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During the sampling of a stratigraphic section along the shore of the Fiastra Lake (Carg Project - Sheet 313 “Camerino” of the Geological Map of Italy at 1:50 000 scale), a small rock boulder with partially exposed bony material was discovered at the base of a small cliff at the northern termination of the Sibillini Mts. In this area, the classical facies of Umbria-Marche stratigraphic succession are well exposed. The Oligocene-Miocene portion of the succession is represented by the ~200 m-thick Scaglia Cinerea Formation, passing upwards to the ~100 m-thick Bisciaro Formation. The microfossil assemblage has allowed the specimen to be constrained to the lower Burdigalian. The skeletal remains were examined using a CT-SCAN, a non-invasive method that has proven to be highly performing. The analysis revealed some articulated vertebrae, deformed by lithostatic compaction, which are attributed to a shark of the Order Lamniformes. Subsequently, the vertebrae were digitally isolated, extracted from the surrounding matrix, and rendered into three-dimensional prints. Through digital retro-deformation, the body length of the lamniform shark was estimated to be approximately 4 metres. Further considerations on the vertebrae allowed us to infer that the studied shark had similarities to either Isurus oxyrinchus Rafinesque, 1810 or Carcharodon carcharias Linnaeus, 1758. The development of a dead-fall microbial community likely facilitated the preservation of the vertebrae. The studied specimen represents the first occurrence of a lamniform shark in the Lower Miocene of the Umbria-Marche Domain and represents one of the very rare recorded occurrences of lamniforms from the Lower Miocene of Italy.

BackgroundAfter traumatic brain injury (TBI), individuals can experience changes to quality of life (QOL). Despite understanding the factors that impact QOL after TBI, there is limited patient-oriented research to understand the subjective priorities for QOL after TBI. This study aims to understand the priorities for QOL after TBI using a group consensus building method.MethodsThe Technique for Research of Information by Animation of a Group of Experts (TRIAGE) method was used to determine priorities for QOL after TBI. In phase one, expert participants were consulted to understand the context of QOL after TBI. In phase two, participants with TBI completed a questionnaire to broadly determine the factors that contributed to their QOL. In phase three, a portion of participants from phase two engaged in focus groups to identify the most relevant priorities. Data was analyzed thematically. In phase four, expert participants were consulted to finalize the priorities.ResultsPhase one included three expert participants who outlined the complexity and importance of QOL after TBI. Phase two included 34 participants with TBI who described broad priorities for QOL including social support, employment, and accessible environments. Phase three included 13 participants with TBI who identified seven priorities for QOL: ensuring basic needs are met, participating in everyday life, trusting a circle of care, being seen and accepted, finding meaning in relationships, giving back and advocating, and finding purpose and value. In phase four, four expert participants confirmed the QOL priorities.InterpretationsFindings emphasize the critical need to address priorities for QOL after TBI to ensure improved health outcomes.

Abstract Background Control of glucose, blood pressure, cholesterol, and smoking improves the prognosis of individuals with diabetes mellitus. Our objective was to assess the level of control of these risk factors in Brazilian adults with known diabetes and evaluate correlates of target achievement. Methods Cross-sectional sample of the Brazilian Longitudinal Study of Adult Health, composed of participants reporting a previous diagnosis of diabetes or the use oof antidiabetic medication. We measured glycated hemoglobin (HbA1c) and LDL-cholesterol at a central laboratory and blood pressure following standardized protocols. We defined HbA1c 10 years since diabetes diagnosis, PR = 0.68; 95%CI 0.63–0.73) less likely. Conclusion Control of ABC targets was poor, notably for LDL-c and especially when considering combined control. Indicators of a disadvantaged social situation were associated with less frequent control.

BackgroundScreening for undiagnosed diabetes using glucose testing is recommended globally to allow preventive action among those detected. Our aim was to evaluate the access to glucose testing to screen for diabetes in Brazil using self-reported information on recent testing and medical consultation from national surveys of Brazilian adults.MethodsThe Pesquisa Nacional de Saúde (PNS) was conducted in 2013 and 2019 drawing probabilistic samples of Brazilians aged 18 years and above. To evaluate glucose testing among those undiagnosed, we excluded those self-reporting a previous diagnosis of diabetes. We then defined recent access to diabetes diagnosis by considering the previous two years and choosing the last blood glucose test and the proximal medical consultation reported. We used Poisson regression with robust variance to assess correlates of access, expressing them with adjusted prevalence ratios (PR) and their 95% confidence intervals.ResultsAccess to recent glucose testing documented that over 70% reported a recent glycemic test, 71% in 2013, and 77% in 2019. These findings are consistent with a wide recent access to medical consultation, 86% and 89% in 2013 and 2019, respectively. Reporting recent glucose testing and medical consultation may better reflect the actual access to medical diagnostic testing. When analyzing this joint outcome, diagnostic access was still wide, 67% and 74%, respectively. Greater access (p< 0.001) was seen for women (PR=1.16; 1.15-1.17), older individuals (PR=1.25; 1.22-1.28), and those with higher education (PR=1.17; 1.15-1.18), obesity (PR=1.06; 1.05-1.08), and hypertension (PR=1.12; 1.11-1.13). In contrast, lower access (p

Abstract The Yacoraite Formation (NW Argentina) displays important microbialitic deposits of varied features throughout its six sub-basins. With the discovery of important microbialitic hydrocarbon reservoirs and the interest in lacustrine systems due to recent hydrocarbon finds in the pre-salt Cretaceous series of the South Atlantic, the importance of these organo-sedimentary structures has increased considerably. Because of this, in the past decade, numerous works in Yacoraite Formation have focused on its microbialites. In this study, we provide an updated summary of the existing background and state of knowledge of the microbialites in the Yacoraite Formation, which occupy different stratigraphic positions in diverse sub-basins separated by several kilometers. Due to this, these structures have developed under diverse conditions, giving rise to a great variety of structures and morphologies, useful as reliable and high-resolution proxies for paleoenvironmental studies and to discuss important ecological paradigms. In addition, microbialites of Yacoraite Formation show promising petrophysical conditions to be evaluated as reservoir rocks. Based on the large number of deposits mentioned throughout this work, and the morphological and structural variety of their microbialites, we can highlight Yacoraite Formation as one of the most important microbialite-bearing units in Argentina and South America.

Introduction With the COVID-19 pandemic, hospitals in low-income countries were faced with a triple challenge. First, a large number of patients required hospitalisation because of the infection’s more severe symptoms. Second, there was a lack of systematic and broad testing policies for early identification of cases. Third, there were weaknesses in the integration of information systems, which led to the need to search for available information from the hospital information systems. Accordingly, it is also important to state that relevant aspects of COVID-19’s natural history had not yet been fully clarified. The aim of this research protocol is to present the strategies of a Brazilian network of hospitals to perform systematised data collection on COVID-19 through the WHO platform.Methods and analysis This is a multicentre project among Brazilian hospitals to provide data on COVID-19 through the WHO global platform, which integrates patient care information from different countries. From October 2020 to March 2021, a committee worked on defining a flowchart for this platform, specifying the variables of interest, data extraction standardisation and analysis.Ethics and dissemination This protocol was approved by the Research Ethics Committee (CEP) of the Research Coordinating Center of Brazil (CEP of the Hospital Nossa Senhora da Conceicao), on 29 January 2021, under approval No. 4.515.519 and by the National Research Ethics Commission (CONEP), on 5 February 2021, under approval No. 4.526.456. The project results will be explained in WHO reports and published in international peer-reviewed journals, and summaries will be provided to the funders of the study.

We assessed the associations of social distancing and mask use with symptomatic, laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection in Porto Alegre, Brazil. We conducted a population-based case-control study during April–June 2020. Municipal authorities furnished case-patients, and controls were taken from representative household surveys. In adjusted logistic regression analyses of 271 case-patients and 1,396 controls, those reporting moderate to greatest adherence to social distancing had 59% (odds ratio [OR] 0.41, 95% CI 0.24–0.70) to 75% (OR 0.25, 95% CI 0.15–0.42) lower odds of infection. Lesser out-of-household exposure (vs. going out every day all day) reduced odds from 52% (OR 0.48, 95% CI 0.29–0.77) to 75% (OR 0.25, 95% CI 0.18–0.36). Mask use reduced odds of infection by 87% (OR 0.13, 95% CI 0.04–0.36). In conclusion, social distancing and mask use while outside the house provided major protection against symptomatic infection.

Cet article interroge les échelles multiples à travers lesquelles nos imaginaires scientifiques actuels cadrent et cartographient les activités de notre cerveau. Le réduit-on à l’encéphale ? au système nerveux qui le nourrit de stimuli, depuis les doigts jusqu’aux talons ? aux réseaux de communication qui alimentent nos sensations d’images et de sons venant des quatre coins de la planète ? La façon dont Gilbert Simondon modélise la dynamique transindividuelle des images dans son cours sur l’imagination et l’invention offre des ressources encore insuffisamment exploitées pour nous aider à imaginer notre cerveau individuel comme un nœud formé de lignes s’étendant bien au-delà de nos personnes corporelles. Notre cerveau apparaît alors tout autant comme un lieu occupé (au sens militaire) par les images qui circulent à travers nous que comme un lieu d’émergence d’images inédites.

BackgroundNon-invasive ventilation (NIV) has been increasingly used in COVID-19 patients. The limited physiological monitoring and the unavailability of respiratory mechanic measures, usually obtainable during invasive ventilation, is a limitation of NIV for ARDS and COVID-19 patients management.ObjectivesThis pilot study was aimed to evaluate the feasibility of non-invasively monitoring respiratory mechanics by oscillometry in COVID-19 patients with moderate-severe acute respiratory distress syndrome (ARDS) receiving NIV.Method15 COVID-19 patients affected by moderate-severe ARDS at the RICU (Respiratory Intensive Care Unit) of the University hospital of Cattinara, Trieste, Italy were recruited. Patients underwent oscillometry tests during short periods of spontaneous breathing between NIV sessions.ResultsOscillometry proved to be feasible, reproducible and well-tolerated by patients. At admission, 8 of the 15 patients showed oscillometry parameters within the normal range which further slightly improved before discharge. At discharge, four patients had still abnormal respiratory mechanics, not exclusively linked to pre-existing respiratory comorbidities. Lung mechanics parameters were not correlated with oxygenation.ConclusionsOur results suggest that lung mechanics provide complementary information for improving patients phenotyping and personalisation of treatments during NIV in COVID 19 patients, especially in the presence of respiratory comorbidities where deterioration of lung mechanics may be less coupled with changes in oxygenation and more difficult to identify. Oscillometry may provide a valuable tool for monitoring lung mechanics in COVID 19 patients receiving NIV.

The Campanian Anacleto Formation holds an abundant and diverse ichnofossil and body-fossil vertebrate record. Despite the striking diversity of this record, pterosaur fossils had never been described from the unit. Here, we report four pterosaur manus tracks from fluvial red beds cropping out in the Área Natural Protegida Municipal Paso Córdoba (Río Negro Province, northern Patagonia, Argentina). Tracks are longer than wide, tridactyl with digit impressions of different lengths (I < II < III), anteriorly directed and laterally asymmetrical. Being on loose slabs and lacking direct examination of pes morphology, the material is classified as undetermined pterosaur tracks. The new find represents the first occurrence of pterosaurs from the lower–middle Campanian of Argentina and one of the few evidences from South America for this time interval. In addition, it is one of the few ichnological pterosaur records from Gondwana, thus shedding light on the palaeobiogeography of this clade during the latest Cretaceous. Pterosaur tracks from the Anacleto Formation allow us to integrate the body-fossil record from the unit and to add a new component, along with birds, to the flying archosaur fauna coexisting with non-avian dinosaurs, notosuchians, chelonians, squamates and mammals in the Campanian of northern Patagonia.

OBJECTIVE: To assess leisure-time physical activity (LTPA) as a modifier of the diabetes/cognitive decline association in middle-aged and older participants in the Estudo Longitudinal de Saude do Adulto (ELSA-Brasil) study. RESEARCH DESIGN AND METHODS: ELSA-Brasil is a cohort of 15,105 participants (age 35–74 years) enrolled between 2008 and 2010. We evaluated global cognitive function, summing the scores of six standardized tests evaluating memory and verbal fluency, including the Trail-Making Test, at baseline and follow-up. Incident cognitive impairment was defined as a global cognitive function score at follow-up lower than −1 SD from baseline mean. Participants reporting ≥150 min/week of moderate to vigorous LTPA at baseline were classified as physically active. We assessed the association of LTPA with global cognition change in those with diabetes in the context of our overall sample through multivariable regression models. RESULTS: Participants’ (N = 12,214) mean age at baseline was 51.4 (SD 8.8) years, and 55.5% were women. During a mean follow-up of 8.1 (SD 0.6) years, 9,345 (76.5%) inactive participants and 1,731 (14.1%) participants with diabetes at baseline experienced faster declines in global cognition than those who were active (β = −0.003, −0.004, and −0.002) and those without diabetes (β = −0.004, −0.005, and −0.003), respectively. Diabetes increased the risk of cognitive impairment (hazard ratio [HR] 1.71; 95% Cl 1.22, 2.39) in inactive but not in active adults (HR 1.18; 95% CI 0.73, 1.90). Among participants with diabetes, those who were active showed a delay of 2.73 (95% CI 0.94, 4.51) years in the onset of cognitive impairment. CONCLUSIONS: In adults living with diabetes, LTPA attenuated the deleterious association between diabetes and cognitive function. [ABSTRACT FROM AUTHOR]

Abstract Background Primary aldosteronism (PA) is associated with an increased prevalence of anxiety and depression. Subnormal quality of life (QoL) scores in PA patients may be improved after surgical treatment. The aim of the study was to assess the impact of surgery on health-related QoL and depression status of patients suffering from PA, comparing the results with a control group of patients undergoing surgery for non-secreting adrenal tumors. Methods Data on QoL and depression status were prospectively collected, from January 2014 to January 2017, before, early after surgery (at 1 month) and at late follow up (at least 6 months) in patients with unilateral PA and in a control group with non-secreting adrenal tumors submitted to unilateral laparoscopic adrenalectomy. QoL was assessed using the Short Form 36 (SF-36) Health Survey for Physical (PCS) and Mental Component (MCS); the depression status by a 20-item depression scale (DS) questionnaire. Results Twenty-six PA patients and 15 controls were recruited. Biochemical cure of the disease was achieved following surgery in all PA patients; hypertension was cured in 31% of cases and improved in the remaining 69% of cases. No morbidity occurred in both groups. There were no significant differences between PA patients and controls concerning demographics, preoperative PCS, MCS and DS values. In patients with PA, MCS values improved at early (42.72 ± 13.68 vs 51.56 ± 9.03, p = 0.0005) and late follow up (42.72 ± 13.68 vs 51.81 ± 7.04, p

Background: The early identification of patients at risk of complications of infective endocarditis (IE) using parameters obtained as part of routine practice is essential for guiding clinical decision-making. This study aimed to identify a parameter at hospital admission that predicts the outcome, adding value to other well-known factors of a poor prognosis in IE. Methods: Two hundred and three patients with IE were included in this study. Clinical evaluation, echocardiography, blood cultures, and routine laboratory tests were performed at hospital admission. The endpoint was in-hospital mortality. Results: The mean age of the patients was 48.2 ± 16.6 years; 62% were male and 38% had rheumatic heart disease. During treatment, cardiac surgery was performed in 111 patients (55%), and the overall in-hospital mortality rate was 32%. In the multivariable analysis, the independent predictors of death were age (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.02–1.13), C-reactive protein (CRP) at hospital admission (OR 1.12, 95% CI 1.04–1.21), length of the vegetation at diagnosis (OR 1.15, 95% CI 1.03–1.28), development of heart failure (OR 6.43, 95% CI 2.14–19.33), and embolic events during antimicrobial therapy (OR 12.14, 95% CI 2.11–71.89). Conclusions: An elevated CRP level at hospital admission and vegetation length at diagnosis were strong predictors of in-hospital mortality in IE, independent of other prognostic parameters, specifically taking into account patient characteristics and complications during therapy. Keywords: Infective endocarditis, C-reactive protein, Echocardiography, Mortality

This article attempts slightly to displace the reference to intermediality by focusing on the problematical ontological and aesthetical status of the media as “intermediary”, i.e. as agents of the “in-between” and of the “among”. It does so by reflecting on the ontological loops of reality formation illustrated by the mass-mediatization of killing sprees, considered here as a strangely rational form of technological delusion. It then ventures into using Karen Barad’s notions of “intra-action” and “agential cut” in order to shed light on the processes through which technological apparatuses of sensoriality (media) produce reality by inter-jecting slices of appearance/relevance among us, human subjects, thus giving perceptible existence to what is at work in-between us. The article concludes with remarks on some of the implications this ontological reflection may bear on aesthetics.

Based on the integration of laser scans, sedimentology, geochemistry, archeobotany, geometric morphometrics and photogrammetry, here we present evidence testifying that a Palaeolithic group of people explored a deep cave in northern Italy about 14 ky cal. BP. Ichnological data enable us to shed light on individual and group level behavior, social relationship, and mode of exploration of the uneven terrain. Five individuals, two adults, an adolescent and two children, entered the cave barefoot and illuminated the way with a bunch of wooden sticks. Traces of crawling locomotion are documented for the first time in the global human ichnological record. Anatomical details recognizable in the crawling traces show that no clothing was present between limbs and the trampled sediments. Our study demonstrates that very young children (the youngest about 3 years old) were active members of the Upper Palaeolithic populations, even in apparently dangerous and social activities.

Systemic sclerosis (SSc) patients are often affected by interstitial lung disease (ILD) and, although there have been recent treatment advances, it remains the leading cause of death among SSc, with a 10-year mortality up to 40%. African Americans and subjects with diffuse cutaneous SSc or anti-topoisomerase 1 antibodies are most commonly affected. Currently, early ILD diagnosis can be made, and it is pivotal to improve the prognosis. The diagnostic mainstay test for SSc-ILD is high-resolution computed tomography for the morphology and pulmonary function tests for the functional aspects. Treatment planning and intensity are guided by the disease severity and risk of progression. Traditionally, therapy has depended on combinations of immunosuppressants, particularly cyclophosphamide and mycophenolate mofetil, which can be supplemented by targeted biological and antifibrotic therapies. Benefits have been observed in trials on hematopoietic autologous stem cell transplantation for patients with progressive SSc, whilst lung transplantation is reserved for refractory SSc-ILD cases. Herein, recent advances in SSc-ILD treatment will be explored.

The pleiotropic effects of glucocorticoids in metabolic, developmental, immune and stress response processes have been extensively investigated; conversely, their roles in reproduction are still less documented. It is well known that stress or long-lasting therapies can cause a strong increase in these hormones, negatively affecting reproduction. Moreover, the need of glucocorticoid (GC) homeostatic levels is highlighted by the reduced fertility reported in the zebrafish glucocorticoid receptor mutant (nr3c1ia30/ia30) line (hereafter named gr−/−). Starting from such evidence, in this study, we have investigated the role of glucocorticoid receptor (Gr) in the reproduction of female zebrafish. Key signals orchestrating the reproductive process at the brain, liver, and ovarian levels were analyzed using a multidisciplinary approach. An impairment of the kiss-GnRH system was observed at the central level in (gr−/−) mutants as compared to wild-type (wt) females while, in the liver, vitellogenin (vtg) mRNA transcription was not affected. Changes were instead observed in the ovary, particularly in maturing and fully grown follicles (classes III and IV), as documented by the mRNA levels of signals involved in oocyte maturation and ovulation. Follicles isolated from gr−/− females displayed a decreased level of signals involved in the acquisition of competence and maturation, causing a reduction in ovulation with respect to wt females. Fourier transform infrared imaging (FTIRI) analysis of gr−/− follicle cytoplasm showed major changes in macromolecule abundance and distribution with a clear alteration of oocyte composition. Finally, differences in the molecular structure of the zona radiata layer of gr−/− follicles are likely to contribute to the reduced fertilization rate observed in mutants.

Lebanon is affected by a protracted environmental and solid waste crisis that is threatening the water resources and the public health of its communities. This study is part of a public participatory research project that aims to evaluate the impacts of solid waste disposal practices on water, air, and health in six villages of Lebanon, stigmatized by the presence of a regional landfill. Community mapping enabled the selection and testing of seven springs and three wells in the upstream basin and 11 wells in the lower basin, covering a broad list of chemical, physical, and bacteriological parameters. Two water quality indices (WQ-1 and WQ-2) were used to assess water quality in the study area. The results for the upstream wells and springs showed a significant bacteriological contamination, while the results in the lower wells showed high levels of conductivity, chlorides, and zinc along with the occurrence of organic micropollutants in trace concentrations. The comparison between the experimental data, with the natural background value established in the same area, did not show major differences, except for zinc and bacteriological indicators. The bacteriological contamination is most likely related to sewage infiltration into groundwater at the time of the assessment. Zinc may result from landfill leachate infiltration but also well corrosion. Saltwater intrusion affecting the coastal basin is masking the results for conductivity, chlorides, and sulfates, whereas the presence of small traces of organic micropollutants in the coastal aquifer may be related to leachate infiltration. WQI-1 results, which included bacteriological indicators, showed highly degraded water quality in the C1-C3 inner basin. In contrast, WQI-2, which includes physio-chemical indicators only, showed good water quality, slightly deteriorating in the coastal area, downstream of the Naameh landfill.

The Los Menucos locality in Patagonia, Argentina, bears a well-known ichnofauna mostly documented by small therapsid footprints. Within this ichnofauna, large pentadactyl footprints are also represented but to date were relatively underinvestigated. These footprints are here analyzed and discussed based on palaeobiological indications (i.e., trackmaker identification). High resolution digital photogrammetry method was performed to achieve a more objective representation of footprint three-dimensional morphologies. The footprints under study are compared with Pentasauropus from the Upper Triassic lower Elliot Formation (Stormberg Group) of the Karoo Basin (Lesotho, southern Africa). Some track features suggest a therapsid-grade synapsid as the potential trackmaker, to be sought among anomodont dicynodonts (probably Kannemeyeriiformes). While the interpretation of limb posture in the producer of Pentasauropus tracks from the Los Menucos locality agrees with those described from the dicynodont body fossil record, the autopodial posture does not completely agree. The relative distance between the impression of the digital (ungual) bases and the distal edge of the pad trace characterizing the studied tracks likely indicates a subunguligrade foot posture (i.e., standing on the last and penultimate phalanges) in static stance, but plantiportal (i.e., the whole foot skeleton and related soft tissues are weight-bearing) during the dynamics of locomotion. The reconstructed posture might have implied an arched configuration of the articulated metapodials and at least of the proximal phalanges, as well as little movement capabilities of the metapodials. Usually, a subunguligrade-plantiportal autopod has been described for gigantic animals (over six hundreds kilograms of body weight) to obtain an efficient management of body weight. Nevertheless, this kind of autopod is described here for large but not gigantic animals, as the putative trackmakers of Pentasauropus were. This attribution implies that such an autopodial structure was promoted independently from the body size in the putative trackmakers. From an evolutionary point of view, subunguligrade-plantiportal autopods not necessarily must be related with an increase in body size, but rather the increase in body size requires a subunguligrade or unguligrade, plantiportal foot. Chronostratigraphically, Pentasauropus was reported from Upper Triassic deposits of South Africa and United States, and from late Middle Triassic and Upper Triassic deposits of Argentina. Based on the stratigraphic distribution of the ichnogenus currently accepted, a Late Triassic age is here proposed for the Pentasauropus-bearing levels of the Los Menucos Group.

The Association for the Advancement of Creative Musicians (AACM), which recently celebrated its 50th birthday, is certainly one of the most important musical movements of the twentieth and twenty-first centuries. This much we know. This thick and dense book, written by French an-thropologist and musical theorist Alexandre Pierrepont over a period of almost twenty years, demonstrates that, on top of inventing new ways to make music, the members of the AACM also invented better ways to make a society. Subtitled A Game-Play of Musical Society, it offers a profound and joyous analysis of the many strata simultaneously developed in Chicago beginning in 1965 by African American musicians who had no alternative but to invent new social relations in order to survive economically and thrive artistically as creators, in a country doubly biased against African Americans and against artistic experimentations and lifestyles.

Vitamin B12 deficiency causes a wide range of hematological, gastrointestinal, psychiatric and neurological disorders. Hematological presentation of cobalamin deficiency ranges from the incidental increase of mean corpuscular volume and neutrophil hypersegmentation to symptoms due to severe anemia, such as angor, dyspnea on exertion, fatigue or symptoms related to congestive heart failure, such as ankle edema, orthopnea and nocturia. Neuropsychiatric symptoms may precede hematologic signs and are represented by myelopathy, neuropathy, dementia and, less often, optic nerve atrophy. The spinal cord manifestation, subacute combined degeneration (SCD), is characterized by symmetric dysesthesia, disturbance of position sense and spastic paraparesis or tetraparesis. The most consistent MRI finding is a symmetrical abnormally increased T2 signal intensity confined to posterior or posterior and lateral columns in the cervical and thoracic spinal cord. Isolated peripheral neuropathy is less frequent, but likely overlooked. Vitamin B12 deficiency has been correlated negatively with cognitive functioning in healthy elderly subjects. Symptoms include slow mentation, memory impairment, attention deficits and dementia. Optic neuropathy occurs occasionally in adult patient. It is characterized by symmetric, painless and progressive visual loss. Parenteral replacement therapy should be started soon after the vitamin deficiency has been established.

Background: Screening for undiagnosed diabetes using glucose testing is recommended globally to allow preventive action among those detected. Our aim was to evaluate the access to glucose testing to screen for diabetes in Brazil using self-reported information on recent testing and medical consultation from national surveys of Brazilian adults. Methods: The Pesquisa Nacional de Saú de (PNS) was conducted in 2013 and 2019 drawing probabilistic samples of Brazilians aged 18 years and above. To evaluate glucose testing among those undiagnosed, we excluded those selfreporting a previous diagnosis of diabetes. We then defined recent access to diabetes diagnosis by considering the previous two years and choosing the last blood glucose test and the proximal medical consultation reported. We used Poisson regression with robust variance to assess correlates of access, expressing them with adjusted prevalence ratios (PR) and their 95% confidence intervals. Results: Access to recent glucose testing documented that over 70% reported a recent glycemic test, 71% in 2013, and 77% in 2019. These findings are consistent with a wide recent access to medical consultation, 86% and 89% in 2013 and 2019, respectively. Reporting recent glucose testing and medical consultation may better reflect the actual access to medical diagnostic testing. When analyzing this joint outcome, diagnostic access was still wide, 67% and 74%, respectively. Greater access (p< 0.001) was seen for women (PR=1.16; 1.15-1.17), older individuals (PR=1.25; 1.22-1.28), and those with higher education (PR=1.17; 1.15-1.18), obesity (PR=1.06; 1.05-1.08), and hypertension (PR=1.12; 1.11-1.13). In contrast, lower access (p<0.001) was seen for those declaring being Black (PR=0.97; 0.95-0.99) or of mixed-race (PR=0.97; 0.96-0.98), those residing in rural areas (PR=0.89; 0.87-0.90), and not having a private health insurance plan (PR=0.85; 0.84-0.86). Conclusions: Although access to diagnostic testing for diabetes is high in Brazil, partly due to its universal health system, social inequities are still present, demanding specific actions, particularly in rural areas and among those selfdeclaring as being Black or mixed-race. [ABSTRACT FROM AUTHOR]

OBJETIVOS: verificar os achados da triagem imitanciométrica e dos testes da avaliação simplificada de processamento auditivo em escolares. MÉTODO: participaram da pesquisa alunos de 1ª a 4ª séries, de sete a dez anos de idade, de uma escola de ensino público de Porto Alegre. Foram avaliados 130 escolares na triagem imitanciométrica, que foi constituída por timpanometria e pesquisa do reflexo acústico ipsilateral e avaliação simplificada do processamento auditivo, incluindo testes de localização sonora, memória sequencial para sons verbais e memória sequencial para sons não verbais. RESULTADOS: na triagem imitanciométrica 43,08% dos escolares passaram, tendo a curva tipo A como mais frequente. O reflexo acústico em 4000 Hz teve percentual de presença inferior comparado com os demais. Passaram nos testes da avaliação simplificada do processamento auditivo 76,15% das crianças. Além disso, foi observado que o teste no qual os escolares obtiveram pior desempenho foi o de memória sequencial para sons verbais. Falharam na triagem imitanciométrica e na avaliação simplificada de processamento auditivo 12,3% dos escolares. CONCLUSÃO: a curva timpanométrica tipo A foi a mais frequente na população estudada. Na avaliação simplificada do processamento auditivo a maioria dos sujeitos passou, tendo maior frequência de acertos no teste de localização sonora. Não houve associação estatística entre o resultado da triagem imitanciométrica e o resultado da avaliação simplificada de processamento auditivo.PURPOSE: to check acoustic immittance screening findings and results of the simplified evaluation of auditory processing in school children. METHOD: the subjects under this study were students from the 1st to the 4th grade, with ages ranging from seven to ten year-old, from a public school in Porto Alegre. 130 students were evaluated in the immitance screening, which consisted of a tympanometry and an ipsilateral acoustic reflex, and a simplified evaluation of auditory processing. This has also involved the tests of sonorous localization, and verbal and non-verbal sequential memory. RESULTS: in the screening immittance, 43.08% of the students passed and the type A curve was the most frequent. The acoustic reflex at 4000 Hz had a lower percentage of appearance when compared with the others. In the tests for simplified evaluation of auditory processing, 76.15% of the children passed. Moreover, it was observed that the worst performance of the evaluated students was found in the verbal sequential memory test. CONCLUSION: the type A tympanometric curve was the most frequent in this population. In the simplified evaluation of auditory processing, most subjects passed, obtaining higher frequency of correct answers in the sonorous localization test. No statistical association between the results of the immittance screening and the simplified evaluation of auditory processing was found.

BACKGROUND:6-18F-fluoro-L-3,4-dihydroxyphenylalanine (18F-FDOPA) PET is a useful tool in the clinical management of pheochromocytoma (PHEO) and medullary thyroid carcinoma (MTC). 18F-FDOPA is a large neutral amino acid biochemically resembling endogenous L-DOPA and taken up by the L-type amino acid transporters (LAT1 and LAT2). This study was conducted to examine the expression of the LAT system in PHEO and MTC. METHODS:Real-time PCR and Western blot analyses were used to assess LAT1 and LAT2 gene and protein expression in 32 PHEO, 38 MTC, 16 normal adrenal medulla and 15 normal thyroid tissue samples. Immunohistochemistry method was applied to identify the proteins' subcellular localization. RESULTS:LAT1 and LAT2 were overexpressed in both PHEO and MTC by comparison with normal tissues. LAT1 presented a stronger induction than LAT2, and their greater expression was more evident in PHEO (15.1- and 4.1-fold increases, respectively) than in MTC (9.9- and 4.1-fold increases, respectively). Furthermore we found a good correlation between LAT1/2 and GLUT1 expression levels. A positive correlation was also found between urinary noradrenaline and adrenaline levels and LAT1 gene expression in PHEO. The increased expression of LAT1 is also confirmed at the protein level, in both PHEO and MTC, with a strong cytoplasmic localization. CONCLUSIONS:The present study is the first to provide experimental evidence of the overexpression in some NET cancers (such as PHEO or MTC) of L-type amino acid transporters, and the LAT1 isoform in particular, giving the molecular basis to explain the increase of the DOPA uptake seen in such tumor cells.

Os objetivos deste trabalho foram comparar métodos de agrupamento, com base nas medidas de dissimilaridade (euclidiana média padronizada e generalizada de Mahalanobis) e obter informações sobre a divergência genética em cultivares de feijão (Phaseolus vulgaris L.). Quatorze cultivares de feijão foram avaliadas em nove experimentos conduzidos em Santa Maria, Estado do Rio Grande do Sul (latitude 29°42S, longitude 53°49W e 95m de altitude), nos anos agrícolas de 2000/2001 a 2004/2005. Foi utilizado o delineamento aleatorizado em blocos, com três repetições, e foram avaliados os caracteres produtividade de grãos, número de vagens por planta e de sementes por vagem, massa de cem grãos, população final de plantas, número de dias da emergência ao florescimento e da emergência à colheita, altura de inserção de primeira e de última vagem e grau de acamamento. Agrupamentos com base na distância euclidiana média padronizada são distintos dos formados com base na distância generalizada de Mahalanobis. O método de Tocher e os métodos hierárquicos da ligação simples, de Ward, da ligação completa, da mediana, da ligação média dentro de grupo e da ligação média entre grupo, com base na distância generalizada de Mahalanobis formam grupos concordantes. A cultivar "Iraí" apresenta comportamento distinto das demais cultivares.The aim of this research was to compare cluster methods, on the basis of the dissimilarity (standardized average euclidian and Mahalanobis generalized) and obtain information on genetic diversity in common bean cultivars (Phaseolus vulgaris). Fourteen common beans cultivars were evaluated in nine experiments conducted in Santa Maria, Rio Grande do Sul State, Brazil (latitude 29°42 S, longitude 53°49 W, altitude 95m), in agricultural years from 2000/2001 to 2004/2005. Randomized blocks design with three repetitions was installed to evaluated the following characters: grain yield, number of pods per plant, number of seeds per pod, weight of 100 grains, final population of plants, number of days of the emergency to flowering, number of days of the emergency to harvest, height of first pod insertion and height of the final pod insertion. Clusters based on the standardized average euclidian distance are distinct from those formed on the basis of Mahalanobis generalized distance. The Tocher's method and hierarchical methods of the single linkage, Ward, complete linkage, median, the average linkage within the group and average linkage between groups, based on the Mahalanobis generalized distance form agreement cluster. The cultivar 'Iraí' presents distinct behavior from other cultivars.