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Objective: An emerging marker of depression in the perinatal period is represented by a reduction in the autonomic nervous system (ANS) activity, reflected by heart rate variability (HRV). This scoping review aims to map the association between HRV and depression during the perinatal period and to understand its potential clinical implications. Introduction: Previous evidence associated ANS dysfunction and depressive symptomatology in the general population. Few observational and intervention studies investigated how HRV could be related to both pre- and post-partum depressive symptoms. However, high heterogeneity in the study designs and methods has been reported. Therefore, this scoping review plans to combine all these findings to build a starting point for future research. Inclusion criteria: This scoping review will consider articles focusing on the association between HRV and depression in the peripartum and – when available – on the impact of interventions on HRV and how this correlates with changes in depressive symptoms. Studies will be included with no restrictions on participants’ age, peripartum time points for the assessment, and HRV parameters collected. Methods: We will perform a systematic search using the Medline (PubMed), PsychInfo, and Web of Science (WoS) databases. Two authors will independently screen titles, abstracts, and then full-text articles that meet the inclusion criteria. The review will include only journal articles published in English, with no time limitations. Data will be extracted and presented in tables and/or graphical representations to summarise and describe the results. Extracted data will be reported in a comprehensive summary.

AIMS: The aim of the present study was to evaluate the performance of various artificial intelligence (AI)-powered chatbots (commercially available in Switzerland up to June 2023) in solving a theoretical cardiology board exam and to compare their accuracy with that of human cardiology fellows. METHODS: For the study, a set of 88 multiple-choice cardiology exam questions was used. The participating cardiology fellows and selected chatbots were presented with these questions. The evaluation metrics included Top-1 and Top-2 accuracy, assessing the ability of chatbots and fellows to select the correct answer. RESULTS: Among the cardiology fellows, all 36 participants successfully passed the exam with a median accuracy of 98% (IQR 91–99%, range from 78% to 100%). However, the performance of the chatbots varied. Only one chatbot, Jasper quality, achieved the minimum pass rate of 73% correct answers. Most chatbots demonstrated a median Top-1 accuracy of 47% (IQR 44–53%, range from 42% to 73%), while Top-2 accuracy provided a modest improvement, resulting in a median accuracy of 67% (IQR 65–72%, range from 61% to 82%). Even with this advantage, only two chatbots, Jasper quality and ChatGPT plus 4.0, would have passed the exam. Similar results were observed when picture-based questions were excluded from the dataset. CONCLUSIONS: Overall, the study suggests that most current language-based chatbots have limitations in accurately solving theoretical medical board exams. In general, currently widely available chatbots fell short of achieving a passing score in a theoretical cardiology board exam. Nevertheless, a few showed promising results. Further improvements in artificial intelligence language models may lead to better performance in medical knowledge applications in the future.

Abstract Objective: to analyze the meaning attributed by parents to the extended and permanent survival of childhood cancer. Method: qualitative narrative inquiry, developed with parents of adolescents and young adults who survived childhood cancer. Recruitment and data collection involved virtual and in-person approaches. The data were collected through semi-structured interviews. Data were analyzed according to reflective thematic analysis. Results: a total of ten parents were included in the study. Two thematic narrative syntheses were constructed: “Times of war”; and “Time of uncertain peace”, with their respective sub-themes. The cancer diagnosis marks the beginning of times of war in the parents’ lives. They experience cancer treatment as “highs and lows” with potential threats to their children’s lives. After that, “Time of uncertain peace” are reached, and the balance of the family unit is reestablished. However, the fear of recurrence makes the family peace uncertain, and its maintenance requires constant vigilance and attention to the signs and symptoms of a possible new battle. Conclusion: the results highlight the experience of being a parent of a childhood cancer survivor and can be applied to develop models of care centered on the survivors’ family.

An adult pet tawny owl (Strix aluco) presented to a veterinary hospital at Parma University with a history of head trauma. After a critical care protocol including thermal, oxygen and fluid support aimed at stabilizing the patient, a neurological examination was performed. During neurological evaluation, marked lethargy and an inability to rise from a recumbent position was noted. Anisocoria was also present, with a mydriatic left pupil exhibiting no pupillary light response (PLR) even on direct illumination of both eyes. On ocular fundus examination, retinal hemorrhage and retinal detachment were observed. Based on these clinical findings, a complete work-up was performed, including hematological exams and total body X-ray studies followed by a computed tomography (CT) scan. Additional examinations, such as brainstem auditory evoked response (BAER) measurement and flash visual evoked potential (FVEP) recording, were performed. FVEP measurements performed on the left eye exhibited no peaks in either series of stimulations, indicating an altered functional integration within the visual pathway. A CT scan revealed a large hypoattenuating lesion within the right cerebral hemisphere, suspected to be intraparenchymal edema. The BAER test demonstrated an altered trace consistent with brainstem involvement and left hypoacusis due to cranial nerve VIII deficiency. Head trauma can result in significant neurological impairments in birds, impacting their behavior, mobility, and cognitive abilities. FVEP recordings, BAER tests and CT scans may be useful diagnostic tools in clinical practice. Understanding the causes and neurologic presentation of avian traumas is essential for effective prevention, diagnosis and treatment of affected birds.

Abstract Purpose To assess the relationship between macular choroidal thickness (CT) measurements and retinal sensitivity (RS) in eyes with myopia and different stages of myopic maculopathy. Methods A masked, cross-sectional, and consecutive study involving patients with emmetropia/myopia (control group) and high myopia (HM) eyes. Automated choroidal thickness (CT) and manual outer retinal layer (ORL) thickness were acquired using swept-source optical coherence tomography, while retinal sensitivity (RS) assessed by microperimetry (MP3) in all regions of the macular Early Treatment Diabetic Retinopathy Study (ETDRS) grid. Comparisons were made between groups, and correlations were performed among these measurements, demographic and ocular parameters and myopic maculopathy classification. Results A total of 37 (74 eyes) patients were included in the study. The mean age was 39 ± 13 years, and 28 patients (76%) were female. HM eyes exhibited inferior best-corrected visual acuity and a more advanced myopic maculopathy classification compared to the control group. The mean macular CT were 255 and 179 μm in the control and HM eyes (P

Background: Congenital toxoplasmosis leads to severe complications in childhood and presents significant global health challenges. In Brazil, the prevalence of toxoplasmosis during pregnancy and congenital cases ranges from 0.3 to 8 per 1000 live births. The clinical manifestations of congenital toxoplasmosis can include neurological and ocular damage, among other health issues, which place significant burdens on affected families. Objective: This study aims to investigate the experiences and motivations of mothers of children with congenital toxoplasmosis who share their journeys on social media, particularly Instagram. Methods: A qualitative virtual ethnography was used that explored the content shared by mothers of children diagnosed with congenital toxoplasmosis, aiming to understand how social media aids in their coping strategies and the support networks they create. Results: Fifteen Instagram accounts were analyzed, and twelve mothers participated in in-depth interviews. Thematic analysis revealed three main themes: the initial search for information and support, the evolving role of social media in advocacy and education, and the creation of a supportive online community. Conclusions: This study highlights the potential of social media to provide emotional support, disseminate information, and foster communities among mothers facing similar challenges, ultimately contributing to better care strategies and professional awareness for supporting families dealing with congenital toxoplasmosis.

Background: Little is known about gender-dependent outcomes after aortic valve replacement (AVR) through right anterior thoracotomy (RAST). The aim of our study was to analyze the mid-term outcomes of our cohort. Methods: This study is a retrospective analysis of 338 patients (2013–2022). Subgroup analysis included a gender-dependent comparison of age groups ≤60 and >60 years. Results: Women were older (69.27 ± 7.98 vs. 64.15 ± 11.47, p < 0.001) with higher Euroscore II (1.25 ± 0.73 vs. 0.94 ± 0.45, p < 0.001). Bypass and cross-clamp time were shorter (109.36 ± 30.8 vs. 117.65 ± 33.1 minutes, p = 0.01; 68.26 ± 21.5 vs. 74.36 ± 23.3 minutes, p = 0.01), while ICU, hospital stay and atrial fibrillation were higher (2.48 ± 8.2 vs. 1.35 ± 1.4 days, p = 0.005; 11 ± 7.8 vs. 9.48 ± 2.3 days, p = 0.002; 6.7% vs. 4.4%, p = 0.024). Mortality was 0.9%, while stroke was 0.6%. Age subgroup analysis showed that women were older (p = 0.025) with longer ICU and hospital stays (p < 0.001, p = 0.007). On mid-term follow-up (4.52 ± 2.67 years) of 315 patients (94.3%), there was no significant difference in survival, MACCE and re-intervention comparing gender and age groups. Conclusions: Despite older age, higher Euroscore II, longer ICU and hospital stay in women, mortality, MACCE and reoperation were low and comparable in gender and age groups. We believe that our patient-tailored heart team decision making combined with RAST translates into gender-tailored medicine, which equalizes the widely reported negative outcomes of female patients after cardiac surgery.

Background Currently, no clear impact of sex on short‐ and long‐term survival following transcatheter edge‐to‐edge mitral valve repair (TEER) is evident, although no data are available on postprocedural life expectancy. Our aim was to assess sex‐specific differences in outcomes of patients with mitral regurgitation (MR) treated by TEER. Methods and Results Short‐term and 5‐year outcomes in men and women undergoing TEER between 2011 and 2018 who were included in the large, multicenter, real‐world MitraSwiss registry were analyzed. Outcomes were compared stratified by sex and according to MR cause (primary versus secondary). The impact of TEER on postprocedural life expectancy was estimated by relative survival analysis. Among 1142 patients aged 60 to 89 years, 39.8% were women. They were older, with fewer cardiovascular risk factors and lower functional capacity compared with men. Thirty‐day mortality was higher in men than in women (3.3% versus 1.1%; odds ratio, 3.16 [95% CI, 1.16–10.7]; P=0.020). Five‐year survival was comparable in both sexes (adjusted hazard ratio for 5‐year mortality in men, 1.14 [95% CI, 0.90–1.44], P=0.275). Both men and women with either primary or secondary MR showed similar clinical efficacy over time. TEER provided high relative survival estimates among all groups, and fully restored predicted life expectancy in women with primary MR (5‐year relative survival estimate, 97.4% [95% CI, 85.5–107.0]). Conclusions TEER is not associated with increased short‐term mortality in women, whereas 5‐year outcomes are comparable between sexes. Moreover, TEER completely restored normal life expectancy in women with primary MR. A residual excess mortality persists in secondary MR, independently of sex.

Abstract Atlantoaxial joint is a possible affected site during rheumatoid arthritis (RA) and, in this work, we evaluated its occurrence and associated characteristics in a “real-life” cohort. By a medical records review study of RA patients longitudinally followed-up, the occurrence of severe atlantoaxial joint involvement was estimated (incidence proportion and incidence rate per 1000 person-years at risk). Regression analyses were also exploited to evaluate possible associated factors. Based on these findings, a prospective recruitment was performed to build a descriptive cross-sectional study in evaluating a subclinical atlantoaxial joint involvement in patients with the same clinical characteristics. Retrospectively, 717 patients (female 56.6%, age 64.7 ± 12.3 years) were studied. The incidence proportion of severe atlantoaxial joint involvement was 2.1% [1.5–2.5], occurring in 15 out of 717 patients, and identified by both MRI and CT scan. Considering over 3091 person-years, an incidence rate of 5.2 × 1000 [2.9–8.3] person-years was estimated. Regression analyses suggested that male gender, a longer disease duration, ACPA positivity and extra-articular manifestations resulted to be significantly associated with a severe atlantoaxial joint involvement. Given these findings, 30 asymptomatic patients were selected according to these clinical characteristics and underwent MRI of cervical spine. To date, almost 50% of these asymptomatic patients showed a subclinical atlantoaxial joint involvement. The occurrence of the severe atlantoaxial joint involvement in RA patients was estimated in a “real-life” setting. Male gender, ACPA positivity, long disease duration, and extra-articular manifestations could be associated with the severe atlantoaxial joint involvement in RA. MRI could provide a useful clinical tool to early evaluate the atlantoaxial joint involvement in RA, also in asymptomatic patients.

Background/Objectives: The COVID-19 pandemic has profoundly affected the lives of adolescents worldwide, especially those living with chronic diseases. This study aims to explore the impact of the COVID-19 pandemic on the daily lives of adolescents with chronic diseases. Methods: This is a scoping review that follows the guidelines proposed by JBI. Eligibility criteria include articles focusing on adolescents aged 10 to 19 during the COVID-19 pandemic, regardless of chronic diseases. Searches were performed in PUBMED, LILACS, CINAHL, SCOPUS, grey literature, and manual searches in March 2024. Results: This review is composed of 35 articles. The analysis revealed two main categories: (1) Adolescents facing social isolation, school closure, and new family interactions, striving to reinvent themselves, and (2) Chasing the best decision: following up the chronic disease while fighting the COVID-19 pandemic. These categories encompass subcategories highlighting changes in social and family interactions and lifestyle habits. The findings suggest a multifaceted interaction of factors influencing adolescents’ well-being, including improved family bonding, heightened disease management, and increased stress and strains on resources. Conclusions: This review emphasizes the importance of long-term follow-up and social inclusion efforts for adolescents with chronic diseases and their families, addressing their unique needs during public health crises.

ObjectivesThere has been growing research interest in loneliness and wisdom in recent decades, but no cross-cultural comparisons of these constructs using standardized rating measures in older adults, especially the oldest-old. This was a cross-sectional study of loneliness and wisdom comparing middle-aged and oldest-old adults in Cilento, Italy and San Diego, United States.MethodWe examined loneliness and wisdom, using the UCLA Loneliness Scale Version 3 (UCLA-3) and San Diego Wisdom Scale (SD-WISE), respectively, in four subject groups: adults aged 50-65 and those ≥90 years from Cilento, Italy (N = 212 and 47, respectively) and San Diego, California, USA (N = 138 and 85, respectively).ResultsAfter controlling for education, there were no significant group differences in levels of loneliness, while on SD-WISE the Cilento ≥90 group had lower scores compared to the other three groups. There was a strong inverse correlation between loneliness and wisdom in each of the four subject groups. Loneliness was negatively associated while wisdom was positively associated with general health, sleep quality, and happiness in most groups, with varying levels of significance.ConclusionThese results largely support cross-cultural validity of the constructs of loneliness and wisdom, and extend previous findings of strong inverse correlations between these two entities. Loneliness has become a growing public health problem, and the results of our study suggest that wisdom could be a protective factor against loneliness, although alternative explanations are also possible. Research on interventions to reduce loneliness by enhancing wisdom in older adults is needed.

Astaxanthin (AX) is known as a very strong antioxidant and has been utilised in many kinds of products such as foods, pharmaceutical, cosmetics, aquaculture, etc. One of the natural resources of AX is Haematococcus pluvialis which has been investigated by some researchers in order to enhance the AX production. However, the production of AX from the microalgae is still costly, hence, this present research is proposing low-cost methods namely bean sprout media (BSM) as an alternative growth media and UV radiation. The variations of BSM concentrations (2, 4, and 6 %) and times of UV radiation (1.5 and 3 hrs) were treated to H. pluvialis in laboratory conditions. BSM 4 % treatment showed an optimum growth of the microalga at 427 x 104 cell/ml (day 8) which also exhibited macrozooid, palmella, and aplanosore phases. UV radiation for 3 hr revealed that the concentration of AX production was as much as 17.37±0.04 mg/l. The research results were potential to be developed further in order to discover better and cheaper methods for scaling up AX production.

Objetivos: describir las características clínicas y el tratamiento del embarazo ectópico implantado en la cicatriz de cesárea, así como las complicaciones y el pronóstico obstétrico. Materiales y métodos: estudio de cohorte retrospectivo de gestantes con diagnóstico de embarazo ectópico implantado en la cicatriz de cesárea según los criterios de la Sociedad de Medicina Materno-Fetal, atendidas entre enero de 2018 y marzo de 2022 en dos instituciones de alta complejidad, pertenecientes a la seguridad social, ubicadas en Lima, Perú. Se hizo un muestreo consecutivo. Se midieron variables sociodemográficas y clínicas de ingreso, diagnóstico, tipo de tratamiento, complicaciones y pronóstico obstétrico. Se hace un análisis descriptivo. Resultados: se incluyeron 17 pacientes, de 29.919 partos. De estas, el 41,2 % recibió tratamiento médico y el resto recibió tratamiento quirúrgico. Se realizó un manejo local exitoso con metotrexato en el saco gestacional en dos pacientes con ectópico tipo 2. Cuatro de las pacientes requirieron histerectomía total. Seis pacientes experimentaron una gestación después del tratamiento, y 4 de ellas culminaron el embarazo con una madre y un neonato saludables. Conclusiones: el embarazo ectópico implantado en la cicatriz de una cesárea es una entidad poco frecuente, para la cual se cuenta con alternativas de manejo médico y quirúrgico con aparentes buenos resultados. Se requieren más estudios con mayor calidad metodológica de asignación aleatoria que ayuden a caracterizar la seguridad y la efectividad de las diferentes alternativas terapéuticas para las mujeres con sospecha de esta patología.

Este artigo apresenta percurso de trabalhos realizados sobre o compositor mineiro Flausino Valle (1894-1954). Valle foi violinista, escritor, poeta, professor e compositor que nasceu em Barbacena, mas viveu a maior parte de sua vida em Belo Horizonte. O objetivo desse trabalho é contribuir com pesquisadores interessados na obra de Valle, fornecendo subsídios para o desenvolvimento inicial ou a continuidade de seus estudos. Como metodologia, partimos de levantamento de trabalhos em repositórios de universidades e de busca por referências em trabalhos já publicados sobre o compositor Como resultado, observamos um escopo importante de pesquisas sobre Valle, com abordagens e objetivos distintos, que, no entanto, não esgotam novas possibilidades de caminhos de pesquisa.

Abstract This article explores the history of Brazilian diplomacy abroad during its formative period, investigating addresses, buildings and neighbourhoods where the first agents lived and worked specifically in London between 1822 and 1829, and why they installed the first legation at Park Crescent, Regent’s Park. The objective is to discuss the meaning of local spaces for the history of the diplomatic mission and the representation of the Empire of Brazil in other territories. The article demonstrates that the first legation in London was installed in a new, rich and modern district at the time, presenting itself in a different space from the other legations and embassies. In conclusion, it is argued that this action expressed a policy of seeking legitimacy and fortifying of relationship with a specific sector of that society, namely, bankers, investors and merchants, who had business in Brazil.

Background: Psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) are inflammatory diseases with shared genetic backgrounds and clinical comorbidities. Headache, a common global health issue, affects over 50% of adults and encompasses various types, including migraine, tension-type, and cluster headaches. Migraine, the most prevalent, recurrent, and disabling type, is often associated with other medical conditions such as depression, epilepsy, and psoriasis, but little is known about the relationship between autoimmune disease and the risk of migraine. Methods: A cross-sectional study was conducted from July to November 2022, enrolling 286 participants, including 216 with PsA, 70 with axSpA, and 87 healthy controls. Results: Headache prevalence was significantly higher in the PsA (39.81%) and axSpA (45.71%) patients compared to the healthy controls. The prevalence of migraine without aura was also significantly higher in both the PsA (18.52%) and axSpA (28.57%) groups compared to the healthy controls. Conclusions: These findings underscore the high burden of headache and migraine in PsA and axSpA participants, highlighting the need for improved management and treatment strategies for these patients.

O presente artigo tem por objetivo relatar a vivência de um licenciando em Química, a partir da observação das aulas em uma turma do ensino médio no período de dez semanas. Os momentos observados, ocorreram exclusivamente durante o ensino remoto emergencial resultante da adequação escolar à pandemia da COVID-19. Sob a orientação da professora de Estágio Supervisionado IV, do curso de Licenciatura em Química, foram analisados diversos aspectos referentes à postura do professor regente, dos estudantes, do estagiário e ao andamento da disciplina de Química em uma escola pública na cidade de Cuiabá/MT. Dessa forma, notou-se que grande parte da turma não possuía acesso aos recursos digitais e poucos completavam bem como devolviam as apostilas elaboradas pelo professor regente. Além disso, a pouca participação nos momentos síncronos se deu por causa das dificuldades socioeconômicas vivenciadas pelos estudantes e suas famílias, portanto, ensinar e aprender não dependem exclusivamente da vontade dos atores envolvidos, mas também, da realidade vivida pela comunidade escolar.

IntroductionCOVID-19 and autoinflammatory diseases, such as Adult-onset Still’s Disease (AOSD), are characterized by hyperinflammation, in which it is observed massive production and uncontrolled secretion of pro-inflammatory cytokines. The specialized pro-resolving lipid mediators (SPMs) family is one the most important processes counteracting hyperinflammation inducing tissue repair and homeostasis restoration. Among SPMs, Protectin D1 (PD1) is able to exert antiviral features, at least in animal models. The aim of this study was to compare the transcriptome of peripheral blood mononuclear cells (PBMCs) from patients with AOSD and COVID-19 and to evaluate the role of PD1 on those diseases, especially in modulating macrophages polarization.MethodsThis study enrolled patients with AOSD, COVID-19, and healthy donors HDs, undergoing clinical assessment and blood sample collection. Next-generation deep sequencing was performed to identify differences in PBMCs transcripts profiles. Plasma levels of PD1 were assessed by commercial ELISA kits. Monocyte-derived macrophages were polarized into M1 and M2 phenotypes. We analyzed the effect of PD1 on macrophages differentiation. At 10 days, macrophages were analyzed for surface expression of subtypes markers by flow cytometry. Cytokines production was measured in supernatants by Bio-Plex Assays.ResultsIn the transcriptomes from AOSD patients and COVID-19 patients, genes involved in inflammation, lipid catabolism, and monocytes activation were specifically dysregulated in AOSD and COVID-19 patients when compared to HDs. Patients affected by COVID-19, hospitalized in intensive care unit (ICU), showed higher levels of PD1 when compared to not-ICU hospitalized patients and HDs (ICU COVID-19 vs not-ICU COVID-19, p= 0.02; HDs vs ICU COVID-19, p= 0.0006). PD1 levels were increased in AOSD patients with SS ≥1 compared to patients with SS=0 (p=0.028) and HDs (p=0.048). In vitro treatment with PD1 of monocytes-derived macrophages from AOSD and COVID-19 patients induced a significant increase of M2 polarization vs control (p

Abstract An accurate prediction of cardiovascular (CV) risk in patients with Axial Spondyloarthritis (axSpA) is a strong unmet need, as CV risk algorithms poorly perform in these subjects. The aim of this study was to establish whether the persistence of high C-reactive protein (CRP) and high disease activity may be considered predictive factors of CVD in axSpA. 295 patients without personal history of CVD, were consecutively enrolled in this study. To evaluate the relationship between CV events occurrence (fatal and non-fatal) and the persistence of increased CRP levels, ASDAS (Ankylosing Spondylitis Disease Activity Score) > 2.1, and BASDAI (Bath Ankylosing Spondylitis Disease Activity) > 4 during the follow-up, univariable and multivariable Cox Proportional Hazard Models have been performed. During follow-up (we analyzed 10-years retrospective data), 23 patients had a CV event. Multivariable Cox Proportional Hazard Models showed a strong association between CV event and the persistency of increased CRP levels (namely, percentage of visits in which CRP levels were increased) (HR = 1.03; 95%CI 1.015–1.045; p 2.1 (HR = 1.014, 95%CI 1.000–1.028, p = 0.047), and of BASDAI > 4 (HR 1.019, 95%CI 1.006–1.033, p = 0.006) during follow-up, after adjustment for age, sex, and diabetes. This study suggests that persistence of increased CRP levels and high disease activity may be considered biomarkers to identify those axSpA patients at higher risk of CVD. Innovative axSpA-specific CV risk score, including these variables, have to be developed.

After the partition of Ireland, the newly established parliament in Belfast was given control over education. The unionist government, mainly representing the majoritarian Protestant population, embarked on a reform of the pre-existing denominational education system and tried to persuade all the churches to transfer their schools to state control in exchange for public funding. Despite the sincere efforts of the first Minister of Education, the Catholic Church rejected interference in education from a government that its followers perceived as hostile, while the Protestant churches became increasingly intransigent in their demands for more control over state schools. In order to ensure their support, the government met their requests, ignoring the instances of teachers and principals who called for independence from clerical managers. The result was a segregated education system that contributed to maintain the deep divisions of the Northern Irish society.

Rhodotorula toruloides is a potential chassis for microbial cell factories as this yeast can metabolise different substrates into a diverse range of natural products, but the lack of efficient synthetic biology tools hinders its applicability. In this study, the modular, versatile and efficient Golden Gate DNA assembly system (RtGGA) was adapted to the first basidiomycete, an oleaginous yeast R. toruloides. R. toruloides CCT 0783 was sequenced, and used for the GGA design. The DNA fragments were assembled with predesigned 4-nt overhangs and a library of standardized parts was created containing promoters, genes, terminators, insertional regions, and resistance genes. The library was combined to create cassettes for the characterization of promoters strength and to overexpress the carotenoid production pathway. A variety of reagents, plasmids, and strategies were used and the RtGGA proved to be robust. The RtGGA was used to build three versions of the carotenoid overexpression cassette by using different promoter combinations. The cassettes were transformed into R. toruloides and the three new strains were characterized. Total carotenoid concentration increased by 41%. The dedicated GGA platform fills a gap in the advanced genome engineering toolkit for R. toruloides, enabling the efficient design of complex metabolic pathways.

Neste artigo, discutimos o processo de produção de centralidades de negócios em áreas anteriormente não-centrais de São Paulo. Considerando a tendência a uma nova expansão do eixo espacial da metrópole que concentra atividades de comando de grandes empresas, o chamado Vetor Sudoeste, analisamos o projeto de intervenção urbana Arco Jurubatuba, plano de reestruturação urbana proposto em 2018. Este projeto visa uma área que identificamos como fronteira sul do Vetor Sudoeste e as suas proposições parecem favorecer o avanço de uma frente imobiliária. No entanto, os objetivos e possíveis impactos do projeto não são homogêneos em relação ao território. A fim de compreender os processos de produção da centralidade, debatemos as suas condições, ligadas à concentração de poder econômico e político em determinadas áreas urbanas. Tendo em vista o sentido econômico de tal process, refletimos sobre o papel da centralidade enquanto localização privilegiada, que gera condições de monopólio para determinados setores do mercado imobiliário. Discutimos também a participação fundamental do Estado na atribuição de centralidade a novas partes,, promovendo substituições de usos e elaborando novas imagens e conteúdos simbólicos para o espaço através da mobilização de dispositivos jurídicos e da força repressiva.

Abstract Postpartum psychosis (PP) is a severe mental disorder that affects women in the first few weeks after delivery. To date there are no biomarkers that distinguish which women at risk (AR) develop a significant psychiatric relapse postpartum. While altered brain connectivity may contribute to the risk for psychoses unrelated to the puerperium, this remains unexplored in PP. We followed up 32 AR and 27 healthy (HC) women from pregnancy to 8-week postpartum. At this point, we classified women as AR-unwell (n = 15) if they had developed a psychiatric relapse meeting DSM-IV diagnostic criteria, or impacting on daily functioning and requiring treatment, or AR-well (n = 17) if they remained asymptomatic. Women also underwent an fMRI scan at rest and during an emotional-processing task, to study within- and between-networks functional connectivity. Women AR, and specifically those in the AR-well group, showed increased resting connectivity within an executive network compared to HC. During the execution of the emotional task, women AR also showed decreased connectivity in the executive network, and altered emotional load-dependent connectivity between executive, salience, and default-mode networks. AR-unwell women particularly showed increased salience network-dependent modulation of the default-mode and executive network relative to AR-well, who showed greater executive network-dependent modulation of the salience network. Our finding that the executive network and its interplay with other brain networks implicated in goal-directed behavior are intrinsically altered suggest that they could be considered neural phenotypes for postpartum psychosis and help advance our understanding of the pathophysiology of this disorder.

O carcinoma renal (CR) é uma neoplasia maligna originária do epitélio tubular renal. Este tipo de neoplasia é rara e acomete geralmente cães machos de meia idade. Os sinais clínicos são inespecíficos, podendo se assemelhar a outras doenças e isso acaba dificultando o diagnóstico que é realizado através dos exames de imagem (ultrassonografia e raio-X), da laparotomia exploratória e histopatológico para confirmação. Para o tratamento sugere-se a nefrectomia em casos de carcinoma renal unilateral e quimioterapia, porém não demonstram um aumento na sobrevida dos pacientes. O presente trabalho tem como objetivo relatar o caso de um cão de 8 anos, que foi atendido devido a sinais de cardiopatia e ao retorno apresentou sinais como êmese, anorexia e dor abdominal. Realizou-se exame de ultrassom, onde identificou-se uma estrutura de 7cm do lado esquerdo, realizou-se também exame de raio-X e posterior laparotomia exploratória, seguida de nefrectomia. O material coletado e enviado para histopatológico confirmou carcinoma renal bem diferenciado, padrão papilar. Após diagnóstico, o paciente foi encaminhado para um especialista em oncologia veterinária, que de acordo com os resultados dos exames realizados novamente, optou-se por não entrar com o tratamento quimioterápico.

The mechanism of the impact of religion on health is still unclear, especially in children and adolescents with chronic illness who live in religious contexts. This study aimed to understand the influence of religion on coping with chronic diseases from the perspective of hospitalized children and adolescents diagnosed with cancer, type 1 diabetes mellitus and cystic fibrosis. Qualitative descriptive research used photo-elicitation interviews with 35 Brazilian children and adolescents with cancer, type 1 diabetes mellitus and cystic fibrosis, aged between 7 and 17 years old. A thematic analysis approach was used to analyze qualitative data. Participants were diagnosed with cystic fibrosis (14.3%), cancer (57.1%), and type 1 diabetes mellitus (28.6%) and 82.9% had a religious affiliation. Three themes were constructed: finding strength and support in the relationship with the divine, religion as an important source of meaning, and religious practice as a promoter of well-being. These themes demonstrate that children and adolescents themselves perceived their illness as a journey through which their faith grew. This research shows the influence of religion on the positive coping of chronic illness, being a source of strength and support from the relationship with the divine, as well as offering a source of meaning, purpose and well-being based on religious practices. This study supports clinical practice, based on the recognition of the patient as a religious and spiritualized person who has spiritual beliefs and needs that are capable of influencing treatment. • Religion influences children and adolescents coping with chronic diseases. • Children and adolescents see their chronic disease as part of the purpose of God. • Religious practices alleviate symptoms of illness. • Children and adolescents feel their religiosity impaired by being hospitalized. [ABSTRACT FROM AUTHOR]

Modern evolutionary theory and population genetics posit that adaptation and habitat expansion of plants result from processes exclusive to their genomes. Here, we present studies showing that plants can grow across complex habitat gradients by modulating symbiotic associations with Class 2 fungal endophytes. Endophyte analysis of three native (Leymus mollis, Distichlis spicata, and Salicornia pacifica) and one invasive (Spartina anglica) plant growing across adjacent microhabitats in the San Juan Archipelago altered associations with Class 2 fungal endophytes in response to soil salinity levels. At the microhabitat interfaces where the gradation of salinity varied, the plants were colonized by endophytes from both microhabitats. A reciprocal transplant study along a salt gradient demonstrated that Leymus mollis (dunegrass) required endophytes indigenous to each microhabitat for optimal fitness and/or survival. In contrast, when dunegrass and Grindelia integrifolia (gumweed) were found growing in low salinity, but high drought habitats, these plant species had their own unique dominant endophyte association regardless of geographic proximity and conferred drought but not high salt stress tolerance. Modulation of endophyte abundance occurred in planta based on the ability of the symbiont to confer tolerance to the stress imposed on plants. The ability of an endophyte to confer appropriate stress tolerance resulted in a significant increase of in planta fungal abundance. Conversely, the inability of an endophyte to confer stress tolerance resulted in a decrease of in planta fungal abundance. Our studies indicate that Class 2 fungal endophytes can provide a symbiotic mechanism for niche expansion and phenotypic plasticity across environmental gradients.

There is increasing interest in using biostimulant products, such as microbial inoculants and alkali-extracted “humic” substances to help manage rangelands regeneratively and rebuild soil health. Understanding how plant and soil communities on rangelands respond to these products is therefore important. In this 3-year study, we examined the combined effects of a commercial inoculant and alkali-extracted “humic” product that are currently on the market (Earthfort Inc. Soil Provide and Revive®) and asked whether they influenced rangeland forage productivity and quality, soil microbial biomass and community composition, and abiotic soil parameters in Central Coastal California. Treatments were established in February 2018 and the products were applied two to three times a year during the growing season (approximately November—May). Sampling of plant and soil samples also began in February 2018 and continued in the fall and spring for three consecutive growing seasons. We found that forage productivity responded positively to the foliar application of these commercial products, with forage production on average 58% percent higher in treated compared to control sites. Some metrics of forage quality (acid detergent fiber, calcium, and fat content) also responded in a desirable way, but these benefits were not mirrored by changes belowground in the microbial community or abiotic parameters. While our study derives from one ranch and therefore requires confirmation of its ubiquity prior to broadscale adoption, our results provide new insights into the usefulness of this approach for managing rangeland productivity in California's Central Coast—and suggest biostimulants could warrant attention as a potential tool for regenerative stewardship of rangelands more broadly.

A pesquisa com alunos egressos mostra-se em crescente desenvolvimento nas últimas décadas. É, porém, ainda incipiente e heterogênea a organização para o acompanhamento, levantamento e análise de dados advindos destes. Este artigo tem como objetivo principal delinear caminhos da pesquisa com o aluno egresso de Música, bem como apresentar e reforçar justificativas que fundamentam acompanhá-lo em sua trajetória profissional após a saída da universidade. A partir de revisão bibliográfica sobre o tema, foram identificadas possíveis estratégias de acompanhamento, como os portais institucionais e as pesquisas científicas específicas. A partir da pesquisa documental, com análise de conteúdo comparativa de três investigações específicas, reforçam-se a importância e a riqueza de informações às quais se pode ter acesso nesse campo investigativo. É razoável afirmarmos que uma das funções da universidade está diretamente vinculada à preparação e construção do profissional que atuará na (e para a) sociedade após sua graduação, e é dentro desse complexo cenário que a pesquisa e o acompanhamento de alunos egressos podem se mostrar ferramentas fundamentais.

Objective: to analyze narratives about the experience of hope of families in the context of pediatric chronic illness. Method: a narrative research using Family Systems Nursing as a conceptual framework. Three families of children and adolescents diagnosed with complex chronic illness participated in this study, totaling 10 participants. Data collection was developed using family photo-elicitation interviews. Family narratives were constructed and analyzed according to inductive thematic analysis with theoretical data triangulation. Results: the analytical theme - Waves of Family Hope in the Context of Pediatric Chronic Illness - is composed of four different types of hope: uncertain hope, caring hope, latent hope, and expectant hope. Movement through these hopes generates a driving energy and depends on a number of factors: support, information, searching for normality, and thoughts and comparisons. Conclusion: the results highlight the interaction and reciprocities of the members of the family unit, and the dynamics of hope, and illustrate the different types of hope and the factors that influence them. This study highlights the experience of hope as a family resource rather than just an individual resource, and supports health professionals in the planning of family care considering hope as an essential and dynamic family resource.

AIMS: The aim of the present study was to describe heart rate profiles and heart rate variability patterns in non-selected scuba divers of different ages under non-experimental real-world conditions. METHODS: We used specially designed silver-loaded polydimethylsiloxane dry electrodes for underwater ECG recordings. With a custom-built setup, heart rate profiles and heart rate variability patterns were documented before submersion, during diving and after resurfacing in 18 separate dives. RESULTS: Heart rates of the divers just before descent were remarkably high (median 114 bpm, interquartile range [IQR] 83–154) with a statistically significant rapid decrease after submersion (median 90 bpm, IQR 70–116; p = 0.008). The percentage heart rate reduction by submersion was individually very variable (median 21%, range 5–39%). We noted a general increase in autonomic nervous system (ANS) activity without predominance of parasympathetic parameters, suggesting a concomitant sympatheticadrenergic activation. CONCLUSIONS: Scuba diving under real-world conditions by non-selected divers is characterised by relatively high heart rates just before submersion, an individually variable but significant bradycardic dive response, and induces an immediate and sustained parallel increase of parasympathetic and sympathetic-adrenergic autonomic nervous system activity. These observations could explain several specific pathophysiological mechanisms of diving incidents (haemodynamic decompensation, arrhythmias, acute coronary syndromes) and underlines the importance of cardiovascular risk stratification in diving eligibility assessment.

ABSTRACT Objective: To describe the chemotherapy-associated symptoms and the strategies used for their management from the perspective of pediatric cancer patients’ family caregivers. Methods: This is a descriptive study with qualitative data analysis. Data collection took place in a pediatric hospital, from December 2017 to December 2018, with family caregivers of pediatric patients undergoing chemotherapy. Semi-structured interviews, subjected to inductive content analysis, were carried out. Concepts from the Symptom Management Theory were used to discuss the results. Results: Eighteen family caregivers participated. The participants mentioned: physical symptoms, especially weakness, alopecia, low immunity, pain, mucositis, constipation, nausea, and vomiting; emotional or psychosocial symptoms such as sadness and mood changes; and constitutional symptoms such as loss of appetite and fever. Pharmacological and non-pharmacological measures were mentioned in the management of symptoms and adverse effects. Conclusion: Participants demonstrated skills to identify and manage symptoms of chemotherapy. Knowing the experience of these families can help nurses in planning care and interventions to minimize these events.

Edino Krieger’s Sonâncias is considered one of the most representative works of his production for the violin. This article aims to present stylistic, idiomatic and interpretative characteristics in Edino Krieger's writing for his own instrument based on the analysis of Sonâncias II (1981), for violin and piano. After an introduction, we present a biographical summary of the composer (concentrating on his relationship with the violin) and approach the particularities of his musical language and his production for the instrument. Then, we present concepts and criteria used in the structural, stylistic and idiomatic analysis of the selected piece. We examine how this work manifests particularities of Krieger's third compositional phase and how his style and writing influence the interpretive choices in the process of constructing the performance. Considering the experience of the composer as a violinist, we sought to relate his writing to the idiomatic characteristics of the instrument. In Sonâncias II (1981) the intervals (both melodic and harmonic) are used as a basic structural unit. Its idiomatic nature reveals a deep mastery of the composer in writing for the instrument, despite no longer playing it during this process and having abandoned his career as a violinist early in his adulthood. Through this article that constitutes a first approach to Edino Krieger’s writing for the violin we seek to contribute to a better understanding and diffusion of Brazilian music for the instrument.

Esse artigo tem como objetivo discutir como a competência em informação pode apoiar as organizações a superar as barreiram que atrapalham o processo de inovação no contexto da Indústria 4.0. O foco é ajudar os professionais a vencer estes desafios por meio da competência em informação. A metodologia é baseada em uma pesquisa bibliográfica, a fim de demonstrar a lacuna teórica sobre competência em informação e Indústria 4.0. Além disso, um quadro foi desenvolvido para explicar a inter-relação de tais conceitos. No final, apresenta-se um modelo conceitual para ajudar os professionais a lidar com as barreiras que prejudicam a inovação das empresas, especialmente aquelas que já estão adotando a tecnologia da Indústria 4.0. As considerações finais demonstram que a competitividade depende da veracidade da informação e da qualidade da inovação. A competência em informação é uma ferramenta fundamental para enfrentar os fatores que prejudiquem a inovação, pois no contexto da Indústria 4.0, os indivíduos precisam ser capacitados para interpretar a informação.

Resumo Objetivo: Conhecer a produção científica sobre a utilização e manutenção do cateter central de inserção periférica (CCIP) em crianças e adolescentes em tratamento oncológico. Método: Revisão do tipo Scoping Review, segundo o método adaptado e proposto por Levac, Colquhoun e O’Brien. Foram percorridas cinco etapas: identificação da questão de pesquisa; buscas por estudos relevantes; seleção de estudos; extração dos dados; agrupamento, resumo e apresentação dos resultados. Utilizaram-se as bases de dados PubMed, CINAHL, Scopus, LILACS e Embase. Foram incluídos artigos de revisão da literatura ou originais, de abordagem quantitativa ou qualitativa, que focalizassem o cateter venoso central de inserção periférica em crianças e adolescentes com câncer, em qualquer fase do tratamento oncológico e contexto de cuidado, publicados em português, inglês e espanhol, no período de 2006 a 2017. Resultados: Buscas nas bases de dados capturaram 609 artigos únicos, dos quais nove compuseram a amostra final. Foram elaborados cinco temas principais relacionados à utilização do cateter venoso central de inserção periférica: indicação, técnica de inserção, manutenção do cateter, complicações relacionadas e desfechos do uso. Os resultados permitem sintetizar as recomendações para a utilização deste dispositivo no que se refere, sobretudo, a: terapêutica e tipo de neoplasia, veias de escolhas, tipos de curativos, principais complicações e desfechos. Conclusão: O cateter venoso central de inserção periférica mostra-se uma opção segura e confiável para a terapia endovenosa na população pediátrica oncológica. O presente estudo contribui por tornar clara a indicação de sua utilização para tal população e apontar temas a serem explorados em futuros estudos empíricos.

This work aims the study of a debutanizer column of a typical petrochemical industry. First a steady state model was built using ASPEN PLUS and then the model was transformed to the dynamic version using ASPEN DYNAMICS. The debutanizer column split a mixture of hydrocarbons into a C4 rich fraction and a C5+ fraction. In the C4 fraction 1-3 butadiene is the desired compound which will be separated in another processing unit. 1-3 butadiene is an important feedstock for the polymer industry. The column dimensions and characteristics and operational conditions where supplied by the company. The first part of the study was the model building and results validation with real data of the industry. Then the model was transformed into the dynamic version for control study purposes. Both open and closed loop studies were performed. The generated curves will be used by the company for control scheme selection purposes.

La agroindustria argentina del azúcar se concentra en la región noroeste. Tucumán es la principal productora, con 70% de la superficie nacional implantada. Resulta casi imposible pensar en el desarrollo económico y social de Tucumán separado de la caña de azúcar y su industrialización. Ahora, con los nuevos paradigmas energéticos que desafían al cultivo, la investigación tecnológica y el trabajo con los actores del sector tienen como objetivo que la producción de la caña de azúcar no solo resulte rentable, sino que además muestre una gestión ambiental coherente con el aumento de superficie de estos últimos 20 años. La sustentabilidad del cultivo de caña de azúcar se relaciona especialmente con el modo de realizar la cosecha, que es la etapa de mayor importancia en su producción. El tipo de cosecha de caña de azúcar influencia una cantidad de aspectos que hacen al desempeño productivo del cultivo, a su resultado económico, a la generación de empleo sectorial y regional, a la evolución de la tecnología industrial y al impacto ambiental de la producción. Además, en cualquiera de sus tipos, la cosecha se destaca por su impacto dentro del costo productivo total, representando entre 25% al 35%, y por lo tanto, cualquier variación que se registre en esa etapa repercute fuertemente en la rentabilidad final del cultivo. En esta revisión bibliográfica se presenta la evolución de las diferentes prácticas de cosecha en la Argentina resaltando la importancia que estas tienen sobre la productividad y longevidad de los cañaverales y las consecuencias sobre los recursos naturales, en especial el suelo. Se realiza una crítica sobre el uso de las cosechadoras integrales, con énfasis sobre las ventajas, limitaciones y desafíos técnicos de este paradigma tecnológico. La mecanización integral de la cosecha –se concluye– dista mucho de ser simplemente el reemplazo de la mano de obra por una máquina, más bien representa un cambio que lleva implícito un nuevo ordenamiento de la actividad; caracterizado por la notable reducción del tiempo necesario para la zafra. Los problemas todavía pendientes de solucionar –la falta de adaptación a plantaciones de poco tamaño, las pérdidas de cosecha a campo y en la interface campo-industria, el potencial de compactación de los suelos/decaimiento de los cultivos y la quema del rastrojo remanente– indican que el sistema mecanizado integral está lejos de ser el fin del camino de desarrollo de la cosecha de caña de azúcar y que todavía resulta necesaria una mayor oferta tecnológica para esta etapa productiva clave.

Background: the endocannabinoid 2-arachidonoylglycerol (2-AG) plays a pivotal role in immune cells regulation. The plasma levels of 2-AG are increased in patients with systemic lupus erythematosus (SLE) and correlate with disease activity. Moreover, in plasmacytoid dendritic cells from SLE patients, 2-AG is able to control the production of type 1 interferon (IFN) through CB2 activation. The aim of this study was to evaluate the potential role of 2-AG on T lymphocytes from SLE patients. Methods: peripheral blood mononuclear cells (PBMCs) from SLE participants and age- and sex-matched healthy donors (HD) were isolated by Ficoll–Hypaque density-gradient centrifugation. The PBMCs were treated with increasing concentrations of 2-AG, and AM251 and AM630 were used to antagonize CB1 and CB2, respectively. Flow cytometry was used to assess the expression of CD3, CD4, CD8, CD25, IFN-ɣ, IL-4, and IL-17A. Results: 2-AG (1 μM) decreased IFN-ɣ expression (p = 0.0005) in the Th1 lymphocytes of SLE patients. 2-AG did not modulate the cytokine expression of any other T lymphocyte population from either SLE or HD. Treatment with both 2-AG and AM630 increased the IFN-ɣ expression in Th1 lymphocytes of SLE patients (p = 0.03). Discussion: 2-AG is able to modulate type 2 IFN production from CD4+ T lymphocytes from SLE patients through CB2 activation.

The goal of this paper is a better understanding of the dynamics of urban change in São Paulo and Lyons when the two cities had the same population, in 1920 with 500,000 inhabitants, and in the previous decades. The former city was at that time in a trajectory of rapid growth, the latter more stable but with a strong industrial economy. We suppose and show here that the comparison, through its methodological exigencies, allows a new understanding of the phenomenon in play. From the works of two groups of scholars, Brazilian and French, the public transportation systems, the industrial development and the spatial growth are studied. This implied the gathering of researches conducted during fifteen years, and efficient methodology, particularly in digital humanities, notably the use of Geographical Information Systems, which led to data of a same nature configured in a same way.