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Abstract Background Nonenveloped viruses, such as hepatitis A virus (HAV) and parvovirus B19 (B19V), are not inactivated by detergents and solvents commonly used to manufacture plasma derivatives. Cases of transfusion-transmitted HAV and B19V have already been described in several countries. This study aimed to determine the incidence of HAV and B19V asymptomatic infections in blood donors from Rio de Janeiro and evaluate the residual risk of transmission to blood derivative recipients. Methods From 2018 to 2019, 1,204 plasma samples were tested by PCR and real-time PCR. HAV and B19V genotypes were determined through sequencing and phylogenetic analysis. The risk of transfusion transmission was determined using a Bayesian statistical approach. Results HAV-RNA and B19V-DNA were detected in 1.66 (95% CI 0.26–5.48) and 3.32 (95% CI 1.00-7.81) per 1000 donors, respectively. For HAV, all positive samples were classified as subgenotype IB. For B19V, the sequenced samples belonged to genotype 1A. The estimated numbers of infectious blood bags with HAV and B19V were 587 (95% CI 92-1936) and 880 (95% CI 355–2759), respectively. Conclusion This study originally assessed the incidence of both Hepatitis A Virus (HAV) and B19 Virus (B19V) among Brazilian blood donors, as well as the potential risk of residual transmission of these infections through blood transfusions. Our findings can contribute to future cost-effective studies aimed at implementing screening methods for these viruses, which could enhance discussion on surveillance in blood banks and protective measures for blood recipients.

Abstract Background Globally, cervical cancer is an increasing public health issue, and vaccination against HPV has proven to be an effective strategy to reduce this neoplasia. The purpose of this study was to assess the effectiveness of the quadrivalent vaccine in reducing the prevalence and incidence of HPV infection in women, aged 18 to 24 years old, in the cities of Ouro Preto and Mariana, Minas Gerais, Brazil. Methods A concurrent cohort study was performed, with an initial follow-up of 12 to 18 months. The selected young women were interviewed and divided into two groups: vaccinated and unvaccinated. Participants underwent a Pap smear and cervical sample collection for HPV detection, genotyping performed by PCR-RFLP, type-specific PCR, and using the PapilloCheck®. The prevalence of HPV infection was analyzed using the compare proportions test. Poisson and Cox multivariate regression models were used to estimate vaccine effectiveness. Results There was no significant difference in the overall prevalence of HPV infection between vaccinated and unvaccinated groups (23.6% vs. 18.7%; p = 0.364). However, the prevalence of infection by HPV 6/11, 16 and 18 types in vaccinated young women (1.1%) was lower than in unvaccinated ones (7.5%; p = 0.030). Regarding non-vaccine types, a higher prevalence was identified among vaccinated women (22.5% vs. 11.2%; p = 0.018). The overall incidence of HPV infection was 15.75/100 young women/year in non-immunized women compared to 9.12/100 young women/year among those immunized. The effectiveness of the vaccine was 64.0%, regardless of the viral type, and no vaccinated woman was detected with the specific vaccine HPV-type in follow-up. HPV33/45, related to cross-protection, were detected in 12.3% of vaccinated women and 1.2% of unvaccinated ones (p

Abstract Maternal adverse childhood experiences (ACEs) are linked to negative health and developmental outcomes in offspring. However, whether maternal ACEs influence infant weight gain in the first months of life, and if this effect differs by infant sex, remains unclear. This study included 352 full-term newborns from low-risk pregnancies and their mothers in low-income settings in Brazil. Anthropometric data (weight, length, head circumference) and other information (feeding type, offspring sex, family income) were collected at delivery (W0), discharge (W1), and up to 8 weeks postpartum (W2). ACEs were assessed using the CDC-Kaiser Questionnaire, and weight gain was calculated as the difference between W2 and W1, divided by the number of days between measurements. The association between maternal ACEs and offspring weight gain was positive only in male offspring (unstandardized coefficient (male) = 1.82, SE = 0.438, p

Purpose: This study aimed to assess the styloid process (TBSP) phenotype and to identify suggestive images of calcified atheromatous plaques (CAP) in panoramic radiographs of patients with primary hyperparathyroidism (PHPT) and post-surgical hypoparathyroidism (hypoPT). Additionally, it aimed to analyze the association between the bone mineral status of patients with parathyroid diseases and the radiographic findings. Material and methods: A cross-sectional case-control study was conducted with individuals diagnosed with PHPT (n = 25) and post-surgical hypoPT (n = 25). A control group (n = 50) comprised individuals without parathyroid gland disorders. Panoramic radiographs were utilized for both quantitative (length) and qualitative (mineralization patterns) evaluation of the TBSP, as well as for assessing the prevalence of CAP. Results: The frequency of TBSP exceeding 30 mm was significantly higher in the PHPT and post-surgical hypoPT groups compared to the control group. CAP occurred more frequently in the PHPT group. Cases of low bone mineral density (BMD) were associated with PHPT. In the PHPT group, low BMD was linked to an increased average TBSP length (p = 0.025) and a higher frequency of elongated TBSP (p = 0.022). Multivariate analysis revealed an inverse relationship between the T-score of the femoral neck and TBSP length in the PHPT group (p = 0.028). Conclusions: Compared to the control group, individuals with PHPT and post-surgical hypoPT showed distinct imaging findings related to TBSP and CAP. Individuals with PHPT and low BMD showed a higher frequency of elongated TBSP.

Abstract Background Endoplasmic reticulum stress (ERS) and the unfolded protein response (UPR) are adaptive mechanisms for conditions of high protein demand, marked by an accumulation of misfolded proteins in the endoplasmic reticulum (ER). Rheumatic autoimmune diseases (RAD) are known to be associated with chronic inflammation and an ERS state. However, the activation of UPR signaling pathways is not completely understood in Sjögren’s disease (SD). This study evaluated the expression of ERS-related genes in glandular tissue of patients with primary SD (pSD), associated SD (aSD) with other autoimmune diseases, and non-Sjögren sicca syndrome (NSS). Methods In a cross-sectional study, minor salivary gland biopsies were obtained from 44 patients with suspected SD and 13 healthy controls (HC). Patients were classified as pSD, aSD, or NSS based on clinical, serological, and histological assessment. Histopathological analysis and mRNA expression analysis of genes associated with ERS and UPR (PERK, XBP1, ATF-6, ATF-4, CANX, CALR, CHOP, and BIP) were performed on the samples. Differences between groups (pSD, aSD, NSS, and HC) were assessed. The influence of chloroquine (CQ) on the ER was also investigated. Results Twenty-eight SD patients showed increased expression of PERK (p = 0.0117) and XBP1 (p = 0.0346), and reduced expression of ATF-6 (p = 0.0003) and CHOP (p = 0.0003), compared to the HC group. Increased expression of BIP (p

Abstract This study investigates the changing epidemiological profile of tongue squamous cell carcinoma (SCC) to young patients, highlighting its rising incidence among non-traditional risk groups. A retrospective descriptive study was conducted, covering data from medical records between 2000 and 2012. Patients were categorised into two age groups (≤ 40 years; 41–50 years). Sociodemographic and clinicopathological characteristics were evaluated. A total of 108 patients participated, mostly aged 41–50. Alcohol consumption (43.3%) surpassed smoking. Majority (56.7%) aged ≤ 40 never smoked. Lateral tongue border was most affected, with stages III and IV prevalent. Patients aged ≤ 40 were mostly eligible for surgery (44%). Survival tied to staging and surgery; age had no significant impact. Young squamous cell carcinoma patients often lacked traditional risk factors like smoking, underwent surgery, and typically had disease-free margins. The study underscores the importance of broad external policies for early diagnosis, beyond just traditional risk groups.

Abstract Background Colorectal cancer (CRC) is the second leading cause of cancer death worldwide. Early detection of precursor lesions or early-stage cancer could hamper cancer development or improve survival rates. Liquid biopsy, which detects tumor biomarkers, such as mutations, in blood, is a promising avenue for cancer screening. Aim To assess the presence of genetic variants in plasma cell-free tumor DNA from patients with precursor lesions and colorectal cancer using the commercial Oncomine Colon cfDNA Assay. Material and methods Cell-free DNA (cfDNA) samples from the plasma of 52 Brazilian patients were analyzed. Eight patients did not have any significant lesions (five normal colonoscopies and three hyperplastic polyps), 24 exhibited precursor lesions (13 nonadvanced adenomas, 10 advanced adenomas, and one sessile serrated lesion), and 20 patients with cancer (CRC). The mutation profile of 14 CRC-associated genes were determined by next-generation sequencing (NGS) using the Oncomine Colon cfDNA Assay in the Ion Torrent PGM/S5 sequencer. Results Thirty-three variants were detected in eight genes (TP53, PIK3CA, FBXW7, APC, BRAF, GNAS, KRAS, and SMAD4). No variants were detected in the AKT1, CTNNB1, EGFR, ERBB2, MAP2K1 and NRAS genes. All variants were considered pathogenic and classified as missense or truncating. The TP53 gene harbored the most variants (48.48%), followed by the KRAS gene (15.15%) and the APC gene (9.09%). It was possible to detect the presence of at least one pathogenic variant in cfDNA in 60% of CRC patients (12/20) and 25% of precursor lesions (6/24), which included variants in three patients with nonadvanced adenoma (3/13 – 23.08%) and three with advanced adenomas (3/10 – 30%). No variants were detected in the eight patients with normal findings during colonoscopy. The detection of mutations showed a sensitivity of 60% and a specificity of 100% for detecting CRC and a sensitivity of 50% and a specificity of 100% for detecting advanced lesions. Conclusion The detection of plasma NGS-identified mutations could assist in early screening and diagnostic of CRC in a noninvasive manner.

Abstract Purpose To assess the retinal microvasculature of Systemic Lupus Erythematosus (SLE) patients using Optical Coherence Tomography Angiography (OCTA). Methods Twenty adult SLE patients without disease activity and no ocular manifestations were recruited and cross-sectionally assessed. A demographically similar cohort of healthy subjects was used for comparison. The main outcome is vascular density (VD). As secondary outcomes, foveal avascular zone (FAZ) parameters, total vessel length (TVL), vessel length density (VLD), vessel diameter and tortuosity, branchpoint density (BD) and fractal dimension (FD) were evaluated. Results Forty eyes of 40 women (20 SLE patients and 20 healthy subjects) were enrolled with a mean ± SD age of 36.7 ± 9.9 years. In both the superficial and deep capillary plexuses, SLE patients presented significantly lower VD and TVL values, mean vessel diameter and FD (all p

Research in rural areas is essential to understand the necessary demands of the population, in addition to enabling the development of effective strategies according to the disparities and characteristics of this environment. The article aims to describe and reflect on weaknesses and potential elements in the data collection process of a study with school communities in rural areas of RS. This is an experience report, originating from data collection for doctoral research. The participants were students, parents, education and health professionals, municipal secretary of education and health. Data collection was the application of questionnaires and recording of interviews and data analysis was through content analysis, in addition to being approved by the research ethics committee. As positive aspects, the receptivity of the municipalities, adherence to research and mobilization of municipal management stand out. As negative aspects, it was considered the difficult access to the rural area, difficulty in reconciling schedules, frequent change of municipal secretaries and difficulty in contacting the Regional Health Coordinators. It is concluded that research in the rural community is vital to understand the needs of the population and regional culture.

Background and aims: The COVID-19 pandemic significantly impacted the mental health of healthcare professionals, especially those working in Psychosocial Care Centers (CAPS), which are crucial services in the Brazilian mental health system. This study aimed to investigate the association between job satisfaction, workload, and psychological distress among CAPS professionals during the pandemic. Methods: A cross-sectional study was conducted with 53 professionals from seven CAPS. The Workload Impact Scale (IMPACTO-BR) and Job Satisfaction Scale (SATIS-BR), the General Health Questionnaire (GHQ-12), and a sociodemographic questionnaire were used. Descriptive and analytical statistical analyses were performed. Multiple linear regression analysis was conducted to examine the relationship between job satisfaction, workload, and psychological distress. Results: Professionals reported moderate satisfaction (3.67 ± 0.45) and mild workload (1.82 ± 0.63). One-third of the sample showed scores indicative of psychological distress. Multiple linear regression analysis revealed that workload (p = 0.0025) and low job satisfaction (p = 0.0495) were significantly associated with psychological distress. Conclusions: Low job satisfaction and high professional workload were predictive variables of psychological distress. These findings highlight the need for investments in promoting the quality of life at work for mental health professionals, especially during crises. The implications for human resource management and public policy development emphasize the importance of an integrated approach that considers the well-being of professionals for the effectiveness and sustainability of the psychosocial care model.

Abstract Atherosclerotic vascular changes can begin during childhood, providing risk for cardiovascular disease (CVD) in adulthood. Identifiable risk factors such as dyslipidemia accelerate this process for some children. The apolipoprotein B (APOB) gene could help explain the inter-individual variability in lipid levels among young individuals and identify groups that require greater attention to prevent CVD. A cross-sectional study was conducted with school-aged children and adolescents in Ouro Preto, Minas Gerais. The study evaluated cardiovascular risk factors’ variables and XbaI polymorphism in the APOB gene for associations with increased total cholesterol (TC). The prevalence of increased TC was notably high, reaching 68.9% in the study population. Carriers of the variant T allele were 1.45 times more likely to develop increased TC in a dominant model (1.09–1.94, p = 0.011). After adjustments, excess weight and a family history of dyslipidemia interacted significantly with XbaI polymorphism in increased TC, resulting in Odds Ratio of 1.74 (1.11–2.71, p = 0.015) and 2.04 (1.14–3.67, p = 0.016), respectively. The results suggest that XbaI polymorphism in the APOB gene may affect the lipid profile of Brazilian children and adolescents and could contribute to the CVD in adulthood.

Abstract A recent study proposed a new genetic lineage of leatherback turtles (Dermochelys coriacea) based on genetic analysis, environmental history, and local ecological knowledge (LEK), suggesting the existence of two possible species or subspecies on the beaches of Oaxaca, diverging ~ 13.5 Mya. However, this hypothesis may be influenced by nuclear mitochondrial DNA segments (NUMTs), which could have been misamplified as true mtDNA. NUMTs are sequences that have migrated from the mitochondrial genome to the nuclear genome and can co-amplify with mtDNA, potentially leading to erroneous phylogenetic interpretations. We re-examined the evidence for this proposed lineage by reviewing taxonomic literature and additional genetic data. Our analysis indicates that the divergent sequences, previously associated with a new lineage of D. coriacea, are NUMTs rather than true mitochondrial sequences. This is the first evidence of NUMTs in sea turtles. We also proposed a more specific primer for the mitochondrial control region (D-loop) for leatherback turtles to avoid amplifying nuclear copies. Our findings highlight the importance of rigorous genetic validation in conservation genetics, where misinterpretations can significantly impact species management. Finally, we developed a general protocol for detecting NUMTs applicable to any species.

Abstract Objective To investigate the factors associated with hypercholesterolemia in older adults residing in a small municipality in northeastern Brazil. Methods This is a population‐based cross‐sectional epidemiological study conducted with 232 older adults (women: 58.60%; men: 41.40%) in Aiquara, Bahia, Brazil. Independent variables included socioeconomic, behavioral, and health‐related factors. The outcome was self‐reported hypercholesterolemia (yes or no). Poisson regression with a robust estimator was used to calculate Prevalence Ratios (PR) and their respective 95% Confidence Intervals (CI) in the inferential analysis. Gross models were initially developed, followed by a hierarchical multiple explanatory model (Level 1: socioeconomic variables; Level 2: behavioral aspects; Level 3: health conditions). Results The observed prevalence of hypercholesterolemia was 34.50% (men: 21.90%; women: 43.40%). Additionally, a higher probability of hypercholesterolemia was observed in women (PR: 1.94; 95% CI: 1.27–2.97); participants with high sedentary behavior (PR: 1.47; 95% CI: 1.03–2.09); those with abdominal obesity (PR: 1.65; 95% CI: 1.06–2.57); and those with diabetes mellitus (PR: 1.54; 95% CI: 1.04–2.29). Conclusion The main results showed that female sex, high sedentary behavior, abdominal obesity, and diabetes mellitus were positively associated with hypercholesterolemia in the older population of the study.

Abstract Zoonotic infections (swine-human) caused by influenza A viruses (IAVs) have been reported and linked to close contact between these species. Here, we describe eight human IAV variant infections (6 mild and 2 severe cases, including 1 death) detected in Paraná, Brazil, during 2020–2023. Genomes recovered were closely related to Brazilian swIAVs of three major lineages (1 A.3.3.2/pdm09, 1B/human-like, and H3.1990.5), including three H1N1v, two H1N2v, two H3N2v and one H1v. Five H1v were closely related to pdm09 lineage, one H1v (H1N2v) grouped within 1B.2.3 clade, and the two H3v grouped within a clade composed exclusively of Brazilian H3 swIAV (clade H3.1990.5.1). Internal gene segments were closely related to H1N1pdm09 isolated from pigs. IAV variant rarely result in sustained transmission between people, however the potential to develop such ability is of concern and must not be underestimated. This study brings into focus the need for continuous influenza surveillance and timely risk assessment.

Objetivo: Verificar a frequência de sintomas de ansiedade, depressão e estresse em acadêmicos do curso de Enfermagem. Método: Pesquisa de abordagem quantitativa, do tipo transversal, com amostra de 199 acadêmicos de Enfermagem de uma Instituição de Ensino Superior Pública. Os dados foram coletados através de questionários aplicados, incluindo um questionário sociodemográfico e a Escala de Ansiedade, Depressão e Estresse DASS-21. Resultados: Observou-se uma alta frequência de sintomas de depressão, ansiedade e estresse, os quais variaram entre os níveis moderado e extremamente severo. Verificou-se uma associação significativa entre o uso de ansiolíticos e o aumento do estresse (p=0,043), e a variável depressão esteve mais associada ao sexo feminino (p=0,026), apontando uma maior frequência desse diagnóstico entre mulheres. Conclusão: A alta frequência dos sintomas entre os alunos revelou a necessidade de desenvolvimento de intervenções e suporte adequado por parte da Instituição de Ensino a fim de promover um contexto mais favorável para a saúde mental dos acadêmicos. ABSTRACT Objective: Verifying the frequency of anxiety, depression, and stress symptoms among Nursing students. Method: A quantitative, and cross-sectional study was conducted with a sample of 199 Nursing students from a public institution. Data were collected through questionnaires, including a sociodemographic questionnaire and the Depression, Anxiety, and Stress Scale (DASS-21). Results: A high frequency of symptoms of depression, anxiety and stress was observed, which varied between moderate and extremely severe levels. There was a significant association between the use of anxiolytics and increased stress (p=0.043) and the variable depression was more associated with females (p=0.026), indicating a greater frequency of this diagnosis among women. Conclusion: The high frequency of symptoms among students revealed the need to develop interventions and adequate support from the Educational Institution to promote a more favorable context for the mental health of students.

Abstract It remains unclear whether exercises leading to different outcomes of delayed onset muscle soreness (DOMS) may also elicit different skin temperature responses. The aim of this study was to determine whether different intensities and volumes of a single-joint exercise influence the DOMS and skin temperature measurements differently in healthy adults. Thirty-nine men and women were randomly assigned to three groups performing different exercise of different intensities and volumes (Exhaustion, Fatigue, Submaximal) to induce DOMS in the biceps brachii. DOMS (numeric pain rate scale, NPRS), pressure pain threshold (PPT) and skin temperature (infrared thermography, IRT) were measured on exercise day and 48 h later. The different exercises resulted in lower PPT responses 48 h after exercise and different DOMS reported across the different groups. Skin temperature outcomes did not differ following the different protocols. We found an increased minimum skin temperature 48 h after exercise in groups performing more intense exercises, but such differences were found in both exercised and non-exercised arms. Differently of PPT outcomes, pain reported depended on exercise intensity, and skin temperature 48 h after exercise could not show acute exercise adaptations. Skin temperature responses are contingent upon the characteristics of the participants rather than exercise intensity.

Wastewater treatment plants play a crucial role in water management by facilitating water reuse, recycling and maintaining a safe level of pollutants released into the environment. The operation of these plants varies according to a several factors, including the season, type of wastewater, and volumes to be treated. These factors commonly influence the consumption of electricity and other input materials, such as coagulants and flocculants. Despite the process being well-established and in use for decades, the use of chemical agents often remains at constant ratios, which may depend on inflow volumes. Consequently, the use of those chemical agents often surpasses the actual process needs, leading to unnecessary costs and environmental impacts. In this context, modelling was employed to analyze the typical operation of a wastewater treatment plant, with the polymer concentration and the electricity demand as the variables to be optimized. The reduction of the amount of polymer was determined by tracking the sedimentation kinetics at different polymer concentrations, combining zeta potential measurement and particle size distribution. Sedimentation data were obtained by interpreting the transmission and backscattering profile using a TurbiScan Lab®. The impact of the sample collection and analysis time on sedimentation kinetics was also investigated. It was found that the optimal concentration of cationic polyacrylamide to treat wastewater containing approximately 5 mg/L of suspended particles and initial concentration of phosphorous of 5.525 mg/mL can vary from 0.1 mg/mL to 1.3 mg/mL depending on the analysis time. Therefore, by implementing in-line sensing, the concentration of suspended particles can be used to optimize polymer consumption. Additionally, a new electricity operation mode is proposed for the wastewater treatment plant in Finland, a concept that could yield benefits beyond economic profit. These findings could be utilized to enhance the operation of wastewater treatment plants worldwide.

Mare endometrosis is a major reproductive problem associated with low fertility and is characterized by persistent inflammation, TGFβ-1 signaling, and consequently, extracellular matrix deposition, which compromises endometrial glands. Mesenchymal stem cell-based products (MSCs), such as extracellular vesicles (EVs), have gained attention due to the regulatory effects exerted by their miRNA cargo. Here, we evaluated the impact of preconditioning equine adipose mesenchymal stem cells with TGFβ-1 for short or long periods on the anti-fibrotic properties of secreted extracellular vesicles. MSCs were isolated from six healthy horses and exposed to TGFβ-1 for 4, 24, and 0 h. The expression of anti-fibrotic and pro-fibrotic miRNAs and mRNAs in treated cells and miRNAs in the cargo of secreted extracellular vesicles was measured. The resulting EVs were added for 48 h to endometrial stromal cells previously induced to a fibrotic status. The expression of anti-fibrotic and pro-fibrotic genes and miRNAs was evaluated in said cells using qPCR and next-generation sequencing. Preconditioning MSCs with TGFβ-1 for 4 h enriched the anti-fibrotic miRNAs (mir29c, mir145, and mir200) in cells and EVs. Conversely, preconditioning the cells for 24 h leads to a pro-fibrotic phenotype overexpressing mir192 and mir433. This finding might have implications for developing an EV-based protocol to treat endometrial fibrosis in mares.

Polyomaviruses (PyVs) are small double-stranded DNA viruses able to infect species across all vertebrate taxa. In cetaceans, PyVs have been reported only in short-beaked common dolphin (Delphinus delphis), common bottlenose dolphin (Tursiops truncatus) and killer whale (Orcinus orca). Herein, we surveyed PyV in 119 cetaceans (29 mysticetes and 90 odontocetes) stranded along the Brazilian coast, from 2002 to 2022, comprising 18 species. DNA extracted from the lungs was tested using a nested PCR targeting the major capsid protein gene of PyV. Polyomavirus was detected in lung samples of 1.7% (2/119) cetaceans: two juvenile female Guiana dolphins (Sotalia guianensis) stranded in Rio de Janeiro (Rio de Janeiro state) and Guriri (Espírito Santo state), in 2018. Both retrieved sequences were identical and presented 93.3% amino acid identity with Zetapolyomavirus delphini, suggesting a novel species. On histopathology, one of the PyV-positive individuals presented basophilic intranuclear inclusion bodies morphologically consistent with polyomavirus in the lungs. Other available tissues from both cases were PyV-PCR-negative; however, both individuals tested positive for Guiana dolphin morbillivirus. To our knowledge, this is the first report of PyV infection in cetaceans of the Southern Hemisphere and the first description of a co-infection with morbillivirus.

BackgroundThe pharmacoinvasive (PhI) strategy is the standard-of-care for ST-elevation myocardial infarction (STEMI) patients when primary percutaneous coronary intervention (pPCI) is unfeasible. Optimal timing for post-fibrinolytic PCI (lysis-PCI) remains elusive. Therefore, this study aimed to assess the clinical and economic impacts of early vs. delayed lysis-PCI in patients with STEMI.MethodsThis retrospective cohort study included 1,043 STEMI patients classified by lysis-PCI timing. The primary outcome was in-hospital major adverse cardiovascular events (4p-MACE), with secondary outcomes such as 3p-MACE, in-hospital mortality, and costs. Multivariable logistic regression models were used to assess the association between lysis-PCI timing and outcomes. Cost analyses were conducted from the perspective of Brazilian public healthcare system, with values converted to international dollars (Int$) for broader applicability.ResultsEvery 4-h delay in lysis-PCI was associated with a 44% reduction in in-hospital mortality [OR = 0.560 (95% CI: 0.381–0.775); p = 0.001] and a 13% decrease in 4p-MACE [OR = 0.877 (95% CI: 0.811–0.948); p = 0.001]. Additionally, 4-h delay in lysis-PCI was also associated with a significant reduction in in-hospital costs (Int$916.20 ± 99) and disease-induced years of productivity lost (β = −41.79 ± 151 years; p = 0.001). These significant trends remained consistent even after adjusting for confounders and applying propensity score matching. Older adults (aged ≥80) experienced an increase in 3p-MACE with earlier lysis-PCI.ConclusionDelaying lysis-PCI was found to be associated with reduced in-hospital cardiovascular adverse events and lower costs, particularly among older adults. Further research should develop evidence-based lysis-PCI protocols that optimize both clinical outcomes and cost-effectiveness.

Objective: The study aimed to optimize protocols for the joint extraction of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) from 0.025 × 106 CFU of Candida albicans, targeting to overcome the challenges in the extraction of these genetic materials. Materials and methods: From this, treated silicon carbide (SiC) granules were added to fungal samples from methods 1, 2, and 3 obtained from aliquots of BHI or Sabouraud medium to cause cell lysis and enable the isolation of these macromolecules by phenol and chloroform. The concentration and integrity of the extracted nucleic acids were analyzed, respectively, by spectrophotometry using the A260/A280 ratios and 1% agarose gel electrophoresis. Results: Therefore, method 3 is the one that most comprises samples considered pure of both DNA and RNA, simultaneously. Furthermore, the presence of intact RNAs corresponding to the base pair size such as 5.8 S rRNA and tRNA was verified during electrophoresis, considering the particularities of RNA, which makes it very unstable and easily degraded. Conclusions: Thus, it results in a faster and simpler method in addition to obtain promising results using minimal amounts of biological sample and offering a valuable alternative for small laboratories to work with molecular biology.

Environmental contamination from mixtures of chemical substances and materials resulting from anthropogenic activities has adverse effects on aquatic biota. Fipronil (FP) is an insecticide widely used in agriculture and public health and is frequently detected in environmental compartments. Microplastics (MPs) represent another class of contaminants that have raised concerns due to their ability to adsorb pollutants, potentially acting as a vector. This study evaluated the influence of polyethylene microplastics on the toxicity of FP in zebrafish (Danio rerio) embryos/larvae. Zebrafish embryos were exposed to aqueous suspension containing purified FP and the FP + MP mixtures for 120 h. Mortality, teratogenicity and cardiotoxicity were observed during the zebrafish development. Larvae were more sensitive to FP than the embryo. The presence of MPs reduced lethality; however, no significant changes were observed for sublethal endpoints. Our findings demonstrate the acute impact of FP on zebrafish embryos/larvae, demonstrating that MPs interfere with toxicity. Therefore, understanding the mechanisms of interaction between contaminants of different classes is essential for predicting the associated risks to biota.

Abstract The use of antibiotics by dentist surgeons faces a lack of consensus among professionals and researchers, whether in relation to prophylaxis, or at least regarding the real need for their use. Recent studies increasingly question the use of prophylactic antibiotic therapy in healthy patients. This study aimed to evaluate the knowledge of dentist surgeons working in offices across Brazil regarding antibiotic use protocols and antibiotic resistance. A questionnaire was made via Google Forms and sent by email. The results showed that most dentists prescribe antibiotics for all surgical procedures performed in their office, regardless of the complexity and the patient. Furthermore, low scientific basis was observed among some of the professionals interviewed regarding the best therapeutic choice and the role of antibiotics in the surgical procedure. The present study highlights the urgent need to improve the knowledge of these professionals in Brazil, to reduce the impact on antibiotic resistance.

Abstract An animal model was applied to develop erosive tooth wear (ETW) and to evaluate the efficacy and safety of titanium tetrafluoride (TiF4) in preventing ETW. Forty-eight male Wistar rats were divided into three groups (n = 16): TiF4 (2.45% F−), NaF (2.45% F−) and placebo varnishes. Eight from each group were subjected to erosive challenges (Sprite Zero) and the other received tap water, both ad libitum. After twenty-eight days, the mandibles were resected for histopathological gingival analysis, clinical and microscopic tooth evaluation by 3D confocal laser microscopy, scanning electron microscopy (SEM-EDX) and micro-Raman spectroscopy (MRS). Organs were evaluated with respect to fluoride content. No significant difference was found in F content in tissues. No histopathological damage was seen in gingiva. ETW was clinically more aggressive in rats from placebo group consuming Sprite compared to water (Q²=12.6, p

Objetivos: Traduzir para a língua portuguesa o Teste de Desempenho Físico (Physical Performance Test) em uma versão modificada e avaliar sua consistência interna e a confiabilidade intra e interexaminadores. Material e Métodos: O processo de adaptação linguística seguiu as etapas: tradução para o português, retradução, avaliação da tradução por especialistas e estudo-piloto. Com a versão final em português, conduziu-se a estudo de confiabilidade intra e interexaminadores em idosos da comunidade. Resultados: Foram avaliados 30 participantes. No processo de tradução e adaptação cultural, apenas no item 8 do teste foi acrescentado o número de degraus que correspondem a um lance de escadas (10 degraus). Não houve dúvidas quanto ao entendimento dos outros itens. Para teste intra e interexaminadores, os valores do coeficiente de correlação intraclasse (ICC) foram 0,81 (IC95% 0,51-0,93) e 0,86 (IC95% 0,63-0,95), respectivamente; e os coeficientes a de Cronbach foram 0,89 e 0,92, respectivamente. No teste t de Student para amostras pareadas foi observado que não houve diferença significativa entre teste-reteste intra e interexaminadores (p > 0,05). Conclusões: O Teste de Desempenho Físico (Physical Performance Test) em sua versão modificada foi traduzido para o português e adaptado para aplicação em idosos brasileiros residentes na comunidade, apresentando níveis adequados de consistência interna e confiabilidade. Geriatria & Gerontologia. 2008;3(2):104-109.

Abstract 3D skin models have been explored as an alternative method to the use of animals in research and development. Usually, human skin equivalents comprise only epidermis or epidermis/dermis layers. Herein, we leverage 3D bioprinting technology to fabricate a full-thickness human skin equivalent with hypodermis (HSEH). The collagen hydrogel-based structure provides a mimetic environment for skin cells to adhere, proliferate and differentiate. The effective incorporation of the hypodermis layer is evidenced by scanning electron microscopy, immunofluorescence, and hematoxylin and eosin staining. The transcriptome results underscore the pivotal role of the hypodermis in orchestrating the genetic expression of a multitude of genes vital for skin functionality, including hydration, development and differentiation. Accordingly, we evidence the paramount significance of full-thickness human skin equivalents with hypodermis layer to provide an accurate in vitro platform for disease modeling and toxicology studies.

Abstract Background Limited information is available about functioning and related impairments of children and adolescents with Cerebral Palsy (CP) in low- and middle-income countries (LMIC) like Brazil. The aim of this study is to describe the characteristics, functioning, and impairments of Brazilian children and adolescents with CP. Methods Cross-sectional preliminary study as part of the PartiCipa Brazil multicentered cohort study. Families of children and adolescents with CP from Brazil, 4 months to 15 years, were enrolled. They responded to an online survey with questions about their child’s health condition, impairments, contextual factors, and functioning according to the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). Data were described as frequencies, percentages, means, and standard deviations, according to age bands. Results Of the 404 participants (6.5±3.6 years) enrolled in this preliminary analysis, 54.7% are male, 90.4% under 12 years of age, 77.7% have bilateral CP, 49% in GMFCS levels IV and V, and 50.7% in MACS levels II and V. Most participants are from Southeast (63.4%) and Centre-west (19.5%) of Brazil. Regarding the impairments and functioning limitations: 1 in 2 did not talk; 1 in 2 has epilepsy; 2 of 5 reports pain, 1 of 4 has visual impairments, 3 out of 5 did not feed themselves, 1 out of 20 has a hearing impairment and 1 of 4 did not go to school. Conclusion This first preliminar Brazilian study shows a high prevalence of children at MACS levels II and V and GMFCS levels IV and V, representing almost half of the group, indicating more impairments and limitations than children/adolescents from high-income countries. This study provides a preliminary deeper understanding of the key impairments and limitations in activities among children and adolescents with CP from various Brazilian regions.

Abstract Background Heterotopic pregnancy and amniotic embolism are rare conditions that can be challenging to diagnose. To date, there are no cases of heterotopic pregnancy associated with amniotic embolism described in the literature. Therefore, we report the case of a pancreatic heterotopic pregnancy, which led to amniotic embolism and an unfavorable maternal outcome. Case Presentation A 20-year-old pregnant woman presented with nausea and abdominal pain refractory to drug treatment. She had an increased lipase of 205 U/L (reference 8 to 78 U/L) and a total abdominal ultrasound with biliary sludge. The pregnant woman had no known risk factors for ectopic and heterotopic pregnancy. The initial diagnostic suspicions were hyperemesis gravidarum or acute pancreatitis. During hospitalization, she fluctuated between periods of clinical improvement and worsening of abdominal pain, but serial laboratory control had a favorable and benign evolution. On the 30th day of hospitalization, the patient developed spontaneous abortion, respiratory failure, and cardiorespiratory arrest. Necropsy showed heterotopic pregnancy in the pancreatic tail, amniotic embolism, and consequent disseminated intravascular coagulation. Conclusion Obstetricians should suspect heterotopic pregnancy in patients with an acute abdomen. The gold standard diagnostic method for this condition is laparoscopy. In the present case, the authors consider that pancreatic pregnancy allowed the introduction of fetal antigens and amniotic fluid into the maternal bloodstream, leading to amniotic embolism and consequent disseminated intravascular coagulation.

Introdução: O envelhecimento populacional é um fenômeno mundial que traz consigo o aumento das doenças crônicas não transmissíveis (DCNTs), com especial atenção às doenças cardiovasculares (DCVs), dentre as quais se destaca a hipertensão arterial sistêmica (HAS). Objetivos: Identificar os fatores que podem interferir na acessibilidade das populações idosas às medicações anti-hipertensivas, nos aspectos relacionados ao paciente e suas relações interpessoais, à estrutura física das unidades de saúde da família (USFs) e ao fluxo de distribuição e dispensação de medicações nas USFs de Recife e Paulista, Pernambuco. Métodos: Os dados foram coletados por meio de um protocolo de entrevista, no período de outubro a dezembro de 2010, nas referidas USFs. Resultados: A média de idade encontrada foi de 67,7 anos, sendo a maioria do sexo feminino. Os fatores que mais interferem na acessibilidade são: dificuldade de ler a receita do médico e o nome na embalagem da medicação, deslocamento da USF, falta de infraestrutura e falta de medicamentos. Conclusão: O Estado deve investir no aprimoramento do serviço de atenção básica à saúde, com o intuito de evitar os entraves à acessibilidade às medicações, de modo a promover um melhor alcance das metas pressóricas do paciente geriátrico e, assim, prevenir as complicações das DCVs.

Background: Traumatic brain injury (TBI) is a major life-threatening event. In addition to neurological deficits, it can lead to long-term impairments in attention and memory. Deep brain stimulation (DBS) is an established therapy for movement disorders that has been recently investigated for memory improvement in various disorders. In models of TBI, stimulation delivered to different brain targets has been administered to rodents long after the injury with the objective of treating motor deficits, coordination and memory impairment. Objective: To test the hypothesis that DBS administered soon after TBI may prevent the development of memory deficits and exert neuroprotective effects. Methods: Male rats were implanted with DBS electrodes in the anterior nucleus of the thalamus (ANT) one week prior to lateral fluid percussion injury (FPI). Immediately after TBI, animals received active or sham stimulation for 6 h. Four days later, they were assessed in a novel object/novel location recognition test (NOR/NLR) and a Barnes maze paradigm. After the experiments, hippocampal cells were counted. Separate groups of animals were sacrificed at different timepoints after TBI to measure cytokines and brain derived neurotrophic factor (BDNF). In a second set of experiments, TBI-exposed animals receiving active or sham stimulation were injected with the tropomyosin receptor kinase B (TrkB) antagonist ANA-12, followed by behavioural testing. Results: Rats exposed to TBI given DBS had an improvement in several variables of the Barnes maze, but no significant improvements in NOR/NLR compared to Sham DBS TBI animals or non-implanted controls. Animals receiving stimulation had a significant increase in BDNF levels, as well as in hippocampal cell counts in the hilus, CA3 and CA1 regions. DBS failed to normalize the increased levels of TNFα and the proinflammatory cytokine IL1β in the perilesional cortex and the hippocampus of the TBI-exposed animals. Pharmacological experiments revealed that ANA-12 administered alongside DBS did not counter the memory improvement observed in ANT stimulated animals. Conclusions: DBS delivered immediately after TBI mitigated memory deficits, increased the expression of BDNF and the number of hippocampal cells in rats. Mechanisms for these effects were not related to an anti-inflammatory effect or mediated via TrkB receptors.

Analysis of clinical and environmental Vibrio cholerae O1 strains obtained during 2008–2015 in Nigeria showed that lineages Afr9 and Afr12 carrying cholera toxin and Vibrio pathogenicity island 1 can be isolated from water. Our findings raise concerns about the role of the environment in maintenance and emergence of cholera outbreaks in Nigeria.

Objetivos: O principal objetivo deste estudo é identificar as alterações no processo de deglutição mais comumente encontradas em pacientes com doença de Alzheimer através do exame de videofluoroscopia. Métodos: A coleta de informações foi através de um banco de dados do setor de fonoaudiologia do Hospital da Cidade de Passo Fundo, no período de junho de 2007 a fevereiro de 2011. Foram selecionados 24 exames, com a patologia de base sendo somente a doença de Alzheimer. Os exames foram realizados com oferta de consistências líquidas e pastosas, analisando fases oral e faríngea na posição lateral. Resultados: Dos 24 exames com consistência pastosa, quatro (16,7%) não deglutiram e 2 pacientes (8,3%) apresentaram grande dificuldade nessa consistência; assim, 18 pacientes (75%) realizaram o exame com ambas as consistências. Na fase oral da deglutição, apresentaram movimentos ondulatórios reduzidos da língua, para líquidos, 17 pacientes (94,4%), e 23 pacientes (95,8%), para pastosos. Na deglutição faríngea com líquidos, a alteração mais predominante foi a dos resíduos em recessos faríngeos nos 18 pacientes (100,0%), sendo que na deglutição com pastosos as alterações mais frequentes foram a reação de deglutição e resíduos em recessos faríngeos, com 19 pacientes (95,0%). Conclusão: Os resultados obtidos permitem evidenciar que as alterações mais significativas na função de deglutição nesses pacientes com doença de Alzheimer apresentam-se na fase oral, quando a maioria dos pacientes retém alimentos na cavidade oral por longo período, possibilitando o escape prematuro posterior para a faringe, seguindo-se reação de deglutição atrasada e, consequentemente, resíduos em recessos faríngeos.

Objetivo: Avaliar o nível de conhecimento de diabéticos idosos (DMI) em alimentação e saúde, atendidos no Núcleo de Apoio ao Idoso (NAI)/PROIDOSO da Universidade Federal de Pernambuco (UFPE). Métodos: Estudo transversal do tipo pré-teste/pós-teste em 60 DMI tipo 2. Foi desenvolvido projeto de educação alimentar e nutricional em 3 cursos, com oficinas específicas de fisiopatologia DMI, tratamento alimentar, medicamentoso e importância da atividade física. A avaliação foi realizada através de notas (0 a 10), de comparação dos grupos e, das oficinas de alimentação e nutrição, realizada por Teste t de Student e Teste Quiquadrado, com significância de 0,005. Resultado: Na comparação através de perguntas no pós-teste de cada curso, não foi revelado aprendizado significativo; por outro lado, quando se comparam as médias obtidas por cada paciente em cada curso, observou-se aprendizado significativo no 1° curso (maioria nível superior), no mesmo tempo em que foi observada uma melhora nos níveis de conhecimento quando se avaliou o nível de aprendizado por nota nos 3 cursos, embora não tenha sido significativa (p = 0,096). Na comparação de aprendizado nas oficinas de tratamento alimentar dos 3 cursos, denota-se aprendizado significativo em 50% nos temas abordados. Conclusão: O estudo demonstrou que o nível de conhecimento nutricional aumentou, e que a educação nutricional poderá ser utilizada no atendimento a idosos diabéticos, como forma de adesão ao tratamento global que inclui a nutrição como foco principal.

Introdução: Entre os residentes em áreas metropolitanas, 15% têm mais de 60 anos. Parte deles é dependente de cuidados de profissionais ou familiares, que também necessitam de atenção especial. Objetivo geral: Conhecer o perfil, nível de estresse e necessidades de cuidadores familiares e profissionais de idosos/acamados atendidos em 2 Unidades Básicas de Saúde (UBS) da área central da cidade de São Paulo. Objetivos específicos: Avaliar morbidade referida, interesse por capacitação e grupos de discussão e o grau de dependência do idoso/acamado. Metodologia: Foram aplicados 4 tipos de questionários em 18 cuidadores familiares e 8 profissionais de 2 UBS: perfil do entrevistado, inventário de sintomas e estresse, versão brasileira da Burden Interview e escala de avaliação funcional do idoso/acamado. Resultados: A maioria dos cuidadores profissionais (85,3% mulheres) tem 36-55 anos; 40,7% dos familiares têm mais de 60 anos; 100% dos familiares referiram patologia; 88% dos profissionais desejam mais capacitação e 88,9% querem participar de grupos de discussão sobre o trabalho; 22,2% dos familiares foram capacitados, 38,9% gostariam de receber capacitação e 83,3% querem participar de grupos de discussão. Estresse: cuidadores profissionais, nenhuma ou pequena sobrecarga; familiares, leve a moderada, mas severa em uma das UBS. Inventário de sintomas de estresse: 44,4% dos familiares; fase de alerta: 14,8% de resistência e 40,8% de exaustão. Avaliação funcional dos idosos/acamados: 77,8% dos cuidados pelos profissionais apresentam alta dependência e 75-100% dos seguidos pelos familiares. Conclusões: O cuidado de idosos/acamados causa estresse nos cuidadores, especialmente nos familiares. Todos valorizaram a capacitação e a participação em grupos de discussão. Recomendação: Atenção especial aos cuidadores familiares de idosos/acamados.

OBJETIVO: Investigar as classes de fármacos utilizados e propensos a produzir alterações do paladar em idosos e identificar o tipo de alteração gustativa mais prevalente. MÉTODOS: Amostra composta de 203 idosos da Associação dos Metalúrgicos Aposentados e Pensionistas de Ipatinga, Minas Gerais, com idade igual ou superior a 60 anos, de ambos os gêneros, em uso crônico de algum fármaco. Para investigar a função gustativa, foi utilizado o teste das três gotas que avalia os quatro gostos primários. RESULTADOS: As classes de fármacos mais utilizadas pelos idosos foram os anti‑hipertensivos (70,9%), hipolipemiantes (36,0%), antiácidos (19,2%), hipoglicemiante orais (17,7%), antiplaquetários (15,3%), hormônio tireoidiano (13,3%), antidepressivos (11,3%) e benzodiazepínicos (9,4%). Observou‑se que os idosos em uso de anti‑hipertensivos apresentaram mais chance de alteração gustativa ao sabor salgado (OR = 2,4; IC95% 1,2 - 4,6) e ao sabor doce (OR = 2,3; IC95% 1,2 - 4,4). Entre os anti‑hipertensivos, os fármacos das categorias betabloqueadores (OR = 1,8; IC95% 1,3 - 4,2) e diuréticos (OR = 2,0; IC95% 1,0 - 3,8) podem aumentar a chance dos pacientes desenvolverem alterações gustativas ao sabor doce. As demais classes de anti‑hipertensivos, bem como os antidepressivos e antiplaquetários não apresentaram associação significativa com as alterações gustativas. Observou‑se que 41,4% da amostra apresentou alguma alteração gustativa ao sabor salgado, 40,4% para o doce, 14,3% para o ácido e 13,8% para o sabor amargo. CONCLUSÃO: Este estudo observou que o uso crônico de medicamentos esteve associado a alterações gustativas, notadamente ao sabor doce. Dentre as classes de medicamentos avaliados, destacaram‑se os anti‑hipertensivos, especificamente os betabloqueadores e diuréticos.

The tumor microenvironment (TME) encompasses the complex and diverse surroundings in which tumors arise. Emerging insights highlight the TME's critical role in tumor development, progression, metastasis, and treatment response. Consequently, the TME has attracted significant research and clinical interest, leading to the identification of numerous novel therapeutic targets. Advances in molecular technologies now enable detailed genomic and transcriptional analysis of cancer cells and the TME and the integration of microenvironmental data to the tumor genomic landscape. This comprehensive review discusses current progress in targeting the TME for drug development, addressing associated challenges, strategies for modulating the pro-tumor microenvironment, and the discovery of new targets.

Wound healing is rarely seen as a problem in healthy individuals; however, under certain pathophysiological conditions, this process can be impaired, leading to the emergence of chronic wounds, which are themselves a serious public health problem. This work aimed to review the most important recent literature on the use of nanoparticles of Ag, Au, and Zn produced from plant extracts and their application as healing agents. To that end, we provide an insight into the pathophysiology of wound healing and the main routes to obtaining metallic nanoparticles. The methodology of synthesis, which is part of the so-called green synthesis, has been the focus of several studies on the use of medicinal plants as a substrate to produce silver, gold, and zinc nanoparticles. Their use as wound healing agents is closely related to their natural antimicrobial, anti-inflammatory, and cicatrizing properties. Finally, we address in vitro and in vivo studies on the efficiency of metallic nanoparticles (MNPs) synthesized from plant extracts and applied to wound healing in different pharmaceutical forms. For instance, the excellent wound contraction rates obtained from silver and gold NPs, respectively, were obtained from Euphorbia milii (92%) and Plectranthus aliciae (almost 97%) extracts in in vivo and in vitro analyses. Based on the satisfactory results, we find that MNPs are a potential therapeutic alternative compared to traditional synthetic healing agents and foresee the production of new pharmaceutical drugs.

Background/Objectives: Parkinson’s disease (PD) is a neurodegenerative disorder characterized by tremors, balance impairments, and mobility limitations. Innovative approaches like combining transcranial direct current stimulation (tDCS) with exercise show promise in addressing these symptoms. This study investigates the effects of exercise combined with tDCS on mobility and tremor management in PD patients. Methods: Twenty-five individuals aged 60−75 (66.6 ± 7.33), diagnosed with PD (Hoehn and Yahr stage 2−3), were assigned to three groups in a randomized controlled design: exercise with active tDCS (n = 8), exercise with sham tDCS (n = 8), and a control group (n = 9). Dual-task training sessions focusing on walking speed, balance, and force control were conducted over ten sessions. Results: No significant differences were detected across the groups for grip strength or force control measures (p > 0.05). Significant improvements were observed in the intervention group: the Timed Up and Go (TUG) test showed a significant reduction in time (mean difference = 2.498 s, p < 0.001, ηp2 = 0.331); anterior–posterior displacement significantly increased (mean difference = 21.375 mm, p = 0.0269, ηp2 = 0.303); and force-tremor decoupling improved, with coherence in the 1−4 Hz band significantly decreasing (p = 0.0067). Finally, changes in TUG from post- to pre-treatment values were significantly positively correlated with the changes in coherence (R = 0.468, p = 0.018). Conclusions: Combining tDCS with exercise enhances mobility and tremor management in PD patients. These findings support the potential for such interventions to improve functional outcomes and quality of life for individuals with PD.

Objective: The purpose of this scoping review was to identify gaps in the literature and summarize findings from studies examining the use of silicon-, silica-, and silicate-based toothpastes for the remineralization and repair of mineralized tooth tissues. Methods: A 10-year literature search was conducted using PubMed and Scopus, adhering to PRISMA 2020 guidelines. A total of 331 studies were initially identified, with 56 full-text review articles. After selecting the manuscripts, 27 studies were qualitatively analyzed by four reviewers, focusing on the results of both in vivo and in vitro methods. Results: The findings suggest that toothpastes containing silicon, silica, and silicate demonstrate promising results for remineralization and enamel repair, with evidence of mineral layer formation and/or deep enamel surface remineralization under various conditions. Additionally, the use of these toothpastes can lead to the obliteration of dentinal tubules within a few days. The results collectively support the efficacy of these toothpastes in enamel repair. Most of the clinical studies focused on dentine hypersensitivity, followed by white spot lesions. Conclusions: Silicon-, silica-, and silicate-based toothpastes (bioactive Si-toothpastes) can be considered effective based mostly on laboratory studies. There remains a need for more in vivo research studies on enamel and dentin mineral repair. Existing studies provide strong evidence that these technologies can reduce dentin hypersensitivity and promote enamel–dentin repair.

Introduction: Dengue is the most fatal virus disease spread by mosquito bites and Aedes aegypti is the main transmitting agent. It is an endemic disease in the tropical and subtropical regions, currently affecting more than 100 countries. Although most patients present mild forms of the disease, a considerable proportion of individuals has severe alterations in the blood count. The aim of this study was to evaluate the consumption pattern of blood components in epidemic and non-epidemic periods and to verify if there was an impact on dengue cases and the death rate. Method: This is a retrospective cross-sectional study conducted through the collection and analysis of data from the Brazilian Ministry of Health from 2008 to 2019 on new cases and deaths from dengue, as well as the consumption of blood components in the period mentioned by hemovigilance bulletins of the Brazilian authority. Results: Regarding the results, no significant difference was found between the absolute amount of blood components used in years with an epidemic peak. Regarding the relative values, an important variation was shown among the distributive consumption patterns of blood components in the outbreak years. In the univariate linear regression analysis, there was statistical significance between the increase in the number of dengue cases and deaths from dengue with the increase in the consumption of red blood cell concentrates (RBP), platelet concentrates (PP), fresh frozen plasma (FFP) and cryoprecipitate (Cryo) (p-value < 0.05). The increase in dengue cases was related to the increase in Cryo consumption with clinical significance (R² > 0.5), but dengue deaths were not correlated to the same. In multivariate analysis, all regression models had clinical and statistical significance. Conclusion: The data obtained in the present study demonstrate that there is a relevant relationship between the increase in cases and deaths from dengue with the blood components usage, especially PP, FFP and cryoprecipitate.

Abstract Background After the establishment of the public health emergency of international concern in 2020, health systems worldwide and in Brazil observed the need to apply more extraordinary logistical efforts and possibly resources to combat the imminent pandemic. Methods Using the historical series of public expenditures of the National Health Fund (FNS), 2015 to 2021, the number of confirmed cases of COVID-19, and a seasonal ARIMAX model, we sought to assess how the increase in the new virus infections affected the systematic financing of the SUS in Brazil. Results There were signs of seasonality and an increasing trend in the expenditure variable, which in practical terms, only indicated that the resource contributions followed an increasing trajectory already underway before the advent of the pandemic. The 1% increase in COVID-19 cases, with a one-month lag, contributes to the 0.062% increase in the variation in FNS expenditures but a decrease of 0.058% with a two-month lag. Conclusion The tests showed no evidence to confirm a positive shift on FNS spending growth trajectory due to the increase of COVID-19 cases, only observing a significant increase one month after the occurrence of COVID cases, probably due to their worsening after this period, which was followed by a similar and comparable decrease in percentage of growth in the following month.

Due to the Internet of Things (IoT) widespread adoption, data traffic to cloud servers for analysis has surged, impacting IoT system latency. Fog Computing emerged as a solution, bringing processing capabilities closer to data generation points, reducing data sent to the cloud, and improving response times. However, it intensifies security concerns due to the proximity of sensitive data to users and limited node computational resources. This research aims to study encryption and data verification algorithms using various datasets and the cryptography software OpenSSL. Testing is performed on Raspberry Pi hardware, facilitating the implementation of Fog nodes. Metrics such as CPU, memory, and energy consumption are evaluated using scripts. Results show that data type does not influence algorithm choice, and patterns related to data size behaviour are identified, aiding in defining security strategies.

Abstract Alzheimer’s disease (AD) is a progressive neurodegenerative condition and the primary form of dementia among elderly people. The amyloidogenic hypothesis is the main theory that explains this phenomenon and describes the extracellular accumulation of amyloid beta (Aβ) peptides. Model organisms such as Drosophila melanogaster have been utilized to improve the understanding of this disease and its treatment. This study evaluated the effects of peptide and metabolic fractions of Brazilian kefir on a strain of D. melanogaster that expresses human Aβ peptide 1–42 in the eye. The parameters assessed included ommatidial organization, vacuole area, retinal thickness, and Aβ peptide quantification. The present study revealed that the fractions, particularly the peptidic fraction, significantly reduced the vacuole area and increased the retina thickness in treated flies, indicating an improvement in neurodegeneration phenotype. The peptidic fraction was also found to alter Aβ aggregation dynamics, inhibiting Aβ fibril formation, as revealed by dynamic light scattering. This study demonstrated that kefir fractions, particularly the peptidic fraction

OBJECTIVE: To describe the perception of a multidisciplinary team on the use of physical restraint in older adults. METHODS: Qualitative research conducted with 58 health professionals in two long term care facilities for older adults located in the state of Rio de Janeiro, Brazil. Semi-structured interviews were further analyzed using thematic content analysis. The data was collected from November 2017 to June 2018. RESULTS: Twenty-one initial codes were identified and organized in three categories: team perception of the consequences and risks of a physical restraint (the patient's safety paradox); implications of the decision of physical restraint of the older adults; and strategies to restrain and not restrain. CONCLUSIONS: The results reinforce the need for training of professionals on restraint-free alternatives of care, as part promoting a culture of care that respects the right to freedom and the dignity of people — especially the most vulnerable ones.

INTRODUCTION: Aging is associated with changes in heart structure and function, and there are benefits of physical exercise in delaying these changes. OBJECTIVES: To characterize the heart of a geriatric cohort at a structural and functional level, and to evaluate the potential cardiac benefits of a personalized exercise intervention program. METHODS: Non-randomized intervention study, including a group of old adults from the AGA@4life cohort. Two echocardiographic evaluations were performed, at baseline and 3 months after the implementation of a multidisciplinary intervention program, integrating the practice of adapted physical exercise. Participants were divided into 2 groups: group 1 with low adherence to the exercise program (< 20% of sessions); group 2 with high adherence to the exercise program (> 90% of sessions). RESULTS: Characteristic heart changes were observed at baseline, mainly at the valvular level, with 89.2% (n = 33) cases of aortic fibrosis, 73% (n = 27) cases of mitral fibrosis, 51.2% (n = 19) cases of aortic regurgitation, and 68% (n = 25) cases of mitral regurgitation. After the intervention, significant changes were observed in several functional parameters in group 2, namely in the maximum velocity of the E' (p = 0.01) and S' (p = 0.02) mitral valve waves, and maximum velocity of the E' tricuspid valve wave (p = 0.02). Positive structural changes were also observed in group 2, namely a reduction in relative wall thickness (p = 0.03) and left ventricular diastolic diameter (p = 0.04). CONCLUSION: Personalized physical exercise implemented as part of a multidisciplinary intervention program is a useful non-pharmacological tool for maintaining adequate cardiac function and structure in the old adult.

Abstract Chimeric antigen receptor (CAR) T-cell therapy fails to achieve durable responses in over 60% of relapsed/refractory (R/R) large B-cell lymphoma (LBCL) patients in the third or later line setting. After CAR-T failure, survival outcomes are heterogeneous and a prognostic model in this patient population is lacking. A training cohort of 216 patients with progressive disease (PD) after CAR-T from 12 Spanish centers was used to develop the Post-CAR Prognostic Index (PC-PI); primary endpoint was overall survival (OS) from CAR-T progression. Validation was performed in an external cohort from three different European centers (n = 204). The prognostic score incorporated five variables, assessed at time of PD to CAR-T: ECOG (> 0), hemoglobin ( 1) and time from CAR-T to PD (

Background: The present study aimed to evaluate the use of multi-frequency, multi-segment bioimpedance for the diagnosis and therapeutic follow-up of clinical stages II and III lymphedema of the lower limbs. Methods and Results: A diagnostic clinical trial was conducted to evaluate the sensitivity and specificity of multi-frequency, multi-segment bioimpedance compared to volumetry for diagnosing and therapeutically following up clinical stages II and III lymphedema of the lower limbs. Treatment comprised the intensive Godoy Method® (eight hours per day for five days). One hundred limbs from 50 patients were evaluated, with 64 true-positive diagnoses, two false positives, three false negatives, and 31 true negatives, resulting in a sensitivity of 95.52% and specificity of 93.94%. Conclusion: Multi-frequency and multi-segment bioimpedance analysis is effective in the diagnosis and therapeutic follow-up of clinical stages II and III lymphedema of the lower limbs, achieving similar results to those obtained using water displacement volumetry.