical surface, separated by two interconnected aqueous channels. Thus, they have a large surface area involving numerous internal segments, giving them a definitive advantage over lamellar liposomes in facilitating the efficient entrapment and sustained release of active therapeutic substances. This Review focuses on the unique properties of cubosomes, such as their ability to encapsulate hydrophobic, hydrophilic, and amphiphilic bioactive substances, which make them attractive for the encapsulation and release of therapeutic molecules, including large biomolecules. Controlled drug release via functionalization has demonstrated cubosomes as a potential vehicle for various administration routes. Their self-assembling properties make their production uncomplicated, with two major manufacturing methods: the top-down and bottom-up methods. Cubosomes are formed when amphiphilic lipids, such as monoolein, monolinolein, phytantriol, etc. , self-assemble into non-lamellar bicontinuous cubic phases in excess water. In this Review, we have endeavored to outline the composition, preparation techniques, drug-encapsulation approaches, and drug-loading and -release mechanisms of cubosomes. Furthermore, the prospective routes for cubosomes, their challenges, and future potentialities are addressed.

The present study aimed to evaluate the toxicity of the association between Fe and Mn in Oreochromis niloticus through genotoxic (micronucleus test and comet assay) and biochemical (CAT and GST enzymes) assays. The tested treatments were T1 = control group (without metal addition), T2 = 2.60 mg L -1 of Fe + 0.2 mg L -1 of Mn, and T3 = 4.40 mg L -1 of Fe + 3.49 mg L -1 of Mn, during 96-h bioassays. All animals exposed to the metals showed a significant increase in erythrocyte micronucleus frequency and DNA damage. The hepatic GST activity increased two times in animals exposed to T3 compared to the control group. The results indicate that Fe + Mn caused genotoxic and biochemical changes in exposed fish. Therefore, excess metals in ecosystems, even those essential for organisms, can be dangerous for the local biota due to the risk associated with high concentrations of these metals., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Caffeine has been reported for its antiinflammatory properties by stimulating phagocytosis. In this study, we investigated the antiinflammatory and antiinfective potential of caffeine in murine macrophage cell cultures and Swiss mice infected with virulent Salmonella enterica serotype typhimurium. Peritoneal macrophages (pMØ) were treated with caffeine on 96-well plates for 24 hr and then infected with Salmonella for 4 hr. In another experiment, the pMØ were first infected with the bacterium for 4 hr and then treated with caffeine for 24 hr. In addition, Swiss mice were inoculated, intraperitoneally, with S. typhimurium and then received caffeine intravenously. Control groups received phosphate-buffered saline (PBS) or dexamethasone. We found that treatments with caffeine increased the macrophage cell viability and reduced the intracellular bacterial load. The administration of caffeine to Swiss mice reduced the infiltration of leukocytes into the peritoneal cavity after the bacterial challenge. Furthermore, the bacterial burdens in the peritoneal fluid, bloodstream, spleen, and liver were decreased by caffeine treatment. The expression levels of tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), IL-6, and inducible nitric oxide synthase (iNOs) were down-regulated after infection in caffeine-treated mice. We can conclude that caffeine has both antiinflammatory and antiinfective properties that can be useful for management of bacterial infections along with antibiotics., (© 2021 John Wiley & Sons Ltd.)

Background: Health-related quality of life is frequently used as an outcome measure that improves the quality of care. The SF-36 and RAND-36 were derived from the Medical Outcomes Study., Objective: The present study aimed to validate the RAND-36 in Brazil, in healthy individuals and patients with liver disease., Methods: Confirmatory factor analysis (CFA) was conducted by using JASP Software. The parameters of the items were estimated using the Robust Diagonally Weighted Least Squares (RDWLS) approach. Comparative fit index (CFI), Goodness-of-fit index (GFI), Tucker-Lewis Index (TLI) and the root mean square error of approximation (RMSEA) were evaluated. Internal consistency was measured using the Composite reliability index. Convergent validity between RAND-36 domains and Work Ability Index (WAI) was conducted., Results: This validation study included 763 individuals, 400 (52.4%) with chronic liver disease. The most prevalent liver diseases were hepatitis C (13.9%), alcoholic liver disease (11.8%), and steatosis (12.1%). The measurement model tested using the CFA obtained the following adjustment indicators: X2 (df): 599.65 (498); CFI: 0.998; GFI: 0.998; TLI: 0.998; RMSEA: 0.016 (90%CI: 0.011-.021). Convergent validity of RAND-36 and total WAI ranged from medium to large correlation., Conclusion: The RAND-36 is effective in measuring the perception of health-related quality of life in individuals with and without chronic liver disease. The results of our study support the developer's claims for the reliability of the RAND-36 version 1 as a measure of health-related quality of life. The evidence for the construct validity of the RAND-36 was substantial.

The current pandemic caused by the severe acute respiratory syndrome coronavirus 2 has triggered a scenario of danger and fear of contagion because of the elevated transmissibility and mortality. This in turn is responsible for development of anxieties and feelings of psychological suffering, triggering possible harm to the mental health of the health professionals who are daily faced with this battlefield scenario. This study aimed to assess the impact of the pandemic caused by COVID-19 on the mental health of health professionals working in this situation. An integrative literature review was conducted based on searches of the electronic scientific databases Virtual Health Library (Biblioteca Virtual em Saúde), National Library of Medicine, Physiotherapy Evidence Database, and Scientific Electronic Library Online. Publications were only identified in the Virtual Health Library database, with a total of 547 articles. After the filtering process, a total of 13 articles remained, which were screened by reading titles, abstracts, and full texts, leaving a total of eight articles, on which the manuscript is based. The scenario of uncertainties, anxieties, and fears faced by health professionals can have negative psychological repercussions for their health., Competing Interests: Conflicts of interest: None

Staphylococcus aureus is a leading cause of bovine mastitis worldwide. Despite some improved understanding of disease pathogenesis, progress towards new methods for the control of intramammary infections (IMI) has been limited, particularly in the field of vaccination. Although herd management programs have helped to reduce the number of clinical cases, S. aureus mastitis remains a major disease burden. This review summarizes the past 16 years of research on bovine S. aureus population genetics, and molecular pathogenesis that have been conducted worldwide. We describe the diversity of S. aureus associated with bovine mastitis and the geographical distribution of S. aureus clones in different continents. We also describe studies investigating the evolution of bovine S. aureus and the importance of host-adaptation in its emergence as a mastitis pathogen. The available information on the prevalence of virulence determinants and their functional relevance during the pathogenesis of bovine mastitis are also discussed. Although traits such as biofilm formation and innate immune evasion are critical for the persistence of bacteria, the current understanding of the key host-pathogen interactions that determine the outcome of S. aureus IMI is very limited. We suggest that greater investment in research into the genetic and molecular basis of bovine S. aureus pathogenesis is essential for the identification of novel therapeutic and vaccine targets., (© 2022. The Author(s).)

Objectives: The study describes a case series of hereditary angioedema with C1 Inhibitor Deficiency (C1INH-HAE) in order to corroborate six clinical warning signs "HAAAAE (H4AE)" to enable early identification of this disease., Methods: The authors analyzed the C1INH-HAE cohort to analyze the clinical aspects of the present study's patients and corroborate the six clinical warning signs of the Hereditary Angioedema Brazilian Guidelines. Data regarding demographics, the onset of disease, time to diagnosis, frequency of attacks per year, organs involved, triggers, crisis duration and their outcomes, and disease treatment were collected. Then the authors developed an acronym, H4AE, to help healthcare professionals remember the warning signs., Results: The authors included 98 patients in the study, with a mean age of 38.1 years, 67.3% being female, and 75.3% with a family history of HAE. HAE diagnosis was delayed, on average, 13.7 years after its initial manifestation. Exploratory laparotomy was reported by 26.9%, and orotracheal intubation by 21.3% of the present study's patients; 61.3% and 30.3% of them were admitted at least once in the hospital and in the intensive care unit, respectively. The authors constructed an acronym "H4AE" with the six warning signs of HAE: Hereditary, recurrent Angioedema, Abdominal pain, Absence of urticaria, Absence of response to antihistamines, Estrogen association., Conclusion: C1INH-HAE is still underdiagnosed and associated with high morbidity. The study showed clinical features of this disease, corroborating the warning signs, which may be useful in raising awareness and improving the diagnosis of C1INH-HAE. The authors suggest the acronym "H4AE" to remind the warning signs., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2022 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.)

Although the understanding of the pathophysiology of major depressive disorder (MDD) has advanced greatly, this has not been translated into improved outcomes. To date, no biomarkers have been identified for the diagnosis, prognosis, and therapeutic management of MDD. Thus, we aim to review the biomarkers that are differentially expressed in MDD. A systematic review was conducted in January 2022 in the PubMed/MEDLINE, Scopus, Embase, PsycINFO, and Gale Academic OneFile databases for clinical studies published from January 2001 onward using the following terms: "Depression" OR "Depressive disorder" AND "Metabolomic." Multiple metabolites were found at altered levels in MDD, demonstrating the involvement of cellular signaling metabolites, components of the cell membrane, neurotransmitters, inflammatory and immunological mediators, hormone activators and precursors, and sleep controllers. Kynurenine and acylcarnitine were identified as consistent with depression and response to treatment. The most consistent evidence found was regarding kynurenine and acylcarnitine. Although the data obtained allow us to identify how metabolic pathways are affected in MDD, there is still not enough evidence to propose changes to current diagnostic and therapeutic actions. Some limitations are the heterogeneity of studies on metabolites, methods for detection, analyzed body fluids, and treatments used. The experiments contemplated in the review identified increased or reduced levels of metabolites, but not necessarily increased or reduced the activity of the associated pathways. The information acquired through metabolomic analyses does not specify whether the changes identified in the metabolites are a cause or a consequence of the pathology., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, F. Guerreiro Costa et al.)

Objective: To assess survival and success rates of dental implants and the occurrence of peri-implant diseases (mucositis/peri-implantitis) in HIV-1-infected individuals., Material and Methods: In this prospective study, 13 HIV-1-infected individuals undergoing highly active antiretroviral therapy (with undetectable plasma HIV RNA levels, and CD4+ T cells > 350/mm 3 ) were followed after implant placement, as well as 13 non-HIV-1-infected matched controls. Patients enrolled in this study were followed up to 120 months (mean = 40.6 months; standard deviation = 22.2; range 18 -120 months). Twenty-five implants were placed in pristine healed sites for each group and bone augmentation procedures, when needed, were done only for contour augmentation. Patients were enrolled in a strict periodontal/peri-implant supportive therapy protocol with three recalls per year. The two groups were compared regarding subject-level characteristics (age, gender, smoking, diabetes) and implant-level characteristics (marginal bone level, peri-implant health status)., Results: All the implants healed uneventfully and reached 100% survival rates (after at least 18 months) in both groups. There were no significant differences between groups for peri-implant diseases (mucositis/peri-implantitis) and for all subject-level co-variables (p > .05). Only the variables dental implant prosthesis type (DIPT) (p = .021, d = .86) and follow up (p = .011, d = .77) showed statistically significant differences between groups., Conclusion: The findings suggest that well-controlled HIV-1-infected individuals are eligible to undergo implant therapy, achieving survival and success rates comparable to non-HIV-1-infected controls., (© 2021 Special Care Dentistry Association and Wiley Periodicals LLC.)

Few studies have examined the neighborhood features related to falls in the older population in low-and-middle-income countries, including Brazil. This study aimed to evaluate if perceived neighborhood features are related to falls among older Brazilian adults living in a large urban area. This cross-sectional study was conducted using data from 834 participants (≥60 years) from a multistage household survey in Belo Horizonte, Brazil. The association between fall history in the previous year and perceived neighborhood features (quality of services, physical and social disorder, and safety) was examined using multilevel logistic regression. The fall prevalence was 13.6%. Older adults living in neighborhoods with a higher physical disorder were more likely to report fall in the previous year, even after controlling for demographic, clinical and social variables (OR = 2.59; 95% CI = 1.14-5.87). The other neighborhood features investigated were not associated with a fall history. Our findings suggest that improving the physical environment represents an important strategy to prevent falls in the Brazilian urban older population.

Purpose: Malignant hyperthermia (MH) is a hypermetabolic disorder that can occur in genetically susceptible individuals exposed to halogenated anesthetics and succinylcholine. Spinal cord injury (SCI) above the sixth thoracic vertebra is associated with dysfunction of the sympathetic/parasympathetic nervous pathways, including thermoregulatory dysfunction, presenting as hypothermia in cold environments because of vasodilation and heat loss. This effect could mitigate or obscure an MH episode. Here, we describe development of a fatal MH crisis in a patient with SCI., Clinical Features: A 27-yr-old male patient with an SCI after fracture of the sixth cervical vertebra was admitted for spinal arthrodesis. Anesthetic medications included remifentanil, propofol, succinylcholine, rocuronium, and isoflurane. After the start of the surgery, muscular contractures resembling myoclonus were noted, which resolved with pancuronium administration. Four hours after the start of anesthesia, the patient presented with hyperthermia, hypercarbia, hypotension, muscle rigidity, arrhythmia, and cardiogenic shock, with metabolic/respiratory acidosis. Malignant hyperthermia was suspected and the treatment was started, but he developed cardiopulmonary arrest and died an hour and a half after the first cardiac arrest. Both parents were investigated and were found to have normal creatine kinase levels and positive in vitro contracture tests. His mother carried a variant in the ryanodine receptor type 1 (RYR1) gene (c.14918C>T), which is associated with MH., Conclusion: Spinal cord injury-induced thermoregulatory dysfunction may obscure the early diagnosis of MH and lead to fatal outcome., (© 2021. Canadian Anesthesiologists' Society.)

Introduction: First-line treatment for obsessive-compulsive disorder (OCD) includes exposure and response prevention behavioral therapy and serotonin reuptake inhibitors, particularly in combination. New and more effective treatments are needed, give that recent studies suggest that glutamatergic neurotransmission contributes to the pathophysiology of the disorder. In these circumstances, ketamine, as a potent N-methyl-D-aspartate receptor antagonist and glutamate modulator, offers alternative possibilities for OCD treatment., Methods: This systematic review aims to investigate the effects of ketamine in OCD, following the Preferred Reporting Items for Systematic Review and Meta-analyses Protocols (PRISMA-P). Searches were carried out using the PubMed/MEDLINE, Embase, and PsycINFO databases., Results: Nine articles were included, of which three were randomized controlled trials, three case reports, two open-label trials, and one a retrospective chart review. Reported data have shown a potential for fast onset of action and good tolerability of ketamine for OCD, even though the principal studies used only single-session racemic ketamine treatments, administered intravenously, and the results have been erratic. In addition, none of the available evidence demonstrates whether racemic ketamine, S-ketamine, or R-ketamine has the best efficacy in controlling OCD symptoms, and only sparse evidence suggests that a combination of ketamine and psychotherapy could benefit patients with OCD., Conclusion: In order to advance clinical practice regarding the use of ketamine in treating OCD, future randomized, double-blind, placebo-controlled trials are required. These trials need to use larger samples to explore ketamine and its enantiomers, with different methods of administration, multiple sessions, and appropriate washout periods., (Copyright © 2022 President and Fellows of Harvard College.)

The objective of this study was to evaluate factors that may influence decision-making with regard to extraction or maintenance of periodontally compromised teeth. A questionnaire with 2 distinct clinical scenarios, each including a radiographic image, was provided to students in their final year of dental school and practicing dentists. The participants were asked to record the action that they would take in each case (tooth maintenance vs extraction) and provide a justification for their decision. The questionnaires were answered by 158 dental students and 57 dentists (N = 215). Among the sample as a whole, 31.16% of participants recommended extraction in scenario 1, while only 5.58% recommended that action in scenario 2. In scenario 1, there was a statistically significant difference in the recommendations of the dental students and the dentists, with the former group significantly more disposed to conservative action, that is, maintenance of the tooth (P < 0.001; chi-square test). When the actions recommended by participants specializing in implants or periodontics (or both) were compared with those recommended by other specialists, there was a statistically significant difference between the groups regarding maintenance and extraction (P = 0.012; Fisher exact test), with the former group recommending fewer extractions. When the responses were evaluated in terms of the participants' years of specialty practice, it was observed that professionals with fewer than 20 years of practice were more conservative in their decisions, choosing tooth maintenance significantly more often than specialists with longer experience (P = 0.031; Fisher exact test). Among the majority of both dental students and practicing dentists, the decision in both scenarios was to maintain the compromised teeth; however, the results suggested that that both the years of experience of the individual and the specialty of the practitioner can influence decision-making.

Objectives: to describe the assembly of a low-cost paracentesis simulator and evaluate its effectiveness, acceptance and impact on the learning of medical students., Methodology: a paracentesis simulator was built using a mannequin and materials such as plastic bottles, Velcro, polyvinyl chloride sheets and silicone were used. A cross-sectional and experimental study was carried out with undergraduate medical students without previous practical experience with paracentesis, which sought to validate the model, evaluating its benefits in learning and obtaining technical skills., Results: after using the simulator there was an increase of 82.4% in the level of confidence in performing paracentesis in a patient, with 98% of respondents considering that the model fulfilled the simulator function with satisfaction, and 100% considering it useful as a teaching tool., Conclusion: the built simulator was effective as an educational resource, serving as an alternative to high-cost commercial models, allowing for greater accessibility in the use of this tool in medical education.

Subsistence hunting is the main source of protein for forest reserve dwellers, contributing to the development of spurious infections by Calodium hepaticum, frequently associated with the consumption of the liver from wild mammals. The prevalence of infections by soil-transmitted helminths (STHs) and intestinal protozoa is considered an indicator of the social vulnerability of a country, besides providing information on habits, customs and quality of life of a given population. Intestinal parasites mostly affect poor rural communities with limited access to clean water and adequate sanitation. This study reports the results of a parasitological survey carried out in 2017 and 2019, in two municipalities (Xapuri and Sena Madureira) in Acre State. Stool samples were collected from 276 inhabitants. Upon receipt, each sample was divided into two aliquots. Fresh samples without preservative were processed and examined by the Kato-Katz technique. Samples fixed in 10% formalin were processed by the spontaneous sedimentation and the centrifugal sedimentation techniques. Calodium hepaticum eggs were found in three stool samples. The overall STH prevalence was 44.9%. The hookworm prevalence (19.2%) was higher than that of Ascaris lumbricoides (2.5%) and Trichuris trichiura (0.7%), an unexpected finding for municipalities belonging to the Western Brazilian Amazon. When considering parasites transmitted via the fecal-oral route, Endolimax nana and Entamoeba coli showed the highest positivity rates, of 13% and 10.9%, respectively. This study is the first report of spurious infection by C. hepaticum among forest reserve dwellers that consume undercooked liver of lowland pacas. Additionally, this is the first report of Blastocystis sp. in Acre State.

This article addresses the compulsory seizing of children from vulnerable women in Brazil. Its objectives were: to discuss the violation of the right to maternity; to present the imposed restrictions especially on poor, black and indigenous women; the strategic control over their lives and children, and the resistance movements that oppose segregation. The sources of the research were: narratives of women in vulnerable situations, family members and health workers; interviews with strategic actors; document analysis; field journal. It became evident that vulnerabilities -linked to the criminalization of poverty and racial prejudice- have justified these separations. The lack of responsibility that State and society practice towards the support network for women, the devaluation of non-hegemonic productions of maternity, and the reinforcement of a 'reason of the world', that produces violence as a tool for exclusion establishing practical limits on the right to maternity. Women and children are disregarded in their singularities. Resistance movements have shown that intersectoral dialogues are an alternative to overcome discrimination and vulnerabilities.

Objectives: The aim of this retrospective cross-sectional study was to estimate the association of HIV-1 infection under highly active antiretroviral treatment (HAART) on the clinical parameters of periodontitis., Materials and Methods: A total of 205 patients were divided in two groups: 74 HIV + and 131 HIV - . Periodontal probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and visible supragingival biofilm (VSB) were recorded. The association of HIV-1 infection with the presence of at least 3 sites with PPD ≥ 5 mm and/or CAL ≥ 4 mm in non-adjacent teeth was estimated using binary logistic regression models., Results: The variables HIV-1 infection (OR = 5.53, p < 0.0001, 95% CI: 2.45-13.64), age [range 35-50 years old (OR = 5.73, p < 0.0001, 95% CI: 2.49-13.20); > 50 years old (OR = 6.29, p = 0.002, 95% CI: 1.94-20.42)], and VSB (OR = 23.68, p < 0.0001, 95% CI: 8.07-69.53) showed a significant direct association with BOP outcome., Conclusions: HIV-1 infection under HAART did not have association with the presence of at least 3 sites with PPD ≥ 5 mm and/or CAL ≥ 4 mm. However, HIV patients on HAART had direct association of HIV-1 infection with BOP and an inverse association with PPD., Clinical Relevance: These results support that monitoring gingival bleeding associated with oral prophylaxis would be beneficial in the prevention and management of periodontitis in HIV-1 patients on HAART., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Depression is the leading cause of years lived with disability worldwide and PLWHIV present a higher risk of developing depressive symptoms. We aimed to evaluate depressive symptoms and their predictors in virologically suppressed PLWHIV. We conducted a cross-sectional study with 200 PLWHIV. Depressive symptoms were defined as scoring ≥ 14 points in the Beck Depression Inventory II. Most of the participants (58.5%) were men, with a median age of 54 years (IQR: 46.25-59.00). Depressive symptoms' prevalence was 19.5% and they were associated with being divorced/widowed (aOR: 2.93, CI 95%: 1.17-7.37), recurrent falls (aOR: 4.24, CI 95%: 1.07-16.85), pre-frailty (aOR: 3.55, CI 95%: 1.47-8.57), and lower scores in all HRQoL dimensions. Although virologically suppressed PLWHIV presented lower prevalence of depressive symptoms than reported in previous studies in Brazil and South America, they were associated with falls and frailty, highlighting the need for screening., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Aim: Aim of this study is to identify signs and symptoms associated with identifying critically ill patients by rapid triage assessment performed by nurses in an emergency department., Background: In some emergency services, the immediate assessment of critically ill patients occurs before opening the hospital formal registration and it is based on the nurse's experience. Studies on the topic are essential to improve this process., Design: This is a cross-sectional, quantitative study., Methods: This study was conducted in a Brazilian emergency department in 2017. Adult patients who presented potentially life-threatening symptoms underwent rapid triage to determine the medical urgency. Those identified as being critically ill were classified as high priority and streamed to the emergency room., Results: A total of 154 (84.6%) patients were classified as high priority from the total of 182 evaluations. Altered state of consciousness (35.2%) and altered skin perfusion (25.3%) were frequently identified. Signs and symptoms associated with identifying critically ill patients by rapid triage were alterations in ventilation (OR 6.09; p = 0.028), neurological dysfunction (OR 44.96; p < 0.001) and pain (OR 5.80; p = 0.004)., Conclusion: Nurses should value neurological and ventilation alterations and pain in patients during rapid triage, since these signs and symptoms are associated with high care priority., (© 2021 John Wiley & Sons Australia, Ltd.)

Background: Pharmacological treatments for mental disorders, such as anxiety and depression, present several limitations and adverse effects. Therefore, new pharmacotherapy with anxiolytic and antidepressant potential is necessary, and the study of compounds capable of interacting with more than one pharmacological target may provide new therapeutic options., Objectives: In this study, we proposed the design, synthesis of a new compound, 2-(4-((1- phenyl-1H-pyrazol-4-yl)methyl)piperazin-1-yl)ethyl acetate (LQFM192), pharmacological evaluation of its anxiolytic-like and antidepressant-like activities, as well as the possible mechanisms of action involved., Methods: Administration of LQFM192 was carried out prior to the exposure of male Swiss mice to behavioral tests, such as the elevated plus-maze and forced swimming test. The involvement of the serotonergic system was studied by pretreatment with WAY-100635 or p-chlorophenylalanine (PCPA) and the involvement of the benzodiazepine site of the GABAA receptor by pretreatment with flumazenil., Results: The treatment with LQFM192 at doses of 54 and 162 μmol/kg demonstrated anxiolyticlike activity that was blocked by WAY-100635, PCPA, and flumazenil pretreatments. The potential antidepressant-like activity was visualized at the same doses and blocked by WAY-100635 and PCPA., Conclusion: In summary, the anxiolytic-like activity of LQFM192 is mediated by the serotonergic system and the benzodiazepine site of the GABAA receptor, and the antidepressant-like activity through the serotonergic system., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The emergence of the pathogen Candida auris is a real concern worldwide, especially due to its multidrug resistance profile, besides the difficulties in establishing the correct identification by conventional laboratory methods and its capacity of causing outbreaks in healthcare settings. The limited arsenal of available antifungal drugs, coupled with the lack of momentum for the development of new reagents, represent a challenge in the management of such a pathogen. In this perspective, we have focused on discussing new, promising treatment options for C. auris infections. These novel drugs include an antifungal agent already approved for medical use in the United States of America, compounds that are already in clinical trials and those with potential for repurposing use against this important fungal pathogen., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objective: to identify factors associated with infection and hospitalization due to COVID-19 in nursing professionals., Method: a cross-sectional study carried out with 415 nursing professionals in a hospital specialized in cardiology. The sociodemographic variables, comorbidities, working conditions and issues related to illness due to COVID-19 were evaluated. Chi-Square, Fisher's, Wilcoxon, Mann-Whitney and Brunner Munzel tests were used in data analysis, as well as Odds Ratio for hospitalization, in addition to binary logistic regression., Results: the rate of nursing professionals affected by COVID-19 was 44.3% and the factors associated with infection were the number of people living in the same household infected by COVID-19 (OR 36.18; p<0.001) and use of public transportation (OR 2.70; p=0.044). Having severe symptoms (OR 29.75), belonging to the risk group (OR 3.00), having tachypnea (OR 6.48), shortness of breath (OR 5.83), tiredness (OR 4.64), fever (OR 4.41) and/or myalgia (OR 3.00) increased the chances of hospitalization in professionals with COVID-19., Conclusion: living in the same household as other people with the disease and using public transportation increased the risk of infection by the new coronavirus. The factors associated with the hospitalization of contaminated professionals were presence of risk factors for the disease, severity and type of the symptoms presented.

The use of pesticides has continue grown over recent years, leading to several environmental and health concerns, such as the contamination of surface and groundwater resources and associated biota, potentially affecting populations that are not primary targets of these complex chemical mixtures. In this work, we investigate lethal and sublethal effects of acute exposure of methomyl commercial formulation in zebrafish embryo and larvae. Methomyl is a broad-spectrum carbamate insecticide and acaricide that acts primarily in acetylcholinesterase inhibition (AChE). Methomyl formulation 96 h-LC 50 was determined through the Fish Embryo Acute Toxicity Test (FET) and resulted in 1.2 g/L ± 0.04. Sublethal 6-day exposure was performed in six methomyl formulation concentrations (0.5; 1.0; 2.2; 4.8; 10.6; 23.3 mg/L) to evaluate developmental, physiological, morphological, behavioral, biochemical, and molecular endpoints of zebrafish early-development. Methomyl affected embryo hatching and larva morphology and behavior, especially in higher concentrations; resulting in smaller body and eyes size, failure in swimming bladder inflation, hypolocomotor activity, and concentration-dependent reduction of AChE activity; demonstrating methomyl strong acute toxicity and neurotoxic effect., (Copyright © 2021. Published by Elsevier Inc.)

Background: Validation of cognitive instruments for detection of Alzheimer's disease (AD) based on correlation with diagnostic biomarkers allows more reliable identification of the disease., Objectives: To investigate the accuracy of the Brief Cognitive Screening Battery (BCSB) in the differential diagnosis between AD, non-AD cognitive impairment (both defined by cerebrospinal fluid [CSF] biomarkers) and healthy cognition, and to correlate CSF biomarker results with cognitive performance., Methods: Overall, 117 individuals were evaluated: 45 patients with mild cognitive impairment (MCI) or mild dementia within the AD continuum defined by the AT(N) classification [A+T+/-(N)+/]; 27 non-AD patients with MCI or mild dementia [A-T+/-(N)+/-]; and 45 cognitively healthy individuals without CSF biomarker results. All participants underwent evaluation using the BCSB., Results: The total BCSB and delayed recall (DR) scores of the BCSB memory test showed high diagnostic accuracy, as indicated by areas under the ROC curve (AUC): 0.89 and 0.87, respectively, for discrimination between AD and non-AD versus cognitively healthy controls. Similarly, total BCSB and DR displayed high accuracy (AUC-ROC curves of 0.89 and 0.91, respectively) for differentiation between AD and controls. BCSB tests displayed low accuracy for differentiation between AD and non-AD. The CSF levels of biomarkers correlated significantly, though weakly, with DR., Conclusions: Total BCSB and DR scores presented good accuracy for differentiation between patients with a biological AD diagnosis and cognitively healthy individuals, but low accuracy for differentiating AD from non-AD patients.

Objectives: Poor sleep quality negatively affects cognitive performance. However, there are limited data on sex differences in functional outcomes of impaired sleep on cognition. Therefore, the aim of this study was to evaluate the association between sleep quality and performance of men and women in cognitive tests., Material and Methods: After screening, 97 individuals with and without insomnia complaints participated of this study. Behavioral scales were evaluated using a number of instruments and the sleep pattern was recorded by actigraph. Subsequently, the participants were submitted to visuospatial/verbal working memory (WM), visual attention, and psychomotor vigilance tests (PVT)., Results: The actigraphic recordings indicated that men sleep later (d=-0.56, p<0.05), fall asleep faster (d=0.42, p<0.05), showed shorter sleep duration (d=0.53, p<0.05), and more sleep fragmentation than women (d=-0.41, p<0.05). The performance in the cognitive tasks also showed sex differences: the men showed better performance in the visuospatial short-term memory (d=-0.78, p<0.05); verbal (d=-0.61, p<0.05), and visuospatial-WM tests (d=-0.84, p<0.05); they also responded faster in the PVT (d=0.69, p<0.05), although made more mistakes (d=-0.85, p<0.01). Longer sleep latency was associated with poor performance in visual attention (r=0.52, p<0.05) and verbal memory tasks (r=-0.30, p<0.05) in men., Conclusion: Our results suggest that difficulty in falling asleep was associated with cognitive impairment, especially in men. Sex differences in sleep quality and cognitive skills should be taken into account in future research in this field.

A new species of Cetopsorhamdia is described from material collected on rapid inventories and ichthyological expeditions in the Amazon region of Peru, Ecuador and Colombia. The new species can be differentiated from all other species of Cetopsorhamdia by the colouration pattern on fins, number of vertebrae, number of ribs, level insertion of dorsal fin, number of rays on dorsal and pectoral fin, osteological characters and several other morphometric characters. The new species is distributed along tributaries of the upper Amazon River basin in Peru, Colombia and Ecuador., (© 2021 Fisheries Society of the British Isles.)

The efficiency of microalgae harvesting on the removal of Giardia spp. cysts, Cryptosporidium spp. oocysts, total coliforms, Escherichia coli, Enterococcus spp. and Clostridium spp. was assessed in lab-scale experiments (Jartest and Flotatest) using effluent from a flat panel photobioreactor used for Chlorella sorokiniana cultivation. Three harvesting methods were evaluated: (1) flocculation induced by pH modulation followed by sedimentation (pH-SED), (2) flocculation induced by pH modulation followed by dissolved air flotation (pH-DAF), and (3) coagulation using an organic coagulant (Tanfloc SG) followed by dissolved air flotation (Coag-DAF). The results indicated that the three harvesting methods were efficient in removing protozoan (oo)cysts and bacteria, achieving percentages of removal higher than 97% for all the analyzed pathogens. Among the three methods, pH-SED showed the best removal performance: 99.60% (2.5 log) for Giardia spp. cysts, 100% (>6.3 log) for total coliforms, 100% (>4.6 log) for Escherichia coli, 100% (>5.8 log) for Enterococcus spp. and 99.96% (3.6 log) for Clostridium spp. Clostridium spp. seemed to be more tolerant to the harvesting methods than the other groups of bacteria analyzed in the study, and its presence was positively correlated to the presence of Giardia spp. cysts., (Copyright © 2021. Published by Elsevier Ltd.)

Background: The lectin from Cratylia argentea (CFL) is able to modulate the immune system response and is thus a potential phytotherapeutic substance., Hypothesis/purpose: In this study, we investigated the role of CFL on control of bacterial infection caused by Listeria monocytogenes, the causative agent of human listeriosis., Study Design: Swiss mice were infected with L. monocytogenes and then treated with CFL., Methods: Adult Swiss mice weighing with 30-40 g were infected intraperitoneally with a bacterial suspension (0.2 ml; 1 × 10 7 CFU/ml). After 30 min, the mice were treated with CFL intravenously at concentrations of 0.1 or 10 mg/kg. Control mice received phosphate-buffered saline (PBS). The animals were euthanized 24 h after infection., Results: We observed that i.v. administration of CFL to Swiss mice did not cause acute toxicity, and reduced the leukocyte counts in the bloodstream 24 h after infection with virulent L. monocytogenes. There was a reduction in the bacterial burden within peritoneal macrophages after infection in CFL-treated mice. Accordingly, the bacterial counts in the bloodstream, spleen and liver also decreased in comparison with the PBS group. Histological damage in the spleen and liver was lower in mice that received CFL treatment. In vitro antimicrobial assays demonstrated that CFL does not inhibit the growth of L. monocytogenes. The mRNA expression of the anti-inflammatory cytokine IL-10 was enhanced with CFL treatment after infection., Conclusion: The lectin from C. argentea (CFL) has immunomodulatory and anti-infective properties of pharmacological interest for control of infectious diseases., (Copyright © 2021 Elsevier GmbH. All rights reserved.)

Since the last decade, several studies have reported the presence and effects of pharmaceutical residues in the marine environment, especially those of the antihypertensive class, such as losartan. However, there is little knowledge about the physiological effects of losartan in marine invertebrates regarding its behavior under possible coastal ocean acidification scenarios. The objective of this study was to evaluate biological effects on marine organisms at different levels of the biological organization caused by the compound losartan in water and sediment under coastal ocean acidification scenarios. Water and sediment samples were collected at five sites around the Santos Submarine Sewage outfall (SSO) and two sites around the Guarujá Submarine Sewage Outfall (GSO). Losartan was found in concentrations ranging from

Persistent inflammatory responses in the elderly may act as modifiers on the progression and repair of chronic apical periodontitis lesions (CAPLs). While the involvement of IL-1β, IL-6 and TNF-α in inflammatory responses and, particularly, in CAPL has been documented, their expression in elderly patients needs to be further characterized. Therefore, the purpose of this study was to evaluate and compare the expressions of pro-inflammatory cytokines in CAPL from elderly individuals with young/middle-aged individuals. Thirty CAPL (15 cysts and 15 granulomas) from elderly patients (>60 years) and 30 CAPL (15 cysts and 15 granuloma) from young/middle-aged individuals (20-56 years) were selected. Immunohistochemical reactions were performed against IL-1β, IL-6 and TNF-α. The slides were subdivided into five high-magnification fields and analyzed. The number of positive stains was evaluated for each antibody. There was no significant difference between the cytokines when the cysts and granuloma were compared in the two groups. In the young/middle-aged, only IL-1β showed a difference and was significantly higher in granulomas ( p = 0.019). CAPL pro-inflammatory cytokine levels in the elderly were significantly higher than in young/middle-aged individuals ( p < 0.05). The pro-inflammatory cytokines IL-1β, IL-6 and TNF-α were significantly higher in CAPL in the elderly compared with the young/middle-aged group. Further elaborate research studies/analyses to elucidate the reasons for and consequences of inflammation in the elderly are recommended.

Vulvovaginal candidiasis is a public health problem with a high incidence among female patients. Currently, there is an increase in the identification of Candida spp. resistant to current therapy, making it necessary to search for new therapeutic alternatives. The synergistic potential of curcumin with fluconazole is described in the literature. However, due to its high lipophilicity, it is necessary to use drug-delivery systems to adequately explore its potential, among which is the nanostructured lipid carrier. However, to date, there is no validated method of high-performance liquid chromatography for simultaneous determination of fluconazole and curcumin in the literature. Thus, the present work developed a high-performance liquid chromatography method for simultaneous determination of fluconazole and curcumin co-encapsulated in nanostructured lipid carrier which was validated according to the International Conference on Harmonization (Technical Requirements for Registration of Pharmaceuticals for Human Use) - Q2 (R1) and the Food and Drug Administration - Guidance for Bioanalytical Method. The method was applied to determine the encapsulation efficiency and drug-loading of curcumin and fluconazole in nanostructured lipid carriers. The developed method proved to be selective, precise, accurate, and robust for the simultaneous determination of both drugs, enabling the quantification of encapsulation efficiency and drug-loading of curcumin and fluconazole in nanostructured lipid carriers., (© 2021 Wiley-VCH GmbH.)

Background. Post-cured composite resins exhibit improvements in physical and mechanical properties due to additional polymerization conversion. However, the post-curing techniques might influence the color stability of composite resin materials. Thus, this study evaluated the color stability of a nanofilled composite resin (Filtek Z350 XT - 3M ESPE) subjected to different post-curing techniques. Methods. Sixty samples (color A2) were randomly allocated to six experimental groups (n=10): G1: photoactivation (P) (control); G2: P + microwave oven with distilled water; G3: P + microwave oven without distilled water; G4: P + conventional oven; G5: P + dry-heat sterilizer; G6: P + steam autoclave. All the groups were stored in distilled water for 60 days and immersed daily in 5 mL of a coffee solution for 3 minutes. The color readings (CIEL*a*b* system) were performed at two different time intervals, initially and after 60 days, in a reflectance spectrophotometer (UV-2600; Shimadzu). The colorimetric readings were performed using the Color Analysis software (CIEL*a*b* system). Results. Group G6 exhibited significantly low values of total color change (ΔE=13.16). The control (ΔE=15.32) and G5 (ΔE=15.49) groups exhibited intermediate values, with no difference between them. In turn, the groups in which the resin was heated in a microwave (G2 ΔE=18.55 and G3 ΔE=19.45) exhibited the most significant color changes (one-way ANOVA and Tukey test, P ≤0.05). Conclusion. Steam autoclave post-polymerization increased the color stability of the nanofilled resin subjected to artificial aging and coffee immersion., (© 2021 The Author(s).)

Biogenic volatile organic compounds (BVOCs) play critical roles in ecological and earth-system processes. Ecosystem BVOC models rarely include soil and litter fluxes and their accuracy is often challenged by BVOC dynamics during periods of rapid ecosystem change like spring leaf out. We measured BVOC concentrations within the air space of a mixed deciduous forest and used a hybrid Lagrangian/Eulerian canopy transport model to estimate BVOC flux from the forest floor, canopy, and whole ecosystem during spring. Canopy flux measurements were dominated by a large methanol source and small isoprene source during the leaf-out period, consistent with past measurements of leaf ontogeny and theory, and indicative of a BVOC flux situation rarely used in emissions model testing. The contribution of the forest floor to whole-ecosystem BVOC flux is conditional on the compound of interest and is often non-trivial. We created linear models of forest floor, canopy, and whole-ecosystem flux for each study compound and used information criteria-based model selection to find the simplest model with the best fit. Most published BVOC flux models do not include vapor pressure deficit (VPD), but it entered the best canopy, forest floor, and whole-ecosystem BVOC flux model more than any other study variable in the present study. Since VPD is predicted to increase in the future, future studies should investigate how it contributes to BVOC flux through biophysical mechanisms like evaporative demand, leaf temperature and stomatal function., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: The aim of this study was to verify the match between 5 shades of composites from different manufacturers with a shade guide and among the systems using a portable spectrophotometer., Materials and Methods: Shade measurements were performed on specimens of Z350 XT (3M ESPE), Charisma Diamond (Heraeus Kulzer GmbH), Esthet X-HD (Dentsply Caulk), and Empress Direct (Ivoclar-Vivadent) for shades A1, A2, A3, B1, and C3 using a Vita Easyshade spectrophotometer (Vita Zahnfabrik) against a white background. Corresponding shades of Vitapan Classical (Vita Zahnfabrik) guide were measured likewise and shade variation (ΔE) was calculated based on International Commission on Illumination L*a*b* parameters. The ΔE of the composites in each shade was compared by one-way analysis of variance and Tukey's post hoc test (α = 0.05)., Results: All composites presented ΔE > 3.7 compared with the shade guide. Variation in shades A3, B1, and C3 was significantly different for all composites. ΔE of Z350 XT was significantly lower for A1 than for the other shades, whereas ΔE of Z350 XT and Charisma Diamond were significantly lower for A2 than for the other shades., Conclusions: No composite shade matched with the shade guide. Equivalent shades of the restorative composite from different manufacturers may show clinically noticeable ΔE., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported., (Copyright © 2021. The Korean Academy of Conservative Dentistry.)

Purpose: To evaluate the prevalence and characteristics of orthopedic injuries associated with the technical-tactical profiles of Brazilian Jiu-Jitsu (BJJ) fighters, according to the fighters' graduation level (beginner and advanced)., Patients and Methods: Cross-sectional study, which included the participation of amateur and professional BJJ athletes, aged between 18 and 60 years and practitioners of the sport for at least six months. All answered a mixed self-reported morbidity questionnaire. Participants were divided into four groups, according to the technical-tactical profile in the fight (keeper and passer) and the fighter's graduation level (beginner and advanced), and also into four subgroups, divided by joining the groups in pairs above. Descriptive and analytical statistical procedures were used, with a level of statistical significance set at 5% (p < 0.05)., Results: A total of 198 participants were included in the study. There was a higher prevalence of musculoskeletal injuries in advanced fighters (p<0.001), with no significant difference between the profiles of guard and passer fighters. Sprains were the most common type of injury in all studied groups and subgroups. The anatomical segments knee and shoulder, respectively, were the most affected in all groups, and both segments showed significant associations of the athletes in the advanced and guard groups., Conclusion: The study showed important data for creation of specifics injury prevention protocols, through the higher prevalence of injuries in athletes of the advanced profile and in the segments of the knee and shoulder, with emphasis on the guard fighters., Competing Interests: No potential conflicts of interest for this work were reported by the authors., (© 2021 Juliano Eustaquio et al.)

Amides derived from ferulic acid have a wide spectrum of pharmacological activities, including antitumor and antifungal activity. In the present study, a series of ten amides were obtained by coupling reactions using the reagents (benzotriazol-1-yloxy) tripyrrolidinophosphonium hexafluorophosphate (PyBOP) and N,N ' - dicyclohexylcarbodiimide (DCC). All the compounds were identified on the basis of their IR, 1 H- and 13 C-NMR, HRMS data, and with yields ranging from 43.17% to 91.37%. The compounds were subjected to cytotoxic tests by the alamar blue technique and antifungal screening by the broth microdilution method to determine the minimum inhibitory concentration (MIC). The amides 10 and 11 displayed the best result in both biological evaluations, and compound 10 was the most potent and selective in HL-60 cancer cells, with no cytotoxicity on healthy cells. This amide had antifungal activity in all strains and had the lowest MIC against Candida albicans and Candida tropicalis . The possible mechanism of antifungal action occurs via the fungal cell wall. Molecular modeling suggested that compounds 10 and 11 interact with the enzymes GWT1 and GSC1, which are essential for the development of C. albicans . The findings of the present study demonstrated that compounds 10 and 11 may be used as a platform in drug development in the future., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Mayara Castro de Morais et al.)

Myotonia congenita is a genetic disease caused by mutations in the CLCN1 gene, which encodes for the major chloride skeletal channel ClC-1, involved in the normal repolarization of muscle action potentials and consequent relaxation of the muscle after contraction. Two allelic forms are recognized, depending on the phenotype and the inheritance pattern: the autosomal dominant Thomsen disease with milder symptoms and the autosomal recessive Becker disorder with a severe phenotype. Before the recent advances of molecular testing, the diagnosis and genetic counseling of families was a challenge due to the large number of mutations in the CLCN1 gene, found both in homozygous or in heterozygous state. Here, we studied a consanguineous family in which three members presented a variable phenotype of myotonia, associated to a combination of three different mutations in the CLCN1 gene. A pathogenic splicing site mutation which causes the skipping of exon 17 was present in homozygosis in one very severely affected son. This mutation was present in compound heterozygosis in the consanguineous parents, but interestingly it was associated to a different second variant in the other allele: c.1453 A > G in the mother and c.1842 G > C in the father. Both displayed variable, but less severe phenotypes than their homozygous son. These results highlight the importance of analyzing the combination of different variants in the same gene in particular in families with patients displaying different phenotypes. This approach may improve the diagnosis, prognosis, and genetic counseling of the involved families., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.)

Objective: Human T-cell lymphotropic virus type-1 (HTLV-1) infection is a neglected tropical disease associated with many clinical manifestations, such as erythematous-scaling skin lesions, cutaneous lymphomas, and spastic paraparesis, which could be a potential cause of mental health concerns. This study investigates the prevalence of symptoms and diagnoses of depression and anxiety and its associated factors in people living with HTLV-1 (PLWH)., Method: A systematic review was performed in the Pubmed/MEDLINE, Embase, LILACS, and PsycINFO databases for original studies investigating symptoms of depression and anxiety and diagnoses of major depressive disorder and anxiety disorders in PLWH, and a random-effects meta-analysis with meta-regression was performed to obtain a summary frequency of symptoms and diagnoses of depression and anxiety., Results: Considering both symptoms and diagnoses, the pooled prevalence for depression was 35% (95% CI: 27 to 43) and for anxiety was 33% (95% CI: 23 to 45). Clinically significant symptoms were more prevalent than diagnosed disorders for depression (47% vs. 21%) and anxiety (44% vs. 11%). PLWH were more likely than seronegative controls to present symptoms and diagnoses of depression (pooled OR: 4.25; 95% CI: 2.7 to 6.68) and anxiety (pooled OR: 3.79; 95% CI: 2.6 to 5.52). Spastic paraparesis was significantly associated with symptoms and diagnoses of depression (pooled OR: 1.81; 95% CI: 1.11 to 2.95) and anxiety (pooled OR: 2.75; 95% CI 1.26 to 5.96)., Conclusions: PLWH present a much higher prevalence of symptoms and diagnoses of depression and anxiety than seronegative controls, which could be explained by social vulnerability or neurological impairment associated with spastic paraparesis. More studies comparing asymptomatic PLWH and seronegative controls are needed., (Copyright © 2021. Published by Elsevier Inc.)