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Abstract Background Previous studies evaluating the accuracy of computed tomography (CT) in detecting caudal vena cava (CVC) invasion by adrenal tumors (AT) used a binary system and did not evaluate for other vessels. Objective Test a 7‐point scale CT grading system for accuracy in predicting vascular invasion and for repeatability among radiologists. Build a decision tree based on CT criteria to predict tumor type. Methods Retrospective observational cross‐sectional case study. Abdominal CT studies were analyzed by 3 radiologists using a 7‐point CT grading scale for vascular invasion and by 1 radiologist for CT features of AT. Animals Dogs with AT that underwent adrenalectomy and had pre‐ and postcontrast CT. Results Ninety‐one dogs; 45 adrenocortical carcinomas (50%), 36 pheochromocytomas (40%), 9 adrenocortical adenomas (10%) and 1 unknown tumor. Carcinoma and pheochromocytoma differed in pre‐ and postcontrast attenuation, contralateral adrenal size, tumor thrombus short‐ and long‐axis, and tumor and thrombus mineralization. A decision tree was built based on these differences. Adenoma and malignant tumors differed in contour irregularity. Probability of vascular invasion was dependent on CT grading scale, and a large equivocal zone existed between 3 and 6 scores, lowering CT accuracy to detect vascular invasion. Radiologists' agreement for detecting abnormalities (evaluated by chance‐corrected weighted kappa statistics) was excellent for CVC and good to moderate for other vessels. The quality of postcontrast CT study had a negative impact on radiologists' performance and agreement. Conclusions and Clinical Importance Features of CT may help radiologists predict AT type and provide probabilistic information on vascular invasion.

Many recent cloud or edge computing strategies for automotive applications require transmitting huge amounts of Light Detection and Ranging (LiDAR) data from terminals to centralized processing units. As a matter of fact, the development of effective Point Cloud (PC) compression strategies that preserve semantic information, which is critical for scene understanding, proves to be crucial. Segmentation and compression have always been treated as two independent tasks; however, since not all the semantic classes are equally important for the end task, this information can be used to guide data transmission. In this paper, we propose Content-Aware Compression and Transmission Using Semantics (CACTUS), which is a coding framework that exploits semantic information to optimize the data transmission, partitioning the original point set into separate data streams. Experimental results show that differently from traditional strategies, the independent coding of semantically consistent point sets preserves class information. Additionally, whenever semantic information needs to be transmitted to the receiver, using the CACTUS strategy leads to gains in terms of compression efficiency, and more in general, it improves the speed and flexibility of the baseline codec used to compress the data.

Recent advancements in self-driving cars, robotics, and remote sensing have widened the range of applications for 3D Point Cloud (PC) data. This data format poses several new issues concerning noise levels, sparsity, and required storage space; as a result, many recent works address PC problems using Deep Learning (DL) solutions thanks to their capability to automatically extract features and achieve high performances. Such evolution has also changed the structure of processing chains and posed new problems to both academic and industrial researchers. The aim of this paper is to provide a comprehensive overview of the latest state-of-the-art DL approaches for the most crucial PC processing operations, i.e., semantic scene understanding, compression, and completion. With respect to the existing reviews, the work proposes a new taxonomical classification of the approaches, taking into account the characteristics of the acquisition set up, the peculiarities of the acquired PC data, the presence of side information (depending on the adopted dataset), the data formatting, and the characteristics of the DL architectures. This organization allows one to better comprehend some final performance comparisons on common test sets and cast a light on the future research trends.

This review paper shows that grain boundary sliding (GBS) is a general phenomenon occurring in all classes of inorganic materials: ceramics, metals and composite materials. The occurrence of relaxations attributed to GBS is also quite general and therefore the mechanical spectroscopy constitutes a sensitive and universal technique to study such phenomenon. GBS is widely observed in ceramics. It can be due to the presence of an amorphous layer between the grains as in zirconia or to dislocations, as in alumina. In each case, a high temperature GBS peak has been identified. In metals, GBS is observed in some deformed materials but the correlation of such phenomenon with internal friction peaks has been controversial. In 1941, C. Zener describes a geometrical model of GBS that could give rise to a relaxation mechanism. In 1947, Kê observed a large relaxation peak in polycrystalline aluminum. This peak being absent in single crystals, the relaxation was attributed to GBS. Today, the Zener model can still be used in most cases for relaxations occurring in the grain boundaries. Instead, according to the grain boundary type, the material or the temperature, either dislocations or the gliding of a disordered layer produce the grain boundary relaxations.

Anelastic behavior and microstructural changes of a Co-Ni-Cr super-alloy were monitored over the temperature range 250-950ºC, by using several complementary techniques. Two grades of this alloy were used, differing by the presence of small quantity of beryllium (

Several aspects of anelastic behavior of Fe-(27-28%)Ga-Tb alloys are considered in this paper: (i) the phase transitions from a metastable to an equilibrium phase and phase transitions between equilibrium phases at higher temperatures in as cast alloys, (ii) the nature of corresponding three transient anelastic effects, (iii) the formation of an intrinsic composite microstructure with a different ratio between the bcc-derivative metastable and fcc-derivative equilibrium phases that have different magnetostriction and the effect of alloys doping by Tb to stabilize the metastable phase with high positive values of magnetostriction.

Abstract Immunotherapy with anti-PD-1 antibodies significantly improved the prognosis in advanced melanoma patients, but most of them develop primary or secondary resistance to the treatment. In this study, we evaluated efficacy and safety of a chemotherapy regimen with weekly carboplatin plus paclitaxel (wCP) in patients previously treated with anti-PD-1 antibodies. We retrospectively identified 30 patients with advanced melanoma treated at our Institute over the last eight years with wCP. The co-primary endpoints of the study were overall survival (OS) and progression-free survival (PFS). In addition, we evaluated treatment tolerability. For this patient cohort, median PFS and OS were 3.25 and 7.69 months, respectively. All included patients had previously received anti-PD-1 immunotherapy, most of them had ECOG PS 0–1, and only 5 patients had a BRAF V600 mutation. In univariable analysis, we observed shorter OS in patients with > 2 involved metastatic sites, superficial spreading histology, and serum lactate dehydrogenase (LDH) values above the median. Liver metastases were associated with worse outcomes, while radiotherapy treatment of brain metastases was associated with improved OS. However, in a multivariable Cox regression model, only LDH above the median, superficial spreading histology, and female sex were significantly associated with worse OS. We reported grade 3 and 4 treatment-related toxicities in 4 and 0 patients, respectively. In conclusion, chemotherapy with wCP is a valid palliative treatment in advanced melanoma who progressed with anti-PD-1 antibodies.

Introduction. Platinum-based chemotherapy represents the standard of care (SoC) for the first-line treatment of advanced urothelial carcinoma (mUC). The benefit of adding immune checkpoint inhibitors (ICIs) to platinum-based chemotherapy was recently investigated. We performed an individual patient data (IPD) meta-analysis of phase 3 clinical trials comparing ICI-based treatments. Methods. A systematic literature search was conducted on the MEDLINE and CENTRAL databases. The results were filtered by including only reports on clinical trials or randomized clinical trials from 2018 to 2023, including 3047 patients from four clinical trials (EV302, CHECKMATE-901, IMVIGOR130, KEYNOTE-361). An IPD meta-analysis was performed by reconstructing IPD from Kaplan–Meier curves. The primary endpoints were overall survival (OS) and progression-free survival (PFS) of Pembrolizumab + EV compared to experimental arms of the other trials of immunotherapy + chemotherapy. Results. The OS analysis showed an advantage of IPD from EV302 vs. all the other trials. For EV302 vs. KEYNOTE-361, the HR was 0.51; for EV302 vs. IMVIGOR130, the HR was 0.47; and for EV302 vs. CHECKMATE-901, the HR was 0.66 (CI 95% 0.51–0.85). In the PFS analysis, the EV302 arm showed a statistically significant advantage compared to CHECKMATE-901 (HR 0.66) and versus IMVIGOR130 (HR 0.51). Limitations: By using reconstructed IPD curves, it was not possible to adjust patient-level covariates, and the heterogeneity of the included population may have affected the pooled results. Conclusions: The EV302 experimental arm showed better OS and PFS when compared to the other immunochemotherapy combinations. An immunochemotherapy combination strategy at the beginning of treatment in mUC seems to be superior in terms of OS and PFS compared to platinum-based chemotherapy alone. EV–Pembrolizumab resulted to have better outcomes compared to avelumab, rather than other immunochemotherapy combinations. However, given the heterogeneity of these studies, a longer follow up and prospective trials are needed to confirm these data.

Abstract Recent studies have shown a growing interest in the so-called “aperiodic” component of the EEG power spectrum, which describes the overall trend of the whole spectrum with a linear or exponential function. In the field of brain aging, this aperiodic component is associated both with age-related changes and performance on cognitive tasks. This study aims to elucidate the potential role of education in moderating the relationship between resting-state EEG features (including aperiodic component) and cognitive performance in aging. N = 179 healthy participants of the “Leipzig Study for Mind–Body-Emotion Interactions” (LEMON) dataset were divided into three groups based on age and education. Older adults exhibited lower exponent, offset (i.e. measures of aperiodic component), and Individual Alpha Peak Frequency (IAPF) as compared to younger adults. Moreover, visual attention and working memory were differently associated with the aperiodic component depending on education: in older adults with high education, higher exponent predicted slower processing speed and less working memory capacity, while an opposite trend was found in those with low education. While further investigation is needed, this study shows the potential modulatory role of education in the relationship between the aperiodic component of the EEG power spectrum and aging cognition.

Objective: Auditory-driven gamma synchrony (GS) is linked to the function of a specific cortical circuit based on a parvalbumin+ and pyramidal neuron loop. This circuit is impaired in neuropsychiatric conditions (i.e. schizophrenia, Alzheimer's disease, stroke etc.) and its relevance in clinical practice is increasingly being recognized. Auditory stimulation at a typical gamma frequency of 40 Hz can be applied as a ‘stress test’ of excitation/inhibition (E/I) of the entire cerebral cortex, to drive GS and record it with magnetoencephalography (MEG) or high-density electroencephalography (EEG). However, these two techniques are costly and not widely available. Therefore, we assessed whether a single EEG electrode is sufficient to provide an accurate estimate of the auditory-driven GS level of the entire cortical surface while expecting the highest correspondence in the auditory and somatosensory cortices. Methods: We measured simultaneous EEG-MEG in 29 healthy subjects, utilizing 3 EEG electrodes (C4, F4, O2) and a full MEG setup. Recordings were performed during binaural exposure to auditory gamma stimulation and during silence. We compared GS measurement of each of the three EEG electrodes separately against full MEG mapping. Time-resolved phase locking value (PLVt) was computed between EEG signals and cortex reconstructed MEG signals. Results: During auditory stimulation, but not at rest, EEG captures a significant amount of GS, especially from both auditory cortices and motor-premotor regions. This was especially true for frontal (C4) and central electrodes (F4). Discussion and Conclusions: While hd-EEG and MEG are necessary for accurate spatial mapping of GS at rest and during auditory stimulation, a single EEG channel is sufficient to detect the global level of GS. These results have great translational potential for mapping GS in standard clinical settings.

Resumo Fundamento Alcançar as metas nutricionais estabelecidas pelas sociedades científicas é um desafio constante e nem sempre alcançado. Objetivo Investigar a adequação alimentar de indivíduos com doença cardiovascular (DCV), participantes do Programa Alimentar Brasileiro Cardioprotetor residentes da região Nordeste do Brasil, segundo as recomendações da Sociedade Brasileira de Cardiologia (SBC). Métodos Análise transversal com dados do estudo de implementação da Dieta Cardioprotetora Brasileira (DICA BR) que avaliou indivíduos com DCV, atendidos em centros especializados em saúde cardiovascular em oito estados do Nordeste. O consumo alimentar foi obtido por recordatório alimentar de 24 horas e a adequação da dieta seguiu as recomendações da SBC. Foram considerados significantes valores de p < 0,05. Resultados Foram estudados 647 pacientes, com média (desvio padrão) de idade de 63,1 (9,4) anos, sendo 50,2% do sexo feminino. Na avaliação da ingestão alimentar, observou-se baixa adequação de carboidratos (52,3%), proteínas (70,9%), lipídios (38,8%) e fibras (22,4%). Observou-se que a maioria das mulheres consumia dieta hipoproteica (59,2%) e idosos tinham maior inadequação no consumo de carboidratos (52,6%). Em relação a ingestão de sódio, os homens apresentaram maior ingestão (72,9%), enquanto os idosos apresentaram redução de 13%. Além disso, foi demonstrado que os homens ingeriam mais fibras (28,1%) e indivíduos com maior escolaridade tinham um consumo elevado de ácidos graxos saturados (70,5%). Conclusões A maioria dos indivíduos não alcançou as metas dietoterápicas preconizadas para prevenção cardiovascular secundária. Os achados do presente estudo reforçam a necessidade de implementação de estratégias estruturadas, a fim de estimular hábitos alimentares saudáveis nesses indivíduos.

Abstract Background The KEYNOTE-048 trial showed that pembrolizumab-based first-line treatment for R/M HNSCC led to improved OS in the PD-L1 CPS ≥ 1 population when compared to the EXTREME regimen. However, the R/M HNSCC real-world population is generally frailer, often presenting with multiple comorbidities, worse performance status and older age than the population included in phase III clinical trials. Methods This is a retrospective, single-centre analysis of patients with R/M HNSCC treated with pembrolizumab-based first-line treatment. Results From February 2021 to March 2023, 92 patients were treated with pembrolizumab-based first-line treatment. Patients treated with pembrolizumab-based chemoimmunotherapy had better ECOG PS and younger age than those treated with pembrolizumab monotherapy. Median PFS and OS were 4 months and 8 months, respectively. PFS was similar among patients treated with pembrolizumab-based chemoimmunotherapy and pembrolizumab monotherapy, while patients treated with pembrolizumab monotherapy had worse OS (log-rank p =.001, HR 2.7). PFS and OS were improved in patients with PD-L1 CPS > = 20 (PFS: log-rank p =.005, HR 0.50; OS: log-rank p =.04, HR 0.57). Patients with higher ECOG PS scores had worse PFS and OS (PFS, log-rank p =.004; OS, log-rank p = 6e-04). In multivariable analysis, ECOG PS2 was associated with worse PFS and OS. Conclusions PFS in our real-world cohort was similar to the KEYNOTE-048 reference while OS was numerically inferior. A deeper understanding of clinical variables that might affect survival outcomes of patients with R/M HNSCC beyond ECOG PS and PD-L1 CPS is urgently needed.

Background: Cortical excitability measures neural reactivity to stimuli, usually delivered via Transcranial Magnetic Stimulation (TMS). Excitation/inhibition balance (E/I) is the ongoing equilibrium between excitatory and inhibitory activity of neural circuits. According to some studies, E/I could be estimated in-vivo and non-invasively through the modeling of electroencephalography (EEG) signals and termed ‘intrinsic excitability’ measures. Several measures have been proposed (phase consistency in the gamma band, sample entropy, exponent of the power spectral density 1/f curve, E/I index extracted from detrend fluctuation analysis, and alpha power). Intermittent theta burst stimulation (iTBS) of the primary motor cortex (M1) is a non-invasive neuromodulation technique allowing controlled and focal enhancement of TMS cortical excitability and E/I of the stimulated hemisphere. Objective: Investigating to what extent E/I estimates scale with TMS excitability and how they relate to each other. Methods: M1 excitability (TMS) and several E/I estimates extracted from resting state EEG recordings were assessed before and after iTBS in a cohort of healthy subjects. Results: Enhancement of TMS M1 excitability, as measured through motor-evoked potentials (MEPs), and phase consistency of the cortex in high gamma band correlated with each other. Other measures of E/I showed some expected results, but no correlation with TMS excitability measures or strong consistency with each other. Conclusions: EEG E/I estimates offer an intriguing opportunity to map cortical excitability non-invasively, with high spatio-temporal resolution and with a stimulus independent approach. While different EEG E/I estimates may reflect the activity of diverse excitatory-inhibitory circuits, spatial phase synchrony in the gamma band is the measure that best captures excitability changes in the primary motor cortex.

Objetivo: Verificar a correlação entre o estado inflamatório e nutricional de pacientes com insuficiência cardíaca. Método: Estudo transversal e quantitativo com pacientes portadores de insuficiência cardíaca, adultos e idosos, de ambos os sexos, no período de agosto a dezembro de 2020. Inflamação foi avaliadas pela relação proteína C-reativa/albumina e o estado nutricional pelos seguintes parâmetros: índice de massa corporal, circunferência do braço, dobra cutânea triciptal, circunferência muscular do braço. A correlação foi testada utilizado o coeficiente de Spearman. Resultados: Participaram do estudo 33 pacientes, com idade média de 53,6 ± 18,7 anos. Não houve correlação estatisticamente significante entre o estado inflamatório (proteína C-reativa/albumina) e os parâmetros antropométricos (índice de massa corporal, circunferência do braço, dobra cutânea triciptal e circunferência muscular do braço) (p>0,05), sendo o diagnóstico de desnutrição mais evidente pela dobra cutânea triciptal (54,5%). Conclusão: Não foi observado correlação estatisticamente significante entre o estado inflamatório e nutricional e nem consenso quanto ao diagnóstico nutricional pelos parâmetros utilizados, mas foi mais evidente desnutrição pela perda de gordura corporal através da dobra cutânea triciptal.

IntroductionTo date, for all non-small cell lung cancer (NSCLC) cases, it is recommended to test for driver alterations to identify actionable therapeutic targets. In this light, comprehensive genomic profiling (CGP) with next generation sequencing (NGS) has progressively gained increasing importance in clinical practice. Here, with the aim of assessing the distribution and the real-world frequency of gene alterations and their correlation with patient characteristics, we present the outcomes obtained using FoundationOne (F1CDx) and FoundationLiquid CDx (F1L/F1LCDx) NGS-based profiling in a nationwide initiative for advanced NSCLC patients.MethodsF1CDx (324 genes) was used for tissue samples, and F1L (70 genes) or F1LCDx (324 genes) for liquid biopsy, aiming to explore the real-world occurrence of molecular alterations in aNSCLC and their relationship with patients’ characteristics.ResultsOverall, 232 advanced NSCLC patients from 11 Institutions were gathered [median age 63 years; never/former or current smokers 29.3/65.9%; adenocarcinoma/squamous 79.3/12.5%; F1CDx/F1L+F1LCDx 59.5/40.5%]. Alterations were found in 170 different genes. Median number of mutated genes per sample was 4 (IQR 3–6) and 2 (IQR 1–3) in the F1CDx and F1L/F1LCDx cohorts, respectively. TP53 (58%), KRAS (22%), CDKN2A/B (19%), and STK11 (17%) alterations were the most frequently detected. Actionability rates (tier I and II) were comparable: 36.2% F1CDx vs. 34% ctDNA NGS assays (29.5% and 40.9% F1L and F1LCDx, respectively). Alterations in KEAP1 were significantly associated with STK11 and KRAS, so as TP53 with RB1. Median tumor mutational burden was 6 (IQR 3–10) and was significantly higher in smokers. Median OS from metastatic diagnosis was 23 months (IQR 18.5–19.5) and significantly lower in patients harboring ≥3 gene mutations. Conditional three-year survival probabilities increased over time for patients profiled at initial diagnosis and exceeded those of individuals tested later in their clinical history after 12 months.ConclusionThis study confirms that NGS-based molecular profiling of aNSCLC on tissue or blood samples offers valuable predictive and prognostic insights.

Transfer entropy (TE), the primary method for determining directed information flow within a network system, can exhibit bias—either in deficiency or excess—during both pairwise and conditioned calculations, owing to high-order dependencies among the dynamic processes under consideration and the remaining processes in the system used for conditioning. Here, we propose a novel approach. Instead of conditioning TE on all network processes except the driver and the target, as in its fully conditioned version, or not conditioning at all, as in the pairwise approach, our method searches for both the multiplets of variables that maximize information flow and those that minimize it. This provides a decomposition of TE into unique, redundant, and synergistic atoms. Our approach enables the quantification of the relative importance of high-order effects compared to pure two-body effects in information transfer between two processes, while also highlighting the processes that contribute to building these high-order effects alongside the driver. We demonstrate the application of our approach in climatology by analyzing data from El Niño and the Southern Oscillation.

The Eurasian otter Lutra lutra faced a significant decline in Italy during the 20th century, leading to local extinctions. After fifty years of otter disappearance from the Tiber basin, this study documents a sighting near Rome, obtained during a long-term trail camera monitoring. The study area, Rio Moscio, offers a habitat rich in hygrophilous vegetation and diverse fauna, including other protected species such as the Italian wolf, the European wildcat, and the European polecat. The observed otter could either mark a potential range expansion or could challenge the presumed extinctions in this region, since it could be in dispersal from the closer known populations or an individual from a Tiber basin relict population. The study emphasises the need for continued monitoring and prompt future genetic analyses to obtain necessary insights for conserving otters in Central Italy.

Introdução: A busca por um corpo padrão tem se tornado cada vez mais visível na sociedade entre os adultos jovens, principalmente em razão do fácil acesso à mídia onde há uma intensa divulgação de informações. Consequentemente, tomam medidas, como dietas, suplementos e exercícios físicos, para conseguirem o que desejam. Quando não supervisionadas por profissionais capacitados, podem se tornar prejudiciais à saúde. A prática de exercícios físicos combinada com uma alimentação saudável deve visar a saúde e não somente a imagem corporal. Objetivo: Avaliar o perfil de adultos jovens, praticantes de exercícios físicos e frequentadores de academias de ginástica da Cidade de São Paulo. Materiais e métodos: Estudo transversal, realizado em academias de ginástica da cidade de São Paulo no período de agosto a novembro de 2019. Utilizou-se questionário desenvolvido e aplicado pelos próprios pesquisadores, contendo questões sobre prática de exercícios, principais tipos de alimentos consumidos, dietas, uso de suplementos, entre outros. Resultados: A maior parte frequenta academias entre 3 e 5 vezes por semana, sendo a saúde e a estética os principais motivos. Quase 50% já realizou algum tipo de dieta, indicadas, em sua maioria, por nutricionistas. Além disso, 60,9% não usa suplementos alimentares e grande parte diz ter conhecimento sobre os efeitos que podem causar no organismo humano. Dentre os consumidores, 48% dizem consumir por iniciativa própria. Conclusão: Há uma busca por equilíbrio entre alimentação saudável e a prática de exercícios pelos participantes, notando um bom consumo de todos os grupos de alimentos, exceto o de oleaginosas e cereais integrais.

Objective. To analyze the temporal trend of tuberculosis incidence and mortality rates in Brazil between 2011 and 2019. Methods. This was an ecological time series study of tuberculosis incidence and mortality rates in Brazil between 2011 and 2019. Data were extracted from the Notifiable Disease Information System and the Mortality Information System, and population estimates were from the Brazilian Institute of Geography and Statistics. Trends were analyzed by Joinpoint regression, which recognizes inflection points for temporal analysis. Results. The average incidence rate of tuberculosis in Brazil in the period was 35.8 cases per 100 000 population. From 2011 to 2015, this coefficient had an annual percentage change of –1.9% (95% CI [–3.4, –0.5]) followed by an increase of 2.4% (95% CI [0.9, 3.9]) until 2019. The average mortality rate between 2011 and 2019 was 2.2 deaths per 100 000 population, with an average annual percentage change of –0.4% (95% CI [–1.0, 0.2]). Amazonas was the only state with an increase in the annual average percentage variation for the incidence rate (3.2%; 95% CI [1.3, 5.1]) and mortality rate (2.7%; 95% CI [1.0, 4.4]) over the years, while Rio de Janeiro state had an increasing inflection for incidence from 2014 to 2019 (2.4%; 95% CI [1.4, 3.5]) and annual average of decreasing percentage variation (–3.5%; 95% CI [–5.0, –1.9]). Conclusions. During the period analyzed, a decreasing trend in incidence was observed between 2011 and 2015, and an increasing trend for the period from 2015 to 2019. On the other hand, no change in the trend for mortality was found in Brazil.

ABSTRACT OBJECTIVE To analyze the geospatialization of tuberculosis-HIV coinfection in Brazil, from 2010 to 2021, and the correlation with socioeconomic, housing, and health indicators. METHODS An ecological study of Brazilian municipalities and states, with data from HIV and tuberculosis information systems, previously reported by the Ministry of Health. The crude and smoothed coefficients were calculated by the local empirical Bayesian method of incidence of coinfection per 100,000 inhabitants in the population aged between 18 and 59 years. Univariate (identification of clusters) and bivariate (correlation with 20 indicators) Moran’s indices were used. RESULTS A total of 122,223 cases of coinfection were registered in Brazil from 2010 to 2021, with a mean coefficient of 8.30/100,000. The South (11.44/100,000) and North (9.93/100,000) regions concentrated the highest burden of infections. The coefficients dropped in Brazil, in all regions, in the years of covid-19 (2020 and 2021). The highest coefficients were observed in the municipalities of the states of Rio Grande do Sul, Mato Grosso do Sul, and Amazonas, with high-high clusters in the capitals, border regions, coast of the country. The municipalities belonging to the states of Minas Gerais, Bahia, Paraná, and Piauí showed low-low clusters. There was a direct correlation with human development indices and aids rates, as well as an indirect correlation with the proportion of poor or of those vulnerable to poverty and the Gini index. CONCLUSIONS The spatial analysis of tuberculosis-HIV coinfection showed heterogeneity in the Brazilian territory and constant behavior throughout the period, revealing clusters with high-burden municipalities, especially in large urban centers and in states with a high occurrence of HIV and/or tuberculosis. These findings, in addition to alerting to the effects of the covid-19 pandemic, can incorporate strategic planning for the control of coinfection, aiming to eliminate these infections as public health problems by 2030.

ABSTRACT Objective: To calculate the rate of tuberculosis recurrence, estimate its average time until recurrence, and identify factors associated with recurrence in Brazil. Methods: Retrospective cohort study with a linked database from the Notifiable Diseases Information System. The study included individuals diagnosed with tuberculosis in 2015, focusing on those who experienced their first recurrence within 6.5 years. We estimated the relative risk (RR) and its 95% confidence interval (95%CI), as well as the population attributable fraction (PAF) or the population preventable fraction (PPF) of associated factors. Results: Within a 6.5-year period, 3,253 individuals (6.5%) experienced tuberculosis recurrence, with a median time of 2.2 years. Positively associated factors included: male sex (RR: 1.4; 95%CI 1.3–1.5; PAF: 22.9%), age 30 to 59 years (RR: 3.0; 95%CI 1.6–5.7; PAF: 36.0%), black race (RR: 1.3; 95%CI 1.2–1.5; PAF: 3.5%), mixed race (RR: 1.3; 95%CI 1.2–1.4; PAF: 10.6%), deprivation of liberty (RR: 1.9; 95%CI 1.7–2.1; PAF: 9.1%), pulmonary/mixed clinical form (RR: 1.7; 95%CI 1.4–1.9; PAF: 37.1%), acquired immunodeficiency syndrome diagnosis (RR: 1.8; 95%CI 1.5–1.9; PAF: 4.3%), and alcohol use (RR: 1.2; 95%CI 1.1–1.3; PAF: 2.9%). Negatively associated factors were: 12 or more years of schooling (RR: 0.5; 95%CI 0.4–0.6; PPF: 3.3%) and supervised treatment (RR: 0.9; 95%CI 0.8–0.9; PPF: 4.4%). Conclusion: This study revealed high tuberculosis recurrence rates in Brazil, influenced by sociodemographic, compartmental, and social factors, both positively and negatively impacting disease recurrence.

Resumo Fundamento: A adesão à uma alimentação adequada em macronutrientes é fundamental para a prevenção secundária de doenças cardiovasculares. Objetivo: Avaliar a prevalência de adesão às recomendações de consumo de ácidos graxos para prevenção e tratamento de doenças cardiovasculares, e estimar se a presença de determinados fatores de risco cardiovascular estaria associada à adesão. Métodos: Estudo transversal com os dados de linha de base de 2358 participantes do estudo "Brazilian Cardioprotective Nutritional Program Trial". Dados de consumo alimentar, e fatores de risco cardiovascular foram avaliados. Foi considerada, de acordo com a Sociedade Brasileira de Cardiologia, uma ingestão adequada de ácidos graxos poli-insaturados (AGPI) ≥10% do consumo total de energia diária, para ácidos graxos monoinsaturados (AGM), 20% e para ácidos graxos saturados (AGS),

Kombucha is created through the fermentation of Camellia sinensis tea leaves, along with sucrose, utilizing a symbiotic consortium of bacteria and yeast cultures. Nonetheless, there exists a dearth of comprehensive information regarding the spectrum of metabolites that constitute this beverage. To explore this intricate system, metabolomics was used to investigate fermentation kinetics of Kombucha. For that, an experimental framework was devised to assess the impact of varying sucrose concentrations and fermentation temperatures over a ten-day period of kombucha fermentation. Following fermentation, samples were analyzed using an LC-QTOF-MS system and a distinctive metabolomic profile was observed. Principal component analysis was used to discriminate between metabolite profiles. Moreover, the identified compounds were subjected to classification using the GNPS platform. The findings underscore notable differences in compound class concentrations attributable to distinct fermentation conditions. Furthermore, distinct metabolic pathways were identified, specially some related to the biotransformation of flavonoids. This comprehensive investigation offers valuable insights into the pivotal role of SCOBY in driving metabolite production and underscores the potential bioactivity harbored within Kombucha.

BackgroundAir embolism is a known risk during thoracic endovascular aortic repair (TEVAR) and is associated with an incomplete deairing of the delivery system despite the saline lavage recommended by the instructions for use (IFU). As the delivery systems are identical and residual air remains frequently in the abdominal aortic aneurysm sac, endovascular aortic repair (EVAR) can be used to examine the effectiveness of deairing maneuvers. We aimed to evaluate whether increasing the flush volume can result in a more complete deairing.MethodsPatients undergoing EVAR were randomly assigned according to flushing volume (Group A, 1× IFU; Group B, 4× IFU). The Terumo Aortic Anaconda and Treo and Cook Zenith Alpha Abdominal stent grafts were randomly implanted in equal distribution (10-10-10). The quantity of air trapped in the aneurysm sac was measured using a pre-discharge computed tomography angiography (CTA). Thirty patients were enrolled and equally distributed between the two groups, with no differences observed in any demographic or anatomical factors.ResultsThe presence of air was less frequent in Group A compared to that in Group B [7 (47%) vs. 13 (87%), p = .02], and the air volume was less in Group A compared to that in Group B (103.5 ± 210.4 vs. 175.5 ± 175.0 mm3, p = .04). Additionally, the volume of trapped air was higher with the Anaconda graft type (p = .025).DiscussionThese findings suggest that increased flushing volume is associated with a higher amount of trapped air; thus, following the IFU might be associated with a reduced risk of air embolization. Furthermore, significant differences were identified between devices in terms of the amount of trapped air. Clinical trial registration[NCT04909190], [ClinicalTrials.gov].

IntroductionPrevious studies suggest that co-fluctuations in neural activity within V1 (measured with fMRI) carry information about observed stimuli, potentially reflecting various cognitive mechanisms. This study explores the neural sources shaping this information by using different fMRI preprocessing methods. The common response to stimuli shared by all individuals can be emphasized by using inter-subject correlations or de-emphasized by deconvolving the fMRI with hemodynamic response functions (HRFs) before calculating the correlations. The latter approach shifts the balance towards participant-idiosyncratic activity.MethodsHere, we used multivariate pattern analysis of intra-V1 correlation matrices to predict the Level or Shape of observed Navon letters employing the types of correlations described above. We assessed accuracy in inter-subject prediction of specific conjunctions of properties, and attempted intra-subject cross-classification of stimulus properties (i.e., prediction of one feature despite changes in the other). Weight maps from successful classifiers were projected onto the visual field. A control experiment investigated eye-movement patterns during stimuli presentation.ResultsAll inter-subject classifiers accurately predicted the Level and Shape of specific observed stimuli. However, successful intra-subject cross-classification was achieved only for stimulus Level, but not Shape, regardless of preprocessing scheme. Weight maps for successful Level classification differed between inter-subject correlations and deconvolved correlations. The latter revealed asymmetries in visual field link strength that corresponded to known perceptual asymmetries. Post-hoc measurement of eyeball fMRI signals did not find differences in gaze between stimulus conditions, and a control experiment (with derived simulations) also suggested that eye movements do not explain the stimulus-related changes in V1 topology.DiscussionOur findings indicate that both inter-subject common responses and participant-specific activity contribute to the information in intra-V1 co-fluctuations, albeit through distinct sub-networks. Deconvolution, that enhances subject-specific activity, highlighted interhemispheric links for Global stimuli. Further exploration of intra-V1 networks promises insights into the neural basis of attention and perceptual organization.

RESUMO O estudo aborda a interdependência das regiões e macrorregiões de saúde no Brasil nas internações de média e alta complexidade, no ano de 2019. Foi realizada a análise dos fluxos estabelecidos, utilizando o Índice de Dependência Regional e Macrorregional, a partir de dados secundários do Sistema Único de Saúde (SUS) obtidos no Sistema de Informação Hospitalar. Os resultados demonstram que grande parte das regiões e macrorregiões de saúde absorvem em seus territórios as internações de média complexidade, com variações entre as especialidades. Nas internações de alta complexidade, a maioria das regiões de saúde apresenta grande dependência, sendo que a assistência está concentrada em 15% delas. Entre as macrorregiões de saúde, o cenário é significativamente heterogêneo, com dependência expressiva nas regiões Norte, Nordeste e Centro-Oeste, e alta resolutividade na região Sul. Em todas as análises, o porte populacional das regiões e macrorregiões de saúde apresenta relação inversa à dependência regional e macrorregional. O aprimoramento da regionalização pressupõe a organização de uma rede de atenção à saúde que considere as desigualdades e as diversidades territoriais, a interdependência e a autonomia entre os territórios e os atores implicados, e a coordenação entre as unidades federativas, de modo a garantir cuidado integral e equânime.